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1.
Pulmonology ; 2024 Apr 13.
Article in English | MEDLINE | ID: mdl-38614859

ABSTRACT

BACKGROUND: Dyspnoea is a common symptom of respiratory disease. However, data on its prevalence in general populations and its association with lung function are limited and are mainly from high-income countries. The aims of this study were to estimate the prevalence of dyspnoea across several world regions, and to investigate the association of dyspnoea with lung function. METHODS: Dyspnoea was assessed, and lung function measured in 25,806 adult participants of the multinational Burden of Obstructive Lung Disease study. Dyspnoea was defined as ≥2 on the modified Medical Research Council (mMRC) dyspnoea scale. The prevalence of dyspnoea was estimated for each of the study sites and compared across countries and world regions. Multivariable logistic regression was used to assess the association of dyspnoea with lung function in each site. Results were then pooled using random-effects meta-analysis. RESULTS: The prevalence of dyspnoea varied widely across sites without a clear geographical pattern. The mean prevalence of dyspnoea was 13.7 % (SD=8.2 %), ranging from 0 % in Mysore (India) to 28.8 % in Nampicuan-Talugtug (Philippines). Dyspnoea was strongly associated with both spirometry restriction (FVC

2.
Int J Tuberc Lung Dis ; 19(1): 21-30, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25519786

ABSTRACT

BACKGROUND: Increasing access to essential respiratory medicines and influenza vaccination has been a priority for over three decades. Their use remains low in low- and middle-income countries (LMICs), where little is known about factors influencing use, or about the use of influenza vaccination for preventing respiratory exacerbations. METHODS: We estimated rates of regular use of bronchodilators, inhaled corticosteroids and influenza vaccine, and predictors for use among 19 000 adults in 23 high-income countries (HICs) and LMIC sites. RESULTS: Bronchodilators, inhaled corticosteroids and influenza vaccine were used significantly more in HICs than in LMICs, after adjusting for similar clinical needs. Although they are used more commonly by people with symptomatic or severe respiratory disease, the gap between HICs and LMICs is not explained by the prevalence of chronic obstructive pulmonary disease or doctor-diagnosed asthma. Site-specific factors are likely to influence use differently. The gross national income per capita for the country is a strong predictor for use of these treatments, suggesting that economics influence under-treatment. CONCLUSION: We still need a better understanding of determinants for the low use of essential respiratory medicines and influenza vaccine in low-income settings. Identifying and addressing these more systematically could improve the access and use of effective treatments.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Asthma/epidemiology , Bronchodilator Agents/therapeutic use , Influenza Vaccines/therapeutic use , Pulmonary Disease, Chronic Obstructive/epidemiology , Adrenal Cortex Hormones/administration & dosage , Aged , Asthma/diagnosis , Asthma/drug therapy , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Poverty , Prevalence , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapy , Socioeconomic Factors , Surveys and Questionnaires , Vaccination/statistics & numerical data
4.
Ann Cardiol Angeiol (Paris) ; 60(2): 92-6, 2011 Apr.
Article in French | MEDLINE | ID: mdl-21281929

ABSTRACT

OBJECTIVE: To examine the prevalence of tobacco use among the teachers in the region of Sousse (Tunisia) and to identify the factors, which determine this behavior. PATIENTS AND METHODS: It is a transactional study; using a self-administered and pre-tested questionnaire to 800 teachers. RESULTS: The population being studied was made up of 739 teachers including 50.6% of professors. The sample was 35.4% male and the average age was of 45.3±8.1 years. The total prevalence of tobacco use was 17.8% (41.4% among men and 4.7% among women). Half of these teachers smoked in their school establishments and in the presence of their pupils. The multivariate analysis had made it possible to identify four factors, which determine the profile of tobacco use in our teachers; these factors were: the sex, the age, knowledge and attitudes. CONCLUSION: It's necessary to intervene with the teachers of the town of Sousse with specific trainings on the topic of the tobacco use and dispose their adapted tools which will be used in the educational programmes of tobacco use prevention in schools.


