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[PMID]:29240325
[Ti] Título:Tort Law--Expert Testimony in Asbestos Litigation--District of South Carolina Holds the Every Exposure Theory Insufficient to Demonstrate Specific Causation Even If Legal Conclusions are Scientifically Sound.--Haskins v. 3m Co., Nos. 2:15-cv-02086, 3:15-cv-02123, 2017 WL 3118017 (D.S.C. July 21, 2017).
[So] Source:Harv Law Rev;131(2):658-65, 2017 Dec.
[Is] ISSN:0017-811X
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Asbestose/etiologia
Causalidade
Prova Pericial/legislação & jurisprudência
Mesotelioma/etiologia
[Mh] Termos MeSH secundário: Seres Humanos
Ciência
South Carolina
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:28853857
[Au] Autor:Forest V; Vergnon JM; Pourchez J
[Ad] Endereço:Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, SAINBIOSE, F-42023 Saint Etienne, France.
[Ti] Título:Biological Monitoring of Inhaled Nanoparticles in Patients: An Appealing Approach To Study Causal Link between Human Respiratory Pathology and Exposure to Nanoparticles.
[So] Source:Chem Res Toxicol;30(9):1655-1660, 2017 Sep 18.
[Is] ISSN:1520-5010
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although necessary, in vitro and in vivo studies are not fully successful at predicting nanomaterials toxicity. We propose to associate such assays to the biological monitoring of nanoparticles in clinical samples to get more relevant data on the chemical and physical nature and dose of nanoparticles found in humans. The concept is to establish the load of nanoparticles in biological samples of patients. Then, by comparing samples from different patient groups, nanoparticles of interest could be identified and a potential link between a given nanoparticle type and toxicity could be suggested. It must be confirmed by investigating the biological effects induced by these nanoparticles using in vitro or in vivo models (mechanistic or dose-response studies). This translational approach from the bedside to the bench and vice versa could allow a better understanding of the nanoparticle effects and mechanisms of toxicity that can contribute, at least in part, to a disease.
[Mh] Termos MeSH primário: Pulmão/efeitos dos fármacos
Nanopartículas/toxicidade
[Mh] Termos MeSH secundário: Asbestose/etiologia
Líquido da Lavagem Broncoalveolar/química
Monitoramento Ambiental
Seres Humanos
Exposição por Inalação
Pulmão/patologia
Metais/química
Nanopartículas/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Metals)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.1021/acs.chemrestox.7b00192


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[PMID]:28481375
[Au] Autor:D' Agostin F; de Michieli P; Negro C
[Ad] Endereço:University of Trieste, Trieste, Italy (Clinical Unit of Occupational Medicine, Department of Medicine, Surgery and Health Sciences). fladagostin@yahoo.it.
[Ti] Título:Pleural mesothelioma in household members of asbestos-exposed workers in Friuli Venezia Giulia, Italy.
[So] Source:Int J Occup Med Environ Health;30(3):419-431, 2017 May 08.
[Is] ISSN:1896-494X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Malignant mesothelioma is closely associated to asbestos exposure. One such exposure may occur through contact with occupationally exposed household members and their belongings. This study examines the features of pleural mesothelioma attributable only to asbestos brought home by another family member. MATERIAL AND METHODS: The data sources were 1063 mesothelioma cases diagnosed between 1995 and 2014, from the Friuli Venezia Giulia Mesothelioma Register. In all cases the diagnosis of mesothelioma was based on the pathology report. Exposure information and demographic data were acquired by an occupational medical standardized questionnaire/interview. RESULTS: Household-exposure mesothelioma cases included 33 women and 2 men. Relationships were: wives (N = 22), daughters (N = 9), sons (N = 2), and mothers (N = 2). Asbestos exposure in the workers predominantly occurred in shipyards. Out of the 35 pleural cases, 19 were epithelial, 9 biphasic, 3 sarcomatoid, and 4 not specified. The mean age at diagnosis was 77 years old. The mean latency was 59 years, with wives having a significant shorter latency than offspring. Latency was not significantly related to morphology and asbestosis. The overall mean survival was 16 months (median 11 months) but treatment was beneficial (mean 16 months vs. 7 months). Biphasic/sarcomatoid histology and presence of asbestosis were associated with a decreased survival, although not with statistical significance. CONCLUSIONS: Our data confirms that household exposure increases the risk for pleural mesothelioma amongst women with no history of occupational asbestos exposure. This is an ongoing problem in many countries, as well as in Italy, where the evaluation of a framework for the compensation of these cases is under debate. Int J Occup Med Environ Health 2017;30(3):419-431.
