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Sample records for weight losing copd

  1. Losing Baby Weight

    Science.gov (United States)

    ... Exercise is a key component of a healthy lifestyle before, during and after pregnancy. After pregnancy, most women can start exercising as ... the skinny jeans. Focus on living a healthy lifestyle, and the rest will fall into place. More tips ... or between pregnancies Nutrition, weight & fitness Prenatal ...

  2. Fat-free mass change after nutritional rehabilitation in weight losing COPD: role of insulin, C-reactive protein and tissue hypoxia

    Directory of Open Access Journals (Sweden)

    Simonetta Baldi

    2010-02-01

    Full Text Available Simonetta Baldi, Roberto Aquilani, Gian Domenico Pinna, Paolo Poggi, Angelo De Martini, Claudio BruschiDepartment of Pneumology and Biomedical Engineering, Scientific Institute of Montescano, Salvatore Maugeri Foundation I.R.C.C.S. Pavia, ItalyBackground: Fat-free mass (FFM depletion marks the imbalance between tissue protein synthesis and breakdown in chronic obstructive pulmonary disease (COPD. To date, the role of essential amino acid supplementation (EAAs in FFM repletion has not been fully acknowledged. A pilot study was undertaken in patients attending pulmonary rehabilitation.Methods: 28 COPD patients with dynamic weight loss > 5% over the last 6 months were randomized to receive EAAs embedded in a 12-week rehabilitation program (EAAs group n = 14, or to the same program without supplementation (C group n = 14. Primary outcome measures were changes in body weight and FFM, using dual X-ray absorptiometry (DEXA.Results: At the 12th week, a body weight increment occurred in 92% and 15% of patients in the EAAs and C group, respectively, with an average increase of 3.8 ± 2.6 kg (P = 0.0002 and −0.1 ± 1.1 kg (P = 0.81, respectively. A FFM increment occurred in 69% and 15% of EAAs and C patients, respectively, with an average increase of 1.5 ± 2.6 kg (P = 0.05 and −0.1 ± 2.3 kg (P = 0.94, respectively. In the EAAs group, FFM change was significantly related to fasting insulin (r2 0.68, P < 0.0005, C-reactive protein (C-RP (r2 = 0.46, P < 0.01, and oxygen extraction tension (PaO2x (r2 = 0.46, P < 0.01 at end of treatment. These three variables were highly correlated in both groups (r > 0.7, P < 0.005 in all tests.Conclusions: Changes in FFM promoted by EAAs are related to cellular energy and tissue oxygen availability in depleted COPD. Insulin, C-RP, and PaO2x must be regarded as clinical markers of an amino acid-stimulated signaling to FFM accretion.Keywords: COPD, pulmonary rehabilitation, branched chain amino acids, insulin, systemic

  3. What It Takes to Lose Weight

    Science.gov (United States)

    ... Limit time spent online, watching TV, and playing video games to less than two hours total per day. ... Tags: diet, losing weight, nutrition, obesity, overweight, patient education, patient information, weight, weight control, weight-loss programs ...

  4. Healthy weight game!: Lose weight together

    NARCIS (Netherlands)

    Lentelink, S.J.; Spil, Antonius A.M.; Broens, T.; Broens, T.H.F.; Hermens, Hermanus J.; Jones, Valerie M.

    2013-01-01

    Overweight and obesity pose a serious and increasing problem worldwide. Current treatment methods can result in weight loss in the short term but often fail in the longer term. Increasing motivation and thereby improving adherence can be a key factor in achieving the needed behavioral change. One

  5. Foods That Help You Lose Weight

    Institute of Scientific and Technical Information of China (English)

    刘伟业

    1995-01-01

    "There are no magic foods," says Kelly Streit,health-education instructor at Kaiser Permanente Medical Care Program in Portland,Ore. "But there are foods that, because of their taste, texture or density, can help you lose weight. " That’s the idea behind the following foods, which trick your body into feeling satisfied with far less fat and fewer calories than it’s used to.

  6. Vegetarian Diet: Will It Help Me Lose Weight?

    Science.gov (United States)

    ... Lifestyle Weight loss If I switch to a vegetarian diet, will I lose weight? Answers from Katherine Zeratsky, R.D., L.D. Not necessarily. A vegetarian diet is not inherently a weight-loss diet, ...

  7. Have Americans Given Up on Losing Weight?

    Science.gov (United States)

    ... and the media need to do a better job emphasizing the importance of maintaining a healthy weight. ... that." SOURCES: Jian Zhang, M.D., DrPH, associate professor, epidemiology, Georgia Southern University, Statesboro, Ga.; Mitchell Roslin, ...

  8. Mushroom Processing Retaining Colour Without Losing Weight

    OpenAIRE

    Gormley, T. R. (Thomas Ronan); Walshe, P.E.

    1986-01-01

    Processed mushrooms must be blanched so that they will retain an acceptable white colour. However,. This can lead to a weight loss of between 20 and 30 per cent, which is bad economy for the processor. Research at Kinsealy Research Centre has come up with some solution for this problem. Breading of unblanched mushrooms prior to freezing is one. Another successful technique is to treat mushrooms with xanthan gum prior to blanching in the case of frozen or canned mushrooms.

  9. Learning to Lose: Weight Loss Classes and Personal Transformation

    Science.gov (United States)

    Jarvis, Christine

    2012-01-01

    Adult learning takes place not only in educational organisations, but through participation in leisure and special interest groups. Commercially operated weight management organisations recruit large numbers of adults to their classes to learn how to eat healthily and lose weight. They publish readers' "real life" success stories in their…

  10. Learning to Lose: Weight Loss Classes and Personal Transformation

    Science.gov (United States)

    Jarvis, Christine

    2012-01-01

    Adult learning takes place not only in educational organisations, but through participation in leisure and special interest groups. Commercially operated weight management organisations recruit large numbers of adults to their classes to learn how to eat healthily and lose weight. They publish readers' "real life" success stories in their…

  11. The ambivalence of losing weight after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Christine Warholm

    2014-01-01

    Full Text Available This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women's experiences, a meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change. This consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience.