Subject(s)
Smoking Prevention , Smoking/epidemiology , Teaching , Adult , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , Middle Aged , Multivariate Analysis , Prevalence , Risk Factors , Schools , Surveys and Questionnaires , Tunisia/epidemiology
5.
Bull Soc Pathol Exot ; 104(1): 62-7, 2011 Feb.
Article in French | MEDLINE | ID: mdl-21243459

ABSTRACT

The aim of the study is to evaluate seroprevalence of rubella virus (RV), cytomegalovirus (CMV), varicella zoster virus (VZV), and parvovirus B19 (PB19) in 404 Tunisian pregnant women, and to determine reliability of maternal past history of eruption. Sociodemographic characteristics, risk factors, and past history of eruption were collected through a questionnaire. Serologic tests were performed using enzyme immunoassays. Risk factors were analyzed using univariate and multivariate logistic regression models. Seroprevalences were 79.7% for rubella, 96.3% for CMV, 80.9% for VZV, and 76.2% for PB19. In multivariate analysis, the number of persons per room (> 2) in the house during childhood was associated with CMV infection (P = 0.004), irregular professional husband's activity was correlated with VZV infection (P = 0.04), and an age of more than 30 years was associated with PB19 infection (P = 0.02). History of rubella, varicella, and PB19 infection was unknown for, respectively, 55.8%, 20%, and 100% of women. False history of rubella and varicella were found for 7.4% and 15% of women, respectively. The positive and negative predictive values (PPV and NPV) of rubella history were, respectively, 92.6% and 17.2%, and were, respectively, 84.9% and 20.9% for varicella history. Susceptibility to RV, VZV, and PB19 infection remains high in pregnancy in our population. Preventive strategies against congenital rubella must be reinforced. Vaccination against VZV should be considered in seronegative women. Systemic CMV screening is not warranted in our country where high immunity is acquired probably in childhood. Since maternal history of eruption is not reliable, we recommend serologic testing to determine immune status of women.


Subject(s)
Antibodies, Viral/blood , Cytomegalovirus Infections/epidemiology , Cytomegalovirus/immunology , Herpes Zoster/epidemiology , Herpesvirus 3, Human/immunology , Parvoviridae Infections/epidemiology , Parvovirus B19, Human/immunology , Pregnancy Complications, Infectious/epidemiology , Rubella virus/immunology , Rubella/epidemiology , Adult , Female , Hospitals, Maternity/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Infectious Disease Transmission, Vertical/prevention & control , Predictive Value of Tests , Pregnancy , Pregnancy Complications, Infectious/virology , Prospective Studies , Risk Factors , Seroepidemiologic Studies , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
6.
Pathol Biol (Paris) ; 59(5): e115-8, 2011 Oct.
Article in French | MEDLINE | ID: mdl-19896306

ABSTRACT

OBJECTIVES: The study was conducted to investigate the prevalence and risk factors for hepatitis E virus (HEV) infection in Tunisian pregnant women. METHODS: A total of 404 pregnant women were enrolled. Data were collected through a standard questionnaire which covered sociodemographic characteristics and risk factors. Blood samples were collected and were tested for HEV IgM and IgG antibodies, IgG against hepatitis A (anti-HAV IgG), hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV). Risk factors were analyzed using univariate and multivariate logistic regression models. RESULTS: Prevalence of anti-HEV IgG, anti-HEV IgM, anti-HAV IgG, HBs Ag and anti-HCV was 12.1 %, 0 %, 97 %, 3 % and 0,5 %, respectively. In multivariate analysis age (>30 years) and the number of persons per room (>2) in the house were independent factors predicting HEV infection. History of agricultural work, kind of water, sewage treatment, use detergent to wash vegetables, contact with animals and parenteral risk factors were not correlated with the presence of anti-HEV IgG. CONCLUSION: The important seropositive rate among pregnant women is compatible with endemicity of HEV in Tunisia. Hepatitis E should be considered in the diagnosis of acute hepatitis during pregnancy. Our result suggests that infection occurs sporadically by person-to-person transmission route but further investigations are needed to determine the natural reservoir of infection.


