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Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Makedonka Gulcev, Cavan Reilly, Timothy J Griffin, Corey D Broeckling, Brian J Sandri, Bruce A Witthuhn, Shane W Hodgson, Prescott G Woodruff, Chris H Wendt
INTRODUCTION: Exacerbations are a leading cause of morbidity in COPD. The objective of this study was to identify metabolomic biomarkers of acute exacerbations of COPD (AECOPD). METHODS: We measured metabolites via mass spectrometry (MS) in plasma drawn within 24 hours of admission to the hospital for 33 patients with an AECOPD (day 0) and 30 days later and for 65 matched controls. Individual metabolites were measured via selective reaction monitoring with mass spectrometry...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Irene Torres-Sánchez, Marie Carmen Valenza, Irene Cabrera-Martos, Isabel López-Torres, Ángela Benítez-Feliponi, Alicia Conde-Valero
The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease (COPD) during hospitalization due to an acute exacerbation. This study was a randomized, single-blind clinical trial. Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD (AECOPD) were included in this study. All patients received standard medical and pharmacological care. Patients assigned to the intervention group also received an exercise intervention...
August 11, 2016: COPD
Feng-Sen Li, Yan-Li Zhang, Zheng Li, Dan Xu, Chun-Yan Liao, Huan Ma, Li Gong, Jun Su, Qi Sun, Qian Xu, Zhen Gao, Ling Wang, Jing Jing, Jing Wang, Min Jiang, Ge Tian, Bilal Hasan
In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012...
October 2016: Experimental and Therapeutic Medicine
Hamdi Boubaker, Mohamed Habib Grissa, Kaouther Beltaief, Zohra Dridi, Mohamed Fadhel Najjar, Wahid Bouida, Riadh Boukef, Soudani Marghli, Semir Nouira
BACKGROUND: The goal of this study was to determine the value of systolic time intervals and their change during Valsalva maneuver (VM) in the diagnosis of left ventricular dysfunction (LVD) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: We included 166 patients admitted to the emergency department for AECOPD. Measurement of systolic time intervals included electromechanical activation time (EMAT), left ventricular ejection time (LVET), and EMAT/LVET ratio...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Amir Sharafkhaneh, Andrew M Spiegelman, Kevin Main, Shahriar Tavakoli-Tabasi, Charlie Lan, Daniel Musher
It is unclear whether concurrent pneumonia and chronic obstructive pulmonary disease (COPD) have a higher mortality than either condition alone. Further, it is unknown how this interaction changes over time. We explored the effect of pneumonia and COPD on inpatient, 30-day and overall mortality. We used a Veterans Health Affairs database to compare patients who were hospitalized for a COPD exacerbation without pneumonia (AECOPD), patients hospitalized for pneumonia without COPD (PNA) and patients hospitalized for pneumonia who had a concurrent diagnosis of COPD (PCOPD)...
September 23, 2016: COPD
Marta Erdal, Ane Johannessen, Tomas Mikal Eagan, Per Bakke, Amund Gulsvik, Rune Grønseth
OBJECTIVES: The objectives of this study were to estimate the impact of recruitment source and outcome definition on the incidence of acute exacerbations of COPD (AECOPD) and explore possible predictors of AECOPD. PATIENTS AND METHODS: During a 1-year follow-up, we performed a baseline visit and four telephone interviews of 81 COPD patients and 132 controls recruited from a population-based survey and 205 hospital-recruited COPD patients. Both a definition based on health care utilization and a symptom-based definition of AECOPD were applied...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Nina Sun, Xiaofang Wei, Jingluan Wang, Zhaozhong Cheng, Weihong Sun
The imbalance of Th17/Treg cells plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Caveolin-1 (Cav-1) has been regarded as a potential critical regulatory protein in pathological mechanisms of chronic inflammatory respiratory diseases. Therefore, we investigated whether the loss of Cav-1 is involved in the homeostasis of Th17/Treg cells in COPD. We examined the expressions of plasma Cav-1 and circulating Th17, Treg cells, and the related cytokines in patients with COPD...
