Respiratory Diseases

Objective: The aim of this clinical review was to have an in-depth knowledge of the antibiotics being used to treat lower respiratory tract infections which are most likely to occur in the pediatric population of different age groups. Methods: This study analyzed 43 articles which were studied and identified according to the research criteria. The required data has been searched using research gate, ncbi, Medscape, Mayo Clinic, WebMD. Results: The findings included different levels of effectiveness in the 5 generations of cephalosporin's as some killed certain bacteria's better than others and are relatively short acting with half-life of about 30-120 minutes when compared to penicillin. For example, first generation cephalosporin's were quite active against gram positive bacteria when compared to gram negative bacteria however, the efficacy was reduced due to resistance. It was discussed regarding second generations that they are effective against both gram negative and gram-positive bacteria and are resistant to B-lactamase more than the first generations, therefore have a high anti-bacterial activity. As far as the third and fourth generations were concerned, they were able to penetrate the blood-brain barrier and were frequently designed for bacterial meningitis which were caused by susceptible pathogens. Fifth generations have a similar mechanism of action as that of the 3 rd generations and can treat resistant staphylococcus aureus and streptococcus species which are resistant to penicillin antibiotics. On the other hand, Carbapenems (penetrates bacterial cell wall of microorganisms and inhibits cell wall synthesis) and aminoglycosides (inhibits protein synthesis by binding to bacterial ribosomes and inducing misreading of the of the genetic code) are one of the most highly efficacious as they prevent severe and high risk bacterial infections although, rare incidents of toxicity and life threatening side effects have been reported when taken aminoglycosides. Conclusion: Penicillin is the safest to treat and prevent the lower respiratory tract infections in the pediatric population as they have minor side effects such as headache, nausea compared to other antibiotics.

Chronic obstructive pulmonary disease (COPD) is one of the most deadly and costly chronic diseases in the world characterized by many breathing problems. The management of COPD and the prevention of exacerbations are a priority goals to improve the quality of life in patients affected by this illness. In addition, it is also crucial to improve the patients' adherence to care which, in turn, depends on their knowledge and understanding of some factors such as the prescribed medical treatment, changes in dailylife, and the process of breathing. In turn, the adherence to care leads to greater autonomy for the patient who is thus able to better manage his illness. Here we presented the application of the Model IARA in patients affected by COPD in order to achieve their autonomy in illness management which, in turn, leads to a better quality of life. IARA is an intervention program which improve the awareness and knowledge of patients with respect to both the disease and symptoms through health education. Moreover, through IARA the patients are encouraged to become more actively involved in COPD care process, also regarding drug therapy adherence. Using St. George's Respiratory Questionnaire combined with qualitative analysis, we demonstrated that IARA could be considered a useful approach in COPD management.

DECLARATION We, Marie Jeanne NYIRABAGENZI and Theophile NIZIGIYIMANA, hereby declare that this project is based on results found by ourselves. Material of this work found by others or taken from other sources have been stated or mentioned in reference list. To the best of our knowledge, this project "design and implementation of carbon monoxide protection using arduino with alarm" has never been presented or submitted to any other university or institutions or college of higher learning for the award of any degree. We therefore declare that this work is our own contribution for the partial fulfillment of the award of the ordinary diploma in Electronic and Telecommunication in TCT. Signature……………… Signature………………… Marie Jeanne NYIRABAGENZI Theophile NIZIGIYIMANA TC 20150159 TC

Introduction: Rapid urban population growth and
physical development has given significant pressure
to the environment as it increase the air pollution. Air
pollution sources from human activity such as motor
vehicles and industries continue to be a serious
problem that cause harm to human health and welfare
especially in more densely populated urban areas.
The Klang Valley of Malaysia, which includes the largest city of Kuala Lumpur and the new capital city
of Putrajaya, is one such area. This study aims to
investigate the level of outdoor air pollution and
incidence of acute respiratory infection among
children in Klang Valley.
Methods: The daily variations of air pollutants
(mean concentrations of PM10, CO, NO2, SO2, and
O3) and meteorological condition in Klang Valley
from 2007 to 2011 were obtained from Malaysian
Department of Environment. The air pollutants
concentration were analyzed and compared with the
Recommended Malaysian Ambient Air Quality
Guideline. Data on daily acute respiratory infection
were obtained from particular District Health Offices
in Klang Valley. All these data were examined by
using Statistical Package of Social Sciences (SPSS)
and Geographical Information Systems (GIS)
software to determine the association between the air
pollutants and the incidence of acute respiratory
infection. Besides, the software was used to
determine the contributing factors for increasing air
quality data and health registry data. The data then
integrated into the software to build digital
topographic map and model of the emergence of ARI
with regards to air pollution and other factors.
Results: There are significant differences of air
pollution level and incidence of acute respiratory
infection between cities in Klang Valley.
Conclusion: There is a significant relationship
between the outdoor air pollution and incidence of
ARI among children.
Keywords: air pollution, acute respiratory infection,
GIS, children

