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Acute exacerbation of chronic obstructive lung disease

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
Theerasuk Kawamatawong, Jitsupa Onnipa, Thitiporn Suwatanapongched
Background: The prevalence rate of bronchiectasis in COPD is variable. Coexisting bronchiectasis and COPD may influence COPD severity and exacerbation. Objective: We investigated whether bronchiectasis is associated with frequent or severe COPD exacerbation. Lower airway bacterial and mycobacterial infections are a possible mechanism for bronchiectasis. Materials and methods: A cross-sectional study was conducted in 2013-2014. COPD exacerbations and hospitalizations were reviewed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Whittney A Warren, Domingo Franco-Palacios, Christopher S King, Oksana A Shlobin, Steven D Nathan, Shalika B Katugaha, Haresh Mani, A Whitney Brown
A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation...
March 2018: Chest
Karen L Osman, Johanna M Jefferies, Christopher H Woelk, David W Cleary, Stuart C Clarke
Non-typeable Haemophilus influenzae (NTHi) is an opportunistic pathogen of the respiratory tract and the greatest contributor to invasive Haemophilus disease. Additionally, in children, NTHi is responsible for the majority of otitis media (OM) which can lead to chronic infection and hearing loss. In adults, NTHi infection in the lungs is responsible for the onset of acute exacerbations in chronic obstructive pulmonary disease (COPD). Unfortunately, there is currently no vaccine available to protect against NTHi infections...
February 8, 2018: Expert Review of Anti-infective Therapy
Ashraf Fawzy, Nirupama Putcha, Laura M Paulin, Carrie P Aaron, Wassim W Labaki, MeiLan K Han, Robert A Wise, Richard E Kanner, Russell P Bowler, R Graham Barr, Nadia N Hansel
BACKGROUND: Thrombocytosis has been associated with COPD prevalence and increased all-cause mortality in patients with acute exacerbation of COPD (AECOPD); but whether it is associated with morbidity in stable COPD is unknown. This study aims to determine the association of thrombocytosis with COPD morbidity including reported AECOPD, respiratory symptoms and exercise capacity. METHODS: Participants with COPD were included from two multi-center observational studies (SPIROMICS and COPDGene)...
January 26, 2018: Respiratory Research
Jinyung Ju
BACKGROUND: The pathophysiology of chronic obstructive pulmonary disease (COPD) includes inflammation, oxidative stress, an imbalance of proteases and antiproteases and apoptosis which has been focused on lately. Abnormal apoptotic events have been demonstrated in both epithelial and endothelial cells, as well as in inflammatory cells including neutrophils and lymphocytes in the lungs of COPD patients. An increased propensity of activated T lymphocytes to undergo apoptosis has been observed in the peripheral blood of COPD patients...
January 24, 2018: Tuberculosis and Respiratory Diseases
Xia Wei, Zhengquan Ma, Nan Yu, Jingting Ren, Chenwang Jin, Jiuyun Mi, Meijuan Shi, Libin Tian, Yanzhong Gao, Youmin Guo
Purpose: COPD is a heterogeneous disease, and the available prognostic indexes are therefore limited. This study aimed to identify the factors associated with acute exacerbation leading to hospitalization. Patients and methods: This was a retrospective study of consecutive patients with COPD (meeting the Global Initiative for Chronic Obstructive Lung Disease [GOLD] diagnostic criteria) hospitalized at the Ninth Hospital of Xi'an Affiliated Hospital of Xi'an Jiaotong University between October 2014 and September 2016...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Anne Gedebjerg, Szimonetta Komjáthiné Szépligeti, Laura-Maria Holm Wackerhausen, Erzsébet Horváth-Puhó, Ronald Dahl, Jens Georg Hansen, Henrik Toft Sørensen, Mette Nørgaard, Peter Lange, Reimar Wernich Thomsen
BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification separates the spirometric 1-4 staging from the ABCD groups defined by symptoms and exacerbations. Little is known about how this new classification predicts mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to establish the predictive ability of the GOLD 2017 classification, compared with earlier classifications, for all-cause and respiratory mortality, both when using its main ABCD groups and when further subdividing according to spirometric 1-4 staging...
