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1.
Nat Microbiol ; 5(10): 1185-1191, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32908214

RESUMO

Antibody-based drugs and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being expedited through preclinical and clinical development. Data from the study of SARS-CoV and other respiratory viruses suggest that anti-SARS-CoV-2 antibodies could exacerbate COVID-19 through antibody-dependent enhancement (ADE). Previous respiratory syncytial virus and dengue virus vaccine studies revealed human clinical safety risks related to ADE, resulting in failed vaccine trials. Here, we describe key ADE mechanisms and discuss mitigation strategies for SARS-CoV-2 vaccines and therapies in development. We also outline recently published data to evaluate the risks and opportunities for antibody-based protection against SARS-CoV-2.


Assuntos
Anticorpos Facilitadores , Betacoronavirus , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Vacinas Virais/efeitos adversos , Animais , Anticorpos Monoclonais/administração & dosagem , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Antivirais/administração & dosagem , Anticorpos Antivirais/imunologia , Anticorpos Facilitadores/imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Humanos , Imunização Passiva/efeitos adversos , Técnicas In Vitro , Modelos Imunológicos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Doenças Respiratórias/etiologia , Doenças Respiratórias/imunologia , Fatores de Risco , Segurança , Vacinas Virais/imunologia
2.
Ecotoxicol Environ Saf ; 202: 110907, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32800242

RESUMO

The impact of bioaerosols in municipal solid waste management is nowadays identified as a growing health concern worldwide. In this study, exposure to endotoxin in composting facilities and its association with lung function and clinical symptoms was investigated in Tehran municipal solid waste management complex (Aradkooh) as one of the largest solid waste management facilities in the Middle East. Airborne endotoxins were collected between June and July 2019 and the concentrations were determined by Limulus Amebocyte Lysate (LAL) method. Healthy workers with no history of respiratory disease were recruited and data on clinical symptoms (cough, phlegm, wheezing, dyspnea, fatigue, headache, eye irritation, runny nose, runny eyes, and sore throat) was obtained by the modified American Thoracic Society questionnaire, and spirometric measurement was performed by an expert. The binary logistic regression test was used and adjusted for confounding variables. The results didn't show any difference in lung function parameters (FEV1, FVC, FEV1/FVC, PEF, FEF25-75%), and most of the respiratory symptoms despite a relatively high difference in the concentration of endotoxin observed in air samples of different locations. Only the increased risk of cough (OR 10.5, 95% CI: 2.4 to 44.8 in the moderately exposed group and 7.8, 95% CI: 1.6 to 39.1 in highly exposed ones), fatigue (OR 3.7, 95% CI: 1.2 to 11.7), and headache (OR 6.02, 95% CI: 1.4 to 24.5) were found in the exposed groups compared to controls after adjusting for age, active and passive smoking. However, findings of the study might be underestimated due to some issues including healthy worker effect, intra and intersubject variability, and self-reporting bias, thereby the results should be interpreted with caution. Although we did not find any relationship, due to the high concentrations of endotoxins observed in some sites, it is recommended to consider some possible prevention measures such as using personal protective equipment to reduce the exposure of workers at an acceptable level.


Assuntos
Poluentes Ocupacionais do Ar/análise , Compostagem , Endotoxinas/análise , Exposição Ocupacional/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Adulto , Microbiologia do Ar , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Testes de Função Respiratória/efeitos adversos , Sons Respiratórios , Doenças Respiratórias/etiologia , Poluição por Fumaça de Tabaco
3.
Lancet ; 396(10243): 27-38, 2020 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-32479829

RESUMO

BACKGROUND: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. METHODS: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. FINDINGS: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28-2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65-3·22], p<0·0001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (2·35 [1·57-3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01-2·39], p=0·046), emergency versus elective surgery (1·67 [1·06-2·63], p=0·026), and major versus minor surgery (1·52 [1·01-2·31], p=0·047). INTERPRETATION: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. FUNDING: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Doenças Respiratórias/etiologia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/mortalidade , Adulto , Idoso , Betacoronavirus , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/mortalidade , Serviços Médicos de Emergência , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto Jovem
4.
Ann Palliat Med ; 9(4): 1851-1858, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32576016

