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Cold air inhalation and exercise-induced bronchoconstriction in relationship to metacholine bronchial responsiveness: different patterns in asthmatic children and children with other chronic lung diseases.

https://arctichealth.org/en/permalink/ahliterature15737
Source
Respir Med. 1998 Feb;92(2):308-15
Publication Type
Article
Date
Feb-1998
Author
K H Carlsen
G. Engh
M. Mørk
E. Schrøder
Author Affiliation
Voksentoppen Centre of Asthma, Allergy and Chronic Lung Diseases, Oslo, Norway.
Source
Respir Med. 1998 Feb;92(2):308-15
Date
Feb-1998
Language
English
Publication Type
Article
Keywords
Asthma, Exercise-Induced - diagnosis
Bronchial Provocation Tests
Bronchoconstrictor Agents - diagnostic use
Child
Cold - adverse effects
Diagnosis, Differential
Exercise Tolerance
Female
Forced expiratory volume
Humans
Lung - physiopathology
Lung Diseases, Obstructive - diagnosis - physiopathology
Male
Methacholine Chloride - diagnostic use
Predictive value of tests
Sensitivity and specificity
Abstract
Cold air inhalation and exercise-induced bronchoconstriction (EIB) have both been used as measures of bronchial responsiveness. Both stimuli are often combined in the Nordic climate. The main objective of the present study was to investigate the climatic influence of cold temperatures upon exercise-induced asthma. The secondary aims were: (a) to assess metacholine bronchial hyper-responsiveness and EIB in children with bronchial asthma (n = 32; mean age 10.8 years) compared to children with other chronic lung diseases (CLD) (n = 26, mean age 10.1 years); and (b) to assess the influence of cold air inhalation upon EIB in the two groups of children. Methods used were: (a) the metacholine concentration causing a reduction in FEV1 of 20% (PC20-M), (b) maximum FEV1 fall (delta FEV1) after submaximal treadmill run (EIB test); and (c) delta FEV1 after submaximal treadmill run while inhaling cold (-20 degrees C) dry air (CA-EIB test). Geometric mean PC20-M did not differ significantly between the asthma children (1.28 mg ml-1) and the CLD children (2.90 mg ml-1). In the asthma children, mean delta FEV1 after EIB test was 12.8% vs 21.8% after adding cold air (P
PubMed ID
9616531 View in PubMed
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Improving pulmonary auscultation as a tool in the diagnosis of bronchial obstruction--results of an educational intervention.

https://arctichealth.org/en/permalink/ahliterature72474
Source
Scand J Prim Health Care. 1998 Sep;16(3):160-4
Publication Type
Article
Date
Sep-1998
Author
H. Melbye
I. Aaraas
J. Hana
A. Hensrud
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Scand J Prim Health Care. 1998 Sep;16(3):160-4
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Auscultation - methods
Clinical Competence - standards
Education, Medical, Continuing - methods
Female
Follow-Up Studies
Forced expiratory volume
Humans
Lung Diseases, Obstructive - diagnosis - physiopathology
Male
Middle Aged
Physicians, Family - education
Predictive value of tests
Research Support, Non-U.S. Gov't
Respiratory Sounds - physiopathology
Spirometry
Abstract
OBJECTIVE: To study the effect of an educational intervention on general practitioners' (GPs') ability to diagnose bronchial obstruction after clinical examination. DESIGN: Based on physical chest examination 11 GPs assessed the degree of bronchial obstruction by estimating the patient's predicted forced expiratory volume in one second (FEV1%). Half way in the study the GPs were taught new knowledge on associations between lung sounds and bronchial airflow. The agreements between estimated and measured FEV1% predicted before and after this educational intervention were compared. SETTING: 11 GPs in five health centres in northern Norway took part. PATIENTS: 351 adult patients were included in phase 1, and 341 in phase 2. MAIN OUTCOME MEASURES: Estimated and measured FEV1% predicted were compared in subgroups of patients according to clinical findings in phase 1 and 2. The effect of the intervention on the doctors' weighting of various chest signs could thus be evaluated. Kappa agreement and correlation between estimated and measured FEV1% predicted in both phases were determined. RESULTS: The agreement between estimated and measured FEV1% predicted increased from Kw (weighted Kappa) = 0.33 in phase 1 to Kw = 0.43 in phase 2 (95% confidence interval 0.35-0.52). The GPs laid more relevant emphasis on rhonchi in their estimates after the educational intervention, while too much weight was laid on uncertain chest findings in phase 2. CONCLUSION: The study shows a potential for better use of physical chest examination in the diagnosis of bronchial obstruction.
PubMed ID
9800229 View in PubMed
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Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease.

https://arctichealth.org/en/permalink/ahliterature72318
Source
Qual Life Res. 1999;8(1-2):45-54
Publication Type
Article
Date
1999
Author
K. Stavem
Author Affiliation
HELTEF Foundation for Health Services Research, Central Hospital of Akershus, Nordbyhagen, Norway.
Source
Qual Life Res. 1999;8(1-2):45-54
Date
1999
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Blood Gas Analysis
Choice Behavior
Cost-Benefit Analysis
Discriminant Analysis
Female
Health status
Humans
Lung Diseases, Obstructive - diagnosis - physiopathology - psychology - therapy
Male
Middle Aged
Norway
Quality-Adjusted Life Years
Questionnaires - standards
Reproducibility of Results
Spirometry
Abstract
The objective of the study was to evaluate the reliability, validity and responsiveness of two generic multiattribute methods for measuring utility for health states: a 15-dimensional (15D) and a five-dimensional method (EuroQol and EQ-TTO). A self-administered questionnaire with both measures was used in 59 outpatients with chronic obstructive pulmonary disease and the findings compared with standard gamble (SG) and time trade-off (TTO) utilities, spirometry and arterial blood gases. Quality of life scores were smallest for EQ-TTO (median 0.73) and highest for SG and TTO (median 0.91 and 0.95 respectively), while 15D gave intermediate values (median 0.80). The test-retest reliability over 14 days was: 15D (p = 0.90) and EQ-TTO (p = 0.73), using Spearman's rank correlation. 15D was better than EQ-TTO at discriminating between groups of patients after reported global rating of change over 12 months (P = 0.004 versus P = 0.09), indicating that 15D was more responsive. The 15D instrument has many attractive properties when compared to the EQ-TTO method, including a better reliability and responsiveness. Validity depends on validation method. The findings in this study indicate that the different utility measures measure different aspects of health-related quality of life (HRQoL). Caution should be taken when choosing utility instruments in cost-utility studies, as this can strongly influence the results.
PubMed ID
10457737 View in PubMed
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