Suchergebnisse

There is a high incidence of bronchitis and asthma cases in veterinary medicine. Thoracic radiographs and bronchoalveolar lavage (BAL) are commonly performed for definitive diagnosis in dogs and cats with suspected bronchitis and asthma. It is believed that a combination of diagnostic tools is the best choice to achieve a diagnosis. The aim of this study was to evaluate the efficacy of thoracic radiographs and BAL in the diagnosis of chronic bronchial disease (CBD) in dogs and cats and whether there is any specific radiographic finding that could influence the indication for bronchoalveolar lavage. It was performed a cross-sectional, prospective, observational study including forty client-owned dogs and cats with lower respiratory tract signs and positive radiographic opacities that were evaluated with BAL followed by cytology and culture. The radiographic results compared with BAL culture showed a sensitivity of 38%, specificity of 95% and accuracy of 65% in detecting patients with pneumonia associated with chronic bronchial disease. Thoracic radiographs were effective in diagnosing 65% of the patients, radiographs plus BAL cytology diagnosed 75% of patients and the combination of radiographs, BAL cytology and culture diagnosed 95% of the patients with chronic bronchial disease. In conclusion, the combination of radiographic examination with BAL followed by cytological and microbiological analyses increases diagnostic success in CBD.

The COVID-19 infection caused by the new coronavirus SARS-CoV-2 has become the real pandemic. Children account for 1–6% of all diagnosed COVID-19 cases. Generally, children have mild disease in comparison to adults, and their mortality rates are extremely low. Despite the fact that all the main efforts of the medical and political community are now focused on preventing the pandemic spread and organizing medical care for patients with moderate and severe COVID-19 course, we still have to remember to implement adequate help for patients with chronic diseases, especially for children with allergic diseases. The pandemic period coincided with natural weather period of dusting of causative plants, that led to annual escalation of both allergic rhinitis and asthma in patient group with specific sensitization to tree pollen. Leading experts of allergology (adapting to modern conditions) have created key guidelines on management of children with allergic diseases during the COVID-19 pandemic. These guidelines are based on the data and results from the Union of Pediatricians of Russia, Russian Association of Allergologists and Clinical Immunologists, European Academy of Allergy and Clinical Immunology (EAACI), European Respiratory Society (ERS), American Thoracic Society (ATS), Global Strategy for Asthma Management (GINA), Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA/MACVIA). ; Инфекция COVID-19, вызванная новым коронавирусом SARS-CoV-2, стала настоящей пандемией. Среди всех диагностированных случаев COVID-19 на долю детей приходится 1–6%. Дети, как правило, имеют более легкое течение заболевания, чем взрослые, показатели смертности у них крайне низкие. Несмотря на то, что основные усилия медицинской и политической общественности в настоящее время направлены на предотвращение распространения пандемии и организацию медицинской помощи больным со среднетяжелым и тяжелым течением COVID-19, нельзя забывать и об адекватной поддержке пациентов с хроническими заболеваниями, особую когорту среди которых составляют дети с аллергическими болезнями. Период пандемии совпал с естественным погодным периодом пыления причинно-значимых растений, что обусловило ежегодное обострение как аллергического ринита, так и астмы в группе пациентов, имеющих специфическую сенсибилизацию к пыльце деревьев. Адаптируясь к современным условиям, ведущие специалисты в области аллергологии составили ключевые рекомендации по ведению детей с аллергией в период пандемии COVID-19, основываясь на результатах наблюдений Союза педиатров России, Российской ассоциации аллергологов и клинических иммунологов, Европейской академии астмы и клинической аллергологии (EAACI), Европейского респираторного общества (ERS), Американского торакального общества (ATS), Глобальной стратегии по достижению контроля над астмой (GINA), Инициативы по аллергическому риниту и его влиянию на астму (ARIA/MACVIA).

