BACKGROUND: The purpose of this study was to assess the impact of bronchiectasis, anxiety and depression, and parameters of disease severity on health-related quality of life (HRQOL) in subjects with COPD. METHODS: Sixty-two subjects with stable COPD were selected for the study. The presence of bronchiectasis in all subjects with COPD was investigated by high-resolution computed tomography. Pulmonary function tests were performed. Dyspnea was assessed using the Modified Medical Research Council (MMRC) dyspnea scale. Psychological disorders were investigated using the Hospital Anxiety and Depression Scale (HADS), and the HRQOL was examined using the St George Respiratory Questionnaire (SGRQ). RESULTS: High-resolution computed tomography revealed that 44 of 62 (70.9%) subjects with COPD had bronchiectasis. There were no differences in pulmonary function tests, symptoms, activities, impact, SGRQ total scores, and HADS scores between COPD subjects with and without bronchiectasis. Pearson correlation analyses showed that there was no significant association between the presence of bronchiectasis, bronchial wall thickness, or severity of bronchial dilatation and all subscales of the SGRQ or HADS scores. Additionally, HADS scores showed significant positive association with all subscales of the SGRQ in all subjects. In linear regression analysis, a statistically significant relationship was found between the SGRQ total score and percent-of-predicted FEV 1 , percent-of-predicted diffusing capacity of the lung for carbon monoxide, MMRC score, and anxiety score, but the SGRQ total score was not associated with age, body mass index, total number of hospitalizations, P aO 2 , or depression score. CONCLUSIONS: The presence of bronchiectasis in subjects with COPD does not impact HRQOL and psychological disorders. However, disease severity, dyspnea levels, and anxiety scores predict poor HRQOL. Key words: chronic obstructive pulmonary disease (COPD); health-related quality of life (HRQOL); anxiety; depression; bronchiectasis. [Respir Care 2015;60(11):1585-1591
Bite wounds in the nose region may lead to serious esthetic problems and functional losses. The authors describe a dog bite to his nose, resulting in a defect involving the entire tip of the nose and a part of the surrounding subunits. He was repaired with forehead flap and auricular conchal cartilage acutely. To the authors’ knowledge, there are very few cases of acute repair in the literature. The authors also made a literature review on this subject.
AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and 32 controls. Measures included each patient completed a questionnaire regarding sleep, Adult ADHD scale. Clinical information, body mass index, 36-item Short Form Health Survey (SF-36), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and polysomnography.The subjects with Apnea-Hypopnea Index (AHI) ≥ 5 events/h were defined as patients with OSA. The control group was accepted as individuals with AHI > 0 events/h. The prevalence of adult ADHD was not different between the patients with OSA and the control group [(7.4 % (6/75) vs. 6.3 % (2/30), p = 0.8, respectively]. OSA patients with ADHD, as compared with those without, had higher anxiety scores and poorer physical component scores of quality of life and higher ESS scores. ADHD scores in patients with OSA were associated with anxiety and depression scores and SF36 physical and mental component scores in bivariate analyses. Thus, in our sample ADHD was not a frequent illness in adult patients with OSA. However, in patients with OSA and ADHD higher levels of anxiety and daytime sleepiness and poorer quality of life was found.
Present study indicated that patients with OSAS compared to snorers displayed significantly more hyopchondriasis and psychopathic deviance personality characteristics. The daytime functions in individuals with sleep-disordered breathing may be influenced by the severity of psychopathology.
Thinning of the skin flap is recommended in patients with a scalp thickness ≥ 7 mm to provide effective transmission, minimalized power requirement, and magnet retention. Suprafascial placement of the receiver coil can be recommended in patients with a thick scalp without any excisional thinning impairing integrity and vascularity of the skin.
Nasal irrigation with the LPHVNS+FP combination during the early postoperative period following septoplasty is an effective method, resulting not only in increased patient satisfaction and nasal air flow but also in decreased edema and crust formation.
The aim of this study is to show if cyclosporine has an antiallergic role in a rat model of ovalbumin-induced allergic rhinitis. The 54 rats were divided into six equal groups. The first group was a negative control group without induced allergic rhinitis; the second group a positive control with induced allergic rhinitis not receiving treatment. The remaining four groups, after induction of allergic rhinitis, received intranasal cyclosporine treatment in doses of 0.05, 0.1, or 0.2% or nasal steroid treatment. In the biochemical examination, on the surface of the tissue tumor necrosis factor (TNF) interferon (IFN), interleukin (IL)-5, IL-13, as well as IL-2, IL-4, IL-17A, and IgE were studied. Histologically, ciliary loss, increase of goblet cells, vascular congestion, and the degree of eosinophil infiltration were rated. In all treatment groups, on average, a significant reduction in all histological and biochemical values was found compared to the positive control group. Comparing each of the three cyclosporine-using groups with the group of nasal corticosteroid did not show any significant difference in the average scores. Cyclosporine nasal drops are effective to be used in an animal model of experimental allergic rhinitis without systemic effects.
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