Microalbuminuria in obstructive sleep apnea syndrome.

OBJECTIVES: Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to intermittent hypoxemia in patients with obstructive sleep apnea syndrome (OSAS). In this study, we investigated the prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with OSAS. METHOD: Ninety-eight patients with OSAS and 26 nonapneic snoring subjects upon polysomnography were included in this study. The urinary albumin-to-creatinine ratio (UACR) was calculated according to a previously described formula. The severity index of chronic diseases was evaluated by using the modified cumulative illness rating scale (MCIRS). Insulin resistance (IR) method was analyzed by homeostasis assessment model (HOMA-IR). Subjective sleepiness was assessed using the Epworth sleepiness scale (ESS). RESULTS: Body mass index (BMI), MCIRS, and UACR were higher in patients with OSAS than nonapneic snoring subjects. In linear regression model, there was a negative relationship between UACR and minimal O2, and there was a significantly positive relationship between UACR and desaturation index. CONCLUSION: Microalbuminuria may be seen in patients with OSAS, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with OSAS should be examined in regular periods for risk of cardiovascular morbidity or mortality.

Personality profile in patients with polycystic ovary syndrome.

AIM: To investigate the personality traits of patients with polycystic ovary syndrome (PCOS). METHODS: Forty-nine patients with PCOS and 34 healthy controls were enrolled in the study. Psychometric evaluation was made with the Minnesota Multiphasic Personality Inventory. Additionally, Short Form-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) were also performed. RESULTS: Polycystic ovary syndrome patients had significantly higher absolute and clinical elevation scores on depression, hysteria, psychasthenia and hypomania compared with the controls. Patients with PCOS had lower SF-36 physical and mental health summary scores and higher HADS anxiety and depression subscale scores. CONCLUSION: Polycystic ovary syndrome patients seem to have depressive, hysterical, psychasthenic and hypomanic personality traits.

Microalbuminuria in chronic obstructive pulmonary disease.

BACKGROUND: Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to hypoxemia in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: In this study, we investigated prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with COPD. METHOD: During the research, 66 consecutive patients with COPD and 40 cases smokers with normal spirometry were included. The urinary albumin creatinin ratio (UACR) was calculated according to previously described formula. The presence of microalbuminuria was defined as UACR being ≥20 in men and ≥30 in women. The severity index of chronic diseases was evaluated by using MCIRS. RESULTS: The rate of presence of microalbuminuria and UACR were higher in patients with COPD than smokers with normal spirometry. Pearson correlation analysis showed a significant inverse relationship between UACR and PaO2, FEV1%, FVC%. On the other hand, there was a positive relationship between UACR and BODE index. There was a significant relationship between the presence of microalbuminuria with PaO2 and BODE index. In the linear regression model, there was a negative relationship between UARC and PaO2 yet there was a significantly positive relationship between UARC and MCIRS score, BODE index. In the logistic regression model, the presence of microalbuminuria showed significant associations with PaO2, BODE index. CONCLUSION: Microalbuminuria may be seen in patients with COPD, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with severe COPD should be examined in regular periods for risk of cardiovascular morbidity or mortality.

Bronchial hyperresponsiveness in patients with obstructive sleep apnea syndrome.

INTRODUCTION: The relationship between obstructive sleep apnea syndrome (OSAS) and bronchial hyperresponsiveness (BHR) is not well known. In this study, we investigated the association between BHR and disease severity in patients with OSAS. MATERIALS AND METHODS: Fourty seven (37 male/10 female) OSAS patients admitted with polysomnography enrolled to the study. Histamine bronchial challenge test was performed and body mass index (BMI, kg/m2) was calculated. Presence of BHR was diagnosed as positivity of bronchial provocative test (BPT) (PD values ≤ 16 mg/mL). Patients were questioned with Epworth sleepiness scale (ESS). RESULTS: Histamine bronchial challenge test was positive in 21 of 47 patients. There were significant negative correlations between PD 20 value and AHI (r= -0.47, p= 0.03), BMI (r= -0.45, p= 0.03), and ESS score (r= -0.45, p= 0.03) in the patients with BHR. In addition, AHI (p= 0.03), BMI (p= 0.02), ESS scores (p= 0.03) were higher in patients with BHR (21 patients) than in patients not having BHR (26 patients). Significant negative relation was found between PD 20 value and AHI (b=-0.45, p= 0.03) and significant positive relation was found between presence of BHR and AHI (p= 0.04), BMI (p= 0.03) independently of age and sex in multiple regression analysis. CONCLUSION: BHR is common in patients with OSAS. As severity of OSAS increased, severity of BHR increased. In addition, obesity may trigger presence of BHR in patients with OSAS.

