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[PMID]:27776225
[Au] Autor:Matt F; Cole-Hunter T; Donaire-Gonzalez D; Kubesch N; Martínez D; Carrasco-Turigas G; Nieuwenhuijsen M
[Ad] Endereço:ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Rudolf Boehm Institute of Pharmacology and Toxicology, PGS Toxicology and Environmental Protection, University of Leipzig, Leipzig, Germany; Biological Safety & Risk Management, Institute Straumann AG, Basel,
[Ti] Título:Acute respiratory response to traffic-related air pollution during physical activity performance.
[So] Source:Environ Int;97:45-55, 2016 12.
[Is] ISSN:1873-6750
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Physical activity (PA) has beneficial, whereas exposure to traffic related air pollution (TRAP) has adverse, respiratory effects. Few studies, however, have examined if the acute effects of TRAP upon respiratory outcomes are modified depending on the level of PA. OBJECTIVES: The aim of our study was to disentangle acute effects of TRAP and PA upon respiratory outcomes and assess the impact of participants TRAP pre-exposure. METHODS: We conducted a real-world crossover study with repeated measures of 30 healthy adults. Participants completed four 2-h exposure scenarios that included either rest or intermittent exercise in high- and low-traffic environments. Measures of respiratory function were collected at three time points. Pre-exposure to TRAP was ascertained from land-use-modeled address-attributed values. Mixed-effects models were used to estimate the impact of TRAP and PA on respiratory measures as well as potential effect modifications. RESULTS: We found that PA was associated with a statistically significant increases of FEV (48.5mL, p=0.02), FEV /FVC (0.64%, p=0.005) and FEF (97.8mL, p=0.02). An increase in exposure to one unit (1µg/m ) of PM was associated with a decrease in FEV (-1.31mL, p=0.02) and FVC (-1.71mL, p=0.01), respectively. On the other hand, for an otherwise equivalent exposure an increase of PA by one unit (1%Heart rate max) was found to reduce the immediate negative effects of particulate matter (PM) upon PEF (PM , 0.02L/min, p=0.047; PM , 0.02L/min p=0.02; PM , 0.03L/min, p=0.02) and the several hours delayed negative effects of PM upon FVC (PM , 0.11mL, p=0.02). The negative impact of exposure to TRAP constituents on FEV /FVC and PEF was attenuated in those participants with higher TRAP pre-exposure levels. CONCLUSIONS: Our results suggest that associations between various pollutant exposures and respiratory measures are modified by the level of PA during exposure and TRAP pre-exposure of participants.
[Mh] Termos MeSH primário: Poluentes Atmosféricos/toxicidade
Poluição do Ar/efeitos adversos
Exercício
Material Particulado/toxicidade
Respiração/efeitos dos fármacos
Emissões de Veículos/toxicidade
[Mh] Termos MeSH secundário: Adulto
Poluentes Atmosféricos/análise
Poluição do Ar/análise
Estudos Cross-Over
Feminino
Frequência Cardíaca/efeitos dos fármacos
Seres Humanos
Masculino
Meia-Idade
Modelos Teóricos
Veículos Automotores
Material Particulado/análise
Testes de Função Respiratória
Emissões de Veículos/análise
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Air Pollutants); 0 (Particulate Matter); 0 (Vehicle Emissions)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29505522
[Au] Autor:Zhang BJ; Tian HT; Li HO; Meng J
[Ad] Endereço:Department of Anesthesia, Jining No. 1 People's Hospital, Jining City, Shandong Province, China.
[Ti] Título:The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery.
