Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 529
Filter
1.
Rev. Pesqui. Fisioter ; 11(2): 411-419, Maio 2021. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1253994

ABSTRACT

OBJETIVO: Iliopsoas e o músculodiafragma compartilham fixação comum nas vértebras L2, a contração do iliopsoas pode levar à redução da excursão do diafragma levando à dificuldade respiratória. Portanto, o presente estudo controlado fornecerá evidências sobre o efeito da liberação do músculo iliopsoas na melhoria da eficiência respiratória em pacientes com dor lombar crônica. MÉTODO / DESENHO: Um total de trinta e quatro participantes com lombalgia crônica mecânica lombar crônica devido à rigidez dos flexores do quadril, dor lombar crônica e dificuldade respiratória serão recrutados com base nos critérios de seleção e serão alocados aleatoriamente em dois grupos, Grupo A (tratamento conservador + liberação miofascial iliopsoas), Grupo B (tratamento conservador + tratamento simulado). Ambos os grupos receberão a intervenção três vezes por semana durante 3 semanas. As medidas de resultado serão o Questionário de Incapacidade de Roland Morris, a Escala Numérica de Avaliação da Dor e a Capacidade de Difusão do Pulmão, pois o monóxido de carbono será usado como medidas de resultado. DISCUSSÃO: Este estudo ajudará a identificar a eficácia da liberação de iliopsoas na dor lombar e seu efeito nos parâmetros respiratórios. REGISTRO DO ENSAIO: Este ensaio foi registrado prospectivamente em cliniclatrials.gov (CTRI / 2020/04/024661), em 16 de abril de 2020.


BACKGROUND AND PURPOSE: Iliopsoas and diaphragm muscle share common attachment at L2 vertebrae, iliopsoas tightness may lead to reduce diaphragm excursion leading to breathing difficulty. Therefore, the present controlled trial will provide evidence on the effect of the iliopsoas muscle release in upgrading respiratory efficiency in patients with chronic low back pain. METHOD/DESIGN: A total of thirty-four participants with mechanical chronic low back pain due to hip flexor tightness and having breathing difficulty will be recruited based on selection criteria. It will be randomly allocated into Group A (conservative treatment + iliopsoas myofascial release), Group B (conservative treatment + sham treatment). Both the group will receive the intervention three times a week for three weeks. The outcome measures will be the Roland Morris Disability Questionnaire, Numeric Pain Rating Scale, and diffuse capacity of Lung for Carbon monoxide as outcome measures. DISCUSSION: This trial will help identify the effectiveness of iliopsoas release in low back pain and its effect on respiratory parameters. TRIAL REGISTRATION: This trial has been prospectively registered at cliniclatrials.gov (CTRI/2020/04/024661) on 16 April 2020.


Subject(s)
Low Back Pain , Diaphragm , Carbon Monoxide
2.
Rev. méd. Urug ; 37(2): e204, 2021. tab
Article in Spanish | LILACS, BNUY | ID: biblio-1280505

ABSTRACT

Resumen: El monóxido de carbono (CO) se acumula en ambientes interiores cuando hay combustión y no es perceptible. Los síntomas de intoxicación son inespecíficos, por lo que las circunstancias en las que ocurre la intoxicación pueden ser orientadoras para el diagnóstico. Objetivo: fortalecer capacidades clínicas para sospechar y confirmar intoxicaciones por CO. Método: estudio descriptivo transversal de los casos sospechosos (pacientes con síntomas neurológicos o digestivos en los que se identifica una fuente de combustión en ambiente interior) consultados en el Centro de Información y Asesoramiento Toxicológico en 2017. Resultados: fueron 111 casos, de los cuales 52 ocurrieron en 22 episodios de exposición colectiva. Los menores de 15 años fueron 37/111 y el porcentaje de niños que se identificó en intoxicaciones colectivas (23/37) es significativamente mayor que en adultos. En el período invernal ocurrieron 67/111, siendo la temperatura mínima media de 9,3 ºC. Los equipos a combustión involucrados con mayor frecuencia fueron los calefones a gas, seguidos de las estufas a gas. El síntoma inicial más frecuente fue la cefalea. La media de la carboxihemoglobina (COHb) fue de 14,7%. Los casos severos (45/111) se correlacionaron significativamente con la exposición a CO de un calefón a gas. Conclusiones: la tasa de intoxicación es baja comparada con países de similar latitud, lo que plantea la posibilidad de un subdiagnóstico. La temperatura mínima ambiental por debajo de 10 °C, la permanencia en espacios con calefacción a combustión y el uso de calefón a gas fueron los escenarios típicos de la intoxicación. La cefalea es un síntoma clave para investigar la exposición. La sospecha diagnóstica puede ser menor cuando se trata de casos individuales, sobre todo en niños.


Summary: Carbon monoxide accumulates in closed environments when there is unnoticed combustion. Signs of poisoning are non-specific, and thus circumstances around poisoning may constitute a diagnostic guide. Objective: to strengthen the clinical capacities to suspect and confirm carbon monoxide poisoning. Method: descriptive, transversal study of suspicious cases (patients with neurological or digestive symptoms for which an indoor combustion source is identified) who consulted at the Poisoning Center in 2017. Results: 111 cases were included in the study, 52 of which occurred in 22 episodes of collective exposure. 37 patients were under 15 years old and the percentage of children identified in collective poisoning (23/37) was significantly greater than the one representing adults. 67 cases occurred in winter, minimum average temperature being 9.3°C. The combustion equipment most frequently involved in poisoning events were gas-fired water heaters in the first place, followed by gas stoves. The most frequent initial symptom was headache. Average COHb was 14.7%. Severe cases (45/111) were significantly corelated to carbon monoxide exposure from gas-fired water heaters. Conclusions: the poisoning rate is low when compared to countries in a similar latitude, what suggests the possibility of under-diagnosis. Minimum environment temperature under 10°C, staying in spaces with combustion-based heating and the use of gas-fired water heaters were the typical poisoning scenarios. Headache is a key symptom to search for exposure. The diagnostic suspicion may be lower when it involves individual cases, mainly in children.