Quality of life and metabolic disorders in patients with obstructive sleep apnea.

PURPOSE: Quality of life (QoL) may be poor in patients with sleep apnea depending on multifactorial reasons. In this observational study, we examined the factors determining QoL in patients with obstructive sleep apnea (OSA) and nonapneic snoring subjects. METHODS: Complete assessments were obtained on 111 subjects who diagnosed OSA and 18 nonapneic snoring subjects. Fasting blood samples of all of subjects were taken to determine insulin resistance (IR) and oral glucose tolerance tests were performed to diagnose disorders of glucose metabolism (DGM). Quality of life, with short form (SF)-36, and excessive daytime sleepiness, with epwort sleepness scale (ESS), were evaluated. RESULTS: The mean age of the patients with OSA was higher than that of the nonapneic snoring subjects (48.4 ± 9.6 years and 43.0 ± 11.8 years, respectively; p=0.03). BMI was also significantly higher in the patients with OSA than in the nonapneic snorers (31.0 ± 4.5 and 27.1 ± 4.0, respectively; p=0.001). The mental health component in the patients with OSA was slightly but not significantly lower than the nonapneic snoring subjects (p=0.05). A negative correlation among most domains of quality of life with scores of ESS, body mass index (BMI), presence of hypertension (HT) and DGM was found. Only physicial functioning was negatively correlated with apnea hypopnea index (AHI). In linear regression analysis, there were negative associations among physical functioning with BMI, presence of HT and DGM while there was no association between physicial functioning and AHI. In addition, there were negative correlations between mental health component with BMI and presence of HT in the multivariate analysis. Obese patients with OSA had lower physicial and mental components compared with nonobese patients with OSA. CONCLUSION: The impact of OSA on quality of life can be attributed to excessive daytime sleepiness. Obesity and metabolic disorders in patients with OSA may also negatively affect the quality of life.

Affect status and perception of exacerbation in patients with asthma.

Exacerbations occur commonly in patients with asthma but factors affecting perception of dyspnea during exacerbation are not well known. This investigation was designed to determine the effects of negative mood on perception of dyspnea during exacerbation. A total of 47 patient aged 28-78 years (mean age, 52.5 years) admitted with acute asthma had recordings of blood gas pressure, negative mood score, forced expiratory volume in 1 second (FEV(1)), and dyspnea score at admission and at the 72nd hour. Perceived intensity of dyspnea was estimated using a modified Borg scale. The negative mood was assessed with an overall of six mood adjectives (nervous-anxious, sad-blue, and tired-drowsy). High negative mood score was defined as the score above the cutoff point (median score, >7). Borg sore of patients with a high negative mood score was higher than that of patients with a low negative mood score (6.3 ± 2.5 versus 4.4 ± 2.4; p = 0.01). The high Borg sore of asthmatic patients with high negative mood persisted even at the 72nd hour (1.6 ± 0.9 versus 1.0 ± 0.7; p = 0.01). FEV(1) values of both groups at admission were similar. The negative mood score (beta = 0.68; p = 0.0001) and initial FEV(1) (beta = -0.42; p = 0.01) were the important determinants of Borg score at admission in all patients with multivariate analysis but not arterial oxygen pressure, arterial carbon dioxide pressure, asthma duration, and female sex. This study indicated that emotional factors, as well as the level of airways obstruction, predicted the magnitude of dyspnea at exacerbation of asthmatic patients. Thus, the emotional factors should be taken into account in the treatment of dyspnea at exacerbation.

