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Zheng L, Sun H, Chen Q, Xie X, Jin H, Ding Y. Influential factors of adherence to inhalation drug therapy in patients with stable chronic obstructive pulmonary disease. J Eval Clin Pract 2024. [PMID: 39092616 DOI: 10.1111/jep.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/25/2024] [Accepted: 06/30/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE This study aimed to investigate the influential factors of adherence to inhalation drug therapy (IDT) in patients with stable chronic obstructive pulmonary disease (COPD). METHODS A total of 243 patients with stable COPD who visited the chronic disease clinic of the respiratory department of our hospital between April 2022 and October 2022 were selected as participants using the convenience sampling method. Relevant information about all participants was collected by questionnaire for investigation, including basic information, clinical characteristics, inhaled drug names, situational awareness, dose and frequency. RESULTS Univariate analysis revealed positive correlations between the following factors: (1) the total score of drug adherence and the total scores of the COPD knowledge questionnaire (COPD-Q), social support, subjective support, objective support and support utilisation, (2) the total score of dosage adherence and the total scores of COPD-Q, objective support and support utilisation and (3) the total score of technical standardisation and the total scores of social support, subjective support and objective support (p < 0.05). Multifactorial analysis showed that COPD health literacy, number of acute exacerbations in the past year and social support factors collectively accounted for 37.4% of the variable of patient adherence to IDT, as did COPD health literacy, modified Medical Research Council (mMRC) grading, duration of COPD, utilisation of support and marital status collectively account for 47.4% of the variable of patient dosage adherence. The goodness-of-fit of age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy to the patients' inhalation technical standardisation in the model was 47.4%. CONCLUSION Dose adherence was predominantly influenced by COPD health literacy, mMRC grading, duration of COPD, utilisation of support and marital status. Inhalation technical standardisation was substantially limited by age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy.
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Affiliation(s)
- Li Zheng
- Department of Surgery, The People's Hospital of SND, Suzhou, China
| | - Haiyan Sun
- Department of Respiratory, The People's Hospital OF SND, Suzhou, China
| | - Qi Chen
- Department of Respiratory, The People's Hospital OF SND, Suzhou, China
| | - Xin Xie
- Department of Respiratory, The People's Hospital OF SND, Suzhou, China
| | - Hong Jin
- Department of Respiratory, The People's Hospital OF SND, Suzhou, China
| | - Ye Ding
- Department of Surgery, The People's Hospital of SND, Suzhou, China
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Halpin DMG. Mortality of patients with COPD. Expert Rev Respir Med 2024. [PMID: 39078244 DOI: 10.1080/17476348.2024.2375416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/04/2024] [Accepted: 06/28/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Chronic Obstructive Pulmonary Disease (COPD) is the third commonest cause of death worldwide and 24% of patients die within 5 years of diagnosis. AREAS COVERED The epidemiology of mortality and the interventions that reduce it in are reviewed. The increasing global deaths reflects increases in population sizes, increasing life expectancy and reductions in other causes of death. Strategies to reduce mortality aim to prevent the development of COPD and improve the survival of individuals. Historic changes in mortality give insights: improvements in living conditions and nutrition, and later improvements in air quality led to a large fall in mortality in the early 20th century. The smoking epidemic temporarily reversed this trend.Older age, worse lung function and exacerbations are risk factors for death. Single inhaler triple therapy; smoking cessation; pulmonary rehabilitation; oxygen therapy; noninvasive ventilation; and surgery reduce mortality in selected patients. EXPERT OPINION The importance of addressing the global burden of mortality from COPD must be recognized. Steps must be taken to reduce it, by reducing exposure to risk factors, assessing individual patients' risk of death and using treatments that reduce the risk of death. Mortality rates are falling in countries that have adopted a comprehensive approach to COPD prevention and treatment.
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Affiliation(s)
- David M G Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
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Darras-Hostens M, Degrendel M, Amouyel P, Dauchet L. Association between residential air pollution exposure and cardiovascular risk factors in adults living in northern France. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:232. [PMID: 38849665 DOI: 10.1007/s10653-024-02006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/22/2024] [Indexed: 06/09/2024]
Abstract
Air pollution is associated with elevated cardiovascular mortality and an increase in cardiovascular risk factors. However, the literature data on associations between air pollution and cardiovascular risk factors are contradictory. To explore the relationship between residential exposure to atmospheric pollutants and cardiovascular risk factors (lipid biomarker and blood pressure levels). We studied a sample of 2339 adult participants in the ELISABET study from the Dunkirk and Lille urban areas of France. The mean annual exposure to atmospheric pollutants (PM10, NO2 and SO2) at the home address was estimated via an air dispersion model. The associations were probed in multivariate linear regression models. The mean NO2 level was 26.05 μg/m3 in Lille and 19.96 µg/m3 in Dunkirk. The mean PM10 level was 27.02 μg/m3 in Lille and 26.53 μg/m3 in Dunkirk. We detected a significant association between exposure to air pollutants and the high-density lipoprotein (HDL) (which is a protective factor against cardiovascular diseases) level: for a 2 µg/m3 increment in PM10, the HDL level decreased by 1.72% (p = 0.0037). None of the associations with other lipid variables or with blood pressure were significant. We didn't find evidence significant associations for most of the risk factors but, long-term exposure of adults to moderate levels of ambient air pollution was associated with a decrement in HDL.
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Affiliation(s)
- Marion Darras-Hostens
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Maxime Degrendel
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Philippe Amouyel
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France
| | - Luc Dauchet
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque Et Déterminants Moléculaires Des Maladies Liées Au Vieillissement, University of Lille, 59000, Lille, France.
- Epidemiology Unit, 2 Rue du Pr. Laguesse (MRRC), Lille University Medical Center, 59037, Lille Cedex, France.
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Wardyn PM, Edme JL, de Broucker V, Cherot-Kornobis N, Ringeval D, Amouyel P, Sobaszek A, Dauchet L, Hulo S. Occupational exposure to crystalline silica in a sample of the French general population. J Occup Med Toxicol 2024; 19:3. [PMID: 38297383 PMCID: PMC10829379 DOI: 10.1186/s12995-024-00402-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE To describe the proportions of subjects exposed to crystalline silica and the sectors of activity concerned between 1965 and 2010 in a sample of the general French population. METHODS We included 2942 participants aged 40 to 65 years, recruited at random from electoral rolls, from the French general population in the cross-sectional ELISABET study between 2011 and 2013. The proportions of subjects exposed to crystalline silica and their sectors of activity were determined on the basis of their career history and the use of the Matgéné job-exposure matrix. RESULTS In the total sample, occupational exposure to crystalline silica was found for 291 subjects (9.9%) between 1965 and 2010, with a predominance of men (20.2% of exposed subjects among men (282 out of 1394) versus 0.6% among women (9 out of 1548)). The highest proportion of participants exposed to crystalline silica was reached in 1980 with 6.1% and then decreases to 4.4% in 2010. Among men, the most frequently exposed sectors of activity were manufacture of basic metals (41.5% of exposed men (117 out of 282)), specialised construction activities (23.1% of exposed men (65 out of 282)) and construction of buildings (14.2% of exposed men (40 out of 282)). CONCLUSIONS Although the proportion of workers exposed to crystalline silica has been decreasing since the 1980s, it is still significant at least until 2010, particularly in the construction sector, and further research is needed to improve the monitoring of workers who are or have been exposed to crystalline silica.
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Affiliation(s)
- Pierre-Marie Wardyn
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France.
- CHU Lille, Service de médecine du travail du personnel hospitalier, pathologies professionnelles et environnement, F-59000, Lille, France.
- Institut Pasteur Lille, F-59000, Lille, France.
| | - Jean-Louis Edme
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Virginie de Broucker
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
- Institut Pasteur Lille, F-59000, Lille, France
- CHU Lille, Service des explorations fonctionnelles respiratoires, F-59000, Lille, France
| | - Nathalie Cherot-Kornobis
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
- CHU Lille, Service de médecine du travail du personnel hospitalier, pathologies professionnelles et environnement, F-59000, Lille, France
- Institut Pasteur Lille, F-59000, Lille, France
| | - David Ringeval
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
- CHU Lille, Service de médecine du travail du personnel hospitalier, pathologies professionnelles et environnement, F-59000, Lille, France
- Institut Pasteur Lille, F-59000, Lille, France
| | - Philippe Amouyel
- Institut Pasteur Lille, F-59000, Lille, France
- Univ. Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000, Lille, France
- Inserm, U1167, F-59000, Lille, France
- CHU Lille, Service d'épidémiologie et de santé publique, F-59000, Lille, France
| | - Annie Sobaszek
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
- CHU Lille, Service de médecine du travail du personnel hospitalier, pathologies professionnelles et environnement, F-59000, Lille, France
- Institut Pasteur Lille, F-59000, Lille, France
| | - Luc Dauchet
- Institut Pasteur Lille, F-59000, Lille, France
- Univ. Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000, Lille, France
- Inserm, U1167, F-59000, Lille, France
- CHU Lille, Service d'épidémiologie et de santé publique, F-59000, Lille, France
| | - Sébastien Hulo
- Univ. Lille, ULR 4483-IMPECS-IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
- Institut Pasteur Lille, F-59000, Lille, France
- CHU Lille, Service des explorations fonctionnelles respiratoires, F-59000, Lille, France
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Chapron A, Lemée T, Pau G, Jouneau S, Kerbrat S, Balusson F, Oger E. Spirometry practice by French general practitioners between 2010 and 2018 in adults aged 40 to 75 years. NPJ Prim Care Respir Med 2023; 33:33. [PMID: 37777534 PMCID: PMC10542800 DOI: 10.1038/s41533-023-00352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/08/2023] [Indexed: 10/02/2023] Open
Abstract
In France, most spirometries are performed by pneumologists. Spirometry is difficult to access due to the distance to medical office and long delays for appointments. This lack of accessibility contributes to the underdiagnosis of chronic obstructive pulmonary disease (COPD) among patients aged between 40 and 75 years. In recent years, general practitioners (GPs) have been performing spirometry in private practice. However, the extent of this practice is unknown. A French retrospective, repetitive transversal study analysed data from the "Système National des Données de Santé" (SNDS) database. The targeted population was GPs in primary care that performed spirometries between 2010 and 2018, in patients aged between 40 and 75 years. Between 2010 and 2018, 302,674 (7.2%) spirometries were performed in France by GPs in private practices, in patients 40 to 75 years old. 5.4% by "expert GPs" (>60 spirometries/year) and 1.8% by "non-expert GPs". In "non-expert GPs" (2.8% of French GPs in 2018), the annual number of spirometries increased by 701 each year (p < 2.104), the annual number of GPs performing spirometries increased by 114 each year (p < 2.10-5). Overall, 24.9% of the spirometries performed by GPs were referrals from other GPs. The number of spirometries performed by GPs and the number of GPs performing spirometries has gradually increased over time. However, this increase is inadequate considering the need to early detect and follow up respiratory disorders.
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Affiliation(s)
- A Chapron
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Department of General Practice, Rennes, France.
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-1414, Rennes, France.