September 9, 2016: Inflammation
Giulia Scioscia, Isabel Blanco, Ebymar Arismendi, Felip Burgos, Concepción Gistau, Maria Pia Foschino Barbaro, Bartolome Celli, Denis E O'Donnell, Alvar Agustí
BACKGROUND: Some patients with COPD report frequent acute exacerbations (AECOPD) of the disease (FE), whereas others suffer them infrequently (IE). Because the current diagnosis of exacerbation relies on patient's perception of increased symptoms (mostly dyspnoea), we hypothesised that dyspnoea perception might be different in COPD patients with FE (≥2 exacerbations or 1 hospitalisation due to AECOPD in the previous year) or IE (≤1 exacerbation in the previous year), AECOPD being defined by the institution antibiotics and/or steroids treatment, or hospital admission...
September 1, 2016: Thorax
Zhiyue Wang, Xuesong Chen, Kouying Liu, Weiping Xie, Hong Wang, Yongyue Wei, Lijun Tang, Yinsu Zhu
The morphologic alterations of pulmonary small vessels measured by computed tomography (CT) have been used to evaluate chronic obstructive pulmonary disease (COPD). However, the relationship between small pulmonary vascular alteration and acute exacerbations of COPD (AECOPD) is not well understood. The aim of this study was to evaluate the cross-sectional area (CSA) of small pulmonary vessel alterations measured on CT images and investigate its relationship with the COPD severity staged by the degree of airflow limitation and the occurrence of AECOPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Allison A Lambert, Nirupama Putcha, M Bradley Drummond, Aladin M Boriek, Nicola A Hanania, Victor Kim, Gregory L Kinney, Merry-Lynn N McDonald, Emily P Brigham, Robert A Wise, Meredith C McCormack, Nadia N Hansel
BACKGROUND: Obesity is prevalent in the United States; however the impact of obesity upon COPD morbidity is unclear. We hypothesized that obesity is associated with worse outcomes in COPD. METHODS: We examined 3631 participants from the multicenter prospective cohort study COPDGene who had spirometry confirmed COPD, a post-bronchodilator FEV1 <80% predicted and a body mass index (BMI) ≥18.5kg/m2. We conducted logistic and linear regression analyses to determine the association between COPD outcomes and obesity class, adjusting for relevant confounders...
August 25, 2016: Chest
Xiaofan Lu, Ya Li, Jiansheng Li, Haifeng Wang, Zhaohuan Wu, Hangjie Li, Yang Wang
Background. Sequential treatments of Chinese medicines for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) risk window (RW) have benefits for preventing reoccurrences of AEs; however, the effects on pulmonary function, pulmonary, and systemic inflammatory biomarkers remain unclear. Methods. Cigarette-smoke/bacterial infections induced rats were randomized into Control, COPD, AECOPD, Tongsai Granule/normal saline (TSG/NS), moxifloxacin + salbutamol/NS (MXF+STL/NS), TSG/Bufei Yishen Granule (BYG), MXF+STL/STL, and TSG+MXF+STL/BYG+STL groups and given corresponding medicine(s) in AE- and/or RW phase...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Zhiwei Lu, Yusheng Cheng, Xiongwen Tu, Liang Chen, Hu Chen, Jian Yang, Jinyan Wang, Liqin Zhang
PURPOSE: The aim of this study was to appraise the effect of community-acquired pneumonia (CAP) on inhospital mortality in critically ill acute exacerbation of COPD (AECOPD) patients admitted to a respiratory intensive care unit. PATIENTS AND METHODS: A retrospective observational study was performed. Consecutive critically ill AECOPD patients receiving treatment in a respiratory intensive care unit were reviewed from September 1, 2012, to August 31, 2015. Categorical variables were analyzed using chi-square tests, and continuous variables were analyzed by Mann-Whitney U-test...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Stephanie Law, Praneel Kumar, Sharon Woods, Krishna B Sriram
OBJECTIVES: There is a paucity of information on the prevalence and clinical implications of malnutrition in patients hospitalised for management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This study aimed to fill this gap in knowledge. METHODS: We performed a retrospective observational cohort study of 100 hospitalised AECOPD patients. The Malnutrition Screening Tool (MST) was used to identify patients at risk of malnutrition (MST ≥2)...
August 25, 2016: Hospital Practice (Minneapolis)
Frank Rassouli, Maurus Pfister, Sandra Widmer, Florent Baty, Barbara Burger, Martin H Brutsche
BACKGROUND: Earlier detection of acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) could reduce emergency admissions and hospitalisations. Studies investigating COPD management programs supported by telehealthcare (THC) have shown conflicting results. OBJECTIVES: To test the feasibility, safety and acceptance of THC for COPD. METHODS: Patients daily filled out an online questionnaire focused on the detection of AECOPD...
