scholarly journals The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*

2014 ◽  
Vol 9 ◽  
Author(s):  
Stefano Nardini ◽  
Isabella Annesi-Maesano ◽  
Mario Del Donno ◽  
Maurizio Delucchi ◽  
Germano Bettoncelli ◽  
...  
Keyword(s):  
Primary Care ◽  
General Population ◽  
Early Diagnosis ◽  
Respiratory Disease ◽  
Respiratory Diseases ◽  
World Health ◽  
Care Practice ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
The World

Respiratory diseases in Italy already now represent an emergency (they are the 3rd ranking cause of death in the world, and the 2nd if Lung cancer is included). In countries similar to our own, they result as the principal cause for a visit to the general practitioner (GP) and the second main cause after injury for recourse to Emergency Care. Their frequency is probably higher than estimated (given that respiratory diseases are currently underdiagnosed). The trend is towards a further increase due to epidemiologic and demographic factors (foremost amongst which are the widespread diffusion of cigarette smoking, the increasing mean age of the general population, immigration, and pollution). Within the more general problem of chronic disease care, chronic respiratory diseases (CRDs) constitute one of the four national priorities in that they represent an important burden for society in terms of mortality, invalidity, and direct healthcare costs. The strategy suggested by the World Health Organization (WHO) is an integrated approach consisting of three goals: inform about health, reduce risk exposure, improve patient care. The three goals are translated into practice in the three areas of prevention (1-primary, 2-secondary, 3-tertiary) as:1) actions of primary (universal) prevention targeted at the general population with the aim to control the causesof disease, and actions of Predictive Medicine - again addressing the general population but aimed at measuring the individual’s risk for disease insurgence; 2) actions of early diagnosis targeted at groups or - more precisely - subgroups identified as at risk; 3) continuous improvement and integration of care and rehabilitation support - destined at the greatest possible number of patients, at all stages of disease severity. In Italy, COPD care is generally still inadequate. Existing guidelines, institutional and non-institutional, are inadequately implemented: the international guidelines are not always adaptable to the Italian context; the document of the Agency for Regional Healthcare Services (AGE.NA.S) is a more suited compendium for consultation, and the recent joint statement on integrated COPD management of the three major Italian scientific Associations in the respiratory area together with the contribution of a Society of General Medicine deals prevalently with some critical issues (appropriateness of diagnosis, pharmacological treatment, rehabilitation, continuing care); also the document “Care Continuity: Chronic Obstructive Pulmonary Disease (COPD)” of the Global Alliance against chronic Respiratory Diseases (GARD)-Italy does not treat in depth the issue of early diagnosis. The present document – produced by the AIMAR (Interdisciplinary Association for Research in Lung Disease) Task Force for early diagnosis of chronic respiratory disease based on the WHO/GARD model and on available evidence and expertise –after a general examination of the main epidemiologic aspects, proposes to integrate the above-mentioned existing documents. In particular: a) it formally indicates on the basis of the available evidence the modalities and the instruments necessary for carrying out secondary prevention at the primary care level (a pro-active,‘case-finding’approach;  assessment of the individual’s level of risk of COPD; use of short questionnaires for an initial screening based on symptoms; use of simple spirometry for the second level of screening); b) it identifies possible ways of including these activities within primary care practice; c) it places early diagnosis within the “systemic”, consequential management of chronic respiratory diseases, which will be briefly described with the aid of schemes taken from the Italian and international reference documents.

A strategy for improvement in diagnosis and treatment of bronchial asthma in primary care

2019 ◽  
Vol 29 (4) ◽  
pp. 457-467
Author(s):  
S. N. Avdeev ◽  
S. R. Aisanov ◽  
A. S. Belevskiy ◽  
A. V. Emel’yanov ◽  
O. M. Kurbacheva ◽  
...  
Keyword(s):  
Primary Care ◽  
Bronchial Asthma ◽  
Primary Care Physicians ◽  
Respiratory Symptoms ◽  
Respiratory Diseases ◽  
Diagnosis And Treatment ◽  
Diagnostic Tools ◽  
Chronic Obstructive ◽  
Asthma Diagnosis ◽  
Chronic Respiratory Diseases

Recently, bronchial asthma is considered as a heterogeneous disease characterized by chronic airway inflammation and respiratory symptoms, which vary in time and intensity and manifest together with variable obstruction of the airways. Asthma is one of the most common chronic respiratory diseases in primary care. Patients with certain respiratory symptoms seek for medical aid initially in primary care physicians, such as therapeutists, general practitioners, and family physicians, who can suspect and diagnose chronic respiratory diseases such as bronchial asthma, chronic obstructive pulmonary disease (COPD), allergic rhinitis, etc. Currently, untimely diagnosis of asthma and late initiation of anti-inflammatory treatment are widespread, mainly due to insufficient knowledge of primary care physicians on diagnostic criteria and therapeutic standards for asthma. Feasible and convenient algorithms for asthma diagnosis and treatment in primary care were developed by experts of Russian Respiratory Society and Russian Association of Allergologists and Clinical Immunologists. A therapeutic algorithm for asthma treatment in primary care institutions uses an approach considering symptom severity both in patients with newly diagnosed and previously treated for asthma. Diagnostic tools, such as a questionnaire for asthma diagnosis and an algorithm for differential diagnosis between asthma and COPD are mainly intended to facilitate diagnosis of chronic respiratory disease, particularly bronchial asthma, by a primary care physician and to improve the healthcare quality for these patients.