- Rennes University, CHU Rennes, INSERM, Ecole des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (IRSET) - UMR_S 1085, Rennes, France.
| | - T Lemée
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Department of General Practice, Rennes, France
| | - G Pau
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Department of General Practice, Rennes, France
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-1414, Rennes, France
| | - S Jouneau
- Rennes University, CHU Rennes, INSERM, Ecole des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (IRSET) - UMR_S 1085, Rennes, France
- CHU Rennes, Department of Respiratory Medicine, Rennes, France
| | - S Kerbrat
- Rennes University, CHU Rennes, INSERM, Ecole des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (IRSET) - UMR_S 1085, Rennes, France
| | - F Balusson
- Rennes University, CHU Rennes, INSERM, Ecole des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (IRSET) - UMR_S 1085, Rennes, France
| | - E Oger
- Rennes University, CHU Rennes, INSERM, Ecole des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (IRSET) - UMR_S 1085, Rennes, France
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Wardyn PM, Edme JL, de Broucker V, Cherot-Kornobis N, Ringeval D, Amouyel P, Sobaszek A, Dauchet L, Hulo S. The impact of occupational exposure to crystalline silica dust on respiratory function (airway obstruction and FEF 25-75) in the French general population. ENVIRONMENTAL RESEARCH 2023; 222:115382. [PMID: 36736759 DOI: 10.1016/j.envres.2023.115382] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Although several studies have studied the relationship between occupational exposure to crystalline silica dust and respiratory mortality, few have examined the relationship with impairments in respiratory function and the exposure threshold triggering spirometric monitoring in exposed workers. The objective of the present study was to evaluate the impact of exposure to crystalline silica dust on respiratory function. METHODS We included 1428 male participants (aged 40 to 65) recruited from the French general population, at random from electoral rolls, in the cross-sectional ELISABET study and for whom data on forced expiratory flow-volume curve indices z-scores (calculated using the Global Lung Function Initiative 2012 equations) and exposure (via a questionnaire) were available. A cumulative exposure index (CEI) for crystalline silica dust (CEIsilica, expressed in mg.m-3.year) was calculated using the Matgéné occupational exposure matrix. RESULTS 293 of the 1428 participants (20.52%) reported exposure to silica dust. We found that the adjusted z-scores for the forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) ratio decreased significantly as CEIsilica increased. After adjustment, the adjusted z-scores for FEV1/FVC (β: -0.426 (95% confidence interval (CI): -0.792, -0.060) per 1 mg m-3.year increment) and the mean forced expiratory flow between 25 and 75% of the forced vital capacity (FEF25-75) (β: -0.552 (95% CI: -0.947, -0.157)) were significantly lower in the participants with CEIsilica ≥1 mg m-3.year than in non-exposed participants. The likelihoods of having airway obstruction (odds ratio (OR): 3.056 (95% CI: 1.107, 7.626)) or having an impaired FEF25-75 (OR: 4.305 (95% CI: 1.393, 11.79)) were also significantly higher in participants with CEIsilica ≥1 mg m-3.year. CONCLUSION Our results emphasize the importance of spirometry-based monitoring in workers exposed to more than 1 mg m-3.year of crystalline silica dust, in order to identify small airway obstruction or airway obstruction as early as possible.
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Affiliation(s)
- Pierre-Marie Wardyn
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France.
| | - Jean-Louis Edme
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la, Santé humaine, F-59000, Lille, France
| | - Virginie de Broucker
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Nathalie Cherot-Kornobis
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - David Ringeval
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Philippe Amouyel
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, F-59000, France
| | - Annie Sobaszek
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Luc Dauchet
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, F-59000, France
| | - Sébastien Hulo
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
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Hubert A, Achour D, Grare C, Zarcone G, Muntaner M, Hamroun A, Gauthier V, Amouyel P, Matran R, Zerimech F, Lo-Guidice JM, Dauchet L. The relationship between residential exposure to atmospheric pollution and circulating miRNA in adults living in an urban area in northern France. ENVIRONMENT INTERNATIONAL 2023; 174:107913. [PMID: 37037173 DOI: 10.1016/j.envint.2023.107913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/04/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION MicroRNAs are epigenetic regulatory factors capable of silencing the expression of target genes and might mediate the effects of air pollution on health. The objective of the present population-based study was to investigate the association between microRNA expression and long-term, residential exposure to atmospheric PM10 and NO2. METHOD We included 998 non-smoking adult participants from the cross-sectional ELISABET survey (2010-2014) in the Lille urban area of France. The mean residential annual pollution levels were estimated with an atmospheric dispersion modelling system. Ten microRNAs were selected on the basis of the literature data, together with two housekeeping microRNAs (miR-93-5p and miR-191-5p) and were quantified with RT-qPCRs. Multivariate linear regression models were used to study the association between microRNAs and air pollution. The threshold for statistical significance (after correction for the FDR) was set to p < 0.1. RESULTS The mean annual exposure between 2011 and the year of inclusion was 26.4 ± 2.0 µg/m3 for PM10 and 24.7 ± 5.1 µg/m3 for NO2. Each 2 µg/m3 increment in PM10 exposure was associated with an 8.6% increment (95%CI [3.1; 14.3]; pFDR = 0.019) in miR-451a expression. A 5 µg/m3 increment in NO2 exposure was associated with a 5.3% increment ([0.7; 10]; pFDR = 0.056) in miR451a expression, a 3.6% decrement (95%CI [-6.1; -1.1]; pFDR = 0.052) in miR-223-3p expression, a 3.8% decrement (95%CI[-6.8; -0.7]; pFDR = 0.079) in miR-28-3p expression, a 4.3% decrement (95%CI [-7.7; -0.8]; pFDR = 0.055) in miR-146a-5p expression, and a 4.0% decrement (95% CI[-7.4; -0.4]; pFDR = 0.059) in miR-23a-5p expression. The difference between the two housekeeping microRNAs miR-93-5p and miR-191-5p was also associated with PM10 and NO2 exposure. CONCLUSION Our results suggest that circulating miRNAs are potentially valuable biomarkers of the effects of air pollution.
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Affiliation(s)
- Audrey Hubert
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Djamal Achour
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Céline Grare
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Gianni Zarcone
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Manon Muntaner
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Aghiles Hamroun
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Victoria Gauthier
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Farid Zerimech
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Jean-Marc Lo-Guidice
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
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Gamma Irradiation Processing on 3D PCL Devices-A Preliminary Biocompatibility Assessment. Int J Mol Sci 2022; 23:ijms232415916. [PMID: 36555555 PMCID: PMC9785431 DOI: 10.3390/ijms232415916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Additive manufacturing or 3D printing applying polycaprolactone (PCL)-based medical devices represents an important branch of tissue engineering, where the sterilization method is a key process for further safe application in vitro and in vivo. In this study, the authors intend to access the most suitable gamma radiation conditions to sterilize PCL-based scaffolds in a preliminary biocompatibility assessment, envisioning future studies for airway obstruction conditions. Three radiation levels were considered, 25 kGy, 35 kGy and 45 kGy, and evaluated as regards their cyto- and biocompatibility. All three groups presented biocompatible properties, indicating an adequate sterility condition. As for the cytocompatibility analysis, devices sterilized with 35 kGy and 45 kGy showed better results, with the 45 kGy showing overall improved outcomes. This study allowed the selection of the most suitable sterilization condition for PCL-based scaffolds, aiming at immediate future assays, by applying 3D-customized printing techniques to specific airway obstruction lesions of the trachea.
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Moita J, Brito U, Rodrigues C, Ferreira L, Vieira JR, Catarino A, Morais A, Hespanhol V, Cordeiro CR. Chronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals - EvaluateCOPDpt, a multicentre, observational, prospective study. Pulmonology 2022:S2531-0437(22)00155-6. [PMID: 36115826 DOI: 10.1016/j.pulmoe.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES In order to improve the quality of chronic obstructive pulmonary disease (COPD) patients' care, better knowledge of clinical practice and the factors associated with patient outcomes are needed. This study aimed to evaluate the relation between clinical practice and the outcomes of patients admitted for COPD exacerbations in Portuguese hospitals. MATERIALS AND METHODS Observational, multicentre, prospective study with a 60-days follow-up period, in 11 hospitals, including patients aged ≥ 30 years, admitted to hospital for at least 24 hours due to an acute exacerbation of COPD. Demographic and clinical data were collected, including sex, age, smoking habits, hospitalisations, pulmonary function, comorbidities, COPD symptoms, and treatment. Sixty days after discharge, COPD exacerbations management, outcome measures, and readmission data were evaluated through a structured phone follow-up interview. RESULTS 196 patients were included (85.7% male, mean age 71.2 years), the majority admitted through the emergency service. Ex-smokers and current smokers accounted for 51% and 36%, respectively. On admission, 72.4% were on LAMA, 54.6% on LABA, and 45.5% were on LABA/LAMA. Inhaled corticosteroids (ICS) were used in 37.3% and systemic steroids (SCS) in 10.3%. 35.7 % had had at least one exacerbation, with hospitalisation, in the previous year. There was no spirometry data for 23.2%. On hospitalisation, 98.5% of patients were treated with oxygen and 38.3% with non-invasive ventilation. Additionally, 93.4% used SCS and 60.2% ICS. Antibiotics were administered to 85.2%. 95.4% of patients were discharged; 9 died, 5 of whom had a COPD-related death. The median length of stay was 12 days for discharged patients and 33 days for patients who died. At discharge, 79.1% were prescribed with LAMA, 63.6% SCS, 61.5% LABA and 55.6% LAMA+LABA. 26,2% were prescribed with ICS+LABA+LAMA. At follow-up, 44.4% had a scheduled medical appointment within the 60 days after being discharged, and 28.3% were later readmitted due to exacerbation, of whom 52.8% were hospitalised. CONCLUSIONS The severity of COPD, particularly in exacerbations, is directly related to impaired lung function and quality of life, mortality, and significant health system costs. Knowledge about COPD exacerbations' management in acute hospital admissions in Portugal may help stimulate a national discussion and review of existing data to engage clinicians, policymakers, managers, and patients, raising awareness and promoting action on COPD.
