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1.
Med. leg. Costa Rica ; 36(2): 68-75, sep.-dic. 2019.
Artigo em Espanhol | LILACS-Express | ID: biblio-1040446

RESUMO

Resumen La exposición al tabaco en el útero se asocia con un menor crecimiento fetal, una disminución en el peso al nacer y un incremento significativo de nacimientos con bajo peso. Por otra parte, diversos estudios han indicado que el tabaquismo materno puede provocar sobrepeso u obesidad y un aumento rápido de peso en la infancia, lo puede aumentar el riesgo de enfermedades cardiovasculares y diabetes tipo 2 en la adultez temprana. Los niños expuestos a humo de tabaco en la vida intrauterina, tienen un sistema autónomo hiperreactivo durante las primeras semanas de vida, un crecimiento desproporcionado entre el parénquima pulmonar y las vías aéreas (crecimiento disináptico pulmonar), una disminución en la función pulmonar, un riesgo aumentado de asma, bronquitis y sibilancias en el producto. Existen asociaciones entre el tabaquismo materno y la reducción de las capacidades psicomotoras infantiles, así como los problemas de conducta incluido el trastorno por déficit de atención/hiperactividad en la niñez. Se ha observado un aumento en el riesgo de neoplasias benignas en la infancia (hemangioma y quiste tiroideo), pero no de neoplasias malignas.


Abstract Exposure to tobacco in the uterus is associated with lower fetal growth, a decrease in birth weight and a significant increase in low birth weight births. On the other hand, several studies have indicated that maternal smoking can cause overweight or obesity and a rapid increase in weight in childhood, which can increase the risk of cardiovascular disease and type 2 diabetes in early adulthood. Children exposed to tobacco smoke in intrauterine life, have a hyperreactive autonomic system during the first weeks of life, a disproportionate growth in lung parenchyma and airways (pulmonary dysynaptic growth), a reduction in lung function, an Increased risk in asthma, bronchitis and wheezing in the product. There are associations between maternal smoking and the reduction of infant psychomotor abilities, as well as behavioral problems that include children attention-deficit/hyperactivity disorder. There has been an increase in the risk of benign neoplasms in childhood (hemangioma and thyroid cyst), but not malignant neoplasms.

2.
Rev. Fac. Nac. Salud Pública ; 37(2): 116-124, may-ago. 2019. tab
Artigo em Espanhol | LILACS-Express | ID: biblio-1013250

RESUMO

Resumen Objetivo: Estimar la mortalidad atribuible al consumo de cigarrillo en el Caribe colombiano durante los años 2009-2013. Metodología: Estudio descriptivo retrospectivo. El número de defunciones se obtuvo del Departamento Administrativo Nacional de Estadísticas. La proporción y las muertes atribuibles al tabaco fueron estimadas a partir de la fracción etiológica poblacional, utilizando un método dependiente de prevalencia de consumo. Se calcularon los años potenciales de vida perdidos (descuento 3 %). La información se analizó en los programas Excel® y Epidat 4.1. Resultados: Se atribuyeron 964 muertes (método i), 1375 muertes (método ii) y 94 muertes (método iii). Los cánceres de tráquea, pulmón y bronquios fueron los que más contribuyeron a dicha mortalidad. Un total de 17 715 años potenciales de vida se perdieron (7745 en hombres, 9970 en mujeres). Conclusión: El consumo de tabaco en el Caribe colombiano contribuye significativamente a la mortalidad por cáncer y al aumento de años potenciales de vida perdidos.


Abstract Objective: To estimate the mortality attributable to cigarette consumption in the Colombian Caribbean during the years 2009-2013. Methodology: retrospective descriptive ecological study. The number of deaths was obtained from the National Administrative Department of Statistics. The proportion and deaths attributable to smoking were estimated from the population etiological fraction, using a method dependent on prevalence of consumption. Potential years of life lost (3% discount) were calculated. The information was analyzed in Excel and Epitat 4.1 programs. Results: There were 964 deaths (method i), 1375 deaths (method ii) and 94 deaths (method iii). Cancer of the trachea, lungs and bronchi was the neoplasia that most contributed to this mortality. A total of 17715 potential years of life were lost (7745 in men, 9970 in women). Conclusion: Tobacco use contributes significantly to cancer mortality and increases in potential years of life lost.


Resumo Objetivo: Estimar a mortalidade atribuível ao tabagismo no Caribe colombiano durante 2009-2013. Metodologia: Estudo descritivo retrospectivo. O número de mortes foi obtida a partir do Departamento Administrativo Nacional de Estatísticas. A proporção e raé mortes atribuíveis foram estimados a partir da fracção etiológico população usando uma prevalência dependente método de utilização. Anos potenciais de vida perdidos (3% de desconto) foram calculados. A informação foi analisada em 4.1 programas Excel e Epidat. Resultados: 964 mortes (método i), de 1375 mortes (Método ii) e 94 mortes (Método iii) é atribuída. Câncer da neoplasia traquéia, pulmão e brônquios foi o principal contribuinte para essa mortalidade. Um total de 17715 anos potenciais de vida perdidos (7745 homens, 9970 mulheres). Conclusão: O consumo de tabaco contribui significativamente para a mortalidade por câncer e aumento de anos potenciais de vida perdidos.

3.
Rev. Soc. Bras. Clín. Méd ; 17(2): 93-100, 20190000.
Artigo em Português | LILACS-Express | ID: biblio-1026517

RESUMO

Objetivo: Avaliar o conhecimento da população sobre pneumologia, doença pulmonar obstrutiva crônica , asma e tabagismo. Métodos: Estudo transversal conduzido entre julho e outubro de 2017, avaliando o conhecimento da população de Curitiba, a partir de 18 anos, a respeito de pneumologia, asma, doença pulmonar obstrutiva crônica e tabagismo, por meio de questionários aplicados em espaços públicos. Médicos foram excluídos. Resultados: Foram entrevistadas 384 pessoas, com idade média de 35±14 anos, sendo 52% mulheres. Tinham Ensino Superior (completo ou incompleto) 55%, 44% não ultrapassaram o Ensino Médio e 5%, o Fundamental. Fumantes atuais ou pregressos representaram 32% da amostra. Sabiam o significado da palavra pneumologista 77%, já o termo "doença pulmonar obstrutiva crônica" foi reconhecido por apenas 7%. A maioria procuraria um clínico geral se apresentasse tosse persistente (69%) ou dispneia (63%). As doenças associadas ao tabagismo mais lembradas foram neoplasia de pulmão (86%) e doenças pulmonares (37%). O tabagismo foi reconhecido como causador de dependência por 98% e como doença por 64%. Em relação aos sintomas da asma, foram citados dispneia (90%), tosse (18%), aperto no peito (16%) e chiado (10%). Da amostra, 53% acreditavam que os dispositivos inalatórios engordavam e 59% que geravam dependência. Maior escolaridade associou-se com menor frequência de tabagismo, maior conhecimento sobre o pneumologista e sobre a associação do tabagismo com doença pulmonar obstrutiva crônica. Conclusão: Os curitibanos têm conhecimento limitado a respeito da doença pulmonar obstrutiva crônica, asma e tabagismo, além de acreditarem em mitos relacionados aos dispositivos inalatórios. A procura pelo médico pneumologista é baixa. Descritores: Asma; Doença