[So] Source:Medicine (Baltimore);97(1):e9500, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of the present study was to explore the effects of different one-lung ventilation (OLV) modes on lung function in elderly patients undergoing esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA Grades I-II, with OLV indications) undergoing elective surgery were recruited in the study. Patients were randomly divided into 4 groups (n = 45). In Group A, patients received low tidal volume (VT < 8 mL/kg) + pressure controlled ventilation (PCV), low tidal volume (VT < 8 mL/kg) + volume-controlled ventilation (VCV) in Group B, high tidal volume (VT ≥ 8 mL/kg) + PCV in Group C and high tidal volume (VT ≥ 8 mL/kg) + VCV in Group D. Two-lung ventilation involved routine tidal volume (8-10 mL/kg) at a frequency of 12 to 18 times/min, and VCV mode. Clinical efficacy among 4 groups was compared. The partial pressure of end-tidal carbon dioxide (PetCO2) did not significantly differ among 4 groups (all P > .05), and the oxygenation index and SO2 in Group A were significantly higher than in the other groups (P < .05). The PetCO2, peak airway pressure (Ppeak), platform airway pressure (Pplat), and mean airway pressure (Pmean) in Group A were significantly lower than those in the other groups (all P < .05). However, airway resistance (Raw) among 4 groups did not significantly differ (all P > .05). The incidence of pulmonary infection, anastomotic fistula, ventilator-induced lung injury, lung dysfunction, difficulty weaning from mechanical ventilation, and multiple organ dysfunction in Groups A and B were lower than that in Groups C and D (all P < .05). The expression levels of IL-6, tumor necrosis factor-α, and C-reactive protein in lavage fluid in Group A were significantly lower than those in the other groups (all P < .05). OLV with low tidal volume (VT < 8 mL/kg) + PCV (5 cmH2O PEEP) improved lung function and mitigated inflammatory responses in elderly patients undergoing esophageal cancer surgery.
[Mh] Termos MeSH primário: Neoplasias Esofágicas/cirurgia
Ventilação Monopulmonar/métodos
[Mh] Termos MeSH secundário: Idoso
Líquido da Lavagem Broncoalveolar/química
Proteína C-Reativa/análise
Feminino
Seres Humanos
Interleucina-6/análise
Masculino
Meia-Idade
Testes de Função Respiratória
Fator de Necrose Tumoral alfa/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (IL6 protein, human); 0 (Interleukin-6); 0 (Tumor Necrosis Factor-alpha); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009500


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[PMID]:29377954
[Au] Autor:Khirfan G; Naal T; Abuhalimeh B; Newman J; Heresi GA; Dweik RA; Tonelli AR
[Ad] Endereço:Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, United States of America.
[Ti] Título:Hypoxemia in patients with idiopathic or heritable pulmonary arterial hypertension.
[So] Source:PLoS One;13(1):e0191869, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The prevalence and prognostic implications of hypoxemia either at rest or during six-minute walk test (6MWT) in patients with idiopathic or heritable pulmonary arterial hypertension (IPAH or HPAH) have not been systemically studied. OBJECTIVES: We sought to determine the prevalence, phenotypic and prognostic implications of hypoxemia in patients with IPAH and HPAH. METHODS: Patients with IPAH or HPAH were identified from the Cleveland Clinic Pulmonary Hypertension Registry. Pulse oximetry (SpO2) at rest and during 6MWT was used to define hypoxemia at rest or during activities when measurements were lower than 90%, respectively. RESULTS: A total of 292 patients (age 50.6 ± 18.0 years, 73% females) with IPAH (88%) and HPAH (12%) were included. Of them, 143 (49%) had SpO2 >90% at rest and during 6MWT, 89 (31%) subjects had hypoxemia during 6MWT and 60 (20%) had hypoxemia at rest. Patients with hypoxemia had older age, greater body mass index, higher prevalence of cardiovascular risk factors, worse functional capacity and pulmonary function tests but less severe pre-capillary pulmonary hypertension. Individuals with hypoxemia either at rest or during the initial 6MWT had worse long-term survival when compared to subjects without hypoxemia, even when adjusting for a great number of potential confounders. (HR: 2.5 (95% CI: 1.54-3.98)). CONCLUSIONS: Hypoxemia in patients with IPAH and HPAH is associated with more comorbidities, less severe pre-capillary pulmonary hypertension and worse survival.
[Mh] Termos MeSH primário: Hipertensão Pulmonar/complicações
Hipóxia/complicações
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Hipertensão Pulmonar/genética
Hipertensão Pulmonar/fisiopatologia
Hipóxia/fisiopatologia
Masculino
Meia-Idade
Oximetria
Testes de Função Respiratória
Estudos Retrospectivos
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[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:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191869


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[PMID]:29203758
[Au] Autor:Stefanski M; Brulinski K; Stefanska M
[Ad] Endereço:Oddzial Chirurgii Klatki Piersiowej, Centrum Pulmonologii I Torakochirurgii, Bystra, Polska.
[Ti] Título:[Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (dipnech) - an overview of the cases diagnosed at the department of thoracic surgery in the years 2010-2014].
