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[PMID]:29446293
[Au] Autor:Beygel EA; Katamanova EV; Shayakhmetov SF; Ushakova OV; Pavlenko NA; Kuks AN; Voronin DA
[Ti] Título:[The impact of the long-term exposure of industrial aerosols on clinical and functional indices of the broncho-pulmonary system in aluminum smelter workers].
[So] Source:Gig Sanit;95(12):1160-3, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:It was found that the appearance of respiratory diseases among workers was established to be associated with the impact of aerosols with the complex chemical composition, exceeding corresponding MAC. Among respiratory diseases in workers there were detected predominantly chronic non-obstructive bronchitis - 59.15%, and chronic obstructive pulmonary disease (COPD) - in 35.2% of cases. In the analysis of spirometric indices of examined patients the vast majority (76.3%) of them showed disturbances of the bronchial patency of mild to moderate degree of the pronouncement. As a result of the implementation offlexible bronchoscopy there was established the presence of a diffuse lesion of bronchi with a predominance of subatrophic and atrophic processes in the mucosa. It was found that under the increase of the concentration of HF in the air of industrial premises the probability of bronchial obstruction and deterioration of the tracheobronchial patency in aluminum smelter workers was established to elevate.
[Mh] Termos MeSH primário: Poluentes Ocupacionais do Ar
Alumínio
Bronquite Crônica
Indústria Química
Doenças Profissionais
Doença Pulmonar Obstrutiva Crônica
[Mh] Termos MeSH secundário: Aerossóis/efeitos adversos
Aerossóis/análise
Aerossóis/química
Poluentes Ocupacionais do Ar/análise
Poluentes Ocupacionais do Ar/toxicidade
Alumínio/análise
Alumínio/química
Bronquite Crônica/epidemiologia
Bronquite Crônica/etiologia
Bronquite Crônica/prevenção & controle
Indústria Química/métodos
Indústria Química/normas
Seres Humanos
Masculino
Meia-Idade
Doenças Profissionais/epidemiologia
Doenças Profissionais/etiologia
Doenças Profissionais/prevenção & controle
Exposição Ocupacional/efeitos adversos
Exposição Ocupacional/análise
Exposição Ocupacional/prevenção & controle
Doença Pulmonar Obstrutiva Crônica/epidemiologia
Doença Pulmonar Obstrutiva Crônica/etiologia
Doença Pulmonar Obstrutiva Crônica/prevenção & controle
Sibéria/epidemiologia
Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aerosols); 0 (Air Pollutants, Occupational); CPD4NFA903 (Aluminum)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE


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[PMID]:29446284
[Au] Autor:Kudaeva IV; Dyakovich OA; Beygel EA; Masnavieva LB; Naumova OV; Budarina LA
[Ti] Título:[Clinical, biochemical and allergological indices characterizing occupational diseases of the bronchial and pulmonary system in employees at aluminium production].
[So] Source:Gig Sanit;95(12):1142-5, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:There are many harmful factors that possess a damaging impact on the body of employees at aluminum production. It leads to the development of bronchial asthma (BA), chronic nonobstructive bronchitis (CNB) and chronic obstructive pulmonary disease (COPD). The pathogenesis of these disorders, as well as sensitizing effect offluorine in the aluminum production is not fully understood. The purpose of this work was to study the characteristics of laboratory indices in patients with occupational diseases of the respiratory system. In workers of aluminum production with the diagnosis of occupational diseases of respiratory system (15 patients with a diagnosis of asthma, 30 CNB cases, 20 COPD patients) we evaluated the content of total protein, total cholesterol, high density lipoprotein cholesterol (HDLC), total calcium, phosphorus, ceruloplasmin, hematological indices and performed emigration of leukocytes braking test (TTEEL). Clinical and biochemical profile ofpersons with occupational asthma was characterized by a low level of total calcium and ceruloplasmin, a high concentration of phosphorus in the blood serum and inhibition of leukocyte emigration in the test with sodium fluoride. For aluminum production CNB workers characteristic active proatherogenic process was pronounced by a decrease in the HDLC level and an increase in atherogenic index; higher hematocrit value and concentration of erythrocytes, and more than 50% of cases of sensitization to the presence of sodium fluoride. COPD cases had occupational lower average concentration of hemoglobin in the erythrocyte, total protein in serum, as well as polymorphic variant response to sodium fluoride in the form of a depression and activation of leucocytes emigration.
