Does the clinical examination predict airflow limitation?

Article Abstract:

A thorough medical examination may detect signs and symptoms of airflow limitation. Airflow limitation is a respiratory disease characterized by narrowed lung passages and increased lung secretions. Researchers reviewed the medical literature that evaluated clinical examination findings indicative of airflow limitation. Patients' exposure to cigarette smoke, particularly the length of smoking history, is positively associated with the risk of airflow limitation. Age is related to airflow limitation, with the highest rates found in children younger than age 10 and adults older than age 30. Physical findings associated with an increased risk of airflow limitation include a rounded, large chest, abnormal breathing sounds including wheezing and rhonchi, abnormal chest sounds heard on percussion, and subxyphoid apical impulse. Patients who cannot blow out a lighted match held 10 centimeters away from their mouth and those with a forced expiratory time greater then nine seconds are likely to have airflow limitation.

Lung diseases, Obstructive, Chronic obstructive lung disease, Airway obstruction (Medicine), Airway obstruction

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Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis

Article Abstract:

A three-day course of the antibiotic trimethoprim-sulfamethoxazole appears to be as effective as a 10-day regimen in treating patients with sinus inflammation. Researchers treated 76 men who had sinus inflammation with a nasal decongestant and two daily doses of 160 milligrams (mg) of trimethoprim and 800 mg of sulfamethoxazole. Thirty-nine men took the antibiotic for three days while 37 men took the drug for 10 days. Symptoms of sinus inflammation significantly improved or were cured in a median of five days in patients on the three-day regimen and 4.5 days in those on the 10-day regimen. After two weeks of treatment, symptoms had significantly improved or resolved in 77% of patients on the three-day regimen and 76% on the 10-day regimen. Of these, 11% of patients in the 3-day treatment group and 4% in the 10-day treatment group relapsed within 30 days and 4% in both groups had a recurrence within 60 days.

Evaluation, Drug therapy, Co-trimoxazole, Trimethoprim-sulfamethoxazole (Drug combination)

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Clinical evaluation for sinusitis: making the diagnosis by history and physical examination

Article Abstract:

Five signs and symptoms are the most useful in diagnosing sinusitis, an inflammation of the membrane lining the sinuses. Among 247 men who had been experiencing symptoms of sinusitis for an average of 12 days, 51% had nasal discharge, 22% were suffering from facial pain and 27% had self-suspected sinusitis. Thirty-eight percent of the patients were diagnosed with sinusitis. Five signs and symptoms that were associated with a diagnosis of sinusitis were toothache in the upper jaw, abnormalities seen during examination of the sinus cavity, failure to respond to nasal decongestants or antihistamines, colored nasal discharge or a discharge containing a combination of mucous and pus. Overall clinical impression was the most useful tool for diagnosing or classifying patients suspected of having sinusitis.

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