January 10, 2018: Lancet Respiratory Medicine
Prem Parkash Gupta, Manjunath B Govidagoudar, Rohtas Yadav, Dipti Agarwal
PURPOSE: The present study aimed at clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease (COPD) to anticipate future exacerbations. METHODS: The study included 80 COPD patients; 40 patients had ≥2 acute exacerbations during preceding 1 year (frequent exacerbation [FECOPD] group) and 40 patients had <2 acute exacerbations during preceding 1 year (infrequent exacerbation [I-FECOPD] group). Clinical profile, sputum microbiology, blood gas analysis, spirometric indices, and diffusion capacity (transfer test) variables were assessed...
January 2018: Lung India: Official Organ of Indian Chest Society
Gopi C Khilnani, Pawan Tiwari
PURPOSE OF REVIEW: The review describes current status of air pollution in India, summarizes recent research on adverse health effects of ambient and household air pollution, and outlines the ongoing efforts and future actions required to improve air quality and reduce morbidity and mortality because of air pollution in India. RECENT FINDINGS: Global burden of disease data analysis reveals more than one million premature deaths attributable to ambient air pollution in 2015 in India...
January 2, 2018: Current Opinion in Pulmonary Medicine
Fernando Sergio Leitao Filho, Nawaf M Alotaibi, Kei Yamasaki, David A Ngan, Don D Sin
The use of beta-blockers in chronic obstructive pulmonary disease (COPD) is controversial, primarily due to concerns that they may worsen lung function and attenuate bronchodilator response. Areas covered: This review summarizes the reasons for and against the use of beta-blockers in COPD by evaluating the literature on the effects of these drugs on lung function, exacerbation rate, and mortality. The safety of beta-blockers in COPD patients with concomitant heart failure, an entity that is not always distinguishable from COPD exacerbations, is also explored...
February 2018: Expert Review of Respiratory Medicine
Melvin Berger, Bob Geng, D William Cameron, Ladonna M Murphy, Edward S Schulman
BACKGROUND: More than half of all primary immune deficiency diseases (PIDD) affect antibody production and are well known as causes of recurrent sinusitis and lung infections. Chronic and recurrent infections of the upper and/or lower airways can contribute to inflammatory and obstructive processes in the lower airways which are initially reversible and considered "asthma", but can eventually cause irreversible remodeling and chronic obstructive pulmonary disease (COPD). Conversely, several lines of evidence suggest that many patients who present with a diagnosis of asthma have an increased incidence of infection, suggesting underlying host-defense defects...
November 2017: Respiratory Medicine
Qun Wu, Di Jiang, Niccolette R Schaefer, Laura Harmacek, Brian P O'Connor, Thomas Eling, Oliver Eickelberg, Hong Wei Chu
Human rhinovirus (HRV) is the most common virus contributing to acute exacerbations of chronic obstructive pulmonary disease (COPD) nearly year-round, but the mechanisms have not been well elucidated. Recent clinical studies suggest that high levels of growth differentiation factor 15 (GDF15) protein in the blood are associated with an increased yearly rate of all-cause COPD exacerbations. Therefore, in the current study, we investigated whether GDF15 promotes HRV infection and virus-induced lung inflammation...
November 30, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
Xia Yang, Bo Huo, Xiaoning Zhong, Wenyan Su, Wenting Liu, Yumei Li, Zhiyi He, Jing Bai
Human regulatory T cells (Tregs) have been reported to be not significantly different in the peripheral blood of patients with chronic obstructive pulmonary disease (COPD) and healthy controls. Recent research has identified some new markers for Tregs and indicated that Tregs are composed of distinct subpopulations. The aim of the study was to describe the changing patterns of circulating Treg subpopulations in patients with acute exacerbation of COPD (AECOPD) and healthy controls, and to explore their potential roles in AECOPD pathogenesis...
