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            "title": "Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema",
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                    "firstName": "Barbara A",
                    "lastName": "Forey"
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                    "firstName": "Alison J",
                    "lastName": "Thornton"
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                    "creatorType": "author",
                    "firstName": "Peter N",
                    "lastName": "Lee"
                }
            ],
            "abstractNote": "ABSTRACT: BACKGROUND: Smoking is a known cause of the outcomes COPD, chronic bronchitis (CB) and emphysema, but no previous systematic review exists. We summarize evidence for various smoking indices. METHODS: Based on MEDLINE searches and other sources we obtained papers published to 2006 describing epidemiological studies relating incidence or prevalence of these outcomes to smoking. Studies in children or adolescents, or in populations at high respiratory disease risk or with co-existing diseases were excluded. Study-specific data were extracted on design, exposures and outcomes considered, and confounder adjustment. For each outcome RRs/ORs and 95% CIs were extracted for ever, current and ex smoking and various dose response indices, and meta-analyses and meta-regressions conducted to determine how relationships were modified by various study and RR characteristics. RESULTS: Of 218 studies identified, 133 provide data for COPD, 101 for CB and 28 for emphysema. RR estimates are markedly heterogeneous. Based on random-effects meta-analyses of most-adjusted RR/ORs, estimates are elevated for ever smoking (COPD 2.89, CI 2.63-3.17, n = 129 RRs; CB 2.69, 2.50-2.90, n = 114; emphysema 4.51, 3.38-6.02, n = 28), current smoking (COPD 3.51, 3.08-3.99; CB 3.41, 3.13-3.72; emphysema 4.87, 2.83-8.41) and ex smoking (COPD 2.35, 2.11-2.63; CB 1.63, 1.50-1.78; emphysema 3.52, 2.51-4.94). For COPD, RRs are higher for males, for studies conducted in North America, for cigarette smoking rather than any product smoking, and where the unexposed base is never smoking any product, and are markedly lower when asthma is included in the COPD definition. Variations by sex, continent, smoking product and unexposed group are in the same direction for CB, but less clearly demonstrated. For all outcomes RRs are higher when based on mortality, and for COPD are markedly lower when based on lung function. For all outcomes, risk increases with amount smoked and pack-years. Limited data show risk decreases with increasing starting age for COPD and CB and with increasing quitting duration for COPD. No clear relationship is seen with duration of smoking. CONCLUSIONS: The results confirm and quantify the causal relationships with smoking.",
            "publicationTitle": "BMC Pulmonary Medicine",
            "publisher": "",
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            "date": "Jun 14, 2011",
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            "pages": "36",
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            "journalAbbreviation": "BMC Pulm Med",
            "DOI": "10.1186/1471-2466-11-36",
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            "itemType": "journalArticle",
            "title": "Adherence to Guideline-based Standard Operating Procedures in Pre-hospital Emergency Patients with Chronic Obstructive Pulmonary Disease",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "G",
                    "lastName": "Bosse"
                },
                {
                    "creatorType": "author",
                    "firstName": "W",
                    "lastName": "Schmidbauer"
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                    "creatorType": "author",
                    "firstName": "C D",
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                    "firstName": "M",
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                {
                    "creatorType": "author",
                    "firstName": "R Ce",
                    "lastName": "Francis"
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                    "firstName": "F",
                    "lastName": "Bubser"
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                {
                    "creatorType": "author",
                    "firstName": "M",
                    "lastName": "Krebs"
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                    "firstName": "T",
                    "lastName": "Kerner"
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            ],
            "abstractNote": "This study investigated improvements in pre-hospital care for patients with acute exacerbated chronic obstructive pulmonary disease (aeCOPD) achieved by using a standard operating procedure (SOP). An SOP for pre-hospital treatment of patients with aeCOPD was designed based on valid national guidelines. A total of 1000 Emergency Medical Service patient care reports were analysed prospectively: 500 before and 500 after introduction of the SOP. Overall guideline adherence was 34.6% before and 53.8% after introduction of the SOP; this increase was not statistically significant. After SOP introduction, the administration of β(2) mimetics by inhalative, intravenous and subcutaneous routes increased significantly. The level of knowledge of the national guidelines was rated at 67% by emergency physicians during self-assessment, but was only 33% when physicians were asked specific questions during interview. Introducing the SOP for patients with aeCOPD did not significantly improve adherence to valid national guidelines, but did help to improve specific elements of therapy.",