  12. Can't wait to lose weight? Characterizing temporal discounting parameters for weight-loss.

    Science.gov (United States)

    Lim, Seung-Lark; Bruce, Amanda S

    2015-02-01

    Obesity is often related to steeper temporal discounting, that is, higher decision impulsivity for immediate rewards over delayed rewards. However, previous studies have measured temporal discounting parameters through monetary rewards. The aim of this study was to develop a temporal discounting measure based on weight-loss rewards, which may help to understand decision-making mechanisms more closely related to body weight regulation. After having their heights and weights measured, healthy young adults completed the Monetary Choice Questionnaire (MCQ), and an adapted version of the MCQ, with weight-loss as a reward. Participants also completed self-reports that measure obesity-related cognitive variables. For 42 participants who expressed a desire to lose weight, weight-loss rewards were discounted over time and had a positive correlation with temporal discounting for monetary rewards. Higher temporal discounting for weight loss rewards (i.e., preference for immediate weight loss) showed correlations with beliefs that obesity is under obese persons' control and largely due to lack of willpower, while temporal discounting parameters for monetary rewards did not. Taken together, our weight loss temporal discounting measure demonstrated both convergent and divergent validity, which can be utilized for future obesity research and interventions.

  13. 'Obesity Gene' Doesn't Affect Ability to Lose Weight: Report

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161090.html 'Obesity Gene' Doesn't Affect Ability to Lose Weight: ... 21, 2016 (HealthDay News) -- Having the so-called "obesity gene" doesn't affect people's ability to shed ...

  14. Attempts to lose weight among overweight and non-overweight adolescents: a cross-national survey

    Directory of Open Access Journals (Sweden)

    Tynjälä Jorma

    2007-10-01

    Full Text Available Abstract Background Despite the global obesity epidemic, few studies have performed cross-national comparisons of adolescents' attempts to lose weight and weight control practices. This study aims to investigate matters mentioned above by weight status in Europe, Israel, and North America. Methods Nationally representative samples of adolescents from over 30 countries completed an anonymous, standardized questionnaire as part of the Health Behaviour in School-aged Children 2001/2002 survey. The prevalence and likelihood of attempts to lose weight were determined. The effect of weight status, self-perception of overweight, age and country of residence upon the likelihood of current attempts to lose weight were evaluated using multilevel multivariate logistic regression in separate analyses for boys and girls. The study also presented the prevalence of weight control practices of overweight and non-overweight adolescents who had controlled their weight in seven countries. Results In general, overweight and obese adolescents were more likely to be engaged in current attempts to lose weight and had tried to control their weight during the past 12 months more often than non-overweight adolescents. Besides weight status, self-perception of overweight and age were significant individual-level factors determining current attempts to lose weight. Country of residence was a significant second-level factor but no clear geographical pattern was found. Several gender-related differences existed. Conclusion The findings indicated that most overweight adolescents were motivated to reduce their weight. The importance of promoting a healthy body image for all adolescents was highlighted by the fact that self-perception of overweight was found to be the most important factor leading to attempts to lose weight.

  15. Weight loss expectations and body dissatisfaction in young women attempting to lose weight.

    Science.gov (United States)

    Siervo, M; Montagnese, C; Muscariello, E; Evans, E; Stephan, B C M; Nasti, G; Papa, A; Iannetti, E; Colantuoni, A

    2014-04-01

    Unrealistic weight loss expectations (WLEs) and greater body dissatisfaction may be associated with the poor long-term outcomes of dietary and lifestyle weight loss treatments. We evaluated the association between body size, WLEs and body dissatisfaction in young women attempting to lose weight. Forty-four young healthy women [age range 18-35 years, body mass index (BMI) range 23-40 kg/m2] were recruited. Women were classified as obese (BMI ≥ 30.0 kg/m2) and non-obese (BMI social (career, family acceptance, peer acceptance, mass media, social pressure) factors. Individual WLEs were compared with recommended clinical targets (5%, 10% and 20%) for weight loss. Body dissatisfaction was lower in non-obese subjects and was directly associated with BMI (P media, whereas they perceived that family and friends were supportive of a lesser degree of weight loss. We observed a mismatch between clinical and personal expectations, and social pressure and interpersonal relationships appear to have a prominent role with respect to influencing the association. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  16. Do patients lose weight after total knee replacement?

    National Research Council Canada - National Science Library

    Schwartsmann, Carlos Roberto; Borges, Alexandre Moreira; Freitas, Geraldo Luiz Schuck de; Migon, Eduardo Zaniol; Oliveira, Gustavo Kaempf de; Rodrigues, Marcos Wainberg

    2017-01-01

    ...) tend to maintain or gain weight after the procedure, which would result in increased wear of the prosthesis and new surgical interventions in a smaller period of time in comparison with patients...

  17. Associations of Trying to Lose Weight, Weight Control Behaviors, and Current Cigarette Use among US High School Students

    Science.gov (United States)

    Johnson, Jonetta L.; Eaton, Danice K.; Pederson, Linda L.; Lowry, Richard

    2009-01-01

    Background: Approximately one-quarter of high school students currently use cigarettes. Previous research has suggested some youth use smoking as a method for losing weight. The purpose of this study was to describe the association of current cigarette use with specific healthy and unhealthy weight control practices among 9th-12th grade students…

  18. The bid to lose weight: impact of social media on weight perceptions, weight control and diabetes.

    Science.gov (United States)

    Das, Leah; Mohan, Ranjini; Makaya, Tafadzwa

    2014-01-01

    Over the last decade the internet has come to permeate every aspect of our lives. With huge leaps in accessibility of the internet via mobile personal devices such as smart cellular phones and tablets, individuals are connected to the internet virtually all the time. It is no surprise therefore that social media now dominates the lives of many people within society. The authors take a look at how social media is influencing diabetes with particular focus on weight perception, weight management and eating behaviours. The authors explore the concept of how the advertising of Size 0 models and photo-shopping of images which are easily available on line and via social media is causing an increase in the number of young people with distorted body images. This has led to an increased number of people resorting to sometimes drastic weight loss programmes. We focus on the bid for 'low-fat' consumption and highlight how this could actually be leading to an increased risk for developing diabetes or worsening the complications of diabetes. We also discuss the increase of eating disorder in diabetes related to this distorted body image.