Resumo: O monóxido de carbono (CO) se acumula em ambientes fechados quando há combustão e não é perceptível. Os sintomas de envenenamento são inespecíficos, portanto, as circunstâncias em que ocorre o envenenamento podem orientar o diagnóstico. Objetivo: fortalecer as capacidades clínicas para suspeitar e confirmar envenenamento por monóxido de carbono. Método: estudo descritivo transversal de casos suspeitos (pacientes com sintomas neurológicos ou digestivos em que uma fonte de combustão é identificada em ambiente interno) consultados no CIAT em 2017. Resultados: foram identificados 111 casos, dos quais 52 ocorreram em 22 episódios de exposição em grupo. Trinta e sete eram menores de 15 anos sendo que a porcentagem de crianças que foram identificadas em intoxicações coletivas (23/37) é significativamente maior do que em adultos. No "período de inverno", com temperatura média mínima de 9,3ºC, ocorreram 67 casos. Os equipamentos de combustão mais frequentemente envolvido foram aquecedores de água a gás, seguidos de fogões a gás. O sintoma inicial mais frequente foi cefaleia. O COHb médio foi de 14,7%. Os casos graves (45/111) foram significativamente correlacionados com a exposição ao CO de um aquecedor de água a gás. Conclusões: o índice de intoxicações é baixo quando comparado a países de latitude semelhante, o que indica a possibilidade de subdiagnóstico. A temperatura ambiente mínima abaixo de 10 ° C, a permanência em ambientes com aquecimento a combustão e o uso de aquecedores a gás foram os cenários típicos de intoxicação. A cefaleia é um sintoma chave para investigar a exposição. A suspeita diagnóstica pode ser menor quando se trata de casos individuais, principalmente em crianças.


Subject(s)
Carbon Monoxide , Carbon Monoxide Poisoning
3.
Ciênc. cuid. saúde ; 20: e51054, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1339637

ABSTRACT

RESUMO Objetivo: analisar a dependência física do tabaco e o nível de monóxido de carbono no ar exalado (status tabágico) em trabalhadores terceirizados de uma universidade pública. Método: estudo descritivo-analítico, transversal, quantitativo, desenvolvido com 316 trabalhadores terceirizados de uma universidade pública. Os dados foram coletados por meio do instrumento de caracterização dos participantes, do Fagerström Test for Nicotine Dependence e do aparelho monoxímetro. Resultados: dos 316 trabalhadores terceirizados, apenas 41 relataram o uso de tabaco ou derivados e 39% destes possuíam grau de dependência física do tabaco elevado/muito elevado. A maioria (90,2%) deles possuía status tabágico considerados fumantes. As variáveis dependência física do tabaco e nível de monóxido de carbono no ar exalado apresentaram associação estatística (p=0,038). Conclusão: alguns trabalhadores possuíam dependência física ao tabaco; por isso, torna-se importante a criação e adoção de políticas públicas que atendam a este tipo de população, assim como, a presença de um enfermeiro nas empresas, com vistas para a promoção da saúde dos trabalhadores.


RESUMEN Objetivo: analizar la dependencia física del tabaco yel nivel de monóxido de carbono en el aire exhalado (status de tabaquismo) enempleados tercerizados de una universidad pública. Método: estudio descriptivo-analítico, transversal, cuantitativo, desarrollado con 316 empleados tercerizados de una universidad pública. Los datos fueronrecolectados por medio del instrumento de caracterización de los participantes, delFagerström Test forNicotineDependencey delmonitor de monóxido de carbono. Resultados: de los 316 empleados tercerizados, solo 41 relataron el uso de tabaco o derivados yel 39% de estos poseía grado de dependencia física del tabaco elevado/muy elevado. La mayor partede ellos (90,2%) poseía statusde tabaquismo considerados fumadores. Las variables dependencia física del tabaco y nivel de monóxido de carbono en el aire exhalado presentaron asociación estadística (p=0,038). Conclusión: algunos empleados poseían dependencia física al tabaco; por ello, es importante la creacióny adopción de políticas públicas que respondan a este tipo de población, así como la presencia de un enfermero en las empresas, a fin de promover la salud de los empleados.


ABSTRACT Objective: to analyze the physical dependence to tobacco and carbon monoxide levels in the exhaled air (smoking status) in outsourced workers at a public university. Method: descriptive-analytical, cross-sectional, quantitative study developed with 316 outsourced workers from a public university. Data were collected using an instrument for characterization of the participants, the Fagerström Test for Nicotine Dependence, and measurements with a monoximeter. Results: of the 316 outsourced workers, only 41 reported the use of tobacco or tobacco products and 39% of them had a high/very high degree of physical dependence to tobacco. The majority (90.2%) had smoking status considered of smokers. The variables physical dependence to tobacco and level of carbon monoxide in exhaled air showed a statistical association (p= 0.038). Conclusion: some workers had physical dependence to tobacco; therefore, the creation and adoption of public policies aimed at this type of population and the presence of nurses in companies are important to promote the health of workers.


Subject(s)
Humans , Male , Female , Tobacco , Carbon Monoxide , Substance-Related Disorders , Outsourced Services , Tobacco Use , Occupational Groups , Tobacco Use Disorder , Smoking , Occupational Health , Nursing , Tobacco Products , Smokers , Nicotine , Nurses
4.
Medicina (B.Aires) ; 80(4): 359-370, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1154829

ABSTRACT

Resumen La capacidad de difusión de monóxido de carbono (DLCO) es, después de la espirometría, la prueba de función pulmonar rutinaria y no invasiva de mayor utilidad clínica. No obstante, hay sustanciales errores de interpretación del significado fisiológico de la DLCO, de sus medidas derivadas y por consiguiente del significado clínico de sus alteraciones. Además de la utilización de diferentes nomenclaturas, otras fuentes de confusión han contribuido a cierta visión negativa de la prueba. Los aspectos técnicos de la prueba de DLCO tienen la ventaja de estar estandarizados. Pero a diferencia de lo que ocurre con otras pruebas de función pulmonar donde disponemos de valores de referencia que permiten determinar la "normalidad o anormalidad" de las mismas, es difícil aplicar esta vía de análisis en el caso de la DLCO. El hecho central en el análisis de la DLCO, el factor de transferencia para el CO (KCO), y el volumen alveolar (VA) es que para una correcta interpretación es necesario tener en cuenta el mecanismo por el cual la patología induce el cambio. Un KCO del 100% puede ser considerado normal en unas circunstancias o patológico bajo otras y, por el momento, el informe automatizado del estudio no puede discriminar. Este artículo describirá los principios de la prueba de DLCO, presentará diferentes modelos de análisis, expondrá ejemplos concretos y ofrecerá pautas para su correcta interpretación. Se considera indispensable efectuar un análisis integrado de la prueba de DLCO en relación con otras pruebas funcionales y con los datos clínicos.


