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end stage copd

Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
Gimano D Amatngalim, Jasmijn A Schrumpf, Fernanda Dishchekenian, Tinne C J Mertens, Dennis K Ninaber, Abraham C van der Linden, Charles Pilette, Christian Taube, Pieter S Hiemstra, Anne M van der Does
Research question : It is currently unknown how cigarette smoke-induced airway remodelling affects highly expressed respiratory epithelial defence proteins and thereby mucosal host defence. Methods: Localization of a selected set of highly expressed respiratory epithelial host defence proteins was assessed in well-differentiated primary bronchial epithelial cell (PBEC) cultures. Next, PBEC were cultured at the air-liquid interface and during differentiation for 2-3 weeks daily exposed to whole cigarette smoke...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Gehan Hassan AboEl-Magd, Maaly Mohamed Mabrouk
OBJECTIVE: To evaluate the value of soluble urokinase-type plasminogen activator receptor (suPAR) in the diagnosis of acute exacerbation of COPD (AECOPD) and in monitoring treatment response, analyzing the relationship between suPAR and fibrinogen in AECOPD. AECOPD leads to increased airway inflammation, contributing to an exaggerated release of inflammatory mediators. METHODS: We recruited 45 patients with AECOPD and 20 healthy control subjects. Medical histories were taken, and all subjects underwent clinical examination, chest X-ray, pulmonary function tests, and blood gas analysis...
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, David Debeaumont, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Jean Quieffin, Olivier Contal, Bouchra Lamia
OBJECTIVE: To evaluate the effect of quadriceps Functional Electrical Stimulation (FES)-Cycling on exertional VO2 compared with Placebo FES-cycling in patients with COPD. DESIGN: A randomised, single-blind, placebo-controlled, cross-over trial SETTING: Pulmonary Rehabilitation Department PARTICIPANTS: 23 consecutive patients with COPD GOLD stage 2, 3 or 4 (mean FEV1 : 1.4±0.4 L (50.3% pred)) who had recently begun a respiratory rehabilitation program. INTERVENTION: Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-Cycling...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
Chien-Hua Chen, Cheng-Li Lin, Long-Bin Jeng
PURPOSE: Chronic pancreatitis (CP) can cause fat or bile acid malabsorption due to exocrine insufficiency. Fat or bile acid malabsorption has been reported to increase the risk of urolithiasis through increased intestinal oxalate absorption. However, no studies have reported an association between CP and urolithiasis. METHODS: We identified 15,848 patients (age: ≥20 years) diagnosed as having CP between 2000 and 2010 from the National Health Insurance Research Database as the study cohort...
2018: PloS One
Amir Qaseem, Timothy J Wilt, Devan Kansagara, Carrie Horwitch, Michael J Barry, Mary Ann Forciea
Description: The American College of Physicians developed this guidance statement to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes. Methods: The National Guideline Clearinghouse and the Guidelines International Network library were searched (May 2017) for national guidelines, published in English, that addressed hemoglobin A1c (HbA1c) targets for treating type 2 diabetes in nonpregnant outpatient adults. The authors identified guidelines from the National Institute for Health and Care Excellence and the Institute for Clinical Systems Improvement...
March 6, 2018: Annals of Internal Medicine
Emma Åhrman, Oskar Hallgren, Lars Malmström, Ulf Hedström, Anders Malmström, Leif Bjermer, Xiao-Hong Zhou, Gunilla Westergren-Thorsson, Johan Malmström
Remodeling of the extracellular matrix (ECM) is a common feature in lung diseases such as chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). Here, we applied a sequential tissue extraction strategy to describe disease-specific remodeling of human lung tissue in disease, using end-stages of COPD and IPF. Our strategy was based on quantitative comparison of the disease proteomes, with specific focus on the matrisome, using data-independent acquisition and targeted data analysis (SWATH-MS)...
