Exercise-Induced Bronchoconstriction Diagnostics:Impact of a Repeated Exercise Challenge Test

Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.

24-hour esophageal pH-monitoring in children suspected of gastroesophageal reflux disease: Analysis of intraesophageal pH monitoring values recorded in distal and proximal channel at diagnosis

AIM: To assess values of 24-h esophageal pH-monitoring parameters with dual-channel probe (distal and proximal channel) in children suspected of gastroesophageal reflux disease (GERD). METHODS: 264 children suspected of gastroesophageal reflux (GER) were enrolled in a study (mean age χ = 20.78 ± 17.23 mo). The outcomes of this study, immunoallerrgological tests and positive result of oral food challenge test with a potentially noxious nutrient, enabled to qualify children into particular study groups. RESULTS: 32 (12.1%) infants (group 1) had physiological GER diagnosed. Pathological acid GER was confirmed in 138 (52.3%) children. Primary GER was diagnosed in 76 (28.8%) children (group 2) and GER secondary to allergy to cow milk protein and/or other food (CMA/FA) in 62 (23.5%) children (group 3). 32 (12.1%) of them had CMA/FA (group 4-reference group), and in remaining 62 (23.5%) children neither GER nor CMA/FA was confirmed (group 5). Mean values of pH monitoring parameters measured in distal and proximal channel were analyzed in individual groups. This analysis showed statistically significant differentiation of mean values in the case of: number of episodes of acid GER, episodes of acid GER lasting > 5 min, duration of the longest episode of acid GER in both channels, acid GER index total and supine in proximal channel. Statistically significant differences of mean values among examined groups, especially between group 2 and 3 in the case of total acid GER index (only distal channel) were confirmed. CONCLUSION: 24-h esophageal pH monitoring confirmed pathological acid GER in 52.3% of children with typical and atypical symptoms of GERD. The similar pH-monitoring values obtained in group 2 and 3 confirm the necessity of implementation of differential diagnosis for primary vs secondary cause of GER.

Environmentally Safe Surfactants in Cosmetic/Detergent Formulations:Risk of Microbial Contamination and Possible Solutions

Eco-and bio-compatible surfactants could potentially increase the risk of microbial contamination of the formulations in which they are included. In the present work, we characterize the microstructure of an hair conditioner formulation based on the bio-compatible cationic surfactant. Behenamidopropyldimethylamine(BAPDA) and evaluated its in vitro microbiological stability. The mixture presents an isotropic micellar structure, as revealed by Electron Paramagnetic Resonance(EPR) spectroscopy. The Challenge Test results show that the formulation is not sel-preserving, requiring the addition of selected preservatives, whose concentration has to be carefully optimized, to inhibit the growth of contaminating micro-organisms.

Diagnosis and management of gestational diabetes mellitus in China

One of the most frequent medical complications of pregnancy is diabetes, and its incidence is increasing every year. A portion of pregnant women with diabetes have overt diabetes whereas the major portion have gestational diabetes mellitus （GDM）,

Efficacy of Chaihu Jisang decoction on post-infection cough and its effect on cough reflex sensitivity

OBJECTIVE:To investigate the efficacy of Chaihu Ji Sang Decoction(CJSD),(a modification of Xiao Chaihu Tang(Minor Decoction of Bupleurum) was evaluated in patients with post-infection cough(PIC).Its effect on cough reflex sensitivity(CRS) was also described.METHODS:One hundred and eighteen patients with PIC were enrolled and randomly divided into an experimental group and control group(54 patients in each group).The experimental group was given CJSD orally,and the control group was given cetirizine hydrochloride for 7 d.Cough symptom scores and TCM symptom scores were compared before and after treatment.Efficacy,cough onset time,recurrence,and adverse drug reactions were additionally evaluated.Finally,CRS was evaluated before and after treatment of PIC patients in the experimental group.RESULTS:Fifty-two patients in the experimental group and fifty control patients completed the study.Cough symptom scores and the TCM symptom scores of the two groups were significantly improved after treatment,however cough symptoms in the experimental group 1(0,2) were significantly lower than the control group 2(1,2) after treatment(P < 0.05).Similarly,TCM symptom scores 4(0,7) in the experimental group were significantly lower than the control group 6(3,12)(P < 0.01).Overall,the effective rate of the experimental treatment(84.60%) was significantly higher than that of the control treatment(68.00%)(P < 0.01).The onset time of efficacy of the experimental treatment was one day faster than the control treatment [2(2,3) d vs 3(2,3) d,P < 0.01].The relapse rate in the experimental group(9.09%) was lower than that of the control group(29.41%)(P < 0.05).39 PIC patients in the experimental group completed a capsaicin cough challenge test before treatment.The lgC2 and lg C5 of the experimental group prior to treatment was 1.19(0.59,1.49) and 1.80(1.49,2.10),respectively.The lgC2,lg C5 of the healthy control group was 1.49(0.89,2.40) and 2.70(2.40,3.00),respectively.The differences in lgC2 and lg C5 between experimental group and healthy groups were significant at this time point(both P < 0.01).After treatment,34 patients in the experimental group received re-examination.lg C5 increased from 1.80(1.49,2.10) to 2.10(1.49,3.00).CRS after treatment/re-examination was significantly lower than those of baseline in the experimental group(P < 0.05).CONCLUSION:CJSD could effectively improve the clinical symptoms of PIC patients,with demonstrable low recurrence and safety.CJSD also significantly decreased the CRS in patients with PIC.