  19. COPD

    Science.gov (United States)

    COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate ...

  20. Trying to lose weight among non-overweight university students from 22 low, middle and emerging economy countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2015-01-01

    The aim of this study was to assess the prevalence of trying to lose weight among non-overweight in university students and its sociodemographic and behavioural factors from 22 low and middle income and emerging economy countries. In a cross-sectional survey we took anthropometric measurements and used a self-administered questionnaire among 15997 undergraduate university students (mean age 20.8, Standard deviation=2.8, age range of 16-30 years) from 22 universities in 22 countries. Body mass index (BMI) was used for weight status. Results indicate that 27.1% non-overweight students were trying to lose weight, 34.6% among women and 16.5% among men. Among underweight or normal weight students, 19.0% perceived themselves to be overweight, 11.3% were dieting to lose weight, and 53.5% considered to lose weight of high importance. Multivariate logistic regression found that being female, coming from a low income country, the perception of being overweight, high importance of losing weight, dieting to lose weight, trying to eat fibre, and avoiding foods with fat and cholesterol were associated with trying to lose weight in non-overweight university students. The study found a high prevalence of weight control practices and several specific risk factors were identified that can be utilized in interventions to target unhealthy weight control measures.

  1. Adaptive thermogenesis can make a difference in the ability of obese individuals to lose body weight.

    Science.gov (United States)

    Tremblay, A; Royer, M-M; Chaput, J-P; Doucet, E

    2013-06-01

    The decrease in energy expenditure that occurs during weight loss is a process that attenuates over time the impact of a restrictive diet on energy balance up to a point beyond which no further weight loss seems to be possible. For some health professionals, such a diminished energy expenditure is the normal consequence of a progressive decrease in the motivation to exercise over the course of a weight-reducing program. Another explanation of decreased energy needs during weight loss is the decrease in body energy stores (that is, fat mass and muscle mass) and its related obligatory costs of living. Many studies have also documented the existence of adaptive thermogenesis in the context of weight loss, which represents a greater-than-predicted decrease in energy expenditure. In this paper, we pursue the analysis of this phenomenon by demonstrating that an adaptive decrease in thermogenesis can have a major role in the occurrence of resistance to further lose fat in weight-reduced obese individuals. Evidence is also presented to support the idea of greater hunger sensations in individuals displaying more pronounced thermogenic changes. Finally, as the decrease in thermogenesis persists over time, it is also likely associated with a greater predisposition to body-weight regain after weight loss. Globally, these observations suggest that the adaptive reduction in thermogenesis that accompanies a prolonged negative energy balance is a major determinant of the ability to spontaneously lose body fat.

  2. Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community.

    Science.gov (United States)

    Pappa, Gisele Lobo; Cunha, Tiago Oliveira; Bicalho, Paulo Viana; Ribeiro, Antonio; Couto Silva, Ana Paula; Meira, Wagner; Beleigoli, Alline Maria Rezende

    2017-01-16

    Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes received per post, and topics discussed

  3. Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community

    Science.gov (United States)

    Ribeiro, Antonio; Couto Silva, Ana Paula; Meira Jr, Wagner

    2017-01-01

    Background Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. Objective We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. Methods A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. Results We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes

  4. Who will lose weight? A reexamination of predictors of weight loss in women

    Directory of Open Access Journals (Sweden)

    Barata José T

    2004-08-01

    Full Text Available Abstract Background The purpose of this study was to analyze pretreatment predictors of short-term weight loss in Portuguese overweight and obese women involved in a weight management program. Behavioral and psychosocial predictors were selected a priori from previous results reported in American women who participated in a similar program. Methods Subjects were 140 healthy overweight/obese women (age, 38.3 ± 5.9 y; BMI, 30.3 ± 3.7 kg/m2 who participated in a 4-month lifestyle weight loss program consisting of group-based behavior therapy to improve diet and increase physical activity. At baseline, all women completed a comprehensive behavioral and psychosocial battery, in standardized conditions. Results Of all starting participants, 3.5% (5 subjects did not finish the program. By treatment's end, more than half of all women had met the recomended weight loss goals, despite a large variability in individual results (range for weight loss = 19 kg. In bivariate and multivariate correlation/regression analysis fewer previous diets and weight outcome evaluations, and to a lesser extent self-motivation and body image were significant and independent predictors of weight reduction, before and after adjustment for baseline weight. A negative and slightly curvilinear relationship best described the association between outcome evaluations and weight change, revealing that persons with very accepting evaluations (that would accept or be happy with minimal weight change lost the least amount of weight while positive but moderate evaluations of outcomes (i.e., neither low nor extremely demanding were more predictive of success. Among those subjects who reported having initiated more than 3–4 diets in the year before the study, very few were found to be in the most successful group after treatment. Quality of life, self-esteem, and exercise variables did not predict outcomes. Conclusions Several variables were confirmed as predictors of success in short

  5. Eating and Psychological Profiles of Women with Higher Depressive Symptoms Who Are Trying to Lose Weight

    Directory of Open Access Journals (Sweden)

    C. Bégin

    2012-01-01

    Full Text Available The aim of this study was to determine whether women with higher depressive symptoms differed from women with lower depressive symptoms on early weight-loss, eating behaviors and psychological profiles. Among a sample of 45 overweight/obese women who had undertaken a self-initiated weight-loss attempt, two groups were formed based on scores from the Beck Depression Inventory (BDI-II, one with lower depressive symptoms (BDI-II < 10; n=21 and one with higher depressive symptoms (BDI ≥ 10; n=24. Even if some women in the higher depressive symptom group did not reach the clinical cut-off for depression (BDI = 14, this group tended to lose less weight in the first two months of their weight-loss attempt and to show a more disturbed eating and psychological profile compared to the group with lower depressive symptoms. In addition, among women with higher depressive symptoms, eating and psychological variables were systematically related to one another whereas these variables were not related among the other group. Results highlight the relevance of considering the presence of depressive symptoms as a marker of clinical severity among the overweight/obese population, and suggest that the BDI-II could be an interesting screening instrument to identify this particular subgroup.