RAO explores the relationship of caste to mental disorders as revealed by mental hospital admissions. The ten major castes of Bihar were studied. PFLANZ and LAMBELET compare the frequency of so-called 'diseases of civilisation' (psycho somatic disorders) between India and Germany. Their field research in India was carried out in a tradition-oriented rural area of Maharashtra State. According to HOCH, bronchial asthma holds the first place among psycho somatic conditions in Indian psychiatric patients and their relatives. The psychodynamics of this disorder in relation to socio-cultural factors are discussed by the author. SPIRO suggests that belief in witchraft is a culturally constituted defense mechanism which contributes to Burmese mental health. But it also has dysfunctional consequences, contributing to the Burmese suspicious attitudes toward, and wariness of, their fellows. WEIDMAN, from her anthropological investigations in Burma, arrives at a reformulation of the shame and guilt problem. Little is known about psychiatric problems in Nepal. SHARMA reports on some of his observations.

Abstract

Background:
The long-term exposure to pollutants in ambient air is associated with higher mortality and occurrence of respiratory and cardiopulmonary diseases. The longitudinal cross-section study focuses on the associations between long-term exposures to carcinogenic and non-carcinogenic pollutants and the prevalence and incidence of such specific diseases including immunodeficiencies.

Methods:
The data on health status from industrial and non-industrial regions were obtained from health documentation for a 5-year period from 2007 to 2011 and represent the whole population living in polluted (1,249,323 inhabitants) and unpolluted (631,387 inhabitants) regions. The data on concentrations of PM10, PM2,5, NO2, SO2, benzene and benzo[a]pyrene were collected. The concentrations of pollutants were estimated from measured data by using dispersion models. The average population-weighted concentration of pollutants, which is representative for a defined geographic area and time period from 2007 to 2011, was calculated from the obtained data. The logistic regression and the Mantel-Haenszel χ2 test were used to determine the odds ratios (OR) and p-values for a linear trend. Moreover, the relative risks of mortality and morbidity to specific diseases were calculated according to theoretical dose-response association published by World Health Organization (WHO).

Results:
The probability of incidence of chronic obstructive pulmonary disease and bronchial asthma is statistically significantly higher in the population living in the polluted region compared to the population living in the unpolluted region. The association between long-term exposure to pollutants and the prevalence of immunodeficiency with predominantly antibody defects (D80) was confirmed. The strongest association was found for exposures to particulate matter (PM2,5). The prevalence of immunodeficiency with predominantly antibody defects was also observed in both regions depending on the age of the population and statistically significant difference was only found in the group of adults (20 and over).

Conclusion:
These associations encourage the hypothesis, that the long-term exposure to PM2.5 might cause the activation of cellular immune response. Further research is needed to explore the correlative immunoregulatory mechanism linking PM2.5 (or other pollutants – SO2) and immune cells. Nowadays, it is also believed that these associations are important in the increase of incidence of immune inflammatory response which is proven risk factor for cardiovascular disease (atherosclerotic disease, coronary heart disease and sudden cardiac death). Positive association between long-term exposure and prevalence of bronchial asthma and chronic obstructive pulmonary disease might be skewed due to important socio-economic factors (especially smoking).

Exhaled Air Analysis in Patients with Different Lung Diseases Using Artificial Odour Sensors
Sniffing breath to diagnose a disease has been practiced by doctors since ancient times. Nowadays, electronic noses are successfully used in the food, textile and perfume industry as well as for air pollution control. The aim of this study was to test whether exhaled breath analysed by an artificial nose could identify and discriminate between different lung diseases. A total of 76 individuals were tested: 25 bronchial asthma, 19 lung cancer, 10 pneumonia, 6 chronic obstructive pulmonary disease (COPD) patients and 16 healthy volunteers. Exhaled air was collected in plastic bags and immediately analysed using an electronic nose instrument (9185, Nordic Sensors AB) containing 14 different odour sensors. Multifactor logistic regression analysis was used to determine correlation between the amplitudes of sensor responses and the clinical diagnoses of patients and to calculate sensitivity and specificity of the method for each diagnosis. For diagnostics of asthma the sensitivity was found to be 84% and specificity — 86%. For lung cancer, the sensitivity was 74% and specificity, 95%; for pneumonia 90% and 98%, but for COPD, 33% and 97%, respectively. We conclude that an artificial nose is able to discriminate among different lung diseases with sufficiently good accuracy. This method may be further developed to implement it in clinical medicine for express diagnostics of acute and chronic lung diseases.

