scholarly journals Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study

2017 ◽  
Vol 49 (5) ◽  
pp. 1601446 ◽  
Author(s):  
Vladimir Koblizek ◽  
Branislava Milenkovic ◽  
Adam Barczyk ◽  
Ruzena Tkacova ◽  
Attila Somfay ◽  
...  
Keyword(s):  
Eastern Europe ◽  
Chronic Bronchitis ◽  
Central And Eastern Europe ◽  
Real Life ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Real Life Setting ◽  
Symptom Load

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region.Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment.3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma–COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma–COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes.The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes.

scholarly journals A non-interventional switch study in adult patients with asthma or COPD on clinical effectiveness of salmeterol/fluticasone Easyhaler® in routine clinical practice

2021 ◽  
Vol 15 ◽  
pp. 175346662110277
Author(s):  
Ines Vinge ◽  
Jörgen Syk ◽  
Athanasios Xanthopoulos ◽  
Hendrik Laßmann ◽  
Mikko Vahteristo ◽  
...  
Keyword(s):  
Real Life ◽  
Clinical Effectiveness ◽  
Chronic Obstructive ◽  
Asthma Control Test ◽  
Life Effectiveness ◽  
Obstructive Pulmonary Disease ◽  
Similar Treatment ◽  
Nurse Perception ◽  
Real Life Setting ◽  
Act Score

Background: Selection of the most appropriate device for a switch from one inhaler to an equivalent product is known to have a major impact on clinical outcomes in patients with asthma or chronic obstructive pulmonary disease (COPD). Salmeterol/fluticasone propionate (S/F) Easyhaler® has been demonstrated to be therapeutically equivalent with a reference product. However, no data on real-life effectiveness are currently available for patients switching to S/F Easyhaler from another S/F inhaler. Methods: The aim of this prospective, open, multicenter, non-interventional study was to assess clinical effectiveness of propionate S/F Easyhaler in adult asthma and COPD patients switched from another inhaler. The primary endpoints were Asthma Control Test (ACT) and COPD Assessment Test (CAT). Secondary endpoints included assessments of patient satisfaction and preference and physician/nurse perception on S/F Easyhaler use. The study included three visits during a 12-week follow-up. Results: A total of 211 patients (160 with asthma; 51 with COPD) were included in the analyses. In patients with asthma, there was a statistically significant increase in the mean ACT score at week 12 (20.2 ± 3.9) compared with the baseline (18.6 ± 4.1), with a mean increase of 1.6 (±3.5) points ( p < 0.0001). In patients with COPD, CAT score persisted from baseline (19.9 ± 8.6) to week 12 (19.6 ± 7.0). Patients were significantly more satisfied with Easyhaler and most patients preferred Easyhaler over their previous inhaler. The physicians/nurses reported that it was ‘very easy’ to teach the use of Easyhaler and the training took less than 5 minutes in most cases. Conclusion: The results from this prospective real-life clinical study indicate better or at least similar treatment control of asthma and COPD after switching to S/F Easyhaler from another S/F inhaler. This study also shows that S/F Easyhaler was favored by the patients and that it is easy to teach, learn and use in a real-life setting. The reviews of this paper are available via the supplemental material section.

scholarly journals Enhanced Transcriptomic Resilience following Increased Alternative Splicing and Differential Isoform Production between Air Pollution Conurbations

Atmosphere ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 959
Author(s):  
Shengkai Pan ◽  
Xiaokai Feng ◽  
Daniel Pass ◽  
Rachel A. Adams ◽  
Yusong Wang ◽  
...  
Keyword(s):  
Air Pollution ◽  
Alternative Splicing ◽  
Real Life ◽  
Chronic Obstructive ◽  
Translational Efficiency ◽  
Ambient Particulate Matter ◽  
Obstructive Pulmonary Disease ◽  
Adverse Health Outcomes ◽  
Membrane Bound ◽  
Migration Capacity

Adverse health outcomes caused by ambient particulate matter (PM) pollution occur in a progressive process, with neutrophils eliciting inflammation or pathogenesis. We investigated the toxico-transcriptomic mechanisms of PM in real-life settings by comparing healthy residents living in Beijing and Chengde, the opposing ends of a well-recognised air pollution (AP) corridor in China. Beijing recruits (BRs) uniquely expressed ~12,000 alternative splicing (AS)-derived transcripts, largely elevating the proportion of transcripts significantly correlated with PM concentration. BRs expressed PM-associated isoforms (PMAIs) of PFKFB3 and LDHA, encoding enzymes responsible for stimulating and maintaining glycolysis. PMAIs of PFKFB3 featured different COOH-terminals, targeting PFKFB3 to different sub-cellular functional compartments and stimulating glycolysis. PMAIs of LDHA have longer 3′UTRs relative to those expressed in Chengde recruits (CRs), allowing glycolysis maintenance by enhancing LDHA mRNA stability and translational efficiency. PMAIs were directly regulated by different HIF-1A and HIF-1B isoforms. BRs expressed more non-functional Fas isoforms, and a resultant reduction of intact Fas proportion is expected to inhibit the transmission of apoptotic signals and prolong neutrophil lifespan. BRs expressed both membrane-bound and soluble IL-6R isoforms instead of only one in CRs. The presence of both IL-6R isoforms suggested a higher migration capacity of neutrophils in BRs. PMAIs of HIF-1A and PFKFB3 were downregulated in Chronic Obstructive Pulmonary Disease patients compared with BRs, implying HIF-1 mediated defective glycolysis may mediate neutrophil dysfunction. PMAIs could explain large variances of different phenotypes, highlighting their potential application as biomarkers and therapeutic targets in PM-induced diseases, which remain poorly elucidated.

