Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.544
Filtrar
1.
Neumol. pediátr. (En línea) ; 14(2): 81-85, jul. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1014999

RESUMO

At present, there is no specific treatment for primary ciliary dyskinesia, nor controlled and randomized clinical trials to determine how the management and monitoring of these patients should be considered. The therapeutic options are extrapolated from other diseases, such as cystic fibrosis, or non-cystic fibrosis bronchiectasis. However, the implementation of specific groups of experts, both in the USA (PDC-foundation) and in Europe (BESTCILIA or BEAT-PD), are helping to increase knowledge of the disease, opening research channels and seeking new treatments. Until we have therapies capable of correcting the basic defect of the disease, the pillars of treatment are the daily cleansing of the airways and aggressive antibiotherapy against respiratory infections. Multidisciplinary care in specialized centers where pulmonary function is monitored and the infection is prevented and treated will improve, as in cystic fibrosis, the results of patients.


En la actualidad no existe un tratamiento específico para la discinesia ciliar primaria, ni se cuenta con ensayos clínicos controlados y randomizados que permitan determinar cómo debe plantearse el manejo y seguimiento de estos pacientes. Las opciones terapéuticas son extrapoladas de otras enfermedades, como la fibrosis quística, o las bronquiectasias no fibrosis quística. Sin embargo, la puesta en marcha de grupos específicos de expertos, tanto en USA (PDC-foundation) como en Europa (BESTCILIA o BEAT-PD), están permitiendo incrementar el conocimiento de la enfermedad, abriendo vías de investigación y buscando nuevos tratamientos. Hasta contar con terapias capaces de corregir el defecto básico de la enfermedad, los pilares del tratamiento son la limpieza diaria de las vías aéreas y la antibioterapia agresiva frente a las infecciones respiratorias. La atención multidisciplinar en centros especializados donde se monitorice la función pulmonar y se prevengan y traten las infecciones mejorará, como en la fibrosis quística, los resultados de los pacientes.


Assuntos
Humanos , Síndrome de Kartagener/diagnóstico , Síndrome de Kartagener/fisiopatologia , Síndrome de Kartagener/genética , Síndrome de Kartagener/terapia , Infecções Respiratórias/tratamento farmacológico , Seguimentos , Pneumopatias/fisiopatologia , Pneumopatias/terapia , Pneumopatias Fúngicas
2.
Neumol. pediátr. (En línea) ; 14(2): 105-110, jul. 2019. graf, ilust, tab
Artigo em Espanhol | LILACS | ID: biblio-1015136

RESUMO

Spirometry is better pulmonary function test for evaluating preschoolers with chronic lung disease and recurrent wheeze. It is useful, accessible and very good performance. For a correct interpretation it must be under the conditions specially controlled for this age group. In this review, product of the work done during the year 2018, by the Committee on pulmonary function in pediatric pulmonology Chilean society, will be showcased aspects for the realization and interpretation of spirometry in preschool children, with emphasis on the differences in the criteria typically described for older children and adults.


La espirometría es la prueba de función pulmonar más adecuada para evaluar a preescolares con enfermedades pulmonares crónicas y sibilancias recurrentes. Es útil, accesible y de buen rendimiento. Para una correcta interpretación debe realizarse bajo las condiciones especialmente normadas para este grupo etario. En esta revisión, producto del trabajo realizado durante el año 2018, por la comisión de función pulmonar de la sociedad Chilena de Neumología Pediátrica, se expondrán los aspectos actualizados para la realización e interpretación de la espirometría en preescolares, con énfasis en las diferencias de los criterios clásicamente descritos para niños mayores y adultos.


Assuntos
Humanos , Pré-Escolar , Espirometria/métodos , Testes de Função Respiratória , Asma/diagnóstico , Asma/fisiopatologia , Índice de Gravidade de Doença , Capacidade Vital , Volume Expiratório Forçado , Fibrose Cística/diagnóstico , Fibrose Cística/fisiopatologia , Pneumopatias/diagnóstico , Pneumopatias/fisiopatologia
3.
Expert Opin Ther Pat ; 29(7): 555-578, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31204543

