Biomedical subjects

A Verduri

Publications and source records attributed to A Verduri.

4 recordsLinked to original sources

PubMed2002

[Educational programs and self-management in bronchial asthma].

Bronchial asthma is one of the most common chronic diseases in the world and can affect people of all ages. In the last few years there has been a considerable improvement in the etiopathogenetic knowledge of the disease and extremely effective anti-asthmatic drugs are available. However, asthma-related morbidity and mortality are increased, especially in Western countries. In an attempt to reverse this negative trend, for a number of years national and international guidelines on asthma have been published all over the world. These guidelines have the aim of improving asthma diagnosis and treatment and of conveying a fundamental educational message both to health workers and to patients and their families. From the data in the literature it can be clearly seen that only through the application of valid educational programs is it possible for asthmatics to improve their knowledge of the disease and to understand how they can look after themselves by a careful evaluation of their own symptoms and respiratory function. They should also be aware of the drugs available for the treatment of both acute asthmatic crises and chronic asthma, but especially of the fact that this chronic inflammatory affection can be fully treated. In particular, an educational program organized with groups of maximum 10-12 people attending 2 lessons and with helpful training tools, can increase significantly asthma knowledge, treatment compliance and patient self-management. The aim of this review is to highlight the importance of educational programs and those obscure areas which slow down their large scale application and universal acceptance.

Adult↗

PubMedDate not supplied

Air pollution and reversible chronic respiratory diseases.

Air pollution is one of the world's most serious environmental problems. It has been common knowledge for many years now that the lung is one of the main target organs of environmental agents. Over the last ten years, in particular, lung diseases have increased dramatically and the literature on the subject reports high death rates from lung cancer and an increased incidence of bronchial asthma and chronic obstructive pulmonary disease (COPD). These respiratory diseases are also caused by exposure to environmental agents, especially air pollution. Outdoor pollution is related to many compounds and, in assessing the air-borne pollutants and their association with respiratory damage, the role of particulate matter (PM) is of major importance. In addition to outdoor pollution, indoor pollution also exists and consists of environmental substances usually found outside which enter the internal environment, and/or of locally produced substances. Air pollution exposure involves the contact of pollutants with the respiratory tract, such exposure being measured according to two parameters: intensity and duration. Generally speaking, the pathogenic effects of environmental pollution on the organism fall into two categories: acute, or short-term effects, and long-term effects, depending on the time required from exposure to the manifestation of its effect. Short-term effects consist of irritant symptoms affecting the airways with different degrees of severity, while long-term effects, related to chronic exposure, are associated with chronic respiratory diseases, and unremitting symptoms such as coughing, wheezing, etc. Moreover, air irritants can give rise to inflammatory damage of the mucous membrane of the airways, thereby making it more susceptible to various types of allergens. In conclusion, air pollution is an important etiological factor for many chronic respiratory disorders, such as bronchial asthma and COPD. Prevention programs and early treatments are essential in an attempt to block the clinical-functional deterioration caused by these respiratory diseases.

Air Pollutants↗

PubMedDate not supplied

Early smoking-induced lung lesions in asymptomatic subjects. Correlations between high resolution dynamic CT and pulmonary function testing.

PURPOSE: To evaluate the prevalence and significance of the pathological effects of cigarette smoking on the lung and the sensitivity of high-resolution CT (HRCT) in the recognition of early smoking-induced lesions in asymptomatic former or current smokers. MATERIALS AND METHODS: We performed a prospective and consecutive analysis of 36 volunteers (16 males, 20 females), 10 non-smokers (3 males; 7 females) and 26 smokers (13 males; 13 females / 17 current smokers; 9 former smokers), all asymptomatic and with normal respiratory flows. These subjects underwent lung function testing and HRCT, after providing written informed consent for the study. The HRCT scans were obtained at three pre-selected levels (aortic arch, tracheal carina and venous hilum). The same scans were obtained in post-expiration phase. At the level of the apical segmental bronchus of the right upper lobe, we measured on the monitor wall thickening, and the total and internal diameters using the techniques reported in literature. Each study was independently evaluated by two radiologists that were blinded to all clinical and functional data; they also evaluated the presence, prevalence and type of emphysema, areas of patchy hyperlucency and oligoemia in the inspiration phase and areas of expiratory air trapping. The extension was evaluated with the visual score method. The data obtained were analysed with the Windows SPSS package for statistical analysis. RESULTS: The two groups (non smokers and smokers) showed significant differences in some functional tests such as FEV1 (p<0.005) and Tiffeneau index (p<0.005), which were lower in current-smokers or former-smokers, although still within the normal range. The HRCT study did not show areas of emphysema or air trapping in non smokers. In the smokers' group, air trapping was observed in 30.7% of cases: 33.3% former-smokers and 29.4% current smokers (mean extension was 21.36% in former smokers and 9.48% in current smokers). Mean extension in the smokers' group was 13.94%. Pulmonary emphysema was found in 34.6% of cases in the smokers' group: 33.3% former-smokers and 35.2% current-smokers. Emphysema was prevalent in the upper lobes (88.8%). Mean extension was 8.76% in the former smokers group and 18.81% in current-smokers, with a total mean extension of 15.47% in the smokers' group. Statistically, there was a significant difference between non-smokers and smokers as regards emphysema extension and expiratory air trapping (p=0.034 and p=0.050, respectively). The smokers' group had a significantly wider diameter of the apical segmental bronchus of the right upper lobe than the controls. There was no significant statistical correlation between this dilatation and the emphysema score (r=0.051; p=0.81). The entity of smoking history did not correlate with emphysema extension or air trapping or with the size of the apical segmental bronchus of the right upper lobe. CONCLUSIONS: Our study demonstrates that HRCT is more sensitive and specific than commonly-used functional tests for the evaluation of initial emphysema in asymptomatic smokers. We observed expiratory air trapping only in the smokers' group, and only of the lobular type, without evidence of disease in inspiratory scans. Among the smokers and former-smokers, air trapping was found in 30.7% of subjects, with a mean extension lower than 10%. Our results therefore suggest that, even in asymptomatic subjects, expiratory air trapping is probably pathological and, once bronchial asthma has been excluded, it may be related to cigarette smoking and indicate early inflammatory bronchiolar damage. HRCT may therefore be regarded as a useful tool in the early diagnosis of smoking-related lung disease.

Bronchography↗

PubMedDate not supplied

High resolution CT (HRCT) of the lung in adults. Defining the limits between normal and pathologic findings.

Under normal conditions, HRCT shows secondary lobule structures and allows for a precise evaluation, with inspiratory and expiratory scans, of central airways dimensions, lung area and parenchymal density. Frequently, asymptomatic smokers with normal lung function tests, present with mild abnormalities not visible at chest X-ray: bronchial thickening, bronchiolectasis, respiratory bronchiolitis and centrilobular or paraseptal emphysema. In the elderly, HRCT studies often show borderline findings such as age-related tracheo-bronchial calcifications and emphasise the progressive increase in the bronchoarterial ratio. Another frequent finding is expiratory air trapping, which can be associated with a variety of lung diseases, but can also represent a physiologic and temporary finding, during an episode of sub-clinical bronchospasm or related to local variation of bronchiolar dynamic compliance. The knowledge of the boundaries between normality and pathology is an essential prerequisite for the correct interpretation HRCT findings.

Journal Article↗