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3.
J Environ Pathol Toxicol Oncol ; 39(3): 213-224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865913

RESUMO

Asthma is a chronic, serious allergic inflammatory disease in the airway. The inflammation in the airway is induced by the allergic T-helper 2 cells (Th2 cells), which leads to unfettered production of inflammatory cytokines. The accretion of inflammatory cells in the airway also speeds up the secretion of reactive oxygen species (ROS) and suppresses antioxidative processes. Hence, the present work aimed to study the antiasthmatic efficacy of betulin and its effect in suppressing the inflammatory markers of ovalbumin (OVA) challenged asthmatic mice. The observed results revealed that the levels of inflammatory cells including neutrophils, eosinophils, lymphocytes, and macrophages were effectively decreased by betulin treatment; furthermore, the inflammatory markers IL-4, IL-5, IL-13, and TNF-α levels were notably suppressed by betulin administration in OVA-challenged asthmatic mice. Similarly, the oral administration of betulin showed a reduction in IgE level and elevation in the IFN-γ level in bronchoalveolar lavage fluid (BALF). The elevated levels of antioxidant enzymes like catalase (CAT), glutathione (GSH), and superoxide dismutase (SOD) were observed in betulin treated mice. Furthermore, reduced levels of reactive oxygen species like NO2, NO3, and MDA were noted in the betulin treated group. Consistently, airway hyperreactivity (AHR) was depleted in the betulin administered group compared with the OVA-challenged asthmatic group. Betulin treatment was revealed to have noteworthy antiasthmatic effects mediated by the suppression of production of inflammatory cells and the expression of other inflammatory markers. Furthermore, the elevation in the level of antioxidant markers helped to disclose the original regulatory mode of betulin on asthma treatment.


Assuntos
Antiasmáticos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Asma/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Triterpenos/uso terapêutico , Animais , Antiasmáticos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Asma/imunologia , Asma/metabolismo , Biomarcadores/análise , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/citologia , Líquido da Lavagem Broncoalveolar/imunologia , Modelos Animais de Doenças , Eosinófilos/citologia , Feminino , Imunoglobulina E/sangue , Pulmão/efeitos dos fármacos , Pulmão/patologia , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/imunologia , Estresse Oxidativo/imunologia , Espécies Reativas de Oxigênio/metabolismo , Testes de Função Respiratória , Triterpenos/administração & dosagem
4.
J Environ Pathol Toxicol Oncol ; 39(3): 225-234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865914

RESUMO

Asthma is marked by chronic irritation in the airway lumen of the lungs due to the accretion of inflammatory cells that influence the regular inhalation process. An extended buildup of inflammation leads to oxidative pressure and the repression of antioxidant functions. In the current study, a potential compound, boldine, was tested for the containment of provocative markers along the path of antiasthmatic activity in an ovalbumin (OVA)-induced asthmatic mice model. As an effect, the boldine (10 and 20 mg/kg) treatment suppressed inflammatory cells such as eosinophil, macrophage, neutrophil, lymphocyte, and other inflammatory markers in the bronchoalveolar lavage fluid (BALF) of OVA-induced mice. Likewise, immunoglobulin E (IgE) levels were drastically condensed in the serum of boldine-treated animals. Levels of enzymatic and nonenzymatic antioxidants, such as superoxide dismutase (SOD) and glutathione (GSH), were upregulated in the boldine treatment group compared to the asthmatic control group, which displays the antioxidant effects of boldine on asthmatic animals. Interestingly, the reactive oxygen species (ROS) and malonaldehyde (MDA) levels were repressed in the BALF of boldine-treated mice groups. Therefore, the effects of boldine are significant for the management of asthma, reducing the accrual of inflammatory cells, along with other inflammatory markers, while improving antioxidant markers and containing ROS. Hence, boldine may be an option for clinical trials of chronic asthma management.