The Dangerous Red Bacili (TBC)
Tuberkulosis (TB) adalah penyakit infeksi menulura yang diesebabkan oleh Mycobacterium tuberculosis. Kuman batang aerobik dan tahan asam ini, dapat merupakan organisme patogen maupun saprofit. Ada beberapa mikobakteri patogen, dan yang patogenik terhadap manusia.

Chronic Obstructive Pulmonary Disease (COPD) adalah Penyakit kronis paru paru yang disebabkan oleh kerusakan paru paru yang tidak bisa lagi disembuhkan. Penyakit ini sangat erat hubungannya dengan asap rokok yang dihirup baik oleh perokok atau pun orang disekitarnya yang juga menghirup asap rokok tersebut secara berkepanjangan.

-----ÖZET: Yirminci yüzyıl başından bu yana dünyada respiratuvar virüslerden kaynaklanan beş pandemi gerçekleşmiştir. Bunlardan ilk dördü grip (İnfluenza A) virüslerinden kaynaklanmışken halihazırda sürmekte olan COVID-19 pandemisi bir koronavirüs suşundan ileri gelmiştir. 1918 tarihli “İspanyol gribi” pandemisi dünya genelinde yaklaşık 500 milyon kişiyi kapsamış ve 40–100 milyon ölümle sonuçlanmış olup, bugün respiratuvar viral pandemiler için olabilecek “en kötü senaryo” kabul edilmektedir. Halihazırdaki COVID-19 pandemisi de Aralık 2019’dan bugüne (Nisan 2020), >1,2 milyon vaka ve >60 bin ölümle sürmektedir. Bu pandemide, virüsün türü (yeni ve pandemik bir SARSr-CoV suşu) ve konağın yaşı (>50–60 yaş) temelinde daha yüksek mortaliteli, yeni bir “koronavirüs hastalığı” gözlenmekte olup tıp (başta epidemiyoloji ve halk sağlığı) tarihinde yeni bir sayfa açılmıştır. Yanı sıra, 1918’de olduğu gibi yüz yıl sonra bugün de halen efektif bir anti(korona)viral tedavi bulunmamakta ve bu çaresizliğin klinik, sosyolojik, psikolojik ve makroekonomik sonuçları dünyada ve ilk resmi vakanın 11 Mart’ta kaydedildiği Türkiye’de şimdiden derinden hissedilmektedir. Ayrıca, yine 1918 pandemisinin mortalitenin giderek arttığı üç dalga halinde seyretmiş olduğu gibi, COVID-19 pandemisinde de gelecek haftalarda daha sarsıcı bir epizodun başlaması endişe edilen ihtimaller arasındadır. Bu yazıda katastrofik 1918 pandemisi esnasında yaşananlardan hareketle önümüzdeki COVID-19 sürecinde yaşanabilecek olanlara dair bir mukayese yapmak ve sonuçlar çıkarmak, önümüzdeki risklerin (başta virülansı ve dolayısıyla mortaliteyi artırabilecek bir viral mutasyon) ciddiyetini vurgulamak ve böylece T.C. Sağlık Bakanlığı başta olmak üzere pek çok ulusal ve küresel sağlık otoritesi tarafından çeşitli medya kanalları aracılığıyla yinelenmekte olan sosyal izolasyon çağrısını desteklemek amaçlanmıştır.

