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Med J Malaysia. 2000 Mar;55(1):33-9.
Prevalence of childhood asthma and allergy in an inner city Malaysian community: intra-observer reliability of two translated international questionnaires.

Norzila MZ, Haifa AL, Deng CT, Azizi BH.

Department of Paediatrics, Institut Pediatrik, Hospital Kuala Lumpur, Kuala Lumpur.

OBJECTIVES: (a) To examine the intra-observer reliability of the Malay language versions of two international respiratory questionnaires i.e. the International Study of Asthma and Allergy in Children (ISAAC) and the American Thoracic Society (ATS) questionnaires, and (b) using the more reliable of these questionnaires, to estimate the prevalence of asthma and allergy related symptoms in an ethnically homogenous inner city community in Kuala Lumpur. METHODS: The study was conducted among 7 to 12 year old school children of Malay ethnic origin living in an inner city area of Kuala Lumpur. The sample consisted of 787 children attending the only primary school in the area. The Malay versions of both questionnaires were administered twice, one month apart, and were completed by parents. Agreement between the first and second responses to the same questions were assessed by Cohen's kappa. Kappa values < 0.4 were indicative of poor intra-observer reliability, 0.4-0.59 moderate reliability, 0.6-0.79 good reliability and > 0.79 excellent reliability. RESULTS: 77.9% and 36.3% of parents responded to the first and second administrations of the questionnaires respectively. Kappa values of > 0.4 were obtained in 15/16 (93.8%) and 17/27 (63.0%) questions of the ISAAC and ATS questionnaires respectively. Excellent kappa values were obtained in 4/16 (25%) questions of the ISAAC questionnaire versus only 1/27 (3.7%) questions of the ATS questionnaire. From the ISAAC questionnaire, all questions on wheeze had good reliability while those on asthma had excellent reliability. Questions on allergic symptoms had poor to moderate reliability. In contrast, from the ATS questionnaire, questions on wheeze had moderate reliability while questions on asthma were excellently reliable. Questions on allergic symptoms had moderate to good reliability while those on cough, phlegm and bronchitis had poor reliability. According to the ISAAC questionnaire the prevalence of ever wheeze, wheeze in the last 12 months, ever asthma and wheeze with exercise in the last 12 months was 12.5%, 6.6%, 10.3% and 5.9% respectively. The prevalence of ever sneeze or runny nose, sneeze or runny nose in the last 12 months, watery eyes in the last 12 months and ever eczema was 15.2%, 11.1%, 4.4% and 8.5% respectively. CONCLUSIONS: The translated ISAAC questionnaire was more reliable than the translated ATS questionnaire. Asthma and related symptoms were common among Malay school children in inner city Kuala Lumpur.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11072488&dopt=Abstract

J Asthma. 2002 Oct;39(7):649-58.
Respiratory symptoms and asthma in relation to cold climate, inhaled allergens, and irritants: a comparison between northern and southern Finland.

Kotaniemi JT, Pallasaho P, Sovijarvi AR, Laitinen LA, Lundback B.

Department of Pulmonary Medicine, Lansi-Pohja Central Hospital, Kemi, Finland. jyrki.kotaniemhks.fi

