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1.
Praxis (Bern 1994) ; 109(1): 13-17, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910765

RESUMO

PneumoLaus: Prevalence of Lung Function Abnormalities in a Sample of the General Population of Lausanne Abstract. Reduced lung function predicts increased mortality. The prevalence of spirometric abnormalities depends on their definition, the references values used and the use or not of bronchodilation. In the PneumoLaus study, conducted between 2014 and 2017 in a sample of the general population of Lausanne, prevalence of chronic obstruction was 3,8 %, of reversible obstruction 2,5 % and of possible restriction 2,2 %. These numbers are lower than in other population studies. Men had more abnormal spirometry results than women, and ever-smokers more than never-smokers. Two thirds of participants with chronic obstruction, most of which without respiratory symptoms, were not aware of any lung disease.


Assuntos
Pneumopatias , Feminino , Humanos , Pneumopatias/epidemiologia , Masculino , Prevalência , Valores de Referência , Espirometria
2.
Tumori ; 106(1): 47-54, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31964281

RESUMO

OBJECTIVE: To assess whether the duration of one-lung ventilation (OLV) affects postoperative pulmonary complications after McKeown esophagectomy for esophageal cancer. METHODS: A retrospective analysis of data stored in a database for esophageal cancer was carried out to identify predictors of postoperative pulmonary complications in patients undergoing McKeown esophagectomy at Sun Yat-sen University Cancer Center between 2010 and 2012. RESULTS: Patients in the OLV ⩾150 minutes group had a higher incidence of postoperative pulmonary complications than those in the OLV <150 minutes group (18.0% vs 7.3%, p < 0.001). Among them, the number of patients who developed pneumonia and atelectasis was also significantly higher (9.0% vs 4.1% [p = 0.031] and 8.7% vs 3.7% [p = 0.018] for the OLV ⩾150 minutes group vs OLV <150 minutes group, respectively). OLV ⩾150 minutes was associated with a prolonged hospital stay (24.2 ± 9.7 vs 21.5 ± 9.2 days, p = 0.001). Multivariate analysis revealed that history of diabetes (odds ratio [OR], 3.56; 95% confidence interval [CI], 1.65-7.68; p = 0.001), chronic obstructive pulmonary disease (OR, 10.65; 95% CI, 5.65-20.08; p < 0.001), and OLV ⩾150 minutes (OR, 3.80; 95% CI, 1.97-7.31; p < 0.001) were independent predictors of postoperative pulmonary complications. CONCLUSION: Long duration of OLV appears to be an important risk factor for postoperative pulmonary complications after McKeown esophagectomy. OLV <150 minutes appears to be the better approach for thoracic surgery. Lung protective measures should be taken when prolonged OLV is anticipated.


Assuntos
Esofagectomia/efeitos adversos , Pneumopatias/epidemiologia , Pneumopatias/etiologia , Ventilação Monopulmonar/efeitos adversos , Complicações Pós-Operatórias , Idoso , Biomarcadores , Esofagectomia/métodos , Feminino , Humanos , Pneumopatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Razão de Chances , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
4.
Lakartidningen ; 1162019 Oct 07.
Artigo em Sueco | MEDLINE | ID: mdl-31593283

RESUMO

Advances in perinatal intensive care have resulted in increased survival of the most immature preterm infants (born before 28 gestational weeks) and these new survivors are now entering school. While the clear majority of all children born preterm have a normal development, the extremely preterm infant is at a considerable risk for long term disabilities and rates of adverse development increase at lower gestational ages. Lung function is commonly affected in children born extremely preterm, and many have treatment for obstructive symptoms. The incidences of major neuromotor impairments, i.e. cerebral palsy, are low, but there is an increasing awareness of common cognitive and neuropsychiatric problems in extremely preterm children and their special needs in school. Extremely preterm children therefore need follow up of lung function and neurodevelopment at least until school start.