RESUMO

INTRODUCTION: Human neutrophil elastase (HNE) is involved in a variety of serious chronic diseases, especially cardiopulmonary pathologies. For this reason, the regulation of HNE activity represents a promising therapeutic approach, which is evident by the development of a number of new and selective HNE inhibitors, both in the academic and pharmaceutical environments. AREAS COVERED: The present review analyzes and summarizes the patent literature regarding human neutrophil elastase inhibitors for the treatment of cardiopulmonary diseases over 2014-2018. EXPERT OPINION: HNE is an interesting and defined target to treat various inflammatory diseases, including a number of cardiopulmonary pathologies. The research in this field is quite active, and a number of HNE inhibitors are currently in various stages of clinical development. In addition, new opportunities for HNE inhibitor development stem from recent studies demonstrating the involvement of HNE in many other inflammatory pathologies, including rheumatoid arthritis, inflammatory bowel disease, skin diseases, and cancer. Furthermore, the development of dual HNE/proteinase 3 inhibitors is being pursued as an innovative approach for the treatment of neutrophilic inflammatory diseases. Thus, these new developments will likely stimulate new and increased interest in this important therapeutic target and for the development of novel and selective HNE inhibitors.


Assuntos
Desenvolvimento de Medicamentos/métodos , Elastase de Leucócito/efeitos dos fármacos , Proteínas Secretadas Inibidoras de Proteinases/farmacologia , Animais , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/enzimologia , Doenças Cardiovasculares/fisiopatologia , Humanos , Inflamação/tratamento farmacológico , Inflamação/fisiopatologia , Elastase de Leucócito/metabolismo , Pneumopatias/tratamento farmacológico , Pneumopatias/enzimologia , Pneumopatias/fisiopatologia , Patentes como Assunto
4.
Artigo em Inglês | MEDLINE | ID: mdl-30974916

RESUMO

Background: Sarcoidosis is a granulomatous disease involving intrathoracic and extrathoracic organs. Genetic and environmental factors, such as exposure to World-Trade Center (WTC) dust after 9/11, may play a role in clinical presentation. Characterization of sarcoidosis in community members with exposure to the WTC dust can provide further insight into the relationship between environmental exposure and sarcoidosis. Methods: Patients with documented sarcoidosis were identified in the WTC Environmental Health Center (EHC), a treatment program for community members. Demographic and clinical data were collected from standardized questionnaires and chart review. Organ involvement was assessed with a standard instrument. Results: Among patients in the WTC EHC, 87 were identified with sarcoidosis after 9/11. Sarcoidosis cases were more likely African-American, local workers, and had more respiratory symptoms, compared with non-sarcoidosis WTC EHC patients. Many (46%) had ≥ Scadding stage 3 on chest imaging, and had reduced lung function measures. Extrathoracic involvement was identified in 33/87 (38%) with a diversity of organs involved. Conclusions: WTC-exposed sarcoidosis in community members is often characterized by severe pulmonary disease and a high rate of diverse extrathoracic involvement. Further analysis is required to characterize the course of disease progression or resolution.


Assuntos
Exposição Ambiental/efeitos adversos , Pneumopatias/diagnóstico , Sarcoidose/diagnóstico , Ataques Terroristas de 11 de Setembro , Adulto , Poeira , Feminino , Humanos , Pulmão/fisiopatologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Sarcoidose/fisiopatologia
5.
Int J Cardiovasc Imaging ; 35(8): 1483-1497, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31030315

RESUMO

Magnetic resonance imaging (MRI) plays an increasingly important role in the non-invasive evaluation of the pulmonary vasculature. MR angiographic (MRA) techniques provide morphological information, while MR perfusion techniques provide functional information of the pulmonary vasculature. Contrast-enhanced MRA can be performed at high spatial resolution using 3D T1-weighted spoiled gradient echo sequence or at high temporal resolution using time-resolved techniques. Non-contrast MRA can be performed using 3D steady state free precession, double inversion fast spin echo, time of flight or phase contrast sequences. MR perfusion can be done using dynamic contrast-enhanced technique or using non-contrast techniques such as arterial spin labelling and time-resolved imaging of lungs during free breathing with Fourier decomposition analysis. MRI is used in the evaluation of acute and chronic pulmonary embolism, pulmonary hypertension and other vascular abnormalities, congenital anomalies and neoplasms. In this article, we review the different MR techniques used in the evaluation of pulmonary vasculature and its clinical applications.