[Mh] Termos MeSH primário: Poluentes Ocupacionais do Ar
Alumínio
Asma Ocupacional
Indústria Química
Doença Pulmonar Obstrutiva Crônica
[Mh] Termos MeSH secundário: Poluentes Ocupacionais do Ar/análise
Poluentes Ocupacionais do Ar/toxicidade
Alumínio/análise
Alumínio/toxicidade
Asma Ocupacional/sangue
Asma Ocupacional/diagnóstico
Asma Ocupacional/epidemiologia
Biomarcadores/análise
Indústria Química/métodos
Indústria Química/normas
Seres Humanos
Masculino
Meia-Idade
Exposição Ocupacional/efeitos adversos
Exposição Ocupacional/análise
Exposição Ocupacional/prevenção & controle
Saúde do Trabalhador/estatística & dados numéricos
Doença Pulmonar Obstrutiva Crônica/sangue
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/epidemiologia
Doença Pulmonar Obstrutiva Crônica/etiologia
Hipersensibilidade Respiratória/sangue
Hipersensibilidade Respiratória/induzido quimicamente
Hipersensibilidade Respiratória/diagnóstico
Sibéria/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Air Pollutants, Occupational); 0 (Biomarkers); CPD4NFA903 (Aluminum)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE


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[PMID]:28459622
[Au] Autor:Martinez CH; Murray S; Barr RG; Bleecker E; Bowler RP; Christenson SA; Comellas AP; Cooper CB; Couper D; Criner GJ; Curtis JL; Dransfield MT; Hansel NN; Hoffman EA; Kanner RE; Kleerup E; Krishnan JA; Lazarus SC; Leidy NK; O'Neal W; Martinez FJ; Paine R; Rennard SI; Tashkin DP; Woodruff PG; Han MK; Subpopulations and Intermediate Outcome Measures in COPD Study Investigators
[Ad] Endereço:1 Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan.
[Ti] Título:Respiratory Symptoms Items from the COPD Assessment Test Identify Ever-Smokers with Preserved Lung Function at Higher Risk for Poor Respiratory Outcomes. An Analysis of the Subpopulations and Intermediate Outcome Measures in COPD Study Cohort.
[So] Source:Ann Am Thorac Soc;14(5):636-642, 2017 May.