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Affiliation(s)
- J Moita
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal.
| | - U Brito
- Pulmonology Unit, Algarve Hospital and University Centre, Faro, Portugal
| | - C Rodrigues
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - L Ferreira
- Pulmonology Unit, Sousa Martins Hospital, Guarda, Portugal
| | - J R Vieira
- Pulmonology Unit, Garcia de Orta Hospital, Almada, Portugal
| | - A Catarino
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A Morais
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - V Hespanhol
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - C R Cordeiro
- University Clinic of Pulmonology, Faculty of Medicine, University of Coimbra, Portugal; Clinical Academic Centre of Coimbra, Portugal
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Darras-Hostens M, Achour D, Muntaner M, Grare C, Zarcone G, Garçon G, Amouyel P, Zerimech F, Matran R, Guidice JML, Dauchet L. Short-term and residential exposure to air pollution: Associations with inflammatory biomarker levels in adults living in northern France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:154985. [PMID: 35398417 DOI: 10.1016/j.scitotenv.2022.154985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Air pollution has an impact on health, and low-grade inflammation might be one of the underlying mechanisms. The objective of the present study of adults from northern France was to assess the associations between short-term and residential exposure to air pollution and levels of various inflammatory biomarkers. METHODS The cross-sectional Enquête Littoral Souffle Air Biologie Environnement (ELISABET) study was conducted from 2011 to 2013 in the Lille and Dunkirk urban areas of northern France. Here, we evaluated the associations between PM10, NO2 and O3 exposure (on the day of the blood sample collection and on the day before, and the mean annual residential level) and levels of the inflammatory biomarkers high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, IL-22, and tumor necrosis factor α. RESULTS We assessed 3074 participants for the association with hsCRP and a subsample of 982 non-smokers from Lille for the association with plasma cytokine levels. A 10 μg/m3 increment in PM10 and NO2 levels on the day of sample collection and on the day before was associated with a higher hsCRP concentration (3.43% [0.68; 6.25] and 1.75% [-1.96; 5.61], respectively, whereas a 10 μg/m3 increment in O3 was associated with lower hsCRP concentration (-1.2% [-3.95; 1.64]). The associations between mean annual exposure and the hsCRP level were not significant. Likewise, the associations between exposure and plasma cytokine levels were not statistically significant. CONCLUSION Short-term exposure to air pollution was associated with higher serum hsCRP levels in adult residents of two urban areas in northern France. Our results suggest that along with other factors, low-grade inflammation might explain the harmful effects of air pollution on health.
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Affiliation(s)
- Marion Darras-Hostens
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Djamal Achour
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Manon Muntaner
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Céline Grare
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Gianni Zarcone
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Guillaume Garçon
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Farid Zerimech
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Jean-Marc Lo Guidice
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
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Abraham RA, Brinker SK. Chronic Obstructive Pulmonary Disease and the Physical Examination. Med Clin North Am 2022; 106:423-435. [PMID: 35491063 DOI: 10.1016/j.mcna.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Performing a hypothesis-driven examination in patients with possible chronic obstructive pulmonary disease (COPD) is an important component of increasing the recognition and diagnosis of this avoidable and costly medical condition. Using known likelihood ratios for various physical examination maneuvers can be combined with known individual risk factors and symptoms to adjust a patient's post-test probability of having COPD and inform appropriate diagnostic work-up. Equally important is intentionality in history-taking and physical examination procedures for patients with known COPD to mitigate the decreased quality of life and mortality and to monitor response to treatment.
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Affiliation(s)
- Reeni Ann Abraham
- Division of General Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Mail Code 9030, Dallas, TX 75390, USA.
| | - Stephanie Kaye Brinker
- Division of General Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Mail Code 9030, Dallas, TX 75390, USA
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Guedes F, Branquinho MV, Sousa AC, Alvites RD, Bugalho A, Maurício AC. Central airway obstruction: is it time to move forward? BMC Pulm Med 2022; 22:68. [PMID: 35183132 PMCID: PMC8858525 DOI: 10.1186/s12890-022-01862-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/14/2022] [Indexed: 12/18/2022] Open
Abstract
Abstract
Introduction
Central airway obstruction (CAO) represents a pathological condition that can lead to airflow limitation of the trachea, main stem bronchi, bronchus intermedius or lobar bronchus.
Main body
It is a common clinical situation consensually considered under-diagnosed. Management of patients with CAO can be difficult and deciding on the best treatment approach represents a medical challenge. This work intends to review CAO classifications, causes, treatments and its therapeutic limitations, approaching benign and malign presentations. Three illustrative cases are further presented, supporting the clinical problem under review.
Conclusion
Management of CAO still remains a challenge. The available options are not always effective nor free from complications. A new generation of costume-tailored airway stents, associated with stem cell-based therapy, could be an option in specific clinical situations.
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Associations among S100A4, Sphingosine-1-Phosphate, and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6041471. [PMID: 35165531 PMCID: PMC8837900 DOI: 10.1155/2022/6041471] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/12/2021] [Accepted: 01/13/2022] [Indexed: 12/26/2022]
Abstract
Background. S100A4 is a member of the S100 calcium-binding protein family and is increased in patients with chronic obstructive pulmonary disease (COPD). Sphingosine-1-phosphate (S1P) is a naturally occurring bioactive sphingolipid, which regulates the adhesion between the cells and the extracellular matrix and affects cell migration and differentiation. The goal of this study was to analyze the correlations among S100A4, S1P, and pulmonary function among COPD patients. Methods. All 139 serum samples and 15 lung specimens were collected in COPD patients and control subjects. S100A4 and S1P were detected in two groups. The markers of fibrosis and epithelial-mesenchymal transition (EMT) were measured in the lungs of COPD patients and control subjects. Results. The protein expression of S100A4 was higher in the lungs and serum of COPD patients than control cases. Additionally, serum S100A4 was inversely associated with pulmonary function among COPD patients. Meanwhile, collagen deposition and EMT nuclear transcription factors were elevated in the lungs of COPD patients. Moreover, the protein expression of S1P was increased in the serum of COPD patients. Serum S1P was gradually increased along with pulmonary function decline in COPD patients. Further correlation analysis revealed that serum S1P was negatively associated with pulmonary function in COPD patients. Furthermore, there was a positive correlation between S1P and S100A4 in COPD patients. Conclusions. These results provide evidence that the elevation of S100A4 and S1P may be involved in the onset and progression of COPD.
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Delmas MC, Bénézet L, Ribet C, Iwatsubo Y, Zins M, Nadif R, Roche N, Leynaert B. Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort. BMC Pulm Med 2021; 21:319. [PMID: 34649556 PMCID: PMC8518215 DOI: 10.1186/s12890-021-01688-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background The burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France. Methods CONSTANCES is a French population-based cohort of adults aged 18–69 years at inception. We analysed data collected at inclusion in 2013–2014. Undiagnosed OLD was defined as spirometry-confirmed airflow limitation (FEV1/FVC < lower limit of normal) without prior diagnosis of asthma, chronic obstructive pulmonary disease, or bronchiectasis. Multivariate analysis was performed with weighted robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of undiagnosed OLD. Results Spirometry results were available for 19,398 participants. The prevalence of airflow limitation was 4.6%. Overall, 64.4% of adults with airflow limitation did not report a previous diagnosis of OLD. Individuals with high cumulative tobacco consumption (≥ 10 pack-years) (aPR: 1.72 [1.28–2.32]), without respiratory symptoms (aPR: 1.51 [1.28–1.78]), and with preserved lung function (aPR: 1.21 [1.04–1.41] for a 10-point increase in FEV1% predicted) had a higher risk of being undiagnosed. Half of symptomatic individuals with airflow limitation (45% of those with moderate to severe airflow limitation) were undiagnosed with OLD. Conclusion Underdiagnosis of OLD is very common among French adults, even in patients with respiratory symptoms. Efforts should be made in France to raise awareness about OLD in the general population, improve the detection of respiratory symptoms, and increase the use of spirometry among primary care professionals. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01688-z.
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Affiliation(s)
- Marie-Christine Delmas
- Santé Publique France, French National Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
| | - Laetitia Bénézet
- Santé Publique France, French National Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Céline Ribet
- Inserm UMS 011, Population-Based Epidemiological Cohorts, Villejuif, France
| | - Yuriko Iwatsubo
- Santé Publique France, French National Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Marie Zins
- Inserm UMS 011, Population-Based Epidemiological Cohorts, Villejuif, France
| | - Rachel Nadif
- Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-Sud, Villejuif, France
| | - Nicolas Roche
- Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-Sud, Villejuif, France.,APHP Centre, Hôpital et Institut Cochin, Service de Pneumologie, Université de Paris, Paris, France
| | - Bénédicte Leynaert
- Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-Sud, Villejuif, France
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15
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Vijayakumar VK, Mustafa T, Nore BK, Garatun-Tjeldstø KY, Næss Ø, Johansen OE, Aarli BB. Role of a Digital Clinical Decision-Support System in General Practitioners' Management of COPD in Norway. Int J Chron Obstruct Pulmon Dis 2021; 16:2327-2336. [PMID: 34413641 PMCID: PMC8370595 DOI: 10.2147/copd.s319753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background The study investigated if a web-based clinical decision–support system (CDSS) tool would improve general practitioners’ (GPs) accuracy of diagnosis and classification of patients with chronic obstructive pulmonary disease (COPD), and whether nonpharmacological and pharmacological treatment would be better aligned with the COPD guidelines. Methods GPs were randomized to either a single use of the CDSS or continuing standard of care. The clinical recommendations of the CDSS were based on the GOLD guidelines and provided suggestions for treatment and management of COPD. Data were collected digitally from GPs and patients in both groups using a tablet computer. A follow-up questionnaire was sent to the GPs 1 year after the conclusion of the study. Results A total of 25 GPs (31% women, mean age 41 years) participated, 12 randomized to using the CDSS tool and 13 followed standard of care when assessing their next five to ten COPD patients. In sum, 149 patients with presumed COPD were included (88 CDSS group, 61 standard-of-care group). In the CDSS group, no COPD misdiagnoses occurred, 98% received vaccine recommendations, and all smokers (n=39) received smoking-cessation advice. The standard-of-care group had 23% misdiagnosis (P<0.001), only 67% received vaccine recommendations (P<0.001), and 87% smoking-cessation advice (P=0.022. All told, 31% of patients did not receive medication as recommended according to guidelines, with no significant differences between the groups. GPs rated the CDSS as very useful. Mean usage time was 3 minutes, 26 seconds. A majority (13 of 19, 68%) of the GPs continued using the CDSS after the conclusion of the study. CAT score identified twice as many patients as having more symptoms than the mMRC, indicating the added value of the multi-item questionnaire. Conclusion Use of the CDSS was associated with preventing misdiagnosis of COPD and improved adherence to recommended nonpharmacological measures, but a single use did not improve pharmacological treatment considerations. ![]()
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Affiliation(s)
- Varun Kumar Vijayakumar
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tehmina Mustafa
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | | | | | | | - Odd Erik Johansen
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Bernt Bøgvald Aarli
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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Hourmant B, Gobert CG, Plumet R, Lott MC, Zabbé C, Tromeur C, Leroyer C, Couturaud F. Screening for COPD in primary care, involving dentists, pharmacists, physiotherapists, nurses and general practitioners (the UNANIME pilot study). Respir Med Res 2021; 80:100853. [PMID: 34385099 DOI: 10.1016/j.resmer.2021.100853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/19/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND COPD is underdiagnosed and is projected to be the third cause of death in 2030. However, recent reviews do not recommend screening for COPD in the general population. METHODS We conducted a prospective study to assess the feasibility of implementing COPD screening in a high-risk COPD population, with the help of various healthcare professionals (General practitioners, pharmacists, dentists, physiotherapists, and nurses). Participants filled out a questionnaire, performed a spirometry (COPD6™) and counselling was performed, including smoking cessation and chest physician referral. Participants were contacted at two months to evaluate the effect of the intervention. RESULTS Between April 7th, 2017 and July 30th, 2018, 157 participants filled out the questionnaires, performed spirometry and were contacted at two months. Thirty-five out of 157 (22% [95% CI, 15.8-28.8]) participants were detected with an airflow obstruction (FEV1/FEV6 < 0.7), using COPD6™ device. At the two-month-contact, 68 participants (43%, [95%CI 35.5-51.1]) were engaged in a smoking cessation program and 22 (14% [95 % CI, 8.6-19.4]) reported having quit smoking. CONCLUSION This pilot study suggested that a predefined screening of COPD by different healthcare professionals could be implemented in primary care and might be part of counselling for smoking cessation (NCT03104348 on ClinicalTrials.gov).