2016: Respiration; International Review of Thoracic Diseases
Luke E Hodgson, Borislav D Dimitrov, Jo Congleton, Richard Venn, Lui G Forni, Paul J Roderick
BACKGROUND: The National Early Warning Score (NEWS), proposed as a standardised track and trigger system, may perform less well in acute exacerbation of COPD (AECOPD). This study externally validated NEWS and modifications (Chronic Respiratory Early Warning Score (CREWS) and Salford-NEWS) in AECOPD. METHODS: An observational cohort study (2012-2014, two UK acute medical units (AMUs)), compared AECOPD (2361 admissions, 942 individuals, International Statistical Classification of Diseases and Related Health Problems-10 J40-J44 codes) with AMU patients (37 109 admissions, 20 415 individuals)...
August 23, 2016: Thorax
Long Chen, Gang Chen, Ming-Qiang Zhang, Xian-Zhi Xiong, Hong-Ju Liu, Jian-Bao Xin, Jian-Chu Zhang, Jiang-Hua Wu, Zhao-Ji Meng, Sheng-Wen Sun
Background. CD8(+) T lymphocytes are known to play a critical role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, systematic analyses of CD8(+) T cell (Cytotoxic T cells, Tc) subsets in COPD patients have yet to be well conducted. Methods. The whole Tc subsets, including Tc1/2/10/17, CD8(+) regulatory T cells (Tregs) and CD8(+) α7(+) T cells, were quantified by flow cytometry in peripheral blood from 24 stable COPD subjects (SCOPD), 14 patients during acute exacerbations (AECOPD), and 14 healthy nonsmokers (HN)...
2016: PeerJ
Xingde Wang, Zhaohua Jiang, Bin Chen, Li Zhou, Zhibin Kong, Sheng Zuo, Hua Liu, Shaojun Yin
BACKGROUND: Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD) may increase the risks of arrhythmia and sudden death. We studied cardiac autonomic function in patients with acute exacerbation of COPD (AECOPD). METHODS: Patients with AECOPD were classified into ventricular tachycardia (VT) and non-VT groups according to the presence or absence of VT. The following parameters derived from 24-h Holter monitoring were compared between groups: average heart rate, heart rate deceleration capacity (DC), heart rate acceleration capacity (AC), standard deviation of normal RR intervals (SDNN), standard deviation of average RR interval in 5-min segments (SDANN), root mean square of standard deviations of differences between adjacent normal RR intervals (rMSSD), low-frequency power (LF), high-frequency power (HF) and LF/HF ratio...
2016: BMC Pulmonary Medicine
Jacob A Winther, Jon Brynildsen, Arne Didrik Høiseth, Ivar Følling, Pål H Brekke, Geir Christensen, Tor-Arne Hagve, Joseph G Verbalis, Torbjørn Omland, Helge Røsjø
BACKGROUND: Hyponatremia is prevalent and associated with mortality in patients with heart failure (HF). The prevalence and prognostic implications of hyponatremia in acute exacerbation of chronic obstructive pulmonary (AECOPD) have not been established. METHOD: We included 313 unselected patients with acute dyspnea who were categorized by etiology of dyspnea according to established guidelines (derivation cohort). Serum Na+ was determined on hospital admission and corrected for hyperglycemia, and hyponatremia was defined as [Na+]<137 mmol/L...
2016: PloS One
Janice M Leung, Virginia Chen, Zsuzsanna Hollander, Darlene Dai, Scott J Tebbutt, Shawn D Aaron, Kathy L Vandemheen, Stephen I Rennard, J Mark FitzGerald, Prescott G Woodruff, Stephen C Lazarus, John E Connett, Harvey O Coxson, Bruce Miller, Christoph Borchers, Bruce M McManus, Raymond T Ng, Don D Sin
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) result in considerable morbidity and mortality. However, there are no objective biomarkers to diagnose AECOPD. METHODS: We used multiple reaction monitoring mass spectrometry to quantify 129 distinct proteins in plasma samples from patients with COPD. This analytical approach was first performed in a biomarker cohort of patients hospitalized with AECOPD (Cohort A, n = 72). Proteins differentially expressed between AECOPD and convalescent states were chosen using a false discovery rate <0...
2016: PloS One
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