[Is] ISSN:2325-6621
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Ever-smokers without airflow obstruction scores greater than or equal to 10 on the COPD Assessment Test (CAT) still have frequent acute respiratory disease events (exacerbation-like), impaired exercise capacity, and imaging abnormalities. Identification of these subjects could provide new opportunities for targeted interventions. OBJECTIVES: We hypothesized that the four respiratory-related items of the CAT might be useful for identifying such individuals, with discriminative ability similar to CAT, which is an eight-item questionnaire used to assess chronic obstructive pulmonary disease impact, including nonrespiratory questions, with scores ranging from 0 to 40. METHODS: We evaluated ever-smoker participants in the Subpopulations and Intermediate Outcomes in COPD Study without airflow obstruction (FEV /FVC ≥0.70; FVC above the lower limit of normal). Using the area under the receiver operating characteristic curve, we compared responses to both CAT and the respiratory symptom-related CAT items (cough, phlegm, chest tightness, and breathlessness) and their associations with longitudinal exacerbations. We tested agreement between the two strategies (κ statistic), and we compared demographics, lung function, and symptoms among subjects identified as having high symptoms by each strategy. RESULTS: Among 880 ever-smokers with normal lung function (mean age, 61 yr; 52% women) and using a CAT cutpoint greater than or equal to 10, we classified 51.8% of individuals as having high symptoms, 15.3% of whom experienced at least one exacerbation during 1-year follow-up. After testing sensitivity and specificity of different scores for the first four questions to predict any 1-year follow-up exacerbation, we selected cutpoints of 0-6 as representing a low burden of symptoms versus scores of 7 or higher as representing a high burden of symptoms for all subsequent comparisons. The four respiratory-related items with cutpoint greater than or equal to 7 selected 45.8% participants, 15.6% of whom experienced at least one exacerbation during follow-up. The two strategies largely identified the same individuals (agreement, 88.5%; κ = 0.77; P < 0.001), and the proportions of high-symptoms subjects who had severe dyspnea were similar between CAT and the first four CAT questions (25.9% and 26.8%, respectively), as were the proportions reporting impaired quality of life (66.9% and 70.5%, respectively) and short walking distance (22.4% and 23.1%, respectively). There was no difference in area under the receiver operating characteristic curve to predict 1-year follow-up exacerbations (CAT score ≥10, 0.66; vs. four respiratory items from CAT ≥7 score, 0.65; P = 0.69). Subjects identified by either method also had more depression/anxiety symptoms, poor sleep quality, and greater fatigue. CONCLUSIONS: Four CAT items on respiratory symptoms identified high-risk symptomatic ever-smokers with preserved spirometry as well as the CAT did. These data suggest that simpler strategies can be developed to identify these high-risk individuals in primary care.
[Mh] Termos MeSH primário: Progressão da Doença
Pulmão/fisiopatologia
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Fumar/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Biomarcadores
Estudos Transversais
Feminino
Volume Expiratório Forçado
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Prospectivos
Qualidade de Vida
Curva ROC
Índice de Gravidade de Doença
Fumar/efeitos adversos
Espirometria
Inquéritos e Questionários
Estados Unidos
Capacidade Vital
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1513/AnnalsATS.201610-815OC


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[PMID]:28459623
[Au] Autor:Morgan AD; Sharma C; Rothnie KJ; Potts J; Smeeth L; Quint JK
[Ad] Endereço:1 Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London.
[Ti] Título:Chronic Obstructive Pulmonary Disease and the Risk of Stroke.
[So] Source:Ann Am Thorac Soc;14(5):754-765, 2017 May.
[Is] ISSN:2325-6621
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for cardiovascular diseases such as myocardial infarction. The role of COPD in cerebrovascular disease is, however, less certain. Although earlier studies have suggested that the risk for stroke is also increased in COPD, more recent investigations have generated mixed results. OBJECTIVES: The primary objective of our review was to quantify the magnitude of the association between COPD and stroke. We also sought to clarify the nature of the relationship between COPD and stroke by investigating whether the risk of stroke in COPD varies with age, sex, smoking history, and/or type of stroke and whether stroke risk is modified in particular COPD phenotypes. RESULTS: The MEDLINE and EMBASE databases were searched in May 2016 to identify articles that compared stroke outcomes in people with and without COPD. Studies were grouped by study design to distinguish those that reported prevalence of stroke (cross-sectional studies) from those that estimated incidence (cohort or case-control studies). In addition, studies were stratified according to study population characteristics, the nature of COPD case definitions, and adjustment for confounding (smoking). Heterogeneity was assessed using the I statistic. We identified 5,493 studies, of which 30 met our predefined inclusion criteria. Of the 25 studies that reported prevalence ratios, 11 also estimated prevalence odds ratios. The level of heterogeneity among the included cross-sectional studies did not permit the calculation of pooled ratios, save for a group of four studies that estimated prevalence odds ratios adjusted for smoking (prevalence odds ratio, 1.51; 95% confidence interval, 1.09-2.09; I = 45%). All 11 studies that estimated relative risk for nonfatal incident stroke reported increased risk in COPD. Adjustment for smoking invariably reduced the magnitude of the associations. CONCLUSIONS: Although both prevalence and incidence of stroke are increased in people with COPD, the weight of evidence does not support the hypothesis that COPD is an independent risk factor for stroke. The possibility remains that COPD is causal in certain subsets of patients with COPD and for certain stroke subtypes.
