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Burney P.,Imperial College London | Jarvis D.,Imperial College London | Perez-Padilla R.,Instituto Nacional Of Enfermedades Respiratorias
International Journal of Tuberculosis and Lung Disease | Year: 2015

With an aging global population, chronic respiratory diseases are becoming a more prominent cause of death and disability. Age-standardised death rates from chronic obstructive pulmonary disease (COPD) are highest in low-income regions of the world, particularly South Asia and sub-Saharan Africa, although airflow obstruction is relatively uncommon in these areas. Airflow obstruction is, by contrast, more common in regions with a high prevalence of cigarette smoking. COPD mortality is much more closely related to the prevalence of a low forced vital capacity which is, in turn, associated with poverty. Mortality from asthma is less common than mortality from COPD, but it is also relatively more common in poorer areas, particularly Oceania, South and South-East Asia, the Middle East and Africa. Again this contrasts with the asthma prevalence among adults, which is highest in highincome regions. In high-income areas, mortality due to asthma, which is predominantly an adult problem, has fallen substantially in recent decades with the spread of new guidelines for treatment that emphasise the use of inhaled steroids to control the disease. Although mortality rates have been falling, the prevalence of atopy has been increasing between generations in Western Europe. Changes in the prevalence of wheeze among adults has been more varied and may have been influenced by the reduction in smoking and the increase in the use of inhaled steroids. © 2015 The Union.


Selman M.,Instituto Nacional Of Enfermedades Respiratorias | Pardo A.,National Autonomous University of Mexico | King Jr. T.E.,University of California at San Francisco
American Journal of Respiratory and Critical Care Medicine | Year: 2012

Hypersensitivity pneumonitis (HP) is a complex syndrome resulting from repeated exposure to a variety of organic particles. HP may present as acute, subacute, or chronic clinical forms but with frequent overlap of these various forms. An intriguing question is why only few of the exposed individuals develop the disease. According to a two-hit model, antigen exposure associated with genetic or environmental promoting factors provokes an immunopathological response. This response is mediated by immune complexes in the acute form and by Th1 and likely Th17 T cells in subacute/chronic cases. Pathologically, HP is characterized by a bronchiolocentric granulomatous lymphocytic alveolitis, which evolves to fibrosis in chronic advanced cases. On high-resolution computed tomography scan, ground-glass and poorly defined nodules, with patchy areas of air trapping, are seen in acute/ subacute cases, whereas reticular opacities, volume loss, and traction bronchiectasis superimposed on subacute changes are observed in chronic cases. Importantly, subacute and chronic HP may mimic several interstitial lung diseases, including nonspecific interstitial pneumonia and usual interstitial pneumonia, making diagnosis extremely difficult. Thus, the diagnosis of HP requires a high index of suspicion and should be considered in any patient presenting with clinical evidence of interstitial lung disease. The definitive diagnosis requires exposure to known antigen, and the assemblage of clinical, radiologic, laboratory, and pathologic findings. Early diagnosis and avoidance of further exposure are keys in management of the disease. Corticosteroids are generally used, although their long-term efficacy has not been proved in prospective clinical trials. Lung transplantation should be recommended in cases of progressive end-stage illness. Copyright © 2012 by the American Thoracic Society.


Perez-Padilla R.,Instituto Nacional Of Enfermedades Respiratorias | Schilmann A.,Instituto Nacional Of Salud Publica | Riojas-Rodriguez H.,Instituto Nacional Of Salud Publica
International Journal of Tuberculosis and Lung Disease | Year: 2010

Domestic pollution is relevant to health because people spend most of their time indoors. One half of the world's population is exposed to high concentrations of solid fuel smoke (biomass and coal) that are produced by inefficient open fires, mainly in the rural areas of developing countries. Concentrations of particulate matter in kitchens increase to the range of milligrams per cubic meter during cooking. Solid fuel smoke possesses the majority of the toxins found in tobacco smoke and has also been associated with a variety of diseases, such as chronic obstructive pulmonary disease in women, acute respiratory infection in children and lung cancer in women (if exposed to coal smoke). Other tobacco smoke-associated diseases, such as tuberculosis, asthma, respiratory tract cancer and interstitial lung diseases, may also be associated with solid fuel smoke inhalation, but evidence is limited. As the desirable change to clean fuels is unlikely, efforts have been made to use efficient, vented wood or coal stoves, with varied success due to inconsistent acceptance by the community. © 2010 The Union.


Catalan-Vazquez M.,Instituto Nacional Of Enfermedades Respiratorias | Riojas-Rodriguez H.,Instituto Nacional Of Salud Publica | Pelcastre-Villafuerte B.E.,Instituto Nacional Of Salud Publica
Science of the Total Environment | Year: 2012

Objective: To analyze the importance attributed to manganese (Mn) in the health-disease-death process and possibilities for participation in risk management of women from two communities who live near the plant in the Molango mining district. Materials and methods: Qualitative study based on 6 focus groups with women of different ages. Audio recordings were made of the sessions, after verbal informed consent, and were transcribed with a word processor. The analysis was conducted according to theme, taking into account the age group and community to which the women belonged, using the Atlas-ti (v.5.0) program. Results: The youngest women from Chiconcoac attribute the cause of headaches and chest pain to manganese, while women from the Tolago community believe it exacerbates disease in general. Women between 31 and 40. years old from Chiconcoac attribute the cause of "brain" pain, burning eyes and coughs to manganese, and those in Tolago report that it causes memory problems. The oldest women in Tolago believe Mn causes learning difficulties and affects children's growth and development. The women of all ages in Tolago believe that Mn has decreased the production of fruit and vegetables in the region. Some of the obstacles to participation in risk management are: women are not allowed to attend meetings at which men discuss the Mn problem and they perceive the mine as a source of employment for the community. Conclusions: The women perceive Mn to have serious effects on health and the local environment and have fewer opportunities than men to participate in risk management. Some of the health consequences attributed to Mn are consistent with those reported by neurological studies, nevertheless, other risks are overestimated. Spaces for communication need to be created to listen to the women's interests and concerns and empower them to participate in the risk management plan. © 2011 Elsevier B.V..


Ortiz-Quintero B.,Instituto Nacional Of Enfermedades Respiratorias
Cell Proliferation | Year: 2016

The discovery of cell-free microRNAs (miRNAs) in serum, plasma and other body fluids has yielded an invaluable potential source of non-invasive biomarkers for cancer and other non-malignant diseases. miRNAs in the blood and other body fluids are highly stable in biological samples and are resistant to environmental conditions, such as freezing, thawing or enzymatic degradation, which makes them convenient as potential biomarkers. In addition, they are more easily sampled than tissue miRNAs. Altered levels of cell-free miRNAs have been found in every type of cancer analysed, and increasing evidence indicates that they may participate in carcinogenesis by acting as cell-to-cell signalling molecules. This review summarizes the biological characteristics and mechanisms of release of cell-free miRNAs that make them promising candidates as non-invasive biomarkers of cancer. © 2016 John Wiley & Sons Ltd.

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