AbstractMitigating the impact of pollution on human health worldwide is important to limit the morbidity and mortality arising from exposure to its effect. The level and type of pollutants vary in different urban and rural settings. Here, we explored the extent of air pollution and its impacts on human health in the megacity of Delhi (India) through a review of the published literature. The study aims at describing the extent of air pollution in Delhi, the magnitude of health problems due to air pollution and the risk relationship between air pollution and associated health effects. We found 234 published articles in the PubMed search. The search showed that the extent of air pollution in Delhi has been described by various researchers from about 1986 onwards. We synthesized the findings and discuss them at length with respect to reported values, their possible interpretations and any limitations of the methodology. The chemical composition of ambient air pollution is also discussed. Further, we discuss the magnitude of health problem with respect to chronic obstructive pulmonary diseases (COPD), bronchial asthma and other illnesses. The results of the literature search showed that data has been collected in last 28 years on ambient air quality in Delhi, though it lacks a scientific continuity, consistency of locations and variations in parameters chosen for reporting. As a result, it is difficult to construct a spatiotemporal picture of the air pollution status in Delhi over time. The number of sites from where data have been collected varied widely across studies and methods used for data collection is also non-uniform. Even the parameters studied are varied, as some studies focused on particulate matter ≤10 μm in aerodynamic diameter (PM10) and those ≤2.5 μm in aerodynamic diameter (PM2.5), and others on suspended particulate matter (SPM) and respirable suspended particulate matter (RSPM). Similarly, the locations of data collection have varied widely. Some of the sites were at busy traffic intersections, some on the terraces of offices and residential houses and others in university campuses or airports. As a result, the key question of the extent of pollution and its distribution across various parts of the city could be inferred. None of the studies or a combination of them could present a complete picture of the burden of diseases like COPD, bronchial asthma and other allergic conditions attributable to pollution in Delhi. Neither could it be established what fraction of the burden of the above diseases is attributable to ambient air pollution, given that other factors like tobacco smoke and indoor air pollution are also contributors to the causation of such diseases. In our discussion, we highlight the knowledge gaps and in the conclusion, we suggested what research can be undertaken to fill the these research gaps.

Intro -- Editor's Dedication -- Acknowledgements -- Contents -- Contributors -- Part 1: The Ecological Range of Relationships Between Behavior and Health -- 1: Introduction -- Scope of Behavior and Health -- Global Trends in Health and Behavior -- Historical and Conceptual Roots of Behavioral Medicine -- Behaviorism -- Cognitive Psychology and Decision Making -- Psychosomatic Medicine -- Public Health and the Ecological Perspective -- Key, Cross-Cutting Concepts -- Principles of Behavior Change Are Not Necessarily Consistent with Perspectives of Clinical Medicine -- Distinctions Among Behaviors Do Not Follow Distinctions Among Clinical Diseases -- Diseases Pose Distinct Behavioral Challenges -- Behavior and Health Behaviors Are Fundamentally Contextual -- Interaction of Genes and Behavior Is the Norm, Not the Exception -- Reciprocal Determinism Is Very Important -- Individual Responsibility Versus It Takes a Village -- Global Perspective -- What Is Global? -- Plan for the Book -- References -- 2: Overview of Types of Disease, Their Epidemiology, and Treatments -- Obesity -- Epidemiology -- Prevention, Management, and Treatment -- Cardiovascular Disease -- Epidemiology -- Prevention, Management, and Treatment -- Cancer -- Epidemiology -- Risk Factors for Cancer -- Prevention, Management, and Treatment -- Diabetes Mellitus -- Epidemiology -- Impacts and Complications -- Prevention, Management, and Treatment -- Chronic Obstructive Pulmonary Disease -- Epidemiology -- Prevention, Management, and Treatment -- Bronchial Asthma -- Epidemiology -- Prevention, Treatment, and Management -- Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome -- Epidemiology -- Prevention, Management, and Treatment -- Tuberculosis -- Epidemiology -- Prevention, Management, and Treatment -- Mental Disorders -- Epidemiology.