Subject(s)
Hepatitis E/diagnosis , Hepatitis E/epidemiology , Pregnancy Complications, Infectious/virology , Adult , Antibodies, Viral/blood , Female , Hepatitis A Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis C Antibodies/blood , Hepatitis E virus/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Multivariate Analysis , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Risk Factors , Tunisia/epidemiology
7.
Rev Pneumol Clin ; 66(3): 179-86, 2010 Jun.
Article in French | MEDLINE | ID: mdl-20561483

ABSTRACT

PURPOSE: To increase knowledge about smoking via a school prevention programme. PATIENTS AND METHODS: This quasi-experimental study included two groups: a control and an intervention group with a pre- and a post-evaluation of knowledge about smoking in each group. The target population consisted of students of 12 to 16 years old in Sousse, Tunisia. To evaluate the intervention, stratified and proportional sampling was used to include 2100 students in the questionnaire. All the students in the intervention group received a standardized program of information about smoking. A pre-tested and self-managed questionnaire in Arabic was used to assess knowledge about smoking, attitudes and behavioural intent before and after the intervention. RESULTS: The intervention group's post-test knowledge and behavioural intent were significantly higher than that of the control group's. No significant differences were found in post-test attitudes between the control and the intervention groups. CONCLUSION: The authors carried out this survey to evaluate the difficulties and resources in order to institute a more complete and durable program.


Subject(s)
Health Education , Smoking Prevention , Adolescent , Child , Female , Humans , Male , Program Evaluation , Surveys and Questionnaires , Tunisia
8.
Int J Tuberc Lung Dis ; 14(7): 841-6, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20550766

ABSTRACT

SETTING: Tunisia. OBJECTIVE: To assess the clinical usefulness of the commercial Pathozyme-Myco G (Myco G) and Pathozyme TB complex plus (Patho) enzyme-linked immunosorbent assay (ELISA) kits for the rapid diagnosis of active tuberculosis (TB) and to distinguish between active TB and non-TB pulmonary diseases in Tunisian patients. DESIGN: Immunoglobulin G mediated humoral immune response against mycobacterial antigens (38 kDa and lipoarabinomannan, Myco G; 16 and 38 kDa, Patho) was evaluated in a group of active TB patients (128 smear-positive pulmonary and 33 extra-pulmonary samples) and in a control group (107 patients with non-tuberculous lung disease and two with leprosy). Active TB cases were confirmed by Mycobacterium tuberculosis culture from clinical samples. RESULTS: The sensitivity of the Myco G test was 71% in active TB (pulmonary and extra-pulmonary), while the specificity was 100%. The Patho test showed a sensitivity of 43.5% with a specificity of 96.3%. A combination of both tests showed a sensitivity of 81% and a specificity of 96.3%. CONCLUSIONS: Both ELISA tests were simple and easy to perform. Their combined use led to an increase in the diagnostic accuracy of active TB and its discrimination from non-TB pulmonary diseases. They could therefore be used as screening tools in poorly equipped laboratories in TB-endemic regions.


Subject(s)
Antigens, Bacterial/immunology , Enzyme-Linked Immunosorbent Assay/methods , Immunoglobulin G/immunology , Tuberculosis/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Time Factors , Tuberculosis/immunology , Tunisia , Young Adult
9.
Cardiovasc J Afr ; 21(1): 13-6, 2010.
Article in English | MEDLINE | ID: mdl-20224839

ABSTRACT

OBJECTIVE: Dyslipidaemia, which is now seen as one of the most important cardiovascular risk factors, is becoming more common in the younger population. The aim of this study was to assess the efficacy of tracking serum lipid levels over a four-year period in an urban population of schoolchildren. METHODS: The study began in 1999 with a cohort of 789 schoolchildren. Four years later this group was resurveyed and a further 452 adolescent were recruited to the study. RESULTS: The percentages of boys who were initially in the extreme quartile for total cholesterol (TC), low-density lipoprotein (LDL) cholesterol and triglycerides were 42.5, 54.8 and 40.4%, respectively. Similarly, the percentages of girls in the extreme quartile were 62.7, 53.8 and 38.2%. Four years later, both the boys and girls were still in the extreme quartile for these parameters. Therefore, the best predictor of followup level for each of the serum lipoprotein cholesterol fractions was the corresponding baseline level. Interestingly, the next best predictor in most of the groups was change in body mass index (DeltaBMI) and smoking status. CONCLUSION: Prevention of coronary heart diseases in adults must begin early on in childhood, and should be driven by health education towards achieving a healthy lifestyle.


