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Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2011; 79(3):253-9.
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Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2010; 78(4):251-5.
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ABSTRACT: The success in smoking cessation depends not only on a method of treatment but also on patient motivation. The aim of this study was to estimate the motivation and the main reason to quit smoking among outpatients attending smoking cessation clinic.
One hundred and eleven patients (50 men and 61 women), mean age 58, filled in a motivation test, nicotine dependence test and a questionnaire of the clinic.
The main motivation to quit was for the health reasons (83%). Mean motivation test result was 6.93; mean nicotine addiction evaluated in dependence test was 5.49. Eighty seven percent of patients were ready to quit smoking during one month (36% in 24 hours; 23% in one week; 28% in four weeks). There was no significant difference between men and women.
The main motivation to quit smoking were the health reasons as well among men as women. There was no correlation between the readiness to quit smoking determined as time to quit attempt and the motivation test.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2010; 78(3):211-5.
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ABSTRACT: The question of whether upper airway resistance syndrome (UARS) is a distinct disease or an initial feature of obstructive sleep apnoea syndrome is still a matter of debate. We evaluated a retrospective group of UARS patients to determine the evolution of UARS over time and the relationship between clinical evolution and subjects' phenotype. Investigations were performed in 30 patients, in whom UARS was diagnosed between 1995 and 2000 by the use of full polysomnography (PSG) without oesophageal pressure (Pes) measurement. The time between initial and follow-up investigations was 6.6 +/- 2.6 years. All subjects had full PSG with Pes measurement and completed a sleep questionnaire, including the Epworth Sleepiness Scale. In 19 subjects, PSG results were compatible with UARS. In nine subjects, obstructive sleep apnoea-hypopnoea syndrome (OSAHS) was diagnosed. In two subjects, PSG did not demonstrate breathing abnormalities. The mean +/- SD apnoea-hypopnoea index in the UARS group was 1.5 +/- 1.7 h(-1) and 25.2 +/- 19 h(-1) in the OSAHS group (P < 0.01). The increase in body mass index (BMI) between initial and follow-up investigations in the UARS group was from 29.4 +/- 4 to 31 +/- 5.7 kg m(-2) (P = 0.014) and in the OSAHS group from 30 +/- 4.1 to 32.4 +/- 4.7 kg m(-2)(P = 0.004). Amplitude of Pes swings during respiratory events was significantly higher in OSAHS than that in UARS (P = 0.014). Our results suggest that UARS is part of a clinical continuum from habitual snoring to OSAHS. Progression from UARS to OSAHS seems to be related to an increase in the BMI.
Journal of Sleep Research 05/2009; 18(3):337-41. · 3.16 Impact Factor
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Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2009; 77(1):97-110.
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ABSTRACT: Poland is the one of the countries in the European Union with the highest prevalence of smokers. The involvement of family physicians in smoking cessation activity could improve this situation. The aim of this study was to estimate smoking habits, their intensity and nicotine dependence in a family physician's practice (urban and rural population). An additional aim was to estimate smoking habits in relation to the presence of smoking-related disease, gender, location and motivation to stop smoking.
This study was part of an investigation into the prevalence and severity of chronic obstructive pulmonary disease (COPD) in the same population. Statistical analysis of questionnaires about smoking and history of respiratory diseases, Fagerström's nicotine dependence test and a motivation to quit test were performed.
Questionnaires were filled in by 1960 subjects (87% of those eligible). There were 29.6% current smokers, 24.9% ex-smokers, and 45.5% never-smokers. There were 39.4% current smokers among men, and 23.3% among women. Current smokers were more numerous in the rural population. 54% of women urban dwellers and 73% of women from rural population never smoked. There were no significant differences in the motivation to stop smoking or in the nicotine dependence among smokers with and without COPD nor according to the severity of COPD.
Smoking habits among the studied population were comparable with national and regional data. The intensity of smoking habits among female town dwellers is especially alarming.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2009; 77(3):248-55.