Abstract The diffusing capacity for carbon monoxide (DLCO) is, after spirometry the standard and noninvasive pulmonary function test of greater clinical use. However, there are substantial errors in the interpretation of the physiological significance of the DLCO, its derived measures and, therefore the clinical significance of its alterations. In addition to the use of different nomenclatures, other sources of confusion have contributed to some negative view of the test. The technical aspects of the DLCO test have the advantage of being well standardized. But unlike what happens with other pulmonary function tests where we have reference values which allow us to determine their "normality or abnormality", it is difficult to apply this route of analysis in the case of DLCO. The central fact in the analysis of DLCO, transference factor for CO (KCO), and alveolar volume (VA) is that for a correct interpretation it is necessary to think about the mechanism by which the pathology induces change. A KCO of 100% can be considered normal in some circumstances or pathological in others and, for the moment, the automated study report cannot discriminate. This article will address the principles of the DLCO test; present different models of analysis submit concrete examples and provide guidelines for their correct interpretation. It is considered essential to carry out an integrated analysis of the DLCO test in relation to other functional tests and clinical data.


Subject(s)
Pulmonary Diffusing Capacity , Reference Values , Respiratory Function Tests , Spirometry , Carbon Monoxide
6.
Rev. méd. Chile ; 147(9): 1128-1135, set. 2019. tab, graf
Article in English | LILACS | ID: biblio-1058655

ABSTRACT

ABSTRACT Background: After acute carbon monoxide intoxication, there may be a higher risk for late adverse cardiac events. However, these patients are usually not followed to monitor the appearance of these effects. Aim: To follow patients seen at an emergency department for carbon monoxide intoxication, monitoring the appearance of myocardial infarction. To assess the predictive value for such complication of serum troponin, carboxyhemoglobin, and procalcitonin levels at the moment of intoxication. Material and Methods: We followed 237 patients receiving emergency care for carbon monoxide intoxication, with a serum carboxyhemoglobin of 5% or more, between 2010 and 2012. Levels of procalcitonin and troponin I were measured. Patients were followed for five years after the intoxication. Results: During the follow up period, 35 patients had a myocardial infarction. These patients had significantly higher carboxyhemoglobin, procalcitonin and troponin I levels at the moment of the intoxication than their counterparts who did not had a myocardial infarction in the follow up. A logistic regression analysis showed that age, carboxyhemoglobin levels, procalcitonin, troponin 1 and length of CO exposure were associated with a higher risk of myocardial infarction. Procalcitonin, troponin and carboxyhemoglobin levels had a high sensitivity and specificity to predict the appearance of myocardial infarction, with high areas under the receiver operating characteristic (ROC) curves. Conclusions: In patients with CO intoxication, carboxyhemoglobin, troponin and procalcitonin levels at the moment of the intoxication are significant predictors of the late appearance of myocardial infarction.


Antecedentes: Después de una intoxicación con monóxido de carbono, hay un mayor riesgo de desarrollar problemas cardiovasculares a largo plazo. Sin embargo, estos pacientes no son seguidos habitualmente para evaluar la aparición de estos eventos. Objetivo: Efectuar un seguimiento de pacientes que han sufrido una intoxicación con CO, evaluando la aparición de infarto del miocardio. Evaluar el valor de los niveles de troponina, carboxihemoglobina y procalcitonina para predecir la aparición de estos eventos. Material y Métodos: Seguimos 237 pacientes que fueron atendidos de urgencia por una intoxicación con CO, con niveles de carboxihemoglobina de 5% o más, entre 2010 y 2012. Se midieron los niveles de procalcitonina, troponina 1 y carboxihemoglobina y los pacientes fueron seguidos por cinco años después de la intoxicación. Resultados: Durante el seguimiento, 35 pacientes tuvieron un infarto al miocardio. Estos pacientes tenían niveles significativamente más altos de procalcitonina, troponina 1 y carboxihemoglobina al momento de la intoxicación, que los pacientes que no tuvieron un infarto durante el seguimiento. Una regresión logística mostró que la edad, carboxihemoglobina, procalcitonina, troponina y la duración de exposición a CO se asociaron a un mayor riesgo de infarto. Procalcitonina, troponina 1 y carboxihemoglobina tuvieron una alta sensibilidad y especificidad para predecir la aparición de infarto, con áreas bajo la curva ROC (receiver operating characteristic) elevadas. Conclusiones: En pacientes con intoxicación por CO, la carboxihemoglobina, procalcitonina y troponina son predictores significativos de la aparición de infarto agudo de miocardio en el largo plazo.


