Respiratory diseases

呼吸系统疾病
  • 文章类型: Journal Article
    牙周炎是一种慢性炎症性非传染性疾病(NCD),其特征是牙齿支撑装置(牙周组织)的破坏,包括牙槽骨,牙周袋的存在,探查时流血。
    概述,对于家庭医生来说,牙周疾病和全身性疾病之间的关联的意义;探讨家庭医生在控制牙周炎作为一种普遍存在的非传染性疾病(NCD)中的作用。
    WONCAEurope与欧洲牙周病联合会之间先前重点合作研讨会的共识报告(使用先前进行的系统综述),专门委托进行的系统审查形成了技术文件,以支持讨论。工作组独立编写提案,随后在全体会议上讨论和批准了这些建议。
    牙周炎与心血管疾病独立相关,糖尿病,慢性阻塞性肺疾病,阻塞性睡眠呼吸暂停,和COVID-19并发症。牙周炎的治疗与全身健康结果的改善有关。文章还提出了证据差距。口腔保健专业人员(OHP)和家庭医生应合作管理这些疾病,包括在初级医疗中心实施早期发现牙周炎病例和在口腔/牙科护理机构实施系统性非传染性疾病的策略。有必要提高对牙周病的认识,其后果,以及家庭医生的相关风险因素。
    OHP和家庭医生之间更紧密的合作对于早期发现和管理心血管疾病等非传染性疾病非常重要。糖尿病,和呼吸道疾病。早期发现/预防非传染性疾病的战略,包括牙周炎,应该为家庭医生开发,其他卫生专业人员(OHP),和医疗保健资助者。应向家庭医生提供所报告的牙周炎与其他非传染性疾病之间关联的循证信息,OHP,医疗保健资助者,病人,和普通民众。
    牙周炎与心血管疾病独立相关,糖尿病,慢性阻塞性肺疾病,阻塞性睡眠呼吸暂停,和COVID-19。最佳结果的牙周治疗可改善糖尿病结局和心血管风险的替代措施。口腔保健专业人员和家庭医生之间更紧密的合作对于非传染性疾病的早期发现和管理非常重要。有关所报告的协会的信息应提供给家庭医生,口腔健康专业人士,医疗保健资助者,病人,和普通民众。
    UNASSIGNED: Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing.
    UNASSIGNED: To outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD).
    UNASSIGNED: The consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings.
    UNASSIGNED: Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors.
    UNASSIGNED: Closer collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population.
    Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19.Periodontal treatment for optimal outcomes improves diabetes outcomes and surrogate measures of cardiovascular risk.Closer collaboration between oral health care professionals and family doctors is important in the early case detection and management of non-communicable diseases.Information on the reported associations should be made available to family doctors, oral health professionals, healthcare funders, patients, and the general population.
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  • 文章类型: Systematic Review
    目的:探讨牙周疾病和全身性疾病之间的关联对牙医和家庭医生的影响,以及牙医和家庭医生在管理非传染性疾病和促进健康生活方式方面的作用。
    方法:先前关于牙周炎和糖尿病(2017年)与牙周炎和心血管疾病(2019年)之间关联的重点研讨会的共识报告形成了技术评论,以支持对这两个主题的讨论。对于与呼吸系统疾病的关联,特别委托对讲习班的讨论进行系统审查。工作组独立编写提案,然后在全体会议上讨论和批准了这些建议。
    结果:牙周炎与心血管疾病独立相关,糖尿病,慢性阻塞性肺疾病(COPD),阻塞性睡眠呼吸暂停和COVID-19并发症。牙医和家庭医生应该合作管理非传染性疾病,在初级保健中心实施早期发现牙周炎和在牙科环境中早期发现心血管疾病或糖尿病的策略。家庭医生应该了解牙周疾病及其后果,和口腔卫生专业人员应了解非传染性疾病的相关性和相关风险因素。
    结论:口腔卫生专业人员和家庭医生之间更紧密的合作对于非传染性疾病的早期发现和管理以及促进健康的生活方式非常重要。应制定和评估家庭医学实践中牙周炎和牙科实践中NCDs早期病例检测的途径。
    To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non-communicable diseases (NCDs) and promoting healthy lifestyles.
    The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings.
    Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID-19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors.
    Closer collaboration between OHPs and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated.