March 1, 2018: Journal of Proteomics
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
February 9, 2018: International Journal of Surgery Case Reports
Daniel A Waxman, Hemal K Kanzaria, David L Schriger
Importance: The Institute of Medicine described diagnostic error as the next frontier in patient safety and highlighted a critical need for better measurement tools. Objectives: To estimate the proportions of emergency department (ED) visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), stroke, aortic dissection, and subarachnoid hemorrhage (SAH) that end in discharge without diagnosis; to evaluate longitudinal trends; and to identify patient characteristics independently associated with missed diagnostic opportunities...
February 26, 2018: JAMA Internal Medicine
Barbara Schuba, Miriam Scheklinski, Vera von Dossow, Christian Schneider, Gerhard Preissler, Nikolaus Kneidinger, Claus Neurohr, Sebastian Michel, Christian Hagl, Rene Schramm
OBJECTIVES: The Lung Allocation Score (LAS) was implemented in Germany on 10 December 2011 after demonstrating favourable outcomes in the USA since its introduction in 2005. There are only limited and short-term data on the effect of the LAS on lung transplantation programmes in Germany. The purpose of this study was to analyse our 5-year single-centre experience with the LAS within the influential area of the Eurotransplant Foundation (ET). METHODS: After implementation of the LAS until December 2016, 294 patients underwent a single-lung transplantation or a bilateral sequential lung transplantation for end-stage lung disease at our centre...
February 15, 2018: European Journal of Cardio-thoracic Surgery
Naoya Tanabe, Dragoş M Vasilescu, Miranda Kirby, Harvey O Coxson, Stijn E Verleden, Bart M Vanaudenaerde, Daisuke Kinose, Yasutaka Nakano, Peter D Paré, James C Hogg
The small conducting airways are the major site of obstruction in chronic obstructive pulmonary disease (COPD). This study examined small airway pathology using a novel combination of multidetector row computed tomography (MDCT), micro-computed tomography (microCT) and histology.Airway branches visible on specimen MDCT were counted and the dimensions of the third- to fifth-generation airways were computed, while the terminal bronchioles (designated TB), preterminal bronchioles (TB-1) and pre-preterminal bronchioles (TB-2) were examined with microCT and histology in eight explanted lungs with end-stage COPD and seven unused donor lungs that served as controls...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Yuan Kao, I-Jung Feng, Chien-Chin Hsu, Jhi-Joung Wang, Hung-Jung Lin, Chien-Cheng Huang
BACKGROUND: A hyperglycemic crisis episode (HCE) is associated with poor management of diabetes, which is a risk factor for end-stage renal disease (ESRD); however, the association between an HCE and ESRD has not been clarified. We conducted a nationwide population-based cohort study with the purpose of delineating this issue. METHODS: We identified 9,208 diabetic patients with an HCE and an identical number of diabetic patients with matched age, sex, and index date without an HCE between 2000 and 2002...
February 1, 2018: Diabetes Research and Clinical Practice
Zaurbek Aisanov, Sergey Avdeev, Vladimir Arkhipov, Andrey Belevskiy, Alexander Chuchalin, Igor Leshchenko, Svetlana Ovcharenko, Evgeny Shmelev, Marc Miravitlles
The high prevalence of COPD together with its high level of misdiagnosis and late diagnosis dictate the necessity for the development and implementation of clinical practice guidelines (CPGs) in order to improve the management of this disease. High-quality, evidence-based international CPGs need to be adapted to the particular situation of each country or region. A new version of the Russian Respiratory Society guidelines released at the end of 2016 was based on the proposal by Global Initiative for Obstructive Lung Disease but adapted to the characteristics of the Russian health system and included an algorithm of pharmacologic treatment of COPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
K D Lucas, C Wheeler, P McLendon, B N Leistikow, J C Mohle-Boetani
A large outbreak of Legionnaires' disease occurred at a California state prison in August 2015. We conducted environmental and epidemiological investigations to identify the most likely source of exposure and characterise morbidity. Sixty-four inmates had probable Legionnaires' disease; 14 had laboratory-confirmed legionellosis. Thirteen (17%) inmates were hospitalised; there were no deaths. Ill inmates were more likely to be ⩾65 years old (P < 0.01), have the chronic obstructive pulmonary disease (P < 0...
