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Allagbé I, Nicolas R, Airagnes G, Frédéric L, Boussadi AA, Le Faou AL. Clinical factors associated with smoking cessation among smokers with Chronic Obstructive Pulmonary Disease by sex: Longitudinal analyses from French smoking cessation services. Heliyon 2024; 10:e30920. [PMID: 38770314 PMCID: PMC11103529 DOI: 10.1016/j.heliyon.2024.e30920] [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: 04/17/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
Background Smoking is responsible for 80 % of cases of Chronic Obstructive Pulmonary Disease (COPD), while the prognosis is improved by smoking cessation (SC). We examined clinical factors associated with SC among smokers with COPD comparing women and men. Methods The study comprised a cohort of 1470 smokers who visited a SC service and completed at least 28-day of follow-up visits. The outcome was smoking status at follow-up (abstinence, reduction, no change). Abstinence was defined as continuous abstinence for at least 28 days, validated by the measurement of expired Carbon Monoxide. Reduction was defined as a halving of the baseline tobacco consumption. Results The average age of the population was 53 (±11) years and 58.2 % were women. Men were 2 years younger than women and consulted more likely after a hospital contact, whereas women consulted on their own initiative. Women more often had a depression history, whereas men had medical comorbidities and co-addictions. There was no significant difference by sex regarding the abstinence rate (41.0 % in women vs 40.7 in men, p > 0.9). The factors significantly associated with higher abstinence rates in both sexes were: at least one previous quit attempt and number of follow-up visits ≥4. The factors negatively associated with quitting in women were diabetes, intake of mood stabilizers and consuming more than 10 cigarettes per day while having a chronic bronchitis, taking antidepressants and having consumed cannabis in the last 30 days hampered SC in men. Conclusions Concerning factors associated with SC, few differences were found between female and male smokers suffering from COPD. However, due to the different medical and smoking behavior characteristics according to sex, it might be important to take these differences into account in order to provide tailored SC management.
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Affiliation(s)
- Ingrid Allagbé
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- Groupement d’Intérêt Scientifique du Réseau Français d’Excellence de Recherche sur le tabac, la nicotine et les produits connexes (REFERtab), Paris, France
| | - Roche Nicolas
- Respiratory and Intensive Care Medicine, Hôpital Cochin, AP-HP. Centre - Université Paris Cité (EA2511), Paris, France
| | - Guillaume Airagnes
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Limosin Frédéric
- Département de Psychiatrie, Hôpital Corentin-Celton, Centre Université Paris Cité, AP-HP, Issy-les-Moulineaux, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- Faculté de Santé, UFR de Médecine, Université Paris Cité, Paris, France
| | - Abdel-Ali Boussadi
- Département de Santé Publique et Informatique Médicale, Hôpital Européen Georges Pompidou, AP-HP. Centre - Université Paris Cité, Paris, France
- INSERM UMR 1138, Equipe 22, Centre de Recherche des Cordeliers, Paris, France
| | - Anne-Laurence Le Faou
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- Respiratory and Intensive Care Medicine, Hôpital Cochin, AP-HP. Centre - Université Paris Cité (EA2511), Paris, France
- Groupement d’Intérêt Scientifique du Réseau Français d’Excellence de Recherche sur le tabac, la nicotine et les produits connexes (REFERtab), Paris, France
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2
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Peiffer G, Perriot J, Underner M, Rouquet RM. [Smoking cessation treatment for smokers with COPD: The importance of therapeutic education]. Rev Mal Respir 2023:S0761-8425(23)00168-7. [PMID: 37208289 DOI: 10.1016/j.rmr.2023.03.008] [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: 10/19/2022] [Accepted: 03/24/2023] [Indexed: 05/21/2023]
Abstract
Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). The diagnosis of tobacco addiction and management of tobacco dependence are part and parcel of COPD treatment, especially in respiratory rehabilitation. Management encompasses psychological support, validated treatments and therapeutic education. The objective of this review is to briefly recall the guiding principles of therapeutic patient education (TPE) as it applies to smokers wishing to quit and, more specifically, to present the tools conducive to shared educational assessment and treatment according to the Prochaska's stages of change model. We are also proposing an action plan and a questionnaire through which TPE sessions can be assessed. Finally, culturally adapted interventions and new communication technologies are taken into consideration insofar as they constructively contribute to TPE.