Subject(s)
Cardiovascular Diseases/etiology , Dyslipidemias/blood , Lipids/blood , Students , Adolescent , Biomarkers/blood , Body Mass Index , Cardiovascular Diseases/blood , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Dyslipidemias/complications , Dyslipidemias/epidemiology , Female , Follow-Up Studies , Humans , Male , Population Surveillance , Prospective Studies , Smoking/adverse effects , Smoking/epidemiology , Time Factors , Triglycerides/blood , Tunisia , Urban Health , Young Adult
10.
Rev Med Interne ; 30(9): 747-53, 2009 Sep.
Article in French | MEDLINE | ID: mdl-19683369

ABSTRACT

INTRODUCTION: To study the clinical features and the outcome of polymyositis (PM) and dermatomyositis (DM) in Tunisia. METHODS: Retrospective multicentre study conducted by the Tunisian Society of Internal Medicine. Adult patients with confirmed and probable PM and DM, according to the Bohan and Peter's criteria, were included in the study and followed-up between 1987 and 2005. RESULTS: Twenty cases of PM and 50 cases of DM were included. Female/male sex-ratio was 2.5. The mean age at diagnosis was 40.7 years. Muscle weakness concerned girdle muscles in 94.3% and pharyngeal muscles in 42.8% of the patients. Interstitial lung disease and heart involvement occurred respectively in 35.7 and 20%. Eyelid erythema, peri-ungual erythema and Gottron's sign occurred in respectively 86, 50 and 36% of the cases of DM. Malignant disease was found in 12.8% of the patients (mainly gynecological and nasopharyngeal cancers). All patients received high dose corticosteroids with additional immunosuppressive drugs in 40% of the cases. The outcome was stabilization or partial improvement in 71.5% of the cases. Death occurred in 20% and was caused by respiratory failure, sepsis and cardiac failure. CONCLUSION: The particularities of PM and DM in Tunisia are the preponderance of DM, early onset of the disease and high frequency of the nasopharyngeal cancer.


Subject(s)
Dermatomyositis , Polymyositis , Adolescent , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Dermatomyositis/complications , Dermatomyositis/diagnosis , Dermatomyositis/epidemiology , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Incidence , Male , Methylprednisolone/administration & dosage , Methylprednisolone/therapeutic use , Middle Aged , Polymyositis/complications , Polymyositis/diagnosis , Polymyositis/epidemiology , Prevalence , Retrospective Studies , Time Factors , Tunisia
11.
Rev Pneumol Clin ; 65(3): 147-52, 2009 Jun.
Article in French | MEDLINE | ID: mdl-19524803

ABSTRACT

Patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) treated by continuous positive airway pressure (CPAP) need to use long-term CPAP to prevent cardiovascular disease. The method of survival analysis was used to allow for long-term CPAP use in 72 patients who were prescribed a CPAP. During a mean follow-up of 22+/-15 months, one patient died and 17 patients stopped their treatment, 29% of them in the first 6 months. In compliant patients, the median value of daily CPAP use was 4.5hours. Kaplan Meier analysis showed that 92% of patients were still using CPAP at 6 months, 83% at 12 months and 59.9% at 3 years. Chronic obstructive pulmonary disease was identified as a predictor factor of long-term CPAP use (OR=4.53, p=0.01). CPAP is a well-accepted long-term therapy for OSAHS with 60% of patients continuing to be compliant with treatment at 3 years.


Subject(s)
Continuous Positive Airway Pressure/statistics & numerical data , Patient Compliance , Sleep Apnea, Obstructive/therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Disease, Chronic Obstructive/epidemiology
12.
Afr Health Sci ; 9(3): 147-52, 2009 Sep.
Article in English | MEDLINE | ID: mdl-20589142