Objective: To evaluate the population knowledge about pneumology, chronic obstructive pulmonary disease, asthma and smoking. Methods: This is a cross-sectional study conducted from July to October 2017 to evaluate the knowledge of the population of the city of Curitiba, above 18 years old, about pneumology, chronic obstructive pulmonary disease, asthma and smoking, using questionnaires applied in public places. Physicians were excluded. Results: A total of 384 people was interviewed, with an average age of 35±14 years, 52% of them being women. Fifty-five percent reported (complete or incomplete) higher education, 44% did not go further than high school, and 5%, intermediate school. Current or past smokers accounted for 32% of the sample. The meaning of the word pulmonologist was known by 77% of people, while the term "chronic obstructive pulmonary disease" was recognized by only 7%. Most would go to a general practitioner if they had persistent cough (69%) or dyspnea (63%). The most remembered smoking-related diseases were: lung cancer (86%) and lung diseases (37%). Smoking was recognized to cause dependence by 98%, and as a disease by 64%. Dyspnea (90%), cough (18%), chest tightness and wheezing (10%) were mentioned as symptoms of asthma. Fifty-three percent of the sample believed that inhaling devices led to weight gain, and 59% believed they generated dependence. Higher level of education was associated with a lower smoking frequency, greater knowledge about the pulmonologist and about the association of smoking with respiratory diseases. Conclusions: The population of Curitiba has a limited knowledge about chronic obstructive pulmonary disease, asthma and smoking, and frequently believes in myths related to inhaling devices. The search for a pulmonologist is low.

4.
Rev. Hosp. Niños B.Aires ; 61(272): 18-24, abr. 2019.
Artigo em Espanhol | LILACS | ID: biblio-995538

RESUMO

Introducción: Los episodios de obstrucción bronquial durante el primer año de vida en los lactantes sanos, constituyen una consulta frecuente en pediatría. El objetivo es evaluar el impacto del tabaquismo prenatal como factor asociado a padecer episodios de sibilancias en el primer año de vida en lactantes sanos, sin historia familiar de asma y/o atopía. Métodos: Estudio transversal realizado entre mayo del 2012/2013 en el Hospital de Niños "Ricardo Gutiérrez", mediante una encuesta dirigida a madres de lactantes sanos de 12 a 15 meses de edad, sin antecedentes familiares de asma y /o atopía. El objetivo fue evaluar el tabaquismo prenatal como factor de riesgo asociado a padecer episodios de obstrucción bronquial en lactantes sanos, en el primer año de vida. Resultados: Se contactaron 601 madres de lactantes sanos de 12 a 15 meses de edad. Fueron elegibles 379 para completar la encuesta acerca de lo ocurrido en el primer año de vida de sus hijos. Mediante análisis multivariado, los factores de riesgo asociados a padecer al menos un episodio de sibilancia fueron: exposición prenatal (EP) al humo del tabaquismo materno (p=0.03 ODDS= 3 IC 95% 1,09 ­ 8,27), sexo masculino (p=0,002, ODDS 2,03 IC 1,29-3,20), edad del primer resfrío (p < 0,001 ODDS 0,76 IC 0,69-0,83). Conclusiones: En lactantes sanos, sin factores de riesgo para asma y/o atopía, el tabaquismo prenatal constituyó un factor de riesgo para generar sibilancias broncopulmonares e infecciones virales respiratorias a una edad más temprana.


Introduction: During the first year of life of healthy infants, bronchial obstructive episodes are a frequent reason of consultation in pediatric practice. The objective was to assess the impact of prenatal smoking as a risk factor associated to bronchospasm episodes during the first year of life in healthy infants without family history of asthma and/or atopia. Methods: Cross-sectional study performed between May, 2012 and May 2013 at Hospital de Niños "Ricardo Gutiérrez", through a survey completed by mothers of healthy infants from 12 to 15 months old without asthma and/or atopia family antecedents. Main purpose was to assess the prenatal smoking as a risk factor associated to bronchospasm episodes during the first year of life in healthy infants. Results: 601 mothers of patients 12 to 15 months old were contacted, among which 379 completed the survey in relation to what had happened during the first twelve months of their children's life. Through multivariate analysis, the risk factors associated to suffer at least one bronchial obstructive episode were: prenatal exposure to maternal smoking (p=0.03 ODDS= 3 IC 95% 1,09 ­ 8,27), male gender (p=0,002 ODDS 2,03 IC 1,29- 3,20), age at first cold (p < 0,001 ODDS 0,76 IC 0,69-0,83). Conclusions: In healthy infants, without risk factors associated to asthma y/o atopia, prenatal smoking represented a risk factor to generate bronchopulmonary wheezing and viral respiratory infections at a younger age.


Assuntos
Lactente , Fatores de Risco , Saúde do Lactente , Efeitos Tardios da Exposição Pré-Natal , Poluição por Fumaça de Tabaco , Sons Respiratórios
5.
Braz. j. med. biol. res ; 52(5): e8233, 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1001522

RESUMO

Special attention has emerged towards biomass smoke-induced chronic obstructive pulmonary disease (COPD), providing new knowledge for prevention and therapeutic approach of non-smoker COPD patients. However, the understanding of biomass smoke COPD is still limited and somewhat controversial. The aim of the present study was to compare COPD exclusively caused by tobacco smoking with COPD exclusively caused by environmental or occupational exposures. For this cross-sectional study, COPD patients were recruited from outpatient clinics and formed two groups: non-smoker COPD group (n=16) with exposure to biomass smoke who did not smoke cigarette and tobacco smoker COPD group (n=15) with people who did not report biomass smoke exposure. Subjects underwent pulmonary function tests, thoracic high-resolution computed tomography, 6-min walk test, and sputum induction. The non-smoker COPD group had biomass smoke exposure of 133.3±86 hour-years. The tobacco COPD group smoked 48.5±27.4 pack-years. Women were 62.5 and 66.7%, respectively, of non-smokers and smokers. The non-smoker COPD group showed higher prevalence of dyspnea, lower arterial oxygen tension (PaO2), and lower arterial oxygen saturation (SaO2%) with similar spirometry results, lung volumes, and diffusion capacity. Regarding inflammatory biomarkers, differences were detected in sputum number of lymphomononuclear cells and in sputum concentrations of interleukin (IL)-6 and IL-8 with higher values in the smoker group. Emphysema was more prevalent in the tobacco smoker group, which also showed higher relative bronchial wall thickness and lower lung density by quantitative analysis. Biomass smoke induced more hypoxemia compared to tobacco in COPD patients with similar severity.

