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Diagnosing GORD in Respiratory Medicine.

Diagnosing GORD in Respiratory Medicine.

Front Pharmacol. 2011;2:40

Authors: Timms CJ, Yates DH, Thomas PS

Abstract
Gastroesophageal reflux disease (GORD) is increasing in prevalence and is highly associated with several lung diseases such as asthma and COPD. Current diagnostic methods are imperfect, being insensitive, non-specific, expensive, or invasive. An accurate diagnosis of GORD can aid effective treatment and have significant clinical impact. Novel methods such as exhaled breath condensate analysis and electronic nose technology have the potential to improve the accuracy of diagnosing GORD.

PMID: 21811465 [PubMed - in process]

PCR for detection of respiratory viruses: seasonal variations of virus infections.

PCR for detection of respiratory viruses: seasonal variations of virus infections.

Expert Rev Anti Infect Ther. 2011 Aug;9(8):615-26

Authors: Olofsson S, Brittain-Long R, Andersson LM, Westin J, Lindh M

Abstract
Real-time PCR and related methods have revolutionized the laboratory diagnosis of viral respiratory infections because of their high detection sensitivity, rapidness and potential for simultaneous detection of 15 or more respiratory agents. Results from studies with this diagnostic modality have significantly expanded our knowledge about the seasonality of viral respiratory diseases, pinpointed the difficulties to make a reliable etiologic diagnosis without the aid of an unbiased multiplex molecular assay for respiratory viruses, and revealed previously unknown details as to possible infections with multiple agents as aggravating factors. The scope of this article is to review and discuss this new knowledge and its implications for diagnostic strategies and other measures essential for the clinical management of respiratory viral infections and for epidemiological surveillance of seasonal respiratory infections.

PMID: 21819328 [PubMed - in process]

Non-communicable diseases and their importance in low and middle income countries.

Non-communicable diseases and their importance in low and middle income countries.

Prim Care Respir J. 2011 Sep;20(3):248-9

Authors: Williams S, Rodriguez MR

PMID: 21847506 [PubMed - in process]

The effects of inhaled formoterol on the autonomic nervous system in adolescents with asthma.

BACKGROUND: The safety of long-acting beta-2-adrenergic agonists is increasingly questioned by physicians. Although formoterol is frequently used in childhood, its effects on the autonomic cardiovascular system have not been studied.

OBJECTIVE: To investigate the effects of inhaled formoterol on autonomic nervous system using heart rate variability in adolescents with persistent asthma.

METHODS: Electrocardiography of 20 asthmatic adolescents (12-20 years) was monitored for 5 specific days. The first day served as basal measurement, and the 2nd and 3rd days reflected the effects of a single and 2 doses of formoterol, respectively. From days 4 to 29, patients received regular treatment with formoterol/budesonide and were monitored on days 30 and 31 to evaluate the development of cardiac and respiratory tolerance after single-dose and 2 doses of formoterol, respectively. Electrocardiographs were analyzed for heart rate, heart rate variability (both time and frequency domain parameters), and spirometry tests were performed.

RESULTS: Inhalation of single-dose formoterol increased heart rate and decreased heart rate variability parameters (ratio of the normal-to-normal [NN] interals changing in excess of 50 ms to total of NN intervals [pNN50], total power [TP][ms], TP[ln]) compared with the corresponding baseline values during the first 12 hours of the day. The heart rate variability parameters (pNN50, TP[ms], TP[ln], root mean square of differences between adjacent NN intervals) during the first 12 hours were increased on the 30th day compared with the 2nd day and decreased on the 31st day compared with the 30th day.

CONCLUSION: Single-dose formoterol inhalation decreases cardiovagal responsiveness and increases the sympathetic tone in cardiac autonomous control, and regular use of formoterol causes development of tolerance to these effects. However, additive doses of formoterol cause loss of this tolerance.

Evaluation of Respiratory Viral Pathogens in Acute Asthma Exacerbations during Childhood.

Common upper respiratory tract viruses are the most frequent and important causes of asthma exacerbations in both children and adults. Prospective epidemiologic studies report that up to 80% of childhood exacerbations are associated with viral upper respiratory tract infections.

Materials and methods. The study group consisted of 104 children with asthma aged 3-17 years who received treatment for asthma exacerbations in our clinic between September 2009 and 2010. Nasopharyngeal and nasal swabs were obtained from all patients during an acute attack, and from the control group (31 subjects). These specimens were investigated for the presence of viral respiratory pathogens using a real-time multiplex PCR method. The patients were compared for the presence of respiratory pathogens and factors related to the severity of the asthma exacerbation.

Results. A pathogenic respiratory virus was detected in 53.8% of patients in the acute exacerbation group. The most commonly encountered viral agent was Rhinovirus (35.6%). Patients who had an acute exacerbation with or without a detectable viral pathogen were compared according to the severity of the exacerbation, the need for systemic steroids, and hospitalization rates. No statistically significant difference was found.

Conclusion. Although viral upper respiratory tract infections are the most common cause of asthma exacerbations, the severity level of the exacerbation seems to be independent of whether a respiratory virus has been detected.

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