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ABSTRACT: Obstructive sleep apnoea syndrome (OSAS) is a frequent disorder; however, the prevalence of sleep-disordered breathing is not well known in many countries. The aim of our investigation was to assess the prevalence of sleep-disordered breathing (SDB) in a representative sample of the population of Warsaw. We studied 676 subjects (57.1% of the randomised cohort from the Monica II study). The sample comprised 356 males (52.7%) and 320 females (47.3%), whose mean age was 56.6 +/- 8.2 years (range 41-72 years). Mean number of apnoeas and hypopnoeas per hour of time in bed (AH) in males was 7 +/- 9.5 and in females 3.9 +/- 6.6 (P < 0.001). SDB (cut-off point AH > 5 or >10) was identified in 188 subjects (27.8%) and 97 subjects (14.3%), respectively. SDB was established twice as frequently in males as in females (respectively 36.5 versus 18.5%; P < 0.001 for AH > 5 and 19.8 versus 8.5%; P < 0.001 for AH > 10). A diagnosis of OSAS AH > 10 and Epworth Sleepiness Score > or =11 points was established in 51 subjects (7.5%). The prevalence of OSAS was nearly four times higher in males (40 subjects, 11.2%) than in females (11 subjects, 3.4%; P < 0.001). The severity of OSAS was similar in both sexes (AH: males 32.3 +/- 14.9 and females 31.4.1 +/- 15.4). Older age and male sex were predictors of SDB. SDB and OSAS were independent predictors of coronary artery disease after adjusting for age, sex, body mass index, neck circumference and smoking habit.
Journal of Sleep Research 03/2008; 17(1):73-81. · 3.16 Impact Factor
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ABSTRACT: The aim of this study was to assess results of 6MWT in non-selected group of obstructive sleep apnoea (OSA) patients. In healthy adult subjects 6-minute walking distance (6MWD) range from 400 to 700 m. Obesity, the main symptom of OSA, is one of the factors associated with reduction of 6MWD (another common factors: older age, shorter height, female sex, pulmonary, cardiovascular and musculoskeletal diseases).
Subjects completed sleep questionnaire and Epworth sleepiness scale before sleep studies (full polysomnography [PSG] or PolyMesam study [PM]). Consecutive OSA subjects (AHI/RDI >10, Epworth score > 9 points) were evaluated. The 6MWT, chest X-ray, spirometry, arterial blood gases, ECG, blood morphology and biochemistry were performed during trial treatment with autoCPAP.
We studied 151 subjects (119 males - 78.8% and 32 females - 21.2%), mean age 53.4 +/- 10.5 years. Subjects were obese - BMI = 35.7 +/- 6.2 kg/m(2) and presented severe OSA - AHI/RDI = 42.4 +/- 23.2. To assess relations between 6MWD and AHI/RDI, BMI, age and concomitant diseases we divided subjects in two groups: 1(st) with 6MWD > or = lower limit of normal (LLN) (123 pts; 81.5%) and 2(nd) with 6MWD < LLN (28 pts; 18.5%). Significant differences between groups were found for BMI, FVC (% of predicted) and Borg dyspnea scale before and after 6MWT. In multiple linear regression analysis we found significant correlation between 6MWD and BMI (beta = 0.41, p < 0.0001) and arterial hypertension (beta = -0.16, p = 0.04). Females had significantly shorter 6MWD than males (401.1 +/- 83.6 m and 451.8 +/- 107 m, respectively; p = 0.01). Difference was significant after adjustment for BMI and age (analysis of covariance) - R = 0.61, R2 = 0.38 (p < 0.0001).
BMI, female sex, arterial hypertension and lower FVC (% of predicted) were related to shorter 6-minute walking distance in OSA patients.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2008; 76(2):75-82.
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ABSTRACT: Obesity and male gender are the main risk factors for the development of obstructive sleep apnoea (OSA); however, some epidemiological data has shown that neck circumference (NC) > or = 43 cm is a better predictor of obstructive event frequency than body mass index (BMI). The aim of this study was to assess the relation between NC and BMI on OSA severity in males.
