Use of the Nijmegen Questionnaire in asthma.

http://ow.ly/P60J7.

The Nijmegen Questionnaire and dysfunctional breathing.

http://ow.ly/MBJj1.

Metabolic acidosis improves airway conductance in patients with asthma.

The objective was to investigate whether acute metabolic acidosis could cause bronchodilation in patients with asthma. Twelve patients with asthma (8 females, mean age 39 (+/- SD 12) years, forced expiratory volume in 1 second [FEV(1)] 93 [+/-9] % predicted, PC(20) 1.9 (+/-1.

Respiratory muscle strength and muscle endurance are not affected by acute metabolic acidemia.

Respiratory muscle fatigue in asthma and chronic obstructive lung disease (COPD) contributes to respiratory failure with hypercapnia, and subsequent respiratory acidosis. Therapeutic induction of acute metabolic acidosis further increases the respiratory drive and, therefore, may diminish ventilatory failure and hypercapnia. On the other hand, it is known that acute metabolic acidosis can also negatively affect (respiratory) muscle function and, therefore, could lead to a deterioration of respiratory failure.

An Integral assessment framework of health status in chronic obstructive pulmonary disease (COPD).

Background: To date, many health status instruments exist, but the validity of these instruments is questionable. This is caused by the fact that health status is poorly defined.

Purpose: To develop a validated framework that improves conceptual insight into health status and its domains.

Are asymptomatic airway hyperresponsiveness and allergy risk factors for asthma? A longitudinal study.

Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, but it is unclear whether asymptomatic AHR is associated with a higher risk of asthma. The present study assessed whether there is an association between asymptomatic AHR in adolescence and asthma in adulthood. The association between allergy and development of asthma was also investigated.

Early intervention with inhaled corticosteroids in subjects with rapid decline in lung function and signs of bronchial hyperresponsiveness: results from the DIMCA programme.

Background: Asthma is generally accepted as an inflammatory disease that needs steroid treatment. However, when to start with inhaled steroids remains unclear. A study was undertaken to determine when inhaled corticosteroids should be introduced as the first treatment step.

Occupational health and general practice: from opportunities lost to opportunities capitalised?

Background And Aim: Western populations are in the middle of the epidemiological transition of chronic diseases. Care of patients with chronic disease is directed at optimising life expectancy and quality of life. Daily and social functioning, including paid work are part of the treatment objectives.

Exercise performance improves in patients with COPD due to respiratory muscle endurance training.

Background: Impaired exercise tolerance is frequently observed in patients with COPD. Respiratory muscle endurance training (RMET) by means of normocapnic hyperpnea can be used to improve respiratory muscle function and probably exercise capacity. RMET is not applied on a large scale because complicated equipment is needed to maintain carbon dioxide homeostasis during hyperpnea, which can also be done by enlarging the dead space of the ventilatory system by breathing through a tube.

Vocational and working career of asthmatic adolescents is only slightly affected.

Introduction: The aim of this study was to investigate whether teenagers and adolescents (10-22 years) with asthma or asymptomatic bronchial hyperresponsiveness, were more likely to experience vocational or professional career limitations in the future, as compared to non-asthmatic contemporaries.

Methods: Data were used from a 14-year follow-up study in general practice, investigating the relationship between respiratory health in childhood and adolescence. At follow-up, the respiratory health status and information about career limitations were obtained.

Impact of a maximal exercise test on symptoms and activity in chronic fatigue syndrome.

Objective: This study examined the effects of exercise on symptoms and activity in chronic fatigue syndrome (CFS).

Methods: Twenty CFS patients and 20 neighborhood controls performed an incremental exercise test until exhaustion. Fatigue, muscle pain, minutes spent resting, and the level of physical activity were assessed with a self-observation list.

Knowledge about asthma and COPD: associations with sick leave, health complaints, functional limitations, adaptation, and perceived control.

We sought to investigate associations between knowledge about the disease and sick leave, health complaints, functional limitations, adaptation and perceived control. Patients with asthma (n = 101) and COPD (n = 64) underwent lung function tests and completed questionnaires. In addition, all were asked the question: 'what is the diagnosis of your disease?', with the response categories: 'asthma' and 'COPD (chronic bronchitis or emphysema)'.

Tube breathing as a new potential method to perform respiratory muscle training: safety in healthy volunteers.

Normocapnic hyperpnea has been established as a method of respiratory muscle endurance training (RMET). This technique has not been applied on a large scale because complicated and expensive equipment is needed to maintain CO(2)-homeostasis during hyperpnea. This CO(2)-homeostasis can be preserved during hyperpnea by enlarging the dead space of the ventilatory system.

Sick leave in workers with asthma and COPD: the role of attitudes, perceived social norms and self efficacy.

We investigated associations of sick leave in 165 workers with asthma and COPD with three components of the Model of Planned Behavior (MPB): attitudes, social norms towards sick leave, and perceived control over sick leave and over health complaints. All participants underwent lung-function tests and completed questionnaires on sick leave, and on the MPB-components. Differences were calculated between high and low sick leave (frequency and duration) for the total group of asthma and COPD and separately for asthma and COPD.

Predictors of changes in sick leave in workers with asthma: a follow-up study.

Objective: The aim of this prospective study was to investigate predictors of 1-year changes in sick leave in workers with asthma.

Methods: The initial cohort consisted of 111 workers with asthma. One-hundred and one participants completed the follow-up after 1 year.