Subject(s)
Humans , Carbon Monoxide Poisoning , Myocardial Infarction/etiology , Troponin , Carboxyhemoglobin , Carbon Monoxide
7.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 28 jun. 2019. a) f: 12 l:17 p. graf, tab.(GCBA. Gerencia Operativa de Epidemiología, 4, 149).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1102790

ABSTRACT

informe realizado por los equipos de trabajo que pertenecen a Salud Ambiental, Agencia de Protección Ambiental y Gerencia Operativa de Epidemiología, del Gobierno de la Ciudad de Buenos Aires. En el presente informe se analizan una serie de indicadores que permiten observar los valores de contaminantes criterio: Material Particulado en suspensión menor a 10 micrones (PM 10), Monóxido de Carbono (CO) y Dióxido de Nitrógeno (NO2), registrados en las estaciones de Monitoreo de Calidad del Aire que posee la Ciudad (La Boca, Parque Centenario y Córdoba), las cuales registran las concentraciones de estos contaminantes en forma continua (durante 24 horas, los 365 días del año), mediante métodos homologados internacionalmente. El periodo registrado abarca los años 2010 hasta el año 2018 completo. (AU)


Subject(s)
Carbon Monoxide/analysis , Air Quality Control , Air Monitoring , Air Pollution/prevention & control , Air Pollution/statistics & numerical data , Particulate Matter/analysis , Nitrogen Dioxide/analysis , Environmental Health Surveillance
8.
Braz. j. med. biol. res ; 52(2): e8130, 2019. tab, graf
Article in English | LILACS | ID: biblio-984026

ABSTRACT

Exposure to air pollution is an important cause of hospital admissions due to respiratory diseases. Nevertheless, few studies use pollutant concentration data estimated by mathematical models. A time-series ecological study was developed, using data from hospitalizations due to respiratory diseases in people over 60 years of age, residents of Cuiabá, Brazil, during 2012, obtained from the Brazilian Ministry of Health. The independent variables were the concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO) estimated by mathematical modeling, minimum temperature, and relative humidity (obtained from the Brazilian Meteorological Agency), and the number of forest fires. The generalized linear regression model of Poisson was used, with lags of 0 to 7 days. The coefficients obtained were transformed into relative risk of hospitalization, with respective 95% confidence intervals; alpha=5% was adopted. In that year, 591 hospitalizations were evaluated, with a daily average of 1.61 (SD=1.49), the PM2.5 average concentration was 15.7 µg/m3, and the CO average concentration was 144.2 ppb. Significant associations between exposure to these contaminants and hospitalizations in lags 3 and 4 in 2012 were observed. There was a hospitalization risk increase of 31.8%, with an increase of 3.5 µg/m3 of PM2.5 concentrations and an increase of 188 in the total number of hospitalizations, with an expense of more than ≈US$ 96,000 for the Brazilian Public Health System. This study provided information on the cost of air pollution to the health system and the feasibility of using a mathematical model to estimate environmental concentration of air pollutants.


Subject(s)
Humans , Middle Aged , Aged , Respiration Disorders/etiology , Carbon Monoxide/adverse effects , Air Pollution/adverse effects , Environmental Exposure/adverse effects , Particulate Matter/adverse effects , Seasons , Time Factors , Brazil , Poisson Distribution , Risk Factors , Hospitalization , Models, Theoretical
9.
J. bras. pneumol ; 45(5): e20180262, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1040282

ABSTRACT

RESUMO Objetivo Derivar valores de referência em adultos brancos para a difusão do monóxido de carbono (DCO) em uma amostra de diferentes locais do Brasil por um mesmo modelo de equipamento (Sensormedics) e comparar os resultados com os derivados pelas equações de Crapo, Miller e Neder, e da proposta pelo Global Lung Initiative (GLI). Métodos Os testes foram realizados de acordo com as normas sugeridas pela ATS/ERS, em 2005, em seis cidades brasileiras, em 120 voluntários adultos de cada sexo, não fumantes, sem anemia referida e sem doenças pulmonares ou cardíacas. Os previstos foram derivados por regressões lineares e as diferenças entre os valores previstos por alguns autores e os observados no estudo atual foram calculadas. Resultados Nos homens, a idade variou de 25 a 88 anos e a estatura, de 156 a 189 cm. Nas mulheres, a idade variou de 21 a 92 anos e a estatura, de 140 a 176 cm. A DCO se correlacionou de maneira significativa positivamente com a estatura e negativamente com a idade. Os valores previstos pelas equações de Crapo, Neder e Miller foram maiores em comparação aos obtidos pelo estudo atual (p<0,01) em ambos os sexos. Nos homens, os valores não diferiram quando comparados aos calculados pelo GLI (p=0,29); nas mulheres, os valores derivados pelo GLI foram levemente maiores: 0,99 mL/min/mmHg (p<0,01). Conclusões Novos valores previstos para a DCO foram derivados em uma amostra de adultos brancos no Brasil. Os valores previstos são semelhantes aos compilados pelas equações GLI e diferem de equações propostas anteriormente.


ABSTRACT Objective To derive reference values from white race adults, for DCO in a sample from different sites in Brazil, through the same equipment model (Sensormedics), and compare the results with the derivatives from Crapo, Miller, Neder equations and from the Global Lung Initiative (GLI) proposal. Methods The tests were performed according to the norms suggested by ATS/ERS in 2005 in six Brazilian cities, with 120 adult volunteers of each gender, non-smokers, without referred anemia and without lung or cardio diseases. The expected values were derived from linear regressions and the differences between the values forecasted by some authors and the ones observed in the current study were calculated. Results Among men, the age varied between 25 and 88 years old, and the height varied between 140 and 176 cm. DCO was correlated significantly and positively with the height and negatively with the age. The values forecasted by Crapo, Neder, and Miller equations were higher in comparison with the ones obtained by the current study (p<0.01) in both genders. Among men, the values did not differ when compared to the ones calculated by GLI (p=0.29); among women, the values derived by GLI were slightly higher: 0.99 ml/min/mmHg (p<0.01). Conclusion new values forecasted for DCO were derived in a sample of white adults in Brazil. The forecasted values are similar to the ones complied by GLI equations and differ from the previously proposed equations.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carbon Monoxide/metabolism , Pulmonary Diffusing Capacity/physiology , European Continental Ancestry Group , Reference Values , Respiratory Function Tests , Body Height/physiology , Brazil , Body Mass Index , Linear Models , Sex Factors , Age Factors , Sex Distribution , Age Distribution
10.
Frontiers of Medicine ; (4): 259-266, 2019.
Article in English | WPRIM | ID: wpr-772706

ABSTRACT

Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV ⩽ 2.8 m/s group and TRV > 2.8 m/s group. Both groups comprised 25 females with an average age of 38.6 ± 8.1 and 41.5 ± 8.9 years. In the TRV > 2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08 ± 12.45 mmHg vs. 30.24 ± 5.25 mmHg, P < 0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (PO), and 6 min walking distance (r =-0.392, -0.351, 0.450, and -0.591, respectively; P < 0.05), in which PO was a risk factor for SPAP elevation (β = 0.064, OR = 1.066, P < 0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0 12.6 mmHg to 35.2 ± 11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.


