Dysponea

We compare the efficacy including spirometry, peak expiratory flow (PEFR) and quality of life and safety of an 8-week treatment with inhaled oxitropium, theophylline or their combination in patients with mild-to-severe chronic obstructive pulmonary disease (COPD). We conducted a multicentre, double-blind, double-dummy randomized, parallel-group study at 29 Italian outpatients clinics. A group of 236 patients with mild-to-severe COPD (baseline FEV1 < or = 70% of predicted value) were recruited. Treatments were as follows: Inhaled oxitropium bromide 200 microg (N=75), sustained-release oral theophylline 300 mg (N=81) or their combination (N=80), taken twice daily...

Chronic bronchitis is associated with acute exacerbation, most often infective in origin. In order to study the bacteriological profile in such cases a total of 58 patients were enrolled in this study from the chest clinic of our hospital. The male to female ratio was 2 to 1. Mean age of study group was 47 years. All patients had increased cough and sputum production. Barlett count, gram stain and sputum cultures were done for all patients. IgM and IgG antibodies for M. pneumoniae by ELISA were estimated in all cases...

BACKGROUND: Hypoxemia is the immediate consequence of hyobaric hypoxia, which is the crucial starting mechanism of acute mountain sickness (AMS). The AMS is generally a benign and self-limiting condition which can be prevented by gradual ascent. However, ascent rates recommended for prophylaxis of AMS are far slower than those attempted during military operations and by climbers. OBJECTIVE: The current study was carried out to quantify the relationship between AMS and hypoxemia alongwith evaluating the benefits of acetazolamide-dexamethasone chemoprophylaxis during acute ascent...

This paper describes the surgical procedures for a fibrolipoma that first appeared as a giant tumour in the hypopharynx and extended to the cardiac antrum of the oesophagus. At the initial surgery, a pedunculated tumour originating from the left arytenoid of the larynx was found to occupy the cervical as well as thoracic oesophagus and was thus removed through a lateral pharyngectomy. A histological examination revealed fibrolipoma. However there was a recurrence of the tumour in the arytenoid and the patient suffered from dysponea...

This study aimed to evaluate the prevalence of dysponea and its predictors in studies on several working male groups in British Columbia (BC), Canada (cedar sawmill, grain elevator, pulpmill, and aluminum smelter workers), and Tuscany (T), Italy, (shoe and furniture makers, millers, bakers, and pharmaceutical workers). We performed cross-sectional health studies (interviews and pulmonary function tests) for 2498 BC and 1474 T workers exposed to air contaminants, and 1110 BC and 243 T controls. Similar questionnaires and the same definitions were used in BC and in T...

Glass bottle workers have been shown to experience an excess of respiratory symptoms. This work describes in detail the symptoms reported by a cohort of 69 symptomatic glass bottle workers. Symptoms, employment history and clinical investigations including radiology, spirometry and serial peak expiratory flow rate records were retrospectively analyzed from clinical records. The results showed a consistent syndrome of work-related eye, nose and throat irritation followed after a variable period by shortness of breath...

Multiple papilloma of the larynx commonly affects the juvenile subjects. Only a few adult cases have been reported. Such a rare case in Bangladesh, is reported here. Twenty five years old one male patient was admitted into Sir Salimullah Medical College & Mitford Hospital with the complaints of hoarseness of voice & dysponea. He was diagnosed as papilloma clinically and histopathologically, and treated with tracheostomy & microlaryngoscopic excision of the masses. The patient was readmitted after 3 months with recurrence of papilloma at the same site and the growth was excised under anaesthesia...

The authors report the case of a 28-year-old woman referred to their department by a respiratory medicine department with an inferior mediastinal tumour arising from the right atrium, presenting in the form of dysponea, dry cough and chest pain associated with a general syndrome composed of fever, weight loss and physical asthenia. Physical examination revealed a superior vena cava syndrome, the electrocardiogram showed diffuse repolarization disorders and the chest x-ray showed an opacity of the anterior and inferior mediastinum...

A 47-year-old female patient had a subclinical superior vena caval syndrome which developed into the 'full blown' acute condition when she was placed into the left lateral position after mediastinoscopy. She developed airway obstruction requiring urgent re-intubation and subsequent admission to the intensive care unit. This subclinical condition might have been suspected pre-operatively if closer attention had been paid to the history, physical examination and review of the computerised axial tomography scan: she had a history of intermittent dysponea, wheeze and cough which was worse on waking and improved as the day progressed, she had a positive Pemberton's sign and the computerised axial tomography scan showed that the lesion was encroaching on the superior vena cava...

