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Control of lung liquid throughout late gestation and labourPfister, Riccardo E. (Riccardo Erennio), 1961- January 2001 (has links)
Abstract not available
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Effectiveness of a patient mediated intervention in increasing the use of cochrane reviews of evidence in clinical practice : a controlled clinical trial in COPDHarris, Melanie January 2006 (has links)
Interventions are needed to improve health outcomes by increasing the practice of evidence based medicine ( EBM ). Patient mediated interventions have been little studied but hold promise : they target identified barriers to EBM and particular types of patient mediated intervention have shown success. Furthermore, consumers are now being given information about evidence but the effects of this on EBM have yet to be properly assessed. The aim of this study was to show whether informing patients about research evidence leads to improved application of that evidence in their medical care. The study trialed a relatively low cost manual, developed using current best practice, which summarised Cochrane Reviews of evidence. The study focused on chronic obstructive pulmonary disease ( COPD ), a high - cost, high - burden chronic disease, showing a large gap between evidence and clinical practice. The study comprised a controlled before - and - after trial and a process evaluation. The trial assessed the success of this manual in changing medical practice for three indicator treatments ( influenza vaccination, bone density testing and pulmonary rehabilitation ) and in changing patient quality of life, knowledge, communication with doctor, satisfaction with information and anxiety. Results were analysed by median split of socioeconomic disadvantage. At 3 months the manual was associated with lower anxiety for participants with lowest socioeconomic disadvantage. At 12 months the manual was associated with higher pulmonary rehabilitation enrolment for participants with greatest socioeconomic disadvantage. Other outcome measures showed no significant change. Limitations included loss of power from unexpectedly good baseline care and adjustments for baseline differences. The process evaluation showed that the manual was read more than a control pamphlet at both 3 and 12 months but a minority of manual recipients reported talking to their doctor about topics from the manual. Very little treatment change was reported. Patient attitudes to evidence and doctor / patient communication norms appeared to be barriers for this patient group. New protocols for the design of behavioural interventions provide a framework for overcoming these barriers in future interventions. / Thesis (Ph.D.)--School of Medicine, 2006.
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Evaluation of quality of life in Hong Kong COPD patients using SF-6DHe, Yongyi, 何勇毅 January 2010 (has links)
published_or_final_version / Public Health / Master / Master of Public Health
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Evidence-based clinical practice guidelines of smoking cessation programs for COPD patientsFung, Yiu-ting, Tina., 馮耀婷. January 2011 (has links)
published_or_final_version / Nursing Studies / Master / Master of Nursing
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The toxicology of sulfur oxides and the in vitro responses of lung macrophagesCrooks, Debra Louise January 1978 (has links)
No description available.
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The respiratory health status of adults who spent their developing years in a polluted area in South Africa : a historical cohort study.Oosthuizen, Maria Aletta. January 2004 (has links)
No abstract available. / Thesis (M.Med.)-University of KwaZulu-Natal, 2004.
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The role of malnutrition in prolonged respiratory failure : the effect of accelerated nutritional rehabilitationHinze, Candace January 1995 (has links)
To investigate the possibility that malnutrition is an important factor that prolongs respiratory failure (PRF), I studied the effects of pharmacologic injections of recombinant human growth hormone (rhGH), an important anabolic stimulus, on nutritional and respiratory parameters in patients requiring mechanical ventilation for more than three days. Patients were excluded from consideration if dominating factors known to prolong ventilatory failure had not been stabilized. Over ten months, 106 patients in PRF were evaluated, but only six met the selection criteria. Three patients were randomized to receive standard nutritional support, and three into a group that received the equivalent nutrition plus 5 mg/day of rhGH for 14 days or until withdrawal of mechanical ventilation. Baseline characteristics of the selected patients were divergent as demonstrated by body mass indexes ranging from 14 to 42 (kg/m$ sp2),$ baseline maximal inspiratory pressures (PI$ sb{ max}$ from $-$15 to $-$70 cm H$ sb2$O, and Day 1 N balances from $-$13.5 to 1.2 g N/day. Despite increased plasma insulin-like growth factor-1 concentrations, the mean daily N balances of the rhGH-treated group were no better than the controls (1.3 $ pm$ 5.0 vs. 0.4 $ pm$ 2.6 g N/day; Mean $ pm$ SD), nor were there differences in PI$ sb{ max},$ level of ventilatory assistance required, and days to weaning. The persistence of respiratory failure in the overwhelming majority of patients in PRF appears to be due to factors already known to prevent weaning from mechanical ventilation. Even the carefully selected patients enrolled in the present study were insufficiently homogeneous or stable enough to allow proper testing of the experimental hypothesis.
