| 1. |
- Ahlström, Gerd, et al.
(författare)
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Respiratory function, electrocardiography and quality of life in individuals with muscular dystrophy.
- 1994
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Ingår i: Chest. - 0012-3692 .- 1931-3543. ; 106:1, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- All individuals in a Swedish county afflicted with any type of hereditary muscular dystrophy (MD) were identified and 57 (85 percent) of eligible individuals in the age range 16 to 64 were included in the study. Respiratory disturbances were estimated by means of spirometry and analysis of arterial blood gases, and 58 percent yielded abnormal results on at least one of these examinations. Elevated PCO2 was found more commonly than reduced forced vital capacity (FVC) and there was a moderate association between these parameters. Respiratory symptoms, most commonly breathlessness, were encountered in 79 percent. Pathologic ECG recordings were found in 21 individuals (37 percent). Conduction disturbances and affection of the myocard were most frequent in myotonic dystrophy. Quality of life was assessed by means of the Sickness Impact Profile instrument and the Kaasa test. The results showed that quality of life was significantly related to FVC and to the symptom of abnormal fatigue. Respiratory and cardiac parameters showed a greater number of significant correlations with measures of functional ability than with subjective well-being.
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| 2. |
- Karlson, Björn W., 1953, et al.
(författare)
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Prognosis and symptoms one year after discharge from the emergency department in patients with acute chest pain.
- 1994
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Ingår i: Chest. - : American College of Chest Physicians. - 0012-3692 .- 1931-3543. ; 105:5, s. 1442-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A high proportion of patients admitted to a medical emergency department due to chest pain are directly sent home, since the initial suspicion of acute myocardial infarction (AMI) can be quickly ruled out. AIM: To describe the outcome of such patients during 1 year of follow-up in terms of mortality, development of AMI, and especially severity of symptoms 1 year after discharge. METHODS: All patients who during 21 months were admitted to the medical emergency department at Sahlgrenska Hospital, Göteborg, Sweden, due to chest pain, and who could be directly sent home, were prospectively followed up for 1 year. Their outcome was compared with patients who had chest pain and were hospitalized for AMI during the same time. RESULTS: Patients with chest pain directly sent home (n = 2,102) had a median age of 52 years (age range, 16 to 96 years), and 54 percent were men. The mortality during 1 year was 3 percent, and 3 percent developed AMI. As compared with patients with AMI, those who were directly sent home less frequently reported various cardiovascular symptoms, with the exception for chest pain at rest and palpitations. On the other hand, various emotional and psychosomatic symptoms were more frequently reported by patients who were directly sent home than by patients with AMI. CONCLUSION: Patients who came to a medical emergency department due to chest pain, and who were sent home, had a low risk of death and development of infarction during the following year. Survivors after 1 year do, however, more frequently report emotional and psychosomatic symptoms than survivors of AMI.
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| 3. |
- Larsson, Kjell, et al.
(författare)
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Hyaluronic acid (hyaluronan) in BAL fluid distinguishes farmers with allergic alveolitis from farmers with asymptomatic alveolitis
- 1992
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Ingår i: Chest. - : Elsevier BV. - 1931-3543 .- 0012-3692. ; 101:1, s. 109-114
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary function measurements, bronchoalveolar lavage (BAL), and analyses of precipitating antibodies in blood were performed in 12 farmers wtih no symptoms from the airways and 12 farmers who were admitted to the hospital due to acute symptoms of alveolitis (all nonsmokers). In addition, a bronchial methacholine provocation test was performed in the asymptomatic farmers. In 11 of the 12 symptomatic farmers but in none of the asymptomatic farmers, precipitating antibodies against one or more of the microorganisms which usually occur in a farmer's environment were found. In the farmers with symptomatic alveolitis, a restrictive impairment of pulmonary function was found, while pulmonary function was normal in all asymptomatic farmers. Findings in the BAL fluid showed increased concentrations of total cells, lymphocytes, and neutrophils and elevated levels of albumin, fibronectin, and angiotensin-converting enzyme in asymptomatic farmers compared with our own reference group. The same analyses in BAL fluid from the symptomatic farmers revealed a further increase in all parameters compared with the asymptomatic farmers. The BAL fluid from asymptomatic farmers had normal levels of hyaluronic acid (hyaluronan) and procollagen 3 N-terminal peptide, while these levels were significantly increased in the symptomatic group. We conclude that inflammation in the alveolar space and signs of activation of alveolar macrophages are present in farmers regardless of respiratory symptoms, although these findings are more pronounced in the presence of symptoms of acute alveolitis; however, the findings of impaired pulmonary function and the occurrence of precipitins and elevated levels of hyaluronic acid and procollagen 3 N-terminal peptide in BAL fluid were exclusively found in the farmers with airways symptoms. We postulate the hyaluronic acid, due to its pronounced ability to immobilize water, may be of importance in the development of the pulmonary function impairment observed in farmer's lung disease.
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| 4. |
- Ekdahl, Karl, et al.
(författare)
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Bronchoscopic diagnosis of pulmonary infections in a heterogeneous, nonselected group of patients
- 1993
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Ingår i: Chest. - 1931-3543. ; 103:6, s. 1743-1748
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Tidskriftsartikel (refereegranskat)abstract
- Fiberoptic bronchoscopy with bronchoalveolar lavage and protected specimen brush technique has become an established method for etiologic diagnosis in severe forms of pulmonary infections during recent years. In this study, including 62 bronchoscopies in 53 patients, a standardized program, covering all important pulmonary pathogens, has been evaluated in a heterogeneous group of patients. Results providing therapeutic guidelines were obtained in 53 percent (16/30) of the immunocompromised patients (including 5 bronchoscopies on HIV-positive patients), but only 19 percent (6/32) of the immunocompetent patients (p < 0.001). We conclude that bronchoscopy is of great value for diagnosing pulmonary infections in immunocompromised patients. In immunocompetent patients, the diagnostic yield is lower and the indication for bronchoscopy must be established for each individual patient based on clinical importance, resources, and risk. When bronchoscopy is performed, we believe that a standardized program like ours reduces the risk of missing important pathogens.
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