Chronic airway diseases in adult life and childhood infections.

BACKGROUND: Respiratory disorders in childhood may predispose to pulmonary disease in late adult life. OBJECTIVES: The aim of this study was to evaluate the relationship between their effects in adult life and the characteristics of the respiratory system in childhood. METHODS: A total of 10,224 parents and grandparents of students from 14 randomly selected primary schools in the city center were asked to answer questionnaires given to their children. 9,853 of 10,224 persons (the overall response rate was 96.3%) were eligible for analysis. In the questionnaire subjects were asked about respiratory system-related symptoms and characteristics. RESULTS: Chronic cough [14.3 vs. 4.7%, OR 3.4 (2.6-4.4), p < 0.001], chronic bronchitis [35.3 vs. 11.8%, OR 4.0 (3.4-4.8), p < 0.001] and asthma [34.2 vs. 5.1%, OR 9.6 (8.0-11.5), p < 0.001] in the childhood respiratory infection group were more common than in the control group. Childhood respiratory infections were associated with an increased risk of asthma (OR 5.6, p < 0.001), chronic bronchitis (OR 2.3, p < 0.001) and chronic cough (OR 1.5, p < 0.001), after adjusting for possible confounding factors. In addition, the presence of dampness or visible mould, wall-to-wall carpets, pets at home and parents' smoking during childhood were associated with an increased risk of frequent childhood respiratory infections. CONCLUSION: These results indicated that frequent respiratory infections during childhood might play an important role in the occurrence of chronic airway diseases in adult life. The removing of risk factors for frequent childhood respiratory infections may reduce the subsequent risk of chronic airway disease in late adult life.

Psychological characteristics of patients with asthma.

INTRODUCTION: Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory). METHODS: Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma < 10 years, long-standing asthma ≥10 years). RESULTS: Patients with asthma compared with control group had significantly higher the rate of clinical elevation on depression, hysteria, psychasthenia and social introversion. Patients with recent-onset asthma compared with long-standing asthma have significantly higher the rate of clinical elevation on depression, hysteria, psychopathic deviate, psychasthenia and social introversion. MMPI mean t score in patients with recent-onset asthma was higher than patients with long-standing asthma. MMPI mean t score in patients with asthma was negatively associated with the symptom duration in multivariate model. CONCLUSIONS: Patients with asthma have relatively more inactivity, anergia, guilt, pessimism, nonspecific physical complaints, irrational fears and introvert. Patients with long-standing asthma have less psychological distress, suggesting that learned to cope with his illness.

Factors Influencing Cognitive Function in Subjects With COPD.

BACKGROUND: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. METHODS: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. RESULTS: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. CONCLUSIONS: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.

Quality of Life and Bronchial Hyper-Responsiveness in Subjects With Bronchiectasis: Validation of the Seattle Obstructive Lung Disease Questionnaire in Bronchiectasis.

BACKGROUND: Bronchiectasis can adversely affect quality of life. However, the tests examining quality of life in bronchiectasis are not sufficient. We examined the validity of a measure designed for COPD, the Seattle Obstructive Lung Disease Questionnaire (SOLQ), in bronchiectasis. In addition, we aimed to compare the quality of life of subjects with bronchiectasis and bronchial hyper-responsiveness with that of those without to identify the effective factors. METHODS: We studied 78 subjects with clinically stable bronchiectasis and 41 healthy controls matched for age and sex. Subjects were assessed by the SOLQ. A detailed history, physical examination, the Medical Outcomes Study 36-Item Short Form questionnaire, the Hospital Anxiety and Depression Scale, and spirometric measurements were obtained. RESULTS: Cronbach α coefficients, which reflected internal consistency, were >0.70 for all SOLQ components except for treatment satisfaction. SOLQ component scores correlated with all of the component scores of the Medical Outcomes Study 36-Item Short Form questionnaire and the Hospital Anxiety and Depression Scale, confirming their concurrent validity. All SOLQ scores correlated positively with percent-of-predicted FEV1, whereas the physical function, treatment satisfaction, and emotional function correlated negatively with the exacerbation frequency in Pearson analysis. Emotional and physical functions were positively associated with percent-of-predicted FEV1 in linear regression analysis. Compared with subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had lower FEV1/FVC and more exacerbations/y. Compared with bronchiectasis subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had significantly lower SOLQ, physical function, and coping skills scores but not emotional function and treatment satisfaction. CONCLUSIONS: The SOLQ is a valid instrument for determining quality of life in subjects with bronchiectasis. Subjects with bronchiectasis and bronchial hyper-responsiveness had a poorer quality of life, lower baseline spirometric values, and more frequent exacerbations, suggesting more severe disease.

