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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4114-4117, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018903

RESUMO

Assessment of pulmonary function is vital for early detection of chronic diseases such as chronic obstructive pulmonary disease (COPD) in home healthcare. However, monitoring of pulmonary function is often omitted owing to the heavy burden that the use of specific medical devices places on the patients. In this study, we developed a non-contact spirometer using a time-of-flight sensor that measures very small displacements caused by chest wall motion during breathing. However, this sensor occasionally failed when estimating the values from breathing waveforms because their shape depends on the subject test experience. As a result, further measurements were required to address motion artifacts. To accomplish high accuracy estimation in the face of these factors, we developed methods to estimate parameters from a part of the waveform and remove outliers from multiple-region measurements. According to laboratory experiments, the proposed system achieved an absolute error of 5.26 % and a correlation coefficient of 0.88. This study also addressed the limitations of depth sensor measurements, thereby contributing to the implementation of high-accuracy COPD screening.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Respiração , Artefatos , Humanos , Movimento (Física) , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4491-4497, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018992

RESUMO

Spirometry test, a measure of the patient's lung function, is the gold standard for diagnosis and monitoring of chronic pulmonary diseases. Spirometry is currently being done in hospital settings by having the patients blow the air out of their lungs forcefully and into the spirometer's tubes under the supervision and constant guidance of clinicians. This test is expensive, cumbersome and not easily applicable to every-day monitoring of these patients. The lung mechanism when performing a cough is very similar to when spirometry test is done. That includes a big inhalation, air compression and forceful exhalation. Therefore, it is reasonable to assume that obstruction of lung airways should have a similar effect on both cough features and spirometry measures. This paper explores the estimation of lung obstruction using cough acoustic features. A total number of 3695 coughs were collected from patients from 4 different conditions and 4 different severity categories along with their lung function measures in a clinical setting using a smartphone's microphone and a hospital-grade spirometry lab. After feature-set optimization and model hyperparameter tuning, the lung obstruction was estimated with MAE (Mean Absolute Error) of 8% for COPD and 9% for asthma populations. In addition to lung obstruction estimation, we were able to classify patients' disease state with 91% accuracy and patients' severity within each disease state with 95% accuracy.Clinical Relevance- This enables effort-independent estimation of lung function spirometry parameters which could potentially lead to passive monitoring of pulmonary patients.


Assuntos
Asma , Tosse , Acústica , Asma/diagnóstico , Tosse/diagnóstico , Humanos , Pulmão , Espirometria
3.
Wiad Lek ; 73(8): 1717-1722, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055340

RESUMO

OBJECTIVE: The aim: This study aims to determine specific predictive factors of bronchiectasis exacerbations. PATIENTS AND METHODS: Materials and methods: 47 patients with bronchiectasis were prospectively recruited into the study in Dnipro, Ukraine. Following the number of exacerbations during the previous year, they were divided into two groups: frequent exacerbators - ≥ 3 cases per year (n = 24) and non-frequent exacerbators - < 3 cases per year (n = 23). Demographic and anthropometric data, medical history, smoking status, shortness of breath by Modified Medical Research Council Dyspnea Scale, sputum culture, respiratory function by computed spirometry, disease severity by Bronchiectasis Severity index and FACED scales were evaluated in both groups. RESULTS: Results: The factors found to be independently associated with frequent exacerbations were: overweight, airway obstruction, longer duration of the disease, more severe dyspnea, greater number of involved pulmonary lobes and presence of one or more comorbid conditions. Non-influencing factors were: underweight, age, sex, smoking status and, unexpectedly, presence of Pseudomonas aeruginosa or other pathogens in sputum culture. CONCLUSION: Conclusions: Particular attention is required for patients with bronchiectasis who have overweight, airway obstruction, longer duration of the disease, more severe dyspnea, the greater number of involved pulmonary lobes and presence of one or more comorbid conditions in order to correct modifiable risk factors of future exacerbations.