Assuntos
Antiasmáticos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antioxidantes/metabolismo , Aporfinas/uso terapêutico , Asma/tratamento farmacológico , Animais , Antiasmáticos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Aporfinas/administração & dosagem , Asma/imunologia , Biomarcadores/análise , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/citologia , Líquido da Lavagem Broncoalveolar/imunologia , Citocinas/análise , Modelos Animais de Doenças , Eosinófilos/citologia , Imunoglobulina E/sangue , Pulmão/efeitos dos fármacos , Pulmão/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Ovalbumina/imunologia , Espécies Reativas de Oxigênio/metabolismo , Testes de Função Respiratória
5.
Medicine (Baltimore) ; 99(38): e22041, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957323

RESUMO

BACKGROUND: Qigong is a traditional Chinese exercise method for health care, keeping fit and getting rid of diseases. It has the advantages of simple operation and few side effects. Corona Virus Disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-COV-2). Its clinical manifestations mainly include fever, fatigue, and dry cough. Clinical practice showed that Qigong had some therapeutic effects on pulmonary dysfunction caused by novel Coronavirus, but there was lacking in evidence of evidence-based medicine. The purpose of this protocol is to systematically evaluate the effects of Qigong on lung function and quality of life in COVID-19 patients, and to add evidence to evidence-based medicine for the clinical application of Qigong therapy. METHODS: Use computer to retrieve English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (China Knowledge Network (CNKI), Wanfang Database, VIP Information Chinese Journal Service Platform (VIP), Chinese Biomedical Database). In addition, we manually retrieve randomized controlled clinical research from Baidu academic and Google academic from its establishment to July 2020. Two researchers independently extracted and evaluated the quality of the data included in the study, using RevMan5.3 to do meta-analyses of articles included, without language restrictions. RESULTS: This research evaluated the effectiveness and safety of Qigongs influence on patients pulmonary function and life quality by index such as 6-minute walk distance (6MWD), Forced expiratory volume in 1 second (FEV1), Forced vital capacity (FVC), Forced expiratory volume in 1 second/Forced vital capacity (FEV1/FVC), Forced expiratory volume in 1 second/prediction (FEV1/PRE), Self-rating anxiety scale (SAS), etc. CONCLUSIONS:: This study will provide reliable evidence-based evidence for the clinical application of Qigong in the treatment of COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020191877.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Medicina Tradicional Chinesa/métodos , Pneumonia Viral/terapia , Qigong/métodos , Qualidade de Vida , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Humanos , Pulmão/fisiopatologia , Metanálise como Assunto , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Projetos de Pesquisa , Testes de Função Respiratória , Revisões Sistemáticas como Assunto , Resultado do Tratamento
6.
Medicine (Baltimore) ; 99(38): e22111, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957331

RESUMO

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a lung disease with the highest incidence and high mortality in the world. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can significantly accelerate the progression of the disease. Pulmonary rehabilitation is one of the effective treatment methods in COPD patients, but few studies have focused on the effect of pulmonary rehabilitation in AECOPD patients. Liuzijue can improve the pulmonary function and relieve symptoms of COPD patients. However, due to the influence of disease and non-invasive ventilation (NIV), AECOPD patients have poor compliance with getting out of bed at the early stage. Sitting and lying Liuzijue is more suitable in AECOPD patients with NIV. Therefore, this study will evaluate the effect of sitting and lying Liuzijue for lung function, exercise endurance, and quality of life in AEOPD patients with NIV. METHODS: This study is a clinical randomized controlled trial. Sixty four AECOPD patients with NIV will be randomly divided into the experimental group and the control group. All participants will be treated with routine treatment and nursing according to their specific condition. The experimental group will be combined with sitting and lying Liuzijue on the basis of the control group. The duration of the exercise will be 3 months. The primary outcomes are the pulmonary function test and 6-minute walking test (6MWT). The secondary outcome measures include blood gas parameters, dyspnea index (the Modified Medical Research Council Dyspnea Scale [mMRC]), the body-mass, airflow obstruction, dyspnea and exercise capacity (BODE) index, anxiety, and depression (Hospital Anxiety and Depression Scale [HADS]), and quality of life (St·George Respiratory Questionnaire [SGRQ]). The measurement of outcomes will be evaluated at week 13. DISCUSSION: It's imperative to focus on pulmonary rehabilitation in AECOPD patients. The purpose of this study is to evaluate the effect of sitting and lying Liuzijue for pulmonary rehabilitation in AECOPD patients with NIV. TRIAL REGISTRATION: ChiCTR2000034530, Registered on July 8th, 2020.