In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.

The article deals with the analysis of demographic characteristics based on data from unified population register. The role of population registers, which are considered the most important sources of population data, is examined. The possibility of a wider use of the data of the unified population register in socio-demographic research is studied. Demographic characteristics are analyzed in the context of the COVID-19 pandemic based on data from individuals integrated into a single registry for experimental assessment. Experience shows that although data from population registers are currently used in demographic research, there is no approach to using data from other government registers. One of the main features of conducting demographic analysis using data collected in different state registers is the presence of a single identification number for each person. In the study, the information on individuals is presented by hypothetical data taken from two separate registers (population registers and health registers). A dataset on 1,000 individuals was combined into a single register. In this dataset, personal data and information about health of the population were collected. The dataset includes each person's PIN, gender, age, position, number of family members, nationality, chronic diseases including diabetes, bronchial asthma, COVID-19 infection, death from COVID-19, recovery from COVID-19. The obtained results show that the creation of a single integrated register based on the population register — electronic demography system — requires an increase in the number of available statistical indicators, integration of various state registers for a more detailed analysis. This will allow processing data and performing statistical analysis more thoroughly and for a longer period of time.

Background: Environmental tobacco smoke (ETS) is associated with human morbidity and mortality, particularly chronic obstructive pulmonary disease (COPD and lung cancer. Although direct DNA-damage is a leading pathomechanism in active smokers, passive smoking is enough to induce bronchial asthma, especially in children. Particulate matter (PM) demonstrably plays an important role in this ETS-associated human morbidity, constituting a surrogate parameter for ETS exposure. Methods: Using an Automatic Environmental Tobacco Smoke Emitter (AETSE) and an in-house developed, non-standard smoking regime, we tried to imitate the smoking process of human smokers to demonstrate the significance of passive smoking. Mean concentration (Cmean) and area under the curve (AUC) of particulate matter (PM2.5) emitted by 3R4F reference cigarettes and the popular filter-tipped and non-filter brand cigarettes "Roth-Händle" were measured and compared. The cigarettes were not conditioned prior to smoking. The measurements were tested for Gaussian distribution and significant differences. Results: Cmean PM2.5 of the 3R4F reference cigarette: 3911 µg/m3; of the filter-tipped Roth-Händle: 3831 µg/m3; and of the non-filter Roth-Händle: 2053 µg/m3. AUC PM2.5 of the 3R4F reference cigarette: 1,647,006 µg/m3·s; of the filter-tipped Roth-Händle: 1,608,000 µg/m3·s; and of the non-filter Roth-Händle: 858,891 µg/m3·s. Conclusion: The filter-tipped cigarettes (the 3R4F reference cigarette and filter-tipped Roth-Händle) emitted significantly more PM2.5 than the non-filter Roth-Händle. Considering the harmful potential of PM, our findings note that the filter-tipped cigarettes are not a less harmful alternative for passive smokers. Tobacco taxation should be reconsidered and non-smoking legislation enforced.

