Search

Introduction: Data collected through ongoing, state-based, cross-sectional health surveys could be used to better understand the contribution of respiratory symptoms to impaired health among the US adult population. Methods: We used the 2015 Behavioral Risk Factor Surveillance System telephone health survey in four states (Kentucky, Florida, South Carolina, Texas) to describe the relationship between symptoms, associated factors such as tobacco smoking, and health impairments. Self-reported productive cough, shortness of breath (SOB), and dyspnea on exertion (DOE) were categorized as minimal, moderate, or severe. Data were analyzed using multiple logistic regression models with age as a covariate to assess relationships of symptoms with other factors. Results: Among adults ≥ 18 years, respiratory impairment [current asthma, chronic obstructive pulmonary disease (COPD), or a current moderate or severe symptom] occurred in 39.1% of the population. More than half of adults reporting moderate or severe symptoms had not been diagnosed with asthma or COPD, particularly with DOE and productive cough. Subjects were at greater risk of moderate and severe SOB or productive cough with increasing age, prolonged smoking duration (≥ 20 years), being an ever-smoker, or if reporting COPD, current asthma, or any other comorbidity except cancer. Morbid obesity [body mass index (BMI) > 35 kg/m2] was associated with severe DOE at a rate similar to current asthma or COPD (25.6%, 95% CI 20.9–30.3%; 20.8%, 95% CI 16.4–25.1%; 21.3%, 95% CI 17.5–25.1%, respectively); it was the most common cause of DOE. SOB was associated with worse general health impairment and limited ambulation compared with other symptoms. Tobacco smoking prevalence and race varied among states, affecting symptom prevalence. Conclusion: In the largest US survey in decades, we provide a current perspective of respiratory symptoms among adults of all ages. While known risk factors were apparent, low-risk persons also frequently reported symptoms and impairments.

The presence of acute reversibility to bronchodilators does not distinguish asthma from COPD. Patients with either condition can benefit from bronchodilators, and should be given a trial to assess their [...]

Study objectives: To describe the health-related quality of life (HRQL) and mental health of persons with sarcoidosis, as well as to assess physician-patient agreement about the presence of sarcoidosis symptoms. [...]

Study objectives: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. Design: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, [...]

Uridine 5'-triphosphate (UTP) is a naturally occurring agonist for P2[Y.sub.2] receptors on the apical surface of ciliated respiratory epithelium. UTP stimulates salt and water transport and cilia beat frequency in [...]

Background: Tiotropium, a once-daily anticholinergic, and salmeterol represent two inhaled, long-acting bronchodilators from different pharmacologic classes. A trial was designed to examine the efficacy and safety of both compounds with [...]

Auditors and finance executives are charged with helping companies make sure they appropriately disclose intangible assets, acquired either separately or as part of a business combination, to financial statement users. [...]

The successful management of asthma is reflected in four outcomes: * Control of symptoms * Decreased bronchial hyperresponsiveness (as reflected by reactivity to such stimuli as exercise, weather changes, and [...]

Objective: To determine whether cognitive status, hand strength, and demographic variables are predictive of correct use of metered-dose inhalers by older subjects. Methods: Clinic patients (n=29) and healthy volunteers (n=42) older than 50 years with no previous or limited metered-dose inhaler use were enrolled. After cognitive (Mini-Mental State Examination) and hand strength assessments, subjects received extensive instruction in proper metered-dose inhaler technique. Technique was independently assessed by two evaluators immediately after instruction and 1 week later. Correct technique was defined as (1) activating the canister in the first half of inhalation, (2) continuing to inhale slowly and deeply, and (3) holding breath at full inspiration (5 seconds). Data for the two subject groups were pooled for analyses. Results: The mean age of the subjects was 69.7 years. Forty subjects (56%) demonstrated correct metered-dose inhaler technique at 1 week. Logistic regression showed that hand strength measurement (odds ratio, 0.68; 95% confidence interval, 0.55 to 0.84), Mini-Mental State Examination score less than 24 (odds ratio, 3.66; 95% confidence interval, 1.07 to 12.4), and male gender (odds ratio, 5.01; 95% confidence interval, 1.07 to 23.5) were significant predictors of incorrect inhaler use. Correct use of the metered-dose inhaler was unrelated to age, education, or subject status. Conclusions: Clinicians should consider cognitive status and hand strength when metered-dose inhaler therapy is initiated for an older adult. Patients with cognitive impairment and hand strength deficits may require more extensive training, frequent follow-up, or alternative dosage forms.

Pneumonia on top of chronic disease Pneumonia risk A patient with cardiac disease is at far greater risk for developing significant morbidity and mortality from respiratory infection than is an [...]

RIGHT MAINTENANCE MIX BOLTS DOWN EXPENSES The easiest way to ensure that a VAX site remains up and running is to contract the maintenance from DEC itself. But this is […]

In this volume of CHEST (see page 89), Johannes et al have examined the risk of nonvertebral fracture related to inhaled corticosteroid (ICS) exposure among adults with chronic lung disease [...]

The Wixela™ Inhub™ device has been developed as a generic equivalent of Advair Diskus®, and provides a combination treatment for patients with asthma whose symptoms are not controlled with inhaled corticosteroids alone and for those with chronic obstructive pulmonary disease (COPD) who are at a high risk for exacerbations. We provide information about the Inhub device and studies conducted to show how Inhub and Diskus are comparable products. Based on the similar results between the two devices, Inhub can be used as a treatment option for patients with asthma or COPD.

