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EN
Purpose: To determine the obstacles encountered by chronic obstructive respiratory disease (COPD) patients when quitting smoking. Materials and methods: Phenomenological research design was used in this study. A total of 20 smoker COPD patients chosen with purposive sampling constituted the universe of this study. Data were collected through the in-depth interview method using semi-structured interview forms. Analysis of the data was performed with inductive analysis using the content analysis method. Results: The challenges encountered by COPD patients when quitting smoking consist of 3 main themes and sub-themes including “İndividual specific challenges, environmental and social challenges and addiction/life with cigarettes”. Conclusions: This study revealed the individual, environmental-social and physical, psychological and social challenges in relation to addiction encountered by COPD patients when quitting smoking. Patients should be informed about the relationship between COPD and smoking through trainings, behaviours of individuals about smoking cessation should be determined and accordingly necessary actions should be taken in line with the motivational interview principles and families be included in these actions.
EN
Introduction and aim. Favre-Racouchot syndrome though mostly reported in Caucasian men (with an estimated prevalence of 6% in adults older than 50 years), cases have been reported in dark-skinned population including Indians, albeit rarely. It is characterized by large open and closed comedones along with epidermal cysts over the nose, cheeks, temples, forehead and periorbital areas. The association of this condition with chronic heavy smoking is what it makes compelling. Description of the case report. We report a case of elderly male, chronic heavy smoker who was diagnosed as a case of chronic obstructive pulmonary disease (COPD) as per standard guidelines. He presented with multiple nodulo-cystic lesions and had undergone a skin biopsy. Histomorphology features were consistent with Favre-Racouchot syndrome. Conclusion. Early identification of this skin condition in mildly symptomatic and asymptomatic smokers may help clinicians to forewarn the patients regarding development of chronic obstructive pulmonary disease (COPD).
EN
Objective: Our aim is to evaluate the validity of exhaled carbon monoxide (CO) and of a newly-created score as markers of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: The CO level was measured in a derivation subsample of a cross-sectional study and linked to COPD diagnosis; its predictors were evaluated, and a scale was constructed. It was evaluated in a validation subsample and in a clinical setting. Results: Individuals with COPD had higher CO levels than healthy individuals. CO level signifi cant predictors were cigarettes per day, waterpipes per week, lower age, male gender, living close to diesel exhaust, heating home with the use of diesel, and having indoor family smokers. A score composed of CO predictors was able to signifi cantly predict COPD (Ora = 4–7.5). Conclusions: Coupled with the clinical judgment of physicians, this scale would be an excellent low-cost tool for screening COPD, in absence of spirometry.
EN
Objectives Prior studies have been performed on cotton textile plants throughout the world. This study was planned to identify the rate of byssinosis and chronic obstructive pulmonary disease (COPD) in hemp and jute workers and those who worked with both of them. Material and Methods The study was realized in a factory which consecutively processed hemp and jute. The study enrollment included 266 people, 164 of whom were active workers and 102 were retired. A questionnaire, plain chest X-rays, physical examination and pulmonary function tests were performed. Dust levels were measured in various sections of the factory during 8 h work shifts. Endotoxin levels of various quality hemp fibers and dusts were measured. Results The rate of byssinosis (28.2%) was higher among the workers that who exposed to both jute and hemp dust. The frequency of chronic bronchitis in retired workers who previously smoked was higher (20%) as compared to currently smoking workers (17%). High dust levels were measured in some parts of the factory (mean (M) = 2.69 mg/m³). Working in dense dust areas, active smoking, being older than 40 years of age, being an ex-smoker, and working in the factory for a period exceeding 15 years were significantly associated with bronchitis and emphysema development. High endotoxin levels were determined for fine hemp dust (605 EU/mg), coarse hemp dust (336 EU/mg) and poor quality hemp fibers (114 EU/mg), whereas in fresh hemp stalks the level of endotoxin was determined to be lower (0.27 EU/mg). Conclusions Because of high exposures to jute and hemp dusts that are associated with high byssinosis rates, personal protection and environmental hygiene is crucial to prevention of byssinosis.
