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1
Cantero, Recasens Gerard 1984. "Cellular Ca2+ homeostasis in the pathophysiology of chronic respiratory diseases." Doctoral thesis, Universitat Pompeu Fabra, 2013. http://hdl.handle.net/10803/104537.
Full textAbstract:
Calcium works as a second intracellular messenger in all cell types and its downstream signalling
is a key pathway for many systemic functions. In the lungs, the majority of activating stimuli
trigger intracellular calcium increase, which is indispensable for the normal functioning of the
airways; thus, deregulation of this pathway leads to pathological conditions. This Thesis aims to
understand the relationship of intracellular calcium homeostasis and chronic respiratory
pathologies such as asthma. I have studied three different processes involved in calcium
homeostasis and their role in asthma pathophysiology: 1) I have shown the genetic association of a
defect in calcium entry via TRPV1 with wheezing and cough, which is one feature of asthma
pathophysiology; 2) I have also demonstrated the product of the asthma associated ORMDL3 gene
is a Ca++ homeostasis and UPR modulator; and 3) I have provided a new Ca++ dependent sorting
mechanism for secretory cargoes that bind calcium.El Calci és un segon missatger intracel·lular en tots els tipus cel·lulars i la cascada de senyalització generada pel calci és una via de senyalització cel·lular clau per moltes funcions sistèmiques. En els pulmons, la majoria d’estímuls activadors produeixen un increment del calci intracel·lular, el qual és indispensable pel funcionament correcte de les vies respiratòries; i, per tant, una desregulació d’aquesta via de senyalització porta a diferents situacions patològiques. Aquesta Tesi té com a objectiu entendre la relació entre l’homeòstasi del calci intracel·lular i les malalties respiratòries cròniques, com per exemple, l’asma. Hem estudiat tres processos diferents implicats en l’homeòstasi del calci i el seu rol en la fisiopatologia de l’asma: 1) Hem demostrat que hi ha una associació genètica entre un defecte en l’entrada de calci via TRPV1 i un dels trets característics de l’asma, la tos; 2) també hem trobat que l’ORMDL3, que havia estat associat amb l’asma, és un modulador de l’homeòstasi del calci i de la UPR; i 3) hem aportat un nou mecanisme de classificació en el Golgi depenent de Ca++ per a proteïnes que uneixen calci i que seran secretades.
2
Chu, Thi Ha. "Phenotyping of chronic respiratory diseases in the South of Vietnam." Doctoral thesis, Universite Libre de Bruxelles, 2019. https://dipot.ulb.ac.be/dspace/bitstream/2013/288355/4/coverpage.pdf.
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Chronic respiratory diseases (CRDs) include chronic diseases involving the airways and other structures of the lung. In the current circumstance of Vietnam, people are exposed to numerous risk factors of CRD, such as heavy smoking, high frequency of pulmonary tuberculosis, chronic helminthiasis, allergic factors, migration and urbanization (the last associated with traffic-related pollution). The phenotype diagnoses should take into account the risk factors of each individual besides the clinical features, while the differential diagnoses mostly depend on the available techniques in each healthcare center. Our aim was to improve the differential diagnoses of the 3 most frequent CRDs: chronic obstructive pulmonary disease (COPD), asthma and COPD – asthma overlap syndrome (ACOS), in Vietnam. In the first part, we evaluated the prevalence of the allergen sensitization among patients with CRD, in regard to the urban and rural area in the South of Vietnam. House dust mites and cockroach droppings were the most frequent sensitizer. Compared with participants born in the urban setting, those born in the rural environment were less frequently sensitized and this protective effect disappeared in the case of migration from rural to urban areas. In the second part, we evaluated skin prick test as a method to screen dust mite sensitization in CRD in southern Vietnam. The data suggested that, in the present circumstance, skin prick test can be used to screen mite sensitization. In the third part, we evaluated the risk of mite sensitization in the native and migrant population, in regard to several environmental factors. Consistently with the hygiene hypothesis, compared to urban, exposure to high endotoxin concentration in rural was a protective factor against allergic sensitization. We reported for the first time that this effect was reversible among the migrants from rural to urban setting in association with lower endotoxin exposure. In the fourth part, we have defined asthma, COPD and ACOS based on clinical symptoms, cumulative smoking and airway expiratory flow with reversibility, on one side, and the age-related of the different phenotypes, on the other side. We hypothesized that the cumulative exposure to noxious particles should increase the age-related prevalence of COPD, while due to the immunosenescence process, the prevalence of IgE-mediated asthma should decrease with age, and ACOS prevalence being not related to age due to the combined mechanisms. In conclusion, we showed in the South of Vietnam that:1) mites and cockroach allergens were the most frequent sensitizer in chronic respiratory diseases;2) the skin prick test to mite has been validated to screen mite sensitization;3) associated with a reduced level of endotoxin level, migration from rural to the urban setting was a risk factor of mite sensitization in chronic respiratory diseases;4) based on the clinical symptoms, spirometric values, and cumulative smoking, the diagnosis of asthma, COPD and ACOS have been made and their prevalence were 25, 42 and 33%, respectively.Doctorat en Sciences biomédicales et pharmaceutiques (Médecine)
info:eu-repo/semantics/nonPublished
3
Baril, Jacinthe. "Interaction between circulatory and respiratory exercise adaptation in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF)." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97901.
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Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients show a marked reduction in exercise capacity compared to that of healthy age-matched individuals. While inadequate gas exchange and resulting hypoxemia appears as the primary factor in COPD, an impaired cardiac output is the predominant explanation for the reduced oxygen delivery in CHF. However, the extent of the contributions of other systemic factors remains unclear. In light of the potential interactions between cardiac output (Qc) and pulmonary hyperinflation, there is surprisingly little data thus far on ventilatory constraints in CHF and on the role of blood flow delivery in COPD which may further limit the exercise capacity. Thus, the purpose of this study was to compare the slope of the Qc versus oxygen uptake (VO2) response through several submaximal cycling loads in patients with moderately severe COPD and with that of moderate to severe CHF patients as well as age-matched healthy control subjects (CTRL). Also examined was the possibility that ventilatory constraints such as dynamic hyperinflation contribute to an abnormal stroke volume response in both diseases. Cardiac output was measured using the CO 2-rebreathing equilibrium technique during baseline conditions and cycling at 20, 40 and 65% of peak power in 17 COPD (Age: 64 +/- 8 yrs; FEV 1/FVC: 37 +/- 11%; FEV1: 41 +/- 15 % predicted), 10 CHF (Age: 57+/- 10 yrs; FEV1/FVC: 73.8 +/- 5.6%; FEV 1: 93 +/- 13% predicted) and 10 age-matched CTRL subjects. Inspiratory capacity (IC) was also measured for the determination of dynamic hyperinflation during the steady state exercise bouts. The results indicate that while the absolute Qc values are lower in COPD and in CHF than in CTRL during 65% peak power cycling (11.30 +/- 2.38 vs 12.40 +/- 2.08 vs 15.63 +/- 2.15 L•min-1 respectively, p < 0.01), likely due to their lower exercise metabolic demand. The Qc/VO2 response to increasing levels of exercise intensity was lower or normal in CHF patients compared to CTRL, while normal or hyperdynamic in most COPD patients. Indeed, the majority of patients with COPD exhibited Qc/VO2 slopes greater than 7.0, which may be indicative of a peripheral muscle bioenergetic disturbance that may drive the need for greater oxygen delivery, and thus result in an exaggerated central circulatory response.
4
Messaggi-Sartor, Monique 1984. "Respiratory muscle dysfunction in respiratory and non-respiratory diseases : clinical and therapeutic approaches." Doctoral thesis, Universitat Pompeu Fabra, 2017. http://hdl.handle.net/10803/565809.
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Respiratory muscle dysfunction is a clinical condition that may be present in both respiratory and non-respiratory diseases. This impairment of muscle function can have a negative effect on clinical outcomes, contributing to a further worsening of the patient’s clinical condition. This doctoral thesis has been directed by the ‘Rehabilitation Research Group’ (RERG) in collaboration with the Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Group (Lung Cancer and Muscle Research Group) of the Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) in Barcelona. Muscle dysfunction has been a priority area of research in these groups from different perspectives: exercise and muscle training in the RERG, Physiopathology and Molecular Biology in the Lung Cancer and Muscle Research Group. The large number of published studies in journals with high impact factor endorses the quality and leadership of these research groups. Up to then, research on RMT had focused on patients with chronic obstructive pulmonary disease, but had been scarcely addressed in other conditions. In the last 5 years, the RERG has aimed to study the effects of RMT in other respiratory diseases (bronchiectasis, lung cancer) and in non-respiratory diseases. The study of respiratory muscle dysfunction in stroke patients has made it possible to start an increasing collaboration with neurorehabilitation researchers, in which RMT plays a role in the management of patients with dysphagia.La disfunción muscular respiratoria es una condición clínica que puede estar presente tanto en las enfermedades respiratorias como no respiratorias. Este deterioro de la función muscular puede tener un efecto negativo en los resultados clínicos, lo que contribuye a un mayor empeoramiento de la condición clínica del paciente. Esta tesis doctoral ha sido dirigida por el "Grupo de Investigación en Rehabilitación" (RERG) en colaboración con el Grupo de Investigación de Enfermedades Respiratorias Crónicas y Cáncer de Pulmón (Grupo de Investigación de Cáncer de Pulmón y Músculo) del Instituto Hospital del Mar de Investigaciones Mèdiques (IMIM) en Barcelona. La disfunción muscular ha sido un área prioritaria de investigación en estos grupos desde diferentes perspectivas: ejercicio y entrenamiento muscular en el RERG, Fisiopatología y Biología Molecular en el Cáncer de Pulmón y el Grupo de Investigación Muscular. El gran número de estudios publicados en revistas con alto factor de impacto refuerza la calidad y liderazgo de estos grupos de investigación. Hasta entonces, la investigación sobre RMT se había centrado en los pacientes con enfermedad pulmonar obstructiva crónica, pero apenas se había abordado en otras condiciones. En los últimos 5 años, el RERG se ha propuesto estudiar los efectos de la RMT en otras enfermedades respiratorias (bronquiectasias, cáncer de pulmón) y en enfermedades no respiratorias. El estudio de la disfunción de los músculos respiratorios en los pacientes con ictus ha permitido iniciar una creciente colaboración con los investigadores de neurorehabilitación, en los que RMT desempeña un papel en el tratamiento de los pacientes con disfagia.
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Koo, Sergio Don. "Quality of life in children with chronic allergic respiratory disease a population-based child health survey in Hong Kong /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42931538.
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Cook, Arlene Jane. "The role of leukotrienes in diseases causing chronic airway obstruction in children." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244248.
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Mazzucato, Roberta <1988>. "Design and Synthesis of Novel Kinase Inhibitors for the Treatment of Chronic Respiratory Diseases." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9617/1/Mazzucato_Roberta_Tesi.pdf.
Full textAbstract:
In 2017, Chronic Respiratory Diseases accounted for almost four million deaths worldwide. Unfortunately, current treatments are not definitive for such diseases. This unmet medical need forces the scientific community to increase efforts in the identification of new therapeutic solutions.
PI3K delta plays a key role in mechanisms that promote airway chronic inflammation underlying Asthma and COPD. The first part of this project was dedicated to the identification of novel PI3K delta inhibitors.
A first SAR expansion of a Hit, previously identified by a HTS campaign, was carried out. A library of 43 analogues was synthesised taking advantage of an efficient synthetic approach.
This allowed the identification of an improved Hit of nanomolar enzymatic potency and moderate selectivity for PI3K delta over other PI3K isoforms. However, this compound exhibited low potency in cell-based assays. Low cellular potency was related to sub optimal phys-chem and ADME properties. The analysis of the X-ray crystal structure of this compound in human PI3K delta guided a second tailored SAR expansion that led to improved cellular potency and solubility.
The second part of the thesis was focused on the rational design and synthesis of new macrocyclic Rho-associated protein kinases (ROCKs) inhibitors. Inhibition of these kinases has been associated with vasodilating effects. Therefore, ROCKs could represent attractive targets for the treatment of pulmonary arterial hypertension (PAH). Known ROCK inhibitors suffer from low selectivity across the kinome. The design of macrocyclic inhibitors was considered a promising strategy to obtain improved selectivity. Known inhibitors from literature were evaluated for opportunities of macrocyclization using a knowledge-based approach supported by Computer Aided Drug Design (CADD). The identification of a macrocyclic ROCK inhibitor with enzymatic activity in the low micro molar range against ROCK II represented a promising result that validated this innovative approach in the design of new ROCKs inhibitors.
