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David Coggon - One of the best experts on this subject based on the ideXlab platform.
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Work related respiratory symptoms in radiographers.
Occupational and Environmental Medicine, 1999Co-Authors: Julia Smedley, Paul Cullinan, Anthony J. Frew, A Newman-taylor, David CoggonAbstract:OBJECTIVE--To determine the prevalence of work related symptoms among radiographers compared with a control group of physiotherapists. METHOD--A postal questionnaire was used to collect information from radiographers and physiotherapists who registered in the United Kingdom during 1985-9. RESULTS--Satisfactory questionnaires were returned by 2354 (65%) of the radiographers and 3048 (69%) of the physiotherapists. There was a clear excess of work related symptoms among the radiographers. In particular, they were more likely to complain of symptoms that were worse at work, mouth soreness, sore, itchy, or runny eyes, persistent blocked nose, persistent itchy nose or sneezing, sore throat, headache, and of lower respiratory tract symptoms, which were also worse on workdays. These symptoms were associated particularly with the use of automatic processing machines. 235 radiographers gave a history of wheeze or Chest Tightness that had been worse at work or on days when at work. CONCLUSIONS--Work related symptoms suggesting irritation of the eyes and upper airways were more common in radiographers than controls, and may be related to exposure to x ray film processing chemicals. Men and women who reported work related wheeze or Chest Tightness will be followed up in more detail to assess the prevalence of occupational asthma in the cohort.
A K Webb - One of the best experts on this subject based on the ideXlab platform.
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effect of tonicity of nebulised colistin on Chest Tightness and pulmonary function in adults with cystic fibrosis
Thorax, 1997Co-Authors: M E Dodd, J Maddison, Janice Abbott, A J Moorcroft, A K WebbAbstract:BACKGROUND: Inhalation of hypertonic nebulised colistin causes Chest Tightness and is a reason for discontinuing the treatment. This study examines the relationship of Chest Tightness and change in lung function in response to the inhalation of a range of tonicities of nebulised colistin and their influence on patients' preference. METHODS: Twenty seven adult patients with cystic fibrosis and a mean forced expiratory volume in one second (FEV1) of 54% predicted (range 24-98) were studied. They inhaled a nebulised solution of hypertonic, isotonic, and hypotonic colistin over three consecutive days in random order in a double blind fashion. Measurements of Chest Tightness, using a visual analogue scale (VAS), and FEV1 were recorded before and 0, 15, 30, 60, and 90 minutes following inhalation. The solution preferred by each patient was determined at the end of the three days. RESULTS: All tonicities caused a significant fall in FEV1 % predicted and an increase in Chest Tightness, with no differences between the solutions. However, the mean (SE) time to the maximum fall in FEV1 % predicted was significantly different between the solutions (hypertonic 7.8 (2.1) min, isotonic 19.2 (5.5) min, and hypotonic 34.2 (5.9) min) with a mean difference (95% CI) between hypotonic and hypertonic solutions of 28.04 (14.6 to 41.5) min, between isotonic and hypertonic solutions of 12.0 (-0.1 to 24.1) min, and between hypotonic and isotonic solutions of 15.6 (1.8 to 29.4) min. Positive correlations existed for the maximum fall in FEV1 % predicted between the hypertonic and isotonic solutions (r = 0.62, p < 0.001) and between the hypotonic and isotonic solutions (r = 0.64, p < 0.001). There was no correlation between the objective and subjective measurements for any solution. The patients' preference varied. CONCLUSIONS: All tonicities of colistin caused equal symptoms of Chest Tightness and reduction in pulmonary function. It is recommended that the patient is challenged with nebulised colistin before prescription of the drug and that the challenge is preceded by an inhaled bronchodilator. Most of the patients preferred the isotonic or hypotonic solutions. The isotonic solution reflects a fall in FEV1 representative of all the solutions. The fall in FEV1 to the hypotonic solution occurred over a longer period and may be better tolerated by some patients.
