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Objective: To determine if exposure to cold environments, during work or leisure time, was associated with increased reporting of airway symptoms in the general population of northern Sweden. Methods: Through a population-based postal survey responded to by 12627 subjects, ages 18–70, living in northern Sweden, the occurrence of airway symptoms was investigated. Cold exposure during work or leisure time was self-reported on numerical rating scales. Binary logistic regression was used to determine the statistical association between cold exposure and airway symptoms. Results: For currently working subjects (N = 8740), reporting any occupational cold exposure was associated to wheeze (OR 1.3; 95% CI 1.1–1.4); chronic cough (OR 1.2; 95% CI 1.1–1.4); and productive cough (OR 1.3; 95% CI 1.1–1.4), after adjusting for gender, age, body mass index, daily smoking, asthma, and chronic obstructive pulmonary disease. Leisure-time cold exposure was not significantly associated to reporting airway symptoms. Conclusions: Occupational cold exposure was an independent predictor of airway symptoms in northern Sweden. Therefore, a structured risk assessment regarding cold exposure could be considered for inclusion in the Swedish workplace legislation. [ABSTRACT FROM AUTHOR]

To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland. In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: Västra Götaland and Norrbotten in Sweden, and Seinäjoki-Vaasa and Helsinki in Finland. The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Seinäjoki-Vaasa (14.8%) and Helsinki (14.4%) than in Västra Götaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in Västra Götaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7–8.2% versus 6.3–6.7%) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7 and 2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in Västra Götaland and Seinäjoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Seinäjoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found. The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex. [ABSTRACT FROM AUTHOR]

Background: To compare peramivir 300 mg single‐dose, peramivir 600 mg repeat‐dose, and oseltamivir effects on health‐related quality of life, including respiratory symptoms and general conditions, time to symptom alleviation, time to fever resolution, incidence of exacerbations, and virus titer, in influenza patients with chronic respiratory disease. Methods: We report additional outcomes from a 2‐week, multicenter, randomized, open‐label study in Japan (UMIN000030118). Influenza patients with chronic respiratory disease received intravenous peramivir (300 mg single‐dose [n = 66], 600 mg repeat‐dose [600 mg/d of 2 consecutive days; n = 70]) or oral oseltamivir (75 mg twice daily, 5 days; n = 72). The principal endpoint of this analysis was change from baseline to Day 14 at each time point in Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scores. Results: Both peramivir regimens reduced total CAT score at Day 3 more than oseltamivir (peramivir 600 mg vs oseltamivir, P =.0032; peramivir 300 mg vs oseltamivir, P =.0203). Cough/phlegm CAT scores were most improved with peramivir 600 mg. Median time to alleviation of three respiratory symptoms was longer with peramivir 600 mg (68.9 hours) than with peramivir 300 mg (50.6 hours, hazard ratio [HR] 1.57; P =.0191) and shorter with peramivir 300 mg than oseltamivir (78.8 hours, HR 0.62; P =.0141). Alleviation of seven influenza symptoms and fever resolution was shortest with peramivir 300 mg. Conclusions: Rapid improvement in CAT score, including cough, and shorter time to alleviation of respiratory symptoms associated with peramivir is of potential benefit to patients with chronic respiratory disease. [ABSTRACT FROM AUTHOR]

Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents. Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD). Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma. Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of our study was to compare community-acquired pneumonia (CAP) patients who were and were not administered treatment in accordance with the Turkish Thoracic Society (TTS) 2009 pneumonia guideline in terms of hospital stay length, treatment cost, and treatment efficacy. MATERIAL AND METHODS: Patients who were admitted to our hospital and who were diagnosed with CAP were included in the study. Demographic characteristics of the patients, symptoms at the time of diagnosis, physical examination, laboratory and radiological findings, treatments, response to treatment at follow-up, length of hospital stay, and direct cost of treatment were recorded in the TTS pneumonia database (TURCAP: TURKEY Community Acquired Pneumonia). Taking into consideration the "Turkish Thoracic Society Consensus Report on the Diagnosis and Treatment of Community-acquired pneumonia in Adults (2009)," the patients recorded in the database were evaluated in terms of conformity to the guideline. RESULTS: This present study included 156 patients diagnosed with CAP. Sixty-six patients (42.3%) were females, and 96 (57.7%) were males, and the mean age of the patients was 70.4 years. The most common symptoms on admission were cough (94.9%), expectoration of purulent sputum (77.6%), and fever (58%). Comorbid diseases were chronic obstructive pulmonary disease (COPD; 29.5%), asthma (3.2%), lung cancer (8.3%), cardiovascular diseases (32.7%), and diabetes mellitus (12.8%). It was observed that 67.3% of the patients received treatment in accordance with the guideline. No significant difference was found in terms of gender and symptoms between the groups that received and did not receive treatment in accordance with the guideline. The mean age of the patients who received treatment according to the guideline was higher than that of the patients who did not receive treatment according to the guideline; COPD was more frequent in the group of patients who received treatment according to the guideline. Pneumonia Severity Index and Confusion, Urea, Respiratory rate, Blood pressure-Age>65 scores of the patients who were treated according to the guideline was higher and treatment resulted in death in 8% of these patients. CONCLUSION: Hospital stay length, treatment cost, and treatment efficacy were similar in patients who were and were not administered treatment in accordance with the guideline. [ABSTRACT FROM AUTHOR]

