Category Archives: Lung

Obstructive Lung Disease Among the Urban Homeless: Conclusion

Obstructive Lung Disease Among the Urban Homeless: ConclusionThis study has several limitations. First, homelessness encompasses a broad range of people and conditions; the characteristics of persons who live on the streets are different from shelter residents or those living with family or friends. Therefore, health indicators, such as the prevalence of OLD, may vary by specific homeless group. This study focuses on one segment of the homeless population that may not be applicable to all homeless individuals, especially in that shelter residents may have better health or at least different degree of disease. However, a large proportion, if not the majority, of homeless people in the United States are staying in a shelter at least part of the time. Shelter residents are more likely to be homeless for the first time and homeless for < 6 months. This has important healthcare consequences, as long-term homeless (> 5 years) are less likely to report a site of care, and unsheltered homeless are more likely to abuse alcohol or drugs. Our finding of higher OLD in the shelter population raises the concern that the street population may have even a higher prevalence of OLD. asthma inhalers

Obstructive Lung Disease Among the Urban Homeless: Homelessness and OLD

Respiratory symptoms suggestive of OLD in our homeless sample were common. While respiratory symptoms related to infections have been well documented in the homeless, few studies evaluated symptoms possibly related to OLD. One study of marginally housed and street homeless male subjects compared to similar urban-housed male subjects found a higher rate of breathlessness in the homeless compared to the housed sample. Moreover, we found a high prevalence of self-reported OLD among the homeless, which was greater than that found in the general population of San Francisco County and the United States. my canadian pharmacy online

Obstructive Lung Disease Among the Urban Homeless: Discussion

Obstructive Lung Disease Among the Urban Homeless: DiscussionDespite the high prevalence of OLD among the homeless, few subjects received regular medical care for their respiratory condition. Among the 22 subjects who reported a physician diagnosis of asthma, chronic bronchitis, emphysema, or COPD, only 11 subjects (50%) indicated that they had at least one ambulatory medical visit for wheezing or dyspnea during the past 12 months. Similarly, a small proportion of homeless adults with OLD, as defined by spirometry, had an outpatient medical visit for respiratory symptoms (n = 10; 30%). Perhaps reflecting the low utilization of ambulatory medical care, the majority (60%) of homeless persons with OLD did not report a physician diagnosis of an airway disease (ie, asthma, chronic bronchitis, emphysema, or COPD). Moreover, only a small proportion of homeless with a self-reported diagnosis of airway disease or OLD (by spirometry) reported treatment with a respiratory medication during the past year (50% and 20%, respectively). canadian drug mall

Obstructive Lung Disease Among the Urban Homeless: OLD

Pulmonary function measurement among 67 homeless adults revealed a high prevalence of impairment (Table 4). The mean FEV1 was 2.80 L/s (SD 0.79), which was 85% predicted for the sample. However, the FEV1 range included some very low values (0.87 to 4.41 L/s), and 37% of the homeless subjects had a low FEV1 (< 80% predicted). The mean FVC was 3.74 L (SD 1.05), which was 91% predicted. The range of FVC also included some very low values (1.51 to 5.82 L), with 30% of homeless subjects having an FVC < 80% predicted. Mean FEVj/FVC ratio was 0.76 (SD 0.10), with 24% of subjects having a ratio < 0.70. canadian family pharmacy

Obstructive Lung Disease Among the Urban Homeless: Chronic respiratory symptoms

Obstructive Lung Disease Among the Urban Homeless: Chronic respiratory symptomsThe duration of the current period of homelessness was a mean of 42 months (SD 82) with 47% homeless < 1 year, 35% homeless 1 to 5 years, and 18% homeless > 5 years (Table 2). Almost one half had never been homeless before (28 subjects; 42%), one fourth had been homeless once before (18 subjects; 26%), one fourth had been homeless two to five times before (15 subjects; 22%), and the minority had been homeless more than five times before (6 subjects; 9%). Not considering the current night, the majority had spent some part of the last 30 days in a shelter (86%), followed by staying outside on the streets, in a car, or an abandoned business (40%), and in a single-occupancy hotel (22%).