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effect of tonicity of nebulised colistin on Chest Tightness and pulmonary function in adults with cystic fibrosis
Thorax, 1997Co-Authors: M E Dodd, J Maddison, Janice Abbott, A J Moorcroft, A K WebbAbstract:BACKGROUND: Inhalation of hypertonic nebulised colistin causes Chest Tightness and is a reason for discontinuing the treatment. This study examines the relationship of Chest Tightness and change in lung function in response to the inhalation of a range of tonicities of nebulised colistin and their influence on patients9 preference. METHODS: Twenty seven adult patients with cystic fibrosis and a mean forced expiratory volume in one second (FEV1) of 54% predicted (range 24-98) were studied. They inhaled a nebulised solution of hypertonic, isotonic, and hypotonic colistin over three consecutive days in random order in a double blind fashion. Measurements of Chest Tightness, using a visual analogue scale (VAS), and FEV1 were recorded before and 0, 15, 30, 60, and 90 minutes following inhalation. The solution preferred by each patient was determined at the end of the three days. RESULTS: All tonicities caused a significant fall in FEV1 % predicted and an increase in Chest Tightness, with no differences between the solutions. However, the mean (SE) time to the maximum fall in FEV1 % predicted was significantly different between the solutions (hypertonic 7.8 (2.1) min, isotonic 19.2 (5.5) min, and hypotonic 34.2 (5.9) min) with a mean difference (95% CI) between hypotonic and hypertonic solutions of 28.04 (14.6 to 41.5) min, between isotonic and hypertonic solutions of 12.0 (-0.1 to 24.1) min, and between hypotonic and isotonic solutions of 15.6 (1.8 to 29.4) min. Positive correlations existed for the maximum fall in FEV1 % predicted between the hypertonic and isotonic solutions (r = 0.62, p
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nebulized colistin causes Chest Tightness in adults with cystic fibrosis
Respiratory Medicine, 1994Co-Authors: J Maddison, M E Dodd, A K WebbAbstract:Nebulized antipseudomonal antibiotics may be useful therapeutic agents in patients with cystic fibrosis (CF) (l-3). Short term studies of nebulized colistin have demonstrated its efficacy in eradicating recently acquired Pseudomonas aeruginosa in children (4) and in the management of chronic infection in adults (5). There is no uniform policy regarding the use of nebulized colistin in different CF centres. In our unit patients infected with P. aeruginosa are candidates for regular therapy with the drug if their requirements for oral or i.v. antibiotics are increasing and their pulmonary function is deteriorating. Each potential candidate is challenged to a standard dose of nebulized colistin and, if immediate side effects are not prohibitive, commences regular therapy with the drug. In stable state we recommend that patients inhale nebulized colistin twicedaily, butduringexacerbationsrequiringi.v. antibiotics that the drug be omitted. We do not use the drug as first line therapy during infective exacerbations. Nebulized colistin causes Chest Tightness in some patients and may lead to discontinuation of regular therapy (4). In this study we have focused specifically on Chest Tightness as a reason for discontinuing therapy. Patients able to maintain regular therapy (tolerant) have been compared to those who discontinued or could not begin regular therapy because of Chest Tightness (intolerant) using three measurements; the degree of bronchoconstriction at colistin challenge, severity of airways disease (% predicted FEV,) and reversibility to bronchodilators in stable state.
Julia Smedley - One of the best experts on this subject based on the ideXlab platform.
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Work related respiratory symptoms in radiographers.
Occupational and Environmental Medicine, 1999Co-Authors: Julia Smedley, Paul Cullinan, Anthony J. Frew, A Newman-taylor, David CoggonAbstract:OBJECTIVE--To determine the prevalence of work related symptoms among radiographers compared with a control group of physiotherapists. METHOD--A postal questionnaire was used to collect information from radiographers and physiotherapists who registered in the United Kingdom during 1985-9. RESULTS--Satisfactory questionnaires were returned by 2354 (65%) of the radiographers and 3048 (69%) of the physiotherapists. There was a clear excess of work related symptoms among the radiographers. In particular, they were more likely to complain of symptoms that were worse at work, mouth soreness, sore, itchy, or runny eyes, persistent blocked nose, persistent itchy nose or sneezing, sore throat, headache, and of lower respiratory tract symptoms, which were also worse on workdays. These symptoms were associated particularly with the use of automatic processing machines. 235 radiographers gave a history of wheeze or Chest Tightness that had been worse at work or on days when at work. CONCLUSIONS--Work related symptoms suggesting irritation of the eyes and upper airways were more common in radiographers than controls, and may be related to exposure to x ray film processing chemicals. Men and women who reported work related wheeze or Chest Tightness will be followed up in more detail to assess the prevalence of occupational asthma in the cohort.