  6. Dilemmas in the process of weight reduction: Exploring how women experience training as a means of losing weight

    Directory of Open Access Journals (Sweden)

    Karen Synne Groven

    2010-04-01

    Full Text Available Patients diagnosed with obesity are usually offered group-based behavior interventions which include dietary advice and exercise programs. In particular, high-intensity training—combining weight lifting with aerobic exercising—has been proven effective for losing weight. Moreover, recent studies have shown that persons participating in high-intensity training are more likely to maintain their weight loss compared to persons with lower levels of physical activity. However, most of the research in the field has made use of quantitative methods focusing on the measurable effect of such interventions. Therefore, the aim of this study was to show how the training is experienced from a first-person perspective, namely the patients themselves. Our hope was to shed some new light on the process of weight loss that concerns more than the measurable “impacts” of the training. A qualitative approach was used based on interviews with five women selected from a primary healthcare clinic in Norway. Our results show that experiences of training are connected to the participants’ general experience of being overweight. Both relationships to other people and earlier experiences are important for how the training is carried out and perceived. Five themes were identified supporting this line of argument: (1 the gaze of others; (2 a common ground; (3 dependence of close-follow up; (4 bodily discomfort as painful; and (5 aiming for results—an ambivalent experience. The results highlight the importance of finding the proper context and support for each patient's needs.

  7. Do more specific plans help you lose weight? Examining the relationship between plan specificity, weight loss goals, and plan content in the context of a weight management programme.

    Science.gov (United States)

    Dombrowski, Stephan U; Endevelt, Ronit; Steinberg, David M; Benyamini, Yael

    2016-11-01

    The conditions under which planning for behaviour change is most effective are not fully understood. In the context of a weight management programme, we examined the interrelationship between plan specificity, type of behaviour planned (diet vs. exercise), and weight loss goals. Prospective design and content analysis of plans formed by participants of a 10-week weight management programme. Participants (n = 239) formulated two plans, for dietary and exercise behaviours, respectively. Plans were rated for specificity by examining the number of plan components. Weight loss goals were assessed by asking how much weight participants intend to lose. Weight was measured objectively each of the 10 weeks. Changes in body mass index (BMI) over time and the interactions between plan specificity and weight loss goals, for all plans and separately for diet and exercise, were estimated using linear mixed models. Plan specificity was unrelated to weight loss, but interacted with weight loss goals in predicting linear change in BMI (t = -2.48): More specific plans were associated with higher decreases in weight in participants with high weight loss goals. Separate interaction tests for plans formulated for diet and exercise change showed that more specific dietary plans, but not exercise plans, were associated with higher decreases in weight in participants with high weight loss goals (t = -2.21). Within a population that is highly motivated to lose weight, the combination of high weight loss goals and formulating detailed plans for changing dietary behaviours may be most effective in supporting weight loss. Statement of contribution What is already known on this subject? More specific plans are associated with increased performance of health-related behaviours. More motivated individuals form more specific plans. The interrelationship between plan specificity, plan content and behaviour-related goals in relation intervention effectiveness has not been explored to date

  8. Dietary Conjugated Linoleic Acid (CLA) increases milk yield without losing body weight in lactating sows.

    Science.gov (United States)

    Lee, Sung-Hoon; Joo, Young-Kuk; Lee, Jin-Woo; Ha, Young-Joo; Yeo, Joon-Mo; Kim, Wan-Young

    2014-01-01

    This study was conducted to evaluate the effects of dietary conjugated linoleic acid (CLA) on the performance of lactating sows and piglets as well as the immunity of piglets suckling from sows fed CLA. Eighteen multiparous Duroc sows with an average body weight (BW) of 232.0 ± 6.38 kg were randomly selected and assigned to two dietary treatments (n = 9 for each treatment), control (no CLA addition) and 1% CLA supplementation. For the control diet, CLA was replaced with soybean oil. Experimental diets were fed to sows during a 28-day lactation period. Litter size for each sow was standardized to nine piglets by cross-fostering within 24 hours after birth. Sow milk and blood samples were taken from sows and piglets after 21 and 27 days of lactation, respectively. Loss of BW was significantly (p sows fed control diet compared to sows fed CLA diet. Piglet weights at weaning and weight gain during suckling were significantly (p sows fed CLA compared to sows fed control diet. Serum non-esterified fatty acid (NEFA) and urea nitrogen concentrations were significantly (p sows fed CLA than in sows fed soybean oil. IgG concentrations of the groups supplemented with CLA increased by 49% in sow serum (p Sows fed CLA showed an increase of 10% in milk yield compared with sows fed soybean oil (p sows fed CLA than in sows fed soybean oil. Solid-not-fat yield was significantly (p sows supplemented with CLA than in sows fed control diet and also protein-to-fat ratio in milk was significantly (p sows fed CLA compared with the control group. The results show that CLA supplementation to sows increased milk yield without losing BW during lactation, whereas soybean oil supplementation resulted in severe BW loss.

  9. Barriers to Lose Weight from the Perspective of Children with Overweight/Obesity and Their Parents: A Sociocultural Approach

    OpenAIRE

    Ana Lilia Rodríguez-Ventura; Ingris Pelaez-Ballestas; Reyna Sámano-Sámano; Carlos Jimenez-Gutierrez; Carlos Aguilar-Salinas

    2014-01-01

    Introduction. There are not enough studies about the barriers to lose weight from the perspective of children and their parents. Methods. Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10–16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorde...