[Mh] Termos MeSH primário: Doença Pulmonar Obstrutiva Crônica/complicações
Fumar/epidemiologia
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Seres Humanos
Incidência
Medição de Risco
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1513/AnnalsATS.201611-932SR


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[PMID]:28457921
[Au] Autor:Budding K; Rossato M; van de Graaf EA; Kwakkel-van Erp JM; Radstake TRDJ; Otten HG
[Ad] Endereço:Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: k.budding@umcutrecht.nl.
[Ti] Título:Serum miRNAs as potential biomarkers for the bronchiolitis obliterans syndrome after lung transplantation.
[So] Source:Transpl Immunol;42:1-4, 2017 06.
[Is] ISSN:1878-5492
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Lung transplantation (LTx) is the last treatment for patients suffering from end-stage lung diseases. Survival post-LTx is hampered by the development of the bronchiolitis obliterans syndrome (BOS) and diagnosis is often late. Given the urgent clinical need to recognize BOS patients at an early stage, we analyzed circulating miRNAs to identify possible stratification markers for BOS development post-transplantation. Therefore, pro-fibrotic (miR-21, miR-155), anti-fibrotic (miR-29a) and fibrosis-unrelated (miR-103, miR-191) miRNAs were analyzed in serum of end-stage lung disease patients and during LTx follow-up. Significant elevated levels of serum miRNAs were observed for all investigated miRNAs in both chronic obstructive pulmonary disease and interstitial lung disease patients compared to healthy controls. The same miRNAs were also significantly increased in the serum of BOS+ vs. BOS- patients. Most importantly, miR-21, miR-29a, miR-103, and miR-191 levels were significantly higher in BOS+ patients prior to clinical BOS diagnosis. We demonstrated that a selected group of miRNAs investigated is elevated in end-stage lung disease and BOS+ patients, prior to clinical BOS diagnosis. Even if further research is expedient on the prognostic value of circulating miRNAs in BOS and lung conditions in general, these results strongly suggest that circulating miRNAs could be used as potential biomarkers for BOS development.
[Mh] Termos MeSH primário: Bronquiolite Obliterante/sangue
Transplante de Pulmão
MicroRNAs/sangue
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/sangue
Estudos Retrospectivos
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (MicroRNAs)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28468749
[Au] Autor:Farmer A; Williams V; Velardo C; Shah SA; Yu LM; Rutter H; Jones L; Williams N; Heneghan C; Price J; Hardinge M; Tarassenko L
[Ad] Endereço:Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
[Ti] Título:Self-Management Support Using a Digital Health System Compared With Usual Care for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial.