6.
Int. j. morphol ; 37(1): 87-92, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-990010

RESUMO

SUMMARY: This study aimed to investigate the toxic effects of cigarette smoke exposure on lung and the protective role of Omega 3 and Vitamin D against these toxic effects biochemically and histologically. 28 pregnant Wistar Albino rats were divided into four groups. The first group was control group; the second group was exposed to smoke of 10 cigarette by puff device 2 hours/day after pregnancy; the third group was exposed to cigarette smoke together with Omega 3 (0.5 mg/kg/day) and the fourth group was exposed to cigarette smoke together with vitamin D (42 microgram/kg/day). Finally, lung tissue sections of the newborn rats were stained with Hemotoxilen eosine and Masson tricromite. Malondialdehyde (MDA) and Fluorescent Oxidation Products (FOU) levels were measured. Fetal weights and the number of fetuses were significantly lower in the group received only cigarette smoke (both p<0.001). Histopathologically, pulmonary volume, number of developed alveols and parenchyma elasticity decreased significantly, meanwhile interstitial tissue increased, elastin and collagen did not develop adequately. Histopathologic changes significantly decreased in the group given Omega 3 and Vitamin D. Statistically, MDA and FOU levels were found to be higher in the group exposed to cigarette smoke compared to the control group, and MDA and FOU levels were lower in the group given Omega 3 along with cigarette smoke (p<0.001). Cigarette smoke caused histologically significant damage to fetal lung tissue, oxidative stress and increased MDA and FOU levels. This damage was significantly reduced with Omega 3 and Vitamine D supplementation. Omega 3 is an important antioxidant; vitamin D has no significant antioxidant effect.


RESUMEN: Este estudio tuvo como objetivo investigar los efectos tóxicos de la exposición al humo de cigarrillo en el pulmón, y el papel protector de Omega 3 y la Vitamina D contra esos efectos. 28 ratas Wistar albino preñadas fueron separadas en cuatro grupos. El primer grupo grupo control; el segundo grupo estuvo expuesto al humo de 10 cigarrillos por dispositivo de inhalación 2 horas / día después de la preñez; el tercer grupo se expuso al humo del cigarrillo junto con Omega 3 (0,5 mg / kg / día) y el cuarto grupo se expuso al humo del cigarrillo junto con vitamina D (42 microgramos / kg / día). Secciones de tejido pulmonar de las ratas recién nacidas se tiñeron con Hematoxilina Eosina y tricrómico de Masson. Se midieron los niveles de malondialdehído (MDA) y productos de oxidación fluorescente (POF). Los pesos fetales y el número de fetos fueron significativamente más bajos en el grupo que recibió solamente humo de cigarrillo (ambos p <0,001). Histopatológicamente, el volumen pulmonar, el número de alveolos desarrollados y la elasticidad del parénquima disminuyeron significativamente; mientras que el tejido intersticial aumentó y la elastina y el colágeno no se desarrollaron adecuadamente. Los cambios histopatológicos disminuyeron significativamente en el grupo que recibió Omega 3 y Vitamina D. Estadísticamente, se encontró que los niveles de MDA y POF eran más altos en el grupo expuesto al humo de cigarrillo en comparación con el grupo control, además los niveles de MDA y POF fueron más bajos en el grupo que recibió Omega 3 junto con el humo del cigarrillo (p <0,001). El humo del cigarrillo causó daños histológicamente significativos en el tejido pulmonar fetal, el estrés oxidativo y el aumento de los niveles de MDA y FOU. Este daño se redujo significativamente con los suplementos de Omega 3 y Vitamina D. El omega 3 es un importante antioxidante; la vitamina D no tiene ningún efecto antioxidante significativo.

7.
J. bras. pneumol ; 45(3): e20180314, 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1012558

RESUMO

ABSTRACT Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.


RESUMO O tabagismo é o maior responsável pelas doenças respiratórias (DR). Os efeitos nocivos do tabaco sobre o aparelho respiratório se iniciam ainda intraútero e influenciam as respostas imunológicas ao longo da infância e vida adulta. Os tabagistas com DR possuem peculiaridades que podem dificultar a cessação tabágica, tais como maior grau de dependência e de abstinência de nicotina; níveis mais elevados de monóxido de carbono exalado; motivação e autoeficácia baixas; maior preocupação com ganho ponderal; e elevada prevalência de ansiedade e depressão. Além disso, requerem tratamento mais intensivo e prolongado. É necessário esclarecer sempre o paciente sobre o fato de que parar de fumar será a única medida que irá reduzir a progressão das DR e melhorar sua qualidade de vida, independentemente do tempo e da gravidade da doença. Os médicos devem sempre oferecer o tratamento de cessação tabágica. O tratamento ambulatorial ou hospitalar deve ser multidisciplinar, baseado em intervenções comportamentais e farmacoterapia, sendo eficaz e custo-efetivo, dobrando as chances de sucesso.

8.
Rev. peru. med. exp. salud publica ; 35(4): 599-609, oct.-dic. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-985793

RESUMO

RESUMEN Objetivos. Estimar la carga de enfermedad asociada al consumo de tabaco en Paraguay y evaluar el potencial efecto económico y sanitario del aumento de precio mediante impuestos. Materiales y métodos. Se diseñó un modelo de microsimulación de Monte Carlo que incorporó la historia natural, costos y calidad de vida de enfermedades asociadas al tabaquismo para el 2015. Asimismo, se estimó el impacto en varios escenarios de aumento de impuestos sobre la prevalencia de tabaquismo y la recaudación fiscal. Resultados. 3354 personas mueren al año en Paraguay por consecuencia del tabaquismo. El 19 % de las muertes son por enfermedad isquémica cardíaca, el 15 % por accidentes cerebrovasculares. El 77 % de las muertes por enfermedad pulmonar obstructiva crónica y el 83 % de cáncer de pulmón son atribuibles al tabaquismo. Estas enfermedades en Paraguay representan un costo médico directo anual de más de 1,5 x 106 millones de guaraníes, mientras la recaudación impositiva por la venta de cigarrillos apenas llega a cubrir un 20 % de este gasto. Un aumento en el precio de los cigarrillos del 50 % vía impuestos, podría llevar a evitar 2507 muertes en diez años y generar recursos por 2,4 x 106 millones por ahorro en gastos sanitarios y aumento de recaudación. Conclusiones. El costo y la carga de enfermedad asociado al consumo de tabaco en el sistema de salud es elevado en Paraguay. Un aumento del precio de los cigarrillos a través de los impuestos tendría importantes beneficios sanitarios y podría compensar parcialmente los costos sanitarios.