The subjects completed a sleep questionnaire and Epworth sleepiness scale before the sleep study (full polysomnography or PolyMesam study). Authors studied 133 consecutive males with confirmed OSA (AHI/RDI > 10, Epworth score > 9 points). Chest X-ray, spirometry, arterial blood gases, ECG, blood morphology and biochemistry were performed during treatment trial with autoCPAP.
Subjects presented with obesity--BMI = 35.8 +/- 6.1 kg/m2, NC = 46 +/- 3.4 cm and severe disease--AHI/RDI = 45.3 +/- 23.6. Mean age was 52.7 +/- 11.3 years. The majority of subjects had NC > or = 43 cm (116 pts, 87.2% - group 1), 17 pts (12.8% - group 2) had NC < 43 cm had 17 pts. Comparison of both groups showed significant differences only for BMI (group 1 - 36.8 +/- 5.7, group 2 - 28.6 +/- 3.7; p < 0.0001). Linear regression analysis revealed significant correlation between NC and AHI/RDI (R2 = 0.07, r = 0.26; p = 0.003); however, the correlation between BMI and AHI/RDI was stronger (R2 = 0.14, r = 0.37; p < 0.0001). In multiple linear regression analysis we found significant correlation between AHI/RDI and age (beta = -0.31, p = 0.003) and BMI (beta = 0.34, p = 0.02). Conclusions: The strongest correlation between AHI/RDI, younger age and BMI. Correlation between neck circumference and AHI/RDI was significant but less when compared to BMI.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2008; 76(5):313-20.
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ABSTRACT: Prevalence of obstructive sleep apnoea (OSA) is higher in postmenopausal females. The aim of this study was to compare OSA severity in postmenopausal females (group E-) and females with preserved estrogen activity (premenopausal or on hormonal replacement therapy - group E+).
We studied 147 OSA females in mean age 58.1 +/- 9.4 years. Subjects presented obesity (BMI = 34 +/- +/- 7.9 kg/m2) and moderate or severe disease (AHI = 35.9 +/- 20.9), SaO(2) mean - 89.4 +/- 5.8%. Group (E-) consisted of 116 pts (75.5%) and group (E+) of 36 pts (24.5%).
Group (E+) presented more severe OSA (AHI/RDI = 42 +/- 26.6) and obesity (BMI = 37.6 +/- 10.1 kg/m(2)) when compared to group E- (AHI/RDI = 33.9 +/- 18.4; p = 0.04 and BMI - 32.8 +/- 6.7 kg/m(2); p = 0.001). In multiple linear regression analysis we found significant negative correlation between AHI and age (beta = -0.29, p = 0.03). After adjustment for BMI and age (analysis of covariance) significant difference was still present between both groups (R = 0.24, p = 0.03).
Majority of OSA females qualified to CPAP therapy were postmenopausal (75.5%). Severity of OSA (AHI/RDI) after adjustment for age and BMI was higher in group (E+).
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2007; 75(2):129-33.
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ABSTRACT: Nocturia (two or more urinations per night) is a common symptom in OSA subjects. Higher secretion of atrial natriuretic peptide, increased intra-abdominal pressure, diuretics, diabetes, excessive fluid intake, awakenings are responsible for nocturnal urination. The aim of this study was to evaluate incidence of nocturia in moderate and severe OSA.
We studied 171 consecutive OSA patients (135 males and 36 females) - means: age - 53.6 +/- +/- 10.8 years, AHI/RDI - 43.6 +/- 23.2, BMI - 35.8 +/- 6.3 kg/m(2).
