scholarly journals Impact of Hyponatremia on COPD Exacerbation Prognosis

2020 ◽  
Vol 9 (2) ◽  
pp. 503
Author(s):  
María-Teresa García-Sanz ◽  
Sandra Martínez-Gestoso ◽  
Uxío Calvo-Álvarez ◽  
Liliana Doval-Oubiña ◽  
Sandra Camba-Matos ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Prolonged Stay ◽  
Santiago De Compostela ◽  
Electrolyte Disorder ◽  
History Of ◽  
Prognostic Implications ◽  
The University

The most common electrolyte disorder among hospitalized patients, hyponatremia is a predictor of poor prognosis in various diseases. The aim of this study was to establish the prevalence of hyponatremia in patients admitted for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), as well as its association with poor clinical progress. Prospective observational study carried out from 1 October 2016 to 1 October 2018 in the following hospitals: Salnés in Vilagarcía de Arousa, Arquitecto Marcide in Ferrol, and the University Hospital Complex of Santiago de Compostela, Galicia, Spain, on patients admitted for AECOPD. Patient baseline treatment was identified, including hyponatremia-inducing drugs. Poor progress was defined as follows: prolonged stay, death during hospitalization, or readmission within one month after the index episode discharge. 602 patients were enrolled, 65 cases of hyponatremia (10.8%) were recorded, all of a mild nature (mean 131.6; SD 2.67). Of all the patients, 362 (60%) showed poor progress: 18 (3%) died at admission; 327 (54.3%) had a prolonged stay; and 91 (15.1%) were readmitted within one month after discharge. Patients with hyponatremia had a more frequent history of atrial fibrillation (AF) (p 0.005), pleural effusion (p 0.01), and prolonged stay (p 0.01). The factors independently associated with poor progress were hyponatremia, pneumonia, and not receiving home O2 treatment prior to admission. Hyponatremia is relatively frequent in patients admitted for AECOPD, and it has important prognostic implications, even when mild in nature.

scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Screening Program ◽  
Tertiary Care ◽  
Airflow Obstruction ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Targeted Screening ◽  
History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

scholarly journals Risk Factors of Pneumonia Associated with Mechanical Ventilation

2020 ◽  
Vol 17 (2) ◽  
pp. 656 ◽  
Author(s):  
Maria Kózka ◽  
Aurelia Sega ◽  
Katarzyna Wojnar-Gruszka ◽  
Agnieszka Tarnawska ◽  
Agnieszka Gniadek
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hemorrhagic Shock ◽  
Pulmonary Disease ◽  
High Risk Group ◽  
University Hospital ◽  
Medical Documentation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The University

Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5–15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

scholarly journals A correlation between severity of chronic obstructive pulmonary disorders, electrocardiography and echocardiography of patients: a prospective observational study

2020 ◽  
Vol 7 (12) ◽  
pp. 1777
Author(s):  
C. Sri Krishna Appaji ◽  
P. Ravinder
Keyword(s):  
Prospective Observational Study ◽  
Low Voltage ◽  
Airflow Obstruction ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Male Predominance ◽  
Copd Patients ◽  
Function Test ◽  
History Of

Background: Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterised by persistent respiratory symptom and airflow limitation which is not fully reversible. It has been reported that patient with COPD has higher mortality due to cardiac disorder. We have designed this study with an aim to evaluate electrocardiography and echocardiography changes in COPD patients and correlate this finding with severity of disease.Method: In present study 60 randomly selected COPD patients were evaluated clinically, echocardiographically, electrocardiographically and pulmonary function test was performed. A careful history of patient was taken regarding demography, symptoms and aggravation factors. Detailed clinical examination of patient was done to know the sign symptom of cardiological and respiratory involvement.Result: In patients with severe COPD 4 (20%) patients have normal ECG, 12 (60%) have P pulmonale, 14 (70%) patients have right ventricular hypertrophy, low voltage complex was found in 6 (30%), RBBB was present in 4 (20%) patients, 12 (60%) have r wave in their electrocardiograph (ECG) and 2 (10%) patients presented with arrhythmia.Conclusions: From our study we can conclude that most of the patients with COPD were in 5th and 6th decade of life with male predominance. Patients with moderate airflow obstruction were common than severe obstruction. Cardiovascular changes depend upon the severity of disease.