The results of treatment in 201 patients with rhinoconjuctivitis due to house dust mite-induced allergy are reported. Bronchial asthma was associated with this condition in 45 of the patients (22.3%). Of the 201, 143 patients in whom symptomatic therapy was not sufficiently efficacious, received immunotherapy (hyposensitization). In most of the 143 patients, hyposensitization with Alutard allergen extract resulted in marked improvement, rendering 107 patients (75%) free of symptoms and signs. The remaining 36 responded as follows: the patient's condition improved considerably in 14 (10%), in seven (5%) it improved, in 10 (7%) it remained unchanged, and in five (3%) it worsened...

It is believed that aspirin (ASA) and other nonsteroidal antiinflammatory drugs elicit dysponea in ASA sensitive asthmatics by blocking the cyclooxygenase. It is unclear whether this bronchospasm is due to shunting of arachidonic acid into the lipooxygenase pathway or removal of cyclooxygenase product which prevent bronchospasm. Diminished tissue concentration of PGE may cause bronchoconstriction. PGE play also modulatory function to mast call decreasing the release of mediators of anaphylaxis. There are some evidences concerning the mast cell degranulation in postaspirin reaction in ASA sensitive asthmatics...

Pleomorphic adenomas of the minor salivary glands are rare. The most common site is in the palate. We have come across a case of pedunculated pleomorphic adenoma of the base of the tongue which came to us only when the tumour had caused respiratory distress.

The diagnosis of childhood illness by maternal health interview surveys is widely used to estimate the prevalence of childhood morbidity in developing countries. To determine the validity of interview-based diagnoses, and to define simple, sensitive and specific diagnostic algorithms, we compared symptoms and signs reported by mothers during structured interviews with physicians' diagnoses for 271 children on the Philippine island of Cebu. The 271 children had 318 physician diagnosed illnesses: 105 acute lower respiratory infections (ALRI), 121 diarrhoeas, 36 measles, 50 upper respiratory infections (URTI), 5 roseola infantums and one milaria rubria...

This study quantified the separate contributions of the intensity of exercise and its duration to muscular effort and dyspnoea during cycle ergometry. Six normal subjects estimated the perceived intensity (Borg scale 0-10) of peripheral muscular effort and dyspnoea during incremental exercise to their maximum work capacity (Wcap). On separate days, the same subjects exercised to endurance or 60 min at work rates rated for leg effort on the initial incremental test as: 2 ("slight", 33.1 +/- 1.45% Wcap) (mean +/- SE); 3 ("moderate", omission 83...

Antiarrhythmic and hemodynamic effects of i.v. disopyramide phosphate (1.7 mg/kg b.wt. over 2 min) have been studied in nine patients, several in various degrees of cardiac decompensation, with sinus rhythm and persistent ventricular ectopic beats (VEBs). In one case with primary cardiomyopathy, with greater than 30 VEBs/min, disopyramide (DE) abolished the arrhythmia for 30 min, but precipitated brief dysponea. Other side-effects were tolerable and mainly attributable to anticholinergic effects of the drug...

Allergic alveolitis is the immunologic response of the alveolar wall and the interstitial spaces of lung to inhalation of different organic, antigenic substances. This paper presents the case of a 12 1/2-year old girl with a pulmonary disease caused by inhalation of protein contained in the excrement dust from budgerigars. In the paat few years several reports already described this disease in breeders of pigeons and budgerigars. During some years our patient had recurrent episodes of a subacute illness with severe cough, dysponea, cyanosis of lips, tachycardia, and weakness...

A six-year old female pug had very severe dysponea. A radiographic opacity was observed in the right cranial area of the thorax. After thoracotomy, the cranial lobe of the lung was removed. Microscopic examination revealed necrosis of the lung and vacular thrombosis. The possibility of a torsion of the affected lobe is discussed.

If diagnosis of chronic thromboses of pulmonary arteries is usually easy at the stage of confirmed chronic pulmonary heart, it is not so when dysponea is the only symptom of the disease. The authors report 30 cases of chronic thrombosis and remark that if respiratory alkalosis is very frequent, hipoxemia is often missing. On the other hand they observe 27 times out of 28 an increase of CO2 alveoloarterial difference; measuring the CO2 difference appears a safe and reliable test for detecting chronic thrombosis...

Of 36 dogs with a history of chronic coughing or dysponea examined by bronchoscopy, eight were found to have parasitic tracheobronchitis. Oral treatment with the anthelmintic levamisole at a rate of 7.5 mg per kg bodyweight was found to be successful in every case.

Seventy out of the 320 patients treated with tracheostomy and respiratory care in an intensive care unit, were included in a follow-up study. A variety of surgical (38) and medical (32) conditions had prompted IPPV for 1-59 days; 33 had had primary and 37 secondary tracheostomies. The final study included an interview, physical examination, radiographic examination and spirometry. Using radiographic measures, the area of stenosis was calculated as well as the pressure drop across the stenosis at various flow rates...