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Affiliation(s)
- Baptiste Hourmant
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France
| | - Christophe Gut Gobert
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France
| | - Régis Plumet
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France
| | | | - Claude Zabbé
- URPS Bretagne, 25 rue Saint-Hélier, Rennes 35000, France
| | - Cécile Tromeur
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France; Centre d'Investigation Clinique, INSERM, Brest 1412, France
| | - Christophe Leroyer
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France; Centre d'Investigation Clinique, INSERM, Brest 1412, France.
| | - Francis Couturaud
- Département de Médecine Vasculaire, Interne et Pneumologie, Groupe D'Etude de la Thrombose de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest EA3878, France; Centre d'Investigation Clinique, INSERM, Brest 1412, France
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de Courrèges A, Occelli F, Muntaner M, Amouyel P, Meirhaeghe A, Dauchet L. The relationship between neighbourhood walkability and cardiovascular risk factors in northern France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:144877. [PMID: 33770881 DOI: 10.1016/j.scitotenv.2020.144877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/30/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although walkability is known to be associated with obesity and hypertension through increased physical activity; data on cardiovascular risk factors (especially in the Europe) are scarce. We assessed the relationship between neighbourhood walkability and cardiometabolic factors (including obesity, hypertension, the blood lipid profile, and serum glycated haemoglobin (HbA1c) levels) among adults living in northern France. METHODS Data were extracted from the ELISABET study database (2011-2013). The participants (aged between 40 and 65) resided in or around the cities of Lille and Dunkirk. For each residential address, we determined a neighbourhood walkability index (using a geographic information system) and the Walk Score®. Multilevel linear and logistic models were used to assess the relationships between neighbourhood walkability on one hand and body mass index (BMI), obesity, blood pressure, hypertension, serum HDLC, LDL-C, triglyceride and HbA1c levels, and physical activity level on the other. RESULTS 3218 participants were included. After adjusting for individual and neighbourhood variables, we found that a higher neighbourhood walkability index was associated with a lower BMI (-0.23 kg.m-2; 95% confidence interval (CI) [-0.44;-0.01] for a one interquartile range (IQR) increment), a lower systolic blood pressure (-1.66 mmHg; 95% CI [-2.46;-0.85] per IQR), a lower prevalence of hypertension (% of increase: -7.12, 95% CI [-13.56;-0.52] per IQR), and a higher prevalence of moderate or high physical activity (% of increase = 6.9; 95% CI [1.2;12.72] per IQR). The walkability index was not significantly associated with other cardiovascular risk factors. Similar results were observed for the Walk Score®. CONCLUSION Our results showed that residence in a more walkable neighbourhood was associated with a lower prevalence of vascular risk factors. Promoting neighbourhood walkability might help to improve the population's cardiovascular health.
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Affiliation(s)
- Antoine de Courrèges
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Florent Occelli
- Univ. Lille, IMT Lille Douai, Univ. Artois, Yncrea Hauts-de-France, ULR 4515 - LGCgE, Laboratoire de Génie Civil et géo-Environnement, F-5activity000 Lille, France.
| | - Manon Muntaner
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Aline Meirhaeghe
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
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Dagnew B, Andualem Z, Angaw DA, Alemu Gelaye K, Dagne H. Duration of exposure and educational level as predictors of occupational respiratory symptoms among adults in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2021; 9:20503121211018121. [PMID: 34094559 PMCID: PMC8142000 DOI: 10.1177/20503121211018121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 04/26/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction: Occupational respiratory symptoms are manifestations of respiratory diseases because of exposure to dust or chemicals such as asbestos, silicon and aluminium in the workplace like cement factory, tannery, textile and/or street sweeping, all of which affect the health condition and productivity. In Ethiopia, several primary studies were conducted regarding the magnitude of occupational respiratory symptoms with the prevalence of 68.89% in street sweepers and associated factors with inconsistent results. This meta-analysis aimed to pool the prevalence of respiratory symptoms and their associated factors among Ethiopian adults working in different workplaces. Methods: PubMed, African Journals Online, Google Scholar, Cochrane Library and Direct Google were systematically searched to identify primary studies. Two authors performed data abstraction and quality assessment for each included study independently. Cochran’s Q-statistic and I2 (I-squared) statistic were used to check heterogeneity. DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and associated factors of respiratory symptoms. Publication bias was checked by funnel plot and Egger’s test, and also sensitivity analyses were performed. Results: Ten primary studies with 3441 study participants were included for the narrative synthesis and meta-analysis of the pooled prevalence of occupational respiratory symptoms. The pooled prevalence of overall occupational respiratory symptom was 54.58% (95% CI: 45.37–63.79). Dry cough was the most encountered respiratory symptom [34.93, 95% CI: 29.52–40.35], followed by breathlessness [28.67%, 95% CI: 20.13–37.22]. Work experience of over 5 years [OR = 2.24, 95% CI: 1.21–4.16] and educational level of Grade 8 and lower [OR = 1.28, 95% CI: 1.06–1.55] were significantly associated with occupational respiratory symptoms. Conclusion: In this review, the pooled prevalence of occupational respiratory symptoms was high. The findings of this study dictate the need for the implementation of workplace safety measures. Special attention is required to employees with lower educational level and longer duration of work experience. Prospero registration: CRD42020176826
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Affiliation(s)
- Baye Dagnew
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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19
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Fonseca W, Lukacs NW, Elesela S, Malinczak CA. Role of ILC2 in Viral-Induced Lung Pathogenesis. Front Immunol 2021; 12:675169. [PMID: 33953732 PMCID: PMC8092393 DOI: 10.3389/fimmu.2021.675169] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022] Open
Abstract
Innate lymphoid type-2 cells (ILC2) are a population of innate cells of lymphoid origin that are known to drive strong Type 2 immunity. ILC2 play a key role in lung homeostasis, repair/remodeling of lung structures following injury, and initiation of inflammation as well as more complex roles during the immune response, including the transition from innate to adaptive immunity. Remarkably, dysregulation of this single population has been linked with chronic lung pathologies, including asthma, chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrotic diseases (IPF). Furthermore, ILC2 have been shown to increase following early-life respiratory viral infections, such as respiratory syncytial virus (RSV) and rhinovirus (RV), that may lead to long-term alterations of the lung environment. The detrimental roles of increased ILC2 following these infections may include pathogenic chronic inflammation and/or alterations of the structural, repair, and even developmental processes of the lung. Respiratory viral infections in older adults and patients with established chronic pulmonary diseases often lead to exacerbated responses, likely due to previous exposures that leave the lung in a dysregulated functional and structural state. This review will focus on the role of ILC2 during respiratory viral exposures and their effects on the induction and regulation of lung pathogenesis. We aim to provide insight into ILC2-driven mechanisms that may enhance lung-associated diseases throughout life. Understanding these mechanisms will help identify better treatment options to limit not only viral infection severity but also protect against the development and/or exacerbation of other lung pathologies linked to severe respiratory viral infections.
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Affiliation(s)
- Wendy Fonseca
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States
| | - Nicholas W Lukacs
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States.,Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI, United States
| | - Srikanth Elesela
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States.,Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI, United States
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20
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Fieldes M, Bourguignon C, Assou S, Nasri A, Fort A, Vachier I, De Vos J, Ahmed E, Bourdin A. Targeted therapy in eosinophilic chronic obstructive pulmonary disease. ERJ Open Res 2021; 7:00437-2020. [PMID: 33855061 PMCID: PMC8039900 DOI: 10.1183/23120541.00437-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common and preventable airway disease causing significant worldwide mortality and morbidity. Lifetime exposure to tobacco smoking and environmental particles are the two major risk factors. Over recent decades, COPD has become a growing public health problem with an increase in incidence. COPD is defined by airflow limitation due to airway inflammation and small airway remodelling coupled to parenchymal lung destruction. Most patients exhibit neutrophil-predominant airway inflammation combined with an increase in macrophages and CD8+ T-cells. Asthma is a heterogeneous chronic inflammatory airway disease. The most studied subtype is type 2 (T2) high eosinophilic asthma, for which there are an increasing number of biologic agents developed. However, both asthma and COPD are complex and share common pathophysiological mechanisms. They are known as overlapping syndromes as approximately 40% of patients with COPD present an eosinophilic airway inflammation. Several studies suggest a putative role of eosinophilia in lung function decline and COPD exacerbation. Recently, pharmacological agents targeting eosinophilic traits in uncontrolled eosinophilic asthma, especially monoclonal antibodies directed against interleukins (IL-5, IL-4, IL-13) or their receptors, have shown promising results. This review examines data on the rationale for such biological agents and assesses efficacy in T2-endotype COPD patients. Patients with severe COPD and eosinophilic inflammation experience uncontrolled symptoms despite optimal pharmaceutical treatment. The development of new biomarkers is needed for better phenotyping of patients to propose innovative targeted therapy.https://bit.ly/2KzWuNO
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Affiliation(s)
- Mathieu Fieldes
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | | | - Said Assou
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | - Amel Nasri
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | - Aurélie Fort
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, Montpellier, France
| | - Isabelle Vachier
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France
| | - John De Vos
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France.,Dept of Cell and Tissue Engineering, Montpellier University Hospital, Montpellier, France
| | - Engi Ahmed
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France
| | - Arnaud Bourdin
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, Montpellier, France
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21
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Decourt C, Janin A, Moindrot M, Chatron N, Nony S, Muntaner M, Dumont S, Divry E, Dauchet L, Meirhaeghe A, Marmontel O, Bardel C, Charrière S, Cariou B, Moulin P, Di Filippo M. PCSK9 post-transcriptional regulation: Role of a 3′UTR microRNA-binding site variant in linkage disequilibrium with c.1420G. Atherosclerosis 2020; 314:63-70. [DOI: 10.1016/j.atherosclerosis.2020.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/21/2020] [Accepted: 10/07/2020] [Indexed: 02/05/2023]
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22
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Naqvi SZH, Choudhry MA. An Automated System for Classification of Chronic Obstructive Pulmonary Disease and Pneumonia Patients Using Lung Sound Analysis. SENSORS 2020; 20:s20226512. [PMID: 33202613 PMCID: PMC7697014 DOI: 10.3390/s20226512] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) and pneumonia are two of the few fatal lung diseases which share common adventitious lung sounds. Diagnosing the disease from lung sound analysis to design a noninvasive technique for telemedicine is a challenging task. A novel framework is presented to perform a diagnosis of COPD and Pneumonia via application of the signal processing and machine learning approach. This model will help the pulmonologist to accurately detect disease A and B. COPD, normal and pneumonia lung sound (LS) data from the ICBHI respiratory database is used in this research. The performance analysis is evidence of the improved performance of the quadratic discriminate classifier with an accuracy of 99.70% on selected fused features after experimentation. The fusion of time domain, cepstral, and spectral features are employed. Feature selection for fusion is performed through the back-elimination method whereas empirical mode decomposition (EMD) and discrete wavelet transform (DWT)-based techniques are used to denoise and segment the pulmonic signal. Class imbalance is catered with the implementation of the adaptive synthetic (ADASYN) sampling technique.
