scholarly journals Diagnostic accuracy of respiratory diseases in primary health units

2014 ◽  
Vol 60 (6) ◽  
pp. 599-612 ◽  
Author(s):  
Bruno Piassi de São José ◽  
Paulo Augusto Moreira Camargos ◽  
Álvaro Augusto Souza da Cruz Filho ◽  
Ricardo de Amorim Corrêa
Keyword(s):  
Diagnostic Accuracy ◽  
General Practitioners ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Diagnostic Errors ◽  
Chronic Obstructive ◽  
World Population ◽  
Diagnostic Ability ◽  
Obstructive Pulmonary Disease ◽  
Primary Health

Respiratory diseases are responsible for about a fifth of all deaths worldwide and its prevalence reaches 15% of the world population. Primary health care (PHC) is the gateway to the health system, and is expected to resolve up to 85% of health problems in general. Moreover, little is known about the diagnostic ability of general practitioners (GPs) in relation to respiratory diseases in PHC. This review aims to evaluate the diagnostic ability of GPs working in PHC in relation to more prevalent respiratory diseases, such as acute respiratory infections (ARI), tuberculosis, asthma and chronic obstructive pulmonary disease (COPD). 3,913 articles were selected, totaling 30 after application of the inclusion and exclusion criteria. They demonstrated the lack of consistent evidence on the accuracy of diagnoses of respiratory diseases by general practitioners. In relation to asthma and COPD, studies have shown diagnostic errors leading to overdiagnosis or underdiagnosis depending on the methodology used. The lack of precision for the diagnosis of asthma varied from 54% underdiagnosis to 34% overdiagnosis, whereas for COPD this ranged from 81% for underdiagnosis to 86.1% for overdiagnosis. For ARI, it was found that the inclusion of a complementary test for diagnosis led to an improvement in diagnostic accuracy. Studies show a low level of knowledge about tuberculosis on the part of general practitioners. According to this review, PHC represented by the GP needs to improve its ability for the diagnosis and management of this group of patients constituting one of its main demands.

scholarly journals Air pollution exposure—the (in)visible risk factor for respiratory diseases

2021 ◽  
Author(s):  
Gabriel-Petrică Bălă ◽  
Ruxandra-Mioara Râjnoveanu ◽  
Emanuela Tudorache ◽  
Radu Motișan ◽  
Cristian Oancea
Keyword(s):  
Air Pollution ◽  
Low Income ◽  
Air Pollutants ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Low Income Countries ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Pollution Exposure

AbstractThere is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.

scholarly journals Pharmacotherapy of specific and unspecific respiratory infections

2005 ◽  
pp. 87-92
Author(s):  
Ya. M. Balabanova ◽  
S. I. Kuznetsov ◽  
K. Grem ◽  
I. M. Fedorin ◽  
M. Raddy ◽  
...  
Keyword(s):  
General Practitioners ◽  
Respiratory Infections ◽  
Acute Bronchitis ◽  
Cross Sectional Study ◽  
Lower Airway ◽  
Chronic Obstructive ◽  
Antibacterial Drug ◽  
Acute Tonsillitis ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Irrational administration of antimicrobials, incorrect regimens and dosing provide occurrence of adverse effects with minimal therapeutic results and development of drug resistance including anti-tuberculosis drugs. The study was designed to detect information sources on drug therapy used by general practitioners and TB specialists, to establish stereotypical models of antibacterial drug administration in prevalent upper and lower airway diseases at the Samara region and to substantiate the supposition about unreasonable empiric administration of anti-tuberculosis drugs in a respiratory patient without microbiological confirmation as a probable cause of drug resistant tuberculosis. A cross-sectional study based on a special questionnaire was performed in 425 general practitioners in primary care facilities, hospitals and in TB specialists at the Samara region. The questionnaire contained several clinical situations and their solving and the respondents should choose the most suitable ones. Results demonstrated that majority of the practitioners (80 %, or 340 / 425 cases) widely use advertising information regarding antimicrobials. Several doctors (1.7 %) chose antibacterial drugs to treat acute respiratory viral infection, 0.8 to 1.6 % of doctors certainly decided to administer anti-tuberculotics in non-TB respiratory diseases such as acute bronchitis, chronic obstructive pulmonary disease, communityacquired pneumonia and acute tonsillitis, and approximately one fifth of the practitioners thought to administer antituberculotics in these diseases (18.4 % (78 / 425) – rifampicin, 21.2 % (90 / 425) – isoniasid).

