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Search Results: 1 - 10 of 1219 matches for " Sin DD "
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Improved patient outcome with smoking cessation: when is it too late?
Wu J, Sin DD
International Journal of Chronic Obstructive Pulmonary Disease , 2011, DOI: http://dx.doi.org/10.2147/COPD.S10771
Abstract: oved patient outcome with smoking cessation: when is it too late? Review (7588) Total Article Views Authors: Wu J, Sin DD Published Date May 2011 Volume 2011:6 Pages 259 - 267 DOI: http://dx.doi.org/10.2147/COPD.S10771 Jane Wu1, Don D Sin1,2 1Department of Medicine (Division of Respirology), The University of British Columbia, Vancouver, BC, Canada; 2UBC James Hogg Research Laboratory, Providence Heart and Lung Institute, St. Paul's Hospital, Vancouver, BC, Canada Abstract: Smoking is the leading modifiable risk factor for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), and lung cancer. Smoking cessation is the only proven way of modifying the natural course of COPD. It is also the most effective way of reducing the risk for myocardial infarction and lung cancer. However, the full benefits of tobacco treatment may not be realized until many years of abstinence. All patients with COPD, regardless of severity, appear to benefit from tobacco treatment. Similarly, patients with recent CVD events also benefit from tobacco treatment. The risk of total mortality and rate of recurrence of lung cancer is substantially lower in smokers who manage to quit smoking following the diagnosis of early stage lung cancer or small cell lung cancer. Together, these data suggest that tobacco treatment is effective both as a primary and a secondary intervention in reducing total morbidity and mortality related to COPD, CVD, and lung cancer. In this paper, we summarize the evidence for tobacco treatment and the methods by which smoking cessation can be promoted in smokers with lung disease.
Improved patient outcome with smoking cessation: when is it too late?
Wu J,Sin DD
International Journal of COPD , 2011,
Abstract: Jane Wu1, Don D Sin1,21Department of Medicine (Division of Respirology), The University of British Columbia, Vancouver, BC, Canada; 2UBC James Hogg Research Laboratory, Providence Heart and Lung Institute, St. Paul's Hospital, Vancouver, BC, CanadaAbstract: Smoking is the leading modifiable risk factor for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), and lung cancer. Smoking cessation is the only proven way of modifying the natural course of COPD. It is also the most effective way of reducing the risk for myocardial infarction and lung cancer. However, the full benefits of tobacco treatment may not be realized until many years of abstinence. All patients with COPD, regardless of severity, appear to benefit from tobacco treatment. Similarly, patients with recent CVD events also benefit from tobacco treatment. The risk of total mortality and rate of recurrence of lung cancer is substantially lower in smokers who manage to quit smoking following the diagnosis of early stage lung cancer or small cell lung cancer. Together, these data suggest that tobacco treatment is effective both as a primary and a secondary intervention in reducing total morbidity and mortality related to COPD, CVD, and lung cancer. In this paper, we summarize the evidence for tobacco treatment and the methods by which smoking cessation can be promoted in smokers with lung disease.Keywords: COPD, lung cancer, tobacco treatment, smoking cessation
Clinical update on the use of biomarkers of airway inflammation in the management of asthma
Wadsworth SJ, Sin DD, Dorscheid DR
Journal of Asthma and Allergy , 2011, DOI: http://dx.doi.org/10.2147/JAA.S15081
Abstract: ical update on the use of biomarkers of airway inflammation in the management of asthma Review (10330) Total Article Views Authors: Wadsworth SJ, Sin DD, Dorscheid DR Published Date June 2011 Volume 2011:4 Pages 77 - 86 DOI: http://dx.doi.org/10.2147/JAA.S15081 SJ Wadsworth1,2, DD Sin1,2, DR Dorscheid1,2 1UBC James Hogg Research Centre, Providence Heart and Lung Institute, St Paul's Hospital, Vancouver, Canada; 2Department of Medicine, University of British Columbia, British Columbia, Canada Abstract: Biological markers are already used in the diagnosis and treatment of cardiovascular disease and cancer. Biomarkers have great potential use in the clinic as a noninvasive means to make more accurate diagnoses, monitor disease progression, and create personalized treatment regimes. Asthma is a heterogeneous disease with several different phenotypes, generally triggered by multiple gene-environment interactions. Pulmonary function tests are most often used objectively to confirm the diagnosis. However, airflow obstruction can be variable and thus missed using spirometry. Furthermore, lung function measurements may not reflect the precise underlying pathological processes responsible for different phenotypes. Inhaled corticosteroids and 2-agonists have been the mainstay of asthma therapy for over 30 years, but the heterogeneity of the disease means not all asthmatics respond to the same treatment. High costs and undesired side effects of drugs also drive the need for better targeted treatment of asthma. Biomarkers have the potential to indicate an individual's disease phenotype and thereby guide clinicians in their decisions regarding treatment. This review focuses on biomarkers of airway inflammation which may help us to identify, monitor, and guide treatment of asthmatics. We discuss biomarkers obtained from multiple physiological sources, including sputum, exhaled gases, exhaled breath condensate, serum, and urine. We discuss the inherent limitations and benefits of using biomarkers in a heterogeneous disease such as asthma. We also discuss how we may modify our study designs to improve the identification and potential use of potential biomarkers in asthma.
Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis
Jen R, Rennard SI, Sin DD
International Journal of Chronic Obstructive Pulmonary Disease , 2012, DOI: http://dx.doi.org/10.2147/COPD.S32765
Abstract: ts of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis Review (2957) Total Article Views Authors: Jen R, Rennard SI, Sin DD Published Date September 2012 Volume 2012:7 Pages 587 - 595 DOI: http://dx.doi.org/10.2147/COPD.S32765 Received: 08 April 2012 Accepted: 28 May 2012 Published: 19 September 2012 Rachel Jen,1 Stephen,1 Rennard,2 Don D Sin1,3 1Department of Medicine, Respiratory Division, University of British Columbia, Vancouver, BC, Canada; 2Internal Medicine Section of Pulmonary and Critical Care, Nebraska Medical Center, Omaha, NE, USA; 3Institute of Heart and Lung Health and the UBC James Hogg Research Center, St Paul's Hospital, Vancouver, BC, Canada Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation in the small airways. The effect of inhaled corticosteroids (ICS) on lung inflammation in COPD remains uncertain. We sought to determine the effects of ICS on inflammatory indices in bronchial biopsies and bronchoalveolar lavage fluid of patients with COPD. Methods: We searched Medline, Embase, Cinahl, and the Cochrane database for randomized, controlled clinical trials that used bronchial biopsies and bronchoalveolar lavage to evaluate the effects of ICS in stable COPD. For each chosen study, we calculated the mean differences in the concentrations of inflammatory cells before and after treatment in both intervention and control groups. These values were then converted into standardized mean differences (SMD) to accommodate the differences in patient selection, clinical treatment, and biochemical procedures that were employed across the original studies. If significant heterogeneity was present (P < 0.1), then a random effects model was used to pool the original data; otherwise, a fixed effects model was used. Results: We identified eight original studies that met the inclusion criteria. Four studies used bronchial biopsies (n = 102 participants) and showed that ICS were effective in reducing CD4 and CD8 cell counts (SMD, 0.52 units and 0.66 units, 95% confidence interval). The five studies used bronchoalveolar lavage fluid (n = 309), which together showed that ICS reduced neutrophil and lymphocyte counts (SMD, 0.64 units and 0.64 units, 95% confidence interval). ICS on the other hand significantly increased macrophage counts (SMD, 0.68 units, 95% confidence interval) in bronchoalveolar lavage fluid. Conclusion: ICS has important immunomodulatory effects in airways with COPD that may explain its beneficial effect on exacerbations and enhanced risk of pneumonia.
Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis
Jen R,Rennard SI,Sin DD
International Journal of COPD , 2012,
Abstract: Rachel Jen,1 Stephen,1 Rennard,2 Don D Sin1,31Department of Medicine, Respiratory Division, University of British Columbia, Vancouver, BC, Canada; 2Internal Medicine Section of Pulmonary and Critical Care, Nebraska Medical Center, Omaha, NE, USA; 3Institute of Heart and Lung Health and the UBC James Hogg Research Center, St Paul's Hospital, Vancouver, BC, CanadaBackground: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation in the small airways. The effect of inhaled corticosteroids (ICS) on lung inflammation in COPD remains uncertain. We sought to determine the effects of ICS on inflammatory indices in bronchial biopsies and bronchoalveolar lavage fluid of patients with COPD.Methods: We searched Medline, Embase, Cinahl, and the Cochrane database for randomized, controlled clinical trials that used bronchial biopsies and bronchoalveolar lavage to evaluate the effects of ICS in stable COPD. For each chosen study, we calculated the mean differences in the concentrations of inflammatory cells before and after treatment in both intervention and control groups. These values were then converted into standardized mean differences (SMD) to accommodate the differences in patient selection, clinical treatment, and biochemical procedures that were employed across the original studies. If significant heterogeneity was present (P < 0.1), then a random effects model was used to pool the original data; otherwise, a fixed effects model was used.Results: We identified eight original studies that met the inclusion criteria. Four studies used bronchial biopsies (n = 102 participants) and showed that ICS were effective in reducing CD4 and CD8 cell counts (SMD, 0.52 units and 0.66 units, 95% confidence interval). The five studies used bronchoalveolar lavage fluid (n = 309), which together showed that ICS reduced neutrophil and lymphocyte counts (SMD, 0.64 units and 0.64 units, 95% confidence interval). ICS on the other hand significantly increased macrophage counts (SMD, 0.68 units, 95% confidence interval) in bronchoalveolar lavage fluid.Conclusion: ICS has important immunomodulatory effects in airways with COPD that may explain its beneficial effect on exacerbations and enhanced risk of pneumonia.Keywords: chronic obstructive pulmonary disease, bronchial biopsies, bronchoalveolar lavage, inhaled corticosteroids, inflammation, inflammatory markers, meta-analysis
Clinical update on the use of biomarkers of airway inflammation in the management of asthma
Wadsworth SJ,Sin DD,Dorscheid DR
Journal of Asthma and Allergy , 2011,
Abstract: SJ Wadsworth1,2, DD Sin1,2, DR Dorscheid1,21UBC James Hogg Research Centre, Providence Heart and Lung Institute, St Paul's Hospital, Vancouver, Canada; 2Department of Medicine, University of British Columbia, British Columbia, CanadaAbstract: Biological markers are already used in the diagnosis and treatment of cardiovascular disease and cancer. Biomarkers have great potential use in the clinic as a noninvasive means to make more accurate diagnoses, monitor disease progression, and create personalized treatment regimes. Asthma is a heterogeneous disease with several different phenotypes, generally triggered by multiple gene-environment interactions. Pulmonary function tests are most often used objectively to confirm the diagnosis. However, airflow obstruction can be variable and thus missed using spirometry. Furthermore, lung function measurements may not reflect the precise underlying pathological processes responsible for different phenotypes. Inhaled corticosteroids and 2-agonists have been the mainstay of asthma therapy for over 30 years, but the heterogeneity of the disease means not all asthmatics respond to the same treatment. High costs and undesired side effects of drugs also drive the need for better targeted treatment of asthma. Biomarkers have the potential to indicate an individual's disease phenotype and thereby guide clinicians in their decisions regarding treatment. This review focuses on biomarkers of airway inflammation which may help us to identify, monitor, and guide treatment of asthmatics. We discuss biomarkers obtained from multiple physiological sources, including sputum, exhaled gases, exhaled breath condensate, serum, and urine. We discuss the inherent limitations and benefits of using biomarkers in a heterogeneous disease such as asthma. We also discuss how we may modify our study designs to improve the identification and potential use of potential biomarkers in asthma.Keywords: asthma, inflammation, airway biomarkers, urinary biomarkers, serum biomarkers
Effect of gene environment interactions on lung function and cardiovascular disease in COPD
Hackett TL, Stefanowicz D, Aminuddin F, Sin DD, Connett JE, Anthonisen NR, Paré PD, Sandford AJ
International Journal of Chronic Obstructive Pulmonary Disease , 2011, DOI: http://dx.doi.org/10.2147/COPD.S18279
Abstract: t of gene environment interactions on lung function and cardiovascular disease in COPD Original Research (3813) Total Article Views Authors: Hackett TL, Stefanowicz D, Aminuddin F, Sin DD, Connett JE, Anthonisen NR, Paré PD, Sandford AJ Published Date May 2011 Volume 2011:6 Pages 277 - 287 DOI: http://dx.doi.org/10.2147/COPD.S18279 Tillie-Louise Hackett1,2,*, Dorota Stefanowicz1,*, Farzian Aminuddin1, Don D Sin1, John E Connett3, Nicholas R Anthonisen4, Peter D Paré1, Andrew J Sandford1 1University of British Columbia, James Hogg Research Laboratories, St Paul's Hospital, Division of Respirology, Department of Medicine, 2Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada; 3School of Public Health, University of Minnesota, Minneapolis, MN, USA; 4Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada *These authors contributed equally to this work Background: The objective of this study was to determine if gene-environment interactions between cigarette smoking and interleukin-6 (IL6), interferon-γ (IFNG), interleukin-1β (IL1B), or interleukin-1 receptor antagonist (IL1RN) single nucleotide polymorphisms are associated with lung function decline and cardiovascular disease in chronic obstructive pulmonary disease (COPD). Methods: Single nucleotide polymorphisms (SNPs) in IL6, IFNG, IL1B, and IL1RN were genotyped in the Lung Health Study and correlated with rate of decline of forced expiratory volume in 1 second (FEV1) over 5 years, baseline FEV1, serum protein levels, cardiovascular disease, and interactions with smoking. Results: The IL6 rs2069825 single nucleotide polymorphism was associated with the rate of decline of prebronchodilator FEV1 (P = 0.049), and was found to have a significant interaction (P = 0.004) with mean number of cigarettes smoked per day. There was also a significant interaction of IFNG rs2069727 with smoking on prebronchodilator (P = 0.008) and postbronchodilator (P = 0.01) FEV1. The IL6 polymorphism was also associated with cardiovascular disease in heterozygous individuals (P = 0.044), and was found to have a significant interaction with smoking (P = 0.024). None of the genetic variants were associated with their respective serum protein levels. Conclusion: The results suggest interactions of IL6 rs2069825 and IFNG rs2069727 single nucleotide polymorphisms with cigarette smoking on measures of lung function. The IL6 rs2069825 single nucleotide polymorphism also interacted with smoking to affect the risk of cardiovascular disease in COPD patients.
