Em uma amostra de 12 por cento da população urbana de Botucatu, São Paulo, constituída de 7.075 pessoas, foram identificados 525 indivíduos com sintomas sugestivos de doença respiratória crônica inespecífica (DRCI). Utilizando o questionário de sintomas respiratórios \"ATS-DLD-78\", aplicado por entrevistadores leigos, a autora determinou a prevalência de alguns sintomas e de associações sugestivas de asma brônquica, bronquite crônica e doença pulmonar obstrutiva crônica (DPOC). Os sintomas mais frequentes no sexo masculino, foram: tosse, expectoração e chiado, cuja prevalência foi de 6,2 por cento , 5,4 por cento e 5,3 por cento , respectivamente. No sexo feminino os sintomas mais frequentes foram: tosse, chiado, dispnéia e rinite alérgica cujas taxas de prevalência foram: 4,7 por cento , 4,7 por cento , 4,2 por cento e 4,0 por cento , respectivamente. Houve maior prevalência de sintomas respiratórios nos maiores de 50 anos de idade e nos menores de 15 anos. A prevalência média de sintomas sugestivos de asma brônquica foi de 5, 0 por cento , e de 1,9 por cento para bronquite crônica e de 0,1 por cento para DPOC. A influência do hábito de fumar, presente entre os sintomáticos respiratórios em 33,7 por cento dos homens e 23,4 por cento das mulheres, foi estudada em relação aos sintomas de tosse e expectoração pela manhã e aos sintomas sugestivos de bronquite crônica. Em vista dos resultados, a autora analisa e comenta a metodologia utilizada e a aplicabilidade do questionário \"ATS-DLD-78\" em nosso meio. Frente a escassez de dados relativos às DRCI, no Brasil, conclui sobre a necessidade de novos inquéritos epidemiológicos em regiões diferentes, realizados com metodologia adequada que possibilite a comparação dos resultados, complementados, quando possível, por estudos clínicos, tendo em vista o planejamento de medidas e programas de intervenção. / In a sample of 12 per cent of the urban population of Botucatu, São Paulo (7075 persons) submitted to a general health and life conditions survey, 525 people with symptoms of inespecific chronic respiratory diseases (ICRD) were detected. The \"ATS-DLD-78\" questionnaire for respiratory symptoms was applyed to these 525 people by non-medical interviewers, and from the collected data the prevalence of some symptoms and association of symptoms suggesting asthma, chronic bronchitis and chronic obstructive pulmonar disease (COPD) was determined. The most frequent symptoms in males were cough (6,2 per cent ), expectoration (5.4 per cent ) and wheezing (5.3 per cent ) and in females, cough (4.7 per cent ), wheezing (4.7 per cent ), dyspnea (4.2 per cent ) and allergic rhinitis (4.01). The prevalence os respiratory symptoms was greater before 15 after 50 years of age. The mean prevalence of symptoms suggesting asthma was 5.0 per cent , suggesting chronic bronchitis, 1.9 per cent and COPD 0,1 per cent . Tobacco smoking was presente in 33.7 per cent of symptomatic men and 23.4 per cent of the symptomatic women. There was a relation between smoking and the presence of morning cough and phlegm and symptoms of chronic bronchitis. The used metodology and the applicability of the \"ATS-DLD-78\" questionnaire to our population is analysed and commented. Taking into account the scarcity of data about ICRD in Brazil, the author concludes emphazising the need of another epidemiological surveys in different parts of the country, using tested and standardized methods that make possible a comparison of data, with the aim of planning intervention measures and programmes.