Assuntos
Bronquiectasia , Adulto , Bronquiectasia/epidemiologia , Progressão da Doença , Humanos , Índice de Gravidade de Doença , Espirometria , Ucrânia
4.
Medicine (Baltimore) ; 99(42): e22449, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080680

RESUMO

INTRODUCTION: Expiratory central airway collapse is defined by excessive inward bulging of either tracheobronchial posterior membrane or cartilage. The former is called excessive dynamic airway collapse (EDAC), and the latter, depending on the site of collapse, tracheomalacia, bronchomalacia or tracheobronchomalacia. Due to their non-specific symptoms and lack of awareness amongst clinicians they tend to be mislabeled as common obstructive lung disorders, or complicate their course undetected. Particular controversies refer to EDAC sometimes considered just as a symptom of obstructive lung disease and not a separate entity. Nonetheless, a growing body of evidence indicates that EDAC might be present in patients without apparent obstructive lung disease or it might be an independent risk factor in chronic obstructive pulmonary disease or asthma patients. PATIENT CONCERNS: Patient #1 was admitted because of idiopathic chronic cough whereas patient #2 was admitted for differential diagnosis of dyspnea of uncertain etiology. In both patients symptoms were unresponsive to bronchodilators and inhaled corticosteroids. FINDINGS AND DIAGNOSIS: In both patients an excess collapse of tracheobronchial posterior membrane was detected during bronchoscopy; in patient #1, of right main bronchus and right upper lobe bronchus and in patient #2 of right upper lobe bronchus and both main bronchi. Excess central airway collapse in patient #2 was also visualized on expiratory chest CT. In patient #1 spirometry did not reveal obturation, whereas in patient #2 only mild, irreversible, obstruction was revealed, disproportionate to patients significant breathlessness. INTERVENTIONS: Both patients were treated with N-acetylcysteine and adjustable positive expiratory pressure valves. OUTCOMES: Due to aforementioned treatment chronic cough in patient #1 subsided almost completely whereas patient's #2 dyspnea improved significantly. CONCLUSIONS: In presented cases EDAC was an unexpected finding, even though, it firmly corresponded with reported symptoms. Treatment modification led to improvement of patients quality of life.


Assuntos
Traqueobroncomalácia/diagnóstico , Traqueobroncomalácia/terapia , Acetilcisteína/uso terapêutico , Adulto , Idoso , Broncoscopia , Diagnóstico Diferencial , Feminino , Humanos , Respiração com Pressão Positiva/instrumentação , Espirometria , Tomografia Computadorizada por Raios X
5.
J Affect Disord ; 277: 772-778, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065816

RESUMO

BACKGROUND: The wearing of respiratory protective devices (RPDs) correctly and continually in situations where people are at risk of respiratory infections is crucial for infection prevention. Certain people are poorly compliant with RPDs due to RPD-related annoyance, including respiratory discomfort. We hypothesized that individuals vulnerable to panic attacks are included in this group. No published studies on this topic are available. The evidence for our hypothesis was reviewed in this study as a starting point for future research. METHODS: We selected a set of experimental studies that measured the respiratory physiological burden in RPD wearers through objective and validated methods. We conducted a bibliographic search of publications in the PubMed database (January 2000-May 2020) to identify representative studies that may be of interest for panic respiratory pathophysiology. RESULTS: Five studies were included. Wearing RPDs exerted significant respiratory effects, including increased breathing resistance, CO2 rebreathing due to CO2 accumulation in the RPD cavity, and decreased inhaled O2 concentration. We discussed the implications of these effects on the respiratory pathophysiology of panic. LIMITATIONS: Most studies had a small sample size, with a preponderance of young participants. Different methodologies were used across the studies. Furthermore, differences in physical responses between wearing RPDs in experimental settings or daily life cannot be excluded. CONCLUSIONS: This research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing RPDs, thereby reducing their tolerance for these devices. Strategies to decrease discomfort should be identified to overcome the risk of poor compliance.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Transtorno de Pânico/fisiopatologia , Pneumonia Viral/prevenção & controle , Transtornos Respiratórios/fisiopatologia , Respiração , Dispositivos de Proteção Respiratória/efeitos adversos , Resistência das Vias Respiratórias , Betacoronavirus , Dióxido de Carbono/metabolismo , Humanos , Oxigênio/metabolismo , Transtorno de Pânico/metabolismo , Transtorno de Pânico/psicologia , Transtornos Respiratórios/etiologia , Transtornos Respiratórios/metabolismo , Transtornos Respiratórios/psicologia , Rinomanometria , Espirometria
6.
J Cancer Res Ther ; 16(4): 788-792, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930119