Factors Associated With Quality of Life in Subjects With Stable COPD.

BACKGROUND: The purpose of this study was to assess the impact of bronchiectasis, anxiety and depression, and parameters of disease severity on health-related quality of life (HRQOL) in subjects with COPD. METHODS: Sixty-two subjects with stable COPD were selected for the study. The presence of bronchiectasis in all subjects with COPD was investigated by high-resolution computed tomography. Pulmonary function tests were performed. Dyspnea was assessed using the Modified Medical Research Council (MMRC) dyspnea scale. Psychological disorders were investigated using the Hospital Anxiety and Depression Scale (HADS), and the HRQOL was examined using the St George Respiratory Questionnaire (SGRQ). RESULTS: High-resolution computed tomography revealed that 44 of 62 (70.9%) subjects with COPD had bronchiectasis. There were no differences in pulmonary function tests, symptoms, activities, impact, SGRQ total scores, and HADS scores between COPD subjects with and without bronchiectasis. Pearson correlation analyses showed that there was no significant association between the presence of bronchiectasis, bronchial wall thickness, or severity of bronchial dilatation and all subscales of the SGRQ or HADS scores. Additionally, HADS scores showed significant positive association with all subscales of the SGRQ in all subjects. In linear regression analysis, a statistically significant relationship was found between the SGRQ total score and percent-of-predicted FEV1, percent-of-predicted diffusing capacity of the lung for carbon monoxide, MMRC score, and anxiety score, but the SGRQ total score was not associated with age, body mass index, total number of hospitalizations, PaO2 , or depression score. CONCLUSIONS: The presence of bronchiectasis in subjects with COPD does not impact HRQOL and psychological disorders. However, disease severity, dyspnea levels, and anxiety scores predict poor HRQOL.

Case of round pneumonia: pulmonary infarct and a rare situation that is similar with the lung cancer.

BACKGROUND AND AIMS: Round pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Köhn and channels of Lambert). The round appearance on chest X-ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well-known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR. METHODS: We presented two cases of RP. One mimicked and was mistaken for pulmonary infarction because of triangular pleural-based density and the other mimicked pulmonary malignancy because of a homogeneous triangular opacity based on the pleura on the posteroanterior radiography and computed tomography. CONCLUSION: These cases were presented because of RP's importance, and RP should be considered a part of differential diagnosis of pulmonary infarct and lung tumor.

Low Cognitive Ability in Subjects With Bronchiectasis.

BACKGROUND: Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis. METHODS: Thirty subjects with stable bronchiectasis and 25 healthy volunteers underwent a cognitive ability assessment using the Wechsler Adult Intelligence Scale. Bronchiectasis was diagnosed by high-resolution computed tomography of the chest. Age, body mass index, the Hospital Anxiety and Depression Scale, and pulmonary function were assessed. Perceived intensity of dyspnea after exercise (after climbing 3 flights of stairs) was estimated using a modified Borg scale. RESULTS: Mean scores on the verbal and performance tests and full-scale IQ scores were significantly lower in subjects with bronchiectasis than in healthy volunteers. Low cognitive ability in subjects with bronchiectasis was associated with higher depression scores, lower oxygen saturation, and poor lung function after adjusting for potential confounders in multivariate analysis. Borg scores after exercise in subjects with bronchiectasis and low cognitive ability were higher than those in subjects with bronchiectasis and high cognitive ability, despite similar PaO2 and FEV1 in both groups. CONCLUSIONS: Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.