-----ABSTRACT: Since the early 20th century, the world has seen five pandemics caused by respiratory viruses. While the first four of these were caused by flu (Influenza A) viruses, the ongoing COVID-19 pandemic is due to a coronavirus strain. Now considered a “worst-case scenario” for respiratory viral pandemics, the “Spanish flu” of 1918 afflicted about 500 million people and resulted in 40–100 million deaths worldwide. Since December 2019 to date (April 2020), the current COVID-19 has been confirmed in >1.2 million cases and >60 thousand deaths around the globe. A new “coronavirus disease,” with a higher mortality based on the type of the virus (a novel, pandemic SARSr-CoV strain) and host age (>50–60 years), has been identified during this global health crisis, opening a new period in the history of medicine, particularly epidemiology and public health. Furthermore, today, one hundred years after 1918, there is still no effective anti(corona)viral treatment, with its clinical, sociological, psychological, and macroeconomic impacts being already felt around the world and in Turkey, where the first official case was reported on 11 March. Also, there is the worrisome possibility that the COVID-19 pandemic may develop into an even more serious problem in the following weeks, similarly to the 1918 pandemic that occurred in three waves marked by increasingly higher mortality. In this study, we aimed to infer from the experience of the catastrophic 1918 pandemic for the rest of the ongoing COVID-19 calamity, highlight the imminent risks (most notably, viral mutation that could result in higher virulence and mortality), and thus support the calls for social isolation, repeated through various mass media by many global and national health authorities, particularly the Turkish Ministry of Health.

The world has experienced several epidemics posing serious threat to global public health, including the 2002 severe acute respiratory syndrome (SARS) epidemic that caused 800 deaths out of about 8 000 cases, the 2009 H1N1 pandemic with 18 500 deaths, the 2012 Middle East respiratory syndrome (MERS) epidemic that caused 800 deaths out of 2 500 cases, the 2014 Ebola outbreak with 28 616 cases and 11 310 deaths, and the current coronavirus disease (COVID-19) pandemic with more than 35 000 deaths out of over 730 000 confirmed cases till now. Emerging infectious diseases continue to infect and reduce human populations. The COVID-19 pandemic has spread to more than 114 countries before it was officially declared as a pandemic by the WHO on the 11th March 2020. Here, the first set of index cases in Africa and the differences between SARS-CoV-2 and other coronaviruses in addition to the preventive strategies on the emergence of COVID-19 were reviewed.

Objectives: To determine antimicrobial resistance pattern of P.aeruginosa in regional tertiary carehospitals of Saudi Arabia.

Method and materials: A total of 121 clinical isolates of P.aeruginosa from eight different hospitals were studied. The clinical data of the patients was collected using a predesigned questionnaire. All isolates were identified as P.aeruginosa using standard bacteriological methods and API 20E kits. Antibiotic susceptibility testing was performed by disk diffusion method recommended by Clinical and Laboratory Standards Institute.

Results: Majority of P.aeruginosa isolates were from patients suffering from respiratory tract infections (43.8%), followed by wound infections (21.5%). The overall drug resistance data of 121 P.aeruginosa strains showed low to moderate resistance to all drugs tested (4.9% to 30.6%). The highest resistance was exhibited by meropenem (30.6%) followed by ticarcillin (22.3%), imipenem (19%), and piperacillin (17.3%). Piperacillin-tazobactam showed lowest resistance (4.9%). Irrespective of site of infection, P.aeruginosa strains showed high resistance to meropenem followed by ticarcillin and imipenem. About 13.2% strains were multidrug resistant.

Conclusion: This study showed low to moderate rate of drug resistance in P.aeruginosa. Resistance rate <10% to amikacin, cefepime and piperacillin-tazobactam is encouraging for the treatment of pseudomonal infection. Continuous monitoring of antimicrobial susceptibilities at each hospital is important to help in deciding the most adequate therapy for P.aeruginosa infection and to know the developing resistance pattern.

Vokal kord paralizileri larinksin farklı fonksiyonlarını çeşitli derecelerde etkileyen, her yaşta görülebilen bozukluklardır. Klinik tablo, problemin tek veya iki taraflı olmasına ve hastanın yaşına göre değişir. Genel olarak iki taraflı paralizilerde solunumla, tek taraflı paralizilerde sesle ilgili belirtiler ön planda olmakla birlikte, pediyatrik yaş grubunda hemen her zaman solunum yetersizliğine ait semptomlar ve bulgular klinik tabloyu belirler. Bu nedenle yenidoğanlarda ve daha büyük çocuklarda solunum yetersizliği tablosu karşısında vokal kord paralizisi ihtimali düşünülmeli, bunun için gerekli tanı yöntemleri kullanılmalı ve tedavi ona göre planlanmalıdır. Bu gözden geçirme makalesinde çocuklarda görülen tek veya iki taraflı vokal kord paralizilerinin semptomları ve bulguları, etiyolojisi, tanı ve tedavi yöntemleri tartışılacaktır.