[Mh] Termos MeSH primário: Asbestos/toxicidade
Exposição Ambiental/efeitos adversos
Características da Família
Neoplasias Pulmonares/epidemiologia
Mesotelioma/epidemiologia
Neoplasias Pleurais/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Asbestose/epidemiologia
Asbestose/etiologia
Feminino
Seres Humanos
Itália/epidemiologia
Neoplasias Pulmonares/etiologia
Masculino
Mesotelioma/etiologia
Meia-Idade
Neoplasias Pleurais/etiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
1332-21-4 (Asbestos)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


  4 / 3973 MEDLINE  
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[PMID]:28478929
[Au] Autor:Macía-Suárez D; Sánchez-Rodríguez E; Lopez-Calviño B; Diego C; Pombar M
[Ad] Endereço:Complexo Hospitalario Universitario de Ferrol, Avda Residencia, s/n, CP: 15405, Ferrol (A Coruña), Spain. Electronic address: david.macia.suarez@gmail.com.
[Ti] Título:Low-voltage chest CT: another way to reduce the radiation dose in asbestos-exposed patients.
[So] Source:Clin Radiol;72(9):797.e1-797.e10, 2017 Sep.
[Is] ISSN:1365-229X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To assess whether low voltage chest computed tomography (CT) can be used to successfully diagnose disease in patients with asbestos exposure. MATERIALS AND METHODS: Fifty-six former employees of the shipbuilding industry, who were candidates to receive a standard-dose chest CT due to their occupational exposure to asbestos, underwent a routine CT. Immediately after this initial CT, they underwent a second acquisition using low-dose chest CT parameters, based on a low potential (80 kV) and limited tube current. The findings of the two CT protocols were compared based on typical diseases associated with asbestos exposure. The kappa coefficient for each parameter and for an overall rating (grouping them based on mediastinal, pleural, and pulmonary findings) were calculated in order to test for correlations between the two protocols. RESULTS: A good correlation between routine and low-dose CT was demonstrated for most parameters with a mean radiation dose reduction of up to 83% of the effective dose based on the dose-length product between protocols. CONCLUSIONS: Low-dose chest CT, based on a limited tube potential, is useful for patients with an asbestos exposure background. Low-dose chest CT can be successfully used to minimise the radiation dose received by patients, as this protocol produced an estimated mean effective dose similar to that of an abdominal or pelvis plain film.
[Mh] Termos MeSH primário: Asbestose/diagnóstico por imagem
Doenças Profissionais/diagnóstico por imagem
Exposição Ocupacional/efeitos adversos
Dose de Radiação
Proteção Radiológica/métodos
Radiografia Torácica/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Masculino
Navios
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


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[PMID]:28431523
[Au] Autor:Kido T; Morimoto Y; Yatera K; Ishimoto H; Ogoshi T; Oda K; Yamasaki K; Kawanami T; Shimajiri S; Mukae H
[Ad] Endereço:Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan. t-kido@med.uoeh-u.ac.jp.
[Ti] Título:The utility of electron microscopy in detecting asbestos fibers and particles in BALF in diffuse lung diseases.
[So] Source:BMC Pulm Med;17(1):71, 2017 Apr 21.