Subject(s)
Adult , Carbon Monoxide , Echocardiography , Exercise Test , Female , Hemodynamics , Humans , Hypertension, Pulmonary , Therapeutics , Logistic Models , Lymphangioleiomyomatosis , Therapeutics , Male , Middle Aged , Multivariate Analysis , Oxygen , Blood , Therapeutic Uses , Respiratory Function Tests , Sirolimus , Therapeutic Uses
11.
Article in English | WPRIM | ID: wpr-777621

ABSTRACT

OBJECTIVES@#The association between concentrations of sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), ozone (O), and emergency ambulance dispatches (EADs) for asthma was explored in the central Sichuan Basin of southwestern China for the first time.@*METHODS@#EADs for asthma were collected from the Chengdu First-Aid Command Center. Pollutant concentrations were collected from 24 municipal environmental monitoring centers and including SO, NO, CO, daily 8-h mean concentrations of O (O-8 h), and particulate matter less than 2.5 μm in aerodynamic diameter (PM). The climatic data were collected from the Chengdu Municipal Meteorological Bureau. All data were collected from years spanning 2013-2017. A time-stratified case-crossover design was used to analyze the data.@*RESULTS@#After controlling for temperature, relative humidity, and atmospheric pressure, IQR increases in SO (13 μg/m), NO (17 μg/m), and CO (498 μg/m) were associated with 18.8%, 11.5%, and 3.1% increases in EADs for asthma, respectively. The associations were strongest for EADs and SO, NO, and CO levels with 3-, 5-, and 1-day lags, respectively.@*CONCLUSIONS@#This study provides additional data to the limited body of literature for potential health risks arising from ambient gaseous pollutants. The results of the study suggest that increased concentrations of SO, NO, and CO were positively associated with emergency ambulance dispatches for asthma in Chengdu, China. Further studies are needed to investigate the effects of individual air pollutants on asthma.


Subject(s)
Air Pollutants , Toxicity , Asthma , Epidemiology , Carbon Monoxide , Toxicity , China , Epidemiology , Cities , Cross-Over Studies , Emergency Medical Dispatch , Environmental Monitoring , Humans , Nitrogen Dioxide , Toxicity , Ozone , Toxicity , Particle Size , Particulate Matter , Toxicity , Risk , Sulfur Dioxide , Toxicity
12.
Article in English | WPRIM | ID: wpr-763314

ABSTRACT

OBJECTIVES: The effects of air pollutants on upper airway disease development have been seldom studied. In this study, we evaluated the effects of air pollution on the prevalence of ENT diseases. METHODS: We identified cases of ENT disease occurring in 2009, as recorded by the Korea National Health and Nutrition Examination Survey, and explored their associations with the levels of five air pollutants: sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), carbon monoxide (CO), and particulate matter (PM₁₀ particles; particulates ≤10 μm in aerodynamic diameter). Subjects diagnosed with at least one of the five studied ENT diseases were included in analysis, but those aged under 19 years were excluded. Linear associations between ENT disease frequency and pollutant levels were evaluated by calculating Spearman correlations. After adjusting for age, gender, and geographic region, multivariate logistic regression was used to obtain odds ratios (OR) with 95% confidence intervals (CI). RESULTS: A total of 7,399 subjects with ENT diseases were identified. A linear association was evident between PM₁₀ concentration and the frequency of septal deviation (Spearman coefficient, 0.507; P=0.045). After adjustment, the PM₁₀ level was associated with high odds ratios for chronic rhinosinusitis (1.22; 95% CI, 1.02 to 1.46) and septal deviation (1.43; 95% CI, 1.22 to 1.67). Both of these conditions were more prevalent in males. CONCLUSION: We found that increased ambient concentrations of PM₁₀ particles were clearly associated with increased the risk of chronic rhinosinusitis and septal deviation; the exposure-response relationship was definitive.


Subject(s)
Air Pollutants , Air Pollution , Carbon Monoxide , Ear , Health Impact Assessment , Humans , Korea , Logistic Models , Male , Nitrogen Dioxide , Nose , Nutrition Surveys , Odds Ratio , Otorhinolaryngologic Diseases , Ozone , Particulate Matter , Pharynx , Prevalence , Respiratory Tract Infections , Sulfur Dioxide
13.
Article in English | WPRIM | ID: wpr-764181

ABSTRACT

PURPOSE: The purpose of this study was to determine the relation between quantitative magnetic resonance imaging biomarkers, and clinical performances in chronic phase of carbon monoxide intoxication. MATERIALS AND METHODS: Eighteen magnetic resonance scans and cognitive evaluations were performed, on patients with carbon monoxide intoxication in chronic phase. Apparent diffusion coefficient (ADC) ratios of affected versus unaffected centrum semiovale, and corpus callosum were obtained. Signal intensity (SI) ratios between affected centrum semiovale, and normal pons in T2-FLAIR (fluid-attenuated inversion recovery) images were obtained. The Mini-Mental State Exam, and clinical outcome scores were assessed. Correlation coefficients were calculated, between MRI and clinical markers. Patients were further classified into poor-outcome and good-outcome groups based on clinical performance, and imaging parameters were compared. T2-SI ratio of centrum semiovale was compared, with that of 18 sex-matched and age-matched controls. RESULTS: T2-SI ratio of centrum semiovale was significantly higher in the poor-outcome group, than that in the good-outcome group and was strongly inversely correlated, with results from the Mini-Mental State Exam. ADC ratios of centrum semiovale were significantly lower in the poor outcome group than in the good outcome group, and were moderately correlated with the Mini-Mental State Exam score. CONCLUSION: A higher T2-SI and a lower ratio of ADC values in the centrum semiovale, may indicate presence of more severe white matter injury and clinical impairment. T2-SI ratio and ADC values in the centrum semiovale, are useful quantitative imaging biomarkers for correlation with clinical performance in individuals with carbon monoxide intoxication.