Given the lack of knowledge of the etiology, pathogenesis and natural history of
IPF, it is perhaps not surprising that that there is a lack of high quality evidence
for the 'standard' treatments currently in use. In such a scenario the ideal therapy
for IPF is still awaited. The present article reviews the potential role of
doxycycline as a novel therapeutic option in the treatment of IPF substantiated by
results of relevant studies on doxycycline. The Matrix metalloproteinases (MMP)
inhibitor property of doxycycline may help it gain its role in IPF in years to come.

Upper respiratory tract infections (URTIs) have been regarded as the most frequent illnesses affecting people worldwide. Several factors contributing to the widespread occurance of URTIs may be attributed to breathing of contaminated air, direct contact with infected people, over-crowded places, cigarette smoking and exposure to pathogens. URTIs can be characterized by a group of disorders which include common cold, pharyngitis, tonsillitis, epiglottitis, sinusitis, bronchitis, rhinitis, and nasopharyngitis, which significantly occurs in upper respiratory tract. URTIs have been known to be caused by either viruses and bacterias; or combination of both. This review article has been aimed to discuss the incidences and types of various URTIs.

Background: PM10 is suspended particles in atmosphere with aerodynamic diameter of 10
micrometres or less. It can penetrate to the lungs and risks the respiratory system. Acute respiratory
infection (ARI) is one of the respiratory system disease related to PM10 concentration. The
primary sources of PM10 are from traffic road, agriculture area, construction sites and industrial
area. Klang valley is a premier city which holds industrial development, infrastructure housing and
business center.
Objective: This paper highlights the spatial correlation of PM10 and ARI incidence among
children in eight major cities of Klang Valley from 2007 to 2011.
Methodology: Secondary data of PM10 were obtained from eight water quality monitoring
stations, Department of Environment and ARI incidence data were obtained from Malaysian
Ministry of Health. An interpolation method in Geographical Information Systems (GIS) software
was used to generate the pattern of PM10 concentration. The map was overlaid to the incidence of
ARI map and was analysed for the correlation.
Results: The highest monthly concentration of PM10, 95.42 ± 17.27μg/m3 was recorded in Klang
in July 2009. The overlaid map has determined a correlation between the ARI incidences with the
PM10 concentration especially in high density population area. An increase number of ARI cases
were determined in Klang Valley area as the PM10 concentration increased.
Keywords: Particulate matter (PM10), acute respiratory infection (ARI), children, GIS, Klang
valley

Background: In the midst of COVID-19, healthcare specialists and researchers worldwide have been actively investigating treatments for this new disease. As of July 3rd, 2020, there have been a total of 11,048,509 confirmed cases in more than 188 countries and regions with more and more cases being identified every day. Though there have been a couple of medications given EUA status by the FDA such as chloroquine and hydroxychloroquine, remdesivir, and Fresenius Propoven, some of these treatments have been found to carry substantial health risks. Chloroquine and hydroxychloroquine, for example, were found to cause abnormal heart rhythms and facilitated higher rates of death among patients in clinical trials. For this reason, a more natural option such as vitamin D has the potential to be safer and more effective in the prevention of SARS-CoV-2 symptoms.

Objective: In this study, we investigate the benefits of vitamin D supplementation as shown in previous clinical trials involving respiratory illnesses and discussed which foods are most rich in vitamin D. Ultimately, we aim to provide an understanding of the mechanisms by which vitamin D is acquired and the most effective amounts that people should regularly consume in order to strengthen their immune system.
Methods: All of the case studies cited in this review were found through Google Scholar or NCBI by search queries such as “Vitamin D supplementation to treat respiratory illness.” From over 48,000 results, we further searched for clinical trial studies on human subjects which had already been completed. Additional information regarding vaccinations and medications was sourced from the FDA and information about the nutritional value of foods was obtained from the USDA.