ABSTRACT

OBJECTIVE: To identify predictors of smoking initiation among non smoking Tunisian school children; and to propose efficient antismoking strategies in order to prevent smoking initiation. METHODS: It was a cohort study surveying prospectively for four years pupils attending schools in Sousse city in Tunisia. 441 non smoking pupils aged 13-15 years attending secondary schools in Sousse. Data were collected by a self administered questionnaire during class session. Two ways cross tabulation, univariate and multivariate logistic regression analyses were the main analytical methods. RESULTS: 57.1% of the surveyed population were girls, 42.9 % were boys. 63% had at least one of their peers who smoked. Before 1999, 16.6% had already tried to smoke, 29.5% had already experienced alcohol. In 2003, smoking prevalence was 17%. 4.8% were girls; 33.3% of boys; p<0,001). 69.9 % of these smokers declared that they would carry on smoking during the following five years. Predictors which were highly associated with smoking initiation were previous experimentation with alcohol and tobacco, having a smoking best friend, lack of sensitization from the part of the school, believing that smoking makes one feel cool and that tobacco shouldn't be forbidden in public places. CONCLUSION: Intervention programs should target young children to avoid experiencing the first cigarette. Multidisciplinary management including community and school based intervention highlighted by mass media campaigns may provide schoolchildren with skills to resist smoking peers prompts to adopt unhealthy habits such as smoking.


Subject(s)
Adolescent Behavior/psychology , Nicotiana , Peer Group , Smoking Cessation/methods , Smoking/psychology , Adolescent , Age Factors , Cohort Studies , Female , Humans , Logistic Models , Male , Mass Media , Prevalence , Prospective Studies , Risk Factors , Schools , Smoking/epidemiology , Smoking Prevention , Tunisia/epidemiology
13.
Clin Exp Rheumatol ; 26(5): 894-902, 2008.
Article in English | MEDLINE | ID: mdl-19032825

ABSTRACT

OBJECTIVE: To investigate the distribution of various anti-anionic and anti-cofactor phospholipid antibodies in children with kala-azar, and to compare them to malaria, toxoplasmosis and auto-immune disease. PATIENTS AND METHODS: The frequency and the concentration of antibodies against cardiolipin (aCL), phosphatidylserine (aPS), phosphatidylinositol (aPI), phosphatidic acid (aPA), Beta2GPI (anti-Beta2GPI), prothrombin (aPT), annexin V (aAnnV), protein C (aPnC) and protein S (aPnS) were studied in sera from 103 children with kala-azar and compared with malaria (n=32), toxoplasmosis (n=31), systemic lupus erythematosus (SLE) (n=40) and antiphospholipid syndrome (APS) (n=35). RESULTS: The prevalence of aCL, aPS, aPI, aPA, anti-Beta2GPI, aPT, aAnnV, aPnC and aPnS was 54%, 56%, 43%, 28%, 73%, 67%, 55%, 30%, 25%, respectively. Ninety-three per cent of children with kala-azar (96/103) had one or more aPL specificities, but none had thromboses. The spectrum of aPL was quite similar to that found in patients with SLE and APS. CONCLUSION: Antiphospholipid antibodies are a frequent finding in kala-azar. The aPL produced mimic those found in autoimmune disease. However, further studies are required to assess the exact role of these aPL during leishmaniasis.


Subject(s)
Antibodies, Antiphospholipid/blood , Leishmaniasis, Visceral/immunology , Adolescent , Adult , Autoimmune Diseases/immunology , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Leishmaniasis, Visceral/epidemiology , Malaria, Falciparum/immunology , Male , Middle Aged , Prevalence , Retrospective Studies , Toxoplasmosis/immunology , Tunisia/epidemiology , Young Adult
14.
Am J Hum Biol ; 20(6): 716-25, 2008.
Article in English | MEDLINE | ID: mdl-18663741

ABSTRACT

We undertook to evaluate the impacts of morphology at birth, physical activity, anthropometric, socioeconomic and environmental factors on lung function in healthy Tunisian children. Pulmonary function parameters were measured with a Minato portable spirometer in a randomized population of 756 healthy children (388 males and 368 females) aged between 6 and 16. The morphology at birth, the gestational age, the physical activity, the socioeconomic status, the type of habitation, and the environmental factors were all assessed by a standard questionnaire. Using univariate analysis, we found that: (1) morphometric parameters (height, weight, maximal inspiratory, and expiratory perimeter), as well as sex were highly associated with pulmonary function parameters; (2) Height at birth showed strong significant relations with FVC, FEV(1), and FEV(1)/FVC; (3) lung function parameters were influenced by physical training of our children, socioeconomic status, indoor pollution, and passive smoking; and (4) we did not observe any association between the gestational age and the weight at their birth and lung function parameters. Using a general linear model analysis, morphometric parameters, age, sex, type of heating, and maximal inspiratory and expiratory perimeters had significant relation with respiratory parameters. In our population of healthy Tunisian children, the main predictive factors of the pulmonary development were the morphological factors such as height, weight, maximal inspiratory, and expiratory thoracic perimeter, sex and age, and the environmental conditions such as type of heating but not morphology at birth, physical activity, or socioeconomic status.