8
Sidani, Souraya 1960. "Effects of sedative music on the respiratory status of clients with chronic obstructive airways diseases." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/277959.
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A quasi-experimental, pre-test post-test study was conducted to examine the effects of sedative music on the perception of dyspnea intensity, respiratory rate, pulse rate and oxyhemoglobin saturation level of clients with Chronic Obstructive Airway Disease (COAD). Data was collected on a convenience sample of 10 subjects who acted as their own control. After a six minutes walk, each subject was randomly exposed to a treatment (listening to music for 20 minutes) and to a control (resting for 20 minutes) situation. A series of paired t-tests was performed to analyze the data. Results indicated that the mean pulse rate and mean respiratory rate were significantly lower after listening to music than after resting only. Correlational analysis indicated that the perceived intensity of dyspnea is positively correlated with pulse and respiratory rates, and negatively correlated with oxygen saturation level. Encouraging clients with COAD to listen to music is a supplemental nursing intervention aiming at reducing dyspnea perception, pulse and respiratory rates.
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古修齊 and Sergio Don Koo. "Quality of life in children with chronic allergic respiratory disease: a population-based child health survey inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42931538.
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Veeranki, Sreenivas P., Shimin Zheng, Yan Cao, and Arsham Alamian. "Association of Serum Vitamin D Levels with Respiratory and Atopic Diseases." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/91.
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Background: Vitamin D is known to be associated with inflammatory diseases, but its relationship with allergic diseases is unclear. The study objective is to determine the association of serum vitamin D levels and markers of wheeze, asthma and atopy.
Methods: Data (n = 9,463) on serum vitamin D levels and atopy were obtained from 2005-2006 National Health and Nutrition Examination Survey. Serum vitamin D level was categorized into four groups: Normal (≥30ng/ml), Insufficient (21-29ng/ml), Deficient (11-20ng/ml) and Severely Deficient (≤10ng/ml). Atopy was defined as at least 1 positive allergen-specific IgE level measured for a panel of 5 common aeroallergens- cat, dog, house dust mite, cock roach and Alternaria species. Doctor-diagnosed asthma and wheeze in the previous 12 months were assessed by means of questionnaire. Multivariable logistic regression analyses were conducted to investigate the association of serum vitamin D with wheeze, asthma and atopy adjusting for age, sex, race, smoking, outdoor physical activity, body mass index and poverty income ratio.
Results: Overall, 15%, 14% and 28% of subjects had wheeze, asthma and atopy, respectively. Approximately 21% had normal serum vitamin D levels, while 35%, 28% and 5% had insufficient, deficient and severely deficient levels. Compared to subjects with normal vitamin D levels, those with insufficient, deficient and severely deficient levels had increased relative odds of wheeze and atopy with highest adjusted estimates in subjects with severe vitamin D deficiency (adjusted odds ratio [OR] 2.31, 95% Confidence Interval [CI] 1.73-3.10 for wheeze; OR 1.49, 95% CI 1.17-1.89 for atopy).
Conclusion: Low serum vitamin D levels were found to be associated with wheeze and atopy. Findings contribute to ongoing efforts to understanding the role of vitamin D in atopic diseases.
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Liu, Yi-Chia. "Understanding chronic inflammatory diseases in the human lung : the cystic fibrosis and idiopathic pulmonary fibrosis paradigms." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/27807/.
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The chronic infection of the cystic fibrosis (CF) lung with Pseudomonas aeruginosa strongly correlates with critical outcomes. Pseudomonas alkyl-quinolone signal (PQS) is a diffusible cell-density dependent signal controlling the production of virulence determinants. The PQS amount in the CF lung was proportionate to P. aeruginosa colonisation and PQS molecules have been demonstrated to inhibit pro-inflammatory signalling. However, how PQS influence the recognition of P. aeruginosa by the human lung is unknown. The contribution of PQS to the interaction of P. aeruginosa with human bronchial epithelial cells (HBECs) was characterised using a PQS-deficient mutant ΔpqsA in comparison with its isogenic wild type (WT). Although ΔpqsA appeared attenuated, the pathogenesis of WT and ΔpqsA upon infection of HBEC did not differ in bacterial growth, actin and junctional protein degradation, and pro-inflammatory activation. Despite PQS being highly secreted by a CF isolate LESB58, preliminary data showed that LESB58 was less cytotoxic than the laboratory WT. Our results suggest that PQS does not alter P. aeruginosa pathogenicity on HBECs. Idiopathic pulmonary fibrosis (IPF) is characterised with heterogeneous pathological patterns caused by scarring leading to irreversible destruction of lung architecture. Emerging evidence suggests that dysregulated immunological events could cause the failure of tissue-healing. Systemic immune responses of patients with IPF and age- and sex-matched healthy donors were determined by quantifying cytokines produced by peripheral blood mononuclear cells (PBMCs) upon an array of stimuli. The results showed that PBMCs in patients with IPF were less likely to produce IL-17A, IL-10 and IL-13 than healthy controls (OR 0.14-0.3, 95% CI 0.003-0.03). Patients with lower levels of cytokines had a four to six-fold increased risk of death (HR 4.31-6.13, 95% CI 0.0052-0.0176). This study contributes to a better understanding of the role of PQS in P. aeruginosa pathogenesis and identified cytokine production as a novel biomarker in IPF.
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ZHOU, TINGYANG ZHOU. "Molecular Roles of ROS in Mouse Respiratory Skeletal Muscle." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1531848449464785.
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Velickovski, Filip. "Clinical decision support for screening, diagnosis and assessment of respiratory diseases: chronic obstructive pulmonary disease as a use case." Doctoral thesis, Universitat de Girona, 2016. http://hdl.handle.net/10803/457000.
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In this thesis we propose a framework for designing, developing, a clinical decision support systems (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), and then demonstrate how these services can be integrated into the work-flow of healthcare providers. Furthermore, we focus on supporting spirometry, one of the main diagnostic tools in respiratory disease assessment. We present two methods to offer decision support in assuring the quality of a spirometry test that can be easily embedded into the CDSS framework. The first method is a novel algorithm that relies on a set of rules operating on 23 new parameters to define a high quality test. The second is a machine-learning approach, where we optimise the distinction between a good quality spirometry test and a poor one using a set of supervised-learning classifiers and hyper-parametersEn esta tesis proponemos un marco para el diseño y desarrollo de un Sistema de Soporte de Decisión Clínica (SSDC) que ofrezca un conjunto de herramientas para el diagnóstico y la evaluación de las enfermedades pulmonares. Al mismo tiempo demostramos como estos servicios se pueden integrar en el flujo de trabajo del personal sanitario. Además, nos centramos en la ayuda en espirometría, una de las herramientas de diagnóstico principales en la evaluación de enfermedades pulmonares. Presentamos dos métodos de SSDC que tienen como objetivo asegurar la calidad de las pruebas de espirometría, y que se pueden integrar en el marco del SSDC. El primero es un nuevo algoritmo basado en un conjunto de reglas que definen lo que es considerado como una prueba de alta calidad. El segundo es un enfoque de aprendizaje supervisado donde se optimiza la distinción entre una prueba correcta de espirometría y una de mala calidad
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Jónsson, Baldvin. "Chronic lung disease of prematurity : a study of selected causative factors and preventive measures /." Stockholm, 1998. http://diss.kib.ki.se/1998/19981204jons/.
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Härter, Martin, Harald Baumeister, Katrin Reuter, Frank Jacobi, Michael Höfler, Jürgen Bengel, and Hans-Ulrich Wittchen. "Increased 12-Month Prevalence Rates of Mental Disorders in Patients with Chronic Somatic Diseases." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100021.
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Background: Although it is well established that chronic somatic diseases are significantly associated with a wide range of psychopathology, it remains unclear to what extent subjects with chronic somatic diseases are at increased risk of experiencing mental disorders. The present epidemiological study investigates age- and sex-adjusted 12-month prevalence rates of mental disorders in patients with cancer, and musculoskeletal, cardiovascular and respiratory tract diseases, based on comprehensive physicians’ diagnoses and compared with physically healthy probands.
Methods: Prevalence rates were calculated from two large epidemiological surveys. These studies investigated inpatients and patients from the general population with cancer (n = 174) and musculoskeletal (n = 1,416), cardiovascular (n = 915) and respiratory tract diseases (n = 453) as well as healthy controls (n = 1,083). The prevalence rates were based on the Munich Composite International Diagnostic Interview, a standardized interview for the assessment of mental disorders.
Results: Prevalence rates were very similar for inpatients (43.7%) and patients from the general population (42.2%). The adjusted odds ratios (OR) of patients with chronic somatic diseases were significantly elevated for mental disorders in comparison with healthy probands (OR: 2.2). Mood, anxiety and somatoform disorders were most frequent. The prevalence rates did not differ significantly between the somatic index diseases. The number of somatic diseases per patient had a higher association with mental disorders.
Conclusions: There is a strong relationship between chronic somatic diseases and mental disorders. A future task is to improve the care of mental disorders in patients with chronic physical illness, specifically with multimorbid conditions.
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Willson, Grant Neville. "Nocturnal non-invasive ventilation for the treatment of Cheyne-Stokes respiration in chronic heart failure." Thesis, The University of Sydney, 2004. https://hdl.handle.net/2123/27912.
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This thesis has investigated the efficacy of non-invasive ventilation in subjects with
congestive heart failure (CHF) and Cheyne—Stokes respiration (CSR). The effect of this
therapy on sleep, breathing and haemodynamic variables has been examined. This thesis
also describes the morphology and magnitude of the blood pressure (BP) and heart rate
(HR) oscillations associated with CSR and elucidates contributing factors to the changes
observed.
Chapter 1 - literature review - outlines the presentation and treatment of CSR in patients
with CHF. Cheyne-Stokes respiration is described with particular emphasis on the
polysomnographic features and haemodynamic consequences of this breathing pattern.
The mechanisms postulated for the genesis of CSR are reviewed. The prevalence and
consequences of CSR are discussed, highlighting the clinical features and their effects
on prognosis. The proposed treatments are considered, with attention being paid to the
mechanisms of action, the effect on sleep, breathing, haemodynamics and the clinical
utility of each therapy. Special emphasis is placed on oxygen and continuous positive
airway pressure (CPAP) therapy. It is proposed that given the lack of universal
acceptance of any one treatment modality, the role of new therapies that emulate the
positive effects of current treatments, warrant further investigation. A review of noninvasive
ventilation including a survey of its historical use, methodological
considerations, physiological consequences and clinical applications has been
undertaken.
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Härter, Martin, Harald Baumeister, Katrin Reuter, Frank Jacobi, Michael Höfler, Jürgen Bengel, and Hans-Ulrich Wittchen. "Increased 12-Month Prevalence Rates of Mental Disorders in Patients with Chronic Somatic Diseases." Karger, 2007. https://tud.qucosa.de/id/qucosa%3A26278.
Full textAbstract:
Background: Although it is well established that chronic somatic diseases are significantly associated with a wide range of psychopathology, it remains unclear to what extent subjects with chronic somatic diseases are at increased risk of experiencing mental disorders. The present epidemiological study investigates age- and sex-adjusted 12-month prevalence rates of mental disorders in patients with cancer, and musculoskeletal, cardiovascular and respiratory tract diseases, based on comprehensive physicians’ diagnoses and compared with physically healthy probands.
Methods: Prevalence rates were calculated from two large epidemiological surveys. These studies investigated inpatients and patients from the general population with cancer (n = 174) and musculoskeletal (n = 1,416), cardiovascular (n = 915) and respiratory tract diseases (n = 453) as well as healthy controls (n = 1,083). The prevalence rates were based on the Munich Composite International Diagnostic Interview, a standardized interview for the assessment of mental disorders.
Results: Prevalence rates were very similar for inpatients (43.7%) and patients from the general population (42.2%). The adjusted odds ratios (OR) of patients with chronic somatic diseases were significantly elevated for mental disorders in comparison with healthy probands (OR: 2.2). Mood, anxiety and somatoform disorders were most frequent. The prevalence rates did not differ significantly between the somatic index diseases. The number of somatic diseases per patient had a higher association with mental disorders.
Conclusions: There is a strong relationship between chronic somatic diseases and mental disorders. A future task is to improve the care of mental disorders in patients with chronic physical illness, specifically with multimorbid conditions.