EN
Objectives In recent years numerous initiatives aimed at reducing air pollution have been undertaken in Poland. The general objective was to examine the correlation between air pollution measured by the level of particulate matter ≤10 μm in diameter (PM₁₀) and emergency hospitalizations due to chronic obstructive pulmonary disease (COPD) and asthma in 16 Polish cities (capitals of the regions). Material and Methods The authors aimed to diagnose the situation across 16 cities over a 5‑year period (2014–2019). Data on the number of hospitalizations was retrieved from the national public insurance system, the National Health Fund. A total number of 22 600 emergency hospitalizations was analyzed (12 000 and 10 600 in 2014 and 2019, respectively). The data on air pollution was accessed via the public register of the Chief Inspectorate for Environmental Protection air quality database. The authors of this article have used the data on PM₁₀ daily exposure in each of the 16 cities in 2014 and 2019. Statistical methods included: non-parametric tests, a 2-stage modelling approach for time-series data, and multivariate meta-analysis of the results. Results The results indicated that there was a statistically significant decrease in PM₁₀ concentration in 2019 in comparison to 2014 in all cities, mainly in the autumn and winter season. However, the correlation between the improvement in the air quality and a decrease in emergency hospitalizations due to asthma and COPD turned out to not be as strong as expected. The authors observed a strong correlation between PM₁₀ concentrations and hospitalizations due to asthma and COPD, but only when air quality norms were significantly above acceptable levels. Conclusions Air pollution measured by PM₁₀ concentration might be used as one of the predictors of the asthma and COPD emergency hospitalization risk, yet other factors like respiratory tract infection, health care organizational aspect, patient self-control, compliance and comorbidities should also be taken into consideration.
EN
Objectives: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment – clinical or hygienic one – is responsible for such a low rate of occupational COPD recognitions. Material and Methods: The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases. Results: In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients. Conclusions: In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139–150
PL
Wstęp. Obturacyjne schorzenia układu oddechowego mają charakter przewlekły i postępujący. Przebiegają z okresowymi zaostrzeniami. Duszność, kaszel znacznie wpływają na funkcjonowanie biopsychospołeczne chorych. Leczenie farmakologiczne i rehabilitacja mają na celu redukcję objawów związanych z chorobą, poprawę wydolności wysiłkowej, stanu psychicznego, radzenia sobie z chorobą, co wpływa na lepszą jakość życia pacjentów. Cel pracy. Ocena jakości życia chorych po przebytej rehabilitacji w warunkach uzdrowiskowych. Materiał i metody. Analizą objęto 176 osób obu płci, wśród których 99 miało zdiagnozowaną astmę, a 77 – POChP (przewlekłą obturacyjną chorobę płuc). Program rehabilitacji trwał 20 dni. Jakość życia oceniono kwestionariuszem SF-36, dokonano analizy statystycznej. Wyniki. Astmę częściowo kontrolowaną stwierdzono u 73 badanych, stadium umiarkowane POChP prezentowały 42 osoby. W subiektywnej ocenie 70,45% chorych rehabilitacja pulmonologiczna wpłynęła na poprawę wydolności wysiłkowej oraz jakości życia w sferze psychicznej. Wnioski. 1. Rehabilitacja uzdrowiskowa pozytywnie wpływa na jakość życia w sferze psychicznej. 2. Ograniczenie napadów duszności poprawia jakość życia. 3. Mężczyźni w większym stopniu wymagają wsparcia psychoterapeutycznego niż kobiety.
EN
Background. Chronic Obstructive Pulmonary Disease (COPD) is characterized by a progressive course with periods of exacerbation. Dyspnoea and cough are factors which considerably affect patients’ biopsychosocial functioning. The aim of rehabilitation and pharmacological treatment is to reduce symptoms of the disease, to improve patients’ stress efficiency and mental status, and to help patients cope with the disease, thus increasing their quality of life. Objectives. To assess the quality of life of patients after health resort rehabilitation. Material and methods. The study involved 176 patients of both sexes, including 99 with a diagnosis of asthma and 77 with COPD. The rehabilitation programme lasted 20 days. Quality of life was measured using the SF-36 questionnaire. Results. Partially controlled asthma was diagnosed in 73 respondents, and moderate COPD in 42 patients. According to 70.45% of the patients, pulmonary rehabilitation improved their stress efficiency and quality of life in mental domain. Conclusions. 1. Health-resort rehabilitation has positive effects on quality of life in mental domain. 2. A decrease in bouts of dyspnoea improves quality of life. 3. Men need psychotherapeutic support more than women.
PL
Haloterapia to forma leczenia uzdrowiskowego, w której wykorzystywana jest sól. Subterraneoterapia to metoda leczenia mikroklimatem w podziemnych komorach wyrobisk solnych. W Polsce najsłynniejszym podziemnym sanatorium jest uzdrowisko w Wieliczce. Celem opracowania było poznanie opinii pacjentów z problemami układu oddechowego na temat skuteczności haloterapii oraz subterraneoterapii. W badaniu ankietowym wzięły udział 164 osoby. Zdaniem 90% respondentów, metody te mają korzystny wpływ na zdrowie. Osoby cierpiące na POChP wyżej oceniają dobroczynny wpływ grot solnych na zdrowie i w większym stopniu dostrzegały poprawę swojego stanu zdrowia niż cierpiący na astmę.