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Respiratory health survey in an Indian South African community : distribution and determinants of symptoms, diseases and lung function.Lalloo, Umesh Gangaram. January 1992 (has links)
A cross-sectional epidemiologic survey of the respiratory health status
was conducted in the adult (15 years and older) Indian South African
population resident in Lenasia, Johannesburg to study the distribution
and determinants of respiratory symptoms, disease and lung function
level. A slightly modified self-administered version of a standardised
respiratory health questionnaire and a wedge spirometer was used.
There were a high proportion of current smokers among men. Although
women smoked less than men in other communities they nevertheless
smoked on average more heavily than other Indian South African
women. Indian men and women who smoked had a high prevalence of
respiratory symptoms. The women also demonstrated an increased
susceptibility to the effects of cigarette smoking when compared with
women in other communities. Indians in this study had spirometric lung
function levels that were lower than that recorded in recent studies in
Blacks and Whites in South Africa. Respiratory symptoms, disease and
lung function level were examined in a multiple logistic regression model
which contained all the potential determinants recorded in the present
study. Voluntary tobacco smoking, recent chest illnesses and any kind
of heart trouble was associated with a significant risk for having most of
the respiratory symptoms and diseases in men and women. In addition
exposure to dust in the work environment, little or no exercise,>Std. 8
education a history of any kind of chest trouble and respiratory trouble
before the age of 16 years was associated with an increased risk for
having respiratory symptoms in men in this model. An increased risk for
respiratory symptoms was demonstrated in women only with age. Age
and standing height were the most important determinants of lung
function level in men and women in the regression model. Dust
exposure in the work environment was associated with a significantly
lower lung function level in men. Alcohol consumption and a history of
whooping cough was also independently associated with a lower lung
function level in men but were of borderline significance. In women
involuntary /passive tobacco smoke exposure and respiratory trouble
before the age of 16 years were associated with a lower lung function
level. Women who spent most of their lives in a rural area and those
who had a university education had a higher lung function level. The
deleterious effects of smoking on lung function were minimal in this
study possibly because lung function was performed only in subjects in
the 18-45 year age category. A "healthy smoker" effect was
demonstrated in men. Men who ever smoked and were without
cardiorespiratory symptoms had significantly higher lung function levels
compared to men who never smoked and were without symptoms. / Thesis (M.D.)-University of Natal, Durban, 1992.
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Respiratory tract symptoms in multi-day trail runners - a focus on allergy.De Waard, Anton Hans. January 2012 (has links)
Introduction: Respiratory tract symptoms (RTS), common in athletes during heavy training and
after events, result in impaired readiness for events and race times. Since the 1980’s exercise
immunologists have investigated the aetiological factors surrounding the development of
exercise induced RTS in order to develop effective preventative strategies. A number of theories
have been put forward and explored, such as increased susceptibility to infection, ‘run-away’
inflammatory response and reactivation of prior viral infection. It has been suggested that the
mechanisms producing exercise induced inflammation could potentiate allergic responses in
sensitized individuals and recently allergic response has been proposed as a potential contributor
to exercise induced RTS. Certainly allergic reactions can produce a range of respiratory
symptoms; however the relationship between allergic sensitization, allergic reaction and the
incidence of post-exercise RTS has not been well defined.
Objectives: The primary objective of this study was to document the incidence of RTS for two
weeks before and two weeks after a three-day trail run and relate these to the general systemic
and salivary immunological profile as well as atopic status of the participants. The secondary
objective was to validate the use of the Phadiatop® assay as a predictor of allergy-associated
post-race RTS in trail runners.
Study Design and Methods: The study formed part of a larger, descriptive field study
examining the physiological responses of trail runners during the Three Cranes Challenge, a
multi-day 95 km event divided into three stages, in Karkloof, KwaZulu-Natal. Outcome
measures examined included self- reported RTS over a 31 day period (pre, during and post race),
as well as pre-race Phadiatop® status, salivary IgA (sIgA) concentrations and changes in
concentrations of serum IgE (sIgE), cortisol, high sensitivity C-Reactive Protein (hs-CRP) and
differential leukocyte counts. The haematological and salivary parameters were obtained at 8
time points before, during and after the event.
A convenience sample of 22 individuals was used and two separate analyses were conducted on
the data. The inclusion criteria of the first analysis were met by 14 participants. In this analysis,
the incidence of RTS was related to each participant’s general immunological profile. Sixteen of
the subjects met the inclusion criteria for the second analysis, in which their Phadiatop® status
was related to their sIgE and blood eosinophil and basophil concentrations in order to establish
the validity of the Phadiatop® assay in predicting the development of allergy–associated postexercise
RTS in trail runners.