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Meren, Mari. "Asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and respiratory symptoms among adults in Estonia: prevalence and risk factors - comparison with Sweden and Finalnd : the "FinEsS" studies - Estonia I /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-537-2/.
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Carandina, Luana. "Prevalência de sintomas sugestivos de doenças respiratórias crônicas inespecíficas na população urbana de Botucatu, São Paulo." Universidade de São Paulo, 1987. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-18102017-184820/.
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Em uma amostra de 12 por cento da população urbana de Botucatu, São Paulo, constituída de 7.075 pessoas, foram identificados 525 indivíduos com sintomas sugestivos de doença respiratória crônica inespecífica (DRCI). Utilizando o questionário de sintomas respiratórios \"ATS-DLD-78\", aplicado por entrevistadores leigos, a autora determinou a prevalência de alguns sintomas e de associações sugestivas de asma brônquica, bronquite crônica e doença pulmonar obstrutiva crônica (DPOC). Os sintomas mais frequentes no sexo masculino, foram: tosse, expectoração e chiado, cuja prevalência foi de 6,2 por cento , 5,4 por cento e 5,3 por cento , respectivamente. No sexo feminino os sintomas mais frequentes foram: tosse, chiado, dispnéia e rinite alérgica cujas taxas de prevalência foram: 4,7 por cento , 4,7 por cento , 4,2 por cento e 4,0 por cento , respectivamente. Houve maior prevalência de sintomas respiratórios nos maiores de 50 anos de idade e nos menores de 15 anos. A prevalência média de sintomas sugestivos de asma brônquica foi de 5, 0 por cento , e de 1,9 por cento para bronquite crônica e de 0,1 por cento para DPOC. A influência do hábito de fumar, presente entre os sintomáticos respiratórios em 33,7 por cento dos homens e 23,4 por cento das mulheres, foi estudada em relação aos sintomas de tosse e expectoração pela manhã e aos sintomas sugestivos de bronquite crônica. Em vista dos resultados, a autora analisa e comenta a metodologia utilizada e a aplicabilidade do questionário \"ATS-DLD-78\" em nosso meio. Frente a escassez de dados relativos às DRCI, no Brasil, conclui sobre a necessidade de novos inquéritos epidemiológicos em regiões diferentes, realizados com metodologia adequada que possibilite a comparação dos resultados, complementados, quando possível, por estudos clínicos, tendo em vista o planejamento de medidas e programas de intervenção.In a sample of 12 per cent of the urban population of Botucatu, São Paulo (7075 persons) submitted to a general health and life conditions survey, 525 people with symptoms of inespecific chronic respiratory diseases (ICRD) were detected. The \"ATS-DLD-78\" questionnaire for respiratory symptoms was applyed to these 525 people by non-medical interviewers, and from the collected data the prevalence of some symptoms and association of symptoms suggesting asthma, chronic bronchitis and chronic obstructive pulmonar disease (COPD) was determined. The most frequent symptoms in males were cough (6,2 per cent ), expectoration (5.4 per cent ) and wheezing (5.3 per cent ) and in females, cough (4.7 per cent ), wheezing (4.7 per cent ), dyspnea (4.2 per cent ) and allergic rhinitis (4.01). The prevalence os respiratory symptoms was greater before 15 after 50 years of age. The mean prevalence of symptoms suggesting asthma was 5.0 per cent , suggesting chronic bronchitis, 1.9 per cent and COPD 0,1 per cent . Tobacco smoking was presente in 33.7 per cent of symptomatic men and 23.4 per cent of the symptomatic women. There was a relation between smoking and the presence of morning cough and phlegm and symptoms of chronic bronchitis. The used metodology and the applicability of the \"ATS-DLD-78\" questionnaire to our population is analysed and commented. Taking into account the scarcity of data about ICRD in Brazil, the author concludes emphazising the need of another epidemiological surveys in different parts of the country, using tested and standardized methods that make possible a comparison of data, with the aim of planning intervention measures and programmes.
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Eyong, Ayuk. "Mediating factors in the relationship between sociodemographic factors and Chronic Lower Respiratory Diseases (CLRD) among adult ACBS respondents in the United States." Thesis, Lancaster University, 2018. http://eprints.lancs.ac.uk/126217/.
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Background: Chronic Lower Respiratory Diseases (CLRD), such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis and emphysema are preventable diseases that constitute a serious public health concern. Estimates indicate that there is an increased prevalence of mortality from these diseases worldwide. Low socio-economic positions (SEP) and poor indoor environmental conditions have been identified as risk factors for CLRD among adults. Given the public health burden of CLRD, there is increasing interest among researchers to identify all relevant factors associated with CLRD. However, many studies identified in the literature only controlled for individual or specific risk factors and most of these studies vary in their definition of risk factors. As a result, the evidence was contradictory. Some studies reported statistical associations while other studies reported no statistical association between specific risk factors and CLRD. Furthermore, questions remain on which risk factors mediate the relationships between socio-demographic factors and respiratory health outcomes. Given this, the study will examine if one or more indoor environmental factors and access to healthcare mediates the relationships between socio-demographic factors and CLRD among adult ACBS respondents in the United States (U.S). The study will further examine if the effects of socio-demographic factors on CLRD depend on indoor environmental factors and access to healthcare. Methods: This study examined three different years of secondary cross-sectional data collected from adults 18 years or older by the Behavioral Risk Factor Surveillance Survey (BRFSS) and Asthma Call-Back Survey (ACBS). 15,403 participants from 2009, 17,753 from 2010 and 16,693 from 2011 were included in the study. Bivariate analyses were used to identify significant predictors, and logistic regression models were used to examine mediation and predictor-mediator interaction effects. CLRD was viii the outcome of interest, socio-demographic factors were used as predictors, and indoor environmental factors and healthcare access were used as potential mediators. Results: The bivariate analyses revealed that gender, age, marital status, education, employment status, income, mold, pest infestation, smoking indoors, being a current or former smoker, occupational exposure and medical cost were significant predictors of CLRD. The mediation tests revealed that mold, mice presence, being a current smoker, smoke indoors and occupational exposure fully or partially mediated the relationship between age, education, employment, income and current asthma. Being a current or former smoker, smoking indoors, and occupational exposure fully or partially mediated the effects of age, marital status, education, employment, income on COPD, bronchitis and emphysema. Mold and medical cost were also identified as mediators for bronchitis and mold for emphysema. These findings indicate that indoor environmental factors and medical cost, fully or partially explain the effects of socio-demographic factors on the reporting of CLRD. The statistical significant predictor-mediator interaction effects that were identified revealed that the effects of gender, age, education, employment and income on the reporting of CLRD depends on mold, mice presence, being a current or former smoker, smoking indoors, occupational exposure and medical cost. Conclusion: This is the first study to use rich cross-sectional secondary data from three different years to demonstrate that poor indoor environmental conditions and inadequate access to healthcare play a significant role in explaining the reporting of CLRD among ACBS respondents in different social, economic and demographic groups. These findings have clear implications for related public health policies. These policies should focus on creating more resources in deprived neighborhoods, improving inadequate housing conditions through housing refurbishment and ensuring adequate access to healthcare for all groups regardless of their SEP.
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Törneke, Karolina. "Pharmacological aspects of adrenoceptor drugs in the horse /." Uppsala : Swedish Univ. of Agricultural Sciences (Sveriges lantbruksuniv.), 1999. http://epsilon.slu.se/avh/1999/91-576-5431-X.pdf.
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Shim, Joanna. "Symptomatic diagnosis of lung cancer in a population referred to lung-shadow clinic with high rates of chronic respiratory diseases : a feasibility study." Thesis, University of Southampton, 2015. https://eprints.soton.ac.uk/384345/.
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n the UK, 86% of lung cancer (LC) patients are diagnosed when curative treatment is not possible. Government guidelines recommend urgent chest X-ray referrals for patients presented with any 1 of 10 suggested LC symptoms. Little evidence currently supports these recommendations. Thus, the need for prospective studies to identify the predictive values of symptoms for LC diagnosis. This study aimed to investigate the feasibility of a prospective study to identify symptoms that predict LC in a secondary care population with high rates of chronic respiratory disease by investigating 1) the content validity and acceptability to this population of a patient-completed questionnaire, and 2) identifying patient-elicited symptoms that predict LC. The Identifying Symptoms that Predict Chest and Respiratory Disease (IPCARD) questionnaire was used to prospectively collect symptom, risk and comorbidity data in a chest clinic population investigated for LC (Patients aged ≥40). LC was identified six months following recruitment. Semi-structured and cognitive interviews explored the acceptability and content validity of the IPCARD questionnaire in this population. Multiple logistic regression was used to identify symptoms independently associated with LC in the clinic population, and in a COPD sub-group; at two levels of entry criteria (p<0.05 and p<0.15). 359 patients (70% of those eligible) completed the IPCARD questionnaire, and 77 (21.4%) were diagnosed with LC. Qualitative research indicated that participants found the IPCARD questionnaire acceptable, and its content validity was established in this secondary care population. Cough and breathing changes first indicated in the last three months, predicted LC in this referred population (p<0.05). In the COPD sub-group, the symptom descriptor, unable to get enough air predicted LC (p<0.05). At the relaxed criteria (p<0.15), five symptoms predicted LC in the full clinic population; a hard/harsh cough without phlegm, increasing chest infections, and weight gain (last 12 months) were added to the previous model. The COPD sub-group at p<0.15, breathing changes experienced (last three months), breathing changes first indicated within the last three months, unable to get enough air, and wheezing sensation, were predictors. Based on the more rigorous entry criteria (p<0.05), the diagnostic criteria for the COPD sub-group (positive likelihood ratio (+LR)=1.91; Area under curve (AUC)=0.739) performed slightly better than the criteria for the full population (+LR=1.49; AUC=0.729) (at optimal cut-off). The better performance of the COPD–specific model supports the need for an adequately powered study to investigate the predictive values of LC symptoms in homogeneous populations with specific respiratory diseases.
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Корнус, Олеся Григорівна, Olesia Hryhorivna Kornus, Анатолій Олександрович Корнус, Anatolii Oleksandrovych Kornus, Володимир Дмитрович Шищук, Алі Хассан Аль-Вхілі, Ali Khassan Al-Vkhili, and Volodymyr Dmytrovych Shyshchuk. "Територіальні відмінності захворюваності населення Сумської області на хронічні обструктивні захворювання легень." Sp. z o.o. «Diamond trading tour», 2019. http://repository.sspu.sumy.ua/handle/123456789/7304.
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Спостереженням охоплено період 2005–2017 років. Станом на 1.01.2018 р. у Сумській області первинна захворюваність на хвороби органів дихання становила 22 070,29 на 100 тис. осіб, а поширеність хвороб – 28 054,31 випадків на 100 тис. населення. Протягом 2005-2017 років спостерігається зростання як первинної захворюваності (на 15,04 %), так і поширеності хвороб органів дихання – на 14,42 %.The observation covers the period 2005-2017. As of January 1, 2018, in the Sumy region, the primary incidence of respiratory diseases was 22,070.29 per 100 thousand people, and the prevalence of diseases was 28,054.31 cases per 100 thousand population. During 2005-2017, there is an increase in both primary morbidity (by 15.04%) and the prevalence of respiratory diseases - by 14.42%.
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Faganello, Marcia Maria. "Fatores associados à ocorrência de exacerbação em pacientes com DPOC /." Botucatu : [s.n.], 2007. http://hdl.handle.net/11449/102611.