Assessment of patients' preferences regarding the characteristics associated with the treatment of chronic obstructive pulmonary disease.

OBJECTIVE: Patient preferences regarding characteristics associated with the treatment of chronic obstructive pulmonary disease (COPD) must be determined to increase the compatibility between the patients and the treatments, but as yet no studies have been performed regarding these characteristics. Here, we evaluate the preferred characteristics associated with the treatment of patients with COPD. METHOD: The expectations of patients receiving copd therapy were assessed in six categories: time allocated by the physician to listen to patients' complaints, treatment to be applied, estimated adverse effect frequency concerning the therapy, ability of patients to visit the same physician each time, integral approach of the physician to the treatment of the patient, and therapy cost. These groups were divided into categories of therapy indicating 25 alternative treatment methods, using conjoint analysis. Patients were sorted to the 25 types of treatment with regard to their preferences. RESULTS: The major expectation of conjoint analysis associated with the treatment of COPD patients is for the therapy to allow the patients to completely recover from their complaints. The order preferred by patients of other treatment expectations is from sufficient time to be allowed by the physician to listen to the patient, to no cost for the treatment, to minimum adverse effects resulting from the treatment, to each follow-up to be performed by the same physician, and to the physician performing an assessment of the patient's well-being, rather than examining only the areas of complaint. CONCLUSION: The major expectation of COPD patients regarding treatment was to completely recover with the help of the therapy. Considering the expectations of the patient may help improve the compatibility of the patient with the treatment.

Effects of septoplasty on pulmonary function tests in patients with nasal septal deviation.

OBJECTIVE: To investigate the effects of septoplasty on pulmonary function tests (PFTs) and bronchial hyperresponsiveness (BHR) in patients who had no previous pulmonary diseases. DESIGN: Prospective, controlled clinical trial. PATIENTS: Fourteen patients with nasal septal deviation (NSD) and 20 controls were enrolled in the study. MAIN OUTCOME MEASURES: All patients were evaluated with anterior rhinoscopy, nasal endoscopy, acoustic rhinometry (AR), visual analogue scale (VAS), PFTs, and bronchoprovocation test (BPT) on the day before surgery and 8 to 12 weeks after surgery. RESULTS: The postoperative values of forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow percentages were higher than preoperative ones, and these results were statistically significant (p = .007, p = .04, and p = .007, respectively). Nine patients had preoperative BHR, and three of them had negative BPT postoperatively. When compared with the preoperative values, there was a borderline decrease in the rate of BHR in six patients. There were significant improvements in the symptoms of left and right nasal congestion, headache, postnasal drip, and olfactory function after surgery. We found important improvement in the values of AR at right minimal cross-sectional area 1 (p = .02), left distance 1 (p = .04), and left distance 2 (p = .04) postoperatively. CONCLUSION: An improvement in both nasal symptoms and PFT values was seen after surgical treatment for NSD. We concluded that septoplasty may be considered as having favourable effects on BHR.

Effects of timolol and latanoprost on respiratory and cardiovascular status in elderly patients with glaucoma.

PURPOSE: To investigate the respiratory and cardiovascular effects of switching therapy from topical timolol 0.5% to latanoprost 0.005% in elderly patients with glaucoma. METHODS: Twenty-five patients with primary open-angle glaucoma (POAG) who were treated with topical timolol 0.5% were included in the study. The beta-blocker treatment was ended due to insufficient intraocular pressure (IOP) and systemic or local side effects. The treatment then switched to latanoprost in these patients. All recruited patients underwent a full ocular, cardiovascular, and respiratory examination including spirometry, pulse rate, and blood pressure. All measurements were made 1 day before the beta-blocker treatment was ended and 30 days after the latanoprost treatment was started. RESULTS: Timolol treatment was associated with numerically but not statistically significant lowered pulse rates, systemic blood pressure, diastolic blood pressure, and reductions in the spirometry measurements. The change to latanoprost treatment was associated with numerical improvement in mean values of spirometric test results. There were no significant differences in changes in mean values of spirometry, pulse rate, or blood pressure. Histamine challenge test was determined to be positive in 16 of 25 patients for timolol, of whom 10 were positive for latanoprost. This was statistically significant (P < 0.05). CONCLUSIONS: Although all the results presented were statistically insignificant, switching to latanoprost treatment may offer some advantages in respiratory and cardiovascular function for elderly people with glaucoma over beta-blocker drugs. Spirometry and the measurement of pulse rate and blood pressure are advised in all patients receiving topical beta-blocker therapy.