            "publicationTitle": "The Journal of International Medical Research",
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            "title": "A low vitamin A status increases the susceptibility to cigarette smoke-induced lung emphysema in C57BL/6J mice",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "S",
                    "lastName": "van Eijl"
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                {
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                    "firstName": "E",
                    "lastName": "Mortaz"
                },
                {
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                    "firstName": "C",
                    "lastName": "Versluis"
                },
                {
                    "creatorType": "author",
                    "firstName": "F P",
                    "lastName": "Nijkamp"
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                    "firstName": "G",
                    "lastName": "Folkerts"
                },
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                    "firstName": "N",
                    "lastName": "Bloksma"
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            ],
            "abstractNote": "Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation. Cigarette smoke has been considered a major player in the pathogenesis of COPD. The inflamed airways of COPD patients contain several inflammatory cells. Vitamin A metabolites have been implicated in the repair of lung damage. Exposure to cigarette smoke has been shown to depress levels of retinol in lungs of rats. The purpose of this study was to investigate if a low, but not deficient, vitamin A status potentiated susceptibility to the development of cigarette smoke-induced lung emphysema in mice. Mice were bred that were the offspring's of 3 generations of mice that were fed a purified diet containing low levels of vitamin A and exposed to cigarette smoke for 3 months, every weekday. Then, levels of 9-cis, 13-cis, and all-trans retinoic acid, retinol and retinyl palmitate were measured in plasma, liver and right lung lobe. The left lung lobe was used to assess mean linear intercept (Lm), as a measure of smoke-induced lung damage. Average feed intakes were not different between treatment groups. We show that both retinol and retinyl palmitate levels were dramatically decreased in the storage organs of mice on the low vitamin A diet (retinol 2-fold in both lung and liver, and retinyl palmitate 5- fold in lung) which shows that the depletion was successful. However, this treatment did not result in the development of lung emphysema. However, smoke exposure led to a significant increase in Lm in mice with a low vitamin A status compared to the room air-breathing controls. Lung levels of acid retinoids were similar in all mice, irrespective of diet or smoke exposure. Concluding, a low vitamin A status increases the susceptibility to the development of cigarette smoke-induced lung emphysema, possibly because of decreased anti-oxidant capacity in the lungs due to locally reduced retinol and retinyl palmitate levels. These observations indicate that human populations with a low vitamin A status and a high prevalence of smoking may be at increased risk of developing lung emphysema.",
            "publicationTitle": "Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society",
            "publisher": "",
            "place": "",
            "date": "Apr 2011",
            "volume": "62",
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            "pages": "175-182",
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            "journalAbbreviation": "J. Physiol. Pharmacol",
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            "url": "http://www.ncbi.nlm.nih.gov/pubmed/21673365",
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            "creatorSummary": "Amoros et al.",
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            "itemType": "journalArticle",
            "title": "Bicycle helmet wearing and the risk of head, face, and neck injury: a French case-control study based on a road trauma registry",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Emmanuelle",
                    "lastName": "Amoros"
                },
                {
                    "creatorType": "author",
                    "firstName": "Mireille",
                    "lastName": "Chiron"
                },
                {
                    "creatorType": "author",
                    "firstName": "Jean-Louis",
                    "lastName": "Martin"
                },
                {
                    "creatorType": "author",
                    "firstName": "Bernard",
                    "lastName": "Laumon"
                }
            ],
