Prevention Of Chronic Respiratory Diseases Research Articles

Современные гигиенические разработки по профилактике хронических заболеваний органов дыхания среди школьников

В статье представлены данные об общей заболеваемости и заболеваемости хроническими патологиями органов дыхания у детей школьного возраста, о гигиенических условиях занятий детей в школе, о качестве воздуха в помещениях (температура и влажность воздуха, концентрация СО2), о конструктивных, эксплуатационных и аллергизирующих аспектах учебных классов и жилых помещений. Полученные данные были использованы для разработки комплекса мер по предупреждению развития респираторных заболеваний у детей школьного возраста, включающие участие представителей как государственных, так и негосударственных служб.

Gut-Lung Microbiota in Chronic Pulmonary Diseases: Evolution, Pathogenesis, and Therapeutics.

The microbiota colonized in the human body has a symbiotic relationship with human body and forms a different microecosystem, which affects human immunity, metabolism, endocrine, and other physiological processes. The imbalance of microbiota is usually linked to the aberrant immune responses and inflammation, which eventually promotes the occurrence and development of respiratory diseases. Patients with chronic respiratory diseases, including asthma, COPD, bronchiectasis, and idiopathic pulmonary fibrosis, often have alteration of the composition and function of intestinal and lung microbiota. Gut microbiota affects respiratory immunity and barrier function through the lung-gut microbiota, resulting in altered prognosis of chronic respiratory diseases. In turn, lung dysbiosis promotes aggravation of lung diseases and causes intestinal dysfunction through persistent activation of lymphoid cells in the body. Recent advances in next-generation sequencing technology have disclosed the pivotal roles of lung-gut microbiota in the pathogenesis of chronic respiratory diseases. This review focuses on the association between the gut-lung dysbiosis and respiratory diseases pathogenesis. In addition, potential therapeutic modalities, such as probiotics and fecal microbiota transplantation, are also evaluated for the prevention of chronic respiratory diseases.

Analysis, Design, and Experiment of FVC Detection Device Using the Cross Four-Electrode Method

The early screening and prevention of chronic respiratory diseases are very important. To achieve the monitoring and management of chronic obstructive pulmonary disease (COPD), this article proposes a new lung impedance measurement method, which uses a cross four-electrode structure. It effectively solves the problems of noncompliance of traditional instruments, risk of cross-infection, and nononline monitoring. Compared with the traditional impedance measurement method, the measurement accuracy of lung function parameters is improved. Using the detection device, the equivalent impedance of the chest was rapidly measured from two orthogonal directions when the people were in the same breath state. The maximum expiratory and inspiratory thoracic impedance was obtained by analyzing 30 samples. The measurement of lung function parameters is realized by solving the change value of impedance and its relationship with the chest circumference. Experiments proved that the cross four-electrode method could consider the two directions of equivalent thoracic impedance, enrich the measurement parameters of thoracic impedance, and make the test results of pulmonary function parameters have good consistency with the results of standard methods. Correlation coefficients of test indexes forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were 0.967 and 0.955 respectively. The consistency boundary diagram showed that more than 95% of monitoring data of the subjects fell within the scope of the consistency boundary, and the maximum relative error of measurement was only 4.65%.

Disadvantaged Early-Life Socioeconomic Circumstances Are Associated With Low Respiratory Function in Older Age.

Poor lung function in late life may stem from early-life risk factors, but the epidemiological evidence is inconsistent. We investigated whether individuals who experienced disadvantageous socioeconomic circumstances (SEC) in early life showed lower levels of respiratory function in older age, a steeper decline over time, and whether these relationships were explained by adult-life SEC, body mass index, and physical inactivity in older age. We used data from the Survey of Health Ageing and Retirement in Europe (2004-2015). Participants' peak expiratory flow (PEF) was assessed with a mini-Wright peak flow meter at second, fourth, and sixth waves. Confounder-adjusted linear mixed-effect models were used to examine the associations between early-life SEC and PEF in older age. A total of 21,734 adults aged 50-96 years (46,264 observations) were included in the analyses. Older adults with disadvantaged early-life SEC showed lower levels of PEF compared with those with advantaged early-life SEC. The association between early-life SEC and late-life PEF persisted after adjusting for adult-life SEC, smoking, physical inactivity, and body mass index. PEF declined with age, but the effect of early-life SEC on this decline was not consistent across robustness and sensitivity analyses. Early life is a sensitive period for respiratory health. Further considering the effect of SEC arising during this period may improve the prevention of chronic respiratory diseases.

