[Anxiety in subjects with bronchial asthma]. / L'anxiete chez les sujets atteints d'asthme bronchique.

INTRODUCTION: Asthma, a frequent chronic respiratory disease, poses a public health problem due to its frequency, its impact on patients' lives and its significant direct and indirect costs. Despite all the published recommendations and the availability of increasingly effective therapies, many asthmatics remain poorly monitored, treated and controlled. This is due to several factors, including the association with comorbidities. The aim of this study was to determine the relationship between anxiety, asthma and its control. PATIENTS AND METHODS: A descriptive cross-sectional study with an analytical aim spread over one year (July 2016-July 2017). Were included in the study all asthmatics whose age was higher than 16 years randomly recruited at the consultation of the pneumophthisiology service of the CHU of Tizi-Ouzou (Algeria). RESULTS: According to the ACT criteria on 300 asthma patients, only 6.3% were controlled, 51.3% had partial control and 42.3% were uncontrolled. The factors negatively influencing asthma control were female gender (p=0.01) and anxiety (p= 0.0004). Factors associated with anxiety were female gender (p=0.001) and heart disease (p=0.00004). CONCLUSION: Our study highlighted the relationship between asthma and anxiety, which has a negative impact on asthma control.

INTRODUCTION: L'asthme, pathologie respiratoire chronique fréquente, pose un problème de santé publique, par sa fréquence, son retentissement sur le vécu des patients ainsi que par son important coût direct et indirect. Malgré toutes les recommandations publiées et la disponibilité des thérapeutiques, de plus en plus performantes, beaucoup d'asthmatiques restent mal suivis, mal traités et mal contrôlés. Ceci est dû à plusieurs facteurs, dont l'association à certaines comorbidités. PATIENTS ET MÉTHODES: Le but de cette étude est de déterminer la relation entre l'anxiété, l'asthme et son contrôle. Étude transversale descriptive prospective à visée analytique étalée sur une année (juillet 2016-juillet 2017). Ont étés inclus dans l'étude tous les asthmatiques dont l'âge était supérieur à 16 ans recrutés de façon aléatoire à la consultation du service de pneumo-phtisiologie du CHU de Tizi Ouzou (Algérie). RÉSULTATS: Selon les critères de l'ACT sur 300 patients asthmatiques, seuls 6,3% étaient contrôlés, 51,3% avaient un contrôle partiel et 42,3% étaient non contrôlés. Les facteurs influençant négativement le contrôle de l'asthme retrouvé étaient le sexe féminin (p=0,01) et l'anxiété (p= 0.0004). Les facteurs associés à l'anxiété étaient le sexe féminin, (p = 0.001) et les cardiopathies (p = 0.00004). CONCLUSION: Notre étude a mis en évidence la relation entre asthme et anxiété qui a un impact négatif sur le contrôle de l'asthme.

Blood withdrawal acutely impairs cardiac filling, output and aerobic capacity in proportion to induced hypovolemia in middle-aged and older women.

Blood donation entails acute reductions of cardiorespiratory fitness in healthy men. Whether these effects can be extrapolated to blood donor populations comprising women remains uncertain. The purpose of this study was to comprehensively assess the acute impact of blood withdrawal on cardiac function, central hemodynamics and aerobic capacity in women throughout the mature adult lifespan. Transthoracic echocardiography and O2 uptake were assessed at rest and throughout incremental exercise (cycle ergometry) in healthy women (n = 30, age: 47-77 yr). Left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac output (Q̇) and peak O2 uptake (V̇O2peak), and blood volume (BV) were determined with established methods. Measurements were repeated following a 10% reduction of BV within a week period. Individuals were non-smokers, non-obese and moderately fit (V̇O2peak = 31.4 ± 7.3 mL·min-1·kg-1). Hematocrit and BV ranged from 38.0 to 44.8% and from 3.8 to 6.6 L, respectively. The standard 10% reduction in BV resulted in 0.5 ± 0.1 L withdrawal of blood, which did not alter hematocrit (P = 0.953). Blood withdrawal substantially reduced cardiac LVEDV and SV at rest as well as during incremental exercise (≥10% decrements, P ≤ 0.009). Peak Q̇ was proportionally decreased after blood withdrawal (P < 0.001). Blood withdrawal induced a 10% decrement in V̇O2peak (P < 0.001). In conclusion, blood withdrawal impairs cardiac filling, Q̇ and aerobic capacity in proportion to the magnitude of hypovolemia in healthy mature women. Novelty: The filling of the heart and therefore cardiac output are impaired by blood withdrawal in women. Oxygen delivery and aerobic capacity are reduced in proportion to blood withdrawal.