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Affiliation(s)
- G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 1, allée du Château, 57085 Metz, France.
| | - J Perriot
- Dispensaire Emile Roux, CLAT 63, Centre de Tabacologie, 63100 Clermont-Ferrand, France
| | - M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 86021 Poitiers, France
| | - R-M Rouquet
- Pneumologue tabacologue, CHU de Toulouse, 24, chemin de Pouvourville, 31059 Toulouse cedex 9, France
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3
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Sinha I, Goel R, Bitzer ZT, Trushin N, Liao J, Sinha R. Evaluating electronic cigarette cytotoxicity and inflammatory
responses in vitro. Tob Induc Dis 2022; 20:45. [PMID: 35611070 PMCID: PMC9081552 DOI: 10.18332/tid/147200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Indu Sinha
- Department of Biochemistry and Molecular Biology, Penn State College of Medicine, United States
| | - Reema Goel
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Zachary T. Bitzer
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Neil Trushin
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Jason Liao
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Raghu Sinha
- Department of Biochemistry and Molecular Biology, Penn State College of Medicine, United States
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4
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García García MDC, Hernández Borge J, García García GM, Márquez Pérez FL. Supervivencia en pacientes con EPOC en tratamiento con oxigenoterapia continua domiciliaria. OPEN RESPIRATORY ARCHIVES 2021. [PMID: 37496844 PMCID: PMC10369520 DOI: 10.1016/j.opresp.2021.100119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Introduction Continuous home oxygen therapy (CHOT), along with smoking cessation, is the first treatment that has been shown to increase the survival of patients with chronic obstructive pulmonary disease (COPD) and chronic hypoxemia. Objective To determine survival in a cohort of COPD patients receiving CHOT and to analyze the main causes and risk factors associated with their mortality. Methods Prospective study of a cohort of COPD patients receiving CHOT. Numerous variables, including survival and cause of death at the end of follow-up, were collected. Results A total of 409 COPD patients receiving CHOT were included (85.6% men; mean age: 71.27 ± 9.74 years). Mean time of CHOT follow-up was 5.86 ± 3.24 years and median survival was 6 years (95% CI: 5.47-6.53). Mortality at the end of follow-up was 75.8%, the leading cause of death being respiratory (36.9%). Longer survival was significantly associated with lower age, correct CHOT compliance, absence of exacerbations in the previous year, use of long-acting anticholinergics (LAMA), less severe COPD, presence of sleep apnea-hypopnea syndrome/obesity hypoventilation syndrome (SAHS/SHO), absence of malignant disease, heart disease, cerebrovascular disease, and kidney disease. Conclusions The survival of COPD patients receiving CHOT was very long. The main causes of mortality were respiratory (36.9%). Independent predictors of mortality were age, presence of exacerbations in the previous year, previous diagnosis of cancer, and presence of cerebrovascular and renal disease.
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Lin TH, Chen SI, Su YC, Lin MC, Lin HJ, Huang ST. Conventional Western Treatment Combined With Chinese Herbal Medicine Alleviates the Progressive Risk of Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study. Front Pharmacol 2019; 10:987. [PMID: 31572178 PMCID: PMC6753872 DOI: 10.3389/fphar.2019.00987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022] Open
Abstract
Background and purpose: Lung cancer has high global incidence and mortality rates. Chronic obstructive pulmonary disease (COPD) is strongly associated with lung cancer and is an independent risk factor for lung cancer with or without smoking. Chinese herbal medicines (CHMs) are used to treat COPD. This study sought to determine whether CHM treatment effectively decreases the incidence of lung cancer in COPD patients receiving conventional Western medical treatment. Methods: Records obtained from the National Health Insurance Research Database (NHIRD) were used to identify 81,780 adults aged ≥18 years newly diagnosed with COPD in Taiwan between 2000 and 2010. Among them, 11,180 received CHMs after COPD diagnosis and 23,319 did not (non-CHM). After excluding patients with missing basic demographic information, each group consisted of 2,682 patients. Statistical methods analyzed the baseline characteristics for both groups and we performed a Cox proportional hazard regression analysis to examine the incidence of lung cancer. The cumulative incidence of lung cancer in COPD patients with or without CHM treatment was calculated by the Kaplan-Meier method. The association between herbs and formulas was examined by NodeXL to perform a network analysis of CHM. Results: COPD patients using CHM had a lower risk for lung cancer (adjusted hazards ratio [aHR] = 0.36, 95% confidence interval [CI] = 0.24–0.53, p < 0.001). Older age was associated with a higher risk of lung cancer: patients aged 40–59 years (aHR = 5.32, 95% CI = 2.19–12.94, p < 0.001) and those aged ≥60 years (aHR = 16.75, 95% CI = 7.54–37.23, p < 0.001) were at significantly greater risk compared with patients aged 18–39 years. CHM use was associated with a trend for a lower cumulative incidence of lung cancer compared with non-CHM use (p < 0.001). Among the 10 most commonly used single herbs and formulas used to decrease the risk of lung cancer in COPD patients, Fritillariae thunbergii was the most commonly used single herb and Xiao Qing Long Tang the most commonly used formula. Conclusion: The findings from this nationwide retrospective cohort study indicate that CHM as adjunctive therapy in COPD treatment regimens may reduce the risk of lung cancer in this vulnerable patient population.