Chronic Respiratory Diseases in the Regions of Northern Russia: Epidemiological Distinctions in the Results of a National Population Study.

The aim of the study is to investigate the epidemiological situation regarding chronic respiratory diseases in populations that inhabit different climatic–geographical regions of Russia, and to develop targeted programs for prevention of these diseases. Methods: (1) a comparative analysis of the standardized mortality data in Russia and other selected regions of the Russian North using the European standard for respiratory diseases, in a population aged 25–64; and (2) data from a randomized cross-sectional epidemiological study, with subjects from three different climatic-geographical regions of Russia. Results: (1) the respiratory disease-related mortality rates in the majority of Russian Northern regions were much higher compared to the national average. Although death rates from chronic lower respiratory diseases were higher among the Northern regions and in the whole of Russia relative to the countries of European Union (EU), the cause of death in the populations of the Northern regions tend to be lower respiratory infections and pneumonia; and (2) despite the absence of any significant differences in the prevalence of smoking, the prevalence of chronic respiratory diseases (COPD) is significantly higher in Far North Yakutsk compared to the other two regions in this study—Chelyabinsk and Vologda. The status of hyperborean had the highest chance of a significant contribution to COPD and cardiorespiratory pathology among all other risk factors. The results revealed a need for effective targeted strategies for primary and secondary prevention of chronic respiratory diseases for the populations of the Northern regions of Russia. Conclusions: The revealed regional distinctions regarding the prevalence of, and mortality from, chronic respiratory diseases should be taken into consideration when designing integrated programs for chronic non-communicable disease prevention in these regions.

Chronic respiratory disease and tobacco consumption. Review

Chronic respiratory diseases (CRD), and in particular chronic obstructive pulmonary disease (COPD), pose a relevant healthcare and social problem globally, reflecting the upward trend in the morbidity and mortality from diseases related to tobacco consumption. Tobacco smoking is the main and only modifiable risk factor for the development of CRD including COPD. The current understanding of the problem suggests that COPD develops in 50% of tobacco users and not in 15% as previously thought; that the disease may have originated even before birth or in early childhood; that capturing the mechanisms of the disease development is essential for timely prevention. Prevention of CRD, particularly COPD, should be aimed at overcoming tobacco consumption and take into account all the other risk factors for these diseases. The current smoking cessation treatments involve behavior counselling in combination with first-line pharmacotherapies such as NCT or varenicline. Patients with COPD need greater support than healthy smokers, and interventions for cessation of tobacco consumption are the most cost-effective in reducing the rates of the lung function deterioration and decreasing morbidity and mortality from the disease.