Em uma amostra de 12 por cento da população urbana de Botucatu, São Paulo, constituída de 7.075 pessoas, foram identificados 525 indivíduos com sintomas sugestivos de doença respiratória crônica inespecífica (DRCI). Utilizando o questionário de sintomas respiratórios \"ATS-DLD-78\", aplicado por entrevistadores leigos, a autora determinou a prevalência de alguns sintomas e de associações sugestivas de asma brônquica, bronquite crônica e doença pulmonar obstrutiva crônica (DPOC). Os sintomas mais frequentes no sexo masculino, foram: tosse, expectoração e chiado, cuja prevalência foi de 6,2 por cento , 5,4 por cento e 5,3 por cento , respectivamente. No sexo feminino os sintomas mais frequentes foram: tosse, chiado, dispnéia e rinite alérgica cujas taxas de prevalência foram: 4,7 por cento , 4,7 por cento , 4,2 por cento e 4,0 por cento , respectivamente. Houve maior prevalência de sintomas respiratórios nos maiores de 50 anos de idade e nos menores de 15 anos. A prevalência média de sintomas sugestivos de asma brônquica foi de 5, 0 por cento , e de 1,9 por cento para bronquite crônica e de 0,1 por cento para DPOC. A influência do hábito de fumar, presente entre os sintomáticos respiratórios em 33,7 por cento dos homens e 23,4 por cento das mulheres, foi estudada em relação aos sintomas de tosse e expectoração pela manhã e aos sintomas sugestivos de bronquite crônica. Em vista dos resultados, a autora analisa e comenta a metodologia utilizada e a aplicabilidade do questionário \"ATS-DLD-78\" em nosso meio. Frente a escassez de dados relativos às DRCI, no Brasil, conclui sobre a necessidade de novos inquéritos epidemiológicos em regiões diferentes, realizados com metodologia adequada que possibilite a comparação dos resultados, complementados, quando possível, por estudos clínicos, tendo em vista o planejamento de medidas e programas de intervenção. / In a sample of 12 per cent of the urban population of Botucatu, São Paulo (7075 persons) submitted to a general health and life conditions survey, 525 people with symptoms of inespecific chronic respiratory diseases (ICRD) were detected. The \"ATS-DLD-78\" questionnaire for respiratory symptoms was applyed to these 525 people by non-medical interviewers, and from the collected data the prevalence of some symptoms and association of symptoms suggesting asthma, chronic bronchitis and chronic obstructive pulmonar disease (COPD) was determined. The most frequent symptoms in males were cough (6,2 per cent ), expectoration (5.4 per cent ) and wheezing (5.3 per cent ) and in females, cough (4.7 per cent ), wheezing (4.7 per cent ), dyspnea (4.2 per cent ) and allergic rhinitis (4.01). The prevalence os respiratory symptoms was greater before 15 after 50 years of age. The mean prevalence of symptoms suggesting asthma was 5.0 per cent , suggesting chronic bronchitis, 1.9 per cent and COPD 0,1 per cent . Tobacco smoking was presente in 33.7 per cent of symptomatic men and 23.4 per cent of the symptomatic women. There was a relation between smoking and the presence of morning cough and phlegm and symptoms of chronic bronchitis. The used metodology and the applicability of the \"ATS-DLD-78\" questionnaire to our population is analysed and commented. Taking into account the scarcity of data about ICRD in Brazil, the author concludes emphazising the need of another epidemiological surveys in different parts of the country, using tested and standardized methods that make possible a comparison of data, with the aim of planning intervention measures and programmes.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Pulmonary rehabilitation (PR) has the potential to reduce the symptoms and complications of respiratory diseases through an interdisciplinary approach. Providing PR services to the increasing number of patients with chronic respiratory diseases challenges the current health care systems because of the shortages in health care practitioners and PR programs. Using telerehabilitation may improve patients’ participation and compliance with PR programs. The purpose of this study was to examine the applicability of the technology acceptance model (TAM) to explain telerehabilitation acceptance and to determine the demographic variables that can influence acceptance. Methods: A cross-sectional survey-based design was utilized in the data collection. The survey scales were based on the TAM. The first group of participants consisted of health care practitioners working in PR programs. The second group of participants included patients attending traditional PR programs. The data collection process started in January 2017 and lasted until May 2017. Results: A total of 222 health care practitioners and 134 patients completed the survey. The results showed that 79% of the health care practitioners and 61.2% of the patients reported positive intention to use telerehabilitation. Regression analyses showed that the TAM was good at predicting telerehabilitation acceptance. Perceived usefulness was a significant predictor of the positive intentions to use telerehabilitation for health care providers (OR: 17.81, p < .01) and for the patients (OR: 6.46, p = .04). The logistic regression outcomes showed that age, experience in rehabilitation, and type of PR increased the power of the TAM to predict the intention to use telerehabilitation among health care practitioners. Age, duration of the disease, and distance from the PR center increased the power of the TAM to predict the intention to use telerehabilitation among patients. Conclusion: This is the first study to develop and validate a psychometric instrument to measure telerehabilitation acceptance among health care practitioners and patients in PR programs. The outcomes of this study will help in understanding the telerehabilitation acceptance. It will help not only to predict future adoption but also to develop appropriate solutions to address the barriers of using telerehabilitation.