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Affiliation(s)
- Tsai-Hui Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shu-I Chen
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yuan-Chih Su
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Jen Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Teng Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.,Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan.,Cancer Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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6
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Peiffer G, Underner M, Perriot J. [COPD and smoking cessation: Patients' expectations and responses of health professionals]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:375-390. [PMID: 30455124 DOI: 10.1016/j.pneumo.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The importance of smoking cessation in the management of COPD is well-established: the benefit of quitting smoking as regards morbidity and mortality outcomes in patients, is unquestioned. The smoking cessation in COPD patients is difficult: high levels of consumption, the duration of smoking, high dependence level, psychological co-morbidities such as anxiety and depression, lower socio-economic and intellectual level, constitute barriers. Studies have shown that patients often minimize the risks of smoking, that others do not believe in the benefits of quitting or doubt their ability to quit smoking. The patients' experience, and expectations with regard to smoking cessation are incompletely satisfied: are considered, the smoking characteristics of these patients, the understanding of the tobacco dependence, the beliefs and ideas of smokers, the knowledge of smoking cessation methods, the role of validated aids and alternative treatments, failure management. The answers of the health professionals can be in several directions: establishment of a better communication patient-doctor (empathy), more centered on the needs of the smoker, the role of the motivation and the place of the motivational interview, the understanding of the mechanisms of addiction, a better individualisation of therapeutics, the necessity of a extended follow-up, the contribution of modern technologies, the electronic cigarette, the smoking cessation in respiratory rehabilitation, guidelines that address smoking cessation treatment.
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Affiliation(s)
- G Peiffer
- Service de pneumologie, hôpital de Mercy, CHR Metz-Thionville, 57038 Metz, France.
| | - M Underner
- Centre hospitalier Henri Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - J Perriot
- Dispensaire Emile Roux - CLAT 63, 11, rue Vaucanson, 63100 Clermont-Ferrand, France
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7
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Gatti V, Banfi P, Centanni S, D'Antonio S, Giustini S, Piraino A, Zibellini M, Marini MG. Enlightening chronic obstructive pulmonary disease through patients' and caregivers' narratives. Int J Chron Obstruct Pulmon Dis 2018; 13:3095-3105. [PMID: 30323580 PMCID: PMC6178274 DOI: 10.2147/copd.s172214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose The primary aim of this research was to raise awareness for COPD through real narratives of patients, caregivers, and pulmonologists. The second objective includes providing clinicians new means of caring for and treating patients with COPD. Methods Using narrative medicine, testimonies from patients, their caregivers, and clinicians were collected through an online questionnaire enriched by a narrative plot. Narrations were analyzed throughout descriptive statistics and an elaboration of recurring words and expressions. Results Throughout the project, 350 narratives were collected from 235 patients, 55 caregivers, and 60 physicians. Though a generally neutral reaction had been observed upon diagnosis, COPD had been found to have a high impact on the patients’ and caregivers’ lives. Metaphors utilized by patients and caregivers were suggestive of fear and panic unlike those utilized by clinicians who usually had a more technical approach. Smoking was a significant concern for not only patients and caregivers but also clinicians. Conclusion Physicians are therefore challenged to find new ways of communicating COPD to raise awareness on this pathology and encourage corrective habits. An important social objective should be the implementation of a health system that is able to optimize patients’ and caregivers’ lives.