December 2017: COPD
Lina Sun, Yahong Chen, Rui Wu, Ming Lu, Wanzhen Yao
Purpose: To investigate how the changes of definition in assessment of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stratification 2017 lead to changes of chronic obstructive pulmonary disease (COPD) patient clinical characteristics across categories in China. Patients and methods: COPD patients from 11 medical centers in China were stratified into old and new groups A-D twice according to the GOLD 2011 and 2017 comprehensive assessment. Demography and clinical characteristics were compared between old and new groups A-D...
2017: International Journal of Chronic Obstructive Pulmonary Disease
Uğur Durmuş, Nurettin Özgür Doğan, Murat Pekdemir, Serkan Yılmaz, Elif Yaka, Adnan Karadaş, Seda Güney Pınar
BACKGROUND: Lactate and lactate clearance are being used as biomarkers in several critical conditions. The aim of this study was to examine the value of sixth hour lactate clearance in patients who were hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations. METHODS: This single-center, cross-sectional study was conducted in a tertiary emergency department (ED) on patients who presented with acute exacerbation of COPD. Discharge or admission decisions were specified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and the clinician's decision...
November 4, 2017: American Journal of Emergency Medicine
Parvaiz A Koul, Hilal A Dar, Rafi A Jan, Sanaullah Shah, Umar Hafiz Khan
OBJECTIVES: Data about long-term mortality of Indian patients following acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are scant. We set out to study the 2-year mortality in north Indian patients following discharge after AECOPD. MATERIALS AND METHODS: One hundred and fifty-one (96 male) patients admitted for AECOPD and discharged were followed for 2 years at 3, 6, 12, 18, and 24 months for mortality. Statistical analysis was performed to identify risk factors associated with mortality...
November 2017: Lung India: Official Organ of Indian Chest Society
Carlos H Martinez, Alejandro A Diaz, Catherine A Meldrum, Merry-Lynn N McDonald, Susan Murray, Gregory L Kinney, John E Hokanson, Jeffrey L Curtis, Russell P Bowler, MeiLan K Han, George R Washko, Elizabeth A Regan
RATIONALE: Handgrip strength (HGS) predicts mortality in the elderly, but its determinants and clinical significance in chronic obstructive pulmonary disease (COPD) has not been defined. OBJECTIVES: We tested associations of HGS with pectoralis muscle area (PMA), subcutaneous adipose tissue (SAT), imaging characteristics, and lung function in smokers with COPD, and evaluated the cross-sectional and longitudinal associations of HGS with acute respiratory events. METHODS: We analyzed demographic, clinical, spirometry, HGS, and imaging data of 272 subjects with COPD, obtaining measures of airway thickness, emphysema, PMA, and SAT from chest computed tomography scans...
November 2017: Annals of the American Thoracic Society
Q L Zeng, X M Wang, S N Li, B Xiong, M Jian, G Huang, Y Q Wu, X H Wang, J Li, F Q Wen, H Zhou
Objective: To investigate the prevalence and clinical characteristics of peripheral blood eosinophilia (EOS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: From July 2014 to June 2016, AECOPD patients in the Department of Respiratory Medicine of Affiliated Hospital of Chengdu University, were retrospectively stratified into two groups according to two standards of eosinophilic exacerbations (the peripheral blood eosinophil count ≥2% or ≥3% on admission). Demography, clinical symptoms, laboratory results, length of stay, total hospitalization expenses, and defined daily expenses were compared between groups...
October 31, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kirstin E Brown, Don D Sin, Helen Voelker, John E Connett, Dennis E Niewoehner, Ken M Kunisaki
BACKGROUND: Bilirubin is a potent anti-oxidant and higher serum concentrations of bilirubin have been associated with better lung function, slower lung function decline, and lower incidence of chronic obstructive pulmonary disease (COPD). We sought to determine whether elevated bilirubin blood concentrations are associated with lower risk for acute exacerbations of COPD (AECOPD). METHODS: We performed a secondary analyses of data in the Simvastatin for Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE) and the Azithromycin for Prevention of Exacerbations of COPD (MACRO) studies...
October 24, 2017: Respiratory Research
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