[Is] ISSN:1471-2466
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In patients with diffuse lung diseases, differentiating occupational lung diseases from other diseases is clinically important. However, the value of assessing asbestos and particles in bronchoalveolar lavage fluid (BALF) in diffuse lung diseases by electron microscopy (EM) remains unclear. We evaluated the utility of EM in detecting asbestos fibers and particles in patients with diffuse lung diseases. METHODS: The BALF specimens of 107 patients with diffuse lung diseases were evaluated. First, detection of asbestos by EM and light microscopy (LM) were compared. Second, the detection of asbestos using surgically obtained lung tissues of 8 of 107 patients were compared with the results of EM and LM in BALF. Third, we compared the results of mineralogical components of particles in patients with (n = 48) and without (n = 59) a history of occupational exposure to inorganic dust. RESULTS: BALF asbestos were detected in 11 of 48 patients with a history of occupational exposure by EM; whereas asbestos as asbestos bodies (ABs) were detected in BALF in 4 of these 11 patients by LM. Eight of 107 patients in whom lung tissue samples were surgically obtained, EM detected BALF asbestos at a level of >1,000 fibers/ml in all three patients who had ABs in lung tissue samples by LM at a level of >1,000 fibers/g. The BALF asbestos concentration by EM and in lung tissue by LM were positively correlated. The particle fractions of iron and phosphorus were increased in patients with a history of occupational exposure and both correlated with a history of occupational exposure by a multiple regression analysis. CONCLUSIONS: EM using BALF seemed to be superior to LM using BALF and displayed a similar sensitivity to LM using surgically-obtained lung tissue samples in the detection of asbestos. Our results also suggest that detection of elements, such as iron and phosphorus in particles, is useful for evaluating occupational exposure. We conclude that the detection of asbestos and iron and phosphorus in particles in BALF by EM is very useful for the evaluation of occupational exposure.
[Mh] Termos MeSH primário: Asbestos/análise
Asbestose/diagnóstico
Líquido da Lavagem Broncoalveolar/química
Microscopia Eletrônica
[Mh] Termos MeSH secundário: Broncoscopia
Feminino
Seres Humanos
Japão
Pulmão/patologia
Masculino
Meia-Idade
Exposição Ocupacional/efeitos adversos
Análise de Regressão
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
1332-21-4 (Asbestos)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170423
[St] Status:MEDLINE
[do] DOI:10.1186/s12890-017-0415-5


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[PMID]:28351840
[Au] Autor:Gu L; Larson-Casey JL; Carter AB
[Ad] Endereço:Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
[Ti] Título:Macrophages utilize the mitochondrial calcium uniporter for profibrotic polarization.
[So] Source:FASEB J;31(7):3072-3083, 2017 Jul.
[Is] ISSN:1530-6860
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fibrosis in multiple organs, including the liver, kidney, and lung, often occurs secondary to environmental exposure. Asbestos exposure is one important environmental cause of lung fibrosis. The mechanisms that mediate fibrosis is not fully understood, although mitochondrial oxidative stress in alveolar macrophages is critical for fibrosis development. Mitochondrial Ca levels can be associated with production of reactive oxygen species. Here, we show that patients with asbestosis have higher levels of mitochondrial Ca compared with normal patients. The mitochondrial calcium uniporter (MCU) is a highly selective ion channel that transports Ca into the mitochondrial matrix to modulate metabolism. Asbestos exposure increased mitochondrial Ca influx in alveolar macrophages from wild-type, but not MCU , mice. MCU expression polarized macrophages to a profibrotic phenotype after exposure to asbestos, and the profibrotic polarization was regulated by MCU-mediated ATP production. Profibrotic polarization was abrogated when MCU was absent or its activity was blocked. Of more importance, mice that were deficient in MCU were protected from pulmonary fibrosis. Regulation of mitochondrial Ca suggests that MCU may play a pivotal role in the development of fibrosis and could potentially be a therapeutic target for pulmonary fibrosis.-Gu, L., Larson-Casey, J. L., Carter, A. B. Macrophages utilize the mitochondrial calcium uniporter for profibrotic polarization.