Results: Vitamin D has been shown to have many beneficial effects on patients suffering from both respiratory and non-respiratory illnesses. These benefits include, but are not limited to, lowered susceptibility to infection and lower bacterial counts, reduced symptoms of illness, increased serum 25(OH)D, and corrected vitamin D deficiency.

Conclusions: Given the striking symptomatic, molecular, and pathological similarities between infection from SARS-CoV-2 and other respiratory illnesses such as influenza, the positive results from vitamin D supplementation suggest that vitamin D may be a viable prevention option for SARS-CoV-2 symptoms. Through the consumption of vitamin D-rich foods like UV-exposed mushrooms, salmon, and trout, low serum 25(OH)D levels could be corrected, and the reduction of symptoms could be naturally facilitated. Through the induction of cathelicidin and defensin, the regulation of cytokines, and the increased production of anti-microbial peptides, vitamin D has the potential to act as a natural prevention option without adverse side-effects like those caused by chloroquine and other proposed drugs.

Keywords: Vitamin D; Deficiency; Respiratory Illness; COVID-19; Influenza; Cathelicidin; Defensin; SARS-CoV-2; ACE2; ANG II.

It is vital to know how to perform and and what to infer from the findings here below are explained in way that that correlates your medical exams as well as our disgnosis for the various pathology step by step The physical examination of the chesst ,thorax and its related areas must be expanded beyond a minimal screening examination to determine the nature of the problem so that a diagnosis can be made. Conditıon and tecnique 1) The environment and The setting for eaminatıon must be comfortable for both clinician and patient 2) The physical examination should start with history taking • The examiner should greet the patient • reason for discomfort or disesase (ie. What brought then to there ,hospiatal) • assessing degree of comfort, inspecting and palpating the hands gently • evaluations of the physical appeareence and condtions should be initiated, the diagnosis should be clear 3) The pulmonary examination consists of inspection, palpation, percussion, and auscultation Palpation can be confirmed by percussion, assessing for tenderness and degree of chest expansion. Auscultation is a more sensitive and sofisticated process confirms earlier findings and may help to identify specific pathologic processes not previously recognized İnspection It starts with the initial greeting and continues uninterruptedly during the entire data collection process the observation plays a vital role, the dynamics of the patient's facial expression in relationship to physiologic activities like inspiration and expiration etc and to the questions asked by the examiner.observe • The use of pursed lips during expiration • the activity and development of the sternocleidomastoid muscles • the use of other accessory muscles of ventilation • the presence of shoulder girdle fixation in relationship to the use of these accessory muscles • Flaring of the nasal alae • The presence of jugular venous distention • the degree of comfort , cyanosis and clubbing • İnspection of the mouth , buccal cavity ,teeth (extensive pyorrhea may indicate extensive pyorrhea) • assesment of the level of consciousness and the appropriateness of behavior may lead one to suspect a primary pulmonary process that secondarily produces alterations of central nervous system function for examples are respiratory acidosis and cerebral metastases from primary carcinoma of the lung • Clothing may also give a clue to occupation or hobby, grooming may be related to the conscientiousness with which the patient may follow a health care plan, and a bulging shirt pocket may be stuffed with an open package of cigarettes

O presente trabalho tem como tema os acometimentos do sistema respiratório relacionados à poluição atmosférica. Para um aprofundamento correto no tema é necessário aprender as generalidades desse sistema em sua homeostase para, posteriormente, compreender as alterações decorrentes de patologias. Primeiramente, é abordada a Anatomia das estruturas envolvidas no processo respiratório. Em seguida, a Histologia, demonstrando os tipos celulares, que se arranjam para formar os tecidos formadores das complexas estruturas anatômicas envolvidas na condução aerífera e trocas gasosas. Finalizando os tópicos de homeostase do organismo, a ventilação pulmonar é elucidada com seus princípios básicos de execução, evidenciando como a maquinaria respiratória se agrupa para um funcionamento eficiente. Apreendido todos esses aspectos, adentramos nas patologias relacionadas ao objetivo deste trabalho. São aqui citados os principais poluentes causadores de doenças respiratórias, além de retratar suas finalidades antagônicas ao bom funcionamento do organismo, conhecendo os mecanismos dessas alterações, são explicados, quando existem, métodos de prevenção e tratamento.

