RESUMEN
INTRODUCTION: Besides dyspnea a dry cough is one of the main symptoms in patients with pulmonary fibrosis. Little is known about the 24-hour-variability of this symptom. Moreover, it is unclear if other auscultation phenomena occur. METHODS: A long-term auscultation for 24-hours was performed in patients with fibrotic lung diseases (LEOSound, Löwenstein Medical GmbH & Co. KG, Medical-Electronics, Bad Ems, Germany). Coughing and wheezing sounds were recorded. For the following analysis the 24-hour period was divided into two intervals of 12 hours each (daytime and nighttime). Events were registered in epochs (at least one event in 30 seconds). RESULTS: 20 patients were included (6 with nonspecific interstitial pneumonia and 14 with idiopathic pulmonary fibrosis). On average 166 coughing epochs were recorded in a 24-hour-period (day/night 116/50; Pâ<â0.001). Moreover, 203 wheezing epochs were registered (day/night 84/119; Pâ=â0.273). Auscultation phenomena did not correlate with spirometric and bodyplethymographic data, nor with data of diffusion capacity. DISCUSSION: The study is showing the clinical potential of long-term auscultation in patients with fibrotic lung diseases. Especially the findings concerning the coughing symptoms were remarkable. It could be shown that there was a decrease of coughing during nighttime in comparison to daytime. In contrast to this, wheezing sounds were increasing at nighttime. The clinical relevance of this finding is yet to be assessed. Finally, there was no correlation between the severity of the disease measured by functional diagnostics and the amount of coughing.
Asunto(s)
Tos , Enfermedades Pulmonares Intersticiales , Auscultación , Tos/diagnóstico , Alemania , Humanos , Pulmón , Enfermedades Pulmonares Intersticiales/diagnóstico , Ruidos RespiratoriosRESUMEN
BACKGROUND: Since September 2007, the Federal Nonsmoker Protection Act regulates a general legal ban on smoking in federal facilities, public transport vehicles and passenger stations. Other smoking bans are not uniformly regulated and vary from state to state. In addition to places of public interest, sports venues and the workplace, particular attention in political debates has always been paid to bars and restaurants, where smoking has always been part of the picture. The situation of the Südstadt pubs in Cologne considered in this paper is governed by the expanded law for the protection of non-smokers in North Rhine Westphalia (NRW) of December 20, 2007. METHODS: A survey using a specifically created questionnaire comprising 24 items was carried out. Persons over 26 years of age visiting selected bars were interviewed in order to ensure that at the time the Nonsmoker Protection Act was introduced, participants had reached the legal age for smoking. Data acquisition was carried out both by direct surveys of participants in selected pubs in Cologne's Südstadt and by means of online surveys, attention to which had been drawn in the press, television and through social media. RESULTS: A total of 1318 completed questionnaires were evaluated. Participants were on average 49 years old (±â12.1). Of the 1318 respondents, 726 were active smokers in 2007 (55.1â%). In 2018, 518 (39.3â%) (p: <â0.001) respondents stated that they were still active smokers. Of the 726 active smokers, 289 (39.8â%) had been consuming more than 20 cigarettes a day in 2007.âIn 2018, 179 of 518 (34.6â%) (p: <â0.001) were heavy smokers. In 2007, 303 persons (41.7â% of smokers) fell into the group of medium smokers with 10â-â19 cigarettes per day, in 2018 there were 227 (43.8â%) (p: <â0.001). The group of people who smoked less and consumed 1â-â9 cigarettes per day included a total of 134 persons (18.5â%) in 2007 and 112 (21.6â%) in 2018 (p: <â0.001). Among active smokers, the smoking ban was the most relevant cause for a change in smoking behaviour in this survey. Among non-smokers or former smokers, health aspects as well as family and friends were the decisive factors in rejecting tobacco products. SUMMARY: Based on a sample of 1318 participants among pub visitors, the study showed that the number of active smokers had significantly and distinctly decreased since the introduction of the Nonsmoker Protection Act in 2007.âFurthermore, the number of people with rather low cigarette consumption showed a significant increase.