scholarly journals Department of Family Medicine NWGMU named after I.I. Mechnikov. First 25 years

2021 ◽  
Vol 25 (2) ◽  
pp. 47-53
Author(s):  
Olga Yu. Kuznetsova
Keyword(s):  
Family Medicine ◽  
Large Scale ◽  
Scientific Research ◽  
Chronic Obstructive ◽  
University Of Iowa ◽  
Obstructive Pulmonary Disease ◽  
International Projects ◽  
History Of ◽  
The University

The article describes the history of the creation of the Department of Family Medicine of the NWSMU named after I.I. Mechnikov, notes the role of international projects in its establishment and development of the main areas of activity. Examples of successful long-term cooperation are given, in particular, with the University of Iowa (USA). The main stages of the formation of teaching the specialty General Practice (Family Medicine) within the framework of professional retraining of primary health care doctors and residency are described. The importance of using various interactive technologies in the learning process is emphasized, including the development of skills in simulation conditions, which were introduced at the department long before their use in the process of accreditation of specialists. The features of teaching the discipline Polyclinic Therapy for the 6th year students of the medical faculty, as well as the experience of leading scientific research that was carried out by participants of the student scientific society are noted. The main directions of scientific research carried out at the department in recent years are described, aimed at a comprehensive study of the features of the management of elderly patients in general medical practice and the prevalence of chronic obstructive pulmonary disease (COPD) in St. Petersburg and Arkhangelsk. The role of international cooperation in the implementation of large-scale scientific projects, in particular with the Catholic University of Leuven (Belgium), is emphasized. The perspectives for the development of the Department of Family Medicine in the near future are outlined.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

scholarly journals What are the barriers to the completion of a home-based rehabilitation programme for patients awaiting surgery for lung cancer: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041907
Author(s):  
Heloise Catho ◽  
Sebastien Guigard ◽  
Anne-Claire Toffart ◽  
Gil Frey ◽  
Thibaut Chollier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Living Alone ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Home Based ◽  
Registration Number

ObjectivesHome-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge.DesignA prospective observational study.InterventionAll patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week).OutcomesThe H-RP was defined as ‘completed’ if the four components were performed before surgery.ResultsOut of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%–75%; 60–74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex.ConclusionFacing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP.Trial registration numberNCT03530059.

scholarly journals Imaging in alpha-1 antitrypsin deficiency: a window into the disease

2021 ◽  
Vol 12_suppl ◽  
pp. 204062232110245
Author(s):  
Yuh-Chin Tony Huang ◽  
Marion Wencker ◽  
Bastiaan Driehuys
Keyword(s):  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Essential Information ◽  
Plain Chest Radiograph ◽  
Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin Deficiency ◽  
History Of ◽  
Detailed Assessment ◽  
Alpha 1 Antitrypsin ◽  
Magnetic Resonance Imaging Mri

Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

scholarly journals Association between Chronic Obstructive Pulmonary Disease and Ménière’s Disease: A Nested Case–Control Study Using a National Health Screening Cohort

2021 ◽  
Vol 18 (9) ◽  
pp. 4536
Author(s):  
So-Young Kim ◽  
Chang-Ho Lee ◽  
Dae-Myoung Yoo ◽  
Chan-Yang Min ◽  
Hyo-Geun Choi
Keyword(s):  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Chronic Obstructive ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Obstructive Pulmonary Disease ◽  
Region Of Residence ◽  
History Of ◽  
Ménière's Disease

This study explored the relation between Ménière’s disease and chronic obstructive pulmonary disease (COPD). The ≥40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort was included. In total, 7734 Ménière’s disease patients and 30,936 control participants were enrolled. Control participants were matched for age, sex, income, and region of residence with Ménière’s disease participants. The odds of having Ménière’s disease given a history of COPD were analyzed using conditional logistic regression. Subgroup analyses were conducted according to age, sex, income, and region of residence. The odds of having Ménière’s disease were found to be 1.18-fold higher with a history of COPD than with no history of COPD (95% confidence intervals (CI) = 1.06–1.32, E-value (CI) = 1.64 (1.31)). The ≥60 years old, male, low-income, and rural subgroups showed increased odds of developing Ménière’s disease when a history of COPD was reported. A history of COPD was associated with an increased risk of Ménière’s disease in the adult population.

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