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Introduction Measurement of daily variability of peak expiratory flow (PEF) is widely accepted as an objective method to assess asthma severity. Recent investigations have proved nonlinearity of original Wright scale of peak flowmeter. All country members of European Union have been obliged to implement a new scale according to standard EN 13826 since 2005. This study examined whether the correction of PEF values for the inaccuracy of the scale would affect asthma management based on their daily variability. Material and methods We analyzed PEF values (2352) in 34 children, aged 5-16. during 3-5 weeks of monitoring in order to establish the diagnosis of asthma by using peak flowmeters with Write scale. The correction of measured values for inaccuracy was managed with original Dr M. Miller's predictive equation. The daily variability of PEF (amplitude percent mean) up to 20% was considered as "normal", 20-29.9% as "raised", and 30% and above as "high". The assessment of daily variability was performed before and after correction. Results There was no significant change in the number of days with airway lability as regarding the assessed whole study group (p=0.475). However. 22 (64.7%) of children had at least one false clinical message about daily variability during the monitoring. It was overestimated in 12 (7%) days in younger (6.6±0.8 years) or of shorter stature (122.6±3.6cm) and underestimated in 13 (4%) days in older (11.1±2.7) or taller ones (150.9±12.5 cm) (p<0.001). Conclusion Usage of peak flow meters with Wright scale may lead to an error in asthma severity assessment based on daily variability of PEP. It may cause overtreatment or undertreatment of asthmatic children. [ABSTRACT FROM AUTHOR]

Background/Aim. Thanatophobia is an exaggerated, specific, structured fear of death. It appears in childhood and continues to grow over the years, and in the old age it is accompanied with nosophobia and other mental disorders. The aim of this study was to analyze thanatophobia in dialysed patients which was in the direct connection with a basic disorder, and the influence of this disorder on functioning and the quality of life of the patients on dialysis. Methods. In the study we examined 753 patients from the chronic program of haemodialysis in a period from 1999 to 2004. The patiens were classified in two groups: 348 randomized patients with Balkan Endemic Nephropathy (BEN), and the control group (N18) of patients with terminal renal insufficiency, and other diagnoses (n = 405). Since the study was a comparative, cross-sectional one, the patients were tested by the appropriate questionnaires for anxiety, depression and general mental functioning. Statistical analysis was done by the standard descriptive and analytic statistic methods. Results. Based on socio-demographics data we revealed a highly significant difference regarding the place of living between the groups BEN and N18 (χ² = 23.970; p < 0.01), the frequency of occurrence of renal comorbidity (χ² = 23.970; p < 0.01), the frequency of familly renal comorbidity in siblings (χ² = 23.970; p < 0.01), and the frequency of migrationes (χ² = 4.874; p < 0.01). According to psychiatry scales, the patiens from the BEN group were significantly more anxious and depressive than those from the control group. Conclusion. The signs of thanatophobia were revealed in both examined groups, but significantly more in the patients with BEN than in those with other nephrologic diseases. Thanatophobia starts before dialysis, and dialysis structures it into fear of death which is in a direct connection with the basic disorder. This intensive fear may be connected with dementia and depression, but also with other mental disorders. [ABSTRACT FROM AUTHOR]

Introduction. Recent literature data suggest that permanent or reversible hearing loss may occur after general anesthesia. The etiology varies, while hearing loss following middle ear surgery is attributed to exposure to nitrous oxide (N2O). The objective of our study was to measure, using tympanometry, the middle air pressure change caused by nitrous oxide during general anesthesia and to establish its emetogenic effects during the postoperative period. Material and Methods. This academic (non-commercial) prospective study included two groups of patients (a total of 58), with ASA status I, II and III. The study group (n 30) consisted of patients undergoing unilateral ear surgery. In this group, the intratympanic pressure was measured in the unoperated (healthy) ear before and during the surgery. The control group (n 28) patients underwent nose, throat or neck surgical interventions. This group underwent measurement of bilateral intratympanic pressure in healthy ears, before and during the surgery. Both groups were operated under general balanced anesthesia. Pain, nausea and antiemetics were monitored during the first 24 postoperative hours. Statistical analysis was performed using the Mann-Whitney-Wilcoxon test. Results. This perioperative study confirmed the following: highly significant (p<0.001) increase in intratympanic pressure in non-operated ears in the study group and significant (p<0.05) in controls. However, there was no statistical significance (p>0.05) between groups. Pain was more frequent in controls, and nausea in the study group, but without significant difference (p>0.05). Conclusions. Postoperative audiometry findings showed no conductive or sensorineural hearing loss after interventions. Nitrous oxide can be used in general balanced anesthesia with discontinuation 15 to 45 minutes before insertion of the tympanic membrane and completion of middle ear surgery. [ABSTRACT FROM AUTHOR]