Rationale for the Turin Conference/Congress 2012

In 1987 the first International Conference on the Management of Chronic Respiratory Failure was held in Veruno (Italy). Twenty five years and six Conferences later much has changed, not only in regard to the organization of the Conference itself (e.g., now it is held every three years instead of five as originally), but also the problems arising from chronic respiratory diseases (CRDs) have changed. Today, according to World Health Organisation’s (WHO) estimates, some 300 million people worldwide suffer from asthma and 80 million people are affected by moderate to severe COPD. These diseases are among the most important causes of death in our society and their burden is constantly increasing. Over the last 20 years effective technical and pharmacological aids have been added to the tool-box of the chest physician, improving the life of patients both in terms of expectancy and quality. Obviously, this development of chest medicine has also had important repercussions on health resources consumption and currently there is a widespread debate on how to cope with the growing burden. The International Conference on “Management and Rehabilitation of Chronic Respiratory Failure” - now in its 7th edition - is recognized as a key international scientific event in this specific field. The 2012 “Pulmonary Advances”, which will be held in Turin, will deal with new developments in respiratory medicine as well as with their cost-effectiveness and the best way to deliver them, with particular focus on the possibilities of integration between specialists and primary care medicine. Two major scientific events will run in parallel: the 7th International Conference and the 3rd National Congress of AIMAR (Interdisciplinary Scientific Association for Research in Lung Disease). The novel idea underpinning AIMAR is that management of respiratory diseases should not be solely in the hands of the pneumologists but should be multidisciplinary. This approach goes beyond the purely ‘organ specialist’ outlook prevalent in clinical practice, integrating the diverse professional figures (including non-medical health professionals) to promote, through continuing professional education, the development of joint clinical controlled studies, epidemiological surveillance and public health education in order to lay the foundations for an optimal management of respiratory diseases. The Conference/Congress of Turin 2012 will thus have a clear interdisciplinary character, offering the maximum in terms of quality, up-to-date information in the fight against and prevention of CRDs. This is in harmony with the scope of GARD (Global Alliance against Chronic Respiratory Diseases), a WHO-based voluntary alliance of national and international organizations aimed at improving the respiratory health of the general population by fighting the current problem of underdiagnosis and undertreatment of CRDs. The benefit of this is very evident to professionals, health planners and decision makers, but what benefit is there for the patient and general public? There is nothing but to gain from a greater flow of information between the various specialists and a more integrated mode of clinical practice. Patient management will no longer be - as it is often today - the fruit of improvised collaboration, but it will be based on a global, comprehensive model of care that coordinates the up-to-date expertise of diverse specialists. Moreover, assuring patients a homogeneous protocol of diagnosis and treatment irrespective of what specialist branch they consult for a respiratory problem will give them the added security of knowing they are cared for by professionals who have a united vision of their case. In short, AIMAR represents a great alliance between physicians, health professionals and patients for the lungs, which means a great alliance for the benefit of all citizens. Our wish is that the commitment manifested by the Scientific Committees and Organizing Committee - in their respective areas of competence - combined with the work of the almost 200 speakers and a fruitful exchange of opinions among participants will enable us to realize that particular “mix” that will make this a unique scientific event.

The Origins of Asthma and Chronic Obstructive Pulmonary Disease in Early Life

Results from birth cohort and cross-sectional studies of young children with wheezing have uncovered strong associations between both lung function and immune responses in early life and the subsequent development of persistent wheezing and chronic airway obstruction up to mid-adulthood. It is now apparent that the pattern of bronchial hyperresponsiveness, deficits in lung function, and structural airway remodeling that are characteristic of asthma may be already established during the preschool years in most patients. Interactions between acute viral infections, especially those due to rhinovirus and respiratory syncytial virus, and exposure to perennial aeroallergens may induce persistent alterations in immune responses and airway function in susceptible subjects. Similarly, deficits in airway function present shortly after birth predict airflow limitation in early adult life, which in turn is a strong predisposing factor for chronic obstructive pulmonary disease. The fact that these alterations are more likely to occur during early life and even in utero than later during childhood suggests that there a developmental window of susceptibility during which exposures can disrupt normal growth trajectories. Novel strategies for primary prevention of chronic respiratory diseases will be based on the identification of the genetic and environmental factors that interactively cause these disruptions.

Enquête sociale et de santé de 1998 au Québec: divers déterminants des maladies chroniques respiratoires

In the course of the "1998 Health and Social Survey", questions were included to verify the prevalence of chronic respiratory diseases and also of wheezing. The objectives of this study were 1) to verify the prevalence of wheezing and its validity as an indicator of chronic respiratory diseases in Québec; and 2) to examine the relationship between chronic respiratory diseases and some of their potential determinants. A total of 30,386 individuals participated in the study. For all ages, the prevalence of wheezing was 5.4%. It was associated with asthma, allergies, chronic bronchitis and emphysema. A low familial income and tobacco smoking were associated with wheezing, asthma, chronic bronchitis and emphysema. Passive smoking was associated with wheezing whereas the presence of carpets was associated with wheezing and asthma. Between 32 and 48% of families with an asthmatic or an allergic member modified their dwelling to alleviate respiratory problems. The prevalence of wheezing documented here was lower than in anglosaxon countries. This result could be explained by a cultural factor (the French translation or the perception of wheezing). This study emphasizes the role of reducing tobacco smoking in the prevention of chronic respiratory diseases.