Prevalence of bronchial hyperresponsiveness and asthma in the adult population in Thailand.

Objectives: We conducted a nationwide cross-sectional survey of respiratory health in adults aged 20 to 44 years during 2001 to 2002 to determine the prevalence of bronchial hyperresponsiveness (BHR) and asthma in the adult Thai population.

Design: Subjects were selected by a multistage stratified random sampling. The stratification was done on geographic area, age group, and sex.

Allergen sensitization to aeroallergens including Blomia tropicalis among adult and childhood asthmatics in Thailand.

To study prevalence of allergen sensitization among asthmatics in Thailand, skin prick tests (SPT) were performed in 84 pediatric, 71 adult asthmatics and 71 adult volunteers. Allergen extracts used for testing included common allergens in Thailand and in Singapore. The incidence of positive SPT to any allergen among the three groups (childhood, adult patients and adult controls) were 64.

Acute respiratory illness in patients with COPD and the effectiveness of influenza vaccination: a randomized controlled study.

Study Objectives: To determine the effectiveness of influenza vaccination on influenza-related acute respiratory illness (ARI) and overall ARI in patients with COPD, and its relationship to the degree of airflow obstruction.

Design: Stratified, randomized, double-blind, placebo-controlled trial.

Setting: From June 1997 to November 1998 at a single university hospital.

Formoterol (OXIS) Turbuhaler as a rescue therapy compared with salbutamol pMDI plus spacer in patients with acute severe asthma.

Formoterol has a similar onset of effect to salbutamol but a prolonged duration of action. However, the relative efficacy of the two drugs in acute severe asthma is not known. This double-blind, double-dummy study compared the safety and efficacy of the maximum recommended daily dose of formoterol and a predicted equivalent dose of salbutamol in 88 patients presenting to the emergency department with acute severe asthma.

Comparison between specified percentage and fifth percentile criteria for spirometry interpretation in Thai patients.

Objectives: The present study was conducted to determine the degree of agreement between the interpretation of spirometry using a specified percentage of predicted value (SPC) and the fifth percentile (FPC) as the cut off between normal and abnormal.

Methodology: Spirometric values were collected for 1754 subjects attending the respiratory service at Siriraj Hospital between February 2000 and April 2001. These values included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, maximal mid-expiratory flow (FEF25-75%) and peak expiratory flow (PEF).

Angiocentric T-cell lymphoma of the pancreas presenting as late-onset diabetes mellitus with diabetic retinopathy.

Pancreatic lymphoma presenting with clinical diabetes mellitus (DM) is rare. We report angiocentric T-cell lymphoma of the pancreas in a 65-year-old Thai woman who presented with progressive deterioration of visual acuity of both eyes. She had diabetic retinopathy (DR) diagnosed only 20 months after the diagnosis of DM at the age of 63.

Reference spirometric values for healthy lifetime nonsmokers in Thailand.

The normal spirometric reference values for Thai people are still not yet available. The aim of this study was to establish standard spirometric equations for Thai people. Subjects 10 years of age and over were selected and their demographic distributions represented that of the population of the whole country.

High-dose inhaled budesonide may substitute for oral therapy after an acute asthma attack.

Patients attending the emergency room with acute asthma, participating in a study comparing salbutamol (albuterol in the United States) via a dry powder inhaler (Turbuhaler) with pressurized metered-dose inhaler (pMDI), were included in this 1-week follow-up study with the aim of assessing whether inhaled budesonide via Turbuhaler may be an alternative to prednisolone tablets after an acute asthma attack. Eighty-one patients with a mean age of 38 years and forced expiratory volume in 1 sec (FEV1) of 64% predicted normal value after treatment with salbutamol were randomized in this double-blind, double-dummy, parallel-group study. The doses given were budesonide 1600 microg b.

Diagnostic value of bronchoalveolar lavage and postbronchoscopic sputum cytology in peripheral lung cancer.

The objective of this study was to evaluate the value of bronchoalveolar lavage (BAL) and postbronchoscopic sputum cytology in diagnosing peripheral lung cancer. We performed a prospective study in 55 patients with lesions on chest radiographs who were suspected of having lung cancer and had non-endoscopically visible lesions on fiberoptic bronchoscopy. The sequence of procedures in all cases was BAL and transbronchial forceps biopsy.

Tropical infection and the lung.