Assuntos
Nascimento Prematuro , Assistência ao Convalescente/organização & administração , Transtorno do Espectro Autista/epidemiologia , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Hipertensão/epidemiologia , Lactente , Lactente Extremamente Prematuro/crescimento & desenvolvimento , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pneumopatias/epidemiologia , Gravidez , Nascimento Prematuro/epidemiologia , Fatores de Risco , Tempo
5.
Lakartidningen ; 1162019 Oct 07.
Artigo em Sueco | MEDLINE | ID: mdl-31593288

RESUMO

Late and moderately preterm infants, born between 32+0/7 and 36+6/7 gestational weeks, comprise more than 80 % of all preterm infants and account for almost 40 % of all days of neonatal care. While their total number of days of care has not changed, an increasing part of their neonatal stay (from 29 % in 2011 to 41 % in 2017) is now within home care programmes. Late and moderate preterm birth is often complicated by respiratory disorders, hyperbilirubinemia, hypothermia and feeding difficulties. These infants also have an increased risk of perinatal death and neurologic complications. In the long run, they have higher risks of cognitive impairment, neuropsychiatric diagnoses and need for asthma medication. As young adults, they have a lower educational level and a lower average salary than their full-term counterparts. They also have an increased risk of long-term sick leave, disability pension and need for economic assistance from society.


Assuntos
Nascimento Prematuro , Corticosteroides/administração & dosagem , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos Cognitivos/epidemiologia , Educação Especial/estatística & dados numéricos , Feminino , Humanos , Lactente , Mortalidade Infantil , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro , Tempo de Internação , Pneumopatias/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Gravidez , Nascimento Prematuro/economia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/mortalidade , Nascimento Prematuro/prevenção & controle , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Fatores de Risco , Tempo
7.
Turk J Pediatr ; 61(1): 59-60, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559723

RESUMO

Çiki K, Dogru D, Kuskonmaz B, Emiralioglu N, Yalçin E, Özçelik U, Uçkan-Çetinkaya D, Kiper N. Pulmonary complications following hematopoietic stem cell transplantation in children. Turk J Pediatr 2019; 61: 59-70. Pediatric data about early or long-term pulmonary complications of hematopoietic stem cell transplantation (HSCT) are limited. Here we aimed to evaluate children who were treated with HSCT in the last 10 years and developed pulmonary complications following HSCT and to determine their risk factors associated with pulmonary complications. In this retrospective study, we evaluated 195 patients for the development of pulmonary complications after HSCT within a 10 years of period. Pulmonary complications developed in 71 (36.4%) patients. Of the 71 patients who had pulmonary complications, 60 had one pulmonary complication, 11 had two pulmonary complications. Pulmonary complications were diagnosed as early in 42 (51.2%) and late in 40 (48.8%) episodes. Pulmonary complications were infectious in 28 (34.1%), noninfectious in 20 (24.4%) and both infectious and nonfectious in 34 (41.5%) episodes. Pulmonary complications developed significantly more frequently in patients with malignancy, congenital immune deficiency and with at least one pulmonary disease before HSCT. The number of patients who had myeloablative conditioning regimen was significantly higher in the group of patients without pulmonary complications than the group with pulmonary complications. However, in multivariate analysis, none of these variables were shown to be effective in predicting pulmonary complications after HSCT (p > 0.05). During follow up, 54 (65.8%) episodes recovered, 20 (24.3%) episodes resulted with death due to pulmonary complications, 6 (7.3%) episodes had chronic pulmonary disease (bronchiolitis obliterans (BO) and bronchiolitis obliterans organizing pneumonia (BOOP)); 2 patients (each patient with one episode) were lost to follow up. In conclusion; identifying children who are at risk for severe pulmonary complications and close longitudinal follow-up after HSCT by pediatric pulmonologists is mandatory to increase survival and life quality of these patients.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Pneumopatias/etiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Pneumopatias/terapia , Masculino , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
9.
MMWR Morb Mortal Wkly Rep ; 68(36): 787-790, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31513561

RESUMO

On September 6, 2019, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). As of August 27, 2019, 215 possible cases of severe pulmonary disease associated with the use of electronic cigarette (e-cigarette) products (e.g., devices, liquids, refill pods, and cartridges) had been reported to CDC by 25 state health departments. E-cigarettes are devices that produce an aerosol by heating a liquid containing various chemicals, including nicotine, flavorings, and other additives (e.g., propellants, solvents, and oils). Users inhale the aerosol, including any additives, into their lungs. Aerosols produced by e-cigarettes can contain harmful or potentially harmful substances, including heavy metals such as lead, volatile organic compounds, ultrafine particles, cancer-causing chemicals, or other agents such as chemicals used for cleaning the device (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis, or other drugs; for example, "dabbing" involves superheating substances that contain high concentrations of THC and other plant compounds (e.g., cannabidiol) with the intent of inhaling the aerosol. E-cigarette users could potentially add other substances to the devices. This report summarizes available information and provides interim case definitions and guidance for reporting possible cases of severe pulmonary disease. The guidance in this report reflects data available as of September 6, 2019; guidance will be updated as additional information becomes available.


