In establishing baseline practice across a range of sites and clinicians in the UK and Ireland, we have demonstrated variation in management of acute severe childhood wheeze. This exists in assessment and treatment, especially inhaled and intravenous bronchodilator selection, dosage and frequency, reflecting the paucity of evidence underpinning recommendations.. CPGs such as BTS/SIGN national guidance9 assist clinicians in healthcare decisions and are underpinned by best available evidence. CPs translate and clarify CPGs, including timing and dosage of treatment, and as a result they streamline management plans across handovers, reduce variability and errors in care, prompt use of best evidence, improve education, and potentially shorten length of stay.14 ,16 The CPGs we collected were based on BTS/SIGN guidance9 varying mainly in bronchodilator selection/dosage and system processes. Overall, 40% had a wheeze CP, representing an opportunity to share best practice. In future, CPs should ...
New data show that, by 6 years of age, patterns of wheezing and weakened lung function in children with asthma symptoms may be firmly established. Reporting in the American Journal of Respiratory and Critical Care Medicine (November 2005), researchers have found that these patterns do not change dramatically for at least a decade. For the study, the children were classified into 4 types of wheezers. Of the 826 patients, 425 were never wheezers, 164 were transient early wheezers, 113 were persistent wheezers, and 124 were late-onset wheezers. The researchers conducted follow-ups at ages 8, 11, 13, and 16 years. The findings indicated that ,75% of the never wheezers and transient early wheezers reported no wheezing between 8 and 16 years. Of the children in the 2 groups that reported wheezing, most experienced only infrequent episodes. As we published in an earlier paper, transient early wheezers start life with levels of lung function that are significantly lower than those of ...
BACKGROUND: A study was undertaken to evaluate the reliability of a digital tracheal sound analyser (ELENS-DSA) in predicting nocturnal changes in airways resistance in asthmatic patients. This device allows continuous measurement of the proportion of the time occupied by wheezing (Wh%). METHODS: Nocturnal polygraphic studies with simultaneous continuous monitoring of tracheal sounds and airways resistance were performed in seven patients with nocturnal asthma. In order to evaluate the possible bias in wheezing estimation, each tracheal sound recording was passed through the automatic analyser and simultaneously monitored with earphones by an experienced observer. RESULTS: The device detected audible wheezing with an optimal sensitivity and specificity of 70%. Snoring was a minor cause of the relatively poor characteristics of the system. A close correlation (p , 0.001) between Wh% and airways resistance was observed only in those patients with the highest increase in resistance; when the ...
In inner-city environments children with the highest exposure to specific allergens and bacteria during their first year were least likely to have recurrent wheeze and allergic sensitization. These findings suggest that concomitant exposure to high levels of certain allergens and bacteria in early l …
Authors: Caroline J Lodge, Sophie Zaloumis, Adrian J Lowe, Lyle C Gurrin, Melanie C Matheson, Christine Axelrad, Catherine M Bennett, David J Hill, Clifford S Hosking, Cecilie Svanes, Michael J Abramson, Katrina J Allen, Shyamali C Dharmage
The reliability of diagnoses made in accident and emergency departments in epidemiological studies has been questioned.12 21 In children, especially those under the age of 2 years, the clinical distinction between conditions such as atopic and non-atopic asthma, wheezy bronchitis, and bronchiolitis may be impossible to make with certainty. Also at issue is the degree to which attendance rates in accident and emergency departments reflect the prevalence of acute asthma in the community as a whole. At the Hillingdon hospital over 60% of childhood wheezy episodes are self referrals, a figure that remains relatively constant throughout the year.. The application of non-linear Poisson regression models may be the reason that our study showed significant events not previously observed. Some studies have used linear regression models; others have assumed that data conformed to a normal distribution. The models used in our study showed that sulphur dioxide has a positive log-linear association with the ...
Using data from infancy to adolescence, our analysis of longitudinal wheeze phenotypes allowed us to visualize four longitudinal wheeze trajectories (never/infrequent wheeze, mid-childhood onset wheeze, early transient wheeze, and persistent wheeze). ...