Bronchial challenge, assessed with forced expiratory manoeuvres and airway impedance.

Objective: The Methacholine concentration at which a 20% decrease of the forced expiratory volume in 1s (PC20_FEV1) or a 40% increase in airway resistance (PC40_Rrs6) occur are accepted indicators for airway hyperresponsiveness. We hypothesised that the level of detection of bronchial hyperresponsiveness will differ between the two methods.

Methods: The response to Methacholine was assessed by forced oscillation technique (FOT) and spirometry in 20 stable hyperresponsive asthmatics.

Sick leave in patients with obstructive lung disease is related to psychosocial and work variables rather than to FEV1.

The aim of this exploratory study was to investigate associations between sick leave in workers with asthma or COPD and disease-related variables, psychosocial variables, and work characteristics. Hundred and eighty-nine patients with physician-diagnosed asthma (N=118) or COPD (n=71) who had paid work in the past 12 months completed questionnaires on sick leave, health complaints, functional limitations, work characteristics and psychosocial issues, and underwent a pulmonary function test (FEV1 and FVC before and after bronchodilation). Logistic regression analyses were performed to investigate variables independently associated with high sick leave (i.

Survival of chronic hypercapnic COPD patients is predicted by smoking habits, comorbidity, and hypoxemia.

Study Objectives: Chronic hypercapnia in patients with COPD has been associated with a poor prognosis. We hypothesized that, within this group of chronic hypercapnic COPD patients, factors that could mediate this hypercapnia, such as decreased maximum inspiratory mouth pressure (P(I(max))), decreased maximum expiratory mouth pressure (P(E(max))), and low hypercapnic ventilatory response (HCVR), could be related to survival. Other parameters, such as arterial blood gas values, airway obstruction (FEV1), body mass index (BMI), current smoking status, and the presence of comorbidity were studied as well.

Flow-volumes indices as means to discriminate between intra- and extrapulmonary restrictive disease.

Restrictive lung disease comes in two major categories: (1) intrapulmonary (= parenchymal) disease caused by fibrotic reactions or (2) extrapulmonary (= compression), like in heart failure. In the first category the conducting airways, tethered in stiffened structures, are less likely to be compressed during forceful expiration and expiratory flows hence are expected to remain high. This could serve as a cheap and easy diagnostic, avoiding more complicated measures.

Employment status and quality of life in patients with chronic obstructive pulmonary disease.

Objectives: Recently, the conditions for disability benefits were redefined in several countries, stimulating employees to participate on the labour market as long as reasonably possible. Little is known of labour participation and quality of life (QoL) of employees with chronic diseases. This study examines the associations between employment status and QoL in COPD patients.

Ventolin Diskus and Inspyril Turbuhaler: an in vitro comparison.

Dose delivery (total emitted dose, or TED) from dry powder inhalers (DPIs), pulmonary deposition, and the biological effects depend on drug formulation and device and patient characteristics. The aim of this study was to measure, in vitro, the relationship between parameters of inhalation profiles recorded from patients, the TED and fine particle mass (FPM) of Diskus and Turbuhaler inhalers. Inhalation profiles (IPs) of 25 patients, a representative sample of a wide range of 1500 IPs generated by 10 stable asthmatics, 3 x 16 (mild/moderate/severe) COPD patients and 15 hospitalized patients with an exacerbation asthma or COPD, were selected for each device.

Salbutamol pMDI gives less protection to methacholine induced airway obstruction than salbutamol via spacer or DPI.

Background: Inhalation device and inhalation technique influence the deposition of drug in the lung. This study evaluated the efficacy of salbutamol as a bronchoprotective agent administered via Diskus, Turbuhaler, pMDI or pMDI + Volumatic against methacholine-induced bronchoconstriction.

Methods: Twenty stable asthmatics participated in this open randomised comparison of the protective effects of 200 microg salbutamol, administered via the various inhalation devices on methacholine-induced airway obstruction, with respect to pulmonary function and dyspnoea sensation.

The course of inhalation profiles during an exacerbation of obstructive lung disease.

Background: Acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD) are associated with increased airflow Limitation, hyperinflation and respiratory muscle fatigue. It is unclear, whether patients are able to perform adequate inhalations through various inhalation devices with different orfices during an exacerbation. The aim of this study was to examine the evolution of inhalation profiles of patients inhaling through Diskus, Turbuhaler, pressurized metered dose inhaler (pMDI) and Volumatic and consequently the appropriateness of using the various devices during an exacerbation.

Tremor side effects of salbutamol, quantified by a laser pointer technique.

Objective: To study tremor side effects of salbutamol an easily applicable, quick and low-priced method is needed. A new method using a commercially available, pen-shaped laser pointer was developed. Aim of the study was to determine sensitivity, reproducibility, reference values and the agreement with a questionnaire.

Asthma and chronic obstructive pulmonary disease: differences between workers with and without sick leave.

Objective: Determinants of sick leave should be investigated before interventions to reduce sick leave can be designed. This cross-sectional study compares employees with asthma and chronic obstructive pulmonary disease (COPD) with and without sick leave.

Methods: One hundred and eighteen participants with asthma and 71 with COPD underwent a lung function test [one-second forced expiratory volume (FEV1), forced vital capacity (FVC)] and completed questionnaires on health complaints, work characteristics, demographic and psychosocial variables, and self-reported sick leave in the past 12 months.