M E Dodd - One of the best experts on this subject based on the ideXlab platform.
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effect of tonicity of nebulised colistin on Chest Tightness and pulmonary function in adults with cystic fibrosis
Thorax, 1997Co-Authors: M E Dodd, J Maddison, Janice Abbott, A J Moorcroft, A K WebbAbstract:BACKGROUND: Inhalation of hypertonic nebulised colistin causes Chest Tightness and is a reason for discontinuing the treatment. This study examines the relationship of Chest Tightness and change in lung function in response to the inhalation of a range of tonicities of nebulised colistin and their influence on patients' preference. METHODS: Twenty seven adult patients with cystic fibrosis and a mean forced expiratory volume in one second (FEV1) of 54% predicted (range 24-98) were studied. They inhaled a nebulised solution of hypertonic, isotonic, and hypotonic colistin over three consecutive days in random order in a double blind fashion. Measurements of Chest Tightness, using a visual analogue scale (VAS), and FEV1 were recorded before and 0, 15, 30, 60, and 90 minutes following inhalation. The solution preferred by each patient was determined at the end of the three days. RESULTS: All tonicities caused a significant fall in FEV1 % predicted and an increase in Chest Tightness, with no differences between the solutions. However, the mean (SE) time to the maximum fall in FEV1 % predicted was significantly different between the solutions (hypertonic 7.8 (2.1) min, isotonic 19.2 (5.5) min, and hypotonic 34.2 (5.9) min) with a mean difference (95% CI) between hypotonic and hypertonic solutions of 28.04 (14.6 to 41.5) min, between isotonic and hypertonic solutions of 12.0 (-0.1 to 24.1) min, and between hypotonic and isotonic solutions of 15.6 (1.8 to 29.4) min. Positive correlations existed for the maximum fall in FEV1 % predicted between the hypertonic and isotonic solutions (r = 0.62, p < 0.001) and between the hypotonic and isotonic solutions (r = 0.64, p < 0.001). There was no correlation between the objective and subjective measurements for any solution. The patients' preference varied. CONCLUSIONS: All tonicities of colistin caused equal symptoms of Chest Tightness and reduction in pulmonary function. It is recommended that the patient is challenged with nebulised colistin before prescription of the drug and that the challenge is preceded by an inhaled bronchodilator. Most of the patients preferred the isotonic or hypotonic solutions. The isotonic solution reflects a fall in FEV1 representative of all the solutions. The fall in FEV1 to the hypotonic solution occurred over a longer period and may be better tolerated by some patients.