EN
Halotherapy is a form of spa treatment which makes use of salt. Subterraneotherapy is a treatment method utilized to give treatment in a micro-climate of underground salt chambers. In Poland, the most popular subterranean health resort is Wieliczka Salt Mine sanatorium. The aim of this paper was to find opinion on the effectiveness of halotherapy and subterraneotherapy among patients with respiratory system problems. 164 patients participated in an anonymous questionnaire research. In the view of 90% respondents, these two methods have had positive impact on their health. Patient suffering from Chronic Obstructive Pulmonary Disease (COPD) assessed the beneficial effect of salt chambers on their health more highly and noticed a more considerable improvement of their health than patients suffering from asthma.
EN
Background Chronic obstructive pulmonary disease (COPD) may be induced by the work environment conditions. According to the estimates, 10–20% of all COPD cases are associated with occupational exposure to dusts and irritant gases. However, in 2014, only 11 cases of work-related COPD were recognized in Poland. The aim of the study was to analyze the reasons for the low incidence of work-related COPD in the context of pulmonologists’ knowledge about occupational risk factors and procedures on reporting suspected occupational diseases. Material and Methods A survey included 94 pulmonologists randomly selected out of 225 specialists registered at the Local Physicians Chamber in Łódź. The study was performed anonymously with the use of original questionnaire. Results More than a half of the surveyed pulmonologists identified environmental risk factors for COPD correctly, while only 23.4% properly identified the main occupational risk factors as the cause of COPD. Only 58.5% of the pulmonologists always asked their patients suffering from COPD about their job/profession and 60.6% of them did not have any knowledge about procedures on reporting suspected occupational diseases. Conclusions The physicians rarely ask patients suffering from COPD about their job/profession and the relationship between their ailments and occupational exposure. What is more, they do not know legal regulations on proper referral of a patient with a suspected case of occupational disease. The results of the study clearly indicate that there is an urgent need for increasing pulmonologists’ knowledge on work-related COPD. Med Pr 2016;67(3):375–384
PL
Wstęp Przewlekła obturacyjna choroba płuc (POChP) może być wywołana warunkami środowiska pracy. Według szacunkowych danych 10–20% wszystkich przypadków POChP ma związek z zawodowym narażeniem na pyły i gazy drażniące. Jednocześnie w 2014 r. w Polsce rozpoznano jedynie 11 przypadków POChP pochodzenia zawodowego. Celem pracy była analiza zależności między niewielką liczbą rozpoznawanej POChP o etiologii zawodowej a wiedzą lekarzy na temat czynników etiologicznych choroby związanych z narażeniem zawodowym oraz znajomości procedur związanych ze zgłaszaniem podejrzenia choroby zawodowej. Materiał i metody Badaniem ankietowym objęto 94 lekarzy pulmonologów losowo wybranych spośród 225 specjalistów chorób płuc zarejestrowanych w Okręgowej Izbie Lekarskiej w Łodzi. Metodą badawczą była autorska anonimowa ankieta. Wyniki Większość ankietowanych pulmonologów prawidłowo określiło środowiskowe czynniki mogące wywoływać POChP, jednocześnie tylko 23,4% wskazało prawidłowo podstawowe czynniki pochodzenia zawodowego jako przyczynę POChP. Jedynie 58,5% pulmonologów zawsze pyta pacjentów z POChP o wykonywany zawód, a 60,6% z nich nie miało wiedzy na temat procedur związanych ze zgłaszaniem podejrzenia choroby zawodowej. Wnioski Lekarze mają niepełną znajomość czynników zawodowych mogących wywoływać POChP, nie zawsze pytają chorych na POChP o wykonywany zawód i związek dolegliwości z wykonywaną pracą, a także nie znają regulacji prawnych dotyczących prawidłowego skierowania pacjenta z podejrzeniem choroby zawodowej do jednostki orzeczniczej. Wyniki przeprowadzonych badań wskazują na potrzebę zwiększania wiedzy lekarzy w zakresie zagadnień związanych z przewlekłą obturacyjną chorobą płuc pochodzenia zawodowego. Med. Pr. 2016;67(3):375–384
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