Se observó correlación negativa estadísticamente significativa entre las variables climatológicas temperatura media y humedad relativa atmosférica y las IRAG indicando que mientras descienden estas variables climatológicas aumentan los casos de IRAG

We performed a retrospective analysis spanning ten years of pediatric practice focused on patients with variable vaccination born into a practice, presenting a unique opportunity to study the effects of variable vaccination on outcomes. The average total incidence of billed office visits per outcome related to the outcomes were compared across groups (Relative Incidence of Office Visit (RIOV)). RIOV is shown to be more powerful than odds ratio of diagnoses. Full cohort, cumulative incidence analyses, matched for days of care, and matched for family history analyses were conducted across quantiles of vaccine uptake. Increased office visits related to many diagnoses were robust to days-of-care-matched analyses, family history, gender block, age block, and false discovery risk. Many outcomes had high RIOV odds ratios after matching for days-of-care (e.g., anemia (6.334), asthma (3.496), allergic rhinitis (6.479), and sinusitis (3.529), all significant under the Z-test). Developmental disorders were determined to be difficult to study due to extremely low prevalence in the practice, potentially attributable to high rates of vaccine cessation upon adverse events and family history of autoimmunity. Remarkably, zero of the 561 unvaccinated patients in the study had attention deficit hyperactivity disorder (ADHD) compared to 0.063% of the (partially and fully) vaccinated. The implications of these results for the net public health effects of whole-population vaccination and with respect for informed consent on human health are compelling. Our results give agency to calls for research conducted by individuals who are independent of any funding sources related to the vaccine industry. While the low rates of developmental disorders prevented sufficiently powered hypothesis testing, it is notable that the overall rate of autism spectrum disorder (0.84%) in the cohort is half that of the US national rate (1.69%). The practice-wide rate of ADHD was roughly half of the national rate. The data indicate that unvaccinated children in the practice are not unhealthier than the vaccinated and indeed the overall results may indicate that the unvaccinated pediatric patients in this practice are healthier overall than the vaccinated.

The Hospital Quality Institute (HQI) Mission is: to advance and accelerate patient safety and quality improvement for coordinated statewide impact, with aims to achieve zero defects, optimize clinical effectiveness, and enhance patient and family experience in health care. The purpose of this tool kit is to advance the mission by providing evidenced-based recommendations and best practices on safe and effective assessment, monitoring, and intervention for patients at risk for unrecognized respiratory depression in a non-ICU environment. In 2014, the Respiratory Monitoring of Patients Outside the ICU Guidelines of Care Tool Kit was created. Since then, health care organizations continued to strive to implement effective frontline and systematic practices that recognize and prevent respiratory depression. HQI member organizations agreed that an update of the original tool kit was needed. In 2017, a California statewide, multidisciplinary group from member hospitals and hospital systems met to review current literature, assess community practice, and provide evidence-based recommendations and best practices that reduce patient harm from respiratory depression through risk mitigation and respiratory monitoring. The result of this group’s work is the 2017 update of the 2014 tool kit. The information and tools in this tool kit are available in electronic format at www.hqinstitute.org/tools-resources.

For the full list of co-authors, see the attached pdf. Academia.edu is not allowing me to add them all.

Wheezes in the respiratory sounds are indicators for a number of diseases. Automatic detection of these signals - which have musical character and one or more dominant frequencies-is very important. In this study investigation of wheeze detection in the respiratory sounds using Hilbert-Huang transform is studied. This method allows analysis of signals which are neither stationary nor linear. Initially Intrinsic Mode Functions are found using Empirical Mode Decomposition. Instantaneous frequencies calculated using Hilbert transform of these signals were found to have distinct values with low variations, and constancy and variation of these instantaneous frequencies were affected by the power of the dominant frequencies in the wheeze.

Covid-19 has made its unexpected entrance into the world some time in late 2019 causing much fear, economic disasters, suffering and fatalities throughout the world. This paper suggests a more aggressive intervention and strategy, for humanity should not let themselves be sitting ducks waiting for the virus to attack, and some possible methods for stopping Covid-19 in its path. (Expanded & Updated)

Objective: This study aims: (1) to describe the pattern
and extent of multimorbidity and polypharmacy in UK
Biobank participants with chronic obstructive pulmonary
disease (COPD) and (2) to identify which comorbidities are
associated with increased risk of adverse drug reactions
(ADRs) resulting from polypharmacy.