scholarly journals Increased Mortality of Respiratory Diseases, Including Lung Cancer, in the Area with Large Amount of Ashfall from Mount Sakurajima Volcano

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Kenta Higuchi ◽  
Chihaya Koriyama ◽  
Suminori Akiba
Keyword(s):  
Lung Cancer ◽  
Respiratory Disease ◽  
Respiratory Diseases ◽  
Volcanic Ash ◽  
Chronic Respiratory Disease ◽  
Chronic Respiratory Diseases ◽  
Disease Mortality ◽  
The World ◽  
Acute Respiratory Diseases ◽  
Standardized Mortality Ratios

Objectives. Mount Sakurajima in Japan is one of the most active volcanoes in the world. This work was conducted to examine the effect of volcanic ash on the chronic respiratory disease mortality in the vicinity of Mt. Sakurajima.Methods. The present work examined the standardized mortality ratios (SMRs) of respiratory diseases during the period 1968–2002 in Sakurajima town and Tarumizu city, where ashfall from the volcano recorded more than 10.000 g/m2/yr on average in the 1980s.Results. The SMR of lung cancer in the Sakurajima-Tarumizu area was 1.61 (95% CI = 1.44–1.78) for men and 1.67 (95% CI = 1.39–1.95) for women while it was nearly equal to one in Kanoya city, which neighbors Tarumizu city but located at the further position from Mt. Sakurajima, and therefore has much smaller amounts of ashfall. Sakurajima-Tarumizu area had elevated SMRs for COPDs and acute respiratory diseases while Kanoya did not.Conclusions. Cristobalite is the most likely cause of the increased deaths from those chronic respiratory diseases since smoking is unlikely to explain the increased mortality of respiratory diseases among women since the proportion of smokers in Japanese women is less than 20%, and SPM levels in the Sakurajima-Tarumizu area were not high. Further studies seem warranted.

Prevention of respiratory disease

2018 ◽  
Author(s):  
Mona Bafadhel
Keyword(s):  
Risk Factors ◽  
Respiratory Disease ◽  
Respiratory Diseases ◽  
Tertiary Care ◽  
Screening Tools ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Factors Associated ◽  
Health Level ◽  
Tract Infections

The prevention of disease at a population health level rather than an individual health level is aimed at reducing causes of ‘preventable’ death and, under the auspices of public health and epidemiology, is an integral part of primary, secondary, and tertiary care. Classification of death is usually according to the type of primary disease or injury. However, there are a number of recognized risk factors for death, and modifications in behaviour or risk factors can substantially reduce preventable causes of death and the associated healthcare and economic burden of chronic disease management. According to the WHO, hundreds of millions of people from infancy to old age suffer from preventable chronic respiratory diseases, there are over four million deaths annually from preventable respiratory diseases, and common respiratory disorders (e.g. lower respiratory tract infections, chronic obstructive pulmonary disease, lung cancer, and tuberculosis) account for approximately 20% of all deaths worldwide. This chapter discusses the prevention of respiratory disease, covering diseases associated with smoking (one of the biggest risk factors associated with preventable deaths), air pollution, and other lifestyle factors associated with respiratory disease; changes in legislation concerning smoking and work-related respiratory disease; and, finally, the prevention of respiratory diseases through the use of immunization and screening tools.

Current updates on COVID-19 - A review

2020 ◽  
Vol 10 (1) ◽  
pp. 1-8
Author(s):  
Ghotekar D S ◽  
Vishal N Kushare ◽  
Sagar V Ghotekar
Keyword(s):  
World Health Organization ◽  
Common Cold ◽  
Respiratory Diseases ◽  
Gastrointestinal Diseases ◽  
Hubei Province ◽  
World Health ◽  
The World ◽  
The Common ◽  
Novel Coronavirus ◽  
Health Organization

Coronaviruses are a family of viruses that cause illness such as respiratory diseases or gastrointestinal diseases. Respiratory diseases can range from the common cold to more severe diseases. A novel coronavirus outbreak was first documented in Wuhan, Hubei Province, China in December 2019. The World Health Organization (WHO) has declared the coronavirus disease 2019 (COVID-19) a pandemic. A global coordinated effort is needed to stop the further spread of the virus. A novel coronavirus (nCoV) is a new strain that has not been identified in humans previously. Once scientists determine exactly what coronavirus it is, they give it a name (as in the case of COVID-19, the virus causing it is SARS-CoV-2).