scholarly journals Chronic Obstructive Pulmonary Disease: Epidemiology, Biomarkers, and Paving the Way to Lung Cancer

2021 ◽  
Vol 10 (13) ◽  
pp. 2889
Author(s):  
Klára Szalontai ◽  
Nikolett Gémes ◽  
József Furák ◽  
Tünde Varga ◽  
Patrícia Á. Neuperger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Alveolar Wall ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Chronic Inflammatory Response ◽  
Disease Epidemiology

Chronic obstructive pulmonary disease (COPD), the frequently fatal pathology of the respiratory tract, accounts for half a billion cases globally. COPD manifests via chronic inflammatory response to irritants, frequently to tobacco smoke. The progression of COPD from early onset to advanced disease leads to the loss of the alveolar wall, pulmonary hypertension, and fibrosis of the respiratory epithelium. Here, we focus on the epidemiology, progression, and biomarkers of COPD with a particular connection to lung cancer. Dissecting the cellular and molecular players in the progression of the disease, we aim to shed light on the role of smoking, which is responsible for the disease, or at least for the more severe symptoms and worse patient outcomes. We summarize the inflammatory conditions, as well as the role of EMT and fibroblasts in establishing a cancer-prone microenvironment, i.e., the soil for ‘COPD-derived’ lung cancer. We highlight that the major health problem of COPD can be alleviated via smoking cessation, early diagnosis, and abandonment of the usage of biomass fuels on a global basis.

scholarly journals Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea

2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  
Keyword(s):  
Racial Differences ◽  
Large Scale ◽  
Ecological Model ◽  
Prevalence Ratio ◽  
Poor Quality ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Us

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

scholarly journals Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis

2015 ◽  
Vol 24 (137) ◽  
pp. 451-461 ◽  
Author(s):  
Mario Cazzola ◽  
Luigino Calzetta ◽  
Clive Page ◽  
Josè Jardim ◽  
Alexander G. Chuchalin ◽  
...  
Keyword(s):  
Relative Risk ◽  
Airway Obstruction ◽  
Chronic Bronchitis ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Regular Treatment ◽  
Copd Exacerbations ◽  
Copd Patients ◽  
High Doses

In order to clarify the possible role of N-acetylcysteine (NAC) in the treatment of patients with chronic bronchitis and chronic obstructive pulmonary disease (COPD), we have carried out a meta-analysis testing the available evidence that NAC treatment may be effective in preventing exacerbations of chronic bronchitis or COPD and evaluating whether there is a substantial difference between the responses induced by low (≤600 mg per day) and high (>600 mg per day) doses of NAC.The results of the present meta-analysis (13 studies, 4155 COPD patients, NAC n=1933; placebo or controls n=2222) showed that patients treated with NAC had significantly and consistently fewer exacerbations of chronic bronchitis or COPD (relative risk 0.75, 95% CI 0.66–0.84; p<0.01), although this protective effect was more apparent in patients without evidence of airway obstruction. However, high doses of NAC were also effective in patients suffering from COPD diagnosed using spirometric criteria (relative risk 0.75, 95% CI 0.68–0.82; p=0.04). NAC was well tolerated and the risk of adverse reactions was not dose-dependent (low doses relative risk 0.93, 95% CI 0.89–0.97; p=0.40; high doses relative risk 1.11, 95% CI 0.89–1.39; p=0.58).The strong signal that comes from this meta-analysis leads us to state that if a patient suffering from chronic bronchitis presents a documented airway obstruction, NAC should be administered at a dose of ≥1200 mg per day to prevent exacerbations, while if a patient suffers from chronic bronchitis, but is without airway obstruction, a regular treatment of 600 mg per day seems to be sufficient.

scholarly journals EFFECT OF HAREETAKYADI YOGA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE – PRE TEST-POST TEST DESIGN

2021 ◽  
pp. 29-35
Author(s):  
Aswathy M ◽  
Radhakrishnan VN ◽  
Jithesh M
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Study Drug ◽  
Lung Parenchyma ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Narrowing ◽  
Post Test ◽  
Stage 1

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing, which is progressive and is not fully reversible. COPD includes chronic bronchitis and emphysema. Symptoms of COPD are well explained in Ayurveda in the context of Kasa and Swasa among which chronic bronchitis can be better correlated to Vataja and Kaphaja kasa and emphysema to Tamaka swasa. COPD is characterized by mucous hyper secretion, airway narrowing, fibrosis and destruction of lung parenchyma. Even though the existing conventional management is excellent, Ayurveda provides additional benefits such as improvement in quality of life. The study drug Hareetakyadi yoga is mentioned in Prakarana of kasa in Chikitsa manjari. The objective of the study was to evaluate the Effect of Hareetakyadi yoga in Chronic Obstructive Pulmonary Disease. The Study includes 10 subjects of age group 40-70 years of both gender, diagnosed clinically and as per investigations satisfying COPD, stage 1 & 2 as per GOLD criteria of spirometry attending department of Kayachikitsa, Government Ayurveda College, Thiruvananthapuram. A protocol from Deepana to Virechana were done as preparatory phase before administering drug. Hareetakyadi yoga having the properties of Kapha vata hara, Agni deepana and Rasayana property seems to be effective in the management of this disease.

scholarly journals Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

10.2196/16343 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16343 ◽  
Author(s):  
Sara Lundell ◽  
Mari Modig ◽  
Åsa Holmner ◽  
Karin Wadell
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Self Management ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Successful Implementation ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Home Telemonitoring

Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

scholarly journals Morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease

2008 ◽  
pp. 48-52
Author(s):  
E. V. Privalova ◽  
T. V. Vavilova ◽  
N. A. Kuzubova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Compensatory Reaction ◽  
Copd Patients

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.

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