To assess relations between nocturia and AHI/RDI, overnight saturation, BMI and daytime sleepiness we divided subjects in two groups: 1(st) - without nocturia - 60 pts; 35.1% (group N-) and 2(nd) - with nocturia - 111 pts; 64.9% (group N+). Group N+ presented with higher AHI/RDI, 48 +/- 22.8 vs. 35.4 +/- 21.7 (p = 0.0006), higher BMI, 36.8 +/- 6.5 vs. 34 +/- 5.5 kg/m(2) (p = 0.004), lower mean overnight SaO(2), 88.6 +/- 5.6 vs. 90.4 +/- 4.3% (p = 0.03) and daytime sleepiness, Epworth score - 14.4 +/- 5.1 vs. 11.3 +/- 5.5 points (p = 0.0002). Multiple linear regression analysis revealed significant correlation between nocturia and Epworth sleepiness score (beta = 0.26, p = 0.0009), coronary artery disease (beta = 0.23, p = 0.004) and AHI/RDI (beta = 0.21, p = 0.04).
Nocturia is frequent in OSA patients (64.9%). Nocturnal urination was related to severity of OSA, excessive daytime sleepiness and coronary artery disease.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2007; 75(2):140-6.
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ABSTRACT: Uvulopalatopharyngoplasty (UPPP) is the most frequent surgical procedure in obstructive sleep apnoea (OSA) treatment. The aim of this study was to assess effects of UPPP in OSA subjects admitted to our Sleep Laboratory.
We studied 22 mostly obese males (mean BMI = 33.1 +/- 4 kg/m(2)) in mean age 51.7 +/- 9.7 years. Polysomnography or polygraphy (Poly-Mesam) was performed 28.5 +/- 30.5 month after UPPP.
Sleep studies after UPPP revealed severe OSA in most of the patients - mean AHI/RDI = 53 +/- 33.2, mean overnight SaO(2) = 88.1 +/- 5.3%. Subjects spent near half night in desaturation below 90% (T90 = 46.8 +/- 33.8%) and presented daytime somnolence (Epworth score: 14.3 +/- 4.8 points). Only in 3 subjects (13.6%), UPPP was successful (AHI/RDI < or = 10).
Our study confirmed previous data that UPPP is ineffective in majority of obese subjects with severe OSA.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2007; 75(2):121-8.
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ABSTRACT: The aim of our study was to assess serum uric acid (UA) in a large group of females with OSA before treatment (normal UA value is from 2.4 to 5.7 mg/dL). We studied 105 consecutive females (73,3% without estrogen activity), mean age 58.5+/-9.9 years, mean BMI = 33.3+/-8.2 kg/m(2) with OSA (mean AHI = 35.6+/-21.5, mean overnight SaO2=89+/-6.3%). We divided patients in two groups: 1st with hyperuricaemia - UA>5.7mg/dL (53pts, 50.5%) and 2nd with normouricaemia - UA < 5.7mg/dL (52pts, 49.5%). Concentartion of serum uric acid was similar in females with and without estrogen activity. Subjects with hyperuricaemia had significantly higher BMI (p<0,001), lower mean SaO2 (p<0,01) and spent more time in desaturation below 90% (p<0,01). This group had lower FVC, FEV1 i PaO2 (p < 0,001), higher PaCO2 (p <0,01) and morning glucose (p <0,001). Females with OSA and hyperuricaemia presented higher prevalence of systemic hypertension (p < 0,001), coronary artery disease (p < 0,05), diabetes (not significant) and COPD (p < 0,05). Multiple regression analysis revealed relation between serum uric acid, BMI and arterial hypertension. CONCLUSIONS: Hyperuricaemia is frequent in females with OSA. Increased UA levels were related especially to obesity and arterial hypertension. Lower: overnight SaO2, FVC, FEV1, PaO2 and higher glucose concentration and PaCO2 may play role in developing of hyperuricaemia.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2006; 74(2):159-65.
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ABSTRACT: We studied 44-year old man with heart failure (ejection fraction -25%). Obesity, arterial hypertension, snoring and excessive daytime sleepiness suggested concomitant obstructive sleep apnoea. Limited polysomnography with Polymesam revealed typical Cheyne-Stokes respiration with mainly central apnoeas (RDI=48/hour). We did not find any obstructive episodes during sleep study. Patient responded to CPAP therapy and apnoea hypopnoe index decreased to 12/hour on 8 mbar pressure.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2006; 74(4):426-30.