[So] Source:J Med Internet Res;19(5):e144, 2017 May 03.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a randomized controlled trial of a digital health system supporting clinical care through monitoring and self-management support in community-based patients with moderate to very severe chronic obstructive pulmonary disease (COPD). OBJECTIVE: The aim of this study was to determine the efficacy of a fully automated Internet-linked, tablet computer-based system of monitoring and self-management support (EDGE' sElf-management anD support proGrammE) in improving quality of life and clinical outcomes. METHODS: We compared daily use of EDGE with usual care for 12 months. The primary outcome was COPD-specific health status measured with the St George's Respiratory Questionnaire for COPD (SGRQ-C). RESULTS: A total of 166 patients were randomized (110 EDGE, 56 usual care). All patients were included in an intention to treat analysis. The estimated difference in SGRQ-C at 12 months (EDGE-usual care) was -1.7 with a 95% CI of -6.6 to 3.2 (P=.49). The relative risk of hospital admission for EDGE was 0.83 (0.56-1.24, P=.37) compared with usual care. Generic health status (EQ-5D, EuroQol 5-Dimension Questionnaire) between the groups differed significantly with better health status for the EDGE group (0.076, 95% CI 0.008-0.14, P=.03). The median number of visits to general practitioners for EDGE versus usual care were 4 versus 5.5 (P=.06) and to practice nurses were 1.5 versus 2.5 (P=.03), respectively. CONCLUSIONS: The EDGE clinical trial does not provide evidence for an effect on COPD-specific health status in comparison with usual care, despite uptake of the intervention. However, there appears to be an overall benefit in generic health status; and the effect sizes for improved depression score, reductions in hospital admissions, and general practice visits warrants further evaluation and could make an important contribution to supporting people with COPD. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 40367841; http://www.isrctn.com/ISRCTN40367841 (Archived by WebCite at http://www.webcitation.org/6pmfIJ9KK).
[Mh] Termos MeSH primário: Doença Pulmonar Obstrutiva Crônica/terapia
Autocuidado/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Nível de Saúde
Seres Humanos
Masculino
Qualidade de Vida
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.7116


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[PMID]:29253921
[Au] Autor:McNamara RJ; Epsley C; Coren E; McKeough ZJ
[Ad] Endereço:Departments of Physiotherapy and Respiratory Medicine, Prince of Wales Hospital, Barker Street, Randwick, NSW, Australia, 2031.
[Ti] Título:Singing for adults with chronic obstructive pulmonary disease (COPD).
[So] Source:Cochrane Database Syst Rev;12:CD012296, 2017 Dec 19.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Singing is a complex physical activity dependent on the use of the lungs for air supply to regulate airflow and create large lung volumes. In singing, exhalation is active and requires active diaphragm contraction and good posture. Chronic obstructive pulmonary disease (COPD) is a progressive, chronic lung disease characterised by airflow obstruction. Singing is an activity with potential to improve health outcomes in people with COPD. OBJECTIVES: To determine the effect of singing on health-related quality of life and dyspnoea in people with COPD. SEARCH METHODS: We identified trials from the Cochrane Airways Specialised Register, ClinicalTrials.gov, the World Health Organization trials portal and PEDro, from their inception to August 2017. We also reviewed reference lists of all primary studies and review articles for additional references. SELECTION CRITERIA: We included randomised controlled trials in people with stable COPD, in which structured supervised singing training of at least four sessions over four weeks' total duration was performed. The singing could be performed individually or as part of a group (choir) facilitated by a singing leader. Studies were included if they compared: 1) singing versus no intervention (usual care) or another control intervention; or 2) singing plus pulmonary rehabilitation versus pulmonary rehabilitation alone. DATA COLLECTION AND ANALYSIS: Two review authors independently screened and selected trials for inclusion, extracted outcome data and assessed risk of bias. We contacted authors of trials for missing data. We calculated mean differences (MDs) using a random-effects model. We were only able to analyse data for the comparison of singing versus no intervention or a control group. MAIN RESULTS: Three studies (a total of 112 participants) were included. All studies randomised participants to a singing group or a control group. The comparison groups included a film workshop, handcraft work, and no intervention. The