ABSTRACT Objectives . To consider the burden of disease associated to tobacco consumption in Paraguay and to evaluate the potential economic and health effect of price increase through taxes. Materials and Methods . A Monte Carlo simulation model was designed incorporating natural history, costs, and quality of life of diseases associated to smoking for 2015. Also, several scenarios were considered for the impact of tax raises on the prevalence of smoking and fiscal collection. Results . In Paraguay, 3,354 people die every year as a consequence of smoking. Nineteen percent of deaths are due to cardiac ischemia, 15% due to stroke. 77% of deaths due to chronic obstructive pulmonary disease (COPD), and 83% of lung cancer can be attributed to smoking. These diseases in Paraguay represent an annual direct medical cost of more than 1.5 trillion PYG, while the tax collection from cigarette sales barely covers 20% of this expense. A 50% increase in the price of cigarettes via taxes could avoid 2507 deaths in ten years and generate resources by 2.4 trillion in savings in health expenses and tax of collection. Conclusions . The cost and the burden of disease associated to tobacco consumption is high in the health system in Paraguay. An increase in cigarette price through taxes could have significant health benefits and could offset health costs in part.

9.
Rev. bras. med. trab ; 16(3): 378-386, out.2018.
Artigo em Inglês, Português | LILACS | ID: biblio-966086

RESUMO

Introdução: A relação entre a sílica e o tabaco como potencializadores na geração de fibrose pulmonar não foi ainda bem estabelecida, embora tenham sido postulados alguns mecanismos fisiopatológicos para embasá-la. É necessário reconhecer o papel das diversas células envolvidas na resposta inflamatória, assim como as diversas vias biológicas que participam na gênese. Esses fatores nos motivaram a desenvolver a presente revisão descritiva. Resultados: Cada vez mais evidências sugerem que a inflamação local produzida por exposição à sílica e à fumaça do tabaco pode ser modulada por fatores genéticos, mecanismos epigenéticos, reações autoimunes e hipóxia local, levando à transição epitélio-mesênquima e ao acúmulo de material necrótico no pulmão, o que contribui à perpetuação da inflamação e a uma resposta imunológica inata exagerada nos trabalhadores com silicose fumantes. Conclusão: Comparações diretas de diferentes estudos de mensuração de biomarcadores inflamatórios associados à silicose e ao tabagismo devem ser realizadas com cautela, devido a uma série de possíveis fatores de confusão, como compartimentalização ou interação com as diversas vias biológicas e tipos celulares envolvidos. Convém destacar que para se evitar a ocorrência de dano pulmonar nos trabalhadores expostos à sílica, devem-se melhorar os sistemas de ventilação e reduzir sua exposição. No contexto da cessação do tabagismo, é necessário o uso de componentes psicoterapêuticos, com o fim de evitar o dano pulmonar precocemente


Background: The relationship between silica dust and tobacco smoking as enhancers of pulmonary fibrosis development has not yet been well established. Some pathophysiological mechanisms which might support this relationship were postulated. The role of different cells involved in the inflammatory response, and of different biological pathways needs to be recognized. These facts encouraged us to perform the present descriptive review. Results: Growing evidence suggests that local inflammation induced by exposure to silica dust and tobacco smoking might be modulated by genetic factors, epigenetic mechanisms, autoimmune reactions and local hypoxia, giving rise to the epithelial­mesenchymal transition. These phenomena lead to accumulation of necrotic material in the lungs, which contributes to inflammation's perpetuation and to an exaggerated innate immunological response among workers with silicosis who smoke. Conclusion: Direct comparisons of different measurement studies of inflammatory biomarkers associated with silicosis and tobacco smoking should be performed cautiously due to several possible confounding factors, such as compartmentalization or interaction among the various biological pathways and cell types involved. Ventilation systems should be improved and exposure reduced to prevent lung damage in workers exposed to silica. In regard to smoking cessation, psychotherapy approaches are needed for early prevention of lung damage


Assuntos
Fibrose Pulmonar/prevenção & controle , Silicose , Tabagismo , Biomarcadores , Dióxido de Silício/efeitos adversos
11.
Rev. am. med. respir ; 18(3): 205-209, set. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-977175

RESUMO

La neumonitis por hipersensibilidad (NH) puede ser causada por múltiples agentes presentes en el lugar de trabajo y en el hogar, como microbios, proteínas animales o vegetales y químicos orgánicos o inorgánicos. El diagnóstico basa en la evaluación de una serie de características clínicas incluyendo antecedentes de exposición significativa a un potencial antígeno, examen físico, tomografía computada de tórax, linfocitosis en el lavado bronquioalveolar, y, en casos seleccionados, histología. La NH puede ser aguda o crónica. Esta última puede ser fibrosante o no. La NH fibrosante tiene una amplia lista de diagnósticos diferenciales y tiene peor pronóstico. Describimos el caso de un varón, tabaquista, trabajador en una fábrica de quesos, con diagnóstico de NH "muy probable", y mala evolución.


Assuntos
Pneumonia , Tabagismo , Doenças Pulmonares Intersticiais
13.
Rev. peru. med. exp. salud publica ; 35(2): 265-271, abr.-jun. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-961872

RESUMO

RESUMEN El objetivo del estudio fue describir las características clínicas de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), atendidos en los servicios de Neumología de centros especializados de Lima y Callao. Se realizó un estudio transversal en 196 pacientes, con una mediana de edad de 69 años, rango intercuartil 63-75 años. El 31,1 % de los pacientes se encontró en el grupo GOLD 1/leve (VEF1 ≥80 %), el 41,8 % en el grupo GOLD 2/moderado (50 %≤VEF1<80 %), el 22,5 % en el grupo GOLD 3/severo (30 %≤VEF1<50 %), y el 4,6 % en el grupo GOLD 4/muy severo (VEF1 <30 %). El 93,9 % usaba algún tipo de medicación para EPOC, la terapia más usada fue la combinación de beta agonistas de acción larga/corticoides inhalados (LABA/ICS) con 31,1 %. Se ha obtenido una primera caracterización de pacientes con EPOC atendidos en estos centros. Es imprescindible complementar lo encontrado con estudios longitudinales.


ABSTRACT The aim of the study was to describe the clinical characteristics of patients with COPD receiving treatment at the pneumology units of specialized care centers in Lima and Callao. A cross-sectional study was performed on 196 patients, with a mean age of 69 years, interquartile range of 63-75 years. Of these patients, 31.1% was classified in the GOLD 1/ mild group (FEV1 ≥80%); 41.8% in the GOLD 2/moderate group (50%≤FEV1<80%); 22.5% in the GOLD 3/severe group (30%≤FEV1<50%), and 4.6% in the GOLD 4/very severe group (FEV1 <30%). A 93.9% of patients used some type of medication for COPD. The most-frequently used therapy was the combination of long-acting beta agonists and inhaled corticosteroids (LABA/ICS) (31.1%). A preliminary characterization has been obtained for COPD patients treated in these centers, but it is essential to complement these findings with longitudinal studies.