Assuntos
Pneumopatias/epidemiologia , Guias de Prática Clínica como Assunto , Índice de Gravidade de Doença , Vaping/efeitos adversos , Humanos , Estados Unidos/epidemiologia
10.
BMC Infect Dis ; 19(1): 764, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477038

RESUMO

BACKGROUND: Environmental bacteria, nontuberculous mycobacteria (NTM), are recognized as one of the major human infection pathogens. NTM are prone to be mistaken as multidrug-resistant Mycobacterium tuberculosis and challenge our fight against TB. In addition, treatment of NTM per se is intractable. Remarkably, the distribution of NTM pathogenic species is geographically specific. Thus, it is very important to summarize the prevalent features and clinical symptoms of NTM pulmonary disease. However, In Nanjing district, southeast China, there is no such a report. METHODS: Through investigating electronic medical records and analyzing data of clinical examination system (Lis), we retrospectively summarized the NTM species from 6012 clinical isolates from May 2017 to August 2018, and analyzed the association between NTM species and clinical symptoms. RESULTS: Of 6012 clinical specimens, 1461 (24.3%) could grow in the MGIT 960 broth. Among these positive isolates, 1213 (83%) were M. tuberculosis, 22 (1.5%) were M. bovis, and 226 (15.5%) were NTM. After deducting redundancy, those NTM specimens were confirmed from 154 patients, among which, 87 (56.5%) patients met the full ATS/IDSA NTM disease criteria. The most common etiologic agent was M. intracellulare (70.1%). NTM infection was associated with age, based on which 68.6% male patients and 77.8% female patients were over 50 years old. The older patients were more likely to have hemoptysis, but the younger patients were more likely to manifest chest congestion. Male patients were more likely to have shortness of breath and females were more likely to have hemoptysis. The most common radiographic presentation of NTM pulmonary disease was bronchiectasis, accounting for 39.1%. Remarkably, multiple and thin-walled cavities were outstanding. The most frequent comorbidity of NTM disease was previous tuberculosis (64%), followed by clinical bronchiectasis (19.5%), HIV (19.5%), and 6.9% chronic obstructive pulmonary disease (COPD). There was no association between NTM species and clinical symptoms. CONCLUSION: This study retrospectively investigated the prevalence of NTM pulmonary disease in Nanjing district, southeast China. Similar to Beijing area, north China, M. intracellulare was the major pathogenic NTM species. Clinical symptoms of the disease were not species-specific. Previous TB and HIV infection immensely enhanced risk of NTM disease.


Assuntos
Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Infecções por Micobactéria não Tuberculosa/diagnóstico , Infecções por Micobactéria não Tuberculosa/epidemiologia , Micobactérias não Tuberculosas/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquiectasia/diagnóstico , Bronquiectasia/epidemiologia , Bronquiectasia/microbiologia , China/epidemiologia , Comorbidade , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/microbiologia , Humanos , Pneumopatias/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/microbiologia , Micobactérias não Tuberculosas/classificação , Prevalência , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Estudos Retrospectivos , Adulto Jovem
12.
World J Surg Oncol ; 17(1): 127, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331339