RESUMO

BACKGROUND: The application of factor analysis in the study of the clinical symptoms of coronavirus disease 2019 (COVID-19) was investigated, to provide a reference for basic research on COVID-19 and its prevention and control. METHODS: The data of 60 patients with COVID-19 in Jingzhou Hospital of Traditional Chinese Medicine and the Second People's Hospital of Longgang District in Shenzhen were extracted using principal component analysis. Factor analysis was used to investigate the factors related to symptoms of COVID-19. Based on the combination of factors, the clinical types of the factors were defined according to our professional knowledge. Factor loadings were calculated, and pairwise correlation analysis of symptoms was performed. RESULTS: Factor analysis showed that the clinical symptoms of COVID-19 cases could be divided into respiratory-digestive, neurological, cough-wheezing, upper respiratory, and digestive symptoms. Pairwise correlation analysis showed that there were a total of eight pairs of symptoms: fever-palpitation, coughexpectoration, expectoration-wheezing, dry mouth-bitter taste in the mouth, poor appetite-fatigue, fatiguedizziness, diarrhea-palpitation, and dizziness-headache. CONCLUSIONS: The symptoms and syndromes of COVID-19 are complex. Respiratory symptoms dominate, and digestive symptoms are also present. Factor analysis is suitable for studying the characteristics of the clinical symptoms of COVID-19, providing a new idea for the comprehensive analysis of clinical symptoms.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/terapia , Doenças do Sistema Digestório/etiologia , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/terapia , Doenças Respiratórias/etiologia , Adulto Jovem
5.
Environ Health Prev Med ; 25(1): 20, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539699

RESUMO

BACKGROUND: Poor air quality of the household is likely to be the largest public health concern in resource-constrained countries. Exposure to household air pollution, poor working environment, and fuel type used at household level have been associated with respiratory symptoms. This study aimed to assess acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in Gondar city, northwest Ethiopia. METHOD: A cross-sectional study was carried out from February 15, 2019 to June 20, 2019. Study participants were selected using simple random sampling, and data were collected via face-to-face interviews. Binary logistic regression analysis was used to test the association of explanatory and outcome variables. Variables with p < 0.05 were considered as significantly associated with the outcome variable. RESULTS: The prevalence of respiratory symptoms among mothers of under-five years-old children in this study was 46.1%. Education (vocational training compared to cannot read and write) (adjusted odd ratio (AOR) = 0.26 at 95% confidence interval (CI): 0.08-0.82), working in dusty environment (AOR = 2.90 at 95% CI: 1.39-6.08), wood fire use (AOR = 0.37 at 95% CI: 0.16-0.85), living in mud- and wood-walled houses (AOR = 0.53 at CI: 0.32-0.89), recent house painting (AOR = 1.95 at 95% CI: 1.03-3.69), new carpet (AOR = 2.02 at 95% CI: 1.08-3.77), pesticide use (AOR = 1.71 at 95% CI: 1.03-2.84), damp stain (AOR = 2.45 at 95% CI: 1.04-5.75), spending longer time in house for 6 to 11 h (AOR = 2.59 at 95% CI: 1.53-4.37) and 11 to 15 h (AOR = 3.47 at 95% CI: 1.87-6.43), and living less than 100 m from unpaved roads/streets (AOR = 4.35 at 95% CI: 2.64-7.18) were significantly associated with respiratory symptoms among mothers of under-five years-old children. CONCLUSION: Respiratory symptoms were common among mothers who have under five-years-old children. Air quality improvement, fuel selection, and residential planning will help to reduce respiratory symptoms.


Assuntos
Mães/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Doença Aguda/epidemiologia , Adulto , Etiópia/epidemiologia , Feminino , Humanos , Prevalência , Doenças Respiratórias/etiologia , Fatores de Risco , Adulto Jovem
6.
J Trauma Acute Care Surg ; 88(4): 486-490, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32213787