RESUMO

Context: Spirometry is an important tool to monitor treatment response in diseases such as chronic obstructive pulmonary disease and asthma. However, there is lack of evidence to support its application to evaluate response to chemotherapy in advanced lung cancer. It might be a useful adjunct to the imaging-based response evaluation which lacks functional assessment of lungs. Aims: The study was conducted to evaluate the change in spirometry in lung cancer patients after chemotherapy and to find its correlation with change in physical tumor size. Subjects and Methods: Sixty-two advanced lung cancer patients who were eligible for palliative chemotherapy were enrolled. Baseline tumor size evaluation using Response Evaluation Criteria in Solid Tumor (RECIST)-based scoring system, and spirometry was done. Four cycles of double agent (platinum doublets) chemotherapy were administered, after which treatment response was evaluated. Repeat spirometry was analyzed and correlated with changes in physical tumor size. Results: Twenty-five patients showed a response (all partial response) to four cycles of chemotherapy. Small cell carcinoma showed a better response rate than non-small cell carcinoma (78% vs. 39%). There was statistically significant improvement in forced expiratory volume in 1 (FEV1) (P = 0.01) and forced vital capacity (P = 0.03) in responders as compared to nonresponders. Change in FEV1 showed a statistically significant correlation with the change in tumor size (RECIST score) (r = -0.34; P = 0.04). Conclusions: Improvement in spirometry correlates with the tumor response as judged using RECIST criteria after chemotherapy. Further studies with bigger sample size are required to consolidate the results.


Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Projetos Piloto , Estudos Prospectivos , Testes de Função Respiratória/métodos , Espirometria/métodos , Resultado do Tratamento , Carga Tumoral/efeitos dos fármacos
7.
PLoS One ; 15(9): e0239602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966342

RESUMO

The association between chronic obstructive pulmonary disease (COPD) and occupational exposures are less studied in Bangladeshi context, despite the fact that occupational exposures are serious public health concerns in Bangladesh. Therefore, this study aimed to evaluate this association considering demographic, health and smoking characteristics of Bangladeshi population. This was a hospital-based quantitative study including 373 participants who were assessed for COPD through spirometry testing. Assessment of occupational exposures was based on both self-reporting by respondents and ALOHA based job exposure matrix (JEM). Here, among the self-reported exposed group (n = 189), 104 participants (55%) were found with COPD compared to 23 participants (12.5%) in unexposed group (n = 184) that differed significantly (p = 0.00). Similarly, among the JEM measured low (n = 103) and high exposed group (n = 236), 23.3% and 41.5% of the participants were found with COPD respectively; compared to unexposed group (14.7%; n = 34), that differed significantly also (p = 0.00). Likewise, participants with longer self-reported occupational exposures (>8 years) showed significantly (p = 0.00) higher proportions of COPD (79.5%) compared to 40.4% in shorter exposure group (1-8 years). Similarly, significant (p = 0.00) higher cases of COPD were observed among the longer cumulative exposure years (>9 years) group than the shorter cumulative exposure years (1-9 years) group in JEM. While combining smoking and occupational exposure, the chance of developing COPD among the current, former and non-smokers of exposed group were 7.4, 7.2 and 12.7 times higher respectively than unexposed group. Furthermore, logistic analysis revealed that after adjustments for confounding risk factors, the chance of developing COPD among the self-reported exposure group was 6.3 times higher (ORs: 6.3, p = 0.00) than unexposed group; and JEM exposure group has odds of 2.8 and 1.1 respectively (p<0.05) for high and low exposures. Further studies are needed to reinforce this association between COPD and occupational exposure in Bangladesh.