  10. Effects of obesity on weight-bearing versus weight-supported exercise testing in patients with COPD.

    Science.gov (United States)

    Maatman, Robbert C; Spruit, Martijn A; van Melick, Paula P; Peeters, Jos P I; Rutten, Erica P A; Vanfleteren, Lowie E G W; Wouters, Emiel F M; Franssen, Frits M E

    2016-04-01

    Obesity is associated with increased dyspnoea and reduced health status in patients with chronic obstructive pulmonary disease (COPD). Studies on the effects of obesity on exercise capacity showed divergent results. The objective of this study is to investigate the impact of obesity on weight-bearing versus weight-supported exercise tolerance in obese and normal weight patients, matched for age, gender and degree of airflow limitation. Retrospective analyses of data obtained during pre-pulmonary rehabilitation assessment in 108 obese COPD patients (OB) (age: 61.2 ± 5.3y, FEV1 : 43.2 ± 7.4%, BMI: 34.1 ± 3.9 kg/m(2) ,) and 108 age and FEV1 -matched normal weight COPD patients (NW) (age: 61.7 ± 3.6y, FEV1 : 41.5 ± 8.4%, BMI: 22.9 ± 1.2 kg/m(2) ,). Cardiopulmonary exercise test (CPET) and 6 min walk test (6MWT) were performed, Borg scores for dyspnoea and leg fatigue were recorded, before and after the tests. Six-minute walk distance differed between OB (398 ± 107 m) and NW patients (446 ± 109 m, P exercise load was comparable (OB: 75 ± 29 W, NW: 70 ± 25 W, ns). Dyspnoea (OB 3.2 ± 2.0 vs NW 3.1 ± 1.7, ns) and leg fatigue (OB 2.4 ± 2.3 vs NW 1.9 ± 1.7, ns) were not significantly different in OB compared with NW after 6MWT, or after CPET (dyspnoea: OB 5.1 ± 2.4 vs NW 5.4 ± 2.2, ns; leg fatigue: OB 4.0 ± 2.3 vs NW 4.0 ± 2.7, ns). In contrast to weight-supported exercise, obesity has a negative impact on weight-bearing exercise capacity, despite comparable exercise-related symptoms. The results of this study enhance the understanding of the impact of obesity on physical performance in COPD. © 2015 Asian Pacific Society of Respirology.

  11. Depressive and anxiety disorders : Associated with losing or gaining weight over 2 years?

    NARCIS (Netherlands)

    de Wit, Leonore M.; van Straten, Annemieke; Lamers, Femke; Cuijpers, Pim; Penninx, Brenda W. J. H.

    2015-01-01

    This longitudinal study examines to what extent different depressive and anxiety disorders and clinical characteristics are associated with subsequent weight change, while controlling for baseline weight, sociodemographics, health status, psychotropic medication use and (un)healthy lifestyle factors

  12. Obese patients lose weight independently of nutritional follow-up after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Beatriz Helena Tess

    2015-04-01

    Full Text Available Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil. Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195 of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%. Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18. Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00. Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

  13. Losing Weight on Reality TV: A Content Analysis of the Weight Loss Behaviors and Practices Portrayed on The Biggest Loser.

    Science.gov (United States)

    Klos, Lori A; Greenleaf, Christy; Paly, Natalie; Kessler, Molly M; Shoemaker, Colby G; Suchla, Erika A

    2015-01-01

    A number of weight loss-related reality television programs chronicle the weight loss experience of obese individuals in a competitive context. Although highly popular, such shows may misrepresent the behavior change necessary to achieve substantial weight loss. A systematic, quantitative content analysis of Seasons 10-13 (n = 66 episodes) of The Biggest Loser was conducted to determine the amount of time and number of instances that diet, physical activity, or other weight management strategies were presented. The average episode was 78.8 ± 15.7 min in length. Approximately 33.3% of an episode, representing 1,121 segments, portrayed behavioral weight management-related content. Within the episode time devoted to weight management content, 85.2% was related to physical activity, 13.5% to diet, and 1.2% to other. Recent seasons of The Biggest Loser suggest that substantial weight loss is achieved primarily through physical activity, with little emphasis on modifying diet and eating behavior. Although physical activity can impart substantial metabolic health benefits, it may be difficult to create enough of an energy deficit to induce significant weight loss in the real world. Future studies should examine the weight loss attitudes and behaviors of obese individuals and health professionals after exposure to reality television shows focused on weight loss.

  14. Dieting to lose weight and occurrence of neural tube defects in offspring of Mexican-American women.

    Science.gov (United States)

    Suarez, Lucina; Felkner, Marilyn; Brender, Jean D; Canfield, Mark A

    2012-05-01

    Lowered maternal weight gain and reduction in early pregnancy have been associated with risk of neural tube defects (NTDs) in offspring. We examined the association of self-reported maternal dieting behaviors on the occurrence of NTDs. We conducted a population based case-control study among Mexican-American women who were residents of the 14 Texas counties bordering Mexico. Case women had an NTD-affected pregnancy identified at birth or prenatally and had deliveries during the years 1995-2000. Control women were those who delivered live born infants without an apparent congenital malformation, randomly selected and frequency-matched to cases by year and facility. One hundred eighty-four case women and 225 control women were asked in person about the use of nutritional supplements, dieting to lose weight, and type of weight reduction supplements used during the 3 months before conception. Women who reported being on a diet to lose weight during the 3 months before conception had an NTD odds ratio (OR) of 1.9 (95% confidence interval (CI) = 1.1, 3.3) compared with those not reporting being on a diet. Neither consuming vitamin drinks (OR = 1.2) nor using diet pills (OR = 1.6) during the 3 months before conception had ORs that were different from the null, when compared to women not reporting those behaviors. The risk effect for dieting did not differ markedly among normal or underweight (OR = 2.0, 95% CI = 0.7, 5.6), overweight (OR = 1.9, 95% CI = 0.7, 5.0), or obese women (OR = 1.5, 95% CI = 0.6, 4.0). No effect was seen among dieting women who were consuming at least 1.0 mg/day of folate (OR = 1.1, CI = 0.3, 4.5). Maternal dieting prior to conception may increase the risk of NTDs in offspring.

  15. African American women exhibit similar adherence to intervention but lose less weight due to lower energy requirements.