[So] Source:Wiad Lek;70(5):1005-1012, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:INTRODUCTION: Pulmonary neuroendocrine cells (PNEC) are present in the normal lungs with the incidence of 1 in 2500 epithelial cells. They usually proliferate in the presence of reactive processes related to inflammation and fibrosis of the lung parenchyma. The division of pulmonary neuroendocrine cell hyperplasia proposed by Travis et al. additionally distinguished diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) or proliferation that occurs in people without reactive hyperplasia risk factors. The confirmation of the DIPNECH diagnosis requires staining of biopsy specimens using the immunohistochemical technique for neuroendocrine markers. AIM: The aim of this study is to overview the cases of 5 patients in whom the histopathological DIPNECH diagnosis was made in the process of invasive diagnostics performed at the Department of Thoracic Surgery. The aim of the study is to evaluate typical clinical, functional, radiological and histopathological features of this rare disease syndrome. MATERIAL AND METHODS: In the period from April 2010 to June 2014, five patients with lesions in the lungs were subjected to invasive diagnostics. Histopathological and immunohistochemical examinations of the collected specimens were used to make the DIPNECH diagnosis in these patients. The natural history of the disease was traced based on a 5-year follow-up in one of the patients. In addition, we analyzed the literature with regard to the described cases. CONCLUSIONS: Thanks to the early diagnosis of non-specific lesions in the lungs, typical carcinoid which develops on the basis of discussed DIPNECH, was found in the resected material in two out of five operated patients. The accurate diagnosis of DIPNECH allows for the implementation of appropriate treatment and channels further management of the patient into the right direction.
[Mh] Termos MeSH primário: Hiperplasia/diagnóstico por imagem
Hiperplasia/patologia
Pneumopatias/diagnóstico por imagem
Pneumopatias/patologia
Células Neuroendócrinas/patologia
[Mh] Termos MeSH secundário: Idoso
Proliferação Celular
Feminino
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Testes de Função Respiratória
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[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:171206
[St] Status:MEDLINE


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[PMID]:28453808
[Au] Autor:Kobayashi N; Kobayashi K; Kikuchi S; Goto Y; Ichimura H; Endo K; Sato Y
[Ad] Endereço:Department of General Thoracic Surgery, Tsukuba University Hospital, Tsukuba, Ibaraki, Japan.
[Ti] Título:Long-term pulmonary function after surgery for lung cancer.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):727-732, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Many patients with lung cancer have been cured by surgical intervention. However, the long-term effects of lung resection on pulmonary function are unclear. Therefore, we investigated long-term pulmonary function after surgery. METHODS: We retrospectively reviewed the medical records of patients who underwent surgery for lung cancer between 2001 and 2009. A total of 445 patients who had survived more than 5 years since the surgery were included. The patients were divided into lobectomy, segmentectomy and partial resection groups. The time-dependent changes in pulmonary function were investigated. RESULTS: The percentages of the vital capacity and forced expiratory volume in 1 second (FEV 1 ) at postoperative year (POY) 1 vs preoperative values were 92.9 ± 11.1% and 91.3 ± 13.0% in the lobectomy group, 95.9 ± 9.0% and 93.8 ± 10.5% in the segmentectomy group and 97.8 ± 7.3% and 98.1 ± 8.3% in the partial resection group, respectively. The values in the lobectomy group were significantly lower than those in the segmentectomy and partial resection groups. The percentages of vital capacity and FEV 1 at POY 5 vs preoperative values were 90.0 ± 11.5% and 86.2 ± 11.9% in the lobectomy group, 93.4 ± 9.8% and 91.1 ± 9.8% in the segmentectomy group and 94.3 ± 8.8% and 94.0 ± 8.0% in the partial resection group, respectively. The decrease in the rates from POY 1 to POY 5 were not significantly different among the procedures. CONCLUSIONS: Pulmonary function declined with pulmonary resection. After the patient recovered from the operation, pulmonary function decreased with time regardless of the surgical procedure.