Subject(s)
Biomarkers , Carbon Monoxide Poisoning , Carbon Monoxide , Carbon , Corpus Callosum , Diffusion , Humans , Magnetic Resonance Imaging , Pons , White Matter
14.
Article in English | WPRIM | ID: wpr-765935

ABSTRACT

BACKGROUND/AIMS: Recent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000–2012. METHODS: We collected data from the Taiwan National Health Insurance Research Database, linked to the Taiwan Air Quality-Monitoring Database according to the insurant living area and the air quality-monitoring station locations. Children < 18 years old, identified from January 1st, 2000, were followed-up until IBS diagnosis or December 31st, 2012. The daily average air pollutant concentrations were categorized into 4 quartile-based groups (Q1–Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for IBS stratified by the quartiles of air pollutant concentration. RESULTS: A total of 3537 children (1.39%) were diagnosed with IBS within the cohort during the follow-up period. The incidence rate for IBS increased from 0.84 to 1.76, from 0.73 to 1.68, from 0.85 to 1.98, and from 0.52 to 3.22 per 1000 person-years, with increase in the carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane quartile (from Q1 to Q4) exposure concentration, respectively. The adjusted HR for IBS increased with elevated carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane exposure in Q4 to 1.98, 2.14, 2.19, and 5.87, respectively, compared with Q1. CONCLUSION: Long-term ambient air pollutant exposure is an environmental risk factor for childhood IBS.


Subject(s)
Air Pollution , Carbon Monoxide , Child , Cohort Studies , Diagnosis , Follow-Up Studies , Humans , Incidence , Irritable Bowel Syndrome , Methane , National Health Programs , Nitrogen Dioxide , Risk Factors , Taiwan
15.
Asian Nursing Research ; : 53-60, 2019.
Article in English | WPRIM | ID: wpr-739597

ABSTRACT

PURPOSE: Adverse health effects of smoking could be made worse by worker's tobacco use, and combining tobacco use with occupational hazards could enhance the likelihood of occupational disease and injury. This study was aimed to develop a workplace smoking cessation program based on self-determination theory (SDT) and then to examine the effectiveness of the program. METHODS: A quasi-experimental design with nonequivalent control group pretesteposttest design was used. An intervention group (n = 30) received a smoking cessation program using individual counseling and tailored text messaging based on SDT during 12 weeks. Participants in the control group (n = 30) received a smoking cessation leaflet and telephonic follow-up for 3 times. RESULTS: At 6 and 12 weeks, there were significant differences between the two groups on autonomous regulation, perceived competence, nicotine dependence, tobacco abstinence rate, and exhaled carbon monoxide concentration. At 12 weeks, the abstinence rate in the intervention group was 96.7%, whereas that in the control group was 12.9%. CONCLUSION: SDT-based workplace smoking cessation program using individual counseling and tailored text messaging is effective in encouraging autonomous regulation and competence for workers.


Subject(s)
Carbon Monoxide , Counseling , Follow-Up Studies , Mental Competency , Occupational Diseases , Pilot Projects , Smoke , Smoking Cessation , Smoking , Text Messaging , Tobacco , Tobacco Use , Tobacco Use Disorder
16.
Yonsei Medical Journal ; : 243-256, 2019.
Article in English | WPRIM | ID: wpr-742537

ABSTRACT

PURPOSE: The effects of air pollution on health can vary regionally. Our goal was to comprehensively review previous epidemiological studies on air pollution and health conducted in Korea to identify future areas of potential study. MATERIALS AND METHODS: We systematically searched all published epidemiologic studies examining the association between air pollution and occurrence of death, diseases, or symptoms in Korea. After classifying health outcomes into mortality, morbidity, and health impact, we summarized the relationship between individual air pollutants and health outcomes. RESULTS: We analyzed a total of 27 studies that provided 104 estimates of the quantitative association between risk of mortality and exposure to air pollutants, including particulate matter with aerodynamic diameter less than 10 µm, particulate matter with aerodynamic diameter less than 2.5 µm, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide in Korea between January 1999 and July 2018. Regarding the association with morbidity, there were 38 studies, with 98 estimates, conducted during the same period. Most studies examined the short-term effects of air pollution using a time series or case-crossover study design; only three cohort studies that examined long-term effects were found. There were four health impact studies that calculated the attributable number of deaths or disability-adjusted life years due to air pollution. CONCLUSION: There have been many epidemiologic studies in Korea regarding air pollution and health. However, the present review shows that additional studies, especially cohort and experimental studies, are needed to provide more robust and accurate evidence that can be used to promote evidence-based policymaking.


Subject(s)
Air Pollutants , Air Pollution , Carbon Monoxide , Cohort Studies , Environmental Medicine , Epidemiologic Studies , Korea , Mortality , Nitrogen Dioxide , Ozone , Particulate Matter , Sulfur Dioxide
17.
Biosci. j. (Online) ; 34(2): 477-485, mar./apr. 2018. ilus, tab, graf
Article in English | LILACS | ID: biblio-966731

ABSTRACT

Studies related to environmental pollution, carbon monoxide levels and smoking need to be deepened, especially in the case of traffic workers. Therefore, the objective was to verify the association between environmental carbon monoxide and carboxyhemoglobin levels among smoking and non-smoking motorcycle taxi drivers. A longitudinal epidemiological study was carried out with 95 motorcycle taxi drivers with measurement of the environmental carbon monoxide, carboxyhemoglobin in the exhaled air in three moments with interval of six months, between June 2014 and March 2015, as well as sociodemographic and occupational characteristics of these workers. The seasons of the year presented different carbon monoxide averages (p <0.05), with higher levels in the spring and lower in the autumn, while carboxyhemoglobin levels among smokers and non-smokers were high in the winter, fair in the spring and low in the autumn. Statistical differences were observed between subgroups: between autumn and spring for nonsmokers (p = 0.024) and between winter and autumn for smokers (p = 0.042). There was a positive correlation between carbon monoxide and carboxyhemoglobin levels for non-smokers (rs = 0.9983; p < 0.01). Environmental pollution represented different levels in the four seasons of the year and significant association with carboxyhemoglobin levels.Thecarboxyhemoglobin levels were higher among smokers, with statistical significance between winter and fall seasons, while non-smokers presented normal levels, whatconfirms the direct influence of tobacco in carboxyhemoglobin levels.