Assuntos
Exposição Ocupacional/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adulto , Bangladesh , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato/estatística & dados numéricos , Espirometria/estatística & dados numéricos
8.
Adv Physiol Educ ; 44(4): 516-519, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880483

RESUMO

This paper describes the process involved in conducting an online spirometry practical through Zoom. The teacher demonstrated the practical from the medical school, and the students observed the procedure from the comfort of their own homes. Students were able to analyze the graphs captured in the teacher's laptop by remotely controlling the teacher's laptop. This method may be useful for places where face-to-face classes are suspended due to the COVID-19 pandemic.


Assuntos
Betacoronavirus/patogenicidade , Instrução por Computador , Infecções por Coronavirus/prevenção & controle , Educação a Distância , Educação de Graduação em Medicina , Pulmão/fisiologia , Pandemias/prevenção & controle , Fisiologia/educação , Pneumonia Viral/prevenção & controle , Espirometria , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Volume Expiratório Forçado , Humanos , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Faculdades de Medicina , Capacidade Vital
9.
Environ Res ; 188: 109847, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32846639

RESUMO

BACKGROUND: Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting. OBJECTIVES: To characterize COPD in dairy farmers. METHODS: 4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice from 2011 to 2015. Subjects with COPD were invited to participate in the characterization phase of the study. Those who accepted were included in two subgroups: dairy farmers with COPD (DF-COPD) (n = 101) and non-farmers with COPD (NF-COPD) (n = 85). Patients with COPD were frequency-matched with subjects with normal spirometry for age, sex and tobacco smoking (pack-years and status) (DF-controls n = 98, NF-controls n = 89). All subjects from these four groups underwent lung function and exercise testing, questionnaires and blood analysis. RESULTS: The frequency of COPD in dairy farmers was 8.0% using the GOLD criterion and 6.2% using the lower limit of normal criterion and was similar in non-farming subjects (7.3% and 5.2%, respectively) although dairy farmers had lower tobacco consumption (screening phase). DF-COPD had better pulmonary function, exercise capacity and quality of life, fewer symptoms and comorbidities than NF-COPD, and higher levels of some Th2 biomarkers (MCP-2, periostin) (characterization phase). In farmers, COPD was not related to occupational exposure factors, supporting the role of host factors. CONCLUSION: COPD secondary to organic dust exposure (dairy farming) appears less severe and associated with fewer comorbidities than COPD secondary to tobacco smoking.


Assuntos
Exposição Ocupacional , Doença Pulmonar Obstrutiva Crônica , Indústria de Laticínios , Fazendeiros , Humanos , Exposição Ocupacional/efeitos adversos , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/etiologia , Qualidade de Vida , Fatores de Risco , Espirometria
10.
Transplantation ; 104(8): 1712-1719, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732851

RESUMO

BACKGROUND: Spirometry is the cornerstone of monitoring allograft function after lung transplantation (LT). We sought to determine the association of variables on best spirometry during the first year after bilateral LT with 3-year posttransplant survival. METHODS: We reviewed charts of patients who survived at least 3 months after bilateral LT (n = 157; age ± SD: 54 ± 13 y, male:female = 91:66). Best spirometry was calculated as the average of 2 highest measurements at least 3 weeks apart during the first year. Airway obstruction was defined as forced expiratory volume in 1-second (FEV1)/forced vital capacity (FVC) ratio <0.7. Survival was compared based on the ventilatory defect and among groups based on the best FEV1 and FVC measurements (>80%, 60%-80%, and <60% predicted). Primary outcome was 3-year survival. RESULTS: Overall, 3-year survival was 67% (n = 106). Obstructive defect was uncommon (7%) and did not have an association with 3-year survival (72% versus 67%, P = 0.7). Although one-half patients achieved an FVC>80% predicted (49%), 1 in 5 (19%) remained below 60% predicted. Irrespective of the type of ventilatory defect, survival worsened as the best FVC (% predicted) got lower (>80: 80.8%; 60-80: 63.3%; <60: 40%; P < 0.001). On multivariate logistic regression analysis, after adjusting for age, gender, transplant indication, and annual bronchoscopy findings, best FVC (% predicted) during the first year after LT was independently associated with 3-year survival. CONCLUSIONS: A significant proportion of bilateral LT patients do not achieve FVC>80% predicted. Although the type of ventilatory defect on best spirometry does not predict survival, failure to achieve FVC>80% predicted during the first year was independently associated with 3-year mortality.