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Affiliation(s)
| | - Paolo Banfi
- Fondazione Don Carlo Gnocchi IRCCS, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST San Paolo e San Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Saffi Giustini
- Italian General Practitioners' Association "SIMG", Florence, Local Health Unit of Montale, Pistoia, Italy
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8
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Peiffer G, Underner M, Perriot J. [The respiratory effects of smoking]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:133-144. [PMID: 29793770 DOI: 10.1016/j.pneumo.2018.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 02/05/2023]
Abstract
A marked increase in the morbidity and mortality of a large number of broncho-pulmonary diseases has been documented in relation to smoking. The influence of tobacco smoking on various respiratory conditions. is discussed: incidence, severity or natural history modification of some respiratory illnesses: obstructive lung diseases (COPD, asthma), lung cancer, bacterial, viral respiratory infections, with the impact of smoking on tuberculosis. Finally, the relationship of tobacco with diffuse interstitial lung disease: protective role of smoking (controversial in sarcoidosis, real in hypersensitivity pneumonitis). The benefits of smoking cessation are described.
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Affiliation(s)
- G Peiffer
- Service de pneumologie, CHR Metz-Thionville, hôpital de Mercy, 1, allée du Château 57085 Metz cedex 3, France.
| | - M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, 86000 Poitiers, France.
| | - J Perriot
- CLAT 63, dispensaire Emile-Roux, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
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9
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Perriot J, Underner M, Peiffer G, Dautzenberg B. [Helping smoking cessation in COPD, asthma, lung cancer, operated smokers]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:170-180. [PMID: 29748064 DOI: 10.1016/j.pneumo.2018.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 02/05/2023]
Abstract
Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality.
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Affiliation(s)
- J Perriot
- Dispensaire Emile-Roux, CLAT63, centre de tabacologie, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
| | - M Underner
- Centre hospitalier Henri-Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - B Dautzenberg
- Groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Malmartel A, Eap D, Ghasarossian C. [Spotting the GLObalRIsk of severe outcomes in undiagnosed COPD patients (GLORI-COPD)]. Rev Mal Respir 2018; 35:347-352. [PMID: 29602483 DOI: 10.1016/j.rmr.2017.10.663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 10/13/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a severe chronic disease and its prevalence is increasing. Nevertheless, mortality linked to moderate and mild COPD without comorbidities is low. The aim of the study is to create and validate a questionnaire in primary care to spot patients with undiagnosed COPD who are at high risk of severe complications considering the severity of their COPD and their comorbidities. METHODS The development of the questionnaire has three steps. The first is the selection of the items which can be included in the questionnaire with a two-round Delphi method. The second step is a cross-sectional study to assess the link between spirometry and the selected items in the first step. The last step is the validation of the questionnaire in a prospective study in primary care. EXPECTED RESULTS Identifying undiagnosed COPD patients with a high global risk of complications in primary care will help to establish which patients have to be diagnosed as a priority. This is particularly useful in general practice as the patient is considered globally and not just on the basis of respiratory criteria. It should allow better selection of patients who need specialised follow up.
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Affiliation(s)
- A Malmartel
- Département de médecine générale, université de médecine Paris-Descartes, 75014 Paris, France.