scholarly journals Role of Nrf2 and Its Activators in Respiratory Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Qinmei Liu ◽  
Yun Gao ◽  
Xinxin Ci
Keyword(s):  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Redox Balance ◽  
Antioxidant Response ◽  
Experimental Models ◽  
26S Proteasome ◽  
Chronic Obstructive ◽  
Related Factor ◽  
Protective Effects ◽  
Obstructive Pulmonary Disease

Transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) is a major regulator of antioxidant response element- (ARE-) driven cytoprotective protein expression. The activation of Nrf2 signaling plays an essential role in preventing cells and tissues from injury induced by oxidative stress. Under the unstressed conditions, natural inhibitor of Nrf2, Kelch-like ECH-associated protein 1 (Keap1), traps Nrf2 in the cytoplasm and promotes the degradation of Nrf2 by the 26S proteasome. Nevertheless, stresses including highly oxidative microenvironments, impair the ability of Keap1 to target Nrf2 for ubiquitination and degradation, and induce newly synthesized Nrf2 to translocate to the nucleus to bind with ARE. Due to constant exposure to external environments, including diverse pollutants and other oxidants, the redox balance maintained by Nrf2 is fairly important to the airways. To date, researchers have discovered that Nrf2 deletion results in high susceptibility and severity of insults in various models of respiratory diseases, including bronchopulmonary dysplasia (BPD), respiratory infections, acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), asthma, idiopathic pulmonary fibrosis (IPF), and lung cancer. Conversely, Nrf2 activation confers protective effects on these lung disorders. In the present review, we summarize Nrf2 involvement in the pathogenesis of the above respiratory diseases that have been identified by experimental models and human studies and describe the protective effects of Nrf2 inducers on these diseases.

scholarly journals Infection-Associated Mechanisms of Neuro-Inflammation and Neuro-Immune Crosstalk in Chronic Respiratory Diseases

2021 ◽  
Vol 22 (11) ◽  
pp. 5699
Author(s):  
Belinda Camp ◽  
Sabine Stegemann-Koniszewski ◽  
Jens Schreiber
Keyword(s):  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Airflow Obstruction ◽  
Microbial Colonization ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Neuro Inflammation

Chronic obstructive airway diseases are characterized by airflow obstruction and airflow limitation as well as chronic airway inflammation. Especially bronchial asthma and chronic obstructive pulmonary disease (COPD) cause considerable morbidity and mortality worldwide, can be difficult to treat, and ultimately lack cures. While there are substantial knowledge gaps with respect to disease pathophysiology, our awareness of the role of neurological and neuro-immunological processes in the development of symptoms, the progression, and the outcome of these chronic obstructive respiratory diseases, is growing. Likewise, the role of pathogenic and colonizing microorganisms of the respiratory tract in the development and manifestation of asthma and COPD is increasingly appreciated. However, their role remains poorly understood with respect to the underlying mechanisms. Common bacteria and viruses causing respiratory infections and exacerbations of chronic obstructive respiratory diseases have also been implicated to affect the local neuro-immune crosstalk. In this review, we provide an overview of previously described neuro-immune interactions in asthma, COPD, and respiratory infections that support the hypothesis of a neuro-immunological component in the interplay between chronic obstructive respiratory diseases, respiratory infections, and respiratory microbial colonization.

scholarly journals Epidemiological evidence relating risk factors to chronic obstructive pulmonary disease in China: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261692
Author(s):  
Hong Chen ◽  
Xiang Liu ◽  
Xiang Gao ◽  
Yipeng Lv ◽  
Liang Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chinese Population ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Early Prevention ◽  
Obstructive Pulmonary Disease ◽  
History Of