Assuntos
Pneumopatias/diagnóstico , Pneumopatias/cirurgia , Transplante de Pulmão/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Espirometria/estatística & dados numéricos , Adulto , Idoso , Aloenxertos/fisiopatologia , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Estimativa de Kaplan-Meier , Pulmão/fisiopatologia , Pneumopatias/mortalidade , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/fisiopatologia , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Espirometria/métodos , Resultado do Tratamento , Capacidade Vital/fisiologia
11.
BMC Med Inform Decis Mak ; 20(1): 192, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795352

RESUMO

BACKGROUND: Asthma is one of the most common chronic diseases in childhood. Regular follow-up of physiological parameters in the home setting, in relation to asthma symptoms, can provide complementary quantitative insights into the dynamics of the asthma status. Despite considerable interest in asthma home-monitoring in children, there is a paucity of scientific evidence, especially on multi-parameter monitoring approaches. Therefore, the aim of this study is to investigate whether asthma control can be accurately assessed in the home situation by combining parameters from respiratory physiology sensors. METHODS: Sixty asthmatic and thirty non-asthmatic children were enrolled in the observational WEARCON-study. Asthma control was assessed according to GINA guidelines by the paediatrician. All children were also evaluated during a 2-week home-monitoring period with wearable devices; a physical activity tracker, a handheld spirometer, smart inhalers, and an ambulatory electrocardiography device to monitor heart and respiratory rate. Multiple logistic regression analysis was used to determine which diagnostic measures were associated with asthma control. RESULTS: 24 of the 27 uncontrolled asthmatic children and 29 of the 32 controlled asthmatic children could be accurately identified with this model. The final model showed that a larger variation in pre-exercise lung function (OR = 1.34 95%-CI 1.07-1.68), an earlier wake-up-time (OR = 1.05 95%-CI 1.01-1.10), more reliever use (OR = 1.11 95%-CI 1.03-1.19) and a longer respiratory rate recovery time (OR = 1.12 95%-CI 1.05-1.20) were significant contributors to the probability of having uncontrolled asthma. CONCLUSIONS: Home-monitoring of physiological parameters correlates with paediatrician assessed asthma control. The constructed multivariate model identifies 88.9% of all uncontrolled asthmatic children, indicating a high potential for monitoring of asthma control. This may allow healthcare professionals to assess asthma control at home. TRIAL REGISTRATION: Netherlands Trail Register, NL6087 . Registered 14 February 2017.


Assuntos
Asma/prevenção & controle , Monitores de Aptidão Física , Monitorização Ambulatorial/métodos , Asma/diagnóstico , Asma/tratamento farmacológico , Estudos de Casos e Controles , Criança , Exercício Físico , Feminino , Humanos , Masculino , Países Baixos , Espirometria
14.
Medicina (B Aires) ; 80(4): 359-370, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32841139