Subject(s)
Adolescent Development/physiology , Child Development/physiology , Health Surveys , Respiratory Function Tests , Adolescent , Body Height , Body Weight , Child , Cluster Analysis , Female , Humans , Male , Motor Activity , Sex Factors , Social Class , Tobacco Smoke Pollution , Tunisia
15.
Bull Soc Pathol Exot ; 100(1): 10-3, 2007 Feb.
Article in French | MEDLINE | ID: mdl-17402685

ABSTRACT

Cystic echinococcosis, which commonly starts during childhood or adolescence, is a serious problem of public health in Tunisia. For 121 children (161 cysts), the localization and fertility of cysts as well as viability of their protoscoleces were determined. Results indicated that the lung was the primary localization of cyst (59%) followed by the liver (35%). Children's infection is more frequent in male than in female (sex ratio 1.96) and the greatest number of cases is observed in the 4-9 year age groups (94 cases). The fertility of the cyst was independent of its site or its size and no incidence of age of children was detected. Nevertheless, the fertility rate is higher in females than in males for the liver localization.


Subject(s)
Echinococcosis/epidemiology , Echinococcus granulosus/isolation & purification , Adolescent , Age Distribution , Animals , Child , Child, Preschool , Echinococcosis/parasitology , Echinococcosis/surgery , Echinococcosis, Hepatic/epidemiology , Echinococcosis, Hepatic/parasitology , Echinococcosis, Hepatic/surgery , Echinococcosis, Pulmonary/epidemiology , Echinococcosis, Pulmonary/parasitology , Echinococcosis, Pulmonary/surgery , Echinococcus granulosus/growth & development , Echinococcus granulosus/physiology , Female , Fertility , Host-Parasite Interactions , Humans , Infant , Male , Sex Distribution , Tunisia/epidemiology
16.
Rev Mal Respir ; 24(9): 1107-15, 2007 Nov.
Article in French | MEDLINE | ID: mdl-18176387

ABSTRACT

INTRODUCTION: There is no clear consensus about what constitutes reversibility of airway obstruction. European Respiratory Society (ERS): Increase in FEV1 and/or FVC>12% of their theoretical value and>0.2l. British Thoracic Society: FEV1>15% of initial value and FEV1>0.2l. Global Initiative for Chronic Obstructive Lung Disease: Increase in FEV1>12% and>0.2l. Australia and New Zealand Thoracic Society: Increase in FEV1 >15%. American Thoracic Society/ERS: Increase in FEV1>12% and>0.2l or increase in FVC>12% and 0.2l. Our principal objective was to determine the percentage of patients with COPD (n=62) who were significant responders to the reversibility test according to the 5 recommendations. METHODS: Plethysmography was performed before and 15 minutes after inhalation of 400 micrograms of a short acting bronchodilator (BD). COPD is defined as a FEV1/FVC post BD<0.7. RESULTS: The percentage of responders varied from 24% to 50% depending on the recommendations used. CONCLUSION: Reversibility of airway obstruction is recommendation dependent.


Subject(s)
Bronchial Provocation Tests , Bronchodilator Agents , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapy , Bronchodilator Agents/therapeutic use , Cross-Sectional Studies , Humans , Male , Middle Aged , Plethysmography , Practice Guidelines as Topic , Predictive Value of Tests , Pulmonary Disease, Chronic Obstructive/classification , Respiratory Function Tests , Sensitivity and Specificity , Severity of Illness Index
17.
Rev Mal Respir ; 23(4 Pt 1): 324-38, 2006 Sep.
Article in French | MEDLINE | ID: mdl-17127908