14.
Neumol. pediátr. (En línea) ; 13(2): 70-71, mar. 2018.
Artigo em Espanhol | LILACS | ID: biblio-947304

RESUMO

Lung cancer is the first cause of death in Chilean cancer patients. Globally it accounts for more than 8 million annual deaths. Of the new cases of cancer, more than 6 million are smoking related, making smoking the most important cancer risk factor and the cause of about 20 % of the global cancer-related mortality. The incidence of lung cancer is directly associated with smoking exposure levels during life, exposure that increases the risk of this disease up to 30 times. This risk decreases exponentially with smoking cessation, especially if it occurs in early life stages. In Chile, 85 % of lung cancers in men and 40 % in women may be explained by smoking, equivalent to 1926 per year. Brief counseling is recommended according to the Clinical Guidelines for the Treatment of Smoking in Chile 2017, and if that is not possible, all smokers with cancer should be referred to smoking cessation therapy, which may be done by telephone (6003607777, Salud Responde Program, MINSAL; the number is on cigarette packets).


El cáncer de pulmón constituye la primera causa de muerte por cáncer en Chile. A nivel mundial da cuenta de más de 8 millones de fallecimientos anuales, de los nuevos casos de cáncer, más de 6 millones están relacionados con tabaco, constituyendo el tabaquismo un importante factor de riesgo y causa directa de cerca del 20% de la mortalidad global asociada a cáncer. La incidencia de cáncer de pulmón está directamente relacionada el nivel de exposición a tabaquismo durante la vida, la exposición puede aumentar el riesgo de esta enfermedad hasta 30 veces. El riesgo disminuye exponencialmente con la cesación de esta adicción, especialmente si ocurre en etapas tempranas de la vida. En Chile el 85% de los cánceres de pulmón en hombres y el 40% en mujeres estarían explicados por tabaquismo, equivalentes a 1926 anuales, siendo la recomendación realizar consejería breve según las Guías Clínicas de Tratamiento del Tabaquismo Chile 2017 y si no es posible derivar a todos los fumadores con cáncer a terapia de cesación del tabaquismo que puede ser telefónica Salud Responde MINSAL 6003607777, el numero está en las cajetillas de cigarrillos.


Assuntos
Humanos , Tabagismo/epidemiologia , Neoplasias Pulmonares/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Chile/epidemiologia , Saúde Global
15.
Rev. cuba. med. mil ; 47(1): 43-49, ene.-mar. 2018.
Artigo em Espanhol | LILACS | ID: biblio-960593

RESUMO

Introducción: el cáncer de pulmón es el tumor maligno más frecuente en el mundo, en Cuba es la segunda causa de muerte, su pronóstico depende de diferentes factores entre ellos el intervalo entre el primer síntoma y el inicio del tratamiento. Objetivo: determinar los factores que influyen en la demora en el diagnóstico de los pacientes con neoplasia de pulmón. Métodos: se realizó un estudio descriptivo, retrospectivo y longitudinal de los pacientes egresados vivos con diagnóstico de neoplasia de pulmón en el Hospital Militar Dr. Carlos J. Finlay en el período comprendido entre enero 2016 a enero 2017. Resultados: la neoplasia de pulmón fue más frecuente en mayores de 50 años, del sexo masculino y con estrecha relación con el hábito de fumar, la falta de aire fue el principal síntoma por el que acudieron los pacientes después de un mes de inicio de la sintomatología. La estadía hospitalaria fue superior a los 20 días y se realizó el diagnóstico histológico en pocos pacientes. Conclusiones: la demora en el diagnóstico de la neoplasia de pulmón influye en su supervivencia, pues no se les puede realizar un tratamiento oncoespecífico(AU)


Introduction: lung cancer is the most frequent malignant tumor in the world, in Cuba it is the second cause of death, its prognosis depends on different factors including the interval between the first symptom and the start of treatment. Objective: to determine the factors that influence the delay in the diagnosis of patients with lung neoplasia. Methods: a descriptive, retrospective and longitudinal study of live patients with diagnosis of lung neoplasm was performed at the Military Hospital Dr. Carlos J. Finlay in the period from January 2016 to January 2017. Results: lung neoplasia was more frequent in men over 50 years of age, and with a close relationship with smoking, lack of air was the main symptom for which patients came after a month of onset of smoking symptomatology. The hospital stay was longer than 20 days and the histological diagnosis was made in a few patients. Conclusions: the delay in the diagnosis of lung neoplasia influences their survival, since they cannot be treated onco-specific(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fumar/fisiopatologia , Diagnóstico Tardio/prevenção & controle , Neoplasias Pulmonares/epidemiologia , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos Longitudinais
16.
Rev. bras. promoç. saúde (Impr.) ; 31(1): 1-2, 28/02/2018.
Artigo em Inglês, Português | LILACS | ID: biblio-881804

RESUMO

O tabagismo é considerado a maior causa de morte evitável em todo o mundo(1), sendo o principal responsável pelo aparecimento da Doença Pulmonar Obstrutiva Crônica (DPOC), considerada, atualmente, a segunda causa de mortalidade em todo o globo de acordo com um estudo recente publicado no importante periódico Lancet(2). Nesse estudo(2), verificou-se um amento de 24,2% das taxas de óbito entre os anos de 2005 e 2016 por DPOC; embora, de acordo com previsões anteriores, houvesse a estimativa de que essa enfermidade fosse a terceira causa de morte somente no ano de 2030. Além disso, a prevalência e morbidade da doença ainda são consideradas subestimadas, pois o diagnóstico é realizado, na grande maioria das vezes, quando já está clinicamente aparente, ou moderadamente avançada, resultando em índices de morbimortalidade elevados e importante impacto econômico e social(3,4). Tal fato ocorre porque o aparecimento das doenças pulmonares crônicas relacionadas ao tabagismo só ocorre após um longo período de consumo do cigarro, o que faz com que esse fator de risco, ainda hoje, seja considerado o grande desafio para a criação de estratégias eficientes e efetivas de prevenção e promoção da saúde. Nesse contexto, o presente número da Revista Brasileira em Promoção da Saúde publicou três artigos originais relacionados à temática do tabagismo em diferentes contextos da Saúde Coletiva; e os principais achados dessas pesquisas dão enfoque às inúmeras repercussões emocionais, psíquicas, físicas e sociais que estão associados ao ato de fumar. Um dos estudos(5) avaliou o uso do tabaco por acadêmicos de um curso da área da saúde de uma instituição de ensino superior brasileira e verificou uma baixa prevalência do tabagismo entre os discentes. Entretanto, verificou que os estudantes que moram com os pais ou parentes apresentaram maior prevalência de tabagismo quando comparados aos que moravam sozinhos. Tal fato incita a reflexão do quanto a família pode (ou não) influenciar no consumo do cigarro e do quanto o ambiente universitário é um local (ou deveria ser) de implementação de estratégias de prevenção e promoção da saúde, o que pode ter contribuído com a baixa prevalência encontrada no estudo. Por sua vez, outro estudo(6) se propôs a avaliar os fatores associados ao tabagismo em pacientes que foram submetidos à cirurgia bariátrica, sendo observada uma significativa prevalência do consumo de tabaco nessa população e encontrada associação com variáveis sociodemográficas, comorbidades, sintomas depressivos, sofrimento psíquicos, distúrbios do sono e religiosidade. Estes achados trazem à tona a importância da implementação de estratégias de promoção de saúde que visem o devido cuidado com o tabagismo em situações clínicas que envolvam o pós-operatório de procedimentos cirúrgicos importantes, como a cirurgia bariátrica, evidenciando, assim, que os pacientes submetidos a essa intervenção necessitam de um adequado manejo multidimensional visando à minimização dos efeitos deletérios ocasionados pelo cigarro. Por fim, outro artigo desse número(7) avaliou a associação entre fatores emocionais e o hábito de fumar em participantes de um programa de cessação do tabagismo. Foram avaliados 173 pacientes e os principais achados do estudo apontam uma correlação entre sintomas de ansiedade e depressão e um maior grau de dependência da nicotina, reforçando o entendimento de que o hábito de fumar apresenta estreita relação com fatores emocionais. Os achados dos estudos mencionados acima trazem, para a comunidade científica e para a sociedade em geral, que existem inúmeros desafios a serem percorridos no âmbito do gerenciamento das estratégias de promoção e prevenção de saúde em indivíduos tabagistas. Essas estratégias deveriam ser amplamente discutidas pela academia, pelos profissionais e pelos gestores públicos/privados de saúde, a fim de serem implementadas em todos os níveis de atenção do sistema de saúde, visando uma adequada taxa de sucesso da interrupção do ato tabágico e da redução dos agravos relacionados ao seu consumo. Nesse sentido, a Revista Brasileira em Promoção da Saúde acompanha, divulga e discute a efetivação desse cuidado estratégico em suas publicações.


Smoking is regarded as the leading cause of preventable death worldwide(1) and is the main responsible for the onset of Chronic Obstructive Pulmonary Disease (COPD), which is currently considered the second leading cause of death across the globe, according to a recent study published in the prominent journal Lancet(2). In this study(2), a 24.2 percent increase in COPD death rates was evidenced between 2005 and 2016, even though, according to previous predictions, there was an estimate that this illness would be the third-leading cause of death only by the year 2030. Moreover, the prevalence and morbidity of the disease are still considered underestimated, since the diagnosis is most of the times made when it is already clinically apparent or moderately advanced, resulting in high morbidity and mortality rates and major economic and social impact(3,4). Such fact occurs because the onset of smoking-related chronic lung diseases only takes place after a long period of cigarette smoking, which renders this risk factor, even in the present days, regarded as the great challenge to the creation of efficient and effective strategies of health prevention and promotion. In this context, the present issue of the Brazilian Journal in Health Promotion has published three original articles related to the topic of smoking in different contexts of Community Health; the main findings of these surveys focus on the many emotional, psychic, physical and social repercussions associated with smoking. One of the studies(5) evaluated the use of tobacco by academics of a program in the health area of a Brazilian higher education institution and verified a low prevalence of smoking among the students. However, it was found that students living with parents or relatives had a higher prevalence of smoking compared to those who live alone. This fact prompts reflection on the extent to which the family can (or not) influence cigarette consumption and the extent to which the university environment is a place (or should be) for implementing health promotion and prevention strategies, which may have contributed to the low prevalence found in the study. On the other hand, other study(6) was intended to evaluate the factors associated with smoking in patients who underwent bariatric surgery, with a significant prevalence of tobacco consumption in this population and found association with sociodemographic variables, comorbidities, depression symptoms, psychological distress, sleep disorders and religiosity. These findings bring to light the importance of implementing health promotion strategies aimed at due attention to smoking in clinical situations involving the postoperative period of major surgical procedures, such as bariatric surgery, thus evidencing that the patients submitted to such intervention need proper multidimensional management aiming at minimizing the deleterious effects caused by the cigarette. Finally, another article in this issue(7) evaluated the association between emotional factors and smoking habit in participants in a smoking cessation program. A total of 173 patients were evaluated and the main findings of the study point to a correlation between anxiety and depression symptoms and a greater degree of nicotine dependence, thus reinforcing the understanding that smoking is closely related to emotional factors. The findings of the aforementioned studies bring to the scientific community, and to the overall society, that there are numerous challenges to be addressed in the management of health promotion and prevention strategies in smokers. These strategies should be widely discussed by academia, professionals and public/private health managers, in order to be implemented at all levels of the healthcare system, aiming at an adequate success rate of smoking cessation and reduction related to its consumption. In this sense, the Brazilian Journal in Health Promotion monitors, discloses and discusses the actualization of this strategic care in its publications.


Assuntos
Editorial
17.
West Indian med. j ; 67(spe): 458-464, 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1045878

RESUMO

ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease predominantly affecting the older population. Not well known, COPD is often confused with asthma. Tobacco smoking is widely acknowledged as the most important risk factor for COPD, but occupational exposures from irritant dust, fumes and, biomass exposures from burning wood and coal indoors, also contribute to COPD prevalence. This paper looks at COPD prevalence and occupational exposures in adults aged 70+ using data from the United Kingdom-based Burden of Obstructive Lung Disease (BOLD) study in Jamaica (www.boldstudy.org). Subject and Method: Jamaica followed a strict BOLD protocol of face to face standardized questionnaire administration and spirometry testing on participants aged ≥ 40 years. Questions included sociodemographic characteristics, smoking practices, respiratory symptoms and occupational exposures. The Occupational questionnaire enquired about time spent in thirteen different occupations including farming, construction, firefighting, domestic and industrial cleaning, welding, coal mining, flour, feed or grain milling to mention a few. Spirometry was performed according to American Thoracic Society (ATS) standards. An island-wide multi-stage random sample of non-institutionalized individuals was selected for recruitment with the assistance of the Statistical Institute of Jamaica (STATIN). All questionnaires and spirometry data from consenting participants were submitted electronically to the United Kingdom Coordinating Centre for data cleaning, quality checks and preliminary analysis. Final data were returned to the local research team for further analysis. Result: Total sample selected for recruitment (and response rate) was 883 (91.4%) for persons aged ≥ 40 years and 190 (87.2%) for persons aged 70+ years. Of the 164 responders in the 70+ group, 91 (55.5%) had usable spirometry. Prevalence of ever-smoking by age and gender in this 70+ cohort was 38.4%. Farming, construction and household cleaning were the most frequently reported occupations (58.8%). Years working in these three occupations ranged from 1-70 (farming and construction) and 1-78 (cleaning). Most were now retired (120 of 164 overall). Weighted estimated population prevalence of Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage 1 (Post-BD FEV1/FVC < 70%; FEV1 ≥ 80% predicted) was 12.1% overall for persons aged 40+, but was highest at 37.8% in the 70+ age group. Estimated prevalence of GOLD Stage 2 (50 ≤ FEV1 < 80% predicted) was 9.6% in the 40+, again highest at 31.3% in the 70+ age group. Conclusion: Overall prevalence of COPD in the 40+ age group whether Stage 1 (mild COPD), or Stage 2 (moderate COPD), while it appears low, was still highest in the 70+ age group. The local data revealed that whilst the prevalence of current smoking had declined by age 70+, the estimated prevalence of GOLD Stage 1 and Stage 2 COPD was highest in this age group. The contribution of occupational exposures to the development of COPD, requires further analysis to look at the occupational exposures across all participants aged 40+ as well as the prevalence of COPD among non-smokers. Progression of Stage 1 to Stage 2 disease and its effect on morbidity and quality of life is likely without patient education regarding complications of tobacco smoke and workplace exposures to the development of COPD.


RESUMEN Antecedentes: La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad respiratoria crónica que afecta predominantemente a la población de personas mayores. Como no se la conoce bien, la EPOC se confunde a menudo con el asma. El tabaquismo es ampliamente reconocido como el factor de riesgo más importante de la EPOC, pero las exposiciones profesionales a polvos irritantes, humos y gases, así como las exposiciones a la biomasa de leña y carbón en espacios cerrados, contribuyen a la prevalencia de la EPOC. El presente trabajo examina la prevalencia de la EPOC y las exposiciones ocupacionales en adultos de 70+ años, utilizando en Jamaica datos del estudio de la Carga de la Enfermedad Pulmonar Obstructiva (BOLD, en inglés) con base en el Reino Unido (www.boldstudy.org). Sujetos y método: Jamaica siguió un estricto protocolo de BOLD consistente en administrar cara a cara cuestionarios estandarizados y pruebas de espirometría a participantes de ≥ 40 años de edad. Las preguntas incluyeron características sociodemográficas, prácticas de tabaquismo, síntomas respiratorios y exposiciones ocupacionales. El cuestionario ocupacional indagó sobre el tiempo transcurrido en trece ocupaciones diferentes, incluyendo trabajo en el campo (agricultura, cría de animales) construcción, extinción de incendios, limpieza doméstica e industrial, soldadura, minería de carbón, y molienda de harina, piensos o granos, por mencionar algunas. La espirometría se realizó de acuerdo con las normas de la Sociedad Torácica Americana (STA). Se seleccionó una muestra aleatoria multietapa de todo el país -formada por individuos no institucionalizados— para el reclutamiento con la ayuda del Instituto Estadístico de Jamaica (STATIN, en inglés). Todos los cuestionarios y datos de espirometría de los participantes consintientes fueron enviados electrónicamente al Centro Coordinador del Reino Unido para la depuración de datos, chequeo de calidad y análisis preliminar. Los datos finales fueron devueltos al equipo de investigación local para su posterior análisis. Resultado: La muestra total seleccionada para el reclutamiento (y la tasa de respuesta) fue de 883 (91.4%) para las personas de ≥ 40 años y 190 (87.2%) para las personas de 70+ años. De los 164 encuestados en grupo de 70+ años, 91 (55.5%) tenían espirometría utilizable. La prevalencia de fumar ocasionalmente por edad y sexo en esta cohorte de 70+ fue de 38.4%. El trabajo en el campo (agricultura, cría de animales), la construcción y la limpieza doméstica fueron las ocupaciones más frecuentemente reportadas (58.8%). Los años de trabajo en estas tres ocupaciones oscilaron entre 1-70 (trabajo en el campo y construcción), y 1-78 (limpieza). La mayoría estaban ahora retirados (120 de 164 en total). La prevalencia ponderada estimada de la población de la Iniciativa Global para la Enfermedad Pulmonar Obstructiva Crónica (GOLD, en inglés) Etapa 1 (post-BD FEV1/FVC < 70%; FEV1 ≥ 80% valor teórico) fue de 12.1% en total para las personas de 40+, pero las más alta fue 37.8% en el grupo de 70+ años. La prevalencia estimada de GOLD Etapa 2 (50 ≤ FEV1 < 80% valor teórico) fue de 9.6% en los de 40+, y de nuevo 31.3% la más alta en el grupo de 70+ años de edad. Conclusión: La prevalencia general de la EPOC en el grupo de 40+ años, ya fuera en la etapa 1 (EPOC leve), o la etapa 2 (EPOC moderada), aunque pareciera baja, seguía siendo más alta en el grupo de 70+ años. Los datos locales revelaron que si bien la prevalencia de fumar regularmente había disminuido a la edad de 70+, la prevalencia estimada de EPOC en GOLD Etapa 1 y Etapa 2 fue mayor en este grupo etario. La contribución de las exposiciones ocupacionales al desarrollo de la EPOC requiere un análisis adicional para examinar las exposiciones ocupacionales en todos los participantes de 40+ años. así como la prevalencia de la EPOC entre los no fumadores. La progresión de la enfermedad de la etapa 1 a la etapa 2 y su efecto sobre la morbilidad y la calidad de vida es probable que tenga lugar si no hay educación del paciente con respecto a las complicaciones que el humo del tabaco y las exposiciones en el centro de trabajo tienen para el desarrollo de la EPOC.

18.
Clinics ; 73: e347, 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-890743

RESUMO

OBJECTIVE: Physicians do not adequately use their unique professional privilege to prevent patients from smoking. The aim of this study was to investigate the type and extent of advice given to patients by physicians of different medical specialties regarding smoking cessation. METHODS: In total, 317 volunteer physicians were included in this study. The participants rated their attitudes toward the smoking habits of their patients by completing a questionnaire. The approaches used to address the smoking habits of patients significantly differed among physicians working at polyclinics, clinics and emergency service departments (p<0.001). Physicians working at clinics exhibited the highest frequency of inquiring about the smoking habits of their patients, while physicians working at emergency service departments exhibited the lowest frequency. RESULTS: Physicians from different medical specialties significantly differed in their responses. Physicians specializing in lung diseases, thoracic surgery, and cardiology were more committed to preventing their patients from cigarette smoking. CONCLUSIONS: The role of physicians, particularly pulmonologists and thoracic surgeons, is critical in the fight against cigarette smoking. Promoting physician awareness of this subject is highly important in all other branches of medicine.

19.
Rev. Investig. Salud. Univ. Boyacá ; 5(2): 295-322, 20180000. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1046966

RESUMO

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC), caracterizada por limitación del flujo aéreo, constituye una patología con alta prevalencia y mortalidad a nivel mundial, representada por exacerbaciones que requieren escalonar el tratamiento; el abordaje se realiza por medio de medidas farmacológicas y no farmacológicas.Objetivo. Sintetizar los aspectos relevantes de las principales guías de manejo y de los artículos cientí-ficos acerca del tratamiento farmacológico y no farmacológico de la enfermedad pulmonar obstructiva crónica.Método. Revisión descriptiva sobre el tratamiento farmacológico y no farmacológico de la enferme-dad pulmonar obstructiva crónica, a partir de la búsqueda de literatura publicada en bases de datos electrónicas especializadas en salud. Se encontraron 265 documentos, entre artículos y guías, que cumplían con los criterios de búsqueda, se seleccionaron 118, se excluyeron 60 y se analizaron 58 referencias.Conclusión. La enfermedad pulmonar obstructiva crónica tiene alta prevalencia y mortalidad a nivel mundial, por esto hay que diagnosticarla bajo los parámetros de la guía de referencia mundial Global Initiative for Chronic Obstructive Lung Disease y de acuerdo con esto, abordar al paciente de forma integral e instaurándole un manejo farmacológico y no farmacológico individualizado con el fin de aumentar la adherencia al tratamiento, disminuir los síntomas y las exacerbaciones y, por consiguien-te, mejorar la calidad de vida.


Introduction. Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation, this disease presents a high prevalence and mortality rateworldwide. It is represented by exacerba-tions requiring step therapy. The treatment approach is performed by means of pharmacological and non-pharmacological measures.Objective. To synthesize the most relevant aspects of the main management guidelines and scientific articles about the pharmacological and non-pharmacological treatment of chronic obstructive pul-monary disease.Method. Descriptive review of pharmacological and non-pharmacological treatment of chronic obs-tructive pulmonary disease, by means of a search of literature published by electronic databases spe-cialized in health sciences. 265 documents were found, including articles and guides, which met the search criteria, 118 were selected, 60 were excluded and 58 references were analyzed.Conclusion. Chronic obstructive pulmonary disease has a high prevalence and mortality rate world-wide, thus, it is necessary to diagnose it by following the parameters set by the worldwide reference guide: Global Initiative for Chronic Obstructive Lung Disease.According to these guidelines it is ne-cessary to treat the patient holistically and establish a pharmacological and non-pharmacological individualized management in order to increase adherence to the treatment, reduce symptoms and exacerbations, and thereby, improve the quality of life.


Introdução. A doença pulmonar obstrutiva crônica (DPOC), caracterizada pela limitação do fluxo aéreo, representa uma patologia com alta prevalência e mortalidade em todo o mundo, sendo repre-sentada por exacerbações que requerem um escalonamento do tratamento; a abordagem é realizada por meio de medidas farmacológicas e não farmacológicas.Objetivo. Sintetizar os aspectos relevantes dos principais guias de gestão e artigos científicos sobre o tratamento farmacológico e não farmacológico da doença pulmonar obstrutiva crônica.Método. Revisão descritiva do tratamento farmacológico e não farmacológico da doença pulmonar obstrutiva crônica, baseado na busca bibliográfica de artigos e guias publicados em bases de dados eletrônicas especializadas em saúde. Foram obtidos 265 artigos e guias que preenchiam os critérios de busca, 118 foram selecionados, 60 foram excluídos e 58 referências foram analisadas.Conclusão. A doença pulmonar obstrutiva crônica tem alta prevalência e mortalidade em todo o mundo, por isso deve ser diagnosticada sob os parâmetros da Global Initiative for Chronic Obstructive Lung Disease e de acordo com isso, abordar o paciente de forma integral e instalando um manejo far-macológico e não farmacológico individualizado, a fim de aumentar a adesão ao tratamento, diminuir os sintomas e as exacerbações e, portanto, melhorar a qualidade de vida.


Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica , Broncodilatadores , Pneumologia , Fumar , Medicina Interna
20.
Rev. cuba. med. mil ; 46(4): 349-360, oct.-dic. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-960580

RESUMO

Introducción: el cáncer de pulmón es la neoplasia más frecuente y la primera causa de muerte por cáncer actualmente. Objetivo: caracterizar clínica y epidemiológicamente a pacientes fumadores con EPOC y cáncer de pulmón no microcítico. Método: estudio observacional, retrospectivo, transversal a pacientes egresados con diagnóstico de cáncer de pulmón y portadores de EPOC, durante el periodo comprendido entre enero de 2009 y enero de 2015. De 112 individuos fueron seleccionados 55 pacientes. Fueron analizadas variables sociodemográficas, intensidad del tabaquismo y del efecto acumulativo del tabaco. Además de las medidas de resumen se empleó análisis de varianzas para establecer la correlación lineal entre tabaquismo, EPOC y cáncer de pulmón. Resultados: la mayoría de los pacientes con cáncer de pulmón y EPOC pertenecían al sexo femenino (85,7 por ciento) y el 75 por ciento de los que portaban ambas afecciones se encontraba en grupos de edades menores de los 60 años. La edad de iniciación temprana del hábito, tiempo fumando, y número de paquetes de cigarrillos consumidos al año, fueron las variables que mostraron una asociación más significativa con ambas entidades (p= 0,01; 0,00; y 0,02 respectivamente). Conclusiones: la coexistencia de EPOC y cáncer de pulmón resultó más frecuente en el sexo femenino y en edades inferiores a los 60 años. Hubo mayor representación en pacientes con mayor intensidad del tabaquismo. Existió correlación entre el efecto acumulativo del tabaquismo y las probabilidades de desarrollar EPOC y cáncer en fumadores, en especial con los de mayor tiempo de consumo y los que fuman mayor número de paquetes al año(AU)


Introduction: Lung cancer is the most frequent neoplasm and the first cause of cancer death today. Objective: To characterize clinically and epidemiologically smokers with COPD and non-small cell lung cancer. Method: An observational, retrospective, cross-sectional study of patients with a diagnosis of lung cancer and COPD, during the period between January 2009 and January 2015. From 112 individuals, 55 patients were selected. Sociodemographic variables, intensity of smoking and the cumulative effect of tobacco were analyzed. In addition to the summary measures, variances analysis was used to establish the linear correlation between smoking, COPD and lung cancer. Results: Most of the patients with lung cancer and COPD belonged to the female sex (85.7 percent) and 75 percent of those with both conditions were in groups under the age of 60 years. The age of early initiation of habit, smoking time, and number of packets of cigarettes consumed per year were the variables that showed a more significant association with both entities (p = 0.01, 0.00, and 0.02 respectively). Conclusions: the coexistence of COPD and lung cancer was more frequent in females and in children under 60 years of age. There was greater occurrence in patients with greater intensity of smoking. There was a correlation between the cumulative effect of smoking and the likelihood of developing COPD and cancer in smokers; especially those with the longest consumption time and those who smoke the greatest number of packages per year(AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Tabagismo/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Neoplasias Pulmonares/mortalidade , Estudos Transversais , Estudos Retrospectivos , Análise de Variância , Estudo Observacional
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