[Questions and answers in respiratory tract diseases. 12. Pulmonary function tests].
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According to recent definitions the person enters a senile age after 65. Each person starts ageing after the completion of maturation. The phenomenon of ageing is highly individual and differs among people with respect to its rate and affected systems and organs. This may be responsible for a frequent inequality of metrical and biological age. Ageing is a multisystem process which also leads to alterations in symptomatology of many diseases. The process of ageing has been very well described, especially in the cardiovascular system. In contrast, ageing of the respiratory tract is far less recognised and still remains a subject of debates. The elderly are affected by the same diseases as younger individuals. The most common diseases at this age are respiratory tract infections, tuberculosis, chronic obstructive pulmonary diseases and bronchial asthma. Their course may be, however, different in the elderly not only due to the physiologic process of ageing but also frequent comorbidities. This fact should be taken into account when establishing a diagnosis and treatment regimens. A therapy of the older person usually requires a highly individualized approach.
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HLA B27 antigen was found in 10/25 patients with arthritis after acute respiratory disease (ARD) and in 21/75 direct relatives of 23 of these probands, where a genealogical investigation could be made. With regard to the 9.5% incidence of HLA B27 in the Czech population this implies a positive association in patients (RR = 6.35) and direct relatives (R = 3.70). In the sub-group of HLA B27 positive probands HLA B27 positivity was found in 19/27 (70.4%) of direct relatives (RR = 22.6). In one female relative a recurrent monoarthritis of the talo-crural joint was found, the remainder did not suffer from inflammatory changes of the joints. The revealed positive associations indicate the probability of arthritis after ARD in HLA B27 positive subjects and their families. They indicate also that in arthritis after ARD reactive arthritis is involved with a less common organ manifestation of the initial infection.
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