Design: Cross-sectional.

Setting: Community cohort. Participants UK Biobank participants comparing self reported COPD (n=8317) with no COPD (n=494 323).
Outcomes Multimorbidity (≥4 conditions) and
polypharmacy (≥5 medications) in participants with COPD
versus those without. Risk of ADRs (taking ≥3 medications
associated with falls, constipation, urinary retention,
central nervous system (CNS) depression, bleeding or renal
injury) in relation to the presence of COPD and individual
comorbidities.

Results: Multimorbidity was more common in participants
with COPD than those without (17% vs 4%). Polypharmacy
was highly prevalent (52% with COPD taking ≥5
medications vs 18% in those without COPD). Adjusting
for age, sex and socioeconomic status, those with COPD
were significantly more likely than those without to be
prescribed ≥3 medications contributing to falls (OR 2.27,
95% CI 2.13 to 2.42), constipation (OR 3.42, 95% CI 3.10
to 3.77), urinary retention (OR 3.38, 95% CI 2.94 to 3.87),
CNS depression (OR 3.75, 95% CI 3.31 to 4.25), bleeding
(OR 4.61, 95% CI 3.35 to 6.19) and renal injury (OR
2.22, 95% CI 1.86 to 2.62). Concomitant cardiovascular
disease was associated with the greatest risk of taking ≥3
medications associated with falls/renal injury. Concomitant
mental health conditions were most strongly associated
with medications linked with CNS depression/urinary
retention/bleeding.

Conclusions: Multimorbidity is common in COPD
and associated with high levels of polypharmacy. Co-prescription
of drugs with various ADRs is common.
Future research should examine the effects on healthcare
outcomes of co-prescribing multiple drugs with similar
potential ADRs. Clinical guidelines should emphasise
assessment of multimorbidity and ADR risk.

To investigate the impact of meteorological parameters and trace gas concentrations on daily hospital walk-ins and admissions in Chiang-Mai province, Thailand, during 2007–2013. Advanced statistical models, including t-tests, Analysis of Variance (ANOVA), Multiple Linear Regression Analysis (MLRA) and Incremental Lifetime Particulate Matter Exposure (ILPE), were constructed using meteorological data from the Pollution Control Department (PCD), Ministry of Natural Resources and Environment (MNRE), Thailand, and the Thai Meteorological Department at Chiang-Mai Province Air Quality Observatory Site (TMCS) as well as the number of walk-in and admitted patients at Nakornping Hospital, Chiang-Mai (NHCM). All trace gaseous species and PM10 were significantly higher during the “haze episode” than during the “non-haze period.” The FTIR spectra highlight the relatively homogeneous organic functional compositions of PM2.5 collected from urban, suburban and rural observatory sites, indicating that agricultural waste burning plays an important role in air quality during the “haze episode.” The effect of age on susceptibility to respiratory diseases was investigated by separating the dataset into four groups (i.e., < 15 years, 15–59 years, 60–74 years and ≥ 75 years). The ANOVA results revealed a significant increase in hospital walk-ins and admissions for both genders in the < 15 years group (p < 0.005). MLRA revealed the significantly highest impacts of CO on hospital walk-ins for both genders. The predicted ILPE of PM10 showed the highest values for both genders during the “haze-episode” in 2007, with average values of 3.338 ± 0.576 g and 1.838 ± 0.317 g for male and female outdoor workers, respectively, over an exposure duration of 25 years.

[Purpose] The aim of this study was to examine the effect of kinesiology taping applied to primary and accessory respiratory muscles on respiratory muscle strength.[Subjects] The subjects were 47 healthy university students (16 female, 31 male), who were all enrolled at the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, The University of Marmara. [Methods] Participants were divided into two groups and diaphrag-matic kinesiology taping was applied to the first group and kinesiology taping to the accessory respiratory muscles of the second group. Respiratory muscle strength was measured with Micro Mouth Pressure Measurement (MPM) before and after taping.[Results] The results show that kinesiology taping of the primary and accessory respiratory muscles caused no significant increase in respiratory strength. [Conclusion] The current findings on the effect of kinesiology taping on muscular strength do not fully support the results of other studies reported in the literature. These results suggest the need for more comprehensive studies of both acute and long-term effects of kinesiology taping on muscular strength of healthy individuals and patients.