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Affiliation(s)
- Syed Zohaib Hassan Naqvi
- Department of Electronics Engineering, University of Engineering and Technology, Taxila 47080, Pakistan
- Correspondence:
| | - Mohammad Ahmad Choudhry
- Department of Electrical Engineering, University of Engineering and Technology, Taxila 47080, Pakistan;
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23
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Xiong H, Huang Q, Shuai T, Zhu L, Zhang C, Zhang M, Wang Y, Liu J. Assessment of comorbidities and prognosis in patients with COPD diagnosed with the fixed ratio and the lower limit of normal: a systematic review and meta-analysis. Respir Res 2020; 21:189. [PMID: 32677946 PMCID: PMC7364614 DOI: 10.1186/s12931-020-01450-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 07/09/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) is not uniform, COPD guidelines recommend fixed ratio (FR), whereas ATS and ERS define airflow obstruction based on lower limit of normal (LLN). We aim to determine if there is difference between the two diagnostic criteria for morbidity, mortality, exacerbation. METHODS Four databases and all relevant studies from the references were searched from inception to June 25, 2019, to find studies that described the rate of comorbidity, the exacerbation rates, mortality in COPD patients. Data analysis was performed using STATA/SE 14.0 and followed the standard of Cochrane Collaboration. A sensitivity analysis was performed to find the source of heterogeneity. RESULTS Thirteen studies and 154,447 participants were finally included in this meta-analysis. The 11 cohort studies and 2 cross-sectional studies were all high-quality. Patients with airflow limitation according to either FR or LLN had higher mortality (HRFR+/LLN- = 1.27, 95% CI = 1.14-1.42; HRFR-/LLN+ = 1.83, 95% CI = 1.17-2.86) than those who met neither criteria. When compared with the FR-/LLN- criteria, those who met the FR criteria were more likely to exacerbate (HR FR+/LLN- = 1.64, 95% CI = 1.09-2.46; HR FR-/LLN+ = 1.58, 95% CI = 0.70-3.55). The meta-analysis for comorbidities showed no significant difference between patients who met neither criteria and those who met LLN or FR criteria. CONCLUSION The patients with airflow limitations according to FR were more likely to exacerbate than those with LLN only. Patients that met either FR or LLN were more likely to have higher mortality than FR-/LLN-. There was no difference between the FR+/LLN- and FR-/LLN+ groups for the occurrence of comorbidities.
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Affiliation(s)
- Huaiyu Xiong
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Qiangru Huang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Tiankui Shuai
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Lei Zhu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Chuchu Zhang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Meng Zhang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Yalei Wang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Jian Liu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.
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24
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Priyadharshini N, Renusha RC, Reshma S, Sindhuri Sai M, Koushik Muthu RM, Rajanandh MG. Prevalence of metabolic syndrome in patients with chronic obstructive pulmonary disease: An observational study in South Indians. Diabetes Metab Syndr 2020; 14:503-507. [PMID: 32388329 DOI: 10.1016/j.dsx.2020.04.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) has a significant association with airflow obstruction and physical inactivity, which are the relevant extra-pulmonary markers of chronic obstructive respiratory disease (COPD). This study aimed to estimate the prevalence of MetS and its correlation with comorbidities and health related quality of life (HRQoL) in South Indian patients with COPD. METHODS A cross-sectional study was conducted among the 76 COPD patients. Pulmonary function test (PFT) and parameters for MetS such as waist circumference, blood pressure, fasting blood glucose, triglycerides (TGs) and high density lipoprotein cholesterol (HDL-C) levels of COPD patients were measured. HRQoL was calculated using Saint George Respiratory Questionnaire (SGRQ). RESULTS 54% of COPD patients were presented with MetS especially in stage II and III. TGs and HDL-C were significantly associated with the severity of COPD (p < 0.05), while waist circumference, TGs and HDL-C were significantly (p < 0.05) correlated with PFT. Symptom, activity, impact and total scores of SGRQ was increased statistically (p < 0.05) in COPD patients with MetS than without MetS. CONCLUSION According to our findings, screening the grade II and III COPD patients for the presence of MetS is a reasonable option. The results of this study should be confirmed with a larger sample of population.
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Affiliation(s)
- N Priyadharshini
- Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India
| | - R C Renusha
- Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India
| | - S Reshma
- Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India
| | - Marella Sindhuri Sai
- Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India
| | - Raja M Koushik Muthu
- Department of Respiratory Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India
| | - M G Rajanandh
- Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Deemed to be University (DU), Porur, Chennai, 600 116, Tamil Nadu, India.
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25
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Wang N, Cong S, Fan J, Bao H, Wang B, Wang L, Fang L. Distribution of Chronic Obstructive Pulmonary Disease - China, 2014-2015. China CDC Wkly 2020; 2:245-248. [PMID: 34594632 PMCID: PMC8428446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/26/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ning Wang
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shu Cong
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Fan
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Heling Bao
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baohua Wang
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Linhong Wang
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liwen Fang
- 1 National Center for Chronic and Non-communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
,Liwen Fang,
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26
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Havet A, Hulo S, Cuny D, Riant M, Occelli F, Cherot-Kornobis N, Giovannelli J, Matran R, Amouyel P, Edmé JL, Dauchet L. Residential exposure to outdoor air pollution and adult lung function, with focus on small airway obstruction. ENVIRONMENTAL RESEARCH 2020; 183:109161. [PMID: 32000005 DOI: 10.1016/j.envres.2020.109161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 05/11/2023]
Abstract
Although a growing body of evidence suggests that chronic exposure to outdoor air pollution is linked to a decline in lung function, data on flow at low lung volumes that may be more specific of small airway obstruction are still scarce. We aimed to study the associations between residential exposure to air pollution and lung function, with specific focus on small airways obstruction. We assessed 2995 French participants (aged between 40 and 65) in the ELISABET cross-sectional survey. Residential exposures to nitrogen dioxide (NO2), particulate matter with a diameter <10 μm (PM10) and sulphur dioxide (SO2) were assessed. The spirometric parameters were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of FVC (FEF25-75) and at 75% of FVC (FEF75). Coefficients in linear regression models were expressed as the z-score [95% confidence interval] for an increment of 5 μg/m3 in NO2 and 2 μg/m3 in PM10 and SO2. NO2 was associated with significantly lower values of FEV1 (-0.10 [-0.15;-0.05]), FVC (-0.06 [-0.11;-0.02]), FEV1/FVC (-0.07 [-0.11;-0.03]), FEF25-75 (-0.09 [-0.14;-0.05]) and FEF75 (-0.08 [-0.12;-0.04]). PM10 was associated with significantly lower values of FEV1 (-0.10 [-0.15;-0.04]), FVC (-0.06 [-0.11;-0.01]), FEV1/FVC (-0.06 [‒0.11;-0.01]), FEF25-75 (-0.08 [-0.13;-0.03]) and FEF75 (-0.08 [-0.12;-0.04]). SO2 was associated with significantly lower values of FEV1 (-0.09 [-0.16;-0.02]), FEV1/FVC (-0.07 [-0.13;-0.01]), FEF25-75 (-0.09 [-0.15;-0.02]) and FEF75 (-0.08 [-0.14;-0.03]) but not FVC (-0.05 [-0.11; 0.009]). Even though spatial variations in pollutant levels were low, residential exposure to outdoor air pollution was associated with lower lung function, including lower FEF25-75 and FEF75 suggesting small airway obstruction.
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Affiliation(s)
- Anaïs Havet
- Univ. Lille, CHU Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Sébastien Hulo
- Univ. Lille, CHU Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Damien Cuny
- Univ. Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Margaux Riant
- Univ. Lille, Inserm, CHU Lille University Hospital, Institut Pasteur de Lille, UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-related, F-59000, Lille, France
| | - Florent Occelli
- EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Nathalie Cherot-Kornobis
- Univ. Lille, CHU Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Jonathan Giovannelli
- Univ. Lille, Inserm, CHU Lille University Hospital, Institut Pasteur de Lille, UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-related, F-59000, Lille, France
| | - Régis Matran
- Univ. Lille, CHU Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille University Hospital, Institut Pasteur de Lille, UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-related, F-59000, Lille, France
| | - Jean-Louis Edmé
- Univ. Lille, CHU Lille, EA4483, IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000, Lille, France
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille University Hospital, Institut Pasteur de Lille, UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-related, F-59000, Lille, France.
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27
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[Modelling the bronchial epithelium in chronic obstructive pulmonary disease using human induced pluripotential stem cells]. Rev Mal Respir 2020; 37:197-200. [PMID: 32146059 DOI: 10.1016/j.rmr.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/12/2020] [Indexed: 11/24/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease leading to irreversible destruction of the terminal bronchioles. Although the precise patho-physiological mechanisms remain to be elucidated, the bronchial epithelium seems to play a pivotal role in the disease. Recent studies have highlighted a great heterogeneity among COPD patients, with various disease courses including, in about half the cases, an origin in childhood. Modelling of COPD is a major goal but currently available models are imperfect. Our work aims to create a new in vitro cellular model to study the pathology of the disease. The differentiation of human induced pluripotential stem cells (hiPSCs) in bronchial epithelium is a step towards a better understanding of the developmental origin and the identification of new therapeutic targets.
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28
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Trouiller-Gerfaux P, Podglajen E, Hulo S, Richeval C, Allorge D, Garat A, Matran R, Amouyel P, Meirhaeghe A, Dauchet L. The association between blood cadmium and glycated haemoglobin among never-, former, and current smokers: A cross-sectional study in France. ENVIRONMENTAL RESEARCH 2019; 178:108673. [PMID: 31520822 DOI: 10.1016/j.envres.2019.108673] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 05/10/2023]
Abstract
INTRODUCTION The association between cadmium levels in the body and diabetes has been extensively studied, with sometimes contrasting results. Smoking is the primary non-occupational source of cadmium, and constitutes a risk factor for diabetes. One can therefore hypothesize that the putative association with cadmium is actually explained by tobacco. To fully control for this confounding factor, we studied the relationship between blood cadmium and glycated haemoglobin (HbA1c) levels separately in never-, former and current smokers. METHODS We studied a sample of 2749 middle-aged adults from the cross-sectional ELISABET survey in and around the cities of Lille and Dunkirk; none had chronic kidney disease or a history of haematological disorders, and none were taking antidiabetic medication. The blood cadmium level-HbA1c associations in never-, former and current smokers were studied in separate multivariate models. The covariables included age, sex, city, educational level, tobacco consumption (or passive smoking, for the never-smokers), body mass index, estimated glomerular filtration rate, and (to take account of the within-batch effect) the cadmium batch number. RESULTS In the multivariate analysis, a significant association between cadmium and HbA1c levels was found in all three smoking status subgroups. A 0.1 μg/L increment in blood cadmium was associated with an HbA1c increase [95% confidence interval] of 0.016% [0.003; 0.029] among never-smokers, 0.024% [0.010; 0.037] among former smokers, and 0.020% [0.012; 0.029] among current smokers. CONCLUSIONS The observation of a significant association between the blood cadmium concentration and HbA1c levels in a group of never-smokers strengthens the hypothesis whereby diabetes is associated with cadmium per se and not solely with tobacco use. The small effect size observed in our population of never smokers with low levels of exposure to cadmium suggested that the risk attributable to this metal is not high. However, the impact of exposure to high cadmium levels (such as occupational exposure) on the risk of diabetes might be of concern.