The article offers clinical information on bronchiectasis, an abnormal and permanent dilatation and distortion of the bronchi. Bronchiectasis is causes by the recurrent inflammation or infection of the airways. Its symptoms include chronic cough, fatigue, shortness of breath, weight loss and pleuritic chest pain, among others. The diagnosis, differential diagnosis and therapeutic management of bronchiectasis are also discussed.

Chronic obstructive pulmonary disease (COPD) and asthma are chronic respiratory diseases with high prevalence and mortality that significantly alter the quality of life in affected patients. While the cellular and molecular mechanisms engaged in the development and evolution of these two conditions are different, COPD and asthma share a wide array of symptoms and clinical signs that may impede differential diagnosis. However, the distinct signaling pathways regulating cough and airway hyperresponsiveness employ the interaction of different cells, molecules, and receptors. Transient receptor potential cation channel subfamily V member 1 (TRPV1) plays a major role in cough and airway inflammation. Consequently, its agonist, capsaicin, is of substantial interest in exploring the cellular effects and regulatory pathways that mediate these respiratory conditions. Increasingly more studies emphasize the use of capsaicin for the inhalation cough challenge, yet the involvement of TRPV1 in cough, bronchoconstriction, and the initiation of inflammation has not been entirely revealed. This review outlines a comparative perspective on the effects of capsaicin and its receptor in the pathophysiology of COPD and asthma, underlying the complex entanglement of molecular signals that bridge the alteration of cellular function with the multitude of clinical effects. [ABSTRACT FROM AUTHOR]

Background: There is conflicting information about the relationship between asthma and socioeconomic status, with different studies reporting no, positive, or inverse associations. Most of these studies have been cross sectional in design and have relied on subjective markers of asthma such as symptoms of wheeze. Many have been unable to control adequately for potential confounding factors.Methods: We report a prospective cohort study of approximately 1000 individuals born in Dunedin, New Zealand in 1972-3. This sample has been assessed regularly throughout childhood and into adulthood, with detailed information collected on asthma symptoms, lung function, airway responsiveness, and atopy. The prevalence of these in relation to measures of socioeconomic status were analysed with and without controls for potential confounding influences including parental history of asthma, smoking, breast feeding, and birth order using cross sectional time series models.Results: No consistent association was found between childhood or adult socioeconomic status and asthma prevalence, lung function, or airway responsiveness at any age. Having asthma made no difference to educational attainment or socioeconomic status by age 26. There were trends to increased atopy in children from higher socioeconomic status families consistent with previous reports.Conclusions: Socioeconomic status in childhood had no significant impact on the prevalence of asthma in this New Zealand born cohort. Generalisation of these results to other societies should be done with caution, but our results suggest that the previously reported associations may be due to confounding. [ABSTRACT FROM AUTHOR]

This article presents various studies related to cough. Chronic cough is an inflammatory condition of the airways and inhaled steroids are often used empirically as a therapeutic trial. The aim of this study was to determine if non-invasive tests of airway inflammation, such as induced sputum cell counts, exhaled nitric oxide (NO) and exhaled carbon monoxide as well as nasal NO can predict a successful response to inhaled steroid treatment. Cough is commonly associated with symptoms of asthma. However, there is conflicting evidence as to whether cough and bronchoconstriction are directly related.