The term "tropical lung" has been used to describe the lungs that are vulnerable to those indigenous diseases that occur with particular prevalence in tropical countries. International travel, student and cultural exchanges and changing immigration patterns are insidiously transforming the face of medicine in Europe and other developed countries. The climates of tropical countries provide an ideal environment for pathogenic organisms, and their vectors and intermediate hosts, to flourish.

Pseudohypoxaemia in a patient with acute leukaemia.

Patients with acute leukaemia may have spuriously low arterial oxygen tensions (PaO2). The markedly increased numbers of white blood cells in these patients rapidly consume dissolved plasma oxygen resulting in dramatically decreased PaO2 and calculated oxygen saturations. The case history is reported of a patient with a white blood count of 191 000/mm3 in whom multiple arterial blood gas measurements documented hypoxaemia out of proportion to the clinical picture.

Effect of salbutamol on oxygen saturation in COPD.

The effect of nebulized salbutamol on oxygen saturation in COPD was evaluated in this study. Twenty patients aged 56-75 years with stable COPD were recruited to the study. All patients received 5 mg of salbutamol nebulizer driven by oxygen at 8 L/min.

The efficacy of doxycycline as a pleural sclerosing agent in malignant pleural effusion: a prospective study.

To determine the efficacy of doxycycline in producing pleuroedesis in patients with malignant pleural effusion (MPE), 31 documented cases of MPE, aged 19-82 years were prospectively studied. Pleural sclerosis was done with 500 mg of doxycycline. Response regarding respiratory symptoms and pleural fluid accumulation were evaluated monthly.

Effect of paper spacer (spader) in conjunction with procaterol metered dose inhaler in the treatment of acute asthma.

Thirty acute asthmatic patients (mean age 35.6 +/- 13.5 years, mean FEV1 0.

Is driving oxygen flow rate clinically important for nebulizer therapy in patients with COPD?

Our study suggests that the administration of bronchodilator drug via nebulizer powered by flow rate 6 L/min is more suitable in COPD patients. The oxygen flow rates should not be given more than 6 L/min. In this study, we recruited COPD patients in a stable stage, in whom the risk of hyperoxic induced hypercarbia is less than in the acute exacerbation stage.

Diagnostic role of fiberoptic bronchoscopy in suspected smear negative pulmonary tuberculosis.

Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) was performed in 40 patients suspected to have pulmonary tuberculosis, in whom chest roentgenogram revealed minimal infiltration and sputum smears were negative for acid-fast bacilli. Bronchoscopic procedures provided overall diagnostic yields in 47.5% (19/40) of patients.

Leiomyomas of the lower respiratory tract: a case report.

A rare case of leiomyoma of the left main bronchus in a 16-year-old female has been reported. Of the pulmonary leiomyomas reported, 18.3 per cent were found in the trachea, 33.

Serum precipitins in pulmonary aspergillosis: preliminary results.

Definitive diagnosis of pulmonary aspergillosis is difficult to establish. Thus, confirmative evidence of active fungal aggression is imperative. In this study, an immunodiffusion test was carried out on 36 cases of pulmonary aspergillosis and two groups of subjects comprising 133 patients with non-fungal diseases and 134 healthy volunteers as controls.

Treatment of community-acquired pneumonia with ofloxacin.

Our study of 28 carefully selected patients proved that ofloxacin is a safe and effective drug for mild to moderately severe community-acquired pneumonia. An effective oral antimicrobial drug such as ofloxacin can be used as an alternative to conventional therapy in community-acquired pneumonia.

Intravenous enprofylline in the treatment of patients with acute asthma.

The safety and efficacy of enprofylline were studied in 55 moderately severe asthmatic patients [forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate (PEFR) no more than 50% of predicted values] presenting with an acute attack. A bolus injection of 1.5 mg/kg enprofylline was given over 20 min and then maintenance infusion of 0.

Clinical assessment of respiratory impairment.

"Respiratory impairment" can be assessed roughly by clinical methods (symptom information and physical examination) and a simple bedside test ('match test'), and quantitatively and accurately by laboratory pulmonary function study (spirometry, arterial blood gas analysis and several other sophisticated tests). Whereas tests of respiratory impairment in a laboratory situation can predict dysfunction level reasonably well, a complete description of the function will depend in part on judgement, and in part on the motivation and attitude of the individual. Subject participation is an integral part of all evaluations.