Obstructive Lung Disease Among the Urban Homeless: Statistical Analysis

Data were analyzed using statistical software (SAS Version 8.1; SAS Institute; Cary, NC). We used a multifaceted approach to define the prevalence of OLD among homeless adults based on symptoms, diagnosis, and pulmonary function. We calculated the prevalence of chronic respiratory symptoms, self-reported physician diagnosed OLD, and OLD based on the Global Initiative for Chronic Obstructive Lung Disease spirometric definition. The 95% confidence intervals (CIs) were calculated using the binomial distribution.
Because approximately half the sample was comprised of African-Americans, we used the x2 test to evaluate the impact of African-American race on the prevalence of chronic respiratory symptoms, self-reported physician-diagnosed OLD, pulmonary function impairment, and OLD based on pulmonary function. In addition, we present the pulmonary function results, including the prevalence of OLD, stratified by African-American race and other race/ethnicity. buy antibiotics online

Obstructive Lung Disease Among the Urban Homeless: Spirometry

Obstructive Lung Disease Among the Urban Homeless: SpirometrySelf-reported general health status was assessed using a question developed for the National Health Interview Survey and used in the Medical Outcomes Study Short Form-36, the most widely used generic health status measure. Respiratory symptoms in the past 12 months were evaluated by questions used in the National Health and Nutrition Examination Survey (NHANES) III: do you usually cough on most days for 3 consecutive months or more during the year, do you bring up phlegm or sputum or mucus on most days for 3 consecutive months or more during the year, have you had wheezing or whistling in your chest, and have you had any times when you had to stop for breath when walking about 100 yards or a few minutes on level ground? Based on these responses, we defined chronic bronchitis as affirmative responses to the cough and phlegm items. They were also asked if they had been told by a health-care professional that they had emphysema, chronic bronchitis, asthma, COPD, or any other lung problem. Other items from NHANES III were used to ascertain ambulatory medical visits and medications received for wheezing and dyspnea during the past 12 months. Finally, past and current use of cigarettes, cigars, and tobacco pipes was evaluated using questions from the National Health Interview Survey. contraceptive pills

Obstructive Lung Disease Among the Urban Homeless: Interview Content

Male subjects were randomly selected by shelter bed number to participate in the survey. For both sexes, shelter residents were ineligible if they were receiving medical treatment for active tuberculosis, had symptoms of active tuberculosis or an active pulmonary infection (fevers, chills, new or changed productive cough), were unable to complete survey (due to language barrier or poor mental status), or had chest or abdominal surgery in last 3 weeks. Written or verbal consent was obtained from all participants. The study was approved by the University of California, San Francisco Committee on Human Research. acular eye drops

Obstructive Lung Disease Among the Urban Homeless

Obstructive Lung Disease Among the Urban HomelessHomeless individuals represent a growing proportion of the US population. The challenges of living on the street, in a shelter, or in a transitional housing facility are unique and may significantly impair health. Homeless have significant rates of smoking, substance abuse, and mental illness, all of which can negatively affect physical health and impede access to care. In fact, the homeless do appear to have poorer perceived health. The prevalence and severity of physical disease among the homeless may be caused by or exacerbated by poor environmental conditions, poor nutritional status, and barriers to health care. The homeless may be at higher risk of obstructive lung disease (OLD), which is a leading cause of death and disability in the United States. Selfreported OLD, including asthma, chronic bronchitis, and emphysema, is higher among the homeless compared to the housed population. Cigarette smoking, a major cause of OLD, also appears to be common among the homeless. Although respiratory infections are a common reason for the homeless to seek medical attention, the occurrence of symptoms specific to OLD, including cough, wheezing, and phlegm production, has not been well documented in this group. The actual prevalence of OLD among the homeless, based on pulmonary function measurement, remains unknown. To examine this problem, we evaluated the prevalence of OLD in a random sample of homeless adults living in San Francisco. alphagan eye drops

Anatomic Evaluation of Postural Bronchial Drainage of the Lung With Special Reference to Patients With Tracheal Intubation: Study Limitation

The lung materials examined in the present study were usually fixed at their maximum expiratory point at death. However, chest physiotherapy is generally performed in the tidal volume range. How much difference in the bronchial courses and branching angles would there be for the fixed cadaveric lungs? Can some of the extreme variation in branching angles be attributed to the maximum expiratory point at death? Although further intensive studies might be necessary to resolve these questions, using three-dimensionally reconstructed images obtained from high-resolution CT for three pairs of healthy lungs of the present authors (N.T., G.M., A.I.), we investigated the difference in branching angles between the tidal volume range and forced expiratory point. The results were summarized as follows: (1) effectiveness for the segmental drainage seemed to be almost consistent because the changes in branching angles of all segmental bronchi were limited to ± 5° except for B and B with + 10 to + 15° (thus, they became more effective); (2) the changes in subsegmental bronchial angles ranged from 26 to + 38° (mean, + 5.2°) in B, B1 + 2, B, and B; and (3) changes in branching angles of another subsegmental bronchi, such as in the middle and lower lobes, were limited to ± 10° and provided no negative influence on the effectiveness category.

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