Chronic respiratory diseases such as asthma and chronic bronchitis have significantly increased in prevalence in Africa over the past 10 years. Recent studies have demonstrated that exposure to air pollution may be associated with an increased risk of chronic respiratory diseases. However, such studies have predominantly been conducted in western societies or often used urbanicity as a proxy for exposure to air pollution. Therefore, we evaluated the association between PM2.5 exposure and asthma/chronic bronchitis in Senegal. A cross-sectional study was conducted for the time period of 3 October 2010 to 28 April 2011 using annual concentrations of PM2.5 measured via multiple satellite instruments, and asthma/chronic bronchitis, which was self-reported at baseline via a health survey questionnaire. We used mixed model logistic regression to evaluate the relationship between PM2.5 exposure and asthma/chronic bronchitis risk while adjusting for lifestyle factors, location, and other air pollutants. Sex was evaluated as an effect modifier. The adjusted association between PM2.5 and asthma/chronic bronchitis was 1.03 (95%CI: 0.99 – 1.06). In males the adjusted odds ratio was 1.09 (95%CI: 1.03-1.15), compared to females (aOR 1.01 (95%CI: 0.97 – 1.05). Our results suggest that increasing levels of exposure to PM2.5 puts individuals at a higher risk for chronic respiratory diseases, especially men. These findings have significant policy implications and should be built upon in future research.

Chronic respiratory diseases (CRDs) include chronic diseases involving the airways and other structures of the lung. In the current circumstance of Vietnam, people are exposed to numerous risk factors of CRD, such as heavy smoking, high frequency of pulmonary tuberculosis, chronic helminthiasis, allergic factors, migration and urbanization (the last associated with traffic-related pollution). The phenotype diagnoses should take into account the risk factors of each individual besides the clinical features, while the differential diagnoses mostly depend on the available techniques in each healthcare center. Our aim was to improve the differential diagnoses of the 3 most frequent CRDs: chronic obstructive pulmonary disease (COPD), asthma and COPD – asthma overlap syndrome (ACOS), in Vietnam. In the first part, we evaluated the prevalence of the allergen sensitization among patients with CRD, in regard to the urban and rural area in the South of Vietnam. House dust mites and cockroach droppings were the most frequent sensitizer. Compared with participants born in the urban setting, those born in the rural environment were less frequently sensitized and this protective effect disappeared in the case of migration from rural to urban areas. In the second part, we evaluated skin prick test as a method to screen dust mite sensitization in CRD in southern Vietnam. The data suggested that, in the present circumstance, skin prick test can be used to screen mite sensitization. In the third part, we evaluated the risk of mite sensitization in the native and migrant population, in regard to several environmental factors. Consistently with the hygiene hypothesis, compared to urban, exposure to high endotoxin concentration in rural was a protective factor against allergic sensitization. We reported for the first time that this effect was reversible among the migrants from rural to urban setting in association with lower endotoxin exposure. In the fourth part, we have defined asthma, COPD and ACOS based on clinical symptoms, cumulative smoking and airway expiratory flow with reversibility, on one side, and the age-related of the different phenotypes, on the other side. We hypothesized that the cumulative exposure to noxious particles should increase the age-related prevalence of COPD, while due to the immunosenescence process, the prevalence of IgE-mediated asthma should decrease with age, and ACOS prevalence being not related to age due to the combined mechanisms.  In conclusion, we showed in the South of Vietnam that:1) mites and cockroach allergens were the most frequent sensitizer in chronic respiratory diseases;2) the skin prick test to mite has been validated to screen mite sensitization;3) associated with a reduced level of endotoxin level, migration from rural to the urban setting was a risk factor of mite sensitization in chronic respiratory diseases;4) based on the clinical symptoms, spirometric values, and cumulative smoking, the diagnosis of asthma, COPD and ACOS have been made and their prevalence were 25, 42 and 33%, respectively. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

Detection of early pathophysiological changes of breathing in children with chronic respiratory disease MD. Vaclav Koucky - Ph.D. thesis Abstract Introduction: Currently, there are different methods for infant pulmonary function testing (iPFT) and morphological assessment of microscopic changes in endobronchial biopsy samples (EBB). In research setting, they allow detection of early pathophysiological changes of breathing in small children with chronic respiratory disease, respectively in risk of its development. Their clinical significance, however, is not fully acknowledged. The aim of this thesis is to evaluate the safety, feasibility and clinical significance of iPFT and EBB in infants younger than 2 years of age. In addition, the relationship between functional and morphological changes of respiratory tract and the function of peripheral chemoreceptors was studied in selected patients' subgroups. Methods: Fifty-five infants with cystic fibrosis (CF), 35 physician-confirmed recurrent wheezers (AB), 9 infants with congenital diaphragmatic hernia, 7 with interstitial lung disease (chILD) and 3 with primary ciliary dyskinesia (PCD) were enrolled. All infants underwent iPFT and relevant clinical history data were recorded. Based on patients' age, CF group was divided into CFmalí (< 6 months) and CFvelcí (>...