frequency of the singing intervention in the studies ranged from 1 to 2 times a week over a 6 to 24 week period. The duration of each singing session was 60 minutes.All studies included participants diagnosed with COPD with a mean age ranging from 67 to 72 years and a mean forced expiratory volume in one second (FEV ) ranging from 37% to 64% of predicted values. The sample size of included studies was small (33 to 43 participants) and overall study quality was low to very low. Blinding of personnel and participants was not possible due to the physical nature of the intervention, and selection and reporting bias was present in two studies.For the primary outcome of health-related quality of life, there was no statistically significant improvement in the St George's Respiratory Questionnaire total score (mean difference (MD) -0.82, 95% confidence interval (CI) -4.67 to 3.02, 2 studies, n = 58, low-quality evidence). However, there was a statistically significant improvement in the SF-36 Physical Component Summary (PCS) score favouring the singing group (MD 12.64, 95% CI 5.50 to 19.77, 2 studies, n = 52, low-quality evidence). Only one study reported results for the other primary outcome of dyspnoea, in which the mean improvement in Baseline Dyspnoea Index (BDI) score favouring the singing group was not statistically significant (MD 0.40, 95% CI -0.65 to 1.45, 1 study, n = 30, very low-quality evidence).No studies examined any long-term outcomes and no adverse events or side effects were reported. AUTHORS' CONCLUSIONS: There is low to very low-quality evidence that singing is safe for people with COPD and improves physical health (as measured by the SF-36 physical component score), but not dyspnoea or respiratory-specific quality of life. The evidence is limited due to the low number of studies and the small sample size of each study. No evidence exists examining the long-term effect of singing for people with COPD. The absence of studies examining singing performed in conjunction with pulmonary rehabilitation precludes the formulation of conclusions about the effects of singing in this context. More randomised controlled trials with larger sample sizes and long-term follow-up, and trials examining the effect of singing in addition to pulmonary rehabilitation, are required to determine the effect of singing on health-related quality of life and dyspnoea in people with COPD.
[Mh] Termos MeSH primário: Doença Pulmonar Obstrutiva Crônica/terapia
Qualidade de Vida
Canto/fisiologia
[Mh] Termos MeSH secundário: Idoso
Dispneia/terapia
Seres Humanos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012296.pub2


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[PMID]:28461224
[Au] Autor:Li X; Obeidat M; Zhou G; Leung JM; Tashkin D; Wise R; Connett J; Joubert P; Bossé Y; van den Berge M; Brandsma CA; Nickle DC; Hao K; Paré PD; Sin DD
[Ad] Endereço:UBC Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada.
[Ti] Título:Responsiveness to Ipratropium Bromide in Male and Female Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease.
[So] Source:EBioMedicine;19:139-145, 2017 May.
[Is] ISSN:2352-3964
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Although the prevalence of chronic obstructive pulmonary disease (COPD) is similar between men and women, current evidence used to support bronchodilator therapy has been generated in therapeutic trials that have predominately enrolled male patients. Here, we determined whether there is any significant sex-related differences in FEV responses to ipratropium bromide. METHODS: Data from the Lung Health Study (n=5887; 37% females) were used to determine changes in FEV with ipratropium or placebo in male and female subjects with mild to moderate COPD over 5years. Lung Expression Quantitative Trait Loci (eQTL) dataset was used to determine whether there were any sex-related differences in gene expression for muscarinic (M2 and M3) receptors in lungs of male and female patients. RESULTS: After 4months, ipratropium therapy increased FEV by 6.0% in female and 2.9% in male subjects from baseline values (p=2.42×10 ). This effect was modified by body mass index (BMI) such that the biggest improvements in FEV with ipratropium were observed in thin female subjects (p for BMI∗sex interaction=0.044). The sex-related changes in FEV related to ipratropium persisted for 2years (p=0.0134). Female compared with male lungs had greater gene expression for M3 relative to M2 receptors (p=6.86×10 ). CONCLUSION: Ipratropium induces a larger bronchodilator response in female than in male patients and the benefits are particularly notable in non-obese females. Female lungs have greater gene expression for the M3 muscarinic receptor relative to M2 receptors than male lungs. Female patients are thus more likely to benefit from ipratropium than male COPD patients.