    Science.gov (United States)

    DeLany, J P; Jakicic, J M; Lowery, J B; Hames, K C; Kelley, D E; Goodpaster, B H

    2014-09-01

    African American (AA) women have been shown to lose less weight than Caucasian women in response to behavioral interventions. Our objective was to examine adherence to intervention and metabolic factors that may explain this difference. We examined longitudinal changes in body weight and energy expenditure (EE), and objective assessment of physical activity (PA) and energy intake (EI) during 6 months of a weight-loss intervention program, including prescribed calorie restriction and increased PA in 66 Caucasian and 39 AA severely obese women. Comparisons were also made in 25 Caucasian and 25 AA women matched for initial body weight. The AA women lost 3.6 kg less weight than Caucasian women. Total daily EE (TDEE) and resting metabolic rate (RMR) adjusted for fat free mass (FFM) were significantly lower in the AA women, whereas the decrease in RMR in response to weight loss was greater in Caucasian women. Adherence to the prescribed PA and change in PA in response to intervention were similar in AA and Caucasian women. Prescribed EI (1794±153 and 1806±153 kcal per day) and measured EI during intervention (2591±371 vs 2630±442 kcal per day) were nearly identical in matched AA and Caucasian women. However, the AA women lost significantly less body weight due to lower energy requirements (2924±279 vs 3116±340 kcal per day; Pweight loss. Therefore, to achieve similar weight loss in AA women, the prescribed caloric restriction cannot be based on weight alone, but must be lower than in Caucasians, to account for lower energy requirements.

  16. Who is counseled to lose weight? Survey results and anthropometric data from 3,149 lower socioeconomic women.

    Science.gov (United States)

    Breitkopf, Carmen Radecki; Egginton, Jason S; Naessens, James M; Montori, Victor M; Jatoi, Aminah

    2012-02-01

    Because obesity is a grave public health concern, this study examined the percentage of disadvantaged women who recalled ever having received weight loss advice from a healthcare provider and factors associated with such advice. This study was part of a 5-clinic, cervical cancer prevention trial. Patients not immediately post-partum completed a Spanish/English survey; height and weight were also obtained. Of the 3,149 respondents (response rate 83%), 2,138 (68%) were overweight or obese (body mass index (BMI) ≥ 25); 94% reported a household income of <$35,000/year; 69% were Hispanic; 10% non-Hispanic black; and 40% completed the survey in Spanish. Only one-third reported ever having been told to lose weight. Based on BMI, these rates were 15% in the 25-29.9 range (overweight); 34% within 30-34.9; 57% within 35-39.9; and 73% ≥ 40. In univariate analyses, among overweight women, diabetes or English-speaking was associated with weight loss advice. In multivariate analyses, being older, more educated, and diabetic were associated with such advice. 48% of non-Hispanic whites, 31% of non-Hispanic blacks, and 29% of Hispanic had a home scale. Among disadvantaged women, obesity alone does not determine who recalls weight loss advice. Language barriers and lack of a home scale merit further study to address obesity.

  17. Assessing Readiness to Lose Weight among Obese Women Attending the Nutrition Clinic

    Directory of Open Access Journals (Sweden)

    Fatemeh Ghannadiasl

    2014-07-01

    Full Text Available Background: Assessing individual’s readiness to change and targeting the intervention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05. Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change orientates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes.

  18. "Lose ten lbs in two weeks" Motivation for weight loss affects autobiographical memory in dieters

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    to dieting related cue words by the dieting group were more self defining, scored higher on the Centrality of Event Scale and contained more body and weight related elements. No differences between the two groups were found on memories recalled in response to the neutral cue words. The dieting group scored...

  19. A Losing Battle: Weight Regain Does Not Restore Weight Loss-Induced Bone Loss in Postmenopausal Women

    Science.gov (United States)

    Villalon, Karen L.; Gozansky, Wendolyn S.; Van Pelt, Rachael E.; Wolfe, Pam; Jankowski, Catherine M.; Schwartz, Robert S.; Kohrt, Wendy M.

    2013-01-01

    Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m2. They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (−1.7 ± 3.5%; P = 0.002) and hip (−0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (−0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: −3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss. PMID:21852813

  20. Losing weight to save lives: A review of the role of automobile weight and size in traffic fatalities

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Marc; Wenzel, Tom

    2001-07-01

    Critics of higher fuel economy standards for vehicles have long argued that improving vehicle fuel economy will require reducing vehicle weight, and that would result in an increase in the number of fatalities from vehicle crashes. Several researchers have estimated that an across-the-board reduction of vehicle weight would reduce passenger safety (Evans 1991; Kahane 1997; U.S. GAO 1994). However, little research has been done on the relationship of vehicle size and fatality rates, independent of weight (see, however, Joksch, Massie, and Pichler 1998). In this report we review previous analyses of the relationship of vehicle weight and safety. We do this to study the opportunities to improve fuel economy in a more sophisticated way than across-the-board mass reduction. The aim is to explore improvements in traffic safety by making selected vehicle groups lighter, and retaining or enlarging selected vehicle dimensions. Unfortunately, the effects of size and mass have not been accurately separated in the crash fatality data, so some of our claims are only supported by general arguments from physics. In a follow-up report we will attempt to analyze crash fatality data to determine crash worthiness if the weight of certain vehicle groups would be decreased while maintaining or increasing vehicle size. The first section of this report provides an introduction to fatal vehicle crashes in the United States. We summarize several trends in automotive crash statistics over the last 20 years. Then we discuss approaches analysts have taken in studying factors that affect ''exposure'', the likelihood of being involved in a serious crash. In Section 2 we discuss standardized crash tests and the basic physics of crashes. We review previous research on the effect of vehicle mass in two-vehicle crashes in Section 3. We also present new research on reductions in risk achieved by recent light vehicles. Section 4 presents previous estimates of the effect of

  1. Evaluation of effect of acarbose consumption on weight losing in non-diabetic overweight or obese patients in Kerman

    Directory of Open Access Journals (Sweden)

    Akram Nakhaee

    2013-01-01

    Full Text Available Background: High prevalence of obesity and the importance of this issue as a risk factor for chronic diseases such as severe cardiovascular diseases, diabetes, and cancer necessitate the need for treatment. The aim of this study was the evaluation of acarbose effect on the weight loss in non diabetic overweight or obese patients in Kerman. Materials and Methods: A double blind randomized controlled clinical trial was performed on 66 patients with the body mass index (BMI between 25 and 35 kg/m2. Patients were divided in treatment and control groups using the randomization. The treatment group took 100 mg acarbose 3 times a day for 20 weeks in combination with the low calorie diet and exercise. Control group was given placebo, low calorie diet, and exercise. BMI was measured after 20 weeks. The analyses were carried out using t test and repeated measured ANOVA. Results: Patients in acarbose and placebo group had a non significant difference in BMI at baseline. Reducing in weight was considered in every month in both groups, but this reduction was higher in the treatment group. At the 5th month, the difference of BMI in the treatment group was significantly lower than the placebo group (2.31 ± 0.6 vs. 0.76 ± 0.6 kg/m2, P < 0.001. Conclusion: Acarbose, especially in combination with the low calorie diet and exercise, seems to lose weight effectively in obese and overweight patients in communities that have a high carbohydrate intake (like Persian diet.