Role of MR and digital mammography for screening
DD Dershaw
Breast Cancer Research , 2007, DOI: 10.1186/bcr1689
Abstract: Digital mammography images the breast using the identical information obtained in screen-film mammography. The image is processed, stored and displayed electronically. This conveys several advantages over film techniques, but the approval of digital mammography by the US Food and Drug Administration has been based on comparable ability to detect cancer, not any diagnostic advantage.Four prospective studies comparing digital and film mammography on the same patients have shown that for population-based screening there is no advantage for digital over film. The last and largest of these studies [1] initially reported an advantage for several subgroups of women for digital screening. Later analysis of data from this study, however, concluded that only women with dense breasts may benefit and that screening of entire populations with digital mammography is excessively costly and not beneficial.Analysis of MR as a screening tool has been directed at women with greatly elevated lifetime risk of developing breast cancer. The ability of MR to detect a large percentage of cancers in these women earlier than mammography, sonography or physical examination and at a stage at which they should be curable has been clearly demonstrated. This has lead the American Cancer Society, along with others, to recommend the use of MR to annually screen women with at least a 20% lifetime risk of developing breast cancer starting at age 25 years. Those at less risk were not included due to lack of supporting data and concern over excessive biopsies in those women.
Recent Trends and Patterns in Nigeria’s Industrial Development
DD Ajayi
Africa Development , 2007,
Abstract: This paper analyses recent trend and spatial patterns of manufacturing in Nigeria. In particular, the paper shows that industrial development in the country involved considerable artisanal crafts firms in the early stages and grew progressively in number over the years to large-scale manufacturing. The pattern of the distribution of manufacturing industries at the city level indicates that there is a marked concentration of manufacturing establishments in the southern part of the country, and especially Lagos, Ibadan and Benin in the southwest. Other locations of relative high concentration of industrial establishments are Kano in the North; and Enugu and Port Harcourt in the southeast. Although, this paper shows that production subcontracting increased and varied amongst subcontracting firms, production subcontracting relationships are concentrated in a few locations. The paper concludes that the spatial pattern could change if industrialists adopt the strategy of industrial linkages, and especially production subcontracting which has become a driving force in contemporary industrial development efforts in the world today. It is expected that the situation could be better enhanced given the ongoing privatisation of industrial concerns in Nigeria.
“The Arabs” in the ecclesiastical historians of the 4th/5th centuries: Effects on contemporary Christian- Muslim relations
DD Grafton
HTS Theological Studies/Teologiese Studies , 2008,
Abstract: Historical inquiry into the origin and history of “the Arabs” has long been a part of Western Orientalist literature. However, Christian scholars from the 7th century onward sought to understand the rise of Islam from within a Biblical framework. This article looks at how the early church historians of the 4th and 5th centuries viewed “the Arabs” and passed on those images to their ecclesiastical descendents. It aims to argue that the pejorative image of “the Arabs” as uncultured pagan barbarians of late antiquity was extended to Muslims in the 7th century and transferred into the Latin derogatory term “the Saracen”. This negative image has been perpetuated in Western Christian literature and continues to color Western Evangelical Christian and Dispensational images of “the Arabs”. The article shows that such perceptions have as much to do with the cultural stereotypes disseminated from the ecclesiastical historians as they do with Biblical hermeneutics. HTS Theological Studies Vol. 64 (1) 2008: pp. 177-192
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