RESUMO

The diffusing capacity for carbon monoxide (DLCO) is, after spirometry the standard and noninvasive pulmonary function test of greater clinical use. However, there are substantial errors in the interpretation of the physiological significance of the DLCO, its derived measures and, therefore the clinical significance of its alterations. In addition to the use of different nomenclatures, other sources of confusion have contributed to some negative view of the test. The technical aspects of the DLCO test have the advantage of being well standardized. But unlike what happens with other pulmonary function tests where we have reference values which allow us to determine their "normality or abnormality", it is difficult to apply this route of analysis in the case of DLCO. The central fact in the analysis of DLCO, transference factor for CO (KCO), and alveolar volume (VA) is that for a correct interpretation it is necessary to think about the mechanism by which the pathology induces change. A KCO of 100% can be considered normal in some circumstances or pathological in others and, for the moment, the automated study report cannot discriminate. This article will address the principles of the DLCO test; present different models of analysis submit concrete examples and provide guidelines for their correct interpretation. It is considered essential to carry out an integrated analysis of the DLCO test in relation to other functional tests and clinical data.


Assuntos
Capacidade de Difusão Pulmonar , Monóxido de Carbono , Valores de Referência , Testes de Função Respiratória , Espirometria
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1009-1013, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741162

RESUMO

Carrying out standardized diagnosis, treatment, intervention, management, surveillance and evaluation of COPD is an important part of the special action for the prevention and treatment of chronic respiratory diseases in the "Healthy China Initiative (2019-2030)" . The surveillance of COPD among Chinese residents provides basic data for assessing the level of standardized diagnosis, treatment, intervention and management of patients with COPD. Based the data of all COPD patients found in the surveillance of COPD (2014-2015), the key series articles report the awareness rate of COPD among patients aged ≥40 years in China, and analyze the spirometry examination rate, medicine treatment rate, inhalation therapy rate, respiratory rehabilitation rate, smoking cessation rate, successful smoking cessation rate, and pneumococcal vaccination rate in COPD patients aged ≥ 40 years and their associated factors, providing a scientific reference for China to carry out special action for the prevention and treatment of chronic respiratory diseases represented by COPD.


Assuntos
Vigilância da População , Doença Pulmonar Obstrutiva Crônica , Adulto , China/epidemiologia , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/terapia , Abandono do Hábito de Fumar/estatística & dados numéricos , Espirometria
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1014-1020, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741163

RESUMO

Objective: To understand the situation of respiratory rehabilitation and oxygen inhalation therapy in chronic obstructive pulmonary disease (COPD) patients aged 40 years or older in China, and provide basic information for the development of pulmonary rehabilitation. Methods: The data were from 2014-2015 COPD surveillance in China. Chinese residents aged 40 years or older were recruited through a complex multi-stage stratified cluster sampling from 125 COPD surveillance points in 31 provinces (autonomous regions, municipalities). Standardized face to face electronic questionnaires were used to collect information about respiratory rehabilitation and oxygen inhalation therapy of the patients. Spirometry was performed on all participants, and patients with post- bronchodilator FEV(1)/FVC<70% were diagnosed with COPD. The number of defined COPD patients was 9 134. Based on the complex sampling design, the respiratory rehabilitation treatment rate and oxygen inhalation therapy rate of COPD patients aged 40 years old or older in China were estimated, and the influencing factors were analyzed. Results: A total of 9 118 COPD patients aged 40 years or older were included in the analysis. The rate of respiratory rehabilitation was 0.8% (95CI: 0.6%-1.0%), and the rate of oxygen inhalation therapy was 2.5% (95%CI: 2.0%-2.9%). Among patients with severe symptoms or high risk of acute exacerbation (combined COPD assessment groups B, C, D), the rate of respiratory rehabilitation was 1.4% (95%CI: 0.9%-1.9%), and the rate of oxygen inhalation therapy was 5.4% (95%CI: 4.4%-6.4%). Multivariate logistic regression analysis showed that urban or rural residences, geographic area, awareness of COPD, history of acute exacerbation and severity of airflow restriction had influences on the respiratory rehabilitation rate in the COPD patients. Gender, geographic area, awareness of COPD, history of acute exacerbation, mMRC scores and severity of airflow restriction had influences on the patients' oxygen inhalation therapy rate. Conclusions: The rate of respiratory rehabilitation and oxygen inhalation therapy in COPD patients aged 40 years or older was relatively low in China. It is necessary to explore an effective model of pulmonary rehabilitation and COPD management, so that more COPD patients may have access to scientific pulmonary rehabilitation treatment.