Many computer users already work on personal computers and workstations with high-resolution color monitors and color graphics capabilities. The irony is that few of these users have a means of […]

ISDN: HEAVY DATACOMM USERS MAY GET BUSY SIGNAL As part of an industrywide effort to generate more interest in Integrated Services Digital Network (ISDN), regional telephone companies and long-distance carriers […]

RDBMS FORMS THE BASIS OF FINANCIAL CONTROL TOWER Combining accounting software with the information stored in distributed relational databases can provide an organization with a tremendous financial boon. By creating […]

Inhaled fixed-dose combinations (FDCs) of a long-acting β-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) have become the cornerstone for the maintenance treatment of symptomatic COPD patients. In this regard, global COPD treatment guidelines have recognized the importance of inhaler devices as integral contributors to the effectiveness of LABA/LAMA FDCs and recommend regular assessment of inhaler device use by the patients in order to improve long-term clinical outcomes. Optimal disease control is also highly dependent upon patient preferences and adherence to inhaler devices. This review objectively examines and compares the major inhaler devices used to deliver different LABA/LAMA FDCs, discusses the inhaler device characteristics that determine drug deposition in the airways, real-life preference for inhaler devices, and handling of inhaler devices that impact the results of the long-term management of COPD. The introduction of new LABA/LAMA FDCs, new inhaler devices, and more clinical studies have created confusion among physicians in choosing the optimal inhaled therapy for COPD patients; in this context, this review attempts to provide an evidence-based framework for informed decision-making with a particular focus on the inhaler devices. Funding.The preparation of this manuscript was funded by Novartis Pharma AG.

Valuing intangible assets including intellectual property (IP) is not new to the mergers and acquisitions community. Determining the intangible assets and goodwill of an acquired company has always been a [...]

To the Editor: In their recent review (March 2000), Wechsler and coauthors[1] stated that the relationship between montelukast and Churg-Strauss syndrome (CSS) is not a direct drug effect, but rather [...]

A 13-Week Multicenter Trial Study objective: To compare the bronchodilator efficacy and safety of tiotropium and placebo. Design: A 3-month, randomized, double-blind, placebo-controlled, multicenter trial. Setting: Outpatient. Patients: Four hundred [...]

The long-acting [Β.sub.2]-agonist salmeterol has been approved for chronic maintenance therapy in asthma[1] and COPD.[2] Previous studies were conducted on outpatients who were well controlled with no comorbidity factors. Because [...]

Flaws and Guffaws To the Editor: A recent article by Mahler et al (April 1999)[1] that compared the effectiveness of a highly potent inhaled Β-agonist with an established and effective [...]

COPD is a highly debilitating disease that represents a substantial and growing health burden in women. There is increasing evidence for sex-related differences in COPD risk, progression, and outcomes. However, the disease receives scant attention as a women’s health issue. Thus, a multifaceted approach is required to address COPD in women, including greater awareness, minimization of risk, and further elucidation of the sex-specific factors (biological and cultural) that affect risk, disease progression, and treatment success. This article reviews the current literature on the topic and provides suggestions for achieving better outcomes for the millions of women with COPD worldwide.

Single-user software bows to network-oriented 'group ware' Just when you thought there were more than enough computer buzzwords, along comes a new one; groupware. Software tha t looks and acts […]

EXPLODING FIVE MYTHS ABOUT ISDN For many system integrators, VARs and OEMs, Integrated Services Digital Network (ISDN) is either a mysterious continent shrouded in myth or an attempt by AT&T […]

Answers in the chips for IBM PS/2 compatibility When IBM Corp. unveiled its Personal System/2 series of computers last April, it made two things very clear to the competition. First, […]

MOBILE, Ala. -- QMS has released the QMS-PS 815MR and QMS-PS 825MR, Adobe PostScript printers featuring 600-dot-per-inch (dpi) resolution. The printers are ideal for companies that do technical publishing, according […]

SEATTLE -- Park Software has unveiled License Key Management System (LKMS), a VAX/VMS utility that lets software developers control which computers can run their programs. LKMS is a set of […]

NASHUA, N.H. -- Logicraft designed its network servers to let VT terminal users in DEC environments run PC applications. But its customers wanted more than that, and in response Logicraft […]

Redmond, Wash. -- Developers who wish to integrate PC systems with RMS-based files on a VAX server can now use ConnX software as an application programming interface (API) to link […]

SOUTHBOROUGH, Mass. -- A year after announcing a joint-development agreement, Chipcom and Cisco Systems have launched their first offering, a version of Cisco's two-port Integrated Gateway Server (IGS) for Chipcom's […]

At long last, DEC is expected to articulate a token-ring strategy for its Pathworks network operating system by reselling Proteon's ProNet-4/16 token-ring adapter boards and by adding support for Proteon […]

MARLBOROUGH, Mass. -- Concord Communications has introduced a network monitoring device that uses 25MHz RISC microprocessors and proprietary software to observe traffic on all network nodes and segments in real […]

DEC last week announced the first third-party access module for its DECmcc Director software. DEC also announced that it plans to port the network management offering to a Unix System […]