Assuntos
Hemodinâmica , Pneumopatias/diagnóstico por imagem , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética , Imagem de Perfusão/métodos , Artéria Pulmonar/diagnóstico por imagem , Circulação Pulmonar , Humanos , Interpretação de Imagem Assistida por Computador , Pneumopatias/fisiopatologia , Pneumopatias/terapia , Valor Preditivo dos Testes , Prognóstico , Artéria Pulmonar/fisiopatologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-30880949

RESUMO

Background: While chronic respiratory diseases are among the leading causes of mortality and morbidity worldwide, little is known about the effect of blood eosinophil levels on lung function trajectories among healthy individuals. Methods: We analyzed data of apparently healthy individuals (n=18,089) recruited for the Tel Aviv Medical Center Inflammation Survey. Blood eosinophil levels were compared between participants with normal and those with abnormal lung function. Multivariate regression was used to assess the OR of forced expiratory volume in 1 second (FEV1) deterioration according to baseline eosinophils in subjects with normal lung function (n=4,141) during a follow-up period of 4 years. Results: Participants with an abnormal, as opposed to a normal, pulmonary function test (PFT) (n=1,832, 10.1%) had significantly higher eosinophil levels, expressed as a percentage or count (2.99%±2.00% compared to 2.67%±1.88% and 0.2210e3/µL±0.163/µL compared to 0.1810e3/µL±0.183/µL, respectively; P<0.001 for both). Among participants with a normal PFT at baseline, those with an eosinophil percentage higher than 4% showed a higher risk for FEV1 decline above 60 mL/year (OR=1.199, 95% CI=1.005-1.431, P=0.044). Conclusion: Our study suggests that higher blood eosinophil levels can predict PFT deterioration even in apparently healthy subjects, implying that these individuals could benefit from frequent lung function evaluation.


Assuntos
Eosinófilos/imunologia , Pneumopatias/diagnóstico , Pulmão/fisiopatologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Feminino , Volume Expiratório Forçado , Humanos , Israel , Contagem de Leucócitos , Pneumopatias/sangue , Pneumopatias/imunologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Espirometria , Fatores de Tempo , Capacidade Vital
7.
Rev. chil. enferm. respir ; 35(1): 49-57, mar. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1003646

RESUMO

Los incendios forestales representan un problema creciente de la salud pública a nivel mundial, especialmente para la población más vulnerable (niños, ancianos, embarazadas y portadores de enfermedades cardiovasculares o respiratorias crónicas) expuesta al humo y a otros contaminantes aéreos. A diferencia de la contaminación atmosférica habitual de grandes urbes, aquella derivada de los incendios forestales tiene una composición diferente y su ocurrencia es esporádica y difícil de prever. La exposición a contaminantes atmosféricos derivados de incendios forestales se asocia a aumento de la morbilidad respiratoria y cardiovascular, mediada por una respuesta inflamatoria pulmonar y sistémica, estrés oxidativo y disfunción endotelial. En sujetos expuestos a humo de incendios forestales se ha observado un aumento en la producción de citoquinas pro-inflamatorias, activación endotelial y disfunción del sistema nervioso autónomo, que produce daño tisular, aumento de los mecanismos protrombóticos, aumento de la presión arterial y cambios en el ritmo cardiaco. Esta revisión analiza los mecanismos que han sido involucrados en generar efectos nocivos para la salud de seres humanos expuestos a material particulado y gases emanados de incendios forestales.


Wildfires represent a growing global public health issue, especially to the most vulnerable segment of the population (children, old people, pregnant women, patients with cardiovascular or respiratory diseases) exposed to smoke and other air borne contaminants generated from these events. In contrast to great cities ' usual atmospheric pollution, that derives from forest fires differ in composition and its occurrence is sporadic and usually unpredictable. Exposure to atmospheric pollutants derived from forest fires has been associated to increased respiratory and cardiovascular morbidity, mediated by an inflammatory systemic response, oxidative stress and endothelial dysfunction. In people exposed to forest fire smoke an increased production of pro-inflammatory cytokines, endothelial activation and autonomic nervous system dysfunction has been observed, that leads to tissue injury, increased prothrombotic response, increased blood pressure and changes in heart rhythm. This review analyzes the mechanisms that have been involved in generating harmful health effects in humans exposed to inhaled particulate matter and gases steaming from wildfires.