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Affiliation(s)
- Philippe Trouiller-Gerfaux
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées Au Vieillissement, F-59000 Lille, France
| | - Elise Podglajen
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées Au Vieillissement, F-59000 Lille, France
| | - Sébastien Hulo
- Univ. Lille, EA 4483, IMPECS, IMPact de L'Environnement Chimique sur La Santé Humaine, F-59000 Lille, France
| | - Camille Richeval
- Univ. Lille, EA 4483, IMPECS, IMPact de L'Environnement Chimique sur La Santé Humaine, F-59000 Lille, France; CHU Lille, Unité Fonctionnelle de Toxicologie, F- 59000 Lille, France
| | - Delphine Allorge
- Univ. Lille, EA 4483, IMPECS, IMPact de L'Environnement Chimique sur La Santé Humaine, F-59000 Lille, France; CHU Lille, Unité Fonctionnelle de Toxicologie, F- 59000 Lille, France
| | - Anne Garat
- Univ. Lille, EA 4483, IMPECS, IMPact de L'Environnement Chimique sur La Santé Humaine, F-59000 Lille, France; CHU Lille, Unité Fonctionnelle de Toxicologie, F- 59000 Lille, France
| | - Régis Matran
- Univ. Lille, EA 4483, IMPECS, IMPact de L'Environnement Chimique sur La Santé Humaine, F-59000 Lille, France
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées Au Vieillissement, F-59000 Lille, France
| | - Aline Meirhaeghe
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées Au Vieillissement, F-59000 Lille, France
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées Au Vieillissement, F-59000 Lille, France.
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Revue générale sur l’adhésion aux traitements inhalés de la BPCO. Rev Mal Respir 2019; 36:801-849. [DOI: 10.1016/j.rmr.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 05/23/2019] [Indexed: 01/12/2023]
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Olofson J, Bake B, Bergman B, Ullman A, Svärdsudd K. Prediction of COPD and Related Events Improves by Combining Spirometry and the Single Breath Nitrogen Test. COPD 2019; 15:424-431. [PMID: 30822242 DOI: 10.1080/15412555.2018.1538330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) develops in small airways. Severity of small airway pathology relates to progression and mortality. The present study evaluated the prediction of COPD of a validated test for small airway disease, i.e. a slope of the alveolar plateau of the single breath nitrogen test (N2-slope). The N2-slope, spirometry, age, smoking habits, and anthropometric variables at baseline were obtained in a population-based sample (n = 592). The cohort was followed for first COPD events (first hospital admission of COPD or related conditions or death from COPD) during 38 years. During follow-up, 52 subjects (8.8%) had a first COPD event, of which 18 (3.0%) died with a first COPD diagnosis. In the proportional hazard regression analysis adjusted for age and smoking habits, the cumulative COPD event incidence increased from 5% among those with high forced expired volume in one second (FEV1) to 25% among those with low FEV1, while increasing from 4% among those with the lowest N2-slope to 26% among those with the highest. However, combining the N2-slope and FEV1 resulted in considerable synergy in the prediction of first COPD event and even more so when taking account of smoking habits. The cumulative COPD event incidence rate was 75% among heavy smokers with the highest N2-slope and lowest FEV1, and less than 1% among never smokers with the lowest N2-slope and highest FEV1. Thus, combining the results of the single breath N2-slope and FEV1 considerably improved the prediction of COPD events as compared to either test alone.
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Affiliation(s)
- Jan Olofson
- a Department of Respiratory Medicine and Allergology , Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Björn Bake
- a Department of Respiratory Medicine and Allergology , Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Bengt Bergman
- a Department of Respiratory Medicine and Allergology , Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Anders Ullman
- b COPD Center Sahlgrenska University Hospital , Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Kurt Svärdsudd
- c Department of Public Health and Caring Sciences , Family Medicine and Preventive Medicine Section, Uppsala University , Uppsala , Sweden
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Klotz LV, Courty Y, Lindner M, Petit-Courty A, Stowasser A, Koch I, Eichhorn ME, Lilis I, Morresi-Hauf A, Arendt KAM, Pepe M, Giopanou I, Ntaliarda G, Behrend SJ, Oplopoiou M, Gissot V, Guyetant S, Marchand-Adam S, Behr J, Kaiser JC, Hatz RA, Lamort AS, Stathopoulos GT. Comprehensive clinical profiling of the Gauting locoregional lung adenocarcinoma donors. Cancer Med 2019; 8:1486-1499. [PMID: 30806043 PMCID: PMC6488114 DOI: 10.1002/cam4.2031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/24/2019] [Accepted: 01/27/2019] [Indexed: 12/19/2022] Open
Abstract
A comprehensive characterization of lung adenocarcinoma (LADC) clinical features is currently missing. We prospectively evaluated Caucasian patients with early‐stage LADC. Patients with LADC diagnosed between 2011 and 2015 were prospectively assessed for lung resection with curative intent. Fifty clinical, pathologic, radiologic, and molecular variables were recorded. Patients were followed till death/study conclusion. The main findings were compared to a separate cohort from France. Of 1943 patients evaluated, 366 were enrolled (18.8%; 181 female; 75 never‐smokers; 28% of registered Bavarian cases over the study period). Smoking and obstruction were significantly more prevalent in GLAD compared with adult Bavarians (P < 0.0001). Ever‐smoker tumors were preferentially localized to the upper lobes. We observed 120 relapses and 74 deaths over 704 cumulative follow‐up years. Median overall and disease‐free survival were >7.5 and 3.6 years, respectively. Patients aged <45 or >65 years, resected >60 days postdiagnosis, with abnormal FVC/DLCOVA, N2/N3 stage, or solid histology had significantly decreased survival estimates. These were fit into a weighted locoregional LADC death risk score that outperformed pTNM7 in predicting survival in the GLAD and in our second cohort. We define the clinical gestalt of locoregional LADC and provide a new clinical tool to predict survival, findings that may aid future management and research design.
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Affiliation(s)
- Laura V Klotz
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany.,Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Yves Courty
- French National Institute of Health and Medical Research (INSERM) Unit 1100, Faculty of Medicine, Research Center for Respiratory Diseases (CEPR), University F. Rabelais, Tours Cedex, Centre, France
| | - Michael Lindner
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany.,Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Agnès Petit-Courty
- French National Institute of Health and Medical Research (INSERM) Unit 1100, Faculty of Medicine, Research Center for Respiratory Diseases (CEPR), University F. Rabelais, Tours Cedex, Centre, France
| | - Anja Stowasser
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany
| | - Ina Koch
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany
| | - Martin E Eichhorn
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany.,Department of Thoracic Surgery, Ruprecht-Karls-University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Ioannis Lilis
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Biomedical Sciences Research Center, Achaia, Greece
| | - Alicia Morresi-Hauf
- Department of Pathology, Asklepios Medical Center, Gauting, Bavaria, Germany
| | - Kristina A M Arendt
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Mario Pepe
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Ioanna Giopanou
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Biomedical Sciences Research Center, Achaia, Greece
| | - Giannoula Ntaliarda
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Biomedical Sciences Research Center, Achaia, Greece
| | - Sabine J Behrend
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Maria Oplopoiou
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Biomedical Sciences Research Center, Achaia, Greece
| | - Valérie Gissot
- INSERM, Center for Clinical Investigation (CIC) Unit 1415, Regional University Hospital Center (CHRU) Tours, Bretonneau Hospital, Tours Cedex, Centre, France
| | - Serge Guyetant
- French National Institute of Health and Medical Research (INSERM) Unit 1100, Faculty of Medicine, Research Center for Respiratory Diseases (CEPR), University F. Rabelais, Tours Cedex, Centre, France.,Regional University Hospital Center (CHRU) Tours, Department of Pathology and Tumor Biobank, Bretonneau Hospital, Tours Cedex, Centre, France
| | - Sylvain Marchand-Adam
- French National Institute of Health and Medical Research (INSERM) Unit 1100, Faculty of Medicine, Research Center for Respiratory Diseases (CEPR), University F. Rabelais, Tours Cedex, Centre, France.,Regional University Hospital Center (CHRU) Tours, Department of Pathology and Tumor Biobank, Bretonneau Hospital, Tours Cedex, Centre, France
| | - Jürgen Behr
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany.,Department of Pneumology, Asklepios Lung Clinic Gauting, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany
| | - Jan-Christian Kaiser
- Institute of Radiation Protection (ISS), Helmholtz Center Munich, Neuherberg, Bavaria, Germany
| | - Rudolf A Hatz
- Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Member of the German Center for Lung Research (DZL), Gauting, Bavaria, Germany
| | - Anne-Sophie Lamort
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany
| | - Georgios T Stathopoulos
- Comprehensive Pneumology Center and Institute for Lung Biology and Disease, University Hospital, Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Bavaria, Germany.,Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Biomedical Sciences Research Center, Achaia, Greece
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Dauchet L, Hulo S, Cherot-Kornobis N, Matran R, Amouyel P, Edmé JL, Giovannelli J. Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults. ENVIRONMENT INTERNATIONAL 2018; 121:610-619. [PMID: 30312964 DOI: 10.1016/j.envint.2018.09.036] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Air pollution impacts health by increasing mortality and the incidence of acute events in unhealthy individuals. In contrast, the acute effects of pollution in healthy individuals are less obvious. The present study was designed to evaluate the associations between short-term exposure to air pollution on one hand and lung function, and inflammatory markers on the other in middle-aged, non-smoking adults with no respiratory disease, in two urban areas in northern France. METHODS A sample of 1506 non-smoking adults (aged from 40 to 65) with no respiratory disease was selected from the participants in the 2011-2013 cross-sectional Enquête Littoral Souffle Air Biologie Environnement (ELISABET) survey in two urban areas in the northern France. We evaluated the associations between (i) mean levels of particulate matter with aerodynamic diameter < 10 μm (PM10), nitrogen dioxide (NO2) and ozone (O3) exposure on the day and the day before the study examination for each participant, and (ii) spirometry data and levels of inflammatory markers. Coefficients of multiple linear regression models were expressed (except for the forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio) as the percentage change [95% confidence interval] per 10 μg increment in each pollutant. RESULTS Levels of PM10, NO2 and O3 exposure were below or only close to the World Health Organization's recommended limits in our two study areas. An increment in NO2 levels was significantly associated with a lower FEV1/FVC ratio (-0.38 [-0.64; -0.12]), a lower forced expiratory flow between 25% and 75% of FVC (FEF25-75%) (-1.70 [-3.15; -0.23]), and a lower forced expiratory flow measured at 75% of FVC (FEF75%) (-3.07 [-4.92; -1.18]). An increment in PM10 levels was associated with lower FEF75% (-1.41 [-2.79; -0.01]) and a non-significant elevation in serum levels of high-sensitivity C-reactive protein (+3.48 [-0.25; 7.36], p = 0.07). Lastly, an increment in O3 levels was associated with a significantly higher blood eosinophil count (+2.41 [0.10; 4.77]) and a non-significant elevation in fractional exhaled nitric oxide (+2.93 [-0.16; 6.13], p = 0.06). CONCLUSION A short-term exposure to air pollution was associated with a subclinical decrement in distal lung function and increment in inflammatory markers in healthy inhabitants of two urban areas in France. If these exploratory results are confirmed, this could suggest that even moderate levels of air pollution could have an impact on respiratory health on the general population, and not solely on susceptible individuals.