  2. Barriers to lose weight from the perspective of children with overweight/obesity and their parents: a sociocultural approach.

    Science.gov (United States)

    Rodríguez-Ventura, Ana Lilia; Pelaez-Ballestas, Ingris; Sámano-Sámano, Reyna; Jimenez-Gutierrez, Carlos; Aguilar-Salinas, Carlos

    2014-01-01

    There are not enough studies about the barriers to lose weight from the perspective of children and their parents. Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10-16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV) about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food.

  3. Barriers to Lose Weight from the Perspective of Children with Overweight/Obesity and Their Parents: A Sociocultural Approach

    Directory of Open Access Journals (Sweden)

    Ana Lilia Rodríguez-Ventura

    2014-01-01

    Full Text Available Introduction. There are not enough studies about the barriers to lose weight from the perspective of children and their parents. Methods. Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD. Twenty-nine children 10–16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. Results. Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. Conclusions. The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food.

  4. Barriers to Lose Weight from the Perspective of Children with Overweight/Obesity and Their Parents: A Sociocultural Approach

    Science.gov (United States)

    Rodríguez-Ventura, Ana Lilia; Pelaez-Ballestas, Ingris; Sámano-Sámano, Reyna; Jimenez-Gutierrez, Carlos; Aguilar-Salinas, Carlos

    2014-01-01

    Introduction. There are not enough studies about the barriers to lose weight from the perspective of children and their parents. Methods. Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10–16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. Results. Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV) about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. Conclusions. The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food. PMID:25371816

  5. Inter-relationships between single carbon units' metabolism and resting energy expenditure in weight-losing patients with small cell lung cancer. Effects of methionine supply and chemotherapy

    DEFF Research Database (Denmark)

    Sengeløv, H; Hansen, O P; Simonsen, L;

    1994-01-01

    The one-carbon unit metabolism was investigated in 8 weight-losing patients with small cell carcinoma of the lung (SCLC). At diagnosis, 6 of the 8 patients had elevated formiminoglutamic acid (FIGLU) excretion after a histidine load, suggesting a lack of one-carbon units. In accordance, a signifi...

  6. Large and forgotten in rural Australia: assessment, attitudes and possible approaches to losing weight in young adult males.

    Science.gov (United States)

    Mendis, Kumara; Forster, Tanya; Paxton, Karen; Hyland, Karen; Yelverton, Jason; McLean, Rick; Canalese, Joseph; Brown, Anthony; Steinbeck, Katharine

    2014-03-11

    Young Adult Males (YAMs) in rural Australia are poorly studied with respect to overweight and obesity. Firstly, we explored the feasibility of recruiting 17-25 year old YAMs to obtain baseline data on overweight and obesity rates, socio-demographics, nutrition, exercise and mobile phone usage. Secondly, we explored the views of YAMs with a waist measurement over 94 cm about using mobile phone text messages to promote weight loss and incentives to promote healthy lifestyles. A two-staged, mixed-methods approach was used to study obesity and overweight issues in Dubbo, a regional city in New South Wales, Australia. In Phase I, socio-demographic, health behaviour and mobile phone usage data were collected using a questionnaire and anthropometric data collected by direct measurement. In Phase II, YAMs' views were explored by focus group discussion using a semi-structured questionnaire. Phase I (145 participants): mean Body Mass Index (BMI) 25.06±5.01; mean waist circumference 87.4±15.4 cm. In total, 39.3% were obese (12.4%) or overweight (26.9%) and 24.1% had an increased risk of metabolic complications associated with obesity. 135 (93.1%) owned a mobile phone and sent on average 17±25 text messages per day and received 18±24. Phase II (30 participants): YAMs acknowledged that overweight and obesity was a growing societal concern with many health related implications, but didn't feel this was something that affected them personally at this stage of their lives. Motivation was therefore an issue. YAMs admitted that they would only be concerned about losing weight if something drastic occurred in their lives. Text messages would encourage and motivate them to adopt a healthy lifestyle if they were individually tailored. Gym memberships, not cash payments, seem to be the most favoured incentive. There is a clear need for an effective health promotion strategy for the almost 40% overweight or obese Dubbo YAMs. The high rate of text message usage makes it feasible to

  7. Inter-relationships between single carbon units' metabolism and resting energy expenditure in weight-losing patients with small cell lung cancer. Effects of methionine supply and chemotherapy

    DEFF Research Database (Denmark)

    Sengeløv, H; Hansen, O P; Simonsen, L

    1994-01-01

    The one-carbon unit metabolism was investigated in 8 weight-losing patients with small cell carcinoma of the lung (SCLC). At diagnosis, 6 of the 8 patients had elevated formiminoglutamic acid (FIGLU) excretion after a histidine load, suggesting a lack of one-carbon units. In accordance, a signifi......The one-carbon unit metabolism was investigated in 8 weight-losing patients with small cell carcinoma of the lung (SCLC). At diagnosis, 6 of the 8 patients had elevated formiminoglutamic acid (FIGLU) excretion after a histidine load, suggesting a lack of one-carbon units. In accordance...... pretreatment FIGLU excretion and REE, although the REE measured in this group of patients was within the normal range. These data demonstrate an increased demand of "active" one-carbon units in energy consumption in a group of weight-losing cancer patients. The one-carbon unit deficit was reconditioned by oral......, a significant decrease of FIGLU excretion was observed in the patients after oral administration of DL-methionine for 4 days. The elevated FIGLU excretion was positively correlated to weight loss prior to diagnosis and negatively correlated to serum albumin at time of diagnosis. After 3 months of combination...