Background: Environmental tobacco smoke (ETS) is associated with human morbidity and mortality, particularly chronic obstructive pulmonary disease (COPD and lung cancer. Although direct DNA-damage is a leading pathomechanism in active smokers, passive smoking is enough to induce bronchial asthma, especially in children. Particulate matter (PM) demonstrably plays an important role in this ETS-associated human morbidity, constituting a surrogate parameter for ETS exposure. Methods: Using an Automatic Environmental Tobacco Smoke Emitter (AETSE) and an in-house developed, non-standard smoking regime, we tried to imitate the smoking process of human smokers to demonstrate the significance of passive smoking. Mean concentration (Cmean) and area under the curve (AUC) of particulate matter (PM2.5) emitted by 3R4F reference cigarettes and the popular filter-tipped and non-filter brand cigarettes "Roth-Händle" were measured and compared. The cigarettes were not conditioned prior to smoking. The measurements were tested for Gaussian distribution and significant differences. Results: Cmean PM2.5 of the 3R4F reference cigarette: 3911 µg/m3; of the filter-tipped Roth-Händle: 3831 µg/m3; and of the non-filter Roth-Händle: 2053 µg/m3. AUC PM2.5 of the 3R4F reference cigarette: 1,647,006 µg/m3·s; of the filter-tipped Roth-Händle: 1,608,000 µg/m3·s; and of the non-filter Roth-Händle: 858,891 µg/m3·s. Conclusion: The filter-tipped cigarettes (the 3R4F reference cigarette and filter-tipped Roth-Händle) emitted significantly more PM2.5 than the non-filter Roth-Händle. Considering the harmful potential of PM, our findings note that the filter-tipped cigarettes are not a less harmful alternative for passive smokers. Tobacco taxation should be reconsidered and non-smoking legislation enforced.

Цель. Оценить особенности экспрессии альфа-субъединицы рецептора к интерлейкину 4 (mRNA IL4Ra) в лимфоцитах периферической крови при бронхиальной астме (БА). Материалы и методы. Обследован 121 больной БА и 16 здоровых лиц. Экспрессию mRNA IL4Ra оценивали путем проведения RT-PCR (reverse transcription-PCR). Результаты. Экспрессия mRNA IL4Ra у больных аллергической и неаллергической БА существенно не отличалась, но была в 2,7 раза выше, чем у здоровых лиц. Выявлено снижение экспрессии у больных БА, получающих высокие дозы системных парентеральных глюкокортикоидов. Выявлены множественные корреляции со скоростными показателями функции внешнего дыхания. Заключение. Экспрессия mRNA IL-4Ra коррелирует с клиническими особенностями заболевания, что может указывать на патогенетическую роль этого рецептора на претрансляционном уровне. Работа поддержана грантами для молодых ученых СПбГМУ им. акад. И.П.Павлова и Правительства Санкт-Петербурга для аспирантов. ; The aim: to evaluate expression features of IL-4 receptor a-subunit (mRNA IL4Ra) of peripheral lymphocytes in bronchial asthma (BA). Material and methods. 121 BA patients and 16 healthy controls were examined. reverse transcription-PCR was used. Results. There was no significant difference of mRNA IL4Ra expression between allergic and nonallergic BA but in BA it was 2,7 times more as compared with healthy controls. Decrease in expression of mRNA IL4Ra in BA patients receiving high doses of parenteral glucocorticoids is revealed. Multiple correlations with velocity indices of the respiratory function are revealed. Conclusion. The expression of mRNA IL-4Ra correlates with clinical features of BA indicating the pathogenetic role of this receptor at pretranslation level. The work is supported by grants for young scientists of Pavlov University and by grants of St.-Petersburg Government for post-graduate students.