RESUMO

BACKGROUND: With the recent birth of the Pennsylvania TQIP Collaborative, statewide data identified unplanned admissions to the intensive care unit (ICU) as an overarching issue plaguing the state trauma community. To better understand the impact of this unique population, we sought to determine the effect of unplanned ICU admission/readmission on mortality to identify potential predictors of this population. We hypothesized that ICU bounceback (ICUBB) patients would experience increased mortality compared with non-ICUBB controls and would likely be associated with specific patterns of complications. METHODS: The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2012 to 2015 for all ICU admissions. Unadjusted mortality rates were compared between ICUBB and non-ICUBB counterparts. Multilevel mixed-effects logistic regression models assessed the adjusted impact of ICUBB on mortality and the adjusted predictive impact of 8 complications on ICUBB. RESULTS: A total of 58,013 ICU admissions were identified from 2012 to 2015. From these, 53,715 survived their ICU index admission. The ICUBB rate was determined to be 3.82% (2,054/53,715). Compared with the non-ICUBB population, ICUBB patients had a significantly higher mortality rate (12% vs. 8%; p < 0.001). In adjusted analysis, ICUBB was associated with a 70% increased odds ratio for mortality (adjusted odds ratio, 1.70; 95% confidence interval, 1.44-2.00; p < 0.001). Adjusted analysis of predictive variables revealed unplanned intubation, sepsis, and pulmonary embolism as the strongest predictors of ICUBB. CONCLUSION: Intensive care unit bouncebacks are associated with worse outcomes and are disproportionately burdened by respiratory complications. These findings emphasize the importance of the TQIP Collaborative in identifying statewide issues in need of performance improvement within mature trauma systems. LEVEL OF EVIDENCE: Epidemiological study, level III.


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Centros de Traumatologia/estatística & dados numéricos , Ferimentos e Lesões/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Mortalidade Hospitalar , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Pennsylvania/epidemiologia , Doenças Respiratórias/etiologia , Doenças Respiratórias/terapia , Estudos Retrospectivos , Fatores de Risco , Ferimentos e Lesões/complicações , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/mortalidade
7.
Artigo em Inglês | MEDLINE | ID: mdl-32121546

RESUMO

BACKGROUND: Employment in the administrative sector is characterized by prolonged sedentary work, which has been tied to increased morbidity and compromised health. The aim of this study was to determine cardiovascular, cardiorespiratory and metabolic risk parameters of German office workers (OWs) in comparison to OWs from other nations. MATERIAL AND METHODS: A total of 46 male office workers from the North Rhine-Westphalia region (Germany) participated in the survey. Anthropometric measurements, cardiovascular and metabolic risk factors, as well as laboratory parameters were taken. The 10-year cardiovascular risk was calculated by using the Framingham risk score. The diagnosis of metabolic syndrome was based on the criteria of the International Diabetes Federation. Cardiorespiratory status was assessed by exercise spirometry. RESULTS: The analyzed group of OWs demonstrated a high prevalence of preobesity (Body Mass Index 26.4 ± 4 and waist circumference 97.3 ± 11.7 cm) and 58.7% of the OWs showed an abnormally large waist circumference. Cardiovascular risk was correspondingly elevated as compared with other international studies (9.7% ± 9.2%). High risk cardiovascular profiles were detected in 10.7% of the participants and 33% of the OWs in our study group were diagnosed with metabolic syndrome. The oxygen uptake of the OWs was 34.1 ± 8.1 mL/kg-1·min-1. CONCLUSIONS: The German OWs show elevated cardiovascular risk assessed using the Framingham risk score and also a high tendency for metabolic syndrome. The OWs need to be made further aware of the cardiovascular risk and resulting health implications. Implementation of health promotion concepts such as corporate sports activities or nutrition courses should be taken into consideration to counteract cardiovascular risk factors and the subsequent development of cardiovascular disease in later life.


Assuntos
Doenças Cardiovasculares/etiologia , Síndrome Metabólica/etiologia , Doenças Profissionais/etiologia , Doenças Respiratórias/etiologia , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Alemanha/epidemiologia , Saúde Global , Inquéritos Epidemiológicos , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Prevalência , Estudos Prospectivos , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Medição de Risco , Fatores de Risco
8.
Artigo em Inglês | MEDLINE | ID: mdl-32121551