Background Chronic obstructive pulmonary disease (COPD), the most common chronic respiratory disease worldwide, not only leads to the decline of pulmonary function and quality of life consecutively, but also has become a major economic burden on individuals, families, and society in China. The purpose of this meta-analysis was to explore the risk factors for developing COPD in the Chinese population that resides in China and to provide a theoretical basis for the early prevention of COPD. Methods A total of 2457 cross-sectional, case-control, and cohort studies published related to risk factors for COPD in China were searched. Based on the inclusion and exclusion criteria, 20 articles were selected. Stata 11.0 was used for meta-analysis. After merging the data, the pooled effect and 95% confidence intervals (CIs) were calculated to assess the association between risk factors and COPD. Heterogeneity between studies was assessed using I2 and Cochran’s Q tests. Begg’s test was used to assess publication bias. Results Exposure to particulate matter less than 2.5 μm in diameter (PM2.5) (pooled effect = 1.73; 95%CI: 1.16~2.58; P <0.01), smoking history (pooled effect = 2.58; 95%CI: 2.00~3.32; P <0.01), passive smoking history (pooled effect = 1.39; 95%CI: 1.03~1.87; P = 0.03), male sex(pooled effect = 1.70; 95%CI: 1.31~2.22; P <0.01), body mass index (BMI) <18.5 kg/m2 (pooled effect = 1.73; 95%CI: 1.32~2.25; P <0.01), exposure to biomass burning emissions (pooled effect = 1.65; 95%CI: 1.32~2.06; P <0.01), childhood respiratory infections (pooled effect = 3.44; 95%CI: 1.33~8.90; P = 0.01), residence (pooled effect = 1.24; 95%CI: 1.09~1.42; P <0.01), and a family history of respiratory diseases (pooled effect = 2.04; 95%CI: 1.53~2.71; P <0.01) were risk factors for COPD in the Chinese population. Conclusion Early prevention of COPD could be accomplished by quitting smoking, reducing exposure to air pollutants and biomass burning emissions, maintaining body mass index between 18.5 kg/m2 and 28 kg/m2, protecting children from respiratory infections, adopting active treatments to children with respiratory diseases, and conducting regular screening for those with family history of respiratory diseases.

Lower respiratory tract infections in patients with comorbidities

2020 ◽  
Vol 1 (1) ◽  
pp. 29-34
Author(s):  
Leonid Dvoretsky ◽  
Keyword(s):  
Respiratory Diseases ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease ◽  
Tract Infections ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Comorbidities are an important factor of the various infectious respiratory diseases emergence, complications development and prognosis. The most frequent comorbidities affecting the course and outcome of respiratory infections are the following: cardiovascular disease (heart failure, various types of coronary artery disease, cerebrovascular disease), chronic obstructive pulmonary disease, diabetes mellitus, obesity. The paper reports data on the discussed comorbidities impact on the course and outcome of bacterial and viral respiratory infections, inter alia in patients with COVID-19.

CRISPR/Cas9 Genome Editing Tool: A Promising Tool for Therapeutic Applications on Respiratory Diseases

2020 ◽  
Vol 20 (5) ◽  
pp. 333-346
Author(s):  
Sadiya Bi Shaikh ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Gene Editing ◽  
Epithelial Mesenchymal Transition ◽  
Respiratory Health ◽  
Chronic Obstructive ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Mesenchymal Transition ◽  
Chronic Respiratory Diseases ◽  
Promising Tool

Respiratory diseases are one of the prime topics of concern in the current era due to improper diagnostics tools. Gene-editing therapy, like Clustered regularly interspaced palindromic repeats- associated nuclease 9 (CRISPR/Cas9), is gaining popularity in pulmonary research, opening up doors to invaluable insights on underlying mechanisms. CRISPR/Cas9 can be considered as a potential gene-editing tool with a scientific community that is helping in the advancement of knowledge in respiratory health and therapy. As an appealing therapeutic tool, we hereby explore the advanced research on the application of CRISPR/Cas9 tools in chronic respiratory diseases such as lung cancer, Acute respiratory distress syndrome (ARDS) and cystic fibrosis (CF). We also address the urgent need to establish this gene-editing tool in various other lung diseases such as asthma, Chronic obstructive pulmonary disease (COPD) and Idiopathic pulmonary fibrosis (IPF). The present review introduces CRISPR/Cas9 as a worthy application in targeting epithelial-mesenchymal transition and fibrinolytic system via editing specific genes. Thereby, based on the efficiency of CRISPR/Cas9, it can be considered as a promising therapeutic tool in respiratory health research.

Hazards for Construction Workers

2017 ◽  
Author(s):  
Gavin H. West ◽  
Laura S. Welch
Keyword(s):  
Heavy Metals ◽  
Prevention And Control ◽  
Respiratory Diseases ◽  
Noise Exposure ◽  
Engineered Nanomaterials ◽  
Construction Workers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
And Control ◽  
The Impact

This chapter describes the hazards for construction workers, with a particular focus on injuries as well as exposures to hazardous chemicals and dusts. A section describes hazardous exposures to lead and other heavy metals. Another section describes noise exposure. The impact of musculoskeletal disorders among construction workers is then discussed. A section on respiratory diseases focuses on asbestosis, silicosis, chronic obstructive pulmonary disease, and asthma. Exposures known to cause dermatitis and cancer are reviewed. There is a discussion of engineered nanomaterials as a potential emerging hazard. Various approaches to prevention and control, including regulations and health services, are described.

scholarly journals Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Official Statistics ◽  
Global Alliance ◽  
Care Level ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Chronic Morbidity ◽  
Official Data

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

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