Os estudos relacionados à poluição ambiental, níveis de monóxido de carbono e o tabagismo, necessitam de aprofundamento, com destaque para os trabalhadores do trânsito. Para tanto, verificar associação entre níveis de monóxido de carbono ambiental e carboxihemoglobina em mototaxistas tabagistas e não tabagistas. Estudo epidemiológico, longitudinal, realizado com 95 mototaxistas com mensuração do monóxido de carbono ambiental, carboxihemoglobina no ar exalado em três momentos com intervalo de seis meses, entre junho de 2014 e março de 2015, assim como as características sociodemográficas e ocupacionais desses trabalhadores. As estações do ano apresentaram diferentes médias de monóxido de carbono (p<0,05), com níveis maiores na primavera e menores no outono, enquanto os níveis de carboxihemoglobina entre tabagistas e não tabagistas apresentaram-se elevados no inverno, intermediário na primavera e baixos no outono. Observou-se diferença estatística entre subgrupos, no outono e na primavera para os não tabagitas (p=0,024) e entre o inverno e outono para os tabagistas (p=0,042). Houve correlação positiva entre os níveis de monóxido de carbono e carboxihemoglobina para não fumantes (rs=0,9983; p<0,01). A poluição ambiental representou diferentes níveis nas quatro estações do ano e associação significativa com os níveis de carboxihemoglobina. Os níveis de carboxihemoglobina mostraram-se mais elevados nos tabagistas, com significância estatística entre a estação inverno e a do outono, enquanto os não tabagistas apresentaram níveis normais, o que reforça a participação direta do tabaco nos níveis de carboxihemoglobina.


Subject(s)
Occupational Health , Environmental Pollution , Tobacco Products , Tobacco Smoking , Tobacco , Carboxyhemoglobin , Carbon Monoxide
18.
São Paulo; s.n; 2018. 118 p.
Thesis in Portuguese | LILACS | ID: biblio-882833

ABSTRACT

Ocorrem anualmente aproximadamente 600.000 mortes de crianças com até cinco anos, no mundo. Pneumonia é a principal causa e mais de 50 por cento destas mortes são atribuídas à poluição do ar. Ela ainda é responsável pelo aumento do risco de infecções respiratórias, asma, condições neonatais adversas e anomalias congênitas. A poluição do ar também afeta o desenvolvimento cognitivo de crianças e induz o desenvolvimento de doenças crônicas na idade adulta. Entre 70 e 80 por cento da poluição do ar em nações em desenvolvimento são de origem veicular. Objetivando definir critérios baseados em medições com sensoriamento remoto para identificação de veículos automotores leves do ciclo Otto com elevadas emissões de monóxido de carbono, hidrocarbonetos ou óxido nítrico, foram utilizados os dados secundários gerados pela Remote Sensing do Brasil Ltda dos quais foram selecionados 179.142 veículos em uso da frota circulante da cidade de São Paulo com medições completas dos índices de emissão dos poluentes monóxido de carbono (CO), hidrocarbonetos (HC) e óxido nítrico (NO) e ainda velocidade e aceleração do veículo quando da medição e inclinação da pista no local escolhido para as medições. Foram ajustados modelos estatísticos da classe Generalised Additive Models for Location, Scale and Shape (GAMLSS) visando testar a influência do Tipo de Combustível, da Potência Específica do Veículo (VSP) e das Fases do Programa de Controle da Poluição do Ar por Veículos Automotores (Proconve) sobre as emissões de CO, HC e NO, medidos usando o Remote Sensing Device (RSD). As emissões foram então conceitualmente subdivididas em dois grupos: veículos com emissões normais e com emissões anormais, isso para os diversos poluentes em veículos das Fases L3, L4 e L5 que são as fases de interesse para o gerenciamento da qualidade do ar. Variáveis latentes foram definidas para indicarem as distribuições dos veículos em relação a esses grupos e Fases. O algoritmo Expectation-Maximization (EM) foi empregado para identificação dos parâmetros das distribuições. Para determinação dos valores associados aos veículos com elevadas emissões de determinado poluente e fase do Proconve, foi empregado o percentil 98 por cento da distribuição ajustada para os veículos dos grupos com emissões normais. Assim sendo, o Erro de Tipo I foi fixado em 2 por cento sendo que esse percentual foi estabelecido considerando o Erro de Tipo II, de apontar o veículo como tendo emissão normal quando na realidade trata-se de um high emitter. Através desta abordagem foram determinados os valores indicativos de veículos com elevadas emissões segundo o poluente e a Fase do Proconve. Os resultados apontaram decréscimo nas emissões de CO e de HC segundo as Fases do Proconve. Para o NO, o comportamento das emissões não acompanhou as reduções impostas pelas Fases do Proconve. Foi constatado que os veículos de 2005 a 2009, movidos exclusivamente a gasool, foram os que apresentaram as maiores emissões de NO. Diversos possíveis fatores causadores deste comportamento diferenciado do NO foram discutidos neste trabalho. Os dados de qualidade do ar detectaram aumento significativo nas concentrações ambientais de Óxidos de Nitrogênio (NOx) em 2007, quando foi monitorado este parâmetro no período de inverno, o que pode indicar a influência dos high emitters, mas necessita de estudos mais aprofundados para confirmação da causa deste comportamento