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Affiliation(s)
- Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Sébastien Hulo
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Nathalie Cherot-Kornobis
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Jean-Louis Edmé
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Jonathan Giovannelli
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
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Diab N, Gershon AS, Sin DD, Tan WC, Bourbeau J, Boulet LP, Aaron SD. Underdiagnosis and Overdiagnosis of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2018; 198:1130-1139. [DOI: 10.1164/rccm.201804-0621ci] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Nermin Diab
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrea S. Gershon
- Department of Medicine, The University of Toronto, Toronto, Ontario, Canada
| | - Don D. Sin
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wan C. Tan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean Bourbeau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; and
| | | | - Shawn D. Aaron
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Riant M, Meirhaeghe A, Giovannelli J, Occelli F, Havet A, Cuny D, Amouyel P, Dauchet L. Associations between long-term exposure to air pollution, glycosylated hemoglobin, fasting blood glucose and diabetes mellitus in northern France. ENVIRONMENT INTERNATIONAL 2018; 120:121-129. [PMID: 30077944 DOI: 10.1016/j.envint.2018.07.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 05/06/2023]
Abstract
INTRODUCTION A growing body of evidence suggests that long-term exposure to air pollutants like nitrogen oxides (NOx) and particulate matter (PM) is associated with the prevalence and incidence of type 2 diabetes mellitus. Serum glucose and glycosylated hemoglobin (HbA1c) levels are biomarkers of glucose homeostasis. Data on the association between glucose homeostasis biomarkers and air pollution are scarce. HbA1c and fasting blood glucose (FBG) concentrations have been linked to PM and NO2 exposure in Taiwan, where mean pollution levels are 3 to 7 times higher than the guideline maximum annual mean values of 40 μg/m3 (for NO2) and 20 μg/m3 (for PM10) set by the World Health Organization (WHO). However, this association is not consistently reported at lower levels of pollution. The objective of the present study was to investigate the relationships between long-term exposure to air pollution at the place of residence, diabetes biomarkers, and prevalent diabetes in two cities with relatively low level of pollution. METHODS Data were recorded for 2895 adults (aged 40 to 65) having participated in the 2011-2013 ELISABET cross-sectional survey of the Lille and Dunkirk urban areas in northern France. Using multiple logistic and generalized linear regression models, we analyzed the associations between individual exposure to pollution on one hand and HbA1c, FBG and prevalent diabetes mellitus (DM) on the other. An atmospheric dispersion modelling system was used to assess annual exposure at the place of residence to coarse particulate matter (PM10), NO2, and sulfur dioxide (SO2). RESULTS The median pollutant levels were 21.96 μg/m3 for NO2, 26.75 μg/m3 for PM10, and 3.07 μg/m3 for SO2. A 2 μg/m3 increment in PM10 was associated with an HbA1c increment [95% confidence interval] of 0.044% [0.021; 0.067]. This association was still statistically significant after adjustment for the neighborhood's characteristics. A 5 μg/m3 increment in NO2 was associated with an HbA1c increment of 0.031% [0.010; 0.053]. Associations between DM or FBG and air pollution did not achieve statistical significance. CONCLUSION Our study of a middle-aged, urban population evidenced an association between elevated HbA1c levels and long-term exposure to PM10 and NO2 pollution levels that were relatively low but close to the WHO's guideline maximum values.
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Affiliation(s)
- Margaux Riant
- CHU Lille, Epidemiology, Health Economics and Prevention Service, F-59000 Lille, France
| | - Aline Meirhaeghe
- Inserm UMR1167 - RID-AGE Risk Factors and Molecular Determinants of Aging-related Diseases, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Jonathan Giovannelli
- Inserm UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université de Lille, Centre Hosp. Univ Lille, Institut Pasteur de Lille, Lille, France
| | - Florent Occelli
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France
| | - Anais Havet
- CHU Lille, Epidemiology, Health Economics and Prevention Service, F-59000 Lille, France; Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France
| | - Damien Cuny
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France
| | - Philippe Amouyel
- Inserm UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université de Lille, Centre Hosp. Univ Lille, Institut Pasteur de Lille, Lille, France
| | - Luc Dauchet
- Inserm UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université de Lille, Centre Hosp. Univ Lille, Institut Pasteur de Lille, Lille, France.
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A scoring system to detect fixed airflow limitation in smokers from simple easy-to-use parameters. Sci Rep 2018; 8:13329. [PMID: 30190580 PMCID: PMC6127215 DOI: 10.1038/s41598-018-31198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/08/2018] [Indexed: 11/08/2022] Open
Abstract
No validated screening method currently exists for Chronic Obstructive Pulmonary Disease (COPD) in smokers. Therefore, we constructed a predictive model with simple parameters that can be applied for COPD screening to detect fixed airflow limitation. This observational cross-sectional study included a random sample of 222 smokers with no previous diagnosis of COPD undertaken in a Spanish region in 2014-2016. The main variable was fixed airflow limitation by spirometry. The secondary variables (COPD factors) were: age, gender, smoking (pack-years and Fagerström test), body mass index, educational level, respiratory symptoms and exacerbations. A points system was developed to predict fixed airflow limitation based on secondary variables. The model was validated internally through bootstrapping, determining discrimination and calibration. The system was then integrated into a mobile application for Android. Fifty-seven patients (25.7%) presented fixed airflow limitation. The points system included as predictors: age, pack-years, Fagerström test and presence of respiratory symptoms. Internal validation of the system was very satisfactory, both in discrimination and calibration. In conclusion, a points system has been constructed to predict fixed airflow limitation in smokers with no previous COPD. This system can be integrated as a screening tool, though it should be externally validated in other geographical regions.
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Devien L, Giovannelli J, Cuny D, Matran R, Amouyel P, Hulo S, Edmé JL, Dauchet L. Sources of household air pollution: The association with lung function and respiratory symptoms in middle-aged adult. ENVIRONMENTAL RESEARCH 2018; 164:140-148. [PMID: 29486345 DOI: 10.1016/j.envres.2018.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/08/2018] [Accepted: 02/12/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The objective of the present study was to investigate the relationship between sources of household air pollution, respiratory symptoms and lung function. METHODS 3039 adults aged from 40 to 65 participated in the 2011-2013 ELISABET cross-sectional survey in northern France. Lung function was measured using spirometry. During a structured interview, respiratory symptoms, household fuels, exposure to moulds, and use of ventilation were recorded on a questionnaire. RESULTS The self-reported presence of mould in at least two rooms (not including the bathroom and the kitchen) was associated with a 2.5% lower predicted forced expiratory volume in 1 s (95% confidence interval, -4.7 to -0.29; p-trend <0.05) and a higher risk of wheezing (p-trend < 0.001). Visible condensation was associated with wheezing (p < .05) and chronic cough (p < .05). There were no significant associations with the type of household fuel or inadequate ventilation/aeration. Similar results were found when the analyses were restricted to participants without known respiratory disease. CONCLUSION Our results suggest that the presence of mould (known to be associated with more severe asthma symptoms) could also have an impact on respiratory symptoms and lung function in the general population and in populations without known respiratory disease.
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Affiliation(s)
- Laurent Devien
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Jonathan Giovannelli
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Damien Cuny
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France
| | - Régis Matran
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Philippe Amouyel
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France
| | - Sébastien Hulo
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Jean Louis Edmé
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France; Pulmonary Function Testing Department, CHU Lille, F-59000 Lille, France
| | - Luc Dauchet
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France; CHU Lille, Epidemiology Service, Health Economics and Prevention, F-59000 Lille, France.
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Montserrat-Capdevila J, Seminario MA, Godoy P, Marsal JR, Ortega M, Pujol J, Castañ MT, Alsedà M, Betriu À, Lecube A, Portero M, Purroy F, Valdivielso JM, Barbé F. Prevalence of chronic obstructive pulmonary disease (COPD) not diagnosed in a population with cardiovascular risk factors. Med Clin (Barc) 2018. [PMID: 29525115 DOI: 10.1016/j.medcli.2017.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE The magnitude of undiagnosed COPD in our population with cardiovascular risk factors (CVRF) is unknown. The objective of this study was to estimate the prevalence of undiagnosed COPD and its specific characteristics in a population with CVRF. MATERIALS AND METHODS Study the prevalence of COPD in patients with CVRF. Spirometry was performed between 01/01/2015 and 12/31/2016 and the percentage of patients with COPD, who had not previously been diagnosed, was determined. Each patient's variables of interest were recorded; the records of patients who had spirometry showing COPD were checked to confirm whether a diagnosis had been recorded or not. The association of undiagnosed COPD with different independent variables was determined with adjusted odds ratio (aOR) by non conditional logistic regression models. RESULTS 2,295 patients with CVRF were studied. The overall prevalence of COPD was 14.5%. An underdiagnosis of 73.3% was observed. Newly diagnosed COPD vs. undiagnosed COPD showed to be higher in women (74.1% vs. 36.0%; P=.081), non-smokers (21.3% vs. 12.4%; P=.577), mild cases (GOLD1) (42.6% vs. 32.4%, P=.008) and cases with lower than average HbA1c (5.5% vs. 5.6%; P=.008) and uric acid (5.1mg/dL vs. 5.6mg/dL; P=.011). The variables associated with undiagnosed COPD were: women (aOR=1.27; 95%CI: 0.74-2.17; P=.383); age (aOR=0.94; 95%CI: 0.87-0.99; P=.018); smokers (smoker/non-smoker) (aOR=0.47; 95%CI: 0.22-1.01; P=.054) and HbA1c (%) (aOR=0.45; 95%CI: 0.23-0.88; P=.019). CONCLUSIONS The under-diagnosis of COPD is very high. The contact patients aged between 50 and 65 years-old who have CVRF with their health system should be reassessed, and they need to ask for a spirometry.