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Orientador: Irma de GodoyBanca: Hugo Hyung Bok Yoo
Banca: Fabio de Oliveira Pitta
Banca: Maria Christina L. O. Machado
Banca: Alberto Cukier
Resumo: Nos últimos anos, vários estudos avaliaram os marcadores da doença associados à freqüência de exacerbação, hospitalização, readmissão e mortalidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, estudos que avaliaram os marcadores associados à ocorrência de exacerbação em pacientes ambulatoriais são limitados. Assim, o objetivo deste estudo foi identificar os fatores de predição da ocorrência de exacerbação no período de um ano em 120 pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - Unesp. Os pacientes tiveram o diagnóstico de DPOC confirmado e foram submetidos às seguintes avaliações: espirometria pré e pós-broncodilatador, composição do corpo (antropometria e bioimpedância), qualidade de vida por meio do Saint Georges Respiratory Questionnaire (SGRQ), intensidade da dispnéia por meio da escala modificada Medical Research Council (MMRC) e do índice basal de dispnéia (BDI) e tolerância ao exercício (distância percorrida em 6 minutos DP6). Em seguida foi calculado o índice BODE de acordo com os pontos de corte do volume expiratório no primeiro segundo (VEF1), do índice de massa do corpo, do MMRC e da DP6. Durante o período de acompanhamento de um ano, 60 pacientes (50%) apresentaram pelo menos um episódio de exacerbação da doença e, em conseqüência da agudização, 25 pacientes foram hospitalizados. Comorbidades extra-pulmonares foram causa de hospitalização em oito pacientes e de óbito em cinco pacientes. Na avaliação inicial, os pacientes que exacerbaram tinham maior comprometimento da função pulmonar e da troca gasosa, valores mais elevados do índice BODE e maior proporção de pacientes com DPOC III e IV. Além disso, apresentavam menores valores de DP6, maior sensação de dispnéi... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint Georges Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
Doutor
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Bugajski, Andrew A. "BIOLOGICAL, BEHAVIORAL, AND PSYCHOSOCIAL ATTRIBUTES OF INDIVIDUALS WITH COPD." UKnowledge, 2018. https://uknowledge.uky.edu/nursing_etds/36.
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The purpose of this dissertation was to evaluate the biological, behavioral, and psychosocial attributes of individuals diagnosed with chronic obstructive pulmonary disease (COPD). Specific aims were to: 1) explore the predictive power of spirometry measures for event-free survival in patients with heart failure and suspected COPD, focusing on the differences in survival between those with and without airflow limitation; 2) examine the psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) in patients with concomitant COPD and heart failure; and 3) test the efficacy of a theory-based, multidimensional, self-care educational intervention using an eHealth platform on measures of symptom severity and variability, anxiety and depressive symptoms, perceived self-care ability, perceived self-care adherence, and selfcare information needs (knowledge) in a sample of adult patients with stable COPD.
Specific aim one was addressed by evaluation of the predictive power of spirometry measures (forced expiratory volume/second [FEV1], forced vital capacity [FVC], and the ratio of FEV1/FVC) for event-free time to combined hospitalization/mortality after controlling for clinical and sociodemographic variables. This analysis revealed that those patients with airflow limitation were 2.2 times more likely to experience hospitalization/mortality compared to those without airflow limitation. The second specific aim was addressed with a psychometric evaluation of the Multidimensional Scale of Perceived Social support (MSPSS) which included determination of internal consistency reliability, the factor structure and construct validity by hypothesis testing in participants with comorbid COPD and heart failure. The MSPSS was a valid and reliable instrument to measure perceived social support in patients with comorbid COPD and heart failure. The third specific aim was addressed by a trial of an eHealth educational intervention in participants with COPD (N = 20). This intervention resulted in significant change in symptom severity evaluation in patients categorized as having medium symptom severity for the following symptoms: distress due to cough, chest tightness, dyspnea with activity and fatigue; these symptoms were perceived as more severe in the intervention period. Anxiety, depressive symptoms and perceived self-care ability were unchanged; however, perceived self-care adherence scores improved, and knowledge needs were significantly reduced after the intervention.
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Wang, Ke-Sheng, Liang Wang, Shimin Zheng, and Long-Yang Wu. "Associations of Smoking Status and Serious Psychological Distress with Chronic Obstructive Pulmonary Disease." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/39.
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Background: Chronic obstructive pulmonary disease (COPD) has been a major public health problem due to its high prevalence, morbidity, and mortality. Smoking is a major risk factor for COPD, while serious psychological distress (SPD) is prevalent among COPD patients. However, no study focusing on the effect of SPD on COPD has been so far conducted, while few studies have focused on the associations of SPD and behavioral factors with COPD by smoking status.
Objectives: This study aimed to examine the associations of SPD and behavioral factors (such as smoking and physical activity) with COPD.
Materials and Methods: Weighted logistic regression models were used for the analysis of 1,248 cases and 39,995 controls from the 2005 California Health Interview Survey (CHIS).
Results: The prevalence of SPD was 10% in cases and 4% in controls, respectively. The percentages of past and current smoking were higher in cases than controls (50% vs. 24% and 27% vs. 15%, respectively). After adjusting for other factors, smoking (OR = 4.56, 95% CI = 3.41-6.11 and OR = 3.24, 95% CI = 2.57-4.08 for current and past smoking, respectively), physical activity (OR = 0.69, 95% CI = 0.55-0.87), obesity (OR = 1.25, 95% CI = 1.03-1.52), older age (OR = 2.86, 95% CI = 2.15-3.82, and OR = 5.97, 95% CI = 4.42-8.08 for middle-aged and elder groups, respectively), SPD (OR = 2.11, 95% CI = 1.47-3.04), employment (OR = 0.62, 95% CI = 0.51-0.76), race (OR = 0.35, 95% CI = 0.23-0.54, OR = 0.59, 95% CI = 0.36-0.97, and OR = 0.47, 95% CI=0.29-0.75 for Latino, Asian, and African American, respectively) and lower federal poverty level (OR=1.89, 95% CI = 1.35-2.63, OR = 1.65, 95% CI = 1.27-2.14, and OR = 1.39, 95% CI = 1.12-1.72 for 0-99% FPL, 100-199% FPL and 200-299% FPL, respectively) were all associated with COPD (P < 0.05). Age group, SPD, race, and employment showed significant interactions with smoking status. Stratified by smoking status, aging was the only risk factor for COPD in the never smoking group; whereas, lack of physical activity, older age, SPD, race, unemployment, and lower federal poverty level were associated with COPD in the smoking groups.
Conclusions: Smoking and aging were major risk factors for COPD, while lack of physical activity and SPD were strongly associated with COPD in the smoking groups.
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Chacko, Anu. "Comparison of human and animal Chlamydia pneumoniae responses to interferon gamma and penicillin treatment." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/85438/1/Anu_Chacko_Thesis.pdf.
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This thesis has made a significant contribution to future chlamydial research by uncovering the chlamydial pathogenic mechanisms which will potentially help in the development of targeted vaccine against the pathogen. This thesis has made important new contributions to our understanding of Chlamydia pneumoniae specific adaptations to stress responses and has provided new perspectives on the survival of this successful pathogen. This thesis has used two well established microbial stressors and has identified major differences in stress responses between human and animal Chlamydia pneumoniae isolates.
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Alibakhshi, Esmaeil. "Femoral bone mineral density and rectus femoris phenotype as sarcopenia indicators after a pulmonary rehabilitation protocol in patients with chronic respiratory disease." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668651.
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INTRODUCTION: Patients with chronic respiratory disease (CRDs) have a disorder in muscle structure and function, but their function increases with physical progress and decreases the risk of general and muscular weakness. CRDs patients with muscle weakness also have higher mortality rates than patients without muscle weakness and they are more likely to develop sarcopenia and the incidence of pathogens. The Main objective of the present study was to evaluate the indicators of Sarcopenia in chronic respiratory patients with a greater focus on musculoskeletal structure and function and quality of life in these patients, which can highest affect their mortality.
METHODS: We randomly selected patients (N=38) with mean age of 72±1.0 years old men and women elderly with chronic respiratory diseases such as asthma, COPD, bronshiectasis and obesity with dyspnea score ≥ 2 in Medical Research Council (MRC) index. All patients after receiving research information and signing informed consent they have gone on performed assessments of pre and post rehabilitation protocol in spirometry for lung function, hand-grip dynamometer, quadriceps strength grading test, body mass index (BMI), skeletal muscle Index (SMI), 6-minute walking test (6-MWT) and quality of life questionnaire SF-36 in rehabilitation and pulmonology departments at the Health Parc Sant Joan de Deu. Then, they have done femor bone mineral density (FBMD) and ultrasound on rectus femoris in mid-tight cross sectional area (RFMTCSA) on quadriceps muscle at the electro-diagnosis department. They have had a 4-month long term a pulmonary rehabilitation protocol, which included: Exercise tests- incremental and constant, 12 weeks, 3 times a week, duration of each session was 1h :15 min. Breathing techniques, respiratory muscle training and self-management, (ATS-ERS guidelines, 2013-2016).
RESULTS: After the rehabilitation protocol, significant changes in BMI were seen in all patients, pre rehabilitation, BMI= 30±1.06 kg/m2 and post rehabilitation, BMI=29±1.00 kg/m2. In the analysis of Pearson’s correlation r =0.607 between T-scores and Z-score in Femur Bone Mineral Density (FBMD) and Rectus femoris Mid-Tight Cross Sectional Area (RFMTCSA) in pre-rehabilitation, there is a little bit significant correlation between the variables (P<0.00). But, in the analysis of the Pearson’s correlation r =0.910 in post-rehabilitation between T-score and Z-scores in FBMD and RFMTCSA, there have a high significant correlation between variables than pre-rehabilitation on P<0.00.
DISCUSSION: When we compared femur bone, rectus femoris muscle parameters and quality of life as indicators diagnosis of sarcopenia in chronic respiratory patients, we observed that in rectus femoris muscle ultrasound as the most effective foot muscle in detecting sarcopenia was the determination of the parameters of RFMTCSA and Circumference muscle, and we found significant change in the test of DEXA scan in T-score some more than Z-score. Also, we observed that T-score and Z-score in femur bone and RFMTCSA had a high significant correlation after the pulmonary rehabilitation protocol. I conclude that it is not necessary to investigate all factors in order to accurately determine the severity of sarcopenia in patients with chronic respiratory disease, and if specialists are considering rectus femoris ultrasound and femoral DEXA as the main intervention of sarcopenic in chronic respiratory patients, they can follow the latest situation health and mortality of them should be more accurately diagnosed.
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Faganello, Marcia Maria [UNESP]. "Fatores associados à ocorrência de exacerbação em pacientes com DPOC." Universidade Estadual Paulista (UNESP), 2007. http://hdl.handle.net/11449/102611.
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Nos últimos anos, vários estudos avaliaram os marcadores da doença associados à freqüência de exacerbação, hospitalização, readmissão e mortalidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, estudos que avaliaram os marcadores associados à ocorrência de exacerbação em pacientes ambulatoriais são limitados. Assim, o objetivo deste estudo foi identificar os fatores de predição da ocorrência de exacerbação no período de um ano em 120 pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - Unesp. Os pacientes tiveram o diagnóstico de DPOC confirmado e foram submetidos às seguintes avaliações: espirometria pré e pós-broncodilatador, composição do corpo (antropometria e bioimpedância), qualidade de vida por meio do Saint George s Respiratory Questionnaire (SGRQ), intensidade da dispnéia por meio da escala modificada Medical Research Council (MMRC) e do índice basal de dispnéia (BDI) e tolerância ao exercício (distância percorrida em 6 minutos DP6). Em seguida foi calculado o índice BODE de acordo com os pontos de corte do volume expiratório no primeiro segundo (VEF1), do índice de massa do corpo, do MMRC e da DP6. Durante o período de acompanhamento de um ano, 60 pacientes (50%) apresentaram pelo menos um episódio de exacerbação da doença e, em conseqüência da agudização, 25 pacientes foram hospitalizados. Comorbidades extra-pulmonares foram causa de hospitalização em oito pacientes e de óbito em cinco pacientes. Na avaliação inicial, os pacientes que exacerbaram tinham maior comprometimento da função pulmonar e da troca gasosa, valores mais elevados do índice BODE e maior proporção de pacientes com DPOC III e IV. Além disso, apresentavam menores valores de DP6, maior sensação de dispnéi...
Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint George s Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
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Chin, Elizabeth D. "Symptom Experience and Treatment Delay during Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Dissertation." eScholarship@UMMS, 2012. https://escholarship.umassmed.edu/gsn_diss/30.
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Chronic obstructive pulmonary disease (COPD) is a major health problem in the United States. Acute exacerbations of COPD are primarily responsible for the physical, psychological and economic burden of this disease. Early identification and treatment of exacerbations is important to improve patient and healthcare outcomes. Little is known about how patients with COPD recognize an impending exacerbation and subsequently decide to seek treatment. The purpose of this qualitative descriptive study was to explore and describe symptom recognition and treatment delay in individuals experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD). Leventhal’s Common Sense Model of illness representation undergirded this study. Using semi-structured interviews, adults hospitalized with an acute exacerbation of COPD were asked to describe their symptom experience and self care behaviors, including treatment seeking, in the days to weeks prior to hospitalization. Data analysis revealed one main theme: Recognizing, responding and reacting to change, and six subthemes: Something’s coming, Here we go again, Seeking urgent treatment, Riding it out, Not in charge anymore and My last day that richly described the COPD exacerbation experience. The study revealed that patients experience an illness prodrome prior to exacerbation and have a recurrent exacerbation symptom pattern that was self-recognized. Treatment seeking was most influenced by the speed and acuity of exacerbation onset, severity of breathlessness, fears of death, nature of patient-provider relationship and the perception of stigmatization during prior healthcare encounters. These findings are important for the development of interventions to improve patient recognition and management of COPD exacerbations in the future.