Assuntos
Humanos , Doenças Cardiovasculares/induzido quimicamente , Incêndios Florestais , Poluição do Ar/efeitos adversos , Pneumopatias/induzido quimicamente , Doenças Cardiovasculares/fisiopatologia , Transtornos Cerebrovasculares/induzido quimicamente , Citocinas/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Estresse Oxidativo , Exposição por Inalação , Poluentes Atmosféricos/efeitos adversos , Material Particulado/efeitos adversos , Pneumopatias/fisiopatologia
8.
BMC Pulm Med ; 19(1): 62, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30866890

RESUMO

BACKGROUND: Relationships between low forced vital capacity (FVC), and morbidity have previously been studied but there are no data available for the Caribbean population. This study assessed the association of low FVC with risk factors, health variables and socioeconomic status in a community-based study of the Trinidad and Tobago population. METHODS: A cross-sectional survey was conducted using the Burden of Obstructive Lung Disease (BOLD) study protocol. Participants aged 40 years and above were selected using a two-stage stratified cluster sampling. Generalized linear models were used to examine associations between FVC and risk factors. RESULTS: Among the 1104 participants studied a lower post-bronchodilator FVC was independently associated with a large waist circumference (- 172 ml; 95% CI, - 66 to - 278), Indo-Caribbean ethnicity (- 180 ml; 95% CI, - 90 to - 269) and being underweight (- 185 ml; 95% CI, - 40 to - 330). A higher FVC was associated with smoking cannabis (+ 155 ml; 95% CI, + 27 to + 282). Separate analyses to examine associations with health variables indicated that participants with diabetes (p = 0∙041), history of breathlessness (p = 0∙007), and wheeze in the past 12 months (p = 0∙040) also exhibited lower post-bronchodilator FVC. CONCLUSION: These findings suggest that low FVC in this Caribbean population is associated with ethnicity, low body mass index (BMI), large waist circumference, chronic respiratory symptoms, and diabetes.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Pneumopatias/fisiopatologia , Magreza/fisiopatologia , Capacidade Vital , Circunferência da Cintura , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Região do Caribe/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Feminino , Humanos , Modelos Lineares , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espirometria , Inquéritos e Questionários , Magreza/epidemiologia
9.
Eur Respir Rev ; 28(151)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30918023

RESUMO

We are currently limited in our abilities to diagnose, monitor disease status and manage chronic airway disease like asthma and chronic obstructive pulmonary disease (COPD). Conventional lung function measures often poorly reflect patient symptoms or are insensitive to changes, particularly in the small airways where disease may originate or manifest. Novel pulmonary function tests are becoming available which help us better characterise and understand chronic airway disease, and their translation and adoption from the research arena would potentially enable individualised patient care.In this article, we aim to describe two emerging lung function tests yielding novel pulmonary function indices, the forced oscillation technique (FOT) and multiple breath nitrogen washout (MBNW). With a particular focus on asthma and COPD, this article demonstrates how chronic airway disease mechanisms have been dismantled with the use of the FOT and MBNW. We describe their ability to assess detailed pulmonary mechanics for diagnostic and management purposes including response to bronchodilation and other treatments, relationship with symptoms, evaluation of acute exacerbations and recovery, and telemonitoring. The current limitations of both tests, as well as open questions/directions for further research, are also discussed.


Assuntos
Pneumopatias/diagnóstico , Pulmão/fisiopatologia , Ventilação Pulmonar , Respiração , Testes de Função Respiratória/métodos , Testes Respiratórios , Humanos , Pneumopatias/fisiopatologia , Pneumopatias/terapia , Oscilometria , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes
11.
Trials ; 20(1): 132, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30764860

RESUMO

BACKGROUND: More than 60,000 people have health problems due to chemical weapons exposure during the Iran-Iraq war. Respiratory consequences of mustard gas exposure are common and disabling; medical interventions have limited effect. Patients complain of cough, sputum, breathlessness and exercise limitation. We hypothesized that patients with this condition would benefit from pulmonary rehabilitation. METHODS: We outline the protocol for an assessor-blind, two-armed, parallel-design randomized controlled clinical trial (IRCT2016051127848N1). Sixty patients with respiratory disease due to documented sulfur mustard gas exposure will be randomized to either take part in a 6-week pulmonary rehabilitation programme or receive usual care. Inclusion criteria include forced expiratory volume in 1 second < 80% predicted and Medical Research Council dyspnoea score ≥ 3. The primary endpoint will be the change in cycle endurance time at 70% baseline exercise capacity at 6 weeks. Lung function, physical activity, the strength and endurance of the quadriceps muscle, and quality of life will also be compared. Outcomes will be assessed at 6 weeks and 12 months. Health care utilization will also be assessed. DISCUSSION: If the study confirms that rehabilitation is effective for patients with mustard gas lung disease this should prompt provision of the intervention to this patient group. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2016051127848N1 . Registered on 24 May 2016.