            "abstractNote": "Background Previous case-control studies on bicycle helmet efficacy are mostly Anglo-Saxon, and based on data from the early 1990s when hard-shell helmets were common. Methods In France, the Rhône county (1.6 million inhabitants) is covered by a road trauma registry that includes emergency department visits, hospital admissions, and fatalities. Over the 1998-2008 period, 13 797 cyclist casualties were identified. The injuries sustained were coded using the Abbreviated Injury Scale (AIS) for injuries to the head (AIS1+ and AIS3+), face (AIS1+), or neck (AIS1+). The study uses a case-control design where the control group includes cyclists injured below the neck-that is, not injured in the region associated with the helmet. We first adjusted for age, gender, and type of crash, as in a previously published Cochrane review. Then we adjusted for injury severity based on non-head, face, or neck injury, and when relevant, for crash location: type of road, urban/rural area. Results The fully adjusted ORs of helmeted versus unhelmeted cyclists are: for AIS1+ head injuries, 0.69 (95% CI 0.59 to 0.81); for AIS3+ head injuries sustained in urban areas, 0.34 (95% CI 0.15 to 0.65), those sustained in rural areas, 0.07 (95% CI 0.02 to 0.23); for AIS1+ facial injuries, 0.72 (95% CI 0.62 to 0.83); and for AIS1+ neck injuries, 1.18 (95% CI 0.94 to 1.47). Conclusion This study confirms the protective effect for head and facial injuries, even though soft-shell helmets have now become more common. The reduction of risk is greater for serious head injuries. The study is inconclusive about the risk for neck injuries.",
            "publicationTitle": "Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention",
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            "date": "May 23, 2011",
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            "journalAbbreviation": "Inj Prev",
            "DOI": "10.1136/ip.2011.031815",
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            "title": "Bicycle helmet use after the introduction of all ages helmet legislation in an urban community in Alberta, Canada",
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                    "firstName": "Mohammad",
                    "lastName": "Karkhaneh"
                },
                {
                    "creatorType": "author",
                    "firstName": "Brian H",
                    "lastName": "Rowe"
                },
                {
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                    "firstName": "L Duncan",
                    "lastName": "Saunders"
                },
                {
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                    "firstName": "Don",
                    "lastName": "Voaklander"
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                    "firstName": "Brent",
                    "lastName": "Hagel"
                }
            ],
            "abstractNote": "BACKGROUND Bicycle trauma is a common cause of recreational death and disability and helmets have been shown to reduce fatal and non-fatal head and face injuries. This study evaluated the effect of mandatory bicycle helmet legislation for all ages in St. Albert, Alberta. METHODS We observed bicyclists from June to September of 2006 in St. Albert, a community subject to both provincial (< 18 years old) and municipal (all ages) helmet legislation, and compared our results with observations taken in 2000 when no legislation existed. Helmet wearing and rider characteristics were recorded by trained observers. Poisson regression analysis was used to obtain helmet prevalence (HP) and prevalence ratio (PR) estimates. RESULTS HP increased from 45% to 92% (PR = 2.03; 95% CI: 1.72-2.39) post-legislation. Controlling for other covariates, children were 53% (PR = 1.53; 95% CI: 1.34-1.74) and adolescents greater than 6 times (PR =6.57; 95% CI: 1.39-31.0) more likely to wear helmets; however, adults (PR = 1.26; 95% CI: 0.96-1.66) did not show a statistically significant change post-legislation. Restricting the analysis to high socio-economic status areas, adult helmet prevalence increased in St. Albert from 58% to 73% post-legislation compared with a 52% to 57% change across the province; this effect was not statistically significant. CONCLUSIONS Helmet legislation in St. Albert was associated with a significant increase in helmet use among child and adolescent cyclists. A larger increase in HP was observed for adults in St. Albert than in other areas of the province; however, this difference was not statistically significant, which may reflect the small sample size or insufficient time passage after bylaw enactment.",
            "publicationTitle": "Canadian Journal of Public Health. Revue Canadienne De Santé Publique",
            "publisher": "",
            "place": "",
            "date": "2011 Mar-Apr",
            "volume": "102",
            "issue": "2",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "134-138",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "Can J Public Health",
            "DOI": "",
            "citationKey": "",
            "url": "http://www.ncbi.nlm.nih.gov/pubmed/21608386",
            "accessDate": "2011-06-06T21:27:58Z",
            "PMID": "",
            "PMCID": "",
            "ISSN": "0008-4263",
            "archive": "",
            "archiveLocation": "",
            "shortTitle": "",
            "language": "",
            "libraryCatalog": "NCBI PubMed",
            "callNumber": "",
            "rights": "",
            "extra": "PMID: 21608386",
            "tags": [],
            "collections": [],
            "relations": {},
            "dateAdded": "2011-06-06T21:28:09Z",
            "dateModified": "2011-06-06T21:28:09Z"
        }
    }
]