Assuntos
Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica/reabilitação , Qigong , Postura Sentada , Decúbito Dorsal , Humanos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória
7.
Medicine (Baltimore) ; 99(33): e21550, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872002

RESUMO

To study the relationship between neutrophil to lymphocyte ratio (NLR) and exercise tolerance of patients with chronic obstructive pulmonary disease (COPD).235 patients with COPD were selected as the study subjects. Complete blood count, C reactive protein (CRP), pulmonary function tests, the 6-minute walk distance (6MWD), Modified Medical Respiratory Council, the COPD assessment test, and clinical COPD questionnaire were tested. Heart rate, oxygen saturation, and Borg scale were tested before or after 6MWD test.By the median of NLR, the subjects were divided into 2 groups, NLR ≥4.5 group and NLR <4.5 group. The white blood cell count (WBC), CRP and deoxygenation saturation in the NLR ≥4.5 group were higher than those in the NLR <4.5 group, while the age, body mass index (BMI), 6MWD, and heart rate variation were lower than those in the NLR <4.5 group. CRP, WBC, and deoxygenation saturation had positive effects on NLR, BMI, 6MWT, and heart rate variation had negative effects on NLR. The Pearson correlation analysis showed NLR was positively correlated with WBC, CRP, BMI index, 6MWT, and deoxygenation saturation, while it was negatively correlated with BMI and heart rate variation.NLR might associate with exercise tolerance and cardiorespiratory reserve of COPD patients, and could be used as an indicator of muscle function in COPD patients.


Assuntos
Tolerância ao Exercício , Linfócitos/metabolismo , Neutrófilos/metabolismo , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Idoso , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Inquéritos e Questionários , Teste de Caminhada
9.
Lung ; 198(5): 771-775, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32915271

RESUMO

PURPOSE: To investigate whether sarcoidosis patients infected with SARS-CoV-2 are at risk for adverse disease outcomes. STUDY DESIGN AND METHODS: This retrospective study was conducted in five hospitals within the Mount Sinai Health System during March 1, 2020 to July 29, 2020. All patients diagnosed with COVID-19 were included in the study. We identified sarcoidosis patients who met diagnostic criteria for sarcoidosis according to accepted guidelines. An adverse disease outcome was defined as the presence of intubation and mechanical ventilation or in-hospital mortality. In sarcoidosis patients, we reported (when available) the results of pulmonary function testing measured within 3 years prior to the time of SARS­CoV­2 infection. A multivariable logistic regression model was used to generate an adjusted odds ratio (aOR) to evaluate sarcoidosis as a risk factor for an adverse outcome. The same model was used to analyze sarcoidosis patients with moderate and/or severe impairment in pulmonary function. RESULTS: The study included 7337 patients, 37 of whom (0.5%) had sarcoidosis. The crude rate of developing an adverse outcome was significantly higher in patients with moderately and/or severely impaired pulmonary function (9/14 vs. 3/23, p = 0.003). While the diagnosis of sarcoidosis was not independently associated with risk of an adverse event, (aOR 1.8, 95% CI 0.9-3.6), the diagnosis of sarcoidosis in patients with moderately and/or severely impaired pulmonary function was associated with an adverse outcome (aOR 7.8, 95% CI 2.4-25.8). CONCLUSION: Moderate or severe impairment in pulmonary function is associated with mortality in sarcoidosis patients infected with SARS­CoV­2.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Testes de Função Respiratória/métodos , Sarcoidose Pulmonar , Comorbidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Sarcoidose Pulmonar/diagnóstico , Sarcoidose Pulmonar/epidemiologia , Sarcoidose Pulmonar/fisiopatologia , Estados Unidos/epidemiologia
10.
Medicine (Baltimore) ; 99(37): e22134, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925765

RESUMO

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is an illness characterized by progressive aggravation of airflow limitation, which seriously affects patients' quality of life, and even life-threatening. The lung function of COPD patients is chronically and progressively deteriorated. Among them, the lung function of early COPD patients deteriorates rapidly, and forced expiratory volume in 1 second (FEV1) declines faster than other stages. If diagnosed early and effectively treated in time, it can greatly affect the prognosis. As a traditional exercise regimen, Baduanjin can improve lung function, exercise capacity, and quality of life of COPD patients. However, high-quality evidence-based medical evidence is so far be lacking to confirm the effectiveness of Baduanjin in reducing or preventing mild COPD lung function decline. METHODS: This study is a randomized controlled trial, 192 patients with mild COPD were randomly divided into experimental group and control group. Both of them will receive basic treatment (health education and Tiotropium bromide), the experimental group will receive Baduanjin exercise training, and the control group will be told to maintain the original lifestyle and control the exercise. The Baduanjin exercise will last for 24 weeks and will be followed up for 72 weeks. The primary outcome is the change in lung function, including FEV1, FEV1/forced vital capacity (FVC), and FEV1/predicted. The secondary results included COPD assessment test, 6-minute walk test, St. George Respiratory Questionnaire, and Dyspnea Scale. Safety will also serve as assessing during the test. DISCUSSION: The results of this trial will provide that traditional Baduanjin exercises can prevent COPD lung function deterioration, and provide a simple, inexpensive, and daily pulmonary rehabilitation measure for the patients with mild COPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Qigong/métodos , Tolerância ao Exercício , Humanos , Seleção de Pacientes , Qualidade de Vida , Testes de Função Respiratória , Tamanho da Amostra
11.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32938776