| | - D Eap
- Département de médecine générale, université de médecine Paris-Descartes, 75014 Paris, France
| | - C Ghasarossian
- Département de médecine générale, université de médecine Paris-Descartes, 75014 Paris, France
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11
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Ricci F, Wollmer P, Engström G, Fedorowski A, Hamrefors V. Markers of cardiovascular autonomic dysfunction predict COPD in middle-aged subjects. Eur Respir J 2018; 51:1702481. [PMID: 29419441 DOI: 10.1183/13993003.02481-2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Autonomic dysfunction is commonly observed in chronic obstructive pulmonary disease (COPD) and may relate to the known comorbidity with coronary artery disease (CAD). We hypothesised that clinical markers of cardiovascular autonomic dysfunction predict COPD in the population, independently of CAD.In a population-based cohort of 24 768 subjects (mean age 45 years) without baseline airflow obstruction, we analysed the cross-sectional relationship of one-minute orthostatic systolic (SBP) and diastolic (DBP) blood pressure changes, and resting heart rate with forced vital capacity (FVC) and forced expiratory volume (FEV1). Cox-regression-models were used to analyse the association of orthostatic SBP and DBP changes (SBP/DBP-decrease) and resting heart rate with incident COPD over 32-year follow-up.Baseline orthostatic SBP-decrease (p=0.020) and DBP-decrease (p=0.001) associated with reduced FVC, whereas resting heart rate associated with reduced FVC and FEV1 (p<0.001). After adjustment for smoking and baseline lung function, SBP-decrease predicted COPD (Hazard ratio [HR] 1.10 per 10 mmHg; 95% confidence interval [CI]:1.03-1.18). Resting heart rate predicted COPD among smokers (HR 1.11 per 10 beats-per-minute increase; 95%CI:1.05-1.18). Results were similar in subjects without CAD.Subtle signs of cardiovascular autonomic dysfunction may precede development of COPD in middle-aged subjects. This association is independent of the relationship between cardiovascular autonomic dysfunction and CAD.
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Affiliation(s)
- Fabrizio Ricci
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Institute for Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University, Chieti, Italy
| | - Per Wollmer
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Viktor Hamrefors
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
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12
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Yan R, Wang Y, Bo J, Li W. Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study. Int J Chron Obstruct Pulmon Dis 2017; 12:3311-3321. [PMID: 29180861 PMCID: PMC5691948 DOI: 10.2147/copd.s144978] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Lifestyle modification is one of the most cost-effective strategies in self-management and secondary prevention of chronic obstructive pulmonary disease (COPD). However, the prevalence of healthy lifestyle behaviors in COPD patients in China remains unclear. The objective of this study was to examine the rates of healthy lifestyle behaviors including smoking cessation, regular exercise, and healthy diet in community population with COPD in China. Methods We recruited 46,285 individuals aged 35-70 years from 115 urban and rural communities in 12 provinces of China from 2005 to 2009. We recorded the smoking status, physical activity intensity, and quality of diet for all spirometry-diagnosed COPD patients by standardized questionnaires. Results Among 3,690 individuals with COPD, 18.2% (95% confidence interval [CI], 13.0-24.9) quitted smoking, 27.1% (95% CI, 24.7-29.7) exercised often, and 34.8% (95% CI, 31.8-38.0) ate high-quality diet. More than half of the individuals followed one or less key healthy lifestyle, and only 8.4% (95% CI, 7.0-10.0) followed all of the three healthy behaviors. Urban residents had significant higher rates of smoking cessation (23.5% [95% CI, 17.3-31.1] vs 14.4% [95% CI, 9.9-20.5], p=0.0008), regular exercise (45.6% [95% CI, 42.4-48.8] vs 14.0% [95% CI, 12.1-16.2], p<0.0001), and healthy diet (38.5% [95% CI, 35.5-41.6] vs 32.2% [95% CI, 29.2-35.4], p=0.0013) than rural residents. Age, sex, education level, body mass index, respiratory symptoms, and family income were associated with healthy living, and the strength of associations varied between urban and rural areas. Conclusion There is a large gap between the anticipated rate and the real participation in healthy lifestyle behaviors in Chinese adults with COPD, especially in rural communities. Simple and effective strategies are warranted to improve patients' lifestyle in China.
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Affiliation(s)
- Ruohua Yan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jian Bo
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Wei Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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13
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Kim J, Song H, Heo HR, Kim JW, Kim HR, Hong Y, Yang SR, Han SS, Lee SJ, Kim WJ, Hong SH. Cadmium-induced ER stress and inflammation are mediated through C/EBP-DDIT3 signaling in human bronchial epithelial cells. Exp Mol Med 2017; 49:e372. [PMID: 28860664 PMCID: PMC5628270 DOI: 10.1038/emm.2017.125] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 02/07/2023] Open
Abstract
Cadmium (Cd), a major component of cigarette smoke, disrupts the normal functions of airway cells and can lead to the development of various pulmonary diseases such as chronic obstructive pulmonary disease (COPD). However, the molecular mechanisms involved in Cd-induced pulmonary diseases are poorly understood. Here, we identified a cluster of genes that are altered in response to Cd exposure in human bronchial epithelial cells (BEAS-2B) and demonstrated that Cd-induced ER stress and inflammation are mediated via CCAAT-enhancer-binding proteins (C/EBP)-DNA-damaged-inducible transcript 3 (DDIT3) signaling in BEAS-2B cells. Cd treatment led to marked upregulation and downregulation of genes associated with the cell cycle, apoptosis, oxidative stress and inflammation as well as various signal transduction pathways. Gene set enrichment analysis revealed that Cd treatment stimulated the C/EBP signaling pathway and induced transcriptional activation of its downstream target genes, including DDIT3. Suppression of DDIT3 expression using specific small interfering RNA effectively alleviated Cd-induced ER stress and inflammatory responses in both BEAS-2B and normal primary normal human bronchial epithelial cells. Taken together, these data suggest that C/EBP signaling may have a pivotal role in the early induction of ER stress and inflammatory responses by Cd exposure and could be a molecular target for Cd-induced pulmonary disease.