RESUMO

BACKGROUND: One third of patients with colorectal cancer (CRC) have comorbidity, which impairs their postoperative outcomes. Scoring systems may predict mortality, but there is limited evidence of effective interventions in high-risk patients. Our aim was to test a trial setup to assess the effect of extra postoperative medical visits and follow-up on 1-year mortality and other outcomes in patients with cardiopulmonary risk factors undergoing elective surgery for colorectal tumours. METHODS: Patients preoperatively screened positive for cardiopulmonary comorbidity were eligible. On postoperative day 4, they were randomised to either routine follow-up (RFU) or RFU with one extra medical visit and additional visits to the Cardiology and Respiratory Medicine Clinics 1 and 3 months postoperatively. The primary outcome measure was 1-year mortality; secondary outcome measures were length of stay (LOS), complications, and readmissions. RESULTS: Of 673 screened patients 326 (48%) were found eligible, 108 declined participation, and 198 were randomised. Postoperative medical problems and/or need for intervention were found in 15-23% of the patients at the extra medical visits. The 90-day mortality was 0 and the 1-year mortality only 2.6% with no differences between the two groups. LOS and complication rates did not differ, but there were significantly fewer readmissions in the intervention group. CONCLUSIONS: The 1-year mortality after elective CRC surgery was low, even in the presence of cardiopulmonary risk factors. There was no evidence of reduced mortality with additional medical follow-up in these patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT02328365 registered 31 December 2014 (retrospectively registered).


Assuntos
Doenças Cardiovasculares/diagnóstico , Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/mortalidade , Procedimentos Cirúrgicos Eletivos/mortalidade , Pneumopatias/diagnóstico , Programas de Rastreamento/métodos , Complicações Pós-Operatórias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Neoplasias Colorretais/patologia , Comorbidade , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Incidência , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida , Adulto Jovem
13.
Respir Res ; 20(1): 136, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272446

RESUMO

BACKGROUND AND OBJECTIVE: The prevalence of lung cancer has been increasing in healthy elderly patients with preserved pulmonary function and without underlying lung diseases. We aimed to determine the prevalence of and risk factors for postoperative pulmonary complications (PPCs) in healthy elderly patients with non-small cell lung cancer (NSCLC) to select optimal candidates for surgical resection in this subpopulation. METHODS: We included 488 patients older than 70 years with normal spirometry results who underwent curative resection for NSCLC (stage IA-IIB) between 2012 and 2016. RESULTS: The median (interquartile range) age of our cohort was 73 (71-76) years. Fifty-two patients (10.7%) had PPCs. Severe PPCs like acute respiratory distress syndrome, pneumonia, and respiratory failure had prevalences of 3.7, 3.7, and 1.4%, respectively. Compared to patients without PPCs, those with PPCs were more likely to be male and current smokers; have a lower body mass index (BMI), higher American Society of Anesthesiologists (ASA) classification, more interstitial lung abnormalities (ILAs), and higher emphysema index on computed tomography (CT); and have undergone pneumonectomy or bilobectomy (all p < 0.05). On multivariate analysis, ASA classification ≥3, lower BMI, ILA, and extent of resection were independently associated with PPC risk. The short-term all-cause mortality was significantly higher in patients with PPCs. CONCLUSIONS: Curative resection for NSCLC in healthy elderly patients appeared feasible with 10% PPCs. ASA classification ≥3, lower BMI, presence of ILA on CT, and larger extent of resection are predictors of PPC development, which guide treatment decision-making in these patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/epidemiologia , Idoso , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Estudos de Coortes , Feminino , Humanos , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Pneumopatias/etiologia , Neoplasias Pulmonares/diagnóstico , Masculino , Estadiamento de Neoplasias/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco
14.
BMC Musculoskelet Disord ; 20(1): 331, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311602

RESUMO

BACKGROUND: Although surgery prevents the progression of deformity and maintains the overall balance of the spine in congenital scoliosis (CS) patients, it is associated with a high risk of perioperative complications. Pulmonary complication is one of the most common complications. This retrospective study aimed to investigate the risk factors for pulmonary complications in CS patients after posterior spinal instrumentation and fusion. METHODS: Analysis of consecutive patients who underwent posterior spinal instrumentation and fusion for congenital scoliosis was performed. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for pulmonary complications. Patients were separated into groups with and without postoperative pulmonary complications. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of pulmonary complications. RESULTS: Three hundred and twenty-three CS patients were included. Forty-five (13.9%) patients developed postoperative pulmonary complications, which included pleural effusion in 34 (75.6%) cases, pneumonia in 24 (53.3%) cases, pneumothorax in 3 (6.7%) cases, atelectasis in 4 (8.9%) cases, pulmonary edema in 2 (4.4%) cases, respiratory failure in 2 (4.4%) cases, and prolonged mechanical ventilation in 4 (8.9%) cases. The independent risk factors for development of pulmonary complications included age (Odds ratio (OR) = 1.088, P = 0.038), reoperation (OR = 5.150, P = 0.012), preoperative pulmonary disease (OR = 10.504, P = 0.004), correction rate (OR = 1.088, P = 0.001), middle thoracic screw-setting (OR = 12.690, P = 0.043), and thoracoplasty (OR = 5.802, P = 0.001). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.903. CONCLUSIONS: Age, reoperation, preoperative pulmonary disease, correction rate, middle thoracic screw-setting, and thoracoplasty were independent risk factors for pulmonary complications after posterior spinal instrumentation and fusion in CS patients.