Approximately 600,000 deaths occur worldwide annually for children up to five years of age. Pneumonia is the leading cause and more than 50 per cent of these deaths are attributed to air pollution. It is still responsible for increased risk of respiratory infections, asthma, adverse neonatal conditions and congenital anomalies. Air pollution also affects the cognitive development of children and induces future development of chronic diseases in adulthood. In order to define criteria based on remote sensing measurements to identify Otto cycle light duty vehicles (LDV) with high emissions of carbon monoxide, hydrocarbons or nitric oxide it was used secondary data produced by Remote Sensing do Brasil Ltda, from which 179,142 inuse vehicles were selected, that belongs to the city of São Paulos current fleet. All those vehicles had complete measurements of emission of carbon monoxide (CO), hydrocarbons (HC) and nitric oxide (NO), and also speed and acceleration of the vehicle during measurements, and slope of the track at the place chosen for the measurements. Statistical models of the Generalized Additive Models for Location, Scale and Shape (GAMLSS) class were adjusted to test the influence of fuel type, Vehicle Specific Power (VSP) and of the Brazilian Vehicle Emission Control Program [Proconve] phases on CO, HC and NO emissions, measured using Remote Sensing Device (RSD). The emissions were then conceptually subdivided into two groups: vehicles with normal and abnormal emission, for the various pollutants in vehicles of L3, L4 and L5 phases of Proconve, which were of interest for the air quality management. Latent variables were defined to indicate the distribution of vehicles in relation to those groups and phases. The algorithm Expectation Maximization (EM) was employed to identify all parameters of the distributions. We use the 98 per cent percentiles of the statistical distribution set, for vehicles of groups with normal emissions to determine the limit values for vehicles with high emissions of pollutants and Proconve Phase. Therefore, the Type I Error was set at 2 per cent and this percentage was established considering the Type II Error to point the vehicle as having normal emission when in fact it is a high emitter. Through this approach, the indicative values of vehicles with high emissions according to the pollutant and the Proconve Phase were determined. Results of emissions measured with the RSD technique indicated a decrease in CO and HC emissions according to the Proconve Phase. For the NO, the emissions behavior did not follow the reductions imposed by the Proconve Phases. It was found that newer vehicles year model from 2005 to 2009 exclusively gasohol-powered vehicles, were the ones that presented the highest NO emissions. Several possible causative factors of this differential behavior of NO were discussed in this study. A significant increase in the environmental concentrations of Nitrogen Oxides (NOx) was detected in 2007, when this parameter was monitored in the winter period. This may indicate the influence of the high emitter vehicles, but it requires a more in-depth cause-effect study for confirmation of this behavio


Subject(s)
Air Pollution/prevention & control , Remote Sensing Technology/instrumentation , Vehicle Emissions/analysis , Carbon Monoxide , Hydrocarbons , Nitric Oxide
19.
Article in Korean | WPRIM | ID: wpr-740970

ABSTRACT

BACKGROUND: Relapse is the common situation of smoking cessation attempts. There are few studies that analyzed the related factors of smoking relapse among military personnel. Thus, This study was performed to investigate factors related to smoking relapse among military personnel who participated smoking cessation clinics in Korea. METHODS: The study subjects were 19,874 military personnel who enrolled smoking cessation clinic from January in 2015 to December in 2017. Smoking cessation applied to criteria exhaled carbon monoxide and urine cotinine levels. Binominal logistic regression analysis was performed to confirm related factors of smoking relapse among military personnel who succeed to quit smoking. RESULTS: The smoking relapse rate of study subjects who succeeded in quitting smoking for 1-month was 15.3% after 3-months and 60.8% after 6-months follow-up. The factors associated with relapse smoking included implementing year, past year quit attempts, number or cigarettes smoked per day, regular exercise, blood pressure. Levels of nicotine dependence affected smoking relapse at 3-months follow-up. CONCLUSIONS: Tailored approaches are necessary to reduce the rates of smoking relapse for military personnel who succeeded to quit smoking shortly but relapse back to smoking.


Subject(s)
Blood Pressure , Carbon Monoxide , Cotinine , Follow-Up Studies , Humans , Korea , Logistic Models , Military Personnel , Recurrence , Smoke , Smoking Cessation , Smoking , Tobacco Products , Tobacco Use Disorder
20.
Chinese Medical Journal ; (24): 1030-1033, 2018.
Article in English | WPRIM | ID: wpr-686987

ABSTRACT

<p><b>Background</b>Asthma is a common chronic respiratory disease and is related to air pollution exposure. However, only a few studies have concentrated on the association between air pollution and adult asthma. Moreover, the results of these studies are controversial. Therefore, the present study aimed to analyze the influence of various pollutants on hospitalization due to asthma in adults.</p><p><b>Methods</b>A total of 1019 unrelated hospitalized adult asthma patients from Northeast China were recruited from 2014 to 2016. Daily average concentrations of air pollutants (particulate matter <2.5 μm [PM], particulate matter <10 μm [PM], sulfur dioxide [SO], nitrogen dioxide [NO], and carbon monoxide [CO]) were obtained from the China National Environmental Monitoring Centre website from 2014 to 2016. Cox logistic regression analysis was used to analyze the relationship between air pollutants and hospital admissions in adult asthma.</p><p><b>Results</b>The maximum odds ratio (OR) value for most air pollutants occurred on lag day 1. Lag day 1 was chosen as the exposure period, and 8 days before onset was chosen as the control period. Three pollutants (PM, CO, and SO) were entered into the regression equation, and the corresponding OR (95% confidence interval) was 0.995 (0.991-0.999), 3.107 (1.607-6.010), and 0.979 (0.968-0.990), respectively.</p><p><b>Conclusions</b>A positive association between hospital admissions and the daily average concentration of CO was observed. CO is likely to be a risk factor for hospital admissions in adults with asthma.</p>


Subject(s)
Air Pollutants , Toxicity , Air Pollution , Asthma , Epidemiology , Carbon Monoxide , Toxicity , China , Environmental Monitoring , Female , Hospitalization , Humans , Male , Odds Ratio , Particulate Matter , Toxicity , Risk Factors , Sulfur Dioxide , Toxicity
SELECTION OF CITATIONS
SEARCH DETAIL