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J Manfreda

Publications and source records attributed to J Manfreda.

79 records · Page 5Linked to original sources
PubMed1978

Prevalence of respiratory abnormalities in a rural and an urban community.

Population samples stratified on sex, age and smoking habits were studied in a rural and an urban community with a low level of air pollution to establish "normal" values of parameters derived from the single-breath N2 curve, the effect of smoking on these parameters, and any differences related to an urban or rural environment. Respiratory symptoms and past illnesses, smoking habits, and residential as well as occupational history were obtained by a respiratory questionnair. Pulmonary function was assessed by the single-breath N2 test and the forced vital capacity maneuver. In "healthy" nonsmokers, residual volume/total lung capacity, closing volume/vital capacity on expiration, and closing capacity/total lung capacity were significantly related to age. The slope of phase III was related to neither height nor age. There was no significant difference in prediction equations between the 2 communities for any of these parameters. Multiple regression analysis indicated that smoking had an effect on residual volume/total lung capacity, closing volume/vital capacity on expiration, closing capacity/total lung capacity, and the slope of phase III in both sexes. Abnormal values were more prevalent among male than female smokers in both communities, the highest prevalence being found in the slope of phase III in both sexes (35 to 40 per cent). The slope of phase III and closing capacity/total lung capacity were consistently related to the current number of cigarettes smoked per day.

Adult↗
PubMedDate not supplied

A case-control study of the role of cold symptoms and other historical triggering factors in asthma exacerbations.

BACKGROUND: Asthma exacerbations can be provoked by many triggers such as allergens, respiratory irritants and viral infections. The relative importance of these has not been prospectively documented in a case-control study. OBJECTIVE: To assess the relative importance of colds and other nonclimatic historical triggers of asthma exacerbations. METHODS: One hundred and nineteen adults and children with asthma in two Canadian cities participated in a one-year study of the role of exacerbating factors in asthma. Among these, 36 pairs (21 adult, 15 children) completed the case-control study. Patients were considered cases if they developed an acute asthma exacerbation and notified the centre within 24 h to allow the completion of a questionnaire and viral studies (cultures of nasopharyngeal swabs and serology). Control people with asthma were matched for sex, age and area of residence, had no exacerbation during the preceding four weeks and participated within 48 h of the case patients. RESULTS: Case patients versus control patients had a mean age of 22 years versus 20 years, 50% versus 55% were male, and 92% versus 86% had at least one positive aeroallergen skin test. Cases were more likely to have taken regular inhaled steroids (63% versus 33%, P<0.002). Cases were more likely to report the following within the previous week: fever (P<0.001), sore throat (P<0.001), increase in nasal symptoms (P<0.01), increased dust exposure (P<0. 05), exposure to others with a cold (P<0.001) and, over the previous year, increased passive smoke exposure (P<0.05). Viral cultures and paired serology were negative. CONCLUSIONS: Symptomatic colds were the most common trigger of asthma exacerbations in the winter and spring, while a transient increase in dust exposure was also identified as a significant trigger. The association with chronic, passive smoke exposure and the use of inhaled costicosteroid medications likely reflected less stable pre-study asthma in those with exacerbations.

Adult↗
PubMedDate not supplied

Spirometry and obstructive lung disease in Manitoba.

BACKGROUND: Spirometry, the measurement of forced expiratory volume in 1 s and forced vital capacity, is recommended in the diagnosis and management of the obstructive lung diseases asthma and chronic obstructive pulmonary disease (COPD). The present report describes spirometry use in Manitoba and tests the hypothesis that regional spirometry use correlates with the prevalence of physician-diagnosed obstructive lung diseases. METHODS: Spirometry is renumerated on a fee-for-service basis by Manitoba Health. Like other physician services, billing data include a diagnosis, patient identifiers, as well as the patient's sex, date of birth and residential postal code. Physician billings for spirometry for 1991 to 1998 were analyzed, comparing data with billings for physician visits for obstructive diseases. Four age groups were examined, as were income quintiles in Winnipeg, Manitoba. In addition, the prevalence of physician-diagnosed obstructive diseases were compared with spirometry rates in 49 service use areas of the province. RESULTS: Annually, about 3% of the Manitoba population underwent spirometry, and in aggregate, about 14% underwent spirometry during the eight years of the study. Rates in Winnipeg were higher than in the remainder of the province. Spirometry rates did not increase with time, and people who underwent spirometry had 1.4 to 1.7 tests/year. In children, higher income quintiles were tested more than lower income quintiles, while in adults, income quintiles were tested with equal frequency. People with obstructive lung disease accounted for about 75% of those tested, and in people with these diagnoses, the likelihood of testing increased approximately linearly with the number of physician visits for asthma or COPD. Children with asthma were tested less often than adults, and adults with asthma or both asthma and COPD were tested more often than those with COPD alone. In adults with asthma or asthma and COPD who had more than 10 physician visits for these diagnoses, testing rates were more than 70%, and multiple tests were common. In patients labelled with COPD only and with more than 20 physician visits, about one-third did not undergo spirometry. In children aged five to 14 years and in adults 15 to 44 years old, regional spirometry rates correlated well with regional asthma rates. Regional spirometry rates also correlated significantly with regional rates of asthma and/or COPD in people older than 34 years old. INTERPRETATION: Spirometry use is considerably higher in patients with asthma than in patients with COPD, suggesting that guidelines are followed more closely in patients with asthma, and that many patients are labelled with COPD without appropriate documentation. Spirometry use is apparently indicative of physician interest in the problem of obstructive lung diseases.

Adolescent↗