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Affiliation(s)
- Jeeyoung Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Haengseok Song
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea
| | - Hye-Ryeon Heo
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Jung Woon Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Hye-Ryun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea
| | - Yoonki Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Se-Ran Yang
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
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14
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Peiffer G, Perriot J, Underner M. Chez le patient atteint de BPCO, la réduction de 50 % du tabagisme permet-elle de limiter le déclin du VEMS ? Rev Mal Respir 2017; 34:177-179. [PMID: 28209421 DOI: 10.1016/j.rmr.2016.10.872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 10/24/2016] [Indexed: 02/08/2023]
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15
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Sepúlveda-Sánchez JM, Canca-Sánchez JC, Rivas-Ruiz F, Martín-García M, Lorente Márquez C, Timonet-Andreu EM. Assessing motivation to smoking cessation in hospitalized patients. ENFERMERIA CLINICA 2017; 28:13-19. [PMID: 28073631 DOI: 10.1016/j.enfcli.2016.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/26/2016] [Accepted: 11/18/2016] [Indexed: 11/18/2022]
Abstract
AIM To assess motivation to quit smoking in patients admitted to an acute care hospital, determine predictors of readiness to change, and identify a risk group that requires targeted motivational interviewing. METHODS A cross-sectional descriptive study. A retrospective study was performed on the medical records of 248 patients aged >18 years with smoking habits admitted to the medical and surgery units of a district hospital between May 2014 and April 2015. The data collected included sociodemographic data, data on respiratory function, number of cigarettes smoked per day, motivation to quit smoking, patient-reported readiness to quit, history of respiratory diseases and previous admissions. RESULTS The Richmond test revealed that 54% of patients (n=134) were poorly motivated to quit smoking vs. 11.74% (n=29) who reported to be highly motivated. The group of patients who reported to be willing to receive support (n=77) was prevailingly composed of men (p=.009) admitted to a medical care unit (p=.026) -mainly the Unit of Cardiology (51%)- who smoked 11/29 cigarettes/day (p=.015). Dyspnoea at admission, a history of respiratory disease and previous admissions for respiratory problems were not predictors of readiness to quit. CONCLUSIONS This study identifies a risk group of patients with respiratory disease, low motivation to quit smoking and poor readiness to receive smoke cessation support, that should be the target of motivational approaches to behavior change.
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Affiliation(s)
| | | | - Francisco Rivas-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Mónica Martín-García
- Departamento de Enfermería, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Celia Lorente Márquez
- Departamento de Enfermería, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
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16
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Masefield S, Powell P, Jiménez-Ruiz C, Hajek P, Lewis K, Andreas S, Tønnesen P, van Schayck O, Gratziou C, Dautzenberg B, Tonstad S, Hering T, Nardini S, Fletcher M. Recommendations to improve smoking cessation outcomes from people with lung conditions who smoke. ERJ Open Res 2016; 2:00009-2016. [PMID: 27730185 PMCID: PMC5005168 DOI: 10.1183/23120541.00009-2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/28/2016] [Indexed: 01/29/2023] Open
Abstract
This study aimed to gain insight into the impact of lung conditions on smoking behaviour and smoking cessation, and identify recommendations for smoking cessation and professional-patient communications. The study was led by the European Lung Foundation in collaboration with the European Respiratory Society Task Force on "Statement on smoking cessation on COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit". A web-based observational cross-sectional questionnaire was developed from a patient-centered literature review. Topics covered were: cohort characteristics; perspectives on smoking cessation; interactions with healthcare professionals; and recommendations to improve cessation outcomes. The questionnaire was disseminated via existing patient and professional networks and social media channels. The survey was available online for a period of 4 months in 16 languages. The data were analysed as a whole, not by country, with thematic analysis of the open responses. Common characteristics were: male (54%); age 40-55 years (39%); 11-20 cigarettes a day (39%); smokes within 30 min of waking (61%); and has made 1-5 cessation attempts in the previous 12 months (54%). 59% had tried cessation treatments, but, of these, 55% had not found any treatments helpful. Recommendations were: earlier intervention; discussion of the patient's smoking beliefs, behaviours and motivation; giving constructive advice; understanding addiction; informed decision-making; and treatment options. Areas for new and further research have been highlighted through exploring the smoking cessation perspectives and recommendations of people with lung conditions in Europe who smoke.