[Mh] Termos MeSH primário: Broncodilatadores/uso terapêutico
Antagonistas Colinérgicos/uso terapêutico
Ipratrópio/uso terapêutico
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Índice de Massa Corporal
Feminino
Volume Expiratório Forçado
Expressão Gênica
Seres Humanos
Masculino
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/genética
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Receptor Muscarínico M2/genética
Receptor Muscarínico M3/genética
Caracteres Sexuais
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Cholinergic Antagonists); 0 (Receptor, Muscarinic M2); 0 (Receptor, Muscarinic M3); GR88G0I6UL (Ipratropium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Texto completo
[PMID]:28449709
[Au] Autor:Sandelowsky H; Krakau I; Modin S; Ställberg B; Nager A
[Ad] Endereço:Division of Family Medicine and Primary Care, NVS, Karolinska Institutet, Alfred Nobels Allé 23, D2, Huddinge, Stockholm, 14183, Sweden. hanna.sandelowsky@ki.se.
[Ti] Título:Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial.
[So] Source:Trials;18(1):197, 2017 Apr 27.
[Is] ISSN:1745-6215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. It is often undiagnosed and insufficiently managed. Effective forms of continuing medical education (CME) for primary care physicians (PCPs) are necessary to ensure the implementation of guidelines in clinical practice and, thus, improve patients' health. METHODS: In this study, we will measure the effects of CME by Case Method and compare them against those of traditional lectures and no CME at all through an unblinded, cluster randomised controlled trial (CRCT). Thirty-three primary health care centres (PHCCs) in Stockholm, Sweden, with a total of 180 PCPs will be involved. Twenty-two primary PHCCs, will be cluster-randomised into: an intervention group who will receive CME by Case Method (n = 11) and a control group who will receive traditional lectures (n = 11). The remaining PHCCs (n = 11) will be a reference group and will receive no CME. From the intervention and control groups, 460 randomly selected patients with COPD in GOLD stages 2 and 3 will participate, while no patients will be recruited from the reference group. For the patients, smoking status, actual treatment and urgent visits to a health provider due to airway problems will be registered. For the PCPs, professional competence (i.e. knowledge and management skills) in COPD, will be measured using a questionnaire based on current guidelines and guideline implementation problems in clinical practice which has previously been described by the authors. Data will be collected at baseline and at follow-up, which will be after 1.5 years for the patients, and 1 year for the PCPs. Statistical methods for individual-level and cluster-level analyses will be used. DISCUSSION: COPD is considered a particularly complex clinical challenge involving managing multimorbidity, symptom adaptation, and lifestyle problematisation. Case Method in CME for PCPs may contribute to a better understanding of the impact of COPD on patients' lives and, thus, improve their management of it. The present study is expected to contribute scientific knowledge about indicators for an effective CME in COPD that is tailor-made to primary care physicians. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02213809 . Registered on 10 August 2014. Protocol version: Issue date: May 2014.
[Mh] Termos MeSH primário: Protocolos Clínicos
Educação Médica Continuada/métodos
Médicos de Atenção Primária/educação
Doença Pulmonar Obstrutiva Crônica/diagnóstico
[Mh] Termos MeSH secundário: Seres Humanos
Avaliação de Resultados (Cuidados de Saúde)
Tamanho da Amostra
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s13063-017-1889-4


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Fotocópia
[PMID]:29428028
[Au] Autor:Bigatao AM; Herbella FAM; Del Grande LM; Nascimento OA; Jardim JR; Patti MG
[Ti] Título:Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease.
[So] Source:Am Surg;84(1):51-55, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD - groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD+. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.
[Mh] Termos MeSH primário: Monitoramento do pH Esofágico
Refluxo Gastroesofágico/complicações
Doença Pulmonar Obstrutiva Crônica/complicações
[Mh] Termos MeSH secundário: Idoso
Índice de Massa Corporal
Feminino
Refluxo Gastroesofágico/diagnóstico
Refluxo Gastroesofágico/fisiopatologia
Seres Humanos
Masculino
Manometria
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Fatores de Risco
Índice de Gravidade de Doença
Fumar/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE



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