Assuntos
Substâncias para a Guerra Química/envenenamento , Terapia por Exercício , Pneumopatias/reabilitação , Pulmão/efeitos dos fármacos , Gás de Mostarda/envenenamento , Educação de Pacientes como Assunto , Teste de Esforço , Terapia por Exercício/efeitos adversos , Tolerância ao Exercício , Humanos , Pulmão/fisiopatologia , Pneumopatias/induzido quimicamente , Pneumopatias/diagnóstico , Pneumopatias/fisiopatologia , Força Muscular , Sistemas de Apoio Psicossocial , Músculo Quadríceps/fisiopatologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória , Fatores de Tempo
12.
Toxicol Appl Pharmacol ; 365: 124-132, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30641074

RESUMO

Exposure to mine tailings dust from active and abandoned mining operations may be a very significant health hazard, especially to sensitive populations living in arid and semi-arid climates like the desert southwest of the US. It is anticipated that early life exposures during sensitive times of development can lead to adult disease. However, very few studies have investigated the effects of inhalation exposure to real world dusts during lung development. Using a mouse model, we have examined the effect(s) of inhalation of real world mine tailing dusts under three separate conditions: (1) Exposure only during in utero development (exposure of the pregnant moms) (2) exposure only after birth and (3) exposures that occurred continuously during in utero development, through gestation and birth until the mice reached adulthood (28 days old). We found that the most significant changes in lung structure and function were observed in male mice when exposure occurred continuously throughout development. These changes included increased airway hyper-reactivity, increased expression of epithelial to mesenchymal (EMT) transition protein markers and increased expression of cytokines related to eosinophils. The data also indicate that in utero exposures through maternal inhalation can prime the lung of male mice for more severe responses to subsequent postnatal exposures. This may be due to epigenetic alterations in gene regulation, immune response, molecular signaling, and growth factors involved in lung development that may make the neonatal lung more susceptible to continued dust exposure.


Assuntos
Poluentes Atmosféricos/toxicidade , Poeira , Exposição por Inalação/efeitos adversos , Pneumopatias/induzido quimicamente , Pulmão/efeitos dos fármacos , Mineração , Fatores Etários , Animais , Hiper-Reatividade Brônquica/induzido quimicamente , Hiper-Reatividade Brônquica/fisiopatologia , Citocinas/metabolismo , Eosinófilos/efeitos dos fármacos , Eosinófilos/metabolismo , Eosinófilos/patologia , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Feminino , Idade Gestacional , Pulmão/metabolismo , Pulmão/patologia , Pulmão/fisiopatologia , Pneumopatias/metabolismo , Pneumopatias/patologia , Pneumopatias/fisiopatologia , Masculino , Camundongos Endogâmicos C57BL , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Medição de Risco
13.
BMC Pulm Med ; 19(1): 1, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606165

RESUMO

BACKGROUND: The lung ultrasound score has been regarded as a decent semiquantitative score to measure the lung aeration loss. The score has been proven to be valuable in diagnosing and monitoring lung pathology, but no studies have demonstrated its relationship to the outcome. We aimed to investigate the relationship between the lung ultrasound score and outcome in shock patients in the Intensive Care Unit. METHODS: The data were extracted from the SHOCK-ICU study, a 14-month prospective study of shock patients in the Medical Intensive Care Unit in West China Hospital. A bivariate logistic regression model was established to identify the correlation between the lung ultrasound score on admission and the 28-day mortality. For subsequent analyses, we divided patients into lung ultrasound score quartiles, and survival analysis was performed using Cox stratified survival analysis and regression analysis with the Breslow method of ties. RESULTS: A total of 175 cases with a completed lung ultrasound exam were included. The mean APACHE II score was 23.7 ± 8.8, and the 28-day mortality was 46.3% (81/175). The multivariate analysis demonstrated that the lung ultrasound score was an independent risk factor for 28-day mortality, as well as the APACHE II score and lactate level. When divided into lung ultrasound score quartiles, after correcting for the APACHE II score, vasoactive use, PaO2/FiO2, and lactate level, the COX analysis reveals that a higher lung ultrasound score was related to a lower survival rate. Quartile 1 and quartile 2 had a significantly lower hazard ratio versus quartile 4 (OR 0.442[0.215-0.911]; 0.484[0.251-0.934], respectively). CONCLUSIONS: The lung ultrasound score is independently related to the 28-day mortality, as well as the APACHE II score and lactate level, in Intensive Care Unit shock patients. A higher elevated lung ultrasound score on admission is associated with a worse outcome. TRIAL REGISTRATION: The study is registered on Clinical Trials. TRIAL REGISTRATION: NCT03082326 ; retrospectively registered on 3 March 2017.