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French, Cynthia L. "Examining Change in Symptoms of Depression, Anxiety, and Stress in Adults after Treatment of Chronic Cough: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsn_diss/31.
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Background: Chronic cough is a common health problem with variable success rates to standardized treatment. Psychologic symptoms of depression, anxiety, and stress have been reported in association with chronic cough. The purpose of this study was to examine changes in the psychologic symptoms of depression, anxiety, and stress in adults with chronic cough 3 months after management using the ACCP cough treatment guidelines.
Methods: This study used a descriptive longitudinal observation design. The major tenets associated with the Theory of Unpleasant Symptoms were examined. Intervention fidelity to the study components was measured.
Results: A sample of 80 consecutive patients with chronic cough of greater than 8 weeks duration was recruited from one cough specialty clinic. Mean age of subjects was 58.54 years; 68.7% were female; 98.7% were white, and 97.5% were non-smokers. Mean cough duration was 85.99 months and mean cough severity was 6.11 (possible 0 –10; higher scores equal greater cough severity). Cough severity improved post treatment (n=65, M=2.32, (SE =.291), t (64) =7.98, p=.000); cough-specific quality-of-life also improved (n=65, M=9.17, (SE=1.30), t (64) =7.02, p=.000). Physiologic (urge-to-cough r=.360, ability to speak r=.469) and psychologic factors (depression r=.512, anxiety r=.507, stress r=.484) were significantly related to cough-specific quality-of-life and to cough severity (urge-to-cough r=.643, ability to speak r=.674 and depression r=.356, anxiety r=.419, stress r=.323) (all r, p=.01); social support and number of diagnoses were not related to either variable. Those experiencing greater financial strain had worse cough severity. Women, those experiencing financial strain, and those taking self-prescribed therapy had worse cough-specific quality-of-life. Intervention fidelity to the study plan was rated as high according to observation, participant receipt, and patient/physician concordance. Qualitative review identified potential areas of variability with intervention fidelity.
Conclusions: By measuring the factors related to the major tenets of the Theory of Unpleasant Symptoms, this theory has helped to explain why those with chronic cough may have symptoms of depression, anxiety, and stress and why these symptoms improve as cough severity and cough-specific quality-of-life improve. Moreover, by measuring intervention fidelity, it may be possible to determine why cough guidelines may not be yielding consistently favorable results.
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Roos-Engstrand, Ester. "T cells in chronic obstructive pulmonary disease." Doctoral thesis, Umeå : Umeå university, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-33677.
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Корнус, Олеся Григорівна, Олеся Григорьевна Корнус, Olesia Hryhorivna Kornus, Анатолій Олександрович Корнус, Анатолий Александрович Корнус, Anatolii Oleksandrovych Kornus, Володимир Дмитрович Шищук, et al. "Територіальні відмінності захворюваності населення Сумської області на хронічні обструктивні захворювання легень." Thesis, "Diamond trading tour", 2019. http://essuir.sumdu.edu.ua/handle/123456789/72895.
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Спостереженням охоплено період 2005–2017 років. Станом на 1.01.2018 р. у Сумській області первинна захворюваність на хвороби органів дихання становила 22 070,29 на 100 тис. осіб, а поширеність хвороб – 28 054,31 випадків на 100 тис. населення. Протягом 2005-2017 років спостерігається зростання як первинної захворюваності (на 15,04 %), так і поширеності хвороб органів дихання – на 14,42 %.Наблюдением охвачен период 2005-2017 годов. По состоянию на 1.01.2018 г. в Сумской области первичная заболеваемость болезнями органов дыхания составила 22 070,29 на 100 тыс. человек, а распространенность болезней - 28 054,31 случаев на 100 тыс. населения. В течение 2005-2017 годов наблюдается рост как первичной заболеваемости (на 15,04%), так и распространенности болезней органов дыхания - на 14,42%.
The observation covers the period 2005-2017. As of January 1, 2018, in the Sumy region, the primary incidence of respiratory diseases was 22,070.29 per 100 thousand people, and the prevalence of diseases was 28,054.31 cases per 100 thousand population. During 2005-2017, there is an increase in both primary morbidity (by 15.04%) and the prevalence of respiratory diseases - by 14.42%.
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Fisher, Kimberly A. "Impact of COPD on the Mortality and Treatment of Patients Hospitalized with Acute Decompensated Heart Failure (The Worcester Heart Failure Study): A Masters Thesis." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/717.
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Objective: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure, yet little is known about the impact of this condition in patients with acute decompensated heart failure (ADHF), especially from a more generalizable, community-based perspective. The primary objective of this study was to describe the in-hospital and post discharge mortality and treatment of patients hospitalized with ADHF according to COPD status.
Methods: The study population consisted of patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during 4 study years: 1995, 2000, 2002, and 2004.
Results: Of the 9,748 patients hospitalized with ADHF during the years under study, 35.9% had a history of COPD. The average age of this population was 76.1 years, 43.9% were men, and 93.3% were white. At the time of hospital discharge, patients with COPD were less likely to have received evidence-based heart failure medications, including beta-blockers and ACE inhibitors/angiotensin receptor blockers, than patients without COPD. Multivariable adjusted in-hospital death rates were similar for patients with and without COPD. However, among patients who survived to hospital discharge, patients with COPD had a significantly higher risk of dying at 1 (adjusted RR 1.10; 95% CI 1.06, 1.14) and 5-years (adjusted RR 1.40; 95% CI 1.28, 1.42) after hospital discharge than patients who were not previously diagnosed with COPD.
Conclusions: COPD is a common co-morbidity in patients hospitalized with ADHF and is associated with a worse long-term prognosis. Further research is required to understand the complex interactions of these diseases and to ensure that patients with ADHF and COPD receive optimal treatment modalities.
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Fisher, Kimberly A. "Impact of COPD on the Mortality and Treatment of Patients Hospitalized with Acute Decompensated Heart Failure (The Worcester Heart Failure Study): A Masters Thesis." eScholarship@UMMS, 2007. http://escholarship.umassmed.edu/gsbs_diss/717.
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Objective: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure, yet little is known about the impact of this condition in patients with acute decompensated heart failure (ADHF), especially from a more generalizable, community-based perspective. The primary objective of this study was to describe the in-hospital and post discharge mortality and treatment of patients hospitalized with ADHF according to COPD status.
Methods: The study population consisted of patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during 4 study years: 1995, 2000, 2002, and 2004.
Results: Of the 9,748 patients hospitalized with ADHF during the years under study, 35.9% had a history of COPD. The average age of this population was 76.1 years, 43.9% were men, and 93.3% were white. At the time of hospital discharge, patients with COPD were less likely to have received evidence-based heart failure medications, including beta-blockers and ACE inhibitors/angiotensin receptor blockers, than patients without COPD. Multivariable adjusted in-hospital death rates were similar for patients with and without COPD. However, among patients who survived to hospital discharge, patients with COPD had a significantly higher risk of dying at 1 (adjusted RR 1.10; 95% CI 1.06, 1.14) and 5-years (adjusted RR 1.40; 95% CI 1.28, 1.42) after hospital discharge than patients who were not previously diagnosed with COPD.
Conclusions: COPD is a common co-morbidity in patients hospitalized with ADHF and is associated with a worse long-term prognosis. Further research is required to understand the complex interactions of these diseases and to ensure that patients with ADHF and COPD receive optimal treatment modalities.
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Flaherty, Helen M. "Informal Caregivers’ Experience During Acute Exacerbation of COPD in Older Adults: A Dissertation." eScholarship@UMMS, 2017. https://escholarship.umassmed.edu/gsn_diss/51.
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Chronic obstructive pulmonary disease (COPD) has been recognized as a leading cause of mortality in older adults involving acute exacerbations as life-threatening events that lead to frequent hospitalization for care. Informal caregivers have been essential to helping older adults with COPD during an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A lack of empirical knowledge exists regarding the experience of informal caregivers of older adults with AECOPD in situation awareness for recognizing, understanding, and responding to an AECOPD in an emergent situation. This qualitative descriptive study explored situation awareness and its components of perception, comprehension and projection of next steps, including the caregiver’s confidence level during the AECOPD event. Fifteen informal caregivers, ages 31-77 years (mean age 48), who provided care for older adults with COPD were interviewed from an underserved community health center. The overarching theme derived from this study was something was wrong and something needed to be done. Subthemes emerged as a heightened sense of awareness, caregiver tipping point, planning next steps, caregiver confidence, and caregiver commitment. This study utilized situation awareness theory as a relevant guiding framework in exploring the experience of lay informal caregivers caring for older adults with AECOPD events. Study findings provided a description of the complex processes involved, including confidence level, for informal caregiver’s in situation awareness to recognize and respond to an AECOPD event in the older adult. Future targeted interventions need to address strategies to enhance individualized care for older adults with AECOPD events for managing care at home.
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Costa, Gerusa Maritimo da. "Efeito do uso de salbutamol nas propriedades mecânicas do sistema respiratório de indivíduos saudáveis, tabagistas e portadores de doença pulmonar obstrutiva crônica." Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=6359.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorA doença pulmonar obstrução crônica (DPOC) é caracterizada pela limitação de fluxo parcialmente reversível, classificada por níveis de obstrução pós-broncodilatador. Há várias evidências de que o FEV1 sozinho não é capaz de mostrar a broncodilatação de pacientes com DPOC, mesmo naqueles que apresentam melhora clínica. A técnica de oscilações forçadas (TOF) tem mostrado alta sensibilidade na detecção precoce de alterações mecânicas na DPOC, contudo o efeito broncodilatador na impedância respiratória de pacientes com DPOC ainda não está esclarecido. Objetiva avaliar a utilidade da TOF nos diferentes estágios de obstrução das vias aéreas; (2) avaliar a resposta da impedância respiratória ao salbutamol em indivíduos saudáveis ao exame espirométrico e pacientes com DPOC em diferentes graus de gravidade. Foram avaliados 25 indivíduos saudáveis sem história de tabagismo, 24 tabagistas e 151 pacientes com DPOC classificados em graus I, II, III e IV. Todos os sujeitos foram avaliados pela TOF seguida da espirometria, antes e após o uso do salbutamol spray. As curvas de resistência e reatância demonstraram alteração em todos os estágios de obstrução das vias aéreas após o uso do salbutamol. O grupo de risco apresentou alterações mecânicas semelhantes ao grupo leve (p=ns). Os parâmetros R0, Rm, Csr,din e Z4Hz apresentam desempenho diagnóstico adequado (AUC > 0,85) em todos os estágios de gravidade da doença. Todos os parâmetros de TOF e espirometria apresentaram diminuição após uso do salbutamol. Os indivíduos saudáveis apresentaram uma pequena diminuição comparada aos subgrupos de DPOC. A variação em termos absolutos da ΔZ4Hz e das derivadas da resistência, ΔR0, ΔRm, ΔS, apresentaram variação significativa (p<0,0001, p<0,003; p<0,04; p<0,0002, respectivamente) com o aumento da obstrução brônquica. Nas derivadas da reatância o ΔXm aumentou com a gravidade da doença (p<0,0002). Por outro lado, a ΔCrs,dyn não demonstrou diferença significativa com a gravidade da DPOC. Em termos percentuais os parâmetros da TOF apresentaram variação expressiva em ΔRm% (p<0,02), ΔS% (p<0,02) e ΔXm% (p<0,004) com o aumento da obstrução nas vias aéreas. Por outro lado, ΔR0%, ΔCrs,dyn% e ΔZ4Hz% não variaram entre os estágios da DPOC. A associação entre a broncodilatação nas vias aéreas e a impedância pulmonar foi fraca entre ΔXm vs ΔFVC (r=0,32, p<0,0001) e ΔZ4Hz% vs ΔFEV1% vs ΔFVC% (r=0.28, p<0,0005; r=0,29, p<0,0003, respectivamente). A TOF é útil na avaliação das alterações mecânicas nos diferentes níveis de obstrução das vias aéreas na DPOC. Demonstramos o benefício da medicação broncodilatadora, quantificando a melhora da ventilação através da TOF. A impedância respiratória diminui em todos os estágios da DPOC, o estágio leve melhorou tanto quanto o estágio muito grave. Isto sugere que a medida da impedância pulmonar não é dependente do volume como ocorre na espirometria e que a broncodilatação ocorre em todas as fases da progressão da DPOC.