Assuntos
Pneumopatias/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Toracoplastia/efeitos adversos , Adolescente , Adulto , Fatores Etários , Parafusos Ósseos/efeitos adversos , Estudos de Casos e Controles , Criança , Feminino , Humanos , Pneumopatias/etiologia , Masculino , Complicações Pós-Operatórias/etiologia , Reoperação/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Escoliose/congênito , Fusão Vertebral/instrumentação , Vértebras Torácicas , Resultado do Tratamento , Adulto Jovem
15.
Int J Colorectal Dis ; 34(8): 1497-1501, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31254068

RESUMO

PURPOSE: Most elderly patients with colorectal cancer have comorbidities and reduced functional reserve, which may increase their risks of postoperative morbidity and mortality, and subsequently influence the treatment choice. Therefore, this study aimed to investigate the treatment choice and compare laparoscopic and open surgery in this setting. METHODS: This retrospective study evaluated 118 patients with colorectal cancer (≥ 85 years old between January 2007 and February 2018) to determine the influence of comorbidities on treatment choice, as well as the safety and feasibility of laparoscopic surgery for these patients. RESULTS: The patients included 42 men (35.6%) and 106 patients (89.8%) with comorbidities. The treatments were curative resection for 90 patients and palliative surgery for 16 patients, including 5 cases of colostomy/ileostomy because of the difficulty of primary cancer resection, pneumonia, or pulmonary hypertension. Twelve patients received non-surgical treatment, including 7 patients with decreased respiratory function because of chronic obstructive pulmonary disease or pneumonia. Forty-three patients underwent open curative resection and 47 patients underwent laparoscopic curative resection, which was associated with a significantly shorter hospital stay (14 days vs. 19days, P < 0.01), a lower morbidity rate (17.0% vs. 37.2%, P = 0.035), and less blood loss (10 mL vs. 140 mL, P < 0.01). One patient in each group died during the postoperative period because of worsened pre-existing pneumonia. CONCLUSION: Laparoscopic surgery was safer and less invasive than open surgery for colorectal cancer among ≥ 85-year-old patients. Pulmonary comorbidities affected the choice of non-curative surgery and may be related to the risk of postoperative mortality.


Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/cirurgia , Pneumopatias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Masculino , Resultado do Tratamento
16.
Artigo em Inglês | MEDLINE | ID: mdl-31163598

RESUMO

This retrospective cross-sectional study was conducted to identify the factors that promote the risk of nontuberculous mycobacteria (NTM) lung infection in subjects with prior occupational dust exposure. All consecutive patients with a history of occupational dust exposure whose expectorated sputum, bronchial wash, or bronchial lavage was subjected to acid-fast Bacilli culture in a tertiary hospital between 2011 and 2016 were identified. The patients who were infected with NTM were identified according to the bacteriological criteria of the American Thoracic Society (ATS) and The Infectious Diseases Society of America (IDSA) statement. Pneumoconiosis-associated radiological findings were graded according to the International Labor Organization guidelines. Of the 1392 patients with prior dust exposure, NTM was isolated from 82. Logistic regression analysis showed that risk factors for NTM lung infection were a history of pulmonary tuberculosis (adjusted odds ratio [aOR] = 1.82, 95% confidence intervals [CI] = 1.03-3.16). Moreover, the unadjusted odds ratios (ORs) were higher when both small-opacity profusion and the large-opacity grades increased. Even after adjustment, the ORs for the A, B, and C large-opacity grades were 2.32 (95% CI = 1.01-4.99), 2.68 (95% CI = 1.35-5.24), and 7.58 (95% CI = 3.02-17.95). Previous tuberculosis, bronchiectasis, and especially extensive small-opacity profusion, and high large-opacity grade associated significantly with NTM lung infection in dust-exposed workers.