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ABSTRACT: COPD is a highly prevalent disease and ranks 4th among main causes of death in Poland. To control the disease national program of early detection and prevention of COPD was proposed. Program, under the auspices of the Ministry of Health, was implemented by the National TB and Lung Diseases Research Institute in Warsaw and run in out-patient chest clinics all over the country. Smokers aged more than 40 years were proposed a free spirometry and antismoking advice. During three years 91,859 subjects were screened, mean age 53.2 +/- 11.5 years, 57.9% males. There were 61.6% of current smokers, 26.7% of former smokers and 9.7% of never smokers. Spirometric measurements were: in 71.8% normal, in 19.9% showed airflow limitation, and in 8.3 % showed restrictive pattern. Severity of airflow limitation was mild in 7.7%, moderate in 6.7% and severe in 5.6% of all investigated subjects. In smokers older then 40 years and a history of more than 10 pack-years AL was diagnosed in 22,75%. Airflow limitation was found in 14.5% of never smokers. IN SUMMARY: Program resulted in a very high (20%) diagnosis of airflow limitation. Subjects screened were not aware of their disease. Even subjects who presented with severe form of airflow limitation were not diagnosed earlier.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2005; 73(2):116-21.
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ABSTRACT: We aimed to characterize smoking habits in participants of the large national screening program for COPD run in Poland in the years 2000-2002.
The program was addressed to smokers aged 40+ years with a smoking history of 10+ packyears. Participants were invited by advertisements in local mass media to attend local outpatient chest clinic located through all over the country for free spirometry. Investigations included history of smoking habit based on questionnaire, Fagerström test for nicotine dependence (FTND) and spirometry.
During three years 91859 subjects were screened, of whom 81091 (88.3%) were current and former smokers. In male smokers (56.6%), mean age 54.2 +/- 11.4 yr, mean exposure to tobacco smoke was 32.8 +/- 18.7 packyears. There were 33289 (61.7%) of current smokers and 14905 (30,9%) of ex-smokers. In female smokers (41.3%), mean age 51.8 +/- 10.0 yr, mean exposure to tobacco smoke was 22.9 +/- 14.8 packyears. There were 22291 (70.7%) of current smokers and 9226 (29.3%) of ex-smokers. Males started to smoke at younger age of (19.2 +/- 4.6 yr) than females (21.8 +/- 5.9 yr). Males were more nicotine dependent than females, 4.93 +/- 2.4 vs 4.48 +/- 2.5 FTND points, respectively. Nicotine dependence was related to number of packyears (r=0.5, p<0.001). Airflow limitation was more prevalent in ex-smokers (23.9%) than in current smokers (19.6%).
We found differences in smoking habits between males and females. Females started smoking at later age and smoked less than males. Nicotine dependence was related to cumulative exposure to tobacco smoke. Frequency of airflow limitation was related to number of packyears.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2005; 73(2):122-7.
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ABSTRACT: Previous studies showed that uric acid (UA) excretion in urine is increased in OSA patients and normalized after CPAP therapy. The aim of our study was to assess serum UA in a large group of males with OSA before treatment.
All subjects had full or limited PSG, measurements of serum uric acid, cholesterol, triglicerydes, glucose levels, lung function tests and medical history for cardiovascular diseases.
We studied 260 consecutive, obese males (BMI = 33.1 +/- 6.2 kg/m2), mean age 51.5 +/- 9.9 years, with severe OSA (mean AHI/RDI = 44 +/- 24, mean overnight SaO2 = 89.2 +/- 5.4%, T90 = 43.8 +/- 34.4%. Hyperuricaemia (UA >7 mg%) was found in 56.2% of studied subjects. UA concentration correlated with obesity and overnight oxygenation. Multiple regression analysis revealed significant correlation between UA and BMI. Subjects with hyperuricaemia presented with higher prevalence of systemic hypertension, coronary artery disease, diabetes mellitus and COPD.