[Mh] Termos MeSH primário: Volume Expiratório Forçado/fisiologia
Neoplasias Pulmonares/cirurgia
Pulmão/fisiopatologia
Pneumonectomia/métodos
Capacidade Vital/fisiologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Pulmão/cirurgia
Neoplasias Pulmonares/fisiopatologia
Masculino
Período Pós-Operatório
Testes de Função Respiratória
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw414


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[PMID]:27773665
[Au] Autor:Kunisaki KM; Niewoehner DE; Collins G; Aagaard B; Atako NB; Bakowska E; Clarke A; Corbelli GM; Ekong E; Emery S; Finley EB; Florence E; Infante RM; Kityo CM; Madero JS; Nixon DE; Tedaldi E; Vestbo J; Wood R; Connett JE; INSIGHT START Pulmonary Substudy Group
[Ad] Endereço:Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; University of Minnesota, Minneapolis, MN, USA. Electronic address: kunis001@umn.edu.
[Ti] Título:Pulmonary effects of immediate versus deferred antiretroviral therapy in HIV-positive individuals: a nested substudy within the multicentre, international, randomised, controlled Strategic Timing of Antiretroviral Treatment (START) trial.
[So] Source:Lancet Respir Med;4(12):980-989, 2016 12.
[Is] ISSN:2213-2619
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Observational data have been conflicted regarding the potential role of HIV antiretroviral therapy (ART) as a causative factor for, or protective factor against, COPD. We therefore aimed to investigate the effect of immediate versus deferred ART on decline in lung function in HIV-positive individuals. METHODS: We did a nested substudy within the randomised, controlled Strategic Timing of Antiretroviral Treatment (START) trial at 80 sites in multiple settings in 20 high-income and low-to-middle-income countries. Participants were HIV-1 infected individuals aged at least 25 years, naive to ART, with CD4 T-cell counts of more than 500 per µL, not receiving treatment for asthma, and without recent respiratory infections (baseline COPD was not an exclusion criterion). Participants were randomly assigned to receive ART (an approved drug combination derived from US Department of Health and Human Services guidelines) either immediately, or deferred until CD4 T-cell counts decreased to 350 per µL or AIDS developed. The randomisation was determined by participation in the parent START study, and was not specific to the substudy. Because of the nature of our study, site investigators and participants were not masked to the treatment group assignment; however, the assessors who reviewed the outcomes were masked to the treatment group. The primary outcome was the annual rate of decline in lung function, expressed as the FEV slope in mL/year; spirometry was done annually during follow-up for up to 5 years. We analysed data on an intention-to-treat basis, and planned separate analyses in smokers and non-smokers because of the known effects of smoking on FEV decline. The substudy was registered at ClinicalTrials.gov number NCT01797367. FINDINGS: Between March 11, 2010, and Aug 23, 2013, we enrolled 1026 participants to our substudy, who were then randomly assigned to either immediate (n=518) or deferred (n=508) ART. Median baseline characteristics included age 36 years (IQR 30-44), CD4 T-cell count 648 per µL (583-767), and HIV plasma viral load 4·2 log copies per mL (3·5-4·7). 29% were female and 28% were current smokers. Median follow-up time was 2·0 years (IQR 1·9-3·0). We noted no differences in FEV slopes between the immediate and deferred ART groups either in smokers (difference of -3·3 mL/year, 95% CI -38·8 to 32·2; p=0·86) or in non-smokers (difference of -5·6 mL/year, -29·4 to 18·3; p=0·65) or in pooled analyses adjusted for smoking status at each study visit (difference of -5·2 mL/year, -25·1 to 14·6; p=0·61). INTERPRETATION: The timing of ART initiation has no major short-term effect on rate of lung function decline in HIV-positive individuals who are naive to ART, with CD4 T-cell counts of more than 500 per µL. In light of updated WHO recommendations that all HIV-positive individuals should be treated with ART, regardless of their CD4 T-cell count, our results suggest an absence of significant pulmonary harm with such an approach. FUNDING: US National Heart Lung and Blood Institute, US National Institute of Allergy and Infectious Diseases, Division of AIDS, Agence Nationale de Recherches sur le SIDA et les Hipatites Virales (France), Australian National Health and Medical Research Council, Danish National Research Foundation, European AIDS Treatment Network, German Ministry of Education and Research, UK Medical Research Council and National Institute for Health Research, and US Veterans Health Administration Office of Research and Development.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Soropositividade para HIV/tratamento farmacológico
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Adulto
Contagem de Linfócito CD4
Linfócitos T CD4-Positivos/virologia
Esquema de Medicação
Feminino
Seguimentos
Soropositividade para HIV/fisiopatologia
Seres Humanos
Pulmão/fisiopatologia
Pulmão/virologia
Masculino
Testes de Função Respiratória
Carga Viral/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:28452395
[Au] Autor:Stangerup I; Kramp NL; Ziegler AK; Dela F; Magnussen K; Helge JW
[Ad] Endereço:Centre of Healthy Aging, Xlab, Department of Biomedical Sciences, University of Copenhagen, Copenhagen.