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Affiliation(s)
| | | | | | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Keir Lewis
- Prince Philip Hospital and Swansea College of Medicine, Dept of Respiratory Medicine, Wales, UK
| | - Stefan Andreas
- Dept of Cardiology and Pneumology, Lungenfachklinik Immenhausen, Immenhausen, Germany
| | | | - Onno van Schayck
- Care and Public Health Research Institute (Caphri), Maastricht University, General Practice, Maastricht, The Netherlands
| | | | | | - Serena Tonstad
- Department of Preventive Cardiology, Ulleval University Hospital, Oslo, Norway
| | - Thomas Hering
- Stellvertretender Vorsitzender des Bundesverbandes der Pneumologen, Lungenarztpraxis Tegel, Berlin, Germany
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17
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Devillier P, Salvator H, Roche N, Grassin-Delyle S, Naline E, Dorocant S, Neveu H. [Long-term treatment strategy in chronic obstructive pulmonary disease: how to change the course of the disease]. Presse Med 2014; 43:1368-80. [PMID: 25455634 DOI: 10.1016/j.lpm.2014.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 09/11/2014] [Accepted: 09/16/2014] [Indexed: 11/18/2022] Open
Abstract
COPD is a pulmonary disease with a systemic impact. The goals of COPD assessment are to determine the severity of the disease to guide management. Smoking cessation is a prime objective at all the stages of the disease to modify the long-term decline in lung function, reduce the COPD symptoms, and the frequency of exacerbations, improve health status and reduce mortality. The bronchodilators are central in the pharmacologic management of COPD. Long-acting bronchodilators are indicated as maintenance treatment to relieve COPD symptoms (particularly dyspnea) despite regular use of short-acting bronchodilators. Long-acting bronchodilators reduce the exacerbation rate. The choice between a long-acting β2-adrenergic and an anticholinergic depends on the patient's perception of symptom relief. The inhaled corticoids are only indicated in COPD combined with long-acting β2-adrenergic in patients with severe COPD and a history of repeated exacerbations, who have significant symptoms despite therapy with bronchodilators. The combination of an inhaled corticosteroid with a long-acting β2-agonist reduces the exacerbation rate. The rehabilitation should be offered to all patients with dyspnea, exercise intolerance, or limitation in everyday activities related to COPD despite optimal pharmacological therapy and management of co-morbidities. Pulmonary rehabilitation is a multidisciplinary and tailored management of the COPD patients which enable to optimize exercise capacity, social reintegration, autonomy, reduce health care costs by decreasing the exacerbation rate, urgent visits and duration of hospitalisation. The rehabilitation is not just focusing on the improvement of exercise capacity, but also seeks sustained behavioural changes that are needed to achieve real improvement in health status and quality of life. Pulmonary rehabilitation is also an excellent opportunity for education which is critical in the healthcare pathway.
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Affiliation(s)
| | - Hélène Salvator
- Hôpital Foch, UPRES EA 220, 92150 Suresnes, France; Hôpital Foch, service de pneumologie, 92150 Suresnes, France
| | - Nicolas Roche
- Université Paris Descartes (EA2511), AP-HP, groupe hospitalier Cochin, site HIA du Val de Grâce, service de pneumologie et soins intensifs respiratoires, 75005 Paris, France
| | | | | | | | - Hélène Neveu
- Hôpital Foch, service de pneumologie, 92150 Suresnes, France
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