Hyperuricaemia is frequent in males with OSA. Elevated UA levels are related to extreme obesity, overnight desaturation and higher prevalence of systemic hypertension, coronary artery disease, diabetes and COPD.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2005; 73(3):254-9.
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ABSTRACT: In 1997 we evaluated answers to a sleep questionnaire in a representative sample of 1186 persons of adult population of Warsaw. In the year 2000 we sent the same questionnaire to all persons who participated in the 1997 investigations. 676 (57%) subjects responded. There were 53% males and 47% females in the studied group. Their mean age was 56.6 +/- 8 years. There was no difference in age and sex between responders and non-responders. The standardized questionnaire contained questions assessing the following items: snoring, excessive daytime sleepiness, apnoeas observed by the sleep partner, sleep time and sleep latency. During a 3-year follow-up mean sleep time on working days did not change and remained 7.1 +/- 1.1 h. However, the subjects slept significantly shorter time at weekends, 8.1 +/- 1.3 and 7.9 +/- 1.3 h respectively (p < 0.001). There was a decrease in percentage of snorers from 81% to 75% and increase in BMI from 27 +/- 4.5 to 29 +/- 5 kg/m2. The daytime sleepiness was reduced from 7.9 +/- 4.5 to 6.4 +/- 3.9 points (p < 0.001).
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2003; 71(3-4):163-8.
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ABSTRACT: COPD is the most frequent chronic lung disease in developed countries. Aim of our study was to assess prevalence of COPD in the population of one district of Warsaw. We studied 676 subjects, aged 41-72 years, (57% of the sampled representative population). Standardized questionnaire concerning history of lung diseases and smoking habits, physical examination and spirometry was taken in each subject. 13 subjects with asthma were excluded from further analysis. Symptoms of COPD and FEV1/FVC < 0.7 was found in 10.7% of the studied population. Tobacco smoking was the main risk factor. There was only a slight preponderance of the disease in males--53%. Extrapolating our data to a population of Poland it may be estimated that there are around 2,000,000 people affected by COPD. Whole nation epidemiological study on prevalence of COPD would be necessary to confirm that estimation.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2003; 71(7-8):329-35.
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ABSTRACT: Stopping smoking is the only known method to slow down the inevitable progression of COPD. Early detection of the disease in smokers at risk of COPD gives a unique opportunity to prevent the disease progression. The aim of the study was to evaluate the effects of smoking intervention in a group of subjects with newly diagnosed airflow limitation (AL). Of 558 current smokers participating in population spirometric screening for COPD combined with smoking cessation advice, 297 were diagnosed to have AL (FEV1/FVC < 0.7). After one year 193 presented for follow-up visit. Thirty subjects (10.1%) quit smoking. Remaining 163 smokers were invited to smokers' clinic. Attendees (n = 70), 40 males, and 30 females, mean age 56 years, were randomized at visit 1 to treatment with nicotine patch (n = 38) or bupropion SR (n = 32). Follow-up was scheduled at 2 weeks, at the end of treatment, 6 months and 12 months. After 12 months a phone call assessed the smoking status. Non smoking was validated with carbon monoxide measurements in exhaled air. Patients who did not attend the follow-up visits were considered smokers. The number of participants at follow-up decreased significantly: from 70 subjects at visit one to 57 after 2 weeks, 34 at end of treatment and 14 subjects at months. Almost all (n = 69) were reached at 12 month by the phone. The validated quit rate after 12 months was 18.5% (13/70), 8 in group treated with nicotine patch and 5 in the group treated with bupropion SR (NS). When total group of smokers with newly diagnosed COPD was considered 10% quit smoking as result of minimal intervention with another 4.5% after pharmacological treatment.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2003; 71(9-10):411-7.