RESUMO

There is continuing debate and public health concern regarding the previously confirmed association between high livestock density and human health. The primary aim of the current study is to assess the prevalence of respiratory and other health problems in a livestock dense area in the Netherlands, based on recent longitudinal health data and a large sample. Analyses are expanded with the investigation of different subgroups of patients with respiratory health problems and the inclusion of various chronic and acute health outcomes, as well as prescribed medication. Prevalence of health symptoms and chronic conditions was assessed for the period 2014-2016, based on electronic health records registered in 26 general practices located in areas with intensive livestock farming in the Netherlands ("livestock dense area", n = 117,459 unique residents in total). These were compared with corresponding health data from general practices (n = 22) in different rural regions with a low density of livestock farms or other major environmental exposures ("control area", n = 85,796 unique residents in total). Multilevel regression models showed a significantly higher prevalence of pneumonia in the total sample in the livestock dense area, which was also observed among susceptible subgroups of children, the elderly, and patients with chronic obstructive pulmonary disease (COPD). Lower respiratory tract infections, respiratory symptoms, vertigo, and depression were also more common in the livestock dense area compared to the control area. In general, there were no significant differences in chronic conditions such as asthma, COPD, or lung cancer. Prescription rates for broad-spectrum antibiotics were more common among patients with pneumonia in the livestock dense area. Acute respiratory infections and symptoms, but not chronic conditions, were considerably more common in areas with a high livestock density. Identification of causal pathogens on the basis of serological analyses could further elucidate the underlying mechanisms behind the observed health effects.


Assuntos
Exposição Ambiental/efeitos adversos , Gado , Doenças Respiratórias/etiologia , Saúde da População Rural/estatística & dados numéricos , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Doença Crônica , Registros Eletrônicos de Saúde , Exposição Ambiental/estatística & dados numéricos , Saúde Ambiental , Fazendas/provisão & distribução , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Sistema de Registros , Doenças Respiratórias/epidemiologia , Adulto Jovem
9.
Ann Agric Environ Med ; 27(1): 1-5, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32208572

RESUMO

Atmospheric pollution suspended in humid air is popularly known as 'smog'. It is composed of dust particles of different sizes, as well as non-metal oxides, organic compounds, and heavy metals. Exposure to harmful substances suspended in the air - apart from, for example - smoking cigarettes, one of the modifiable factors leading to the development of respiratory diseases. There are six types of substances present in the air that have a negative impact on public health and result in significant consequences: ozone, particulate matter (PM) of different diameters - PM2.5µ, PM2.5‒10 µ, PM10 µ, nitrogen dioxide, sulphur dioxide, carbon monoxide and lead. Particular attention is given to small dust particles (PM10 and PM2.5) because they can penetrate into the lower respiratory tract. Apart from describing the composition of smog and sources of air pollution, the article also discusses the impact of atmospheric pollutants on both development and aggravation of the symptoms of such respiratory tract diseases as asthma, chronic obstructive pulmonary disease, respiratory infections and lung cancer. Some of legal measures applied in different countries aimed at reducing exposure to noxious air pollutants are reviewed. The authors believe that the increased focus on risks arising from inhaling toxic air pollution may be a first step for developing systemic solutions aimed at resolving or, at least, decreasing those risks.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Doenças Respiratórias/etiologia , Smog/efeitos adversos , Poluição do Ar/legislação & jurisprudência , Exposição Ambiental , Humanos , Óxidos/toxicidade , Material Particulado/efeitos adversos , Smog/análise
10.
Thorax ; 75(3): 220-226, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32079666