Assuntos
Poeira , Pneumopatias/epidemiologia , Infecções por Micobactéria não Tuberculosa/epidemiologia , Micobactérias não Tuberculosas/isolamento & purificação , Exposição Ocupacional/estatística & dados numéricos , Radiografia , Idoso , Estudos Transversais , Feminino , Humanos , Pneumopatias/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/microbiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
17.
J Pak Med Assoc ; 69(6): 869-873, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31201394

RESUMO

OBJECTIVE: To examine the risk and preventive factors of working in a cement plant. METHODS: The cross-sectional study was conducted from July to September, 2016, at a leading cement manufacturing plant in the Khyber Pakhtunkhwa province of Pakistan. An interviewer-administered questionnaire was used to collect data about the characteristics of exposed and unexposed subjects. The characteristics and occupational illnesses were compared between exposed and unexposed workers. Logistic regression was applied to estimate the odds ratio for risk and preventive factors associated with pulmonary illnesses linked with the profession. RESULTS: Of the 550 workers contacted, 260(47.3%) agreed to participate. The mean age of the sample was 30.48}6.13 years. Of the total, 80(31%) were exposed and 180(69%) were unexposed. Overall, 96(37%) workers had medical coverage facility, while 114(63%) reported very good health. All socioeconomic and working characteristics were highly significant between exposed and unexposed workers (p<0.05). There were 67(25.7%) workers with pulmonary illnesses and the difference between the exposed and unexposed groups were significant (p<0.05). CONCLUSIONS: Pulmonary health among workers could be improved by implementing occupational health improving strategies..


Assuntos
Poeira , Pneumopatias/epidemiologia , Máscaras/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Humanos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Masculino , Indústria Manufatureira , Instalações Industriais e de Manufatura , Pessoa de Meia-Idade , Paquistão/epidemiologia , Fumar/epidemiologia , Fatores de Tempo , Adulto Jovem
18.
Medicine (Baltimore) ; 98(19): e15585, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083241

RESUMO

Bronchoscopy is one of the most common diagnostic procedures in pulmonary practice. Data on the outcome of patients following a non-diagnostic bronchoscopy are sparse. Diagnostic yield depends on indication, the characteristics of patients, and the chest imaging. The aim of this study was to evaluate the outcomes of patients with a non-diagnostic bronchoscopy and to compare patients who had a diagnostic with those that had a non-diagnostic bronchoscopy.Retrospective, single-center study of adult patients who underwent bronchoscopy with transbronchial biopsy (TBBX) and/or endobronchial biopsy (EBBX), endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA), or brushing. A strict definition for a "diagnostic" bronchoscopy was used. Univariate and multivariate analyses were performed.A total of 684 patients were identified, 350 (51%) had a diagnostic procedure. Of the 334 patients with a non-diagnostic bronchoscopy, 196 (58.6%) were followed, but only 172 (88%) completed 1 year of follow-up. Most of the patients (57.8%) had resolution or stabilization of the condition; in the remaining patients, malignancy was most commonly diagnosed after further investigation followed by diffuse lung diseases and infections. Pulmonary tuberculosis was diagnosed in 8 patients. EBUS-TBNA and EBBX were the procedures associated with a diagnostic bronchoscopy. Presence of bilateral interstitial infiltrates predicted a non-diagnostic bronchoscopy.A significant number of patients with non-diagnostic bronchoscopy may have serious treatable disease that is identified upon further investigation. Close follow up of patients with a non-diagnostic procedure is warranted. Our study found no clear clinical or radiological predictors of diagnostic bronchoscopy.