[Ti] Título:Temporary impact of blood donation on physical performance and hematologic variables in women.
[So] Source:Transfusion;57(8):1905-1911, 2017 08.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: No former studies have examined how blood donation influences physical performance in women, who due to menstruation may have a slower recovery of performance. Therefore, the aim of this study was to clarify how VO , time trial (TT) performance, and hematologic variables are affected in 18 iron-sufficient (plasma ferritin [P-ferritin] > 30 µg/L) women after a standard 450-mL blood donation. STUDY DESIGN AND METHODS: VO , TT performance, and blood variables were measured at baseline and 3, 7, 14, 21, and 28 days after blood donation in 18 iron-sufficient women. Anthropometrics were measured at baseline and Day 28. RESULTS: VO was reduced by 7.5 ± 1.1% from 2973 ± 87 mL/min at baseline to 2765 ± 73 mL/min 3 days after blood donation and remained below baseline until 28 days. The TT performance was reduced by 5.2 ± 1.0% from baseline (868 ± 31 sec) to Day 3 (915 ± 29 sec), but was not different from baseline 14 days after blood donation. Blood hemoglobin (B-Hb) concentration declined by 7.6 ± 2.1% from 8.4 ± 0.1 to 7.8 ± 0.1 mmol/L at baseline and on Day 3, respectively. P-ferritin at baseline was 58 ± 7 µg/L and it decreased (55 ± 3%) to a nadir of 24 ± 3 µg/L 28 days after blood donation and remained lower at 36 ± 4 µg/L after 90 days. CONCLUSION: VO and B-Hb were only recovered 28 days after a blood donation whereas TT performance was back to baseline 14 days after blood donation.
[Mh] Termos MeSH primário: Doadores de Sangue
Ferritinas/sangue
Hemoglobinas/análise
Resistência Física/fisiologia
[Mh] Termos MeSH secundário: Adulto
Teste de Esforço
Feminino
Seres Humanos
Recuperação de Função Fisiológica
Testes de Função Respiratória
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Hemoglobins); 9007-73-2 (Ferritins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14121


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[PMID]:29289256
[Au] Autor:Edriss H; Selvan K; Denega T; Rodrigues T; Test V; Nugent K
[Ad] Endereço:Department of Pulmonary and Critical Care Medicine, Texas Tech University Health Science Center, Lubbock, Texas. Electronic address: Hawa.edriss@ttuhsc.edu.
[Ti] Título:The Complexity of Characteristics, Diagnoses and Treatment of Older Patients With Pulmonary Hypertension.
[So] Source:Am J Med Sci;355(1):13-20, 2018 Jan.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Older patients with pulmonary hypertension (PH) are more likely to have complex comorbidity than younger patients with pulmonary arterial hypertension (PAH). The best approach to the evaluation and management of these patients is unclear. METHODS: We, retrospectively, reviewed the clinical records of patients older than 60 years referred for evaluation for PAH. We recorded patient demographics, comorbidity, functional classification (FC), right heart catheterization data, echocardiographic data, chest radiographic images and pulmonary function results. We recorded the final diagnoses according to World Health Organization (WHO) subgroups and treatment outcomes based on changes in FC. RESULTS: Ninety-seven records were reviewed in detail. The mean age was 71.2 ± 7.5 years with 66% women. Cardiovascular disease was the most frequent comorbidity. Mean PA pressure by catheterization was 39.5 ± 12.2mmHg (n = 65). The overall distribution after evaluation included 21 (21.6%) Group 1, 35 (36.1%) Group 2, 16 (16.5%) Group 3, 18 (18.6%) mixed Group 2 and 3, 6 (6.2%) Group 4 and 1 (1%) Group 5 patients. Group 1 patients were treated with PAH specific drug, and 12 patients had an improvement in FC with treatment. CONCLUSIONS: Older patients with suspected PH often have significant cardiovascular and respiratory comorbidity. Comprehensive evaluations are needed to determine the severity of PH and associated diseases and to initiate treatment focused on FC. Patients in WHO Group 2 and mixed Group 2 and 3 were frequently identified and constituted a diagnostic and treatment challenge in this study. Older patients with PAH may benefit from PAH specific drugs.