Five annual observations of respiratory findings in gun factory workers exposed to solvents.

OBJECTIVE: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions. METHODS: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms. RESULTS: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 +/- 89.9 vs 75.8 +/- 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03). CONCLUSIONS: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence.

Female sexual and hormonal status in patients with bronchial asthma: relationship with respiratory function tests and psychological and somatic status.

OBJECTIVES: To assess the relationship among the sexual, hormonal, physical, and psychological status of women with bronchial asthma (BA) compared with that of healthy volunteers. METHODS: Thirty-eight women with BA were enrolled in the study. The patients were asked to complete the Female Sexual Function Index, General Health Questionnaire, and Medical Outcomes Study Short Form 36-item Health Survey (SF-36). Using the answers on the SF-36, the mental and physical component summary scores were calculated. A total of 20 healthy women were enrolled in the study as the control group. The same questionnaires were given to this group as well. Statistical analysis was performed using the Mann-Whitney U test and Pearson correlation tests. RESULTS: At the end of the study, statistically significant differences were observed for all questionnaire scores (P <0.05). The most common female sexual dysfunction was diminished arousal (n = 30, 78.9%) in women with BA. In the correlation analysis, the total Female Sexual Function Index score had a statistically significant and positive correlation with the mental component summary score (r = 0.503, P = 0.001) and a negative correlation with the General Health Questionnaire score (r = -0.380, P = 0.020). CONCLUSIONS: The results of our study have shown that BA, as a chronic medical condition, can be a cause of female sexual dysfunction with mental and psychiatric mechanisms.

Perception of dyspnea during exacerbation and histamine-related bronchoconstriction in patients with asthma.

BACKGROUND: Numerous studies have been performed concerning the perception of dyspnea during changes in airway caliber provoked in the laboratory setting, but studies of asthma exacerbation are scarce. OBJECTIVE: To investigate whether the perception of dyspnea during histamine-induced bronchoconstriction might be used to identify patients with asthma who sense dyspnea poorly during exacerbation. METHODS: The perception of dyspnea in 50 patients (45 female, 5 male) with asthma was evaluated at admission with exacerbation and during a stable period. Perceived intensity of dyspnea was estimated using a modified Borg scale. The perception of dyspnea in the stable period 4 to 6 weeks after exacerbation was measured with the histamine challenge test. Perception parameters were defined as the change in Borg score divided by the change in forced expiratory volume in 1 second (FEV1) as a percentage of the baseline FEV1 (deltaBorg/deltaFEV1) and as the Borg score at 20% decrease (PS20Histamine) or increase (PS20Exacerbation) in FEV1. RESULTS: The perception of dyspnea during asthma exacerbation was unrelated to the perception of dyspnea during histamine-induced bronchoconstriction (for deltaBorg/deltaFEV1, beta = .08, P = .50; for PS20, beta = -.11, P = .40). The kappa value for the agreement of poor perceivers at exacerbation and during the stable period was -0.21 (P = .10). However, the intensity of dyspnea caused by histamine-induced bronchoconstriction was lower than that caused by asthma exacerbation (PS20: 1.6 +/- 1.1 vs 2.8 +/- 2.5, respectively, P = .004; deltaBorg/deltaFEV1: 0.08 +/- 0.05 vs 0.21 +/- 0.28, respectively, P = .001). CONCLUSION: The perception of dyspnea during asthma exacerbation is not correlated with the perception of dyspnea during histamine-induced bronchoconstriction. Therefore, the perception of dyspnea during histamine-induced bronchoconstriction cannot be used to identify the asthmatic patients who perceive dyspnea poorly.