Assuntos
Broncoscopia , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Biópsia , Broncoscopia/métodos , Comorbidade , Feminino , Seguimentos , Humanos , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Populações Vulneráveis
19.
BMC Infect Dis ; 19(1): 423, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092207

RESUMO

BACKGROUND: Determining the etiology of pneumonia is essential to guide public health interventions. Diagnostic test results, including from polymerase chain reaction (PCR) assays of upper respiratory tract specimens, have been used to estimate prevalence of pneumococcal pneumonia. However limitations in test sensitivity and specificity and the specimen types available make establishing a definitive diagnosis challenging. Prevalence estimates for pneumococcal pneumonia could be biased in the absence of a true gold standard reference test for detecting Streptococcus pneumoniae. METHODS: We conducted a case control study to identify etiologies of community acquired pneumonia (CAP) from April 2014 through August 2015 in Thailand. We estimated the prevalence of pneumococcal pneumonia among adults hospitalized for CAP using Bayesian latent class models (BLCMs) incorporating results of real-time polymerase chain reaction (qPCR) testing of upper respiratory tract specimens and a urine antigen test (UAT) from cases and controls. We compared the prevalence estimate to conventional analyses using only UAT as a reference test. RESULTS: The estimated prevalence of pneumococcal pneumonia was 8% (95% CI: 5-11%) by conventional analyses. By BLCM, we estimated the prevalence to be 10% (95% CrI: 7-16%) using binary qPCR and UAT results, and 11% (95% CrI: 7-17%) using binary UAT results and qPCR cycle threshold (Ct) values. CONCLUSIONS: BLCM suggests a > 25% higher prevalence of pneumococcal pneumonia than estimated by a conventional approach assuming UAT as a gold standard reference test. Higher quantities of pneumococcal DNA in the upper respiratory tract were associated with pneumococcal pneumonia in adults but the addition of a second specific pneumococcal test was required to accurately estimate disease status and prevalence. By incorporating the inherent uncertainty of diagnostic tests, BLCM can obtain more reliable estimates of disease status and improve understanding of underlying etiology.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Pneumopatias/diagnóstico , Adulto , Idoso , Antígenos de Bactérias/urina , Teorema de Bayes , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , DNA Bacteriano/genética , DNA Bacteriano/metabolismo , Feminino , Humanos , Pneumopatias/epidemiologia , Pneumopatias/patologia , Masculino , Pessoa de Meia-Idade , Nasofaringe/microbiologia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificação , Tailândia/epidemiologia
20.
BMC Infect Dis ; 19(1): 436, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101082

RESUMO

BACKGROUND: Information on non-tuberculosis mycobacterial (NTM) diseases remains limited in Singapore and other Southeast Asian countries. This study aimed to delineate epidemiological and clinical features of pulmonary NTM disease. METHODS: A retrospective review was performed on all NTM isolates identified in Singapore General Hospital from 2012 to 2016 using the 2007 ATS/IDSA diagnostic criteria. RESULTS: A total of 2026 NTM isolates from 852 patients were identified. M. abscessus-chelonae group (1010, 49.9%) was the most commonly isolated and implicated in pulmonary NTM disease. Pulmonary cases (352, 76%) had the highest prevalence among patients diagnosed with NTM diseases (465/852, 54.6%) with no gender difference. Male patients were older (68.5 years, P = 0.014) with a higher incidence of chronic obstructive pulmonary disease (COPD) (23.6%, P < 0.001) and recurrent cough with phlegm production (51.6%, P = 0.035). In contrast, more female patients had bronchiectasis (50%, P < 0.001) and haemoptysis (37.6%, P = 0.042). Age and COPD were associated with multiple NTM species isolation per patient. CONCLUSIONS: M. abscessus-chelonae group was the commonest NTM species isolated in Singapore. Pulmonary NTM infection has the highest frequency with male and female patients associated with a higher incidence of COPD and bronchiectasis respectively. Age and COPD were associated with multiple NTM species isolation per patient.


Assuntos
Pneumopatias/microbiologia , Infecções por Micobactéria não Tuberculosa/epidemiologia , Infecções por Micobactéria não Tuberculosa/etiologia , Micobactérias não Tuberculosas/isolamento & purificação , Idoso , Bronquiectasia/epidemiologia , Bronquiectasia/microbiologia , Comorbidade , Feminino , Hemoptise/epidemiologia , Hemoptise/microbiologia , Hospitais Gerais , Humanos , Incidência , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/microbiologia , Micobactérias não Tuberculosas/patogenicidade , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Estudos Retrospectivos , Fatores Sexuais , Singapura/epidemiologia
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