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  • 文章类型: Journal Article
    背景:在1979年至2013年发表的中国呼吸系统疾病临床实践指南(CPGs)质量低之后,最近出版了一些手册来规范指导方针的发展。中国每年CPG的生产和传播都有很大的增长,其质量和潜在影响未知。
    方法:对2013年1月至2018年12月的4个文献数据库进行系统检索,以确定中国人呼吸道疾病的CPG。使用研究和评估指南II(AGREEII)工具评估合格的CPG。
    结果:总共确定了197个CPG进行审查。与以往的研究结果相比,筛选了六个AGREEII领域的得分增加:范围和目的(57.3%vs.57.8%),利益相关者参与(17.6%与25.0%),发展的严谨(10.2%与13.2%),清晰度和演示文稿(55.2%与58.4%),适用性(9.3%与25.9%),和编辑独立性(1.1%与6.3%)。对纳入CPG的改进总体评估为:推荐(4,2.0%vs.0,0%)和建议修改(26,13.2%vs.3、2.8%)。用于提出建议的证据水平提高了59,11.9%比168,22.4%和88,17.7%比195,26.0%,A和B,分别。
    结论:2013-2018年中国发布的呼吸系统疾病CPG总体质量略有提高,但与最佳水平有很大差距,特别是在发展的严谨和编辑独立方面。需要加大努力,以开发高质量的基于证据的呼吸道疾病CPG。
    BACKGROUND: After the low quality of Chinese clinical practice guidelines (CPGs) for respiratory diseases published from 1979 to 2013 was reported, some handbooks were published to standardize guidelines\' development recently. There was a great increase in the production and dissemination of CPGs annually in China, whose quality and potential impact were unknown.
    METHODS: A systematic search of four literature databases was performed for the period January 2013 to December 2018 to identify Chinese CPGs for respiratory diseases. Eligible CPGs were evaluated using the appraisal of guidelines for research and evaluation II (AGREE II) instrument.
    RESULTS: A total of 197 CPGs were identified for review. Compared with the result of previous study, the increased scores of the six AGREE II domains were screened: Scope and purpose (57.3% vs. 57.8%), Stakeholder involvement (17.6% vs. 25.0%), Rigor of development (10.2% vs. 13.2%), Clarity and presentation (55.2% vs. 58.4%), Applicability (9.3% vs. 25.9%), and Editorial independence (1.1% vs. 6.3%). The improved overall assessment for included CPGs were: Recommended (4, 2.0% vs. 0, 0%) and Recommended with modifications (26, 13.2% vs. 3, 2.8%). The improved level of evidence used to make recommendations were 59, 11.9% versus 168, 22.4% and 88, 17.7% versus 195, 26.0%, A and B, respectively.
    CONCLUSIONS: The overall quality of CPGs for respiratory diseases published from 2013 to 2018 in China was slightly improved, but had a big gap with the optimum level, especially in Rigor of development and Editorial independence. Increased efforts are required to enable the development of high-quality evidence-based CPGs for respiratory diseases.
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  • 文章类型: Practice Guideline
    怀孕期间吸烟会导致胎儿被动吸烟。它与几种产科并发症有关,并且是母体和胎儿发病率的主要可改变因素。长期后果也存在,但对卫生专业人员和普通人群来说不太了解。
    Medline®数据库咨询。
    孕妇在怀孕期间吸烟与婴儿猝死综合征(NP2)的后代有关。肺功能受损(NP2),下呼吸道感染和哮喘(NP2),超重和肥胖(NP2),癌症(NP3),烟草使用的风险,尼古丁依赖和早期吸烟(NP2)。未经调整的分析显示子宫内烟草暴露与认知缺陷(NP3)之间的关联,学校表现受损(NP3)和儿童行为障碍(NP2),这在很大程度上是由环境因素解释的。怀孕期间吸烟有跨代效应。例如,在吸烟妇女的孙辈中观察到哮喘风险增加(NP4).产前吸烟和产后吸烟各自的作用仍然难以评估。
    这些结果突出了在一般人群中预防烟草使用的措施的重要性。以及怀孕前或怀孕开始时的筛查措施和戒烟支持。
    Smoking during pregnancy leads to fetal passive smoking. It is associated with several obstetrical complications and is a major modifiable factor of maternal and fetal morbidity. Long-term consequences also exist but are less well known to health professionals and in the general population.
    Consultation of the Medline® database.
    Maternal smoking during pregnancy is associated in the offspring with sudden infant death syndrome (NP2), impaired lung function (NP2), lower respiratory infections and asthma (NP2), overweight and obesity (NP2), cancers (NP3), risk of tobacco use, nicotine dependence and early smoking initiation (NP2). Unadjusted analyses show associations between in utero tobacco exposure and cognitive deficits (NP3), impaired school performance (NP3) and behavioral disorders in children (NP2), which are in a large part explained by environmental factors. There is a cross-generational effect of smoking during pregnancy. For example, an increased risk of asthma is observed in the grandchildren of smoking women (NP4). The respective roles of ante- and post-natal smoking remain difficult to assess.
    These results highlight the importance of prevention measures against tobacco use in the general population, as well as screening measures and support for smoking cessation before or at the beginning of the pregnancy.
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