Background: The domestic smoke exposure increases the risk of a range of common and serious diseases. Further, association of exposure with chronic bronchitis and chronic obstructive lung disease is quite well established in recent researches. This work was carried out to determine the health impact of indoor air pollution in rural hill region of Nepal. Methods: A cross-sectional study on health impact of indoor air pollution to exposed kitchen dwellers and children, was done using random sampling method devised with probability proportion in Malikarjun Village Development Committee, Nepal. This study was conducted in two phases, in first phase. Adult kitchen dwellers were assessed for prevalence of respiratory disorder while in second phase, during three months Acute Respiratory Infection episodes of children below two years were recorded. Results: Eight kinds of respiratory ailments and related symptoms were prevalent in adult respondents of 42 households. Cough phlegm, breathlessness, wheezing, chronic obstructive pulmonary disease, and bronchial asthma were significantly varied with higher exposure category (P<0.05) and smoking habit (P<0.01). Peak expiratory flow rate PEFR results significantly varied with both smoking habit and exposure level both in male and female (P<0.01). Correlation analysis denoted higher prevalence of diseases and symptoms in smokers (r = 0.464; P<0.01). Acute Respiratory Infection episodes per child was significant in grade I (P<0.01) and grade II (P<0.05) for both exposure level and parental smoking habit. Conclusions: A significant association between exposure of Indoor Air Pollution and prevalence of respiratory disorders and related symptoms in kitchen dwelling adults and children was found. Key words: acute respiratory infection; exposure duration; indoor air pollution; prevalence; respiratory disorder. DOI: 10.3126/jnhrc.v7i2.3009 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 69-75

Ensuring that the local population has access to medicines is one of the functions of a modern democratic state and an important element of social policy. The question of the affordability of medicines to the public is extremely important. This is also due to the fact that, unlike in European countries, Ukraine did not have a system of medicines reimbursement. To date, the reimbursement Affordable Medicines Programme has been in effect since April 2017 and is applicable to patients with cardiovascular disease, bronchial asthma, and type II diabetes. In total, 258 medicines are included in the Programme, 64 of which can be obtained free of charge and the others with a small extra payment. The respondents' perceptions of the Programme were conducted through a secondary analysis based on the third wave of the «Health Index. Ukraine» which was held in 2018 by the International Renaissance Foundation, the School of Public Health of the National University of Kyiv Mohyla Academy, and the Kyiv International Institute of Sociology. This study aims to present the results of the research of the attitude of Ukrainians to the government Affordable Medicines Programme and their perception of its implementation. The total number of respondents to this survey totaled more than 10,000 household rep­resentatives. The results of the research indicate a positive assessment of the respondents who participated in the survey «Health Index. Ukraine» (76% in 2018), which is confirmed by other research of the Kyiv International Institute of Sociology (63% in 2019) and by international experts. The results of the survey do not allow us to draw any official conclusions about the impact of the Programme on the health of Ukrainians, but during the interview 60.6% of the respondents said that the Programme «helped improve health»; in addition, positive changes in health were indicated by the most financially vulne­rable categories of the population. It is also noted that 80–82% of prescriptions were reimbursed to Programme participants.

Ensuring that the local population has access to medicines is one of the functions of a modern democratic state and an important element of social policy. The question of the affordability of medicines to the public is extremely important. This is also due to the fact that, unlike in European countries, Ukraine did not have a system of medicines reimbursement. To date, the reimbursement Affordable Medicines Programme has been in effect since April 2017 and is applicable to patients with cardiovascular disease, bronchial asthma, and type II diabetes. In total, 258 medicines are included in the Programme, 64 of which can be obtained free of charge and the others with a small extra payment. The respondents' perceptions of the Programme were conducted through a secondary analysis based on the third wave of the «Health Index. Ukraine» which was held in 2018 by the International Renaissance Foundation, the School of Public Health of the National University of Kyiv Mohyla Academy, and the Kyiv International Institute of Sociology. This study aims to present the results of the research of the attitude of Ukrainians to the government Affordable Medicines Programme and their perception of its implementation. The total number of respondents to this survey totaled more than 10,000 household rep­resentatives. The results of the research indicate a positive assessment of the respondents who participated in the survey «Health Index. Ukraine» (76% in 2018), which is confirmed by other research of the Kyiv International Institute of Sociology (63% in 2019) and by international experts. The results of the survey do not allow us to draw any official conclusions about the impact of the Programme on the health of Ukrainians, but during the interview 60.6% of the respondents said that the Programme «helped improve health»; in addition, positive changes in health were indicated by the most financially vulne­rable categories of the population. It is also noted that 80–82% of prescriptions were reimbursed to Programme participants.