[Mh] Termos MeSH primário: Hipertensão Pulmonar/diagnóstico por imagem
Hipertensão Pulmonar/terapia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Anti-Hipertensivos/uso terapêutico
Bases de Dados Factuais
Feminino
Seres Humanos
Hipertensão Pulmonar/classificação
Masculino
Meia-Idade
Testes de Função Respiratória/métodos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180101
[St] Status:MEDLINE


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[PMID]:29289255
[Au] Autor:Fagan KA
[Ad] Endereço:Division of Pulmonary and Critical Care Medicine, University of South Alabama, Mobile, Alabama. Electronic address: kfagan@usouthal.edu.
[Ti] Título:Pulmonary Hypertension-Is It the Same Disease in Young Versus Older Patients?
[So] Source:Am J Med Sci;355(1):1-2, 2018 Jan.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hipertensão Pulmonar/diagnóstico por imagem
Hipertensão Pulmonar/fisiopatologia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Hipertensão Pulmonar/epidemiologia
Masculino
Meia-Idade
Testes de Função Respiratória/métodos
Testes de Função Respiratória/normas
Disfunção Ventricular Esquerda/diagnóstico por imagem
Disfunção Ventricular Esquerda/epidemiologia
Disfunção Ventricular Esquerda/fisiopatologia
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180101
[St] Status:MEDLINE


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[PMID]:27773453
[Au] Autor:Liu Y; Vela M; Rudakevych T; Wigfield C; Garrity E; Saunders MR
[Ad] Endereço:Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
[Ti] Título:Patient factors associated with lung transplant referral and waitlist for patients with cystic fibrosis and pulmonary fibrosis.
[So] Source:J Heart Lung Transplant;36(3):264-271, 2017 Mar.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Since 2005, the Lung Allocation Score (LAS) has prioritized patient benefit and post-transplant survival, reducing waitlist to transplant time to <200 days and decreasing mortality on the waitlist. A current challenge is the wait for the waitlist-the time between the patient's transplant-eligible diagnosis and waitlist registration. METHODS: We investigated whether sociodemographic (age, sex, race, insurance, marital status, median household income) and clinical (forced expiratory volume in 1 second [FEV ] percent of predicted, body mass index, depression/anxiety, alcohol/substance misuse, absolute/relative contraindications) factors influenced referral and waitlist registration. We conducted a retrospective cohort study through chart review of hospitalized patients on the University of Chicago general medicine service from 2006 to 2014 who met transplant-eligible criteria and ICD-9 billing codes for cystic fibrosis (CF) and pulmonary fibrosis (PF). We analyzed the times from transplant eligibility to referral, work-up and waitlisting using Kaplan-Meier curves and log-rank tests. RESULTS: Overall, the referral rate for transplant-eligible patients was 64%. Of those referred, approximately 36% reach the lung transplant waitlist. Referred CF patients were significantly more likely to reach the transplant waitlist than PF patients (CF 60% vs PF 22%, p < 0.05). In addition, CF patients had a shorter wait from transplant eligibility to waitlist than PF patients (329 vs 2,369 days, respectively [25th percentile], p < 0.05). Patients with PF and CF both faced delays from eligibility to referral and waitlist. CONCLUSIONS: Quality improvement efforts are needed to better identify and refer appropriate patients for lung transplant evaluation. Targeted interventions may facilitate more efficient evaluation completion and waitlist appearance.
[Mh] Termos MeSH primário: Fibrose Cística/cirurgia
Transplante de Pulmão/métodos
Fibrose Pulmonar/cirurgia
Encaminhamento e Consulta/estatística & dados numéricos
Listas de Espera
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Estudos de Coortes
Comorbidade
Fibrose Cística/diagnóstico
Fibrose Cística/mortalidade
Feminino
Rejeição de Enxerto
Sobrevivência de Enxerto
Seres Humanos
Cobertura do Seguro
Estimativa de Kaplan-Meier
Transplante de Pulmão/mortalidade
Masculino
Meia-Idade
Seleção de Pacientes
Fibrose Pulmonar/diagnóstico
Fibrose Pulmonar/mortalidade
Testes de Função Respiratória
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Estatísticas não Paramétricas
Análise de Sobrevida
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE



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