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effect of tonicity of nebulised colistin on Chest Tightness and pulmonary function in adults with cystic fibrosis
Thorax, 1997Co-Authors: M E Dodd, J Maddison, Janice Abbott, A J Moorcroft, A K WebbAbstract:BACKGROUND: Inhalation of hypertonic nebulised colistin causes Chest Tightness and is a reason for discontinuing the treatment. This study examines the relationship of Chest Tightness and change in lung function in response to the inhalation of a range of tonicities of nebulised colistin and their influence on patients9 preference. METHODS: Twenty seven adult patients with cystic fibrosis and a mean forced expiratory volume in one second (FEV1) of 54% predicted (range 24-98) were studied. They inhaled a nebulised solution of hypertonic, isotonic, and hypotonic colistin over three consecutive days in random order in a double blind fashion. Measurements of Chest Tightness, using a visual analogue scale (VAS), and FEV1 were recorded before and 0, 15, 30, 60, and 90 minutes following inhalation. The solution preferred by each patient was determined at the end of the three days. RESULTS: All tonicities caused a significant fall in FEV1 % predicted and an increase in Chest Tightness, with no differences between the solutions. However, the mean (SE) time to the maximum fall in FEV1 % predicted was significantly different between the solutions (hypertonic 7.8 (2.1) min, isotonic 19.2 (5.5) min, and hypotonic 34.2 (5.9) min) with a mean difference (95% CI) between hypotonic and hypertonic solutions of 28.04 (14.6 to 41.5) min, between isotonic and hypertonic solutions of 12.0 (-0.1 to 24.1) min, and between hypotonic and isotonic solutions of 15.6 (1.8 to 29.4) min. Positive correlations existed for the maximum fall in FEV1 % predicted between the hypertonic and isotonic solutions (r = 0.62, p
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nebulized colistin causes Chest Tightness in adults with cystic fibrosis
Respiratory Medicine, 1994Co-Authors: J Maddison, M E Dodd, A K WebbAbstract:Nebulized antipseudomonal antibiotics may be useful therapeutic agents in patients with cystic fibrosis (CF) (l-3). Short term studies of nebulized colistin have demonstrated its efficacy in eradicating recently acquired Pseudomonas aeruginosa in children (4) and in the management of chronic infection in adults (5). There is no uniform policy regarding the use of nebulized colistin in different CF centres. In our unit patients infected with P. aeruginosa are candidates for regular therapy with the drug if their requirements for oral or i.v. antibiotics are increasing and their pulmonary function is deteriorating. Each potential candidate is challenged to a standard dose of nebulized colistin and, if immediate side effects are not prohibitive, commences regular therapy with the drug. In stable state we recommend that patients inhale nebulized colistin twicedaily, butduringexacerbationsrequiringi.v. antibiotics that the drug be omitted. We do not use the drug as first line therapy during infective exacerbations. Nebulized colistin causes Chest Tightness in some patients and may lead to discontinuation of regular therapy (4). In this study we have focused specifically on Chest Tightness as a reason for discontinuing therapy. Patients able to maintain regular therapy (tolerant) have been compared to those who discontinued or could not begin regular therapy because of Chest Tightness (intolerant) using three measurements; the degree of bronchoconstriction at colistin challenge, severity of airways disease (% predicted FEV,) and reversibility to bronchodilators in stable state.
Ping Chen - One of the best experts on this subject based on the ideXlab platform.
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response of patients with Chest Tightness variant asthma with routine asthma treatment regimen a 1 year multicenter prospective real world study
Clinical and translational medicine, 2020Co-Authors: Fugui Yan, Weijie Guan, Min Chen, Chen Qiu, Wei Tang, Xiansheng Liu, Xudong Xiang, Meiling Jin, Yuanrong Dai, Ping ChenAbstract:BACKGROUND Asthmatic patients with Chest Tightness as their only presenting symptom (Chest Tightness variant asthma [CTVA]) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA); however, whether CTVA has similar response to antiasthma treatment as compared with CA remains unclear. OBJECTIVE The response of 76 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists was explored in a 52-week multicenter, prospective, real-world study. RESULTS After 52 weeks of treatment with therapy regimens used for CA, the mean 5-point Asthma Control Questionnaire (ACQ-5) score decreased markedly from 1.38(first administration) to 0.71 (52 weeks, mean decrease: 0.674, 95%CI: 0.447-0.900, P<.001).The mean asthma quality-of-life questionnaire (AQLQ) score increased from 5.77 (first administration) to 6.20 (52 weeks, mean increase: 0.441, 95% CI 0.258-0.625, P<.001). Furthermore, at week 52, FVC, FEV1 %, the diurnal variation in PEFand the PD20-FEV1 were significantly improved. Subgroup analysis revealed that the patients at first administration in the responsive group had higher ACQ-5 scores than those in the nonresponsive group (P < .05). CONCLUSION In conclusion, patients with CTVA had a good therapeutic response to the guideline-recommended routine treatment (containing inhaled corticosteroids). The association between the treatment response and the severity of CTVA suggested that CTVA patients with higher ACQ-5 scores had better therapeutic effects.