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Affiliation(s)
- Josep Montserrat-Capdevila
- Consultorio Local de Bellvís-Els Arcs, UGA Terres de l'Urgell, Atención Primaria, Institut Català de la Salut, Lleida, Cataluña, España; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España.
| | - María Asunción Seminario
- Grupo de Patología Respiratoria, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España
| | - Pere Godoy
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; Agència de Salut Pública de Catalunya, Departament de Salut, Lleida, Cataluña, España; Facultat de Medicina, Universitat de Lleida, Lleida, Cataluña, España; CIBER de epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Josep Ramon Marsal
- Unitat de Suport a la Recerca Lleida, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Universitat Autònoma de Barcelona, Cataluña, España; Unitat d'Epidemiologia del Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Cataluña, España
| | - Marta Ortega
- Unitat de Suport a la Recerca Lleida, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Universitat Autònoma de Barcelona, Cataluña, España; Atención Primaria, Institut Català de la Salut, Lleida, Cataluña, España
| | - Jesús Pujol
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; Facultat de Medicina, Universitat de Lleida, Lleida, Cataluña, España; ABS Balaguer, Atención Primaria, Institut Català de la Salut, Lleida, Cataluña, España
| | - Maria Teresa Castañ
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; ABS Balaguer, Atención Primaria, Institut Català de la Salut, Lleida, Cataluña, España
| | - Miquel Alsedà
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; Agència de Salut Pública de Catalunya, Departament de Salut, Lleida, Cataluña, España; Facultat de Medicina, Universitat de Lleida, Lleida, Cataluña, España
| | - Àngels Betriu
- Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; Unidad de Diagnóstico y Tratamiento de Enfermedades Aterotrombóticas (UDETMA), Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lleida, Cataluña, España
| | - Albert Lecube
- Servicio de Endocrinología, Hospital Universitari Arnau de Vilanova, Lleida, Cataluña, España
| | - Manel Portero
- Grupo de Fisiopatología Metabólica, Departamento de Medicina Experimental, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España
| | - Francisco Purroy
- Servicio de Neurología, Hospital Universitari Arnau de Vilanova, Lleida, Cataluña, España
| | - José Manuel Valdivielso
- Laboratorio de Nefrología Experimental, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España
| | - Ferran Barbé
- Grupo de Patología Respiratoria, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Cataluña, España; Facultat de Medicina, Universitat de Lleida, Lleida, Cataluña, España; Servicio de Neumología, Hospital Universitari Arnau de Vilanova, Lleida, Cataluña, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
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Chérot-Kornobis N, Hulo S, Giovannelli J, de Broucker V, Matran R, Amouyel P, Sobaszek A, Dauchet L, Edmé JL. Exhaled breath NOx levels in a middle-aged adults population-based study: reference values and association with the smoking status. Respir Med 2018; 137:134-140. [PMID: 29605196 DOI: 10.1016/j.rmed.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Biomarkers in exhaled breath condensate (EBC) are potentially sensitive indicators of early biochemical changes in airways following exposure to pneumotoxic substances, particularly in susceptible subjects. NOx are the stable end products of the nitrite-nitrate-NO oxidative stress pathway and can be used to monitor airway inflammatory diseases, especially in asthma. Nevertheless, population-based surveys are needed to better interpret EBC NOx levels in clinical studies. The aim of this study was to establish reference values of EBC NOx in a large group of middle-aged, healthy adults of a sample of the general population with particular focus on the smoking status. METHODS The EBC NOx levels were analysed from 2872 subjects among the ELISABET population-based cross sectional study including a representative sample of men and women aged from 40 to 66 years olds conducted in northern France, which included comprehensive questionnaires by interview and spirometry data. Healthy participants were defined as participants with no self-reported respiratory disease. RESULTS For the healthy subjects (n = 1251), the median NOx concentration (IQR) was equal to 7.2 μM (3.12) and concentrations of NOx in EBC did not differ significantly according to smoking status. The upper fifth percentile (95%) (ULN) of NOx concentrations among healthy subjects was equal to 13.6 μM, ranging from 12.7 μM (smokers) to 14.4 μM (ex smokers). Among subjects with EBC NOx values higher than the ULN and compared with subjects that had EBC NOx values lower than the ULN, we found a significant higher proportion of subjects with current asthma (10.5% vs 6.5%) or with chronic bronchitis symptoms (7.6% vs 3.3%). CONCLUSION This population-based study has provided the distribution and the upper limit reference value of a nitrosative stress biomarker (NOx) in EBC of middle aged, healthy adults. EBC NOx levels were not associated with smoking status.
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Affiliation(s)
- Nathalie Chérot-Kornobis
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service Médecine du Travail du Personnel Hospitalier et de Pathologies Professionnelles et Environnementales, F-59000 Lille, France.
| | - Sébastien Hulo
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Jonathan Giovannelli
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Virginie de Broucker
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Annie Sobaszek
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service Médecine du Travail du Personnel Hospitalier et de Pathologies Professionnelles et Environnementales, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Jean-Louis Edmé
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
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Giovannelli J, Trouiller P, Hulo S, Chérot-Kornobis N, Ciuchete A, Edmé JL, Matran R, Amouyel P, Meirhaeghe A, Dauchet L. Low-grade systemic inflammation: a partial mediator of the relationship between diabetes and lung function. Ann Epidemiol 2018; 28:26-32. [DOI: 10.1016/j.annepidem.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 11/10/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022]
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Clement G, Giovannelli J, Cottel D, Montaye M, Ciuchete A, Dallongeville J, Amouyel P, Dauchet L. Changes over time in the prevalence and treatment of cardiovascular risk factors, and contributions to time trends in coronary mortality over 25 years in the Lille urban area (northern France). Arch Cardiovasc Dis 2017; 110:689-699. [DOI: 10.1016/j.acvd.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/28/2017] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
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Andreeva E, Pokhaznikova M, Lebedev A, Moiseeva I, Kuznetsova O, Degryse JM. Spirometry is not enough to diagnose COPD in epidemiological studies: a follow-up study. NPJ Prim Care Respir Med 2017; 27:62. [PMID: 29138407 PMCID: PMC5686137 DOI: 10.1038/s41533-017-0062-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 10/18/2017] [Accepted: 10/20/2017] [Indexed: 01/08/2023] Open
Abstract
A hallmark of the diagnosis of chronic obstructive pulmonary disease (COPD) is the measurement of post-bronchodilator (post-BD) airflow obstruction (AO) by spirometry, but spirometry is not enough for the provision of a clinical diagnosis. In the majority of previous epidemiological studies, COPD diagnosis has been based on spirometry and a few clinical characteristics. The aim of our study was to identify outcomes in patients newly diagnosed with airflow obstruction (AO) based on a diagnostic work-up conducted as part of a population-based cross-sectional study in North-Western Russia. Spirometry was performed before (pre-BD) and after BD administration, and AO was defined using the FEV1/FVC <0.70 and FEV1/FVC
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Affiliation(s)
- Elena Andreeva
- Institute of Health and Society, Université Catholique de Louvain, IRSS, Clos Chapelle-aux-Champs, 30/10.15, 1200, Brussels, Belgium
- Department of Family Medicine, Northern State Medical University, pr. Troitsky, 51, 163000, Arkhangelsk, Russia
| | - Marina Pokhaznikova
- Department of Family Medicine, North-Western State Medical University named after I.I. Mechnikov, Kirochnaya str., 41, 191015, St. Petersburg, Russia
| | - Anatoly Lebedev
- Department of Family Medicine, North-Western State Medical University named after I.I. Mechnikov, Kirochnaya str., 41, 191015, St. Petersburg, Russia
| | - Irina Moiseeva
- Department of Family Medicine, North-Western State Medical University named after I.I. Mechnikov, Kirochnaya str., 41, 191015, St. Petersburg, Russia
| | - Olga Kuznetsova
- Department of Family Medicine, North-Western State Medical University named after I.I. Mechnikov, Kirochnaya str., 41, 191015, St. Petersburg, Russia
| | - Jean-Marie Degryse
- Institute of Health and Society, Université Catholique de Louvain, IRSS, Clos Chapelle-aux-Champs, 30/10.15, 1200, Brussels, Belgium.
- Department of Public Health and Primary Health Care, K.U.Leuven, Kapucijnenvoer 33, B3000, Leuven, Belgium.
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Shin B, Lee H, Kang D, Jeong BH, Kang HK, Chon HR, Koh WJ, Chung MP, Guallar E, Cho J, Park HY. Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients. Respirology 2017; 22:935-941. [PMID: 28117553 DOI: 10.1111/resp.12988] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The association between airflow limitation severity and post-operative pulmonary complications (PPCs) among COPD patients undergoing extra-pulmonary surgery is unknown. We evaluated the association between forced expiratory volume in 1 s (FEV1 ) and PPC in COPD patients undergoing extra-pulmonary surgery. METHODS Using prospective cohort of PPC evaluation for extra-pulmonary surgery, we identified 694 COPD patients who conducted PPC evaluation before extra-pulmonary surgery between March 2014 and January 2015 at a tertiary hospital, Seoul, Korea. RESULTS The overall incidence of PPC was 24.4%. The incidence of PPC in quintiles 1-5 of FEV1 (% predicted) was 31.4, 25.8, 23.7, 21.6 and 19.7%, respectively (P for trend: 0.019). In fully adjusted multivariable models, the relative risks (RRs, 95% CI) for PPC comparing participants in quintiles 1-4 of FEV1 (% predicted) with those in quintile 5 were 1.69 (1.03-2.79), 1.41 (0.83-2.37), 1.26 (0.75-2.11) and 1.30 (0.76-2.22), respectively (P for trend: 0.046). The association of severe airflow limitation with respiratory failure and post-operative exacerbations was stronger in participants who did not use bronchodilators compared with those who did. CONCLUSION We found a progressive and significant relationship between severity of airflow limitation and the incidence of PPC in COPD patients undergoing extra-pulmonary surgery. Furthermore, perioperative bronchodilator use was associated with a reduced risk of respiratory failure and post-operative exacerbations in patients with severe airflow limitation.
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Affiliation(s)
- Beomsu Shin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Danbee Kang
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Koo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Hae Ri Chon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won-Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Pyo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eliseo Guallar
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Juhee Cho
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea.,Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hulo S, de Broucker V, Giovannelli J, Cherot-Kornobis N, Nève V, Sobaszek A, Dauchet L, Edmé JL. Global Lung Function Initiative reference equations better describe a middle-aged, healthy French population than the European Community for Steel and Coal values. Eur Respir J 2016; 48:1779-1781. [PMID: 27540022 DOI: 10.1183/13993003.00606-2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/17/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Sébastien Hulo
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
| | - Virginie de Broucker
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
| | - Jonathan Giovannelli
- U1167, RID-AGE: Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Institut Pasteur de Lille, University of Lille, INSERM, CHU Lille, Lille, France
| | - Nathalie Cherot-Kornobis
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
| | - Véronique Nève
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
| | - Annie Sobaszek
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
| | - Luc Dauchet
- U1167, RID-AGE: Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Institut Pasteur de Lille, University of Lille, INSERM, CHU Lille, Lille, France
| | - Jean-Louis Edmé
- EA 4483, IMPECS: IMPact de l'Environnement Chimique sur la Santé Humaine, University of Lille, CHU Lille, Lille, France
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