RESUMO

RATIONALE: There are no population-based studies from sub-Saharan Africa describing longitudinal lung function in adults. OBJECTIVES: To explore the lung function trajectories and their determinants, including the effects of air pollution exposures and the cleaner-burning biomass-fuelled cookstove intervention of the Cooking and Pneumonia Study (CAPS), in adults living in rural Malawi. METHODS: We assessed respiratory symptoms and exposures, spirometry and measured 48-hour personal exposure to fine particulate matter (PM2.5) and carbon monoxide (CO), on three occasions over 3 years. Longitudinal data were analysed using mixed-effects modelling by maximum likelihood estimation. MEASUREMENTS AND MAIN RESULTS: We recruited 1481 adults, mean (SD) age 43.8 (17.8) years, including 523 participants from CAPS households (271 intervention; 252 controls), and collected multiple spirometry and air pollution measurements for 654 (44%) and 929 (63%), respectively. Compared with Global Lung Function Initiative African-American reference ranges, mean (SD) FEV1 (forced expiratory volume in 1 s) and FVC (forced vital capacity) z-scores were -0.38 (1.14) and -0.19 (1.09). FEV1 and FVC were determined by age, sex, height, previous TB and body mass index, with FEV1 declining by 30.9 mL/year (95% CI: 21.6 to 40.1) and FVC by 38.3 mL/year (95% CI: 28.5 to 48.1). There was decreased exposure to PM2.5 in those with access to a cookstove but no effect on lung function. CONCLUSIONS: We did not observe accelerated lung function decline in this cohort of Malawian adults, compared with that reported in healthy, non-smoking populations from high-income countries; this suggests that the lung function deficits we measured in adulthood may have origins in early life.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Exposição Ambiental/efeitos adversos , Pulmão/fisiopatologia , Doenças Respiratórias/epidemiologia , Adulto , Monóxido de Carbono/toxicidade , Culinária/instrumentação , Monitoramento Ambiental , Feminino , Volume Expiratório Forçado , Humanos , Estudos Longitudinais , Malaui/epidemiologia , Masculino , Pessoa de Meia-Idade , Material Particulado/toxicidade , Estudos Prospectivos , Doenças Respiratórias/etiologia , Doenças Respiratórias/fisiopatologia , População Rural , Avaliação de Sintomas , Capacidade Vital
11.
BMC Infect Dis ; 20(1): 148, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070275

RESUMO

BACKGROUND: The influenza virus spreads rapidly around the world in seasonal epidemics, resulting in significant morbidity and mortality. Influenza-related incidence data are limited in many countries in Africa despite established sentinel surveillance. This study aimed to address the information gap by estimating the burden and seasonality of medically attended influenza like illness in Ethiopia. METHOD: Influenza sentinel surveillance data collected from 3 influenza like illness (ILI) and 5 Severe Acute Respiratory Illness (SARI) sites from 2012 to 2017 was used for analysis. Descriptive statistics were applied for simple analysis. The proportion of medically attended influenza positive cases and incidence rate of ILI was determined using total admitted patients and catchment area population. Seasonality was estimated based on weekly trend of ILI and predicted threshold was done by applying the "Moving Epidemic Method (MEM)". RESULT: A total of 5715 medically attended influenza suspected patients who fulfills ILI and SARI case definition (77% ILI and 23% SARI) was enrolled. Laboratory confirmed influenza virus (influenza positive case) among ILI and SARI suspected case was 25% (1130/4426) and 3% (36/1289). Of which, 65% were influenza type A. The predominantly circulating influenza subtype were seasonal influenza A(H3N2) (n = 455, 60%) and Influenza A(H1N1)pdm09 (n = 293, 38.81%). The estimated mean annual influenza positive case proportion and ILI incidence rate was 160.04 and 52.48 per 100,000 population. The Incidence rate of ILI was higher in the age group of 15-44 years of age ['Incidence rate (R) = 254.6 per 100,000 population', 95% CI; 173.65, 335.55] and 5-14 years of age [R = 49.5, CI 95%; 31.47, 130.43]. The seasonality of influenza has two peak seasons; in a period from October-December and from April-June. CONCLUSION: Significant morbidity of influenza like illness was observed with two peak seasons of the year and seasonal influenza A (H3N2) remains the predominantly circulating influenza subtype. Further study need to be considered to identify potential risks and improving the surveillance system to continue early detection and monitoring of circulating influenza virus in the country has paramount importance.


Assuntos
Influenza Humana/epidemiologia , Influenza Humana/virologia , Adolescente , Adulto , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Laboratórios , Masculino , Pessoa de Meia-Idade , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Estações do Ano , Vigilância de Evento Sentinela , Adulto Jovem
12.
Ann Epidemiol ; 42: 19-24.e2, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32081535