Chronic obstructive pulmonary disease (COPD) is characterized by partially reversible flow limitation, classified by the post-bronchodilator level of airway obstruction. There is abundant evidence that FEV1 alone is not able to show bronchodilation in COPD patients, even in patients with clinical improvement. The forced oscillation technique (FOT) has shown high sensitivity for early detection of mechanical changes in COPD. However, the bronchodilator effect on respiratory impedance is still unclear. Objective to evaluate the utility of FOT in the diagnosis of different stages of airway obstruction, (2) to investigate the response to salbutamol in healthy, smoking and COPD patients in different degrees of severity. We evaluated 25 healthy subjects with no history of smoking, 24 smokers and 151 COPD patients classified into grades I, II, III and IV of severity. All subjects were assessed by the FOT followed by spirometry before and after the use of salbutamol spray. The resistance and reactance curves showed change at all stages of airway obstruction after the use of salbutamol. The smoking group showed similar mechanical changes to the mild group (p=ns). The parameters R0, Rm, Csr,din and Z4Hz presented adequate diagnostic accuracy (AUC>0.85) in all stages of disease severity. All FOT and spirometry parameters showed decreased after salbutamol use. Healthy individuals showed a small decrease compared with the subgroups of COPD. The variations of the impedance module (ΔZ4Hz) and resistance parameters, (ΔR0, ΔRm, Δs) were significant (p<0.0001, p<0.003, p<0.04 and p<0.0002, respectively) with increased bronchial obstruction. Mean reactance (ΔXm) increased with disease severity (p<0.0002). The ΔCrs,dyn showed no significant change with the severity of COPD. In percentage terms, FOT parameters showed significant variation in ΔRm% (p<0.02), Δs (p<0.02) and ΔXm% (p<0.004) with increased airway obstruction. ΔR0% ΔCrs,dyn% and ΔZ4Hz% did not vary between different stages of COPD. The association between bronchodilation in the airways and lung impedance was weak between ΔXm vs ΔFVC (r=0.32, p<0.0001) and ΔZ4Hz% vs ΔFEV1% vs ΔFVC% (r=0.28, p<0.0005, r=0.29, p<0.0003, respectively). The FOT is useful in the evaluation of the mechanical changes at different levels of airway obstruction in COPD. We demonstrate the benefit of a bronchodilator, quantifying the improvement of ventilation through the FOT. The respiratory impedance decreases in all stages of COPD. This suggests that the impedance changes are not dependent on lung volume as in spirometry and that bronchodilation occurs at all stages of the progression of COPD.
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Mentro, Anne M. "Vitamin A status and inflammation during the first week of life in extremely premature infants at risk for bronchopulmonary dysplasia." Connect to this title online, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1092500146.
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Thesis (Ph. D.)--Ohio State University, 2004.Title from first page of PDF file. Document formatted into pages; contains xiv, 133 p.; also includes graphics (some col.) Includes bibliographical references (p. 107-133). Available online via OhioLINK's ETD Center
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Günther, Sven. "Remodelage vasculaire pulmonaire associé à la fibrose pulmonaire : implication de l'axe MIF-CD74 A role of MIF and D-DT in immune-inflammatory, autoimmune, and chronic respiratory diseases: from pathogenic factors to therapeutic targets MIF inhibition in a murine model of bleomycin-induced pulmonary fibrosis." Thesis, Sorbonne Paris Cité, 2018. https://wo.app.u-paris.fr/cgi-bin/WebObjects/TheseWeb.woa/wa/show?t=2253&f=14280.
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Des travaux récents ont mis en évidence une surexpression du facteur MIF (facteur inhibiteur de la migration des macrophages), un des plus anciens médiateurs immunologiques connus, et de son récepteur CD74 dans l'hypertension pulmonaire idiopathique. Or, la sur-activation de cet axe MIF-CD74 est connue pour contribuer à l'acquisition et au maintien d'un phénotype pro-inflammatoire de la cellule endothéliale pulmonaire (Le Hiress et al. 2015). Les taux sériques élevés de MIF ont été mis en évidence dans de nombreuses pathologies respiratoires chroniques, notamment dans la fibrose pulmonaire idiopathique (FPI) et l'hypertension pulmonaire (HTP) associée ou non à une sclérodermie systémique (SSc) (Olivieri et al. 2016 ; Bargagli et al. 2009 ; Marshall et al. 2017 ; Le Hiress et al. 2015 ; Stefanantoni et al. 2015). De plus, il est bien établi que les maladies respiratoires chroniques ont un fort retentissement sur la circulation pulmonaire et peuvent conduire à son remodelage et donc au développement d'HTP, ce qui assombrit encore plus le pronostic de ces patients surtout lorsque celle-ci est dépistée tardivement. Nous avons donc émis l'hypothèse qu'une sur-activation de l'axe MIF/CD74 pourrait contribuer au remodelage structurelle et fonctionnelle de la circulation pulmonaire dans le contexte d'une fibrose pulmonaire. Pour tester cette hypothèse, notre projet s'est articulé autour de deux objectifs. D'abord, nous avons étudié l'état d'activation de l'axe MIF/CD74 dans les poumons de patients avec fibrose pulmonaire idiopathique présentant ou non une HTP. Ces mêmes expériences ont ensuite été menées sur des poumons de souris présentant une fibrose pulmonaire induite par injection intra-trachéale de bléomycine. Puis, nous avons testé l'efficacité de l'inhibition du facteur MIF dans un modèle murin de fibrose pulmonaire induite par la bléomycine à l'aide de deux antagonistes spécifiques de cette voie : le (S, R)-3-(4-hydroxyphényl)-4,5-dihydro-5-isoxazole acétique ester méthylique d'acide (ISO-1) et le N-(5-méthylphényl)-benzoxazol-2-one 31 (composé 31) (Le Hiress et al. 2018). Pour cela, une évaluation de l'hémodynamique pulmonaire par cathétérisme cardiaque droit a été réalisée, ainsi qu'une étude histologique afin d'évaluer le remodelage vasculaire pulmonaire, l'infiltration inflammatoire ainsi que le dépôt de collagènes chez des souris traitées ou non pendant 21 jours avec les deux antagonistes spécifiques du MIF (20mg/kg/j, par gavage). Contrairement à l'endothélium des artères pulmonaires de patients avec IPF, nous avons ainsi pu mettre en évidence une surexpression de MIF et de son récepteur CD74 dans l'endothélium dysfonctionnel des artères pulmonaires remodelées de patients IPF avec HTP. De plus, ces observations ont pu être reproduites dans les poumons de souris traitées à la bléomycine. De manière intéressante, nos données montrent que les souris bléomycine développent des HTP modérées et que des traitements chroniques avec ISO-1 ou le composé 31 atténuent partiellement la sévérité de cette HTP, ainsi que le dépôt de collagène et l'infiltration pulmonaire de cellules inflammatoires. En conclusion, nos données indiquent que MIF et son récepteur CD74 représentent des cibles thérapeutiques potentielles qui pourraient prévenir le remodelage vasculaire pulmonaire induit par le développement de la fibrose pulmonaireRecently, it has been demonstrated that MIF (macrophage migration inhibitory factor) and its endothelial receptor CD74 are up-regulated in idiopathic pulmonary hypertension (iPH) and contribute to the pro-inflammatory endothelial phenotype (Le Hiress et al. 2015). However, it is well established that chronic respiratory diseases have a strong impact on the homeostasis of the pulmonary circulation which can lead to its remodeling and the development of PH, that further darkens the prognosis of these patients. In addition, it is known that high serum MIF levels are found in several chronic respiratory diseases, particularly in patients with idiopathic pulmonary fibrosis (IPF) or PH associated with or not to systemic scleroderma (SSc) (Bargagli et al. 2009; Le Hiress et al. 2015; Stefanantoni et al. 2015 ; Olivieri et al. 2016; Marshall et al. 2017). We therefore hypothesized that over-activation of the MIF/CD74 axis could contribute to the pulmonary vascular remodeling and the development of PH in the context of pulmonary fibrosis. To test this hypothesis, we first studied the activation state of the MIF/CD74 axis in idiopathic pulmonary fibrosis patients with or without PH. Similar investigations were also performed on pulmonary sections of lungs of mice with established pulmonary fibrosis induced by intra-tracheal injection of bleomycin. Second, we tested the effect of MIF inhibition in a murine model of bleomycin-induced pulmonary fibrosis using two antagonists specific for this pathway: (S, R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester (ISO-1) and N-(5-methylphenyl)-benzoxazol-2-one 31 (compound 31) (Le Hiress et al. 2018). Pulmonary hemodynamic parameters were measured by right heart catheterization and histological analyses were performed to evaluate the degree of pulmonary vascular remodeling, lung infiltration of inflammatory cells, and collagen deposition in mice treated or not with the two specific MIF antagonists (20mg/kg/day for 21 days, per os). In contrast to the pulmonary endothelium of IPF patients, our data indicate that an over-expression of MIF and its CD74 receptor in the dysfunctional pulmonary endothelium of remodeled vessels of pulmonary fibrosis patients with PH. In addition, these observations were replicated in lungs of bleomycin-treated mice. Interestingly, we also found that bleomycin-injected mice exhibit mild PH as reflected by increased values of right ventricular systolic pressure (RVSP), of Fulton index (right ventricular hypertrophy) and of percentage of muscularized pulmonary arteries. In addition, we found that chronic treatments of bleomycin-injected mice with ISO-1 or compound 31 partially attenuated PH, collagen deposition and pulmonary inflammatory infiltration. Taken together, our data support that MIF and its CD74 receptor could represent an attractive therapeutic target for preventing pulmonary vascular remodeling induced by the development of pulmonary fibrosis
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Domínguez, Fandos David. "Estudio de los efectos de agentes anticolinérgicos y de inhibidores de fosfodiesterasa-5 sobre la estructura pulmonar en un modelo experimental de enfermedad pulmonar obstructiva crónica inducido por humo de tabaco en el cobayo." Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/293379.
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La enfermedad pulmonar obstructiva crónica (EPOC) es una patología prevenible caracterizada por una limitación al flujo aéreo progresiva y no completamente reversible, disnea, producción de esputo y tos crónica.
La obstrucción al flujo aéreo se asocia a un proceso inflamatorio crónico en la vía aérea y el parénquima pulmonar en respuesta a partículas nocivas o gases inhalados, en particular al humo de cigarrillo (HC) (Figura. Esta respuesta inflamatoria crónica puede inducir la destrucción del parénquima pulmonar o enfisema y alteraciones estructurales de la vía aérea pequeña al alterar los mecanismos de reparación y defensa. De esta manera, se produce limitación progresiva al flujo aéreo debido a la menor retracción elástica y aumento de la distensibilidad pulmonar. La inflamación y el estrechamiento de la vía aérea periférica también contribuyen a la limitación del flujo aéreo produciendo una disminución del volumen de aire espirado en el primer segundo de la espiración forzada (FEV1) en la espirometría forzada. Además, alteraciones en las relaciones ventilación-perfusión (VA/Q) pueden dar lugar a hipoxemia e hipercapnia en estos pacientes. Por otro lado, la inflamación inducida por el HC lleva a la hipersecreción mucosa, que también se asocia con el declive del FEV1, debida al mayor número de células caliciformes en la epitelio bronquial y al aumento de las glándulas submucosas, resultando en tos productiva que es característica de la bronquitis crónica, entidad clínica independiente.
En el curso evolutivo de la EPOC puede desarrollarse hipertensión pulmonar (HP) debida al remodelado vascular caracterizado por la hiperplasia de la capa íntima y la muscularización de arteriolas (8). Estos cambios se han atribuido a la acción directa del HC sobre el endotelio vascular, a la cual puede añadirse la vasoconstricción pulmonar hipóxica (VPH). Por otro lado, se postula que la perdida de lecho capilar pulmonar debido al enfisema podría contribuir al desarrollo de la HP asociada a la EPOC. También se ha demostrado infiltración por células inflamatorias y disfunción endotelial en las arterias pulmonares de pacientes con EPOC. Por su parte, la HP sostenida puede promover la hipertrofia del ventrículo derecho (VD) y llevar al desarrollo de “cor pulmonale” e insuficiencia cardiaca derecha. Los pacientes con EPOC también presentan comorbilidades a nivel sistémico, incluyendo enfermedades cardiovasculares, disfunción del musculo esquelético, y cáncer de pulmón.