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response of patients with Chest Tightness variant asthma with routine asthma management regimen a one year multicenter prospective real life study
Authorea Preprints, 2020Co-Authors: Fugui Yan, Weijie Guan, Min Chen, Chen Qiu, Wei Tang, Xiansheng Liu, Xudong Xiang, Meiling Jin, Yuanrong Dai, Ping ChenAbstract:Background: Although asthmatic patients with Chest Tightness as their only presenting symptom (Chest Tightness variant asthma, CTVA) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA), the response of CTVA to treatment regimens used for CA is unclear. Objective: The response of 76 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists was explored. Methods: The study was a multicenter, prospective, real-life study conducted in 16 centers in China. The primary efficacy endpoint was the changes in 5-point asthma control questionnaire (ACQ-5) score before and after treatment. Results: After 52 weeks of treatment with therapy regimens used for CA, the ACQ-5 scores decreased markedly from 1.38±0.91 (first administration) to 0.74±0.75 (26 weeks), and 0.71±0.78 (52 weeks) (P<0.01), and the mean decrease for ACQ-5 between 52 weeks and first administration was 0.674(95%CI 0.447-0.9, P<0.001), while the asthma quality of life questionnaire (AQLQ) scores increased from 5.77±0.75 (first administration) to 6.23±0.59 (26 weeks) and 6.20±0.58 (52 weeks) (P<0.01), and the mean increase for AQLQ between 52 weeks and first administration was 0.441(95%CI 0.258-0.625, P<0.001). Diurnal variation in peak expiratory flow (PEF) decreased from 18.4%±9.78(first administration) to 9.32%±5.33 (52 weeks) (P<0.01), and the provocation dose that caused a 20% fall in the FEV1 (PD20-FEV1) was significantly improved after one year of treatment. Conclusion: CTVA patients showed a good clinical response to anti-asthma treatments, and the treatment effects may be related to the severity of CTVA.
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therapeutic response of patients with Chest Tightness variant asthma a one year multicenter prospective real life study
Social Science Research Network, 2020Co-Authors: Fugui Yan, Min Chen, Chen Qiu, Wei Tang, Xiansheng Liu, Xudong Xiang, Meiling Jin, Yuanrong Dai, Ping Chen, Zhongmin QiuAbstract:Background: Although asthmatic patients with Chest Tightness as their only presenting symptom (Chest Tightness variant asthma, CTVA) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA), the response of CTVA to treatment regimens used for CA is unclear. Methods: To explore the clinical course and response of 96 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists in a 52-week multicenter, prospective, real-life study. Findings: After 52 weeks of treatment with therapy regimens used for CA, the 5-point Asthma Control Questionnaire (ACQ-5) scores decreased markedly from 1·34±0·88(before treatment; V0) to 0·97±0·70 (4 weeks, V1), 0·83±0·72 (13 weeks, V2), 0·73±0·76 (26 weeks, V3), and 0·76±0·79(52 weeks, V4) ( P <0·01), while the Asthma Quality of Life Questionnaire (AQLQ) scores increased from 5·76±0·76 (V0) to 6·24±0·60(V3) and 6·14±0·60(V4) ( P <0·01). The Self-rating Anxiety Scale(SAS) score improved as evidenced by a decrease from 41·44±10·24 (V0) to 37·61±11·41 (V2) and 37·67±8·07 (V4) ( P <0·01). Diurnal variation in peak expiratory flow (PEF) and the bronchial provocation test were improved at one year. However, forced expiratory volume (FEV1) andnitric oxide levels in exhaled breath (FeNO) showed no improvement. Interpretation CTVA patients showed a good clinical response to anti-asthma treatments, and the treatment effects may be related to theseverity of CTVA. Interpretation: CTVA patients showed a good clinical response to antiasthma treatments, and the treatment effects may be related to the severity of CTVA. Trial Registration: ClinicalTrials.gov identifier: NCT 03237221 Funding: 1.This study was supported by the Zhejiang Medical and Health Science and Technology program from Health Commission of Zhejiang Province (WKJ2014-ZJ-01412). 2.This work was funded by the Precision Medicine Research of The National Key Research and Development Plan of China (2016YFC0905800). 3.This study was supported by the program for the Key Site of National Clinical Research Center for Respiratory Disease, the Key ScienceTechnology Innovation Team of Zhejiang Province (2011R50016). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Institutional Review Board for Human Studies of Second Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China).