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.

Interleukin-17A: A Potential Therapeutic Target in Chronic Lung Diseases

2019 ◽  
Vol 19 (7) ◽  
pp. 921-928 ◽  
Author(s):  
Sadiya Bi Shaikh ◽  
Ashwini Prabhu ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Inflammatory Cytokine ◽  
Inflammatory Responses ◽  
Chronic Obstructive ◽  
Interleukin 17 ◽  
Potential Therapeutic Target ◽  
Chronic Respiratory Diseases ◽  
Chronic Lung Diseases ◽  
Interleukin 17A ◽  
Insight Into

Background: Interleukin-17A (IL-17A) is a pro-inflammatory cytokine that has gained a lot of attention because of its involvement in respiratory diseases. Interleukin-17 cytokine family includes six members, out of which, IL-17A participates towards the immune responses in allergy and inflammation. It also modulates the progression of respiratory disorders. Objective: The present review is an insight into the involvement and contributions of the proinflammatory cytokine IL-17A in chronic respiratory diseases like Idiopathic Pulmonary Fibrosis (IPF), Chronic Obstructive Pulmonary Distress (COPD), asthma, pneumonia, obliterative bronchiolitis, lung cancer and many others. Conclusion: IL-17A is a major regulator of inflammatory responses. In all the mentioned diseases, IL- 17A plays a prime role in inducing the diseases, whereas the lack of this pro-inflammatory cytokine reduces the severity of respective respiratory diseases. Thereby, this review suggests IL-17A as an instrumental target in chronic respiratory diseases.

Non-Communicable Diseases and Global Health Politics

2019 ◽  
pp. 626-659
Author(s):  
Roger Magnusson
Keyword(s):  
Respiratory Diseases ◽  
Communicable Diseases ◽  
World Health ◽  
Global Response ◽  
Non Communicable Diseases ◽  
Health Politics ◽  
Chronic Respiratory Diseases ◽  
Health Organization ◽  
High Level ◽  
And Control

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, are responsible for around 70 percent of global deaths each year. This chapter describes how NCDs have become prevalent and critically evaluates global efforts to address NCDs and their risk factors, with a particular focus on the World Health Organization (WHO) and United Nations (UN) system. It explores the factors that have prevented those addressing NCDs from achieving access to resources and a priority commensurate with their impact on people’s lives. The chapter evaluates the global response to NCDs both prior to and since the UN High-Level Meeting on Prevention and Control of Non-communicable Diseases, held in 2011, and considers opportunities for strengthening that response in future.

scholarly journals Hospitalisation for COPD in Puglia: the role of hospital discharge database to estimate prevalence and incidence

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
P. Trerotoli ◽  
N. Bartolomeo ◽  
A.M. Moretti
Keyword(s):  
Disease Management ◽  
Hospital Discharge ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Diagnostic Procedures ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Hospital Discharge Database ◽  
Discharge Database

Background and aim. Chronic Obstructive Pulmonary Disease (COPD), although largely preventable, is a great health burden in all the countries worldwide. Statistics of morbidity and mortality of COPD show the need for correct management of the disease. Chronic Obstructive Respiratory Diseases (DRG 88) are in 9th place for discharge in in-patient hospital admission. It is necessary to establish specific indicators which are efficacious and relevant for the patient, the doctor and the health manager. This study will analyse the information in respect of hospital admissions (Hospital discharge database) in Puglia for the period 2000-2005. Methods. The analysis was carried out utilising the Puglia Region hospital patient discharge database, selecting those patients with admission for chronic respiratory disease as principal or secondary diagnosis. Results. Chronic respiratory diseases are more frequent in males and in people over 45 years old with frequency increasing with age. Geographical distribution shows that there are greater rates of hospitalisation in big cities and in the neighbourhood of industrial areas. Although the trend over time is slight. A higher percentage of re-admission has been found for patients with COPD, and the interval between the two admissions occurs within one or two months; the diagnosis at the second admission is the same as for the first. 10.6% of discharge forms report one diagnosis, especially in patients older than 65 years of age. Little could be said about diagnostic procedures because these are not reported on the discharge form. Conclusion. Hospitalisation data confirms expectations regarding age and sex of patients. The high hospitalisation rates indicate that in-patients care still remains the only viable treatment for COPD and other chronic respiratory diseases. The high number of exacerbations reflect the absence of out-patients service or community care, and the same diagnosis in more than one episode shows the lack of efficiency of health services and disease management. This data is necessary to understand disease distribution and the modification of disease management in order to reduce health care costs, to increase efficacy in disease control and to limit repeated exacerbation and so to obtain the maximum benefit for the patients.

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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