ABSTRACT
BACKGROUND: The prevalence of asthma and chronic obstructive pulmonary disease (COPD) is high ( approximately 7.4-18%) in the general population, but less than half are diagnosed. Several studies have shown FEV(6) as a good surrogate marker for forced vital capacity (FVC) to detect airflow limitations. OBJECTIVES: The aim of this study was to evaluate if it is possible to simplify and improve the diagnosis of so far undiagnosed asthma or COPD in the primary care setting by measuring FEV(6) with a new simple screening device (PiKo-6). METHODS: 507 patients were recruited from three general practices from May to June 2005. Patients with any known pulmonary disease were excluded by questionnaire. FEV(1), FEV(6) and FEV(1)/FEV(6) were determined using a PiKo-6 device. Patients with an FEV(1)/FEV(6) <80% (PiKo positive) were invited to a standardized pulmonary function test to confirm or rule out airflow limitation. RESULTS: 401 (79.1%) patients showed FEV(1)/FEV(6) > or =80% (PiKo negative), and 106 (20.9%) patients were PiKo positive. Of the 106 PiKo-positive patients, 74 patients (14.7% of total) agreed to further studies and 18 patients (3.6%) of them suffered from COPD [COPD 0: 5 (1.0%); COPD I: 9 (1.8%); COPD II: 4 (0.8%), and none with COPD III or IV] and 14 patients (2.8%) suffered from bronchial hyperresponsiveness or asthma. In 42 patients (8.3%), the pulmonary function test was normal. CONCLUSIONS: Measurement of FEV(6) using a new simple screening device (PiKo-6) may improve the detection rate of undiagnosed airflow limitation in the primary care setting. However, patients should be carefully selected.
Subject(s)
Airway Obstruction/diagnosis , Forced Expiratory Volume , Mass Screening/instrumentation , Primary Health Care , Adult , Aged , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Recent developments in the construction of microstructured reaction devices and their wide-ranging applications in many different areas of chemistry suggest that microreactors may significantly impact the way chemists conduct experiments. Miniaturizing reactions offers many advantages for the synthetic organic chemist: high-throughput scanning of reaction conditions, precise control of reaction variables, the use of small quantities of reagents, increased safety parameters, and ready scale-up of synthetic procedures. A wide range of single and multiphase reactions has been performed in microfluidic-based devices. Certainly, microreactors cannot be applied to all chemistries yet and microfluidic systems also have disadvantages. Limited reaction time ranges, high sensitivity to precipitating products, and analytical challenges have to be overcome. An overview of microfluidic devices available for chemical synthesis is provided and some specific examples, mainly from our laboratory, are discussed to illustrate the potential of microreactors.
Subject(s)
Chemistry, Organic/methods , Equipment Design , Glycosylation , Microchemistry/methods , Microchip Analytical Procedures , Microfluidic Analytical Techniques , Microfluidics/methods , Miniaturization/methods , Models, Chemical , Oligosaccharides/chemistry , Peptides/chemistry , Polymers/chemistryABSTRACT
The use of creative teaching techniques in nursing staff development generates enthusiasm for learning in both the learner and the educator. We report the process used to develop alternative teaching approaches and examples of these programs. A cost analysis of a traditional versus an innovative program is provided. Advantages and disadvantages of these approaches are reviewed.
Subject(s)
Creativity , Nursing Staff/education , Teaching/methods , Humans , Nursing Process , Staff DevelopmentABSTRACT
The purpose of this study was to examine whether a 3-month therapy with disodium cromoglycate (DSCG) is able to lower bronchial hyperreactivity in patients with perennial bronchial asthma and hyperreactive airways. Therefore, 24 patients with this condition (11 women, 13 men; age range from 16 to 41 years) were randomly allocated to either active treatment (20 mg DSCG four times daily) or to placebo in a prospectively designed, double-blind study. Bronchial hyperreactivity was assessed by acetylcholine-induced bronchoconstriction before and after 6 and 12 weeks of either DSCG or placebo treatment, respectively. As test values, the variations in FEV1 and oscillatory resistance (Ros) before and after inhaled acetylcholine was used. Despite the fact that DSCG significantly attenuated acetylcholine-induced acute bronchoconstriction in all patients studied, it did not exhibit a significant reduction in bronchial hyperreactivity in this patient population.