Assuntos
APACHE , Mortalidade Hospitalar , Pneumopatias/diagnóstico por imagem , Choque/fisiopatologia , Ultrassonografia , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
14.
Environ Pollut ; 246: 811-818, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30623837

RESUMO

Pyrethroids are a class of man-made insecticides associated with various adverse health outcomes including respiratory problems. However, there were limited evidences on the relation between 3-phenoxybenzoic acid (3-PBA) as a metabolite of pyrethroids and pulmonary function, particularly among elderly population who have declining pulmonary function. Therefore, we collected urine samples and performed pulmonary function test (PFT) repeatedly in a total of 559 Korean elderly living in Seoul as an urban area. After measurement of urinary 3-PBA levels, cross-sectional relations of visit-to-visit variation in 3-PBA level on visit-to-visit variation in PFT parameters were evaluated using linear mixed effect models and generalized additive mixed models after adjustment for age, sex, body mass index, smoking status, education, visit episode, and phthalate metabolite levels. The Korean elderly were highly exposed to pyrethroids with 30.2% of elderly people with 3-PBA level over reference value derived on the 95th percentile of representative samples (2 ng/mL). Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of FVC (FEF25-75) as PFT parameters showed significant reductions by an increase of 3-PBA level (FEV1, ß = -1.48, p-value < 0.01; FVC, ß = -1.14, p-value < 0.01; and FEF25-75, ß = -1.11, p-value = 0.03). The negative associations of 3-PBA level with FEV1, FVC, and FEF25-75 were found only for females (FEV1, ß = -1.64, p-value < 0.01; FVC, ß = -1.47, p-value < 0.01; and FEF25-75, ß = -1.06, p-value = 0.07), but not for males. However, the longitudinal effect of 3-PBA level on the trajectory of FEV1, FVC, and FEF25-75 declines in females was not found. Community-level exposure to pyrethroids was associated with pulmonary function reduction in elderly population, indicating that more stringent control of pyrethroids is necessary to protect the elderly who have declining pulmonary function.


Assuntos
Benzoatos/efeitos adversos , Benzoatos/urina , Exposição Ambiental/efeitos adversos , Idoso Fragilizado , Pneumopatias/etiologia , Pneumopatias/fisiopatologia , População Urbana , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Monitoramento Ambiental , Feminino , Volume Expiratório Forçado , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , República da Coreia , Testes de Função Respiratória , Seul , Capacidade Vital
15.
Int J Hematol ; 109(3): 299-308, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30604314

RESUMO

Reduced pulmonary function is commonly observed after allogeneic hematopoietic stem cell transplantation (HSCT); however, its relationship with the development of noninfectious pulmonary complications (NIPCs) is unclear, and the impact of changes in pulmonary function test (PFT) values on HSCT outcome remains controversial. We conducted a retrospective study including 150 patients to investigate changes in PFTs and impact on clinical outcome. PFT data at around 1 year after HSCT were available in 84 patients, and showed a significant time-dependent decline in percentage predicted forced expiratory volume in 1 s and other parameters. We focused on %FEV1, calculated decline of %FEV1 from pretransplant to around 1 year after HSCT (Δ%FEV1), and divided patients into good-Δ%FEV1 or poor-Δ%FEV1 groups, using a cut-off point of 20% decline of Δ%FEV1. In the poor-Δ%FEV1 group, half of the patients developed NIPCs. In the good-Δ%FEV1 group, PFT values were maintained, whereas those of the poor-Δ%FEV1 group declined significantly. Multivariate analysis showed that busulfan use was a risk factor for %FEV1 decline, and poor-Δ%FEV1 was a risk factor for overall survival. These data indicate that decline of %FEV1 may be a useful indicator of pulmonary damage after HSCT, and is strongly associated with busulfan use.