RESUMO

For healthy individuals, it is increasingly accepted that lung function follows along an individual percentile established early in life and that the level of maximal function reached as a young adult can affect the subsequent development of lung disease that occurs with the normal aging process. This emphasizes the need to maximize early lung function. The trajectories of lung function are at least partially established by perinatal factors, including prematurity and in utero exposures (tobacco exposure, nutrition, inflammation, etc), although they can also be affected by a variety of additional factors and exposures throughout the life span. Whether lung function trajectories can be impacted or reset if established under suboptimal conditions is an unanswered question, offering new avenues for research. In this review, we will summarize important articles outlining lung function trajectories and linking pediatric lung function tests to adult lung function tests decades later. We will focus on perinatal factors and outline progress and opportunities for further investigation into the potential ability to reset trajectories to impact long-term lung health.


Assuntos
Pneumopatias/fisiopatologia , Pulmão/fisiologia , Criança , Feminino , Humanos , Lactente , Recém-Nascido Prematuro , Doenças do Prematuro , Pulmão/embriologia , Pneumopatias/prevenção & controle , Assistência Perinatal , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Testes de Função Respiratória
12.
Am J Phys Med Rehabil ; 99(10): 887-894, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32960527

RESUMO

OBJECTIVE: This study used a 3-point pressure spinal orthosis made of fabric material in neuromuscular scoliosis patients with flexible spinal curve to evaluate the in-brace correction of the spinal curve and to estimate changes in pulmonary function associated with brace wearing. DESIGN: Twenty-eight children with neuromuscular scoliosis with spinal curve flexibility of more than 50% were enrolled. A custom-made 3-point pressure spinal orthosis was fitted for each patient. The Cobb angles in sitting and supine positions, forced vital capacity, forced expiratory volume in the first second, and peak cough flow were measured before and after applying spinal orthoses. Each participant recorded the brace wearing duration, and questionnaires on brace tolerance were collected. RESULTS: Cobb angles after application of orthosis decreased from 31.0 degrees (interquartile range = 21.9-45.0 degrees) to 16.6 degrees (interquartile range = 10.0-34.0 degrees) in the sitting position and from 13.3 degrees (interquartile range = 4.0-21.0 degrees) to 1.4 degrees (interquartile range = 0.0-19.0 degrees) while supine (P < 0.01, P = 0.04, respectively). Preorthosis and postorthosis application forced vital capacity, forced expiratory volume in the first second, and peak cough flow were unaffected. Caregivers reported improved sitting postures and manual activities. CONCLUSIONS: In children with flaccid-type neuromuscular scoliosis, curve correction can be achieved using a simple fabric-type spinal orthosis when applied to patients with flexible scoliosis, without compromising lung function. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Describe the factors associated with the effects of spinal braces in neuromuscular scoliosis; (2) Discuss the characteristics of flaccid-type neuromuscular scoliosis; and (3) Discuss the benefits of fabric-type orthosis regarding pulmonary function and patient compliance. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Assuntos
Aparelhos Ortopédicos , Desenho de Prótese , Ajuste de Prótese , Escoliose/terapia , Têxteis , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Testes de Função Respiratória , Escoliose/diagnóstico por imagem , Inquéritos e Questionários
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1034-1040, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741166