Results: In the first analysis, 78.6 % (n=11) of subjects met the criteria for positive diagnosis of
upper respiratory symptoms (URS) during the two week post-race period. In four subjects (36.4
%), URS appeared to be of inflammatory origin, but these were not linked to systemic markers of
an allergic response. Of the URS positive subjects, six (54.5 %) presented with markers of
infection, three (27.3 %) with markers of a de novo infection and three (27.3%) with a profile
suggestive of reactivation of previous infection. Of those presenting with markers of infection
66.7 % (n=4) had concomitantly elevated levels of IgE suggestive of allergic response. There
was, however, no evidence of isolated allergic reaction independent of other causes amongst the
symptomatic subjects.
In the second analysis, 75% (n=12) of runners presented with post-race RTS and seven of these
were Phadiatop® positive. In four of the Phadiatop® positive RTS subjects, symptoms appeared
to be of allergic origin. Although total IgE concentrations were significantly higher (p< 0.01) in
Phadiatop® positive group, there was no significant difference between the eosinophil and
basophil concentrations or post-race RTS of the positive and negative groups (p>0.05). Of the
four subjects who did not develop RTS, three were Phadiatop® positive.
Conclusion: Respiratory tract symptoms in trail runners have a multi-factorial aetiology. A link
between concurrent markers of an allergic response and infection is common in symptomatic
trail runners. The Phadiatop® assay does not accurately predict the incidence of allergic postexercise
RTS in trail runners. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Westville, 2012.
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Occupational exposures and chronic obstructive pulmonary disease : a hospital-based case-control study.Govender, Nadira. January 2009 (has links)
Aim
The aim of this study was to determine the contribution of occupational exposures
to the burden of Chronic Obstructive Pulmonary Disease (COPD) among a sample
of hospital based patients.
Methods
Cases (n=110) with specialist physician diagnosed COPD from the three public
sector specialist respiratory clinics in KZN and controls (n=102) from other nonrespiratory
chronic ailment specialist clinics at the same institutions were selected.
An interviewer administered questionnaire and exposure history was obtained for
each participant. In addition, a valid lung function test was obtained for each case.
Data was analysed using STATA version 10. Multivariate regression models were
developed to examine the relationship between COPD and occupational
exposures while adjusting for age, sex, smoking and previous history of
tuberculosis. The relationship of FEV1 and occupational exposures, adjusted for
age, height, previous history of tuberculosis and smoking history, was investigated
among cases.
Results
Cases and controls were similar with respect to age and sex distribution. Cigarette
smoking differed significantly between cases and controls with a larger proportion
of cases having ceased to smoke compared to controls (72% vs 46%, p<0.01). A
higher proportion of controls reported employment in administrative, managerial
and quality control positions (21.3% vs 12.0%, 7.7% vs 2.6% and 5.4% vs 0.3%
respectively). Employment in the construction and shoe manufacturing industries
was reported more frequently by cases (10.3% vs 3.2% and 10.0% vs 4.9%
respectively). Cases were more likely than controls to have been exposed to dust
(72% vs 28%, p<0.001) or to chemicals, gas or fumes (74% vs 25.5%, p<0.001)
and reported exposure durations 3-4 fold higher than that of controls (p<0.001).
Dust and chemical, gas or fume exposure was associated with an increased odds
of developing COPD. Exposure to dusts (OR 7.9, 95% CI 3.9-15.7, p<0.001),
chemicals, gas or fumes (OR 6.4, 95% CI 3.2-12.8, p<0.001) were significantly
associated with odds of developing COPD. In addition, previous history of
tuberculosis, as well as smoking were associated with an increased odds of
COPD (OR 5.7, 95% CI 1.2-27.4 p<0.001 and OR 6.4, 95% CI 2.3-17.7, p<0.001).
Discussion and Conclusion
This is one of the first hospital based case-control studies looking at occupational
contribution to COPD undertaken in South Africa. In this sample of participants,
strong associations were observed between self-reported occupational exposures
to dust, and chemicals, gas or fumes, and physician’s diagnosis of COPD. The
study also demonstrated a strong association between smoking and previous
history of tuberculosis, and risk of COPD. The findings suggest that persons with
known occupational exposures to respiratory irritants should be monitored to
detect the onset of respiratory ill-health and that preventive strategies should
reduce exposure to these agents in the workplace. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2009.
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