Assuntos
Bussulfano/efeitos adversos , Transplante de Células-Tronco Hematopoéticas , Pneumopatias , Adulto , Idoso , Aloenxertos , Bussulfano/administração & dosagem , Intervalo Livre de Doença , Feminino , Volume Expiratório Forçado , Humanos , Pneumopatias/induzido quimicamente , Pneumopatias/mortalidade , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
16.
Int J Rheum Dis ; 22(3): 507-515, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30548402

RESUMO

OBJECTIVES: To identify factors associated with deterioration of pulmonary function with disproportional decline in diffusing capacity for carbon monoxide (DLCO) relative to forced vital capacity (FVC) in patients with dermatomyositis (DM) and polymyositis (PM). METHODS: This retrospective cohort study included patients with DM and PM, in whom serial pulmonary function tests were available. Changes in FVC and DLCO over time were estimated using a linear mixed-effects model. RESULTS: A total of 103 patients were included. During follow-up, 31 (30.1%) and 37 (35.9%) had a disproportionally better (ΔDLCO/ΔFVC>mean slope + 95% CI) or a disproportionally worse (ΔDLCO/ΔFVC

Assuntos
Anticorpos Antinucleares/imunologia , Dermatomiosite/complicações , Pneumopatias/etiologia , Pulmão/fisiopatologia , Polimiosite/complicações , Doença de Raynaud/complicações , Adulto , Anticorpos Antinucleares/sangue , Biomarcadores/sangue , Dermatomiosite/sangue , Dermatomiosite/diagnóstico , Dermatomiosite/imunologia , Progressão da Doença , Feminino , Humanos , Pneumopatias/diagnóstico , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Polimiosite/sangue , Polimiosite/diagnóstico , Polimiosite/imunologia , Capacidade de Difusão Pulmonar , Doença de Raynaud/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Capacidade Vital
17.
Exp Anim ; 68(2): 159-168, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-30531117

RESUMO

Inhalation of pathogenic bacteria transported by particulate matter (PM) presents an important potential threat to human health. Therefore, the pulmonary toxicity in mice caused by Staphylococcus aureus (S. aureus) and PM as individual matter and mixtures was studied. PM and S. aureus were instilled intratracheally into Kunming mice at doses of 0.2 mg/mouse and 5.08 × 106 CFU /mouse, respectively, as individual matter and in combination two times at 5-day intervals. After the exposure period, oxidative stress markers and nitric oxide (NO) in the lung, cellular infiltration, neurotrophins, chemokines, and cytokines in bronchoalveolar lavage fluid (BALF), and immunoglobulin (Ig) in sera were examined. Exposure to the combination of PM and S. aureus caused significant increases in malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and NO and significant decreases in total antioxidant capacity (T-AOC) and the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG) in the lung. Meanwhile, the ratio of interleukin (IL)-4 to interferon (INF)-γ, the IL-4 level in BALF, and the IgE concentration in sera were significantly increased in the groups exposed to S. aureus or the combination of PM and S. aureus. Substance P and IL-8 in BALF were significantly increased in mice exposed to PM, S. aureus or their combination. In addition, PM, S. aureus, and their combination caused infiltration of leukocytes into the alveolar tissue spaces. The results suggested that exposure to the combination of PM and S. aureus induced a lung inflammatory response that was at least partly caused by oxidative stress and mediators from the activated eosinophils, neutrophils, alveolar macrophages, and epithelial cells.


Assuntos
Inflamação/fisiopatologia , Pneumopatias/fisiopatologia , Material Particulado/toxicidade , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/fisiologia , Animais , Inflamação/induzido quimicamente , Inflamação/imunologia , Inflamação/microbiologia , Pneumopatias/induzido quimicamente , Pneumopatias/imunologia , Pneumopatias/microbiologia , Masculino , Camundongos
18.
Respir Physiol Neurobiol ; 261: 1-8, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30583069

RESUMO

The aim of this study was to examine long-term changes in pulmonary function and respiratory impedance (Zrs) as assessed by forced oscillation technique (FOT) of rheumatoid arthritis (RA)-related pulmonary disorders. Data of 42 RA patients who underwent pulmonary function tests and Zrs measurements at least twice at a >900-day interval were retrospectively reviewed. Zrs, respiratory resistance (Rrs) and reactance (Xrs), were measured as a function of oscillatory frequency from 4 to 36 Hz. The Rrs and difference between inspiratory and expiratory phases of Xrs were significantly decreased. Annual changes in Xrs parameters significantly correlated with those of spirometric parameters. Zrs parameters were significantly different between the low (the lower 75 percentile of incidence) and high (the top quartile) frequency of adverse respiratory event groups. The Zrs combined with spirometry may be beneficial to evaluate alterations in respiratory functions of RA.