We have compared data from northern and southern Finland in a large epidemiological survey on respiratory conditions. The aim was to compare the prevalence of respiratory symptoms, asthma, and chronic bronchitis in northern and southern Finland. The study was a part of comparative studies in Finland, Estonia, and Sweden, the FinEsS studies. Data from a postal survey on subjects aged 20-69 was analyzed. Participation rate was 84% of 7937 invited in Lapland in the north, and 77% of 7877 in Helsinki in the south. Physician-diagnosed asthma was reported by 5.6% in Helsinki, and by 5.5% in Lapland. Symptoms common in asthma were also equally prevalent in the two areas. Hay fever was significantly more common in Helsinki, 36% vs. 26% (p < 0.001). The prevalence for physician-diagnosed chronic bronchitis was not significantly higher in Helsinki (3.4%) than in Lapland (2.9%). Those working outdoors reported more bronchitic symptoms than people working indoors (p < 0.05). Respiratory symptoms provoked by pollen or animal dander were more common in Helsinki, while symptoms provoked by inhaled irritants or cold weather conditions were more prevalent in Lapland. Current smoking was equally prevalent: 37% in Lapland and 38% in Helsinki. Risk factor analysis showed an elevated risk for chronic productive cough for living in Helsinki (OR 1.32), however, increasing age and current smoking were the strongest risk factors. In conclusion, prevalence of asthma and asthma-related symptoms was similar in southern and northern Finland, but chronic bronchitis and bronchitic symptoms were more common in Helsinki, and the highest prevalence was found among current smokers working outdoors. Respiratory symptoms in cold weather were more prevalent in the north, while hay fever and respiratory symptoms provoked by allergens were more common in the south. The results support the view that environmental factors have a substantial effect on respiratory symptoms, but less effect on the prevalence of asthma.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12442955&dopt=Abstract

Pol Arch Med Wewn. 1999 Dec;102(6):1047-53.
[Influence of heparin on macrophages activity and expression of endothelin in experimentally provoked rat bronchitis]

[Article in Polish]

Krasnowska M, Jankowska B, Kwasniewski A, Rabczynski J, Kuryszko J, Ogorzalek A.

Katedra i Klinika Chorob Wewnetrznych i Alergologii AM we Wroclawiu.

The rats exposition for 15 weeks to SO2 inhalation resulted in chronic bronchitis. The BALF evaluation revealed an increase in inflammatory cells number: neutrophils, macrophages, lymphocytes. Electron microscope examination demonstrated that macrophages were activated in comparison to healthy rats. Immunoreactive endothelin was found in bronchial specimens mainly in alveolar macrophages (we used a computer-assisted system of image analysis). The expression of endothelin was significantly increased in rats irritated with SO2. Low molecular weight heparin-nadroparine has been administered parenterally in 3 doses to 3 groups of rats. In animals subjected to SO2 irritation and simultaneous heparin treatment we observed significant decrease in number and activation of macrophages and endothelin expression as well. The results of this experiment suggest antiinflammatory properties of heparin.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11072540&dopt=Abstract

Schweiz Med Wochenschr. 2000 Oct 14;130(41):1437-46.
[Diagnosis and antibiotic therapy of infections in outpatients]

[Article in German]

Sturchler MS, Vuille P, Zemp E, Tschudi P, Zimmerli W.

Abteilung fur Infektiologie, Departement Innere Medizin, Universitatskliniken Basel.

BACKGROUND: The study aim was to analyse the diagnostic and therapeutic approach to selected infectious diseases, in particular with regard to the use of antibiotics, in the light of current guidelines and the problem of developing resistance. METHODS: A questionnaire was sent to all physicians with a general or internal medicine practice in the Cantons Basel-Stadt and Basel-Landschaft, Switzerland. RESULTS: Of 440 physicians, 286 (65%) took part in the study. The most frequent diagnoses of infection were cystitis (16.6%), flu-like syndrome (16.4%), acute bronchitis (12.3%), and tonsillopharyngitis (10.1%). The most frequent indications for antimicrobial therapy were cystitis (19.9%), acute sinusitis (14.1%), acute bronchitis (11.5%), and tonsillopharyngitis (9.2%). Macrolides (24.0%), aminopenicillins (22.6%), and fluoroquinolones (16.8%) were the most frequently prescribed antibiotics. CONCLUSIONS: The majority of physicians diagnosed and treated according to rational principles. However, a few exceptions were found, e.g. omission of x-ray in the diagnosis of pneumonia (24%), the use of antibiotics in the treatment of viral diseases and antibiotic therapy for tonsillopharyngitis despite a negative rapid antigen detection test against group A streptococci (75%).

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11075407&dopt=Abstract

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