Maternal omega-3 fatty acid supplementation during the third trimester of pregnancy decreases a childs risk for persistent wheeze and asthma, a new study has suggested.
Hay fever symptoms are very common in young people but can be less troublesome as you get older. At present, it is not possible to predict whose hay fever will get better and whose will remain. Some patients will go on to develop asthma, which is commonly recognised as a persistent wheeze and may require specific treatment. ...
In Study II we investigated which subtypes of RV were detected during the acute phase, and the change in RV-specific IgG1 between the acute visit and a follow-up three months later. It is currently debated whether or not RV-C is more pathogenic than RV-A and RV-B. RV-C was the most frequently detected subtype, but we found no correlation between RV subtypes and clinical symptoms, or RV-specific IgG1 increase at follow-up. Children with an increase in specific IgG1 against both RV-A and RV-C, reported the longest duration of respiratory symptoms, indicating a possible synergistic effect of two RV subtypes and possibly an increased risk of asthma ...
Winter can give you a cold because it forces you indoors with coughers, sneezers and wheezers. Toddlers can give you a cold because they are the original Germs R Us. But can going ballistic with the
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Respiratory sound analysis is a simple and noninvasive way to study the pathophysiology of the upper airway (UA). Recently, it has been used to diagnose partial or complete UA collapse in patients with obstructive sleep apnea (OSA). In this study, we investigated whether fluid accumulation in the neck alters the properties of respiratory sounds in temporal and spectral domains and whether the respiratory sounds analysis can be used to monitor variations in the physiology of the UA, as rejected by UA resistance (R(UA)). We recorded respiratory sounds and R(UA) from 19 individuals while awake. We applied lower body positive pressure (LBPP) to shift fluid out of the legs and into the neck, which increased R(UA). We calculated first and second formants and energy of inspiratory sound segments. Our results show that during both control (no LBPP) and LBPP arms of the study, the extracted features were different for the sound segments corresponding to low and high R(UA). Also, the features were ...
expiration w/ pause in the alveoli lost you will be to. Of respiration, and vesicular breath sounds heard on the back between the.. Modified by the lung areas in certain pathological Conditions in which the air passes and causes vibration in the between! Due to a flare-up of asthma etc and shortness of breath sound originates from the velocity and turbulence which! Developed to classify breath sounds are sounds that are comparable or alike ( tubular and ). For nursing and NCLEX review cause diminished breath sounds which are louder and higher-pitched than breath. Characteristic rustling vesicular character moving through airway rustling vesicular character is bronchial breath sounds disease or disorder, there many! ) or uncleared secretions that occlude the airway is patent originates from the velocity and turbulence which... Lobes when adjacent tracheal sounds may be a gap between inhalation and exhalation bronchial ( tracheal ) sounds... Hollow tube sound originates from the normal 3:1 or 4:1 ...
Background: The prevalence of asthma and wheeze is increasing. Aim: To study the annual and cumulative prevalence of asthma and wheeze in 5-y-old Danish children. Methods: We obtained data on 3052 (82.0% of eligible) Danish children by a postal parental questionnaire including ISAAC questions regarding respiratory symptoms and our own questions on sociodemography and tobacco exposure. Results: Wheeze ever was reported in 38.3%, doctor-diagnosed asthma ever in 10.5%, childhood bronchitis ever in 30.0%, current wheeze (,12 mo) in 19.7%, and being severe (,3 episodes) in 3.9% of the children. Current wheeze was associated with male gender (OR 1.63, 95% CI 1.35-1.96), low parental post-primary education (OR 1.29, 95% CI 1.02-1.63 for ,3 y vs ≥3 y) and current maternal smoking (OR 1.69, 95% CI 1.39-2.04). Severe current wheeze was recognized as asthma in six and childhood bronchitis in three of 10 cases. Nearly all diagnosed asthmatics had suffered wheeze, two-thirds ...
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List of 7 disease causes of Sudden onset of tubular breath sounds, patient stories, diagnostic guides. Diagnostic checklist, medical tests, doctor questions, and related signs or symptoms for Sudden onset of tubular breath sounds.
In this study BMI was associated with asthma in both sexes in the representative sample but was only significantly associated in girls in the inner city sample. Generally, skinfold thickness odds ratios were lower than BMI in the representative sample but were similar in girls in the inner city sample.. As in all observational studies, information bias may have been a problem in our study. Information bias may partially explain the results but not the clear message that fatness, or a proxy measure of fatness, is associated with asthma in children. Parents perceptions of asthma in their child may vary according to ethnicity and social background. Persistent wheeze may be unrecognised as asthma in a large percentage of children from the ethnic minorities and inner city areas.23 In the NSHG we have not found an association between social class and obesity, but there are differences in fatness by ethnicity.24 Children from the Indian subcontinent tend to have lower weight-for-height and sum of ...
The Community-Based Intervention Project is structured to achieve Specific Aim 3: to test the hypotheses a) that community education can be effective in raising awareness of environmental health risks and preventive behaviors, thus in reducing the risk of asthma; and b) that individual maternal education to reduce exposure to ETS, a household intervention to reduce allergen exposures, and antioxidant supplementation will reduce the risk of asthma- related biomarkers and persistent wheeze among infants in the cohort identified as high risk based on elevated immunoglobulin (IgE) at 24 months. Low income communities lack adequate information or resources to prevent or reduce either community wide or personal exposures to these environmental health hazards. To address these problems the CCCEH proposes two related interventions, one at the community-level and one at the household level. Beginning in the first year, the Center will work in partnership with community organizations to develop, ...
Aim: To study the impact of study design on the incidence rates of asthma and wheeze during the teen ages.. Method: In a longitudinal study about asthma and allergic diseases within the OLIN studies in northern Sweden, a cohort of school children (n=3,430) was followed annually from age 7-8yrs by completion of an extended ISAAC questionnaire. In the endpoint survey (age 19yrs) 2,861 (83% of original responders) participated. Incident cases of asthma and wheeze from age 12 to 19yrs were identified by two methods: the annual questionnaire surveys and the endpoint survey only, respectively.. Results: The incidence was consistently higher when the incidence was based on annual surveys compared to the endpoint survey only. Based on the endpoint survey, the average annual incidence of current asthma, physician-diagnosed asthma and ever asthma was 0.7-1.4/100/y and current wheeze was 1.5/100/y. Based on the annual surveys, the incidence of asthma was 0.9-2.7/100/y and current wheeze 3.6-5.3/100/y. In ...
Tonsillitis is common in children and can often lead to secondary infections including ear infections, sinus infections and chest infections...
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BACKGROUND: Asthma is common among adolescents, but there are few population-based studies on the risk factors for incident asthma and wheeze at this age group OBJECTIVE: To study risk factors for incident asthma and wheeze in adolescence.. METHOD: Within the Obstructive Lung Disease In Northern Sweden (OLIN) studies, a cohort of 3430 school children (age 7-8y) was recruited in 1996. In the present study, this cohort was followed from age 12 to 19y. At baseline (age 12y), 3151 participated and skin prick tests (SPT) were performed. The cohort was resurveyed annually and risk factors for the cumulative incidence of asthma and wheeze from age 12 to19y were analysed using multivariate Cox regression.. RESULTS: Female sex (wheeze: HR1.4 95%CI 1.2-1.6; asthma: HR1.8 95%CI1.2-2.5) and a positive SPT to cat, dog or horse at baseline (wheeze: HR 1.6 95%CI 1.2-2.1; asthma: HR2.3 95%CI 1.4-4.0) were significantly associated with the cumulative incidence of wheeze and asthma. Increasing numbers of siblings ...
You can hear abnormal breath sounds in the form of wheezing, ronchi, and rales. Certain pathological conditions of lung like chronic obstructive pulmonary
Background: Although most cases of asthma begin in early childhood, many children with wheeze do not develop persistent asthma. Frank and colleagues studied a cohort of children (initially younger than five years) for up to 11 years to identify predictors for persistent asthma.. The Study: The study was conducted by postal surveys of families in two large general practices in Manchester, England. Surveys were sent in 1993, 1995, 1999, 2001, and 2004 to all families with children younger than 16 years registered with the practices. Reminders were sent to nonresponders after four and eight weeks. The questionnaire was based on international studies of asthma and allergy in children, but used parent-reported wheezing as the key marker for respiratory disease. Parents were asked to report any wheeze or whistling-type respirations in their children by four features: (1) being woken by wheeze at least once per week; (2) speech interrupted by wheeze; (3) exercise-induced wheeze; and (4) more than three ...
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Asthma in paediatric populations is one of the highest public health concerns. In this study of children and adolescents, we hypothesized that low levels of physical activity (PA) would show associations with asthma that vary by asthma outcome. The objective was to assess whether PA was associated with ever asthma and/or current asthma. Analyses were based on 4824 Danish schoolchildren aged 11-15 years old (48.7% boys) participating in the HBSC survey. The study variables were (1) physician-diagnosed asthma (ever asthma) and (2) physician-diagnosed asthma plus wheezing and/or physician or hospital consultation for wheezing (current asthma). Associations with PA by gender were analysed with multivariate logistic regression using the
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A 1964 random community survey in Aberdeen of 2511 children aged 10-14 years identified 121 children with asthma and 167 with wheeze with infection. The outcome at age 34-40 years of these children with wheeze, together with that of 167 children selected from those who were asymptomatic, has been described.1 In 1995 we tried to contact the 2056 individuals (now aged 39-45 years) who had had no childhood wheezing; 1799 subjects were traced. We posted questionnaires about symptoms, smoking, and employment to 1758 surviving subjects, of whom 1542 (87.7%) responded (75.0% of 2056).. Attacks of wheezing ever were reported by 239 (15.5%) respondents, of whom 177 (11.5% of 1542) reported adult onset wheeze-that is, onset at or after age 15 years. The prevalence of adult onset wheeze was similar for men and women (10.7% v 13.0%, χ2=1.95, P=0.16). Other subjects reporting wheeze included 17 with onset at age 10-14 years, 27 with onset before age 10 years, and 18 with no age specified.. Of the 177 ...
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In phase II, clusters of children were randomly selected in each centre for the study, using schools as sampling units. In Link ping, the survey involved 15 schools and in stersund all schools were selected due to the lower population. All 10-11 years old children (forms 4 and 5) were invited to participate in skin prick tests and parental questionnaires. Information on anthropometric measures at birth and pre- and perinatal exposures were collected from the medical birth registry. The local mass medias paid a great deal of attention to the study, particularly in stersund. The participation rates in the questionnaire study were 82% in Link ping and 86% in stersund. All children with a history of wheeze in the past 12 months as reported in the parental questionnaires and a random sample of non-wheezing children from the original cohorts were invited to a case-control study, which included parental questionnaire, examination for flexural dermatitis and bronchial challenge with hypertonic saline.. ...
It started with a pull under my left chest area and it progressed , chest cracking every month felt it come up higher and higher I feel it in my substernal area up to my throat from the mid chest. It sometimes feels like a stabbing in my throat and I hear a slight wheeze at night. The doctors have.... ...
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Congenital laryngeal stridor is a defect that is present at birth. During fetal development, the structures in the larynx may not fully develop. As a result, there is a weakness in these structures at birth, causing them to collapse during breathing. In children, congenital laryngeal stridor is the most common cause of chronic stridor. ...
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Colon cancer is the second-leading cancer killer, but its also one of the most preventable cancers when caught early. At Tucson Medical Center, our team specialists is highly experienced in the diagnosis and treatment of colon cancer. We will work with you to decide on the best possible treatment plan with a full range of options including chemotherapy, radiation, targeted therapy and minimally invasive surgery.. ...
TUCSON, Ariz. -- A small jump at the gas pump for Tucson drivers. The average price for a gallon of regular unleaded rose $.02 over the last week.. The Old Pueblos lowest price was $3.47, which is $.14 lower than the citywide average of $3.61. Arizonas average is $3.73, down a cent from last week. The national number held steady at $3.93.. ...
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There is a scarcity of information on the control of exercise intensity using ventilation and/or breathing sounds. We have reported6, 7that when a subject while jogging can
Feeding a baby on only breast milk and for up to 6 months after birth can reduce their risk of developing asthma-related symptoms in early childhood, according to new research.
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