Assuntos
Artrite Reumatoide/fisiopatologia , Pneumopatias/fisiopatologia , Transtornos Respiratórios/fisiopatologia , Respiração , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Artrite Reumatoide/epidemiologia , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Pulmão/fisiopatologia , Pneumopatias/epidemiologia , Pneumopatias/etiologia , Masculino , Pessoa de Meia-Idade , Transtornos Respiratórios/epidemiologia , Transtornos Respiratórios/etiologia , Testes de Função Respiratória , Estudos Retrospectivos
19.
BMC Anesthesiol ; 18(1): 192, 2018 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-30567490

RESUMO

OBJECTIVE: To compare the analgesic effects of patient-controlled intravenous analgesia (PCA) with hydromorphone and sufentanil after thoracic surgery on postoperative pulmonary complications (PPCs). METHODS: A total of 142 patients who were scheduled for thoracic surgery were randomly allocated to receive PCA with hydromorphone (group A: experimental group): hydromorphone 0.2 mg/kg + dezocine 0.5 mg/kg + ramosetron 0.6 mg diluted with normal saline to 200 mL; or with sufentanil (group B: control group): sufentanil 3.0µg/kg + dezocine 0.5 mg/kg + ramosetron 0.6 mg diluted with normal saline to 200 mL. The parameters of intravenous analgesia pump were set as background dose 4 ml/h, PCA dose 1 mL, locking time 15 min. Pain NRS (numerical rating scale), Ramsay sedation score, nausea or vomiting score were evaluated at 0 h, 6 h, 12 h, 24 h, 48 h after operation. The cases of PPCs (atelectasis, pulmonary infection, respiratory failure), CRP (C-reaction protein) and inflammatory cells (white cell count and percentage of neutrophils) and blood gas analysis at 12 h after operation, length of ICU and postoperative stay were recorded for each patient. RESULTS: Data of 136 patients were analyzed. Compared with group B (4[IQR:2,2]), the pain NRS in group A (2[IQR:4,4]) was significantly lower at 6 h after operation (P = 0.000). The CRP in group A (69.79 ± 32.13 mg/L) were lower than group B (76.76 ± 43.42 mg/L) after operation, but the difference was not significant (P = 0.427). No difference of nausea or vomiting was found between group A (7.3%) and group B (5.8%) postoperatively (P = 0.999). The PPCs were happened in 11 patients in group A (16.2%) and 22 patients in group B (32.4%) and the difference between two groups was significant (P = 0.027). Seven patients in group A (10.3%) and eighteen patients in group B (26.5%) had clinical evidence of pneumonia and the difference between two groups was significant (P = 0.014). The length of ICU and postoperative stay in group A were 2.73 h and 1.82 days less than group B respectively but the differences were not significant (P = 0.234, P = 0.186 respectively). CONCLUSION: Compared with sufentanil, hydromorphone may provide better postoperative analgesic effect with less pulmonary complications for patients undergoing thoracic surgery, and it may accelerate patients' rehabilitation. TRIAL REGISTRATION: Randomized Controlled Trials ChiCTR1800014282c . Registered 3 January 2018.


Assuntos
Hidromorfona/administração & dosagem , Complicações Pós-Operatórias/epidemiologia , Sufentanil/administração & dosagem , Procedimentos Cirúrgicos Torácicos/métodos , Adulto , Analgesia Controlada pelo Paciente/métodos , Benzimidazóis/administração & dosagem , Gasometria , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Pneumopatias/epidemiologia , Pneumopatias/etiologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Tetra-Hidronaftalenos/administração & dosagem
20.
Exp Suppl ; 108: 111-151, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30536170

RESUMO

Lung diseases are common and significant causes of illness and death around the world. Inflammasomes have emerged as an important regulator of lung diseases. The important role of IL-1 beta and IL-18 in the inflammatory response of many lung diseases has been elucidated. The cleavage to turn IL-1 beta and IL-18 from their precursors into the active forms is tightly regulated by inflammasomes. In this chapter, we structurally review current evidence of inflammasome-related components in the pathogenesis of acute and chronic lung diseases, focusing on the "inflammasome-caspase-1-IL-1 beta/IL-18" axis.


Assuntos
Inflamassomos , Pneumopatias/imunologia , Caspase 1/imunologia , Humanos , Interleucina-18/imunologia , Interleucina-1beta/imunologia , Pneumopatias/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA