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Swiss Medical Weekly
Article . 2006 . Peer-reviewed
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Swiss Medical Weekly
Article . 2006
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The absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?

Authors: d'Andiran, G.; Schindler, C.; Leuenberger, P.;

The absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?

Abstract

The diagnosis of obstructive lung disease (OLD) may be overlooked because of the poor correlation between the intensity of symptoms and the severity of airway obstruction (AO). Undiagnosed airflow obstruction (UDAO) is associated with health impairment and mortality. Questions remain such as the reasons for its occurrence and the underlying diseases. In a pulmonologist's private practice, the objectives were to detect UDAO in the absence of dyspnoea, cough and wheezing, to improve its screening following other anamnestic data, and to separate UDAO patients into "silent asthma" (SA) or "persistent obstruction".Patients were subjected to a verbal questionnaire for the detection of alternative indication for pulmonary function tests (PFTs), to a physical examination and, in the case of a severe smoking habit, to a chest X-ray. PFTs were performed whenever an OLD history or another lung disease was present and, in the absence of any dyspnoea, cough and wheezing, when other symptoms and conditions occurred (sputum, chest tightness, fatigue, rhinitis, snoring; active/passive smoking, recurrent lower respiratory tract infections, asthma in childhood or in family, atopy).Of 3762 consecutive patients, 1389 patients with AO were identified. Among them, 147 UDAO patients were detected with no history of dyspnoea, cough and wheezing (3.9% and 10.6%, respectively). All these patients had other suggestive symptoms and AO risk factors which justified PFTs. They presented with mild (65%), moderate (21%) or even severe (16%) AO. SA patients normalized their spirometric values under treatment.The absence of dyspnoea, cough and wheezing is a fairly frequent finding and a reason for UDAO. PFTs are warranted with any suggestive symptoms and AO risk factors. The favourable follow-up underlines the importance of screening for UDAO.

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Keywords

Adult, Male, Adolescent, Adolescent; Adult; Aged; Aged, 80 and over; Airway Obstruction/complications; Airway Obstruction/diagnosis; Airway Obstruction/epidemiology; Airway Obstruction/physiopathology; Asthma/complications; Asthma/diagnosis; Cough/etiology; Cough/physiopathology; Dyspnea/etiology; Dyspnea/physiopathology; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Male; Middle Aged; Prospective Studies; Respiratory Sounds/etiology; Respiratory Sounds/physiopathology; Risk Factors; Severity of Illness Index; Social Class; Surveys and Questionnaires; Switzerland/epidemiology; Vital Capacity, Severity of Illness Index, Risk Factors, Forced Expiratory Volume, Surveys and Questionnaires, Respiratory system abnormalities, Airflow obstruction, Humans, Prospective Studies, Aged, Respiratory Sounds, Aged, 80 and over, Undiagnosed airflow obstruction, screening, R, Middle Aged, Asthma, Airway Obstruction, Dyspnea, Cough, Social Class, symptoms, Medicine, Perception, Female, Follow-Up Studies

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    popularity
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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
11
Average
Average
Average
Green
Published in a Diamond OA journal