[Mh] Termos MeSH primário: Asbestose/metabolismo
Canais de Cálcio/metabolismo
Regulação da Expressão Gênica/fisiologia
Macrófagos/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Animais
Cálcio/metabolismo
Canais de Cálcio/genética
Haplótipos
Seres Humanos
Camundongos
Meia-Idade
Fibrose Pulmonar
Espécies Reativas de Oxigênio
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcium Channels); 0 (Reactive Oxygen Species); 0 (mitochondrial calcium uniporter); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1096/fj.201601371R


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[PMID]:28348451
[Au] Autor:Ying S; Jiang Z; He X; Yu M; Chen R; Chen J; Ru G; Chen Y; Chen W; Zhu L; Li T; Zhang Y; Guo X; Yin X; Zhang X; Lou J
[Ad] Endereço:Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China.
[Ti] Título:Serum HMGB1 as a Potential Biomarker for Patients with Asbestos-Related Diseases.
[So] Source:Dis Markers;2017:5756102, 2017.
[Is] ISSN:1875-8630
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:High-mobility group box 1 (HMGB1) functions as a proinflammatory cytokine and is one of the most intriguing molecules in inflammatory disorders and cancers. Notably, HMGB1 is a potential therapeutic target and novel biomarker in related diseases. However, the diagnostic value of HMGB1 for benign and malignant asbestos-related diseases (ARDs) remains unclear. In this work, we detected preoperative serum HMGB1 levels in Chinese asbestos-exposed (AE) and ARDs populations and further evaluated the diagnostic value of HMGB1 in patients with certain types of ARDs, including those with pleural plaques, asbestosis, or malignant mesothelioma (MM). The experimental data presented that the serum level of HMGB1 was significantly elevated in AE and ARDs subjects. Our findings indicated that serum HMGB1 is a sensitive and specific biomarker for discriminating asbestosis- and MM-affected individuals from healthy or AE individuals. In addition, serum matrix metalloproteinases 2 and 9 are not correlated with HMGB1 in ARDs. Thus, our study provides supporting evidence for HMGB1 as a potential biomarker either for the clinical diagnosis of high-risk AE cohorts or for evaluating ARDs.
[Mh] Termos MeSH primário: Asbestose/sangue
Biomarcadores Tumorais/sangue
Proteína HMGB1/sangue
Neoplasias Pulmonares/sangue
Mesotelioma/sangue
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Metaloproteinase 2 da Matriz/sangue
Metaloproteinase 9 da Matriz/sangue
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (HMGB1 Protein); 0 (HMGB1 protein, human); EC 3.4.24.24 (MMP2 protein, human); EC 3.4.24.24 (Matrix Metalloproteinase 2); EC 3.4.24.35 (MMP9 protein, human); EC 3.4.24.35 (Matrix Metalloproteinase 9)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170420
[Lr] Data última revisão:
170420
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1155/2017/5756102


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[PMID]:28345684
[Au] Autor:Cwynar E; Swiatkowska B; Tomczyk J
[Ad] Endereço:Dolnoslaski Wojewódzki Osrodek Medycyny Pracy we Wroclawiu, Oddzial Jelenia Góra / Regional Centre of Occupational Medicine, Jelenia Góra Department, Wroclaw, Poland (Dyrektor Oddzialu / Head of the Department). womp.jg@womp.wroc.pl.
[Ti] Título:[Analysis of changes in radiographic lung image and lung ventilation disorders in workers occupationally exposed to chrysotile in the past].
[Ti] Título:Analiza zmian w obrazie radiologicznym pluc i zaburzen czynnosci wentylacyjnej pluc u pracowników zawodowo narazonych na azbest chryzotylowy w przeszlosci..