Assuntos
Oxigenoterapia/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Adulto , China/epidemiologia , Pesquisas sobre Serviços de Saúde , Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Espirometria
18.
Artigo em Inglês | MEDLINE | ID: mdl-32674528

RESUMO

Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7-16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF25-75%) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF25-75% than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect.


Assuntos
Asma , Poluição por Fumaça de Tabaco , Adolescente , Asma/epidemiologia , Asma/etiologia , Criança , Estudos Transversais , Feminino , Volume Expiratório Forçado , Humanos , Itália/epidemiologia , Pulmão/fisiopatologia , Masculino , Gravidez , Fatores de Risco , Espirometria , Poluição por Fumaça de Tabaco/efeitos adversos
19.
Respir Res ; 21(1): 163, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600344

RESUMO

OBJECTIVE: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase. METHODS: A retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-min walking distance (6MWD) and high resolution CT being collected at 30 days after discharged. RESULTS: Fifty-seven patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p = 0.019), higher lung total severity score (TSS) and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit. CONCLUSION: Impaired diffusing-capacity, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Músculos Respiratórios/fisiopatologia , Síndrome Respiratória Aguda Grave/diagnóstico , Adulto , Idoso , Distribuição de Qui-Quadrado , China/epidemiologia , Estudos de Coortes , Convalescença , Teste de Esforço , Feminino , Seguimentos , Volume Expiratório Forçado , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Força Muscular , Pandemias , Alta do Paciente , Radiografia Torácica/métodos , Testes de Função Respiratória , Estudos Retrospectivos , Medição de Risco , Síndrome Respiratória Aguda Grave/epidemiologia , Espirometria/métodos , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X/métodos , Capacidade Vital/fisiologia
20.
Niger Postgrad Med J ; 27(3): 163-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687114

RESUMO

Background: Pulmonary tuberculosis (PTB) contributes significantly to morbidity and mortality worldwide, and despite microbiological cure for the disease, many patients still demonstrate residual respiratory symptoms and spirometric abnormalities. Aim and Objectives: The study aimed at identifying the prevalence, pattern and factors associated with spirometric abnormalities in patients successfully treated for PTB in Ilorin, Nigeria. Materials and Methods: This was a hospital-based cross-sectional study at the pulmonary outpatient clinics of the University of Ilorin Teaching Hospital and Kwara State Specialist Hospital, Sobi, Ilorin. A total of 308 consenting patients who had been certified microbiologically cured for bacteriologically confirmed PTB in the preceding 3 years had assessment of residual pulmonary symptoms, spirometry and plain chest radiograph. Results: The prevalence of abnormal spirometry following treatment for PTB was 72.1% (confidence interval: 0.6682-0.7695), with restrictive pattern being the predominant abnormality (42.2%). Over half of the patients (56.5%) had at least one residual respiratory symptom. The significant predictors of abnormal spirometry were PTB retreatment (adjusted odds ratio [aOR] = 6.918; P = 0.012), increasing modified Medical Research Council dyspnoea scores (aOR = 7.935; P = 0.008) and increasing radiologic scores (aOR = 4.679; P ≤ 0.001) after treatment. Conclusion: There is significant residual lung function impairment in majority of the individuals successfully treated for PTB in Ilorin. This highlights the need for spirometric assessment and follow-up after treatment.


Assuntos
Antituberculosos/uso terapêutico , Pulmão/fisiopatologia , Espirometria/estatística & dados numéricos , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Estudos Transversais , Feminino , Humanos , Pulmão/microbiologia , Masculino , Nigéria/epidemiologia , Prevalência , Testes de Função Respiratória/métodos , Tuberculose Pulmonar/epidemiologia
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