Vistos los antecedentes, la presente tesis doctoral se plantea en base a las siguientes hipótesis:
1. El modelo experimental de EPOC por exposición al HC en cobayos reproduce la destrucción del parénquima y las alteraciones en la vía aérea y vasos pulmonares características de la EPOC, en los que diferentes mediadores químicos y células inflamatorias tendrían un papel fisiopatológico destacable. Por este motivo, hipotetizamos que la exposición crónica al HC producirá en cobayos un proceso inflamatorio asociado con cambios morfológicos y funciónales en las estructuras pulmonares similares a lo que se observa en los pacientes con EPOC.
2. La adecuada caracterización del modelo experimental de EPOC en cobayos permitiría su uso en la evaluación de los efectos de nuevos fármacos y dianas terapéuticas en el tratamiento de la EPOC. En este sentido, se evalúan los efectos de bromuro de aclidinio, un antagonista muscarínico de acción prolongada, y sildenafilo, un inhibidor selectivo de la PDE5.
Teniendo en cuenta todo ello, los objetivos que se plantearon en los tres artículos que conforman esta tesis doctoral fueron:
1.- Primer artículo. “Pulmonary inflammatory reaction and structural changes induced by cigarette smoke exposure in the Guinea pig.”
A) Objetivo general: Evaluar la naturaleza y características de la reacción inflamatoria en el pulmón, y su implicación en los cambios estructurales que tienen lugar a nivel pulmonar en el modelo experimental de EPOC en cobayos expuestos crónicamente al HC.
B) Objetivos concretos: I. Caracterizar el tipo de células inflamatorias y su distribución en las estructuras pulmonares (vía aérea, vasos y parénquima). II. Analizar el remodelado de la vía aérea y de los vasos pulmonares. III. Evaluar la presencia de fibrosis y la aparición de enfisema en el parénquima. IV. Explorar los mecanismos que interconectan la infiltración de células inflamatorias con las alteraciones estructurales características de la EPOC. V. Establecer la importancia, el orden secuencial y la dinámica de estas alteraciones en el desarrollo de la EPOC.
2.- Segundo artículo. “Effects of Aclidinium Bromide in a Cigarette Smoke-Exposed Guinea Pig Model of Chronic Obstructive Pulmonary Disease”.
A) Objetivo general. Investigar los efectos del broncodilatador bromuro de aclidinio sobre los cambios histopatológicos y el infiltrado de células inflamatorias en los pulmones del modelo de EPOC en cobayos crónicamente expuestos al HC.
B) Objetivos concretos. I. Evaluar el efecto de aclidinio sobre las alteraciones morfológicas, como potencial agente antirremodelado de la vía aérea. II. Evaluar el efecto de aclidinio sobre la infiltración de células inflamatorias en las estructuras pulmonares, como potencial agente antiinflamatorio. III. Evaluar el efecto de aclidinio sobre la función pulmonar y los signos respiratorios característicos de la EPOC, particularmente su efecto broncodilatador. IV. Evaluar el efecto de aclidinio sobre otras alteraciones típicas de la EPOC como la metaplasia de células caliciformes y el desarrollo de enfisema pulmonar. V. Explorar posibles mecanismos que interconectan los diferentes cambios observados con la administración de aclidinio.
3.- Tercer artículo. “Sildenafil in a cigarette smoke-induced model of COPD in the guinea pig”.
A) Objetivo general. Evaluar los efectos del vasodilatador sildenáfilo sobre la hemodinámica pulmonar, función endotelial, y el remodelado vascular y del parénquima, en el modelo de EPOC en cobayos crónicamente expuestos al HC.
B) Objetivos concretos. I. Evaluar el efecto de sildenafilo sobre la hemodinámica pulmonar, como agente vasodilatador de la circulación pulmonar. II. Evaluar el efecto de sildenafilo sobre la hipertrofia del VD y la función endotelial de arterias pulmonares. III. Evaluar el efecto de sildenafilo sobre las alteraciones morfológicas y el remodelado vascular pulmonar, como potencial agente antiproliferativo. IV. Evaluar el efecto de sildenafilo sobre el funcionalismo respiratorio. V. Integrar posibles mecanismos que expliquen los cambios producidos con la administración de sildenafilo.
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Balasubramanian, Deepak. "Pseudomonas Aeruginosa AmpR Transcriptional Regulatory Network." FIU Digital Commons, 2013. http://digitalcommons.fiu.edu/etd/863.
Full textAbstract:
In Enterobacteriaceae, the transcriptional regulator AmpR, a member of the LysR family, regulates the expression of a chromosomal β-lactamase AmpC. The regulatory repertoire of AmpR is broader in Pseudomonas aeruginosa, an opportunistic pathogen responsible for numerous acute and chronic infections including cystic fibrosis. Previous studies showed that in addition to regulating ampC, P. aeruginosa AmpR regulates the sigma factor AlgT/U and production of some quorum sensing (QS)-regulated virulence factors. In order to better understand the ampR regulon, the transcriptional profiles generated using DNA microarrays and RNA-Seq of the prototypic P. aeruginosa PAO1 strain with its isogenic ampR deletion mutant, PAO∆ampR were analyzed. Transcriptome analysis demonstrates that the AmpR regulon is much more extensive than previously thought influencing the differential expression of over 500 genes. In addition to regulating resistance to β-lactam antibiotics via AmpC, AmpR also regulates non-β-lactam antibiotic resistance by modulating the MexEF-OprN efflux pump. Virulence mechanisms including biofilm formation, QS-regulated acute virulence, and diverse physiological processes such as oxidative stress response, heat-shock response and iron uptake are AmpR-regulated. Real-time PCR and phenotypic assays confirmed the transcriptome data. Further, Caenorhabditis elegans model demonstrates that a functional AmpR is required for full pathogenicity of P. aeruginosa. AmpR, a member of the core genome, also regulates genes in the regions of genome plasticity that are acquired by horizontal gene transfer. The extensive AmpR regulon included other transcriptional regulators and sigma factors, accounting for the extensive AmpR regulon. Gene expression studies demonstrate AmpR-dependent expression of the QS master regulator LasR that controls expression of many virulence factors. Using a chromosomally tagged AmpR, ChIP-Seq studies show direct AmpR binding to the lasR promoter. The data demonstrates that AmpR functions as a global regulator in P. aeruginosa and is a positive regulator of acute virulence while negatively regulating chronic infection phenotypes. In summary, my dissertation sheds light on the complex regulatory circuit in P. aeruginosa to provide a better understanding of the bacterial response to antibiotics and how the organism coordinately regulates a myriad of virulence factors.
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Salomão, Junior João Batista. "Competência social e transtornos comportamentais em crianças portadoras de asma moderada e grave." Faculdade de Medicina de São José do Rio Preto, 2001. http://bdtd.famerp.br/handle/tede/154.
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Previous issue date: 2001-06-12Objective Evaluate, social competence and behavior disorders in children with moderate to severe asthma according to parental perception. Casuistics: Sixty-two patients were studied, 36 male and 26 female, ages ranging from 7 to 16 years (MA: 10.94; SD: 2.28), with clinical diagnosis of moderate to severe asthma, without comorbidity, seen at the Pediatric Pneumology Service and the Allergy and Immunology Service at a University Hospital, from March to September, 2000. A control group was simultaneously studied and included 62 patients, 37 male and 25 female, ages ranging from 7 to 16 years (MA: 10.26; SD: 2.37), seen at the Orthopedics and Ophthalmology Outpatient Wards at the same hospital, without symptoms of asthma, respiratory allergy and no chronic diseases. Material and method An Identification Form, a Clinical Data Form and the CBCL (Child Behavior Checklist), a tool to evaluate social competence and behavior disorders, were used. Results Results were evaluated by the proportional tests, Student s t test and ANADEP and ANADEPMU and a significance level of 0.05 was chosen. Patients were classified according to the clinical manifestations of asthma: 42 had moderate asthma and 20 had severe asthma, most of them (93.55%) had been diagnosed since 3 years of age. There was no significant difference in age and gender between the group with asthma and the control group. There was a marked association between overall social competence and asthma (with p=0.000) and between social competence associated to activities (with p=0.001) and school (with p=0.01). There was no difference between children with asthma and the control group for social markers (with p=0.23). There was no correlation between gender and age when evaluating social competence, or overall social competence specific parameters: activities, school and social activities. The evaluation of social competence and type of asthma did not show a correlation. There was a strong association between the presence of behavior disorders and asthma (p=0.005), specially internalizing disorders (p=0.001). There was no association between the externalizing disorders and the disease. Behavior disorders were not associated to gender, age and type of asthma. Conclusions Children with asthma showed alterations in overall social competence and social competence related to activities and school, when compared to the control group. They also showed overall and internalizing disorders, which may be harmful to their development, their quality of life, compliance with the treatment and adequate management of the disease. The integration of biological, psychological and social factors is essential to establish adequate programs for the treatment of children with asthma and their families.
Objetivo - avaliar competência social e transtornos comportamentais em crianças com asma moderada e grave, a partir de percepção dos pais. Causística: foram estudados 62 pacientes, 36 do sexo masculino e 26 do sexo feminino, com idade entre 7 e 16 anos (im:10,94; dp:2,28), com diagnóstico clínico de asma moderada e grave, sem comorbidade, atendidos nos serviços de pneumologia infantil e alergia e imunologia de um hospital escola, no perído de março e setembro de 2000. Um grupo de controle foi estudado no mesmo período, composto de 62 pacientes, 37 do sexo masculino e 25 do sexo feminino, com idade entre 7 e 16 anos (im: 10,26; dp: 2,37), atendidos nos ambulatório de ortopedia e oftalmologia do mesmo hospital, sem qualquer sintomatologia de asma, de alergia respiratória e sem qualquer doença crônica. Material e método - foram utilizados na obtenção dos dados uma ficha de identificação, uma ficha de dados clínicos e um instrumento que avalia competência social e transtornos comportamentais - child behavior checklist (cbcl). Resultados - os resultados foram analisados com testes proporção x (ao quadrado), teste t de student, anadep e anadepmu, adotando-se nível de significância de 0,05. Os pacientes foram classificadossegundo manifestações clínicas da asma: 42 com asma moderada e 20 com asma grave, sendo que 93,55% receberam o diagnóstico da doença antes dos 3 anos de idade. Não houve diferença significante em termos de idade e sexo entre os grupos com asma e controle. Houve associação entre competência social e global e asma (p=0,000) e entre competência social associada a atividades (p=0,001) e escola (p=0,01). Não houve diferença entre crianças com asma e o grupo controle em relação ao aspecto social (p=0,23). Não houve relação entre sexo e idade na análise da competência social, nem quanto à competência social global nem quanto aos aspectos específicos: atividades, escola e social. A análise entre competência social e tipo de asma também não mostrou associação. Houve associação entre presença de transtornos comportamentais e asma (p=0,005), principalmente os transtornos internalizantes (p=0,001). Não houve associação dos externalizantes com a doença. Os transtornos comportamentais não se mostraram associados ao sexo, idade da amostra e tipo de asma. Conclusões - as crianças com asma apresentaram alterações na competência social e global e competência social relacionada a atividades e escola, quando comparadas ao grupo controle. Apresentaram ainda transtornos globais e internalizantes, que podem prejudicar o seu desenvolvimento, sua qualidade de vida, a adesão ao tratamento e o manejo adequado da doença. A integração dos aspectos biológicos, psicológicos e sociais é imprescindível para o delineamento de programas adequados de atendimento à criança portadora de asma e a seus familiares.
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Nguyen, Tu Son. "Promoting quality use of medicine in chronic respiratory diseases in Vietnam: the role of pharmacists." Thesis, 2019. http://hdl.handle.net/1959.13/1404547.
