Characterisation of a paediatric population referred for a dysfunctional breathing assessment
Dysfunctional breathing (DB) is recognised as a modifiable factor in asthma management, and a differential diagnosis for exercise induced breathlessness (EIB). Recognition of DB can prevent excessive use of drug therapy. Further characterisation of this population seeks to assist clinicians in guiding referral for breathing retraining.Consecutive referrals to a dysfunctional breathing physiotherapy clinic were audited between 06/18 and 05/20. Patients with incomplete data sets were omitted. 77 referrals were included (7-17y (median 12y)). 24 (31%) had a confirmed asthma diagnosis, and asthma had been investigated and excluded in 38 (49%). Of that 38, 18 had continued their asthma medication. 17 (22%) had attended A&E with shortness of breath and 19 (25%) referrals mentioned induced laryngeal obstruction (ILO). 59 CYP (77%) presented with exercise induced symptoms, only 14/59 (25%) with breathlessness alone and 38/59 (49%) with breathlessness plus other symptoms including chest tightness, and chest pain. 18/77 referrals did not report exercise induced symptoms and of these 8 presented with anxiety and 5 with suspected habit cough. 28 (36%) of referrals mentioned anxiety. 23 (30%) participated in competitive sport or regular training reporting reduced performance and participation.Onset of breathing difficulty appears to occur in early or pre-adolescence. This may be accounted for by the pubertal growth spurt or changes in exercise habits or symptom awareness.Breathing retraini...
In the article “New treatments for chronic urticaria” by P Kolkhir et al (Ann Allergy Asthma Immunl 2020:124(1): 2-12), the following text has been removed. The article has been corrected online at https://doi.org/10.1016/j.anai.2019.08.014.
Technology is one of those items with which all clinicians (probably everyone) seem to have a love-hate relationship. The electronic medical record has made documenting and billing patient encounters much easier, yet at the same time, it seems to have erected a barrier between the patient and provider. Along with the growth of the electronic health record has been an explosion in the use of handheld devices and health-related applications (apps). These apps allow for more engagement and involvement with patients, including health monitoring by providers.
We thank the respondents to our article1 for their insightful comments. Although we have matched subjects in both cohorts by age, sex, comorbidities, and index date, Lin et al2 indicate a lack of adjustment for co-medication status, including the use of corticosteroids and disease-modifying antirheumatic drugs (DMARDs), in the propensity score. We agree that these medications are important confounders on fracture. We therefore had conducted multivariate analysis in t he published article by adjustment for corticosteroids, DMARDs, and phototherapy.
We read with great interest the article by Lin et al1 reporting the association of incidental fractures in patients with atopic dermatitis (AD). We appreciate the authors who collected data from Taiwan's National Health Insurance Research Database and conducted a great cohort study. Nevertheless, we highlight some key points.
This study analyzed cross-sectional datasets of adults (aged ≥ 40 years) in the Korean National Health and Nutrition Examination Survey 2010-2016. Health-related QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L) index score. The presence of chronic cough and other conditions were defined using structured questionnaires. RESULTS: The prevalence of chronic cough was 3.48% ± 0.17% among adults aged ≥ 40 years. The overall EQ-5D-3L index score was significantly lower in subjects with than without chronic cough (0.79 ± 0.01 vs. 0.86 ± 0.00, P
(HAMBURG, Pa.) — The spring breezes of 2020 are carrying more than just tree pollen. There’s a whiff of paranoia in the air. For millions of seasonal allergy sufferers, the annual onset of watery eyes and scratchy throats is bumping up against the global spread of a new virus that produces its own constellation of respiratory symptoms. Forecasters are predicting a brutal spring allergy season for swaths of the U.S. at the same time that COVID-19 cases are rising dramatically. That’s causing angst for people who never have had to particularly worry about their hay fever, other than to stock up on antihista...
Conclusion The results obtained from this research shows, in general, the fragility in the social and political infrastructure necessary to improve the living conditions of populations, particularly those that depend on family agriculture in drought prone areas. The conditions of social, economic and environmental vulnerabilities presented in the region can be amplified by the drought process, and can aggravate the impacts resulting drought events, thus disadvantaging the population of this region, as shown in the Fig. 1. The general perception of the interviewees of the health sector shows an agreement with what is found...