[So] Source:Med Pr;68(2):247-258, 2017 Mar 24.
[Is] ISSN:0465-5893
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:BACKGROUND: The adverse health effects of occupational exposure to asbestos dust may occur several years after first exposure. The objective of the study was to assess the relationship between lesions in the respiratory system and the factors contributing to occupational exposure to asbestos described in the first medical examination as well as to analyze the factors responsible for the progression of these changes in further medical tests. MATERIAL AND METHODS: The study group comprised 591 former workers of asbestos processing plant "Gambit" in Lubawka. The results of medical examinations carried out in 2001-2012 were assessed. Statistical inference was performed based on bilateral significance tests at the 0.05 level of significance. RESULTS: A higher risk of interstitial lung changes along with an increase in the cumulative concentration of asbestos was indicated; for the employees with the highest exposure, the adjusted odds ratio (OR) was 1.63 (95% confidence interval (CI): 0.99-2.71), while for changes with the severity degree qualifying for asbestosis diagnosis, the risk was significantly increased, over fivefold higher, compared to subjects employed in the lowest exposure. The analysis of the relationship between the progression of interstitial changes and the exposure to asbestos dust showed a fourfold higher risk of the progression in workers employed in the highest exposure. Mean values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity), FEV1/FVC (forced expiratory volume in 1 s to forced vital capacity) were significantly lower in the subjects working in a higher asbestos exposure. The effect of tobacco smoking on the occurrence of interstitial lung changes and their progression was also confirmed. CONCLUSIONS: The results of prophylactic medical examinations of the health status of workers formerly employed in the plants using chrysotile indicate the importance andthe need for a long-term clinical follow-up and the promotion of anti-smoking prevention in this group of former employees. Med Pr 2017;68(2):247-258.
[Mh] Termos MeSH primário: Asbestos Serpentinas/efeitos adversos
Asbestose/patologia
Pulmão/patologia
Exposição Ocupacional/efeitos adversos
Ventilação Pulmonar
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Asbestose/diagnóstico por imagem
Asbestose/epidemiologia
Asbestose/fisiopatologia
Poeira
Feminino
Seres Humanos
Pulmão/diagnóstico por imagem
Pulmão/fisiopatologia
Masculino
Meia-Idade
Polônia
Radiografia Torácica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Asbestos, Serpentine); 0 (Dust)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170328
[St] Status:MEDLINE


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[PMID]:28328293
[Au] Autor:Barlow CA; Sahmel J; Paustenbach DJ; Henshaw JL
[Ad] Endereço:a Cardno ChemRisk , Boulder , CO , USA.
[Ti] Título:History of knowledge and evolution of occupational health and regulatory aspects of asbestos exposure science: 1900-1975.
[So] Source:Crit Rev Toxicol;47(4):286-316, 2017 Apr.
[Is] ISSN:1547-6898
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The understanding by industrial hygienists of the hazards of asbestos and appropriate ways to characterize and control exposure has evolved over the years. Here, a detailed analysis of the evolution of industrial hygiene practices regarding asbestos and its health risks, from the early 1900s until the advent of the national occupational health and safety regulatory structure currently in place in the US (early-to-mid 1970s) is presented. While industrial hygienists recognized in the early 1900s that chronic and high-level exposures to airborne concentrations of asbestos could pose a serious health hazard, it was not until the mid-1950s that the carcinogenic nature of asbestos began to be characterized and widespread concern followed. With the introduction of the membrane filter sampling method in the late 1960s and early 1970s, asbestos sampling and exposure assessment capabilities advanced to a degree which allowed industrial hygienists to more precisely characterize the exposure-response relationship. The ability of industrial hygienists, analytical chemists, toxicologists, and physicians to more accurately define this relationship was instrumental to the scientific community's ability to establish Occupational Exposure Levels (OELs) for asbestos. These early developments set the stage for decades of additional study on asbestos exposure potential and risk of disease. This was followed by the application of engineering controls and improved respiratory protection which, over the years, saved thousands of lives. This paper represents a state-of-the-art review of the knowledge of asbestos within the industrial hygiene community from about 1900 to 1975.