ABSTRACT

INTRODUCTION: The aim of this study was to analyse the factors influencing pulmonary function and inspiratory muscle strength in healthy Tunisian women aged >or=45 years and in particular to determine the effect of parity. METHODS: A medical questionnaire together with an evaluation of sporting activity score and 2 levels for schooling and socio-economic status was administered. Parity was introduced as numeric, as dichotomous (G1:or=4) and in 3 classes (C1:<2; C2:=3-4; C3: > 4). Plethysmography with measurement of airway conductance and maximal inspiratory pressure was performed. RESULTS: 108 women were included. According to the ascending multiple linear regression, and in decreasing order, the following influencing factors are noted: Age and height, parity, weight and daily activity, schooling level, and finally leisure activity, body mass index, and physical activity. With high parity, and especially in women aged >or=60 years, there was a decrease in inspiratory muscle strength and an obstructive tendency, without associated restrictive component. Parity effects are age independent. CONCLUSIONS: Factors influencing the pulmonary function of healthy Tunisian women aged >or=45 years are multiple. Lung function declines with increasing parity.


Subject(s)
Respiration , Respiratory Muscles/physiopathology , Age Factors , Aged , Aged, 80 and over , Algorithms , Body Mass Index , Cross-Sectional Studies , Educational Status , Female , Humans , Middle Aged , Motor Activity , Parity , Pregnancy , Respiratory Function Tests/methods , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Tunisia
19.
Rev Mal Respir ; 23(3 Pt 1): 211-8, 2006 Jun.
Article in French | MEDLINE | ID: mdl-16788521

ABSTRACT

BACKGROUND: The lung is subject to many physiological changes during life. The aim of this study was to identify factors that influence gas transfer, which depends on membrane diffusion (Dm) and pulmonary capillary blood volume (Vc). METHODS: Dm and Vc measurements were performed at rest in 135 healthy patients divided into three groups according to age and after an exercise in 22 non-trained children. Measurements were made using a simultaneous transfer of 2 gases; nitric oxide (NO) and carbon monoxide (CO). RESULTS: Dm was correlated with height in the adult group and with weight in the elderly group. Vc was not correlated with weight in the three studied groups, but correlated with height in the adult group. Dm and Vc declined with age (p<0.05), For Dm this started at the age of forty whereas a fall in Vc was apparent at sixty. Pulmonary and vascular ageing could explain these results. Sex had no effect on Dm and Vc. Exercise led to a significant rise in Dm and Vc (p<0.05) which was attributed to pulmonary capillary distension and recruitment. CONCLUSION: Knowledge of these physiological changes permits a better understanding of pathological changes.


Subject(s)
Blood Volume , Capillaries , Pulmonary Diffusing Capacity , Adolescent , Adult , Age Factors , Body Height/physiology , Body Weight/physiology , Capillaries/physiology , Child , Cross-Sectional Studies , Exercise Test , Humans , Middle Aged
20.
Int J Tuberc Lung Dis ; 10(3): 328-32, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16562715

ABSTRACT

OBJECTIVE: To assess the behaviour, knowledge and attitudes towards smoking among medical students in Sousse, Tunisia. DESIGN: A cross-sectional survey in classroom settings using a self-administered questionnaire was conducted at the School of Medicine during September 2004. RESULTS: The numbers of students who entered the first and the fifth years of medical training at the University of Sousse in 2004 and completed the questionnaire were respectively 120 and 110. The population age ranged from 18 to 21 years (mean 19 +/- 0.62 years) in first year students and from 22 to 30 years (mean 23 +/- 1.38 years) in fifth year students. The prevalence of daily smoking (both sexes combined) was 4.5% among first year students and 16.7% among final year students. The prevalence of daily smoking according to sex was 29.6% among boys and 0.7% among girls. Over 90% of students thought smoking was harmful to health, but there was considerable underestimation of its causal role in a number of diseases, notably coronary heart disease, bladder cancer and peripheral vascular disease. There were important defects in both knowledge and motivation regarding counselling patients to stop smoking. CONCLUSIONS: The results of this study may provide baseline data to develop an anti-smoking programme in the university.


Subject(s)
Population Surveillance , Smoking/epidemiology , Students, Medical/statistics & numerical data , Adolescent , Adult , Attitude to Health , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Incidence , Male , Retrospective Studies , Sex Distribution , Tunisia/epidemiology
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