Full textAbstract:
Research Doctorate - Doctor of Philosophy (PhD)Nowadays, the role of pharmacists has evolved to become health care providers of pharmaceutical care services that incorporates patient-orientated and product-orientated services. They not only work together with other health care providers, but also with patients in order to achieve positive outcomes for their therapeutic management. However, in Vietnam and other developing countries, both community and hospital pharmacists are still substantially under-utilised for patient care compared against the pharmaceutical care model of practice. How to improve the contribution of pharmacists in health care is still a tough question that need to be answered, especially in Vietnam with a rising number of better-qualified pharmacists as well as a shortage in other health care human resources, such as doctors and nurses. At the same time, non-communicable diseases are becoming a major public health issue putting a heavy burden on society and the economy of Vietnam. Of these diseases, prevention and treatment of COPD and asthma is contributing to several problems including increasing number of patients, high rate of non-adherence to therapy in patients, and a low proportion of patients using inhalers correctly. Therefore, in exploring how to increase the role of hospital pharmacists in Vietnam, our study has chosen inhaler technique and medication adherence to demonstrate the role of hospital pharmacists’ interventions in the management of COPD and asthma. Our findings showed that hospital pharmacists can teach COPD patients to improve their inhaler technique and counsel patients to improve adherence in a very efficient manner. The pharmacist-led programs also showed positive impact on patients’ quality of life. How to improve pharmacists’ contribution to management of asthma in the community setting is another issue that needs to be addressed. Literature showed that a continuing education program is a key strategy for the community pharmacy sector to assist in improving the management of asthma in developing countries like Vietnam. Our present study developed and evaluated an educational program for community pharmacists and evaluated its effectiveness with the simulated patient method. The study demonstrated that our training program was highly effective in equipping community pharmacists with the necessary knowledge and practical skills to counsel asthmatic patients about the management of their condition and medications. It is suggested that such education programs should be promptly implemented and made compulsory for community pharmacists in Vietnam to improve the quality of counselling for patients with asthma and other non-communicable diseases. Overall, our studies demonstrated that with proper encouragement and simple continued professional education, both hospital and community pharmacists can expand their role to contribute to better management of asthma and COPD in Vietnam. This model may produce the same positive outcomes in other chronic diseases and should be considered by the relevant authorities in Vietnam and other developing countries.
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Govender, Nadira. "Occupational exposures and chronic obstructive pulmonary disease : a hospital-based case-control study." Thesis, 2009. http://hdl.handle.net/10413/4793.
Full textAbstract:
Aim
The aim of this study was to determine the contribution of occupational exposures
to the burden of Chronic Obstructive Pulmonary Disease (COPD) among a sample
of hospital based patients.
Methods
Cases (n=110) with specialist physician diagnosed COPD from the three public
sector specialist respiratory clinics in KZN and controls (n=102) from other nonrespiratory
chronic ailment specialist clinics at the same institutions were selected.
An interviewer administered questionnaire and exposure history was obtained for
each participant. In addition, a valid lung function test was obtained for each case.
Data was analysed using STATA version 10. Multivariate regression models were
developed to examine the relationship between COPD and occupational
exposures while adjusting for age, sex, smoking and previous history of
tuberculosis. The relationship of FEV1 and occupational exposures, adjusted for
age, height, previous history of tuberculosis and smoking history, was investigated
among cases.
Results
Cases and controls were similar with respect to age and sex distribution. Cigarette
smoking differed significantly between cases and controls with a larger proportion
of cases having ceased to smoke compared to controls (72% vs 46%, p<0.01). A
higher proportion of controls reported employment in administrative, managerial
and quality control positions (21.3% vs 12.0%, 7.7% vs 2.6% and 5.4% vs 0.3%
respectively). Employment in the construction and shoe manufacturing industries
was reported more frequently by cases (10.3% vs 3.2% and 10.0% vs 4.9%
respectively). Cases were more likely than controls to have been exposed to dust
(72% vs 28%, p<0.001) or to chemicals, gas or fumes (74% vs 25.5%, p<0.001)
and reported exposure durations 3-4 fold higher than that of controls (p<0.001).
Dust and chemical, gas or fume exposure was associated with an increased odds
of developing COPD. Exposure to dusts (OR 7.9, 95% CI 3.9-15.7, p<0.001),
chemicals, gas or fumes (OR 6.4, 95% CI 3.2-12.8, p<0.001) were significantly
associated with odds of developing COPD. In addition, previous history of
tuberculosis, as well as smoking were associated with an increased odds of
COPD (OR 5.7, 95% CI 1.2-27.4 p<0.001 and OR 6.4, 95% CI 2.3-17.7, p<0.001).
Discussion and Conclusion
This is one of the first hospital based case-control studies looking at occupational
contribution to COPD undertaken in South Africa. In this sample of participants,
strong associations were observed between self-reported occupational exposures
to dust, and chemicals, gas or fumes, and physician’s diagnosis of COPD. The
study also demonstrated a strong association between smoking and previous
history of tuberculosis, and risk of COPD. The findings suggest that persons with
known occupational exposures to respiratory irritants should be monitored to
detect the onset of respiratory ill-health and that preventive strategies should
reduce exposure to these agents in the workplace.Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2009.
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Almojaibel, Abdullah. "Understanding intention to use telerehabilitation : applicability of the Technology Acceptance Model (TAM)." Diss., 2017. http://hdl.handle.net/1805/14970.
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Indiana University-Purdue University Indianapolis (IUPUI)Background: Pulmonary rehabilitation (PR) has the potential to reduce the symptoms and complications of respiratory diseases through an interdisciplinary approach. Providing PR services to the increasing number of patients with chronic respiratory diseases challenges the current health care systems because of the shortages in health care practitioners and PR programs. Using telerehabilitation may improve patients’ participation and compliance with PR programs. The purpose of this study was to examine the applicability of the technology acceptance model (TAM) to explain telerehabilitation acceptance and to determine the demographic variables that can influence acceptance. Methods: A cross-sectional survey-based design was utilized in the data collection. The survey scales were based on the TAM. The first group of participants consisted of health care practitioners working in PR programs. The second group of participants included patients attending traditional PR programs. The data collection process started in January 2017 and lasted until May 2017. Results: A total of 222 health care practitioners and 134 patients completed the survey. The results showed that 79% of the health care practitioners and 61.2% of the patients reported positive intention to use telerehabilitation. Regression analyses showed that the TAM was good at predicting telerehabilitation acceptance. Perceived usefulness was a significant predictor of the positive intentions to use telerehabilitation for health care providers (OR: 17.81, p < .01) and for the patients (OR: 6.46, p = .04). The logistic regression outcomes showed that age, experience in rehabilitation, and type of PR increased the power of the TAM to predict the intention to use telerehabilitation among health care practitioners. Age, duration of the disease, and distance from the PR center increased the power of the TAM to predict the intention to use telerehabilitation among patients. Conclusion: This is the first study to develop and validate a psychometric instrument to measure telerehabilitation acceptance among health care practitioners and patients in PR programs. The outcomes of this study will help in understanding the telerehabilitation acceptance. It will help not only to predict future adoption but also to develop appropriate solutions to address the barriers of using telerehabilitation.
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Омельченко, Світлана Анатоліївна. "Ефективність гімнастики Цигун в комплексній реабілітації осіб з хронічними обструктивними захворюваннями легень." Магістерська робота, 2020. https://dspace.znu.edu.ua/jspui/handle/12345/4549.
Full textAbstract:
Омельченко С. А. Ефективність гімнастики Цигун в комплексній реабілітації осіб з хронічними обструктивними захворюваннями легень : кваліфікаційна робота магістра спеціальності 227 «Фізична терапія, ерготерапія» / наук. керівник І. В. Кальонова. Запоріжжя : ЗНУ, 2020. 60 с.UA : Дипломна робота: 60 сторінок, 4 таблиці, 10 рисунків, 54 літературних джерела. Об’єкт дослідження – Цигун терапія у легеневій реабілітації хворих на хронічні обструктивні захворювання легень. Мета дослідження – оцінка ефективності застосування гімнастики Цигун в комплексній реабілітації хворих на хронічні обструктивні захворювання легень. Методи дослідження – теоретичний аналіз науково-методичної літератури; виявлення функціонального стану кардіореспіраторної системи шляхом вимірювання ЧСС, ЖЄЛ, ЧД та проведення динамічної спірометрії (проба Розенталя), визначення індексу Скибінського; методи математичної статистики. Порівняльна оцінка показників функціонального стану кардіореспіраторної системи чоловіків та жінок, які проходили курс стаціонарного лікування в терапевтичному відділенні міської лікарні, а саме – ароматерапії у комплексі з дихальною гімнастикою та ароматерапії в поєднані з гімнастикою Цигун, виявила позитивну динаміку. Після проходження реабілітаційних заходів в обох групах покращились показники кардіореспіраторної системи, як у спокої, так і після дозованого навантаження. Однак включення до реабілітаційної програми підходів Цигун терапії – легеневих функціональних вправ на фоні інгаляцій ефірної олії лаванди дало більш кращі результати, ніж після проходження реабілітаційних заходів традиційного підходу. Одержані результати вказують на ефективність застосування гімнастики Цигун в реабілітації зазначеної категорії хворих.
EN : Thesis: 60 pages, 4 tables, 10 figures, 54 literary sources. The object of research – Cygnus therapy in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease. The purpose of the study was to evaluate the effectiveness of Cygnus Gymnastics in the comprehensive rehabilitation of patients with chronic obstructive pulmonary disease. Research methods – theoretical analysis of scientific and methodological literature; detection of the functional state of the cardiorespiratory system by measuring heart rate, VL, BH and dynamic spirometry (Rosenthal test), determining the Skibinsky index; methods of mathematical statistics. Comparative evaluation of the functional state of the cardiorespiratory system of men and women who underwent inpatient treatment in the therapeutic department of the city hospital, namely – aromatherapy in combination with respiratory gymnastics and aromatherapy in combination with Cygnus gymnastics, showed positive dynamics. After undergoing rehabilitation measures in both groups, the indicators of the cardiorespiratory system improved, both at rest and after dosed exercise. However, the inclusion of Cygnus therapy approaches in the rehabilitation program – pulmonary functional exercises on the background of inhalations of lavender essential oil gave better results than after the rehabilitation measures of the traditional approach. The obtained results indicate the effectiveness of Cygnus gymnastics in the rehabilitation of this category of patients.
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Cravidão, Rita Almeida Carreiras da Fonseca. "Acompanhamento farmacêutico da DPOC na farmácia comunitária." Master's thesis, 2017. http://hdl.handle.net/10437/8314.
Full textAbstract:
Orientação: Madalena PereiraA DPOC assume nos dias de hoje particular relevância nas sociedades mais desenvolvidas. É uma doença subdiagnosticada, representando uma das principais causas de morbilidade e mortalidade quer em Portugal, quer a nível internacional, prevendo-se o aumento da sua prevalência nos próximos anos. Assim, o aumento desta patologia conduz a uma preocupação crescente no que respeita à sua prevenção e controlo, sendo objeto de estudo neste trabalho. Desta forma, procedeu-se à elaboração de um fluxograma de orientação farmacêutica na DPOC para que possa ser aplicado em Farmácias Comunitárias, detetando possíveis casos de DPOC não diagnosticada.
Today, COPD is particularly relevant in developed societies. It is an underdiagnosed disease, representing one of the main causes of morbidity and mortality both in Portugal and internationally, and is expected to increase its prevalence in the next years. Thus, the increase of this pathology leads to a growing concern regarding its prevention and control, therefore is going to be object of study in this work. Accordingly, a flow chart of pharmaceutical orientation in COPD was developed so that it can be applied in Community Pharmacies, detecting possible cases of undiagnosed COPD.
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Koucký, Václav. "Detekce časných patofyziologických změn dýchání u dětí s chronickým plicním onemocněním." Doctoral thesis, 2020. http://www.nusl.cz/ntk/nusl-412517.
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Detection of early pathophysiological changes of breathing in children with chronic respiratory disease MD. Vaclav Koucky - Ph.D. thesis Abstract Introduction: Currently, there are different methods for infant pulmonary function testing (iPFT) and morphological assessment of microscopic changes in endobronchial biopsy samples (EBB). In research setting, they allow detection of early pathophysiological changes of breathing in small children with chronic respiratory disease, respectively in risk of its development. Their clinical significance, however, is not fully acknowledged. The aim of this thesis is to evaluate the safety, feasibility and clinical significance of iPFT and EBB in infants younger than 2 years of age. In addition, the relationship between functional and morphological changes of respiratory tract and the function of peripheral chemoreceptors was studied in selected patients' subgroups. Methods: Fifty-five infants with cystic fibrosis (CF), 35 physician-confirmed recurrent wheezers (AB), 9 infants with congenital diaphragmatic hernia, 7 with interstitial lung disease (chILD) and 3 with primary ciliary dyskinesia (PCD) were enrolled. All infants underwent iPFT and relevant clinical history data were recorded. Based on patients' age, CF group was divided into CFmalí (< 6 months) and CFvelcí (>...