[Mh] Termos MeSH primário: Poluentes Ocupacionais do Ar/análise
Asbestos/análise
Asbestose/epidemiologia
Exposição Ocupacional/estatística & dados numéricos
Saúde do Trabalhador
[Mh] Termos MeSH secundário: Exposição por Inalação
Exposição Ocupacional/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Air Pollutants, Occupational); 1332-21-4 (Asbestos)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1080/10408444.2016.1258391


  10 / 3973 MEDLINE  
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[PMID]:28213592
[Au] Autor:Dowman LM; McDonald CF; Hill CJ; Lee AL; Barker K; Boote C; Glaspole I; Goh NSL; Southcott AM; Burge AT; Gillies R; Martin A; Holland AE
[Ad] Endereço:Discipline of Physiotherapy, La Trobe University, Alfred Centre, Prahran, Victoria, Australia.
[Ti] Título:The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial.
[So] Source:Thorax;72(7):610-619, 2017 Jul.
[Is] ISSN:1468-3296
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Uncertainty exists regarding the clinical relevance of exercise training across the range of interstitial lung diseases (ILDs). OBJECTIVE: To establish the impact of exercise training in patients with ILDs of differing aetiology and severity. METHODS: 142 participants with ILD (61 idiopathic pulmonary fibrosis (IPF), 22 asbestosis, 23 connective tissue disease-related ILD (CTD-ILD) and 36 with other aetiologies) were randomised to either 8 weeks of supervised exercise training or usual care. Six-minute walk distance (6MWD), Chronic Respiratory Disease Questionnaire (CRDQ), St George Respiratory Questionnaire IPF-specific version (SGRQ-I) and modified Medical Research Council dyspnoea score were measured at baseline, 9 weeks and 6 months. MEASUREMENTS AND MAIN RESULTS: Exercise training significantly increased 6MWD (25 m, 95% CI 2 to 47 m) and health-related quality of life (CRDQ and SGRQ-I) in people with ILD. Larger improvements in 6MWD, CRDQ, SGRQ-I and dyspnoea occurred in asbestosis and IPF compared with CTD-ILD, but with few significant differences between subgroups. Benefits declined at 6 months except in CTD-ILD. Lower baseline 6MWD and worse baseline symptoms were associated with greater benefit in 6MWD and symptoms following training. Greater gains were seen in those whose exercise prescription was successfully progressed according to the protocol. At 6 months, sustained improvements in 6MWD and symptoms were associated with better baseline lung function and less pulmonary hypertension. CONCLUSIONS: Exercise training is effective in patients across the range of ILDs, with clinically meaningful benefits in asbestosis and IPF. Successful exercise progression maximises improvements and sustained treatment effects favour those with milder disease. TRIAL REGISTRATION NUMBER: Results, ACTRN12611000416998.
[Mh] Termos MeSH primário: Terapia por Exercício
Exercício/fisiologia
Doenças Pulmonares Intersticiais/fisiopatologia
Doenças Pulmonares Intersticiais/reabilitação
Condicionamento Físico Humano/fisiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Asbestose/fisiopatologia
Asbestose/reabilitação
Dispneia/etiologia
Feminino
Seres Humanos
Fibrose Pulmonar Idiopática/fisiopatologia
Fibrose Pulmonar Idiopática/reabilitação
Doenças Pulmonares Intersticiais/etiologia
Masculino
Meia-Idade
Qualidade de Vida
Método Simples-Cego
Inquéritos e Questionários
Fatores de Tempo
Teste de Caminhada
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE
[do] DOI:10.1136/thoraxjnl-2016-208638



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