February 1, 2018: Epidemiology and Infection
María Jesús Prunera-Pardell, Susana Padín-López, Adolfo Domenech-Del Rio, Ana Godoy-Ramírez
OBJECTIVE: To evaluate the effectiveness of the multidisciplinary respiratory rehabilitation (RR) programme in patients with severe or very severe chronic obstructive pulmonary disease pre the RR programme, at the end of the programme and one year after the RR, measuring changes in ability to exercise (walking test), effort tolerance(forced expiratory volume (FEV1)) and health-related quality of life. METHOD: Quasi-experimental single group design. We included patients diagnosed with severe or very severe chronic obstructive pulmonary disease (stages III and IV of the GOLD classification) who entered the rehabilitation programme for the years 2011 and 2012...
December 26, 2017: Enfermería Clínica
Marek Ochman, Marcin Maruszewski, Jacek Wojarski, Sławomir Żegleń, Wojtek Karolak, Anita Stanjek-Cichoracka, Piotr Przybyłowski, Marian Zembala, Michał Kukla
BACKGROUND The aim of this study was to investigate serum concentrations of visfatin, irisin, and omentin in patients with end-stage lung diseases (ESLD) before and after lung transplantation (LTx) and to find relationship between adipokines levels and clinical outcomes. MATERIAL AND METHODS Fourteen consecutive lung transplant recipients (six males and seven females; age 32.0±14.2 years; body mass index (BMI) 21.8±5.3 kg/m²) who underwent lung transplantation with initial diagnosis of respiratory failure due to cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) were included...
December 26, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Debajyoti Roy, Anupama Roy Chowdhury, Shrikant Pande, Jia Wen Kam
BACKGROUND: Increasing numbers of elderly patients are undergoing long-term dialysis. However, the role of dialysis in survival and quality of life is unclear, and poor outcomes may be associated with comorbidities rather than with age only. The initiation of unplanned dialysis in elderly patients with chronic kidney disease (CKD) has been reported to be associated with poor survival. We evaluated patient and practice factors associated with poor survival. METHODS: We performed a retrospective analysis of 90 consecutive elderly patients (≥75 years) with CKD initiated on long-term dialysis at our renal unit between October 2010 and February 2014...
December 19, 2017: BMC Nephrology
Faisal M Siddiqui, Joshua M Diamond
PURPOSE OF REVIEW: Lung transplantation offers an effective treatment modality for patients with end-stage chronic obstructive pulmonary disease (COPD). The exact determination of when to refer, list, and offer transplant as well as the preferred transplant procedure type remains unclear. Additionally, there are special considerations specific to patients with COPD being considered for lung transplantation, including the implications of single lung transplantation on lung cancer risk, native lung hyperinflation, and overall survival...
March 2018: Current Opinion in Pulmonary Medicine
Lindsey J Anderson, Haiming Liu, Jose M Garcia
With aging and other muscle wasting diseases, men and women undergo similar pathological changes in skeletal muscle: increased inflammation, enhanced oxidative stress, mitochondrial dysfunction, satellite cell senescence, elevated apoptosis and proteasome activity, and suppressed protein synthesis and myocyte regeneration. Decreased food intake and physical activity also indirectly contribute to muscle wasting. Sex hormones also play important roles in maintaining skeletal muscle homeostasis. Testosterone is a potent anabolic factor promoting muscle protein synthesis and muscular regeneration...
2017: Advances in Experimental Medicine and Biology
Mario Mascalchi, Gianna Camiciottoli, Stefano Diciotti
Lung densitometry assesses with computed tomography (CT) the X-ray attenuation of the pulmonary tissue which reflects both the degree of inflation and the structural lung abnormalities implying decreased attenuation, as in emphysema and cystic diseases, or increased attenuation, as in fibrosis. Five reasons justify replacement with lung densitometry of semi-quantitative visual scales used to measure extent and severity of diffuse lung diseases: (I) improved reproducibility; (II) complete vs. discrete assessment of the lung tissue; (III) shorter computation times; (IV) better correlation with pathology quantification of pulmonary emphysema; (V) better or equal correlation with pulmonary function tests (PFT)...
September 2017: Journal of Thoracic Disease
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