RESUMO

Objective: To understand the awareness of chronic obstructive pulmonary disease (COPD) status and awareness of COPD-related knowledge and its influencing factors in COPD patients aged ≥40 years in China in 2014-2015. Methods: The study subjects were selected through multi-stage stratified cluster sampling from 125 COPD surveillance points in 31 provinces (autonomous regions, municipalities) in China. The number of the subjects was 75 107. The relevant variables about COPD diagnosis and COPD-related knowledge awareness were collected by electronic questionnaire in face to face interviews. A total of 9 134 participates with post-bronchodilator FEV(1)/FVC<70% were diagnosed with COPD. Based on the complex sampling design, the awareness rate of COPD status and related knowledge were estimated, and the influencing factors were analyzed. Results: A total of 9 132 COPD patients were included in the analysis. Among COPD patients aged ≥40 years in China, 0.9% were aware of their COPD status (95%CI: 0.6%-1.1%), and 5.7% were aware of COPD related knowledge (95%CI: 4.8%-6.6%), and 3.4% were aware of pulmonary function test (95%CI: 2.8%-4.0%). The COPD status awareness rate was 3.9% in the patients with history of chronic respiratory disease (95%CI: 2.9%-4.8%), 2.4% in the patients with respiratory symptoms (95%CI: 1.7%-3.1%), and 7.1% in the patients with COPD related knowledge awareness (95%CI: 4.5%-9.8%) respectively. The results of multivariate logistic regression analysis showed that chronic respiratory disease history, respiratory symptoms, occupational dust and/or harmful gas exposure and COPD related knowledge awareness had influences on the awareness rate of COPD status. Educational level and chronic respiratory disease history had influences on the awareness rate of COPD related knowledge. And ethnic groups, educational level and history of chronic respiratory diseases had influences on the awareness rate of pulmonary function test. Conclusions: The awareness rates of COPD status, COPD-related knowledge and pulmonary function test in COPD patients in China were low. The comprehensive intervention of COPD should be carried out to improve the level of diagnosis and the awareness COPD status of COPD patients.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adulto , China/epidemiologia , Humanos , Testes de Função Respiratória , Inquéritos e Questionários
14.
Ecotoxicol Environ Saf ; 202: 110907, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32800242

RESUMO

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


Assuntos
Poluentes Ocupacionais do Ar/análise , Compostagem , Endotoxinas/análise , Exposição Ocupacional/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Adulto , Microbiologia do Ar , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Testes de Função Respiratória/efeitos adversos , Sons Respiratórios , Doenças Respiratórias/etiologia , Poluição por Fumaça de Tabaco
17.
Codas ; 32(4): e20190036, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32756854

RESUMO

PURPOSE: To verify the relationship between the risk of dysphagia and health status in patients with Chronic Obstructive Pulmonary Disease (COPD). METHOD: Cross-sectional study with convenience sample. Twenty-three individuals with a diagnosis of COPD according to GOLD 2019 criteria. The individuals participated in a pulmonary rehabilitation program, clinically stable (without exacerbations of at least 30 days) and in optimized drug treatment were included. The study analyzed anthropometric measures (BMI), peak expiratory flow (PEF), mental status (MEEM), eating assessment tool (EAT-10), and health status (COPD Assessment Test -CAT). The mean age was 60.39 ± 9.90 years, 11 individuals were female and eutrophic. RESULTS: We observed a positive and moderate association (r = 0.57, p = 0.004) between the CAT and EAT-10 scores in the sample studied. CONCLUSION: The results demonstrated relationship between the risk of dysphagia and the health status in individuals with COPD.


Assuntos
Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória , Inquéritos e Questionários
19.
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
20.
Int J Antimicrob Agents ; 56(4): 106143, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32853672

RESUMO

As no specific pharmacological treatment has been validated for use in coronavirus disease 2019 (COVID-19), we aimed to assess the effectiveness of azithromycin (AZM) in these patients at a referral centre in Iran. An open-label, randomised controlled trial was conducted on patients with laboratory-confirmed COVID-19. A total of 55 patients in the control group receiving hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) were compared with 56 patients in the case group who in addition to the same regimen also received AZM. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American College of Cardiology (ACC) risk assessment for use of AZM and HCQ. The main outcome measures were vital signs, SpO2 levels, duration of hospitalisation, need for and length of intensive care unit admission, mortality rate and results of 30-day follow-up after discharge. Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO2 levels at discharge were significantly higher, the respiratory rate was lower and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. Patients who received AZM in addition to HCQ and LPV/r had a better general condition. HCQ+AZM combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmia based on the ACC criteria.


Assuntos
Anti-Infecciosos/uso terapêutico , Azitromicina/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Adulto , Idoso , Betacoronavirus/patogenicidade , Proteína C-Reativa/metabolismo , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Progressão da Doença , Combinação de Medicamentos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Segurança do Paciente , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Prognóstico , Testes de Função Respiratória , Análise de Sobrevida , Linfócitos T/patologia , Linfócitos T/virologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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