RESUMO

PURPOSE: Few studies have investigated the association of childhood obesity with respiratory disease-related outcomes in adulthood and findings are inconsistent. The aim of this study was to examine the associations of body mass index (BMI) in childhood with the occurrence of respiratory events in adulthood. METHODS: We analyzed a cohort of 4537 school-aged children who attended the Busselton Health Study. Height and weight were measured and generated BMI z-scores were categorized into four groups. Participants were followed for respiratory disease-related hospital admissions or death using the Western Australia Data Linkage System. The associations between childhood BMI and respiratory events in adulthood were investigated using Cox regression models. A subgroup of 2196 that reattended a survey in young adulthood was also analyzed. RESULTS: During the 122,781 person-years of follow-up, 810 participants experienced a respiratory event. Childhood BMI group was not associated with risk of respiratory event in adulthood (hazard ratio for BMI z ≥ 1 vs. < -1 = 0.90; 95% CI, 0.70-1.17; P = .295) and this persisted after adjustment for selected confounders in the subgroup (hazard ratio 0.80; 95% CI, 0.43-1.48; P = .476). CONCLUSIONS: Childhood BMI is not associated with risk of respiratory events in adulthood.


Assuntos
Hospitalização/estatística & dados numéricos , Obesidade/complicações , Obesidade Pediátrica/epidemiologia , Doenças Respiratórias/epidemiologia , Adulto , Austrália/epidemiologia , Índice de Massa Corporal , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Obesidade/mortalidade , Doenças Respiratórias/etiologia , Doenças Respiratórias/mortalidade , Adulto Jovem
13.
Occup Med (Lond) ; 70(1): 52-59, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-31863117

RESUMO

BACKGROUND: The world of work is continually changing, and this could result in new and emerging risks being introduced, including those that may cause work-related respiratory diseases (WRRD). AIMS: To describe recently emerging and new cases of WRRD and the relevant methodology using data in a national occupational respiratory disease surveillance scheme in the UK. METHODS: Incident cases of respiratory diseases reported by physicians to the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) between January 2015 and December 2017 were included. Potentially emerging respiratory hazards manifesting in SWORD data were identified with the following hierarchical approach: (i) new respiratory disease not previously associated with work, (ii) specific exposure/agent not previously associated with WRRD and (iii) industry and/or occupation not previously associated with WRRD. RESULTS: A total of 1215 cases of WRRD were reported to SWORD between January 2015 and December 2017. No new WRRD were identified. Thirteen potentially emerging causes of occupational asthma were identified, including exposures to agents such as ninhydrin. Four potential new causes were identified for interstitial pneumonia, which included wood and brass dust. Two potentially emerging causes of WRRD were identified for inhalational accidents (green coffee and nitrocellulose), hypersensitivity pneumonitis (diphenylmethane diisocyanate and salami mould), rhinitis (morphine and Amaranthus quitensis) and sarcoidosis (prions and horses). CONCLUSIONS: Continuous monitoring and reporting of any new work-related disease is a critical function of any occupational disease reporting scheme. Potential emerging causes of work-related health risks have been identified by using a simple and systematic way of detecting emerging causes of WRRDs.


Assuntos
Monitoramento Epidemiológico , Doenças Profissionais/epidemiologia , Doenças Respiratórias/epidemiologia , Humanos , Doenças Profissionais/etiologia , Doenças Respiratórias/etiologia , Reino Unido/epidemiologia
14.
Environ Res ; 180: 108868, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31711659

RESUMO

BACKGROUND: Respiratory diseases are a major component of morbidity in children and their symptoms may be spatially and temporally exacerbated by exposure gradients of fine particulate matter (PM2.5) in large polluted urban areas, like the Mexico City Metropolitan Area (MCMA). OBJECTIVES: To analyze the association between satellite-derived and interpolated PM2.5 estimates with children's (≤9 years old) acute respiratory symptoms (ARS) in two probabilistic samples representing the MCMA. METHODS: We obtained ARS data from the 2006 and 2012 National Surveys for Health and Nutrition (ENSaNut). Two week average exposure to PM2.5 was assessed for each household with spatial estimates from a hybrid model with satellite measurements of aerosol optical depth (AOD-PM2.5) and also with interpolated PM2.5 measurements from ground stations, from the Mexico City monitoring network (MNW-PM2.5). We used survey-adjusted logistic regressions to analyze the association between PM2.5 estimates and ARS reported on children. RESULTS: A total of 1,005 and 1,233 children were surveyed in 2006 and 2012 representing 3.1 and 3.5 million children, respectively. For the same years and over the periods of study, the estimated prevalence of ARS decreased from 49.4% (95% CI: 44.9,53.9%) to 37.8% (95% CI: 34,41.7%). AOD-PM2.5 and MNW-PM2.5 estimates were associated with significantly higher reports of ARS in children 0-4 years old [OR2006 = 1.29 (95% (CI): 0.99,1.68) and OR2006 = 1.24 (95% CI: 1.08,1.42), respectively]. We observed positive non-significant associations in 2012 in both age groups and in 2006 for children 5-9 years old. No statistically significant differences in health effect estimates of PM2.5 were found comparing AOD-PM2.5 or MNW-PM2.5 for exposure assessment. CONCLUSIONS: Our findings suggest that PM2.5 is a risk factor for the prevalence of ARS in children and expand the growing evidence of the utility of new satellite AOD-based methods for estimating health effects from acute exposure to PM2.5.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Material Particulado , Doenças Respiratórias , Doença Aguda , Aerossóis , Criança , Pré-Escolar , Cidades , Monitoramento Ambiental , Humanos , Lactente , Recém-Nascido , México , Material Particulado/toxicidade , Doenças Respiratórias/etiologia , Inquéritos e Questionários
15.
Environ Res ; 182: 109002, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31855698

RESUMO

BACKGROUND: Although there is evidence on the effects of short-term ozone (O3) exposures on children's respiratory health, few studies have reported results on the effects of long-term exposures. We report the effects of long-term exposure to O3 on respiratory health outcomes in 10-11-year old children. METHODS: We conducted a panel study in a sample of the general population of school children in two cities with high average O3 concentrations, Athens and Thessaloniki, Greece. All 186 participating students were followed up intensively for 5 weeks spreading across a school year. Data was collected through questionnaires, weekly personal O3 measurements, spirometry, FeNO and time-activity diaries. Long-term O3 exposure was assessed using fixed site measurements and modeling, calibrated for personal exposures. The associations between measured lung function parameters and lung function growth over the study period, as well as FeNO and the occurrence of symptoms with long-term O3 exposure were assessed through the application of multiple mixed effects 2-level regression models, adjusting for confounders and for short-term exposures. RESULTS: A 10 µg/m3 increase in calibrated long-term O3exposure, using measurements from fixed site monitors was associated with lower FVC and FEV1 by 17 mL (95% Confidence Interval: 5-28) and 13 mL (3-21) respectively and small decreases in lung growth: 0.008% (0.002-0.014%) for FVC and 0.006% (0.000-0.012%) in FEV1 over the study period. No association was observed with PEF, FeNO or the occurrence of symptoms. A similar pattern was observed when the exposure estimates from the dispersion models were employed. CONCLUSIONS: Our study provides evidence that long-term O3 exposure is associated with reduced lung volumes and growth.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ozônio , Doenças Respiratórias , Criança , Cidades , Exposição Ambiental , Grécia , Humanos , Pulmão/patologia , Pulmão/fisiopatologia , Medidas de Volume Pulmonar , Ozônio/toxicidade , Doenças Respiratórias/etiologia
16.
Curr Opin Pulm Med ; 26(2): 119-127, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31851023

RESUMO

PURPOSE OF REVIEW: To present an overview of the impact of climate change upon human respiratory health. RECENT FINDINGS: Climate change involves two major types of change. First, there is overall progressive warming. Second, there is increased variability/unpredictability in weather patterns. Both types of change impact negatively upon human respiratory health. Worsening air quality and increased allergens can worsen existing disease. Climate-related changes in allergens and in vectors for infection can cause new disease. Redundant sophisticated studies have projected marked increases in respiratory morbidity and mortality throughout the world as a direct result of climate change. This article summarizes some of those studies. SUMMARY: The clarity of our vision with respect to the dramatic impact of climate change upon human respiratory health approaches 20/20. The data represent a mandate for change. Change needs to include international, national, and individual efforts.


Assuntos
Poluição do Ar/efeitos adversos , Mudança Climática , Doenças Respiratórias , Saúde Global , Humanos , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia
17.
Radiol Clin North Am ; 58(1): 133-150, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731897

RESUMO

Imaging plays a central role in the evaluation of patients following cardiothoracic surgery, both for monitoring in the early postoperative period and for assessing for suspected complications. Patients with postsurgical complications can develop a range of signs and symptoms, from hypotension and tachycardia, as the result of severe bleeding, to fever and leukocytosis because of infection. The radiologist is an important member of the care team in the postoperative period, helping identify and manage complications of cardiothoracic surgery. This article reviews the common complications of cardiothoracic surgery focusing on the role of imaging and clues to diagnosis.


Assuntos
Cardiopatias/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Doenças Respiratórias/diagnóstico por imagem , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cardiopatias/etiologia , Humanos , Complicações Pós-Operatórias/etiologia , Radiografia/métodos , Doenças Respiratórias/etiologia , Doenças Vasculares/etiologia
18.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1578-1583, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823562

RESUMO

Objective: To summarize the progress of diagnosis and treatment of upper respiratory obstruction in patients with Treacher Collins syndrome (TCS). Methods: The domestic and abroad literature about the diagnosis and treatment of upper respiratory obstruction in patients with TCS was extensively reviewed and analyzed. Results: TCS is an autosomal-dominant craniofacial developmental syndrome. It is often accompanied by midface and/or mandibular hypoplasia, soft tissue hypertrophy, and other respiratory tissue developmental abnormalities, which can lead to different degrees of upper respiratory obstruction symptoms. Respiratory obstruction in patients with TCS is affected by many factors, and the obstructive degree are different. Early detection of the causes and obstructive sites and adopted targeted treatments can relieve the symptoms of respiratory obstruction and avoid severe complications. Conclusion: Due to the low incidence of TCS, there is still a lack of high-quality research evidence to guide clinical treatment. Large-scale and prospective clinical studies are needed to provide new ideas for the treatment and prevention of upper respiratory obstruction.


Assuntos
Disostose Mandibulofacial , Doenças Respiratórias , Face , Ossos Faciais , Humanos , Disostose Mandibulofacial/complicações , Disostose Mandibulofacial/diagnóstico , Disostose Mandibulofacial/terapia , Estudos Prospectivos , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/etiologia , Doenças Respiratórias/terapia
19.
PLoS One ; 14(12): e0226221, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31830088

RESUMO

Health effects of traffic-related air pollution (TRAP) concentrations in densely populated areas are previously described. However, there is still a lack of knowledge of the health effects of moderate TRAP levels. The aim of the current study, a population-based survey including 16 099 adults (response rate 33%), was to assess the relationship between TRAP estimates and respiratory symptoms in an area with modest levels of traffic; Telemark County, Norway. Respondents reported respiratory symptoms the past 12 months and two TRAP exposure estimates: amount of traffic outside their bedroom window and time spent by foot daily along a moderate to heavy traffic road. Females reported on average more symptoms than males. Significant relationships between traffic outside their bedroom window and number of symptoms were only found among females, with the strongest associations among female occasional smokers (incidence rate ratio [IRR], 1.75, 95% confidence interval (CI) [1.16-2.62] for moderate or heavy traffic compared to no traffic). Significant relationship between time spent daily by foot along a moderate to heavy traffic road and number of symptoms was found among male daily smokers (IRR 1.09, 95% CI [1.04-1.15] per hour increase). Associations between traffic outside bedroom window and each respiratory symptom were found. Significant associations were primarily detected among females, both among smokers and non-smokers. Significant associations between time spent by foot daily along a moderate to heavy traffic road (per hour) and nocturnal dyspnoea (odds ratio (OR) 1.20, 95% CI [1.05-1.38]), nocturnal chest tightness (OR 1.13 [1.00-1.28]) and wheezing (OR 1.14 [1.02-1.29]) were found among daily smokers, primarily men. Overall, we found significant associations between self-reported TRAP exposures and respiratory symptoms. Differences between genders and smoking status were identified. The findings indicate an association between TRAP and respiratory symptoms even in populations exposed to modest levels of TRAP.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição Ambiental/efeitos adversos , Doenças Respiratórias/etiologia , Autorrelato , Poluição Relacionada com o Tráfego/efeitos adversos , Emissões de Veículos/análise , Adolescente , Adulto , Asma/epidemiologia , Asma/etiologia , Estudos Transversais , Dispneia/epidemiologia , Dispneia/etiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Sons Respiratórios/etiologia , Doenças Respiratórias/epidemiologia , Adulto Jovem
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