  8. Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

    Directory of Open Access Journals (Sweden)

    Sherman Scott

    2010-06-01

    Full Text Available Abstract Background Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change. Methods We conducted post-visit surveys with obese patients to assess physician's use of 5As counseling techniques and the overall patient-centeredness of the physician.. Patients also reported on their motivation to lose weight and their intentions to eat healthier and exercise. One-way ANOVAs were used to describe mean differences in number of counseling practices across levels of self-rated intention and motivation. Logistic regression analyses were conducted to assess associations between number of 5As counseling practices used and patient intention and motivation. Results 137 patients of 23 physicians were included in the analysis. While 85% of the patients were counseled about obesity, physicians used only a mean of 5.3 (SD = 4.6 of 18 possible 5As counseling practices. Patients with higher levels of motivation and intentions reported receiving more 5As counseling techniques than those with lower levels. Each additional counseling practice was associated with higher odds of being motivated to lose weight (OR 1.31, CI 1.11-1.55, intending to eat better (OR 1.23, CI 1.06-1.44, and intending to exercise regularly (OR 1.14, CI 1.00-1.31. Patient centeredness of the physician was also positively associated with intentions to eat better (OR 2.96, CI 1.03-8.47 and exercise (OR 26.07, CI 3.70-83.93. Conclusions Quality of physician counseling (as measured using the 5As counseling framework and patient-centeredness scales was associated with motivation to lose weight and intentions to change behavior. Future studies should determine whether higher quality obesity

  9. On Basic Contents and Training Methods of Exercising to Lose Weight%论运动减肥的基本内容与方法

    Institute of Scientific and Technical Information of China (English)

    张天熙

    2013-01-01

    Obesity refers to the phenomenon that subcutaneous fat in the human body exceeds the standard problem,but it is not completely a weight problem.Of course,often taking part in physical exercise can effectively control and change their body shape,also can keep a standard weight.Many methods and means can be used to lose weight,such as controlling diet and the steam bath,but com-prehensive physical exercise is the main way to lose weight.%肥胖是指人体的皮下脂肪超标问题,而不完全是体重问题。当然经常参加体育运动可以有效地控制和改变自身的身体形态,同时也能保持一个标准体重。减肥的方法和手段较多,如控制和节制饮食和蒸汽浴等,但身体的综合性练习是减肥的主要途径。

  10. COPD Medicine

    Science.gov (United States)

    ... Education & Training Home Treatment & Programs Medications COPD Medications COPD Medications Make an Appointment Ask a Question Refer ... control the symptoms of chronic obstructive pulmonary disease (COPD). Most people with COPD take long-acting medicine ...

  11. Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement.

    Science.gov (United States)

    Barber, M D; McMillan, D C; Preston, T; Ross, J A; Fearon, K C

    2000-04-01

    Weight-losing patients with advanced cancer often fail to gain weight with conventional nutritional support. This suboptimal response might be explained, in part, by an increased metabolic response to feeding. It has been suggested that eicosapentaenoic acid (EPA) can modify beneficially the metabolic response to cancer. The aim of the present study was to examine the metabolic response to feeding in cancer and the effects of an EPA-enriched oral food supplement on this response. A total of 16 weight-losing, non-diabetic patients with unresectable pancreatic adenocarcinoma and six healthy, weight-stable controls were studied by indirect calorimetry in the fasting and fed states. Body composition was estimated by bioimpedence analysis. Cancer patients were then given a fish-oil-enriched nutritional supplement providing 2 g of EPA and 2550 kJ daily, and underwent repeat metabolic study after 3 weeks of such supplementation. At baseline, resting energy expenditure whether expressed per kg body weight, lean body mass or body cell mass was significantly greater in the cancer patients compared with controls. Fat oxidation was significantly higher in the fasting state in cancer patients [median 1.26 g.kg(-1).min(-1) (interquartile range 0.95-1.38)] than in controls [0.76 g.kg(-1). min(-1) (0.62-0.92); Pfeeding period, changes in insulin and glucose concentrations in cancer patients suggested relative glucose intolerance. In response to oral meal feeding, the percentage change in the area under the curve of energy expenditure was significantly lower in the cancer patients [median 7.9% (interquartile range 3.4-9.0)] than in controls [12.6% (9.9-15.1); Ppatients had increased and the energy expenditure in response to feeding had risen significantly [9.6% (6. 3-12.4)], such that it was no different from baseline healthy control values. Similarly, fasting fat oxidation fell to 1.02 g. kg(-1).min(-1) (0.8-1.18), again no longer significantly different from baseline healthy

  12. Weight losing, antihyperlipidemic and cardioprotective effects of the alkaloid fraction of Hunteria umbellata seed extract on normal and triton-induced hyperlipidemic rats

    Institute of Scientific and Technical Information of China (English)

    Adejuwon; Adewale; Adeneye; Peter; Anthony; Crooks

    2015-01-01

    Objective: To investigate the weight losing, antihyperlipidemic and cardioprotective effects of the alkaloid fraction of Hunteria umbellata(H. umbellata) seed.Methods: Adult female Wistar rats(weight range: 120-150 g) were randomly divided into 4 and 5 treatment groups in the normal and triton-induced hyperlipidemic models, respectively. and were daily treated for 14 d before they were humanely sacrificed under inhaled diethyl ether anesthesia. About 5 mL of whole blood was obtained by cardiac puncture from each treated rat, from which serum for lipids assay was subsequently separated. Tissue samples of livers of treated rats were harvested and processed for histopathological analysis.Results: Repeated daily oral treatments of normal rats with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata resulted in significant(P<0.05 and P<0.001) and dose-dependent weight loss, and decreases in the serum triglyceride, total cholesterol and low density lipoprotein cholesterol, while significantly(P<0.001) increased the serum levels of high density lipoprotein cholesterol fraction. Similarly, oral pre-treatments with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata for 14 d before induction of hyperlipidemia with triton WR-1339 significantly(P<0.01, P<0.001) and dose-dependently attenuated increases in the average body weights, serum levels of triglyceride, total cholesterol and low density lipoprotein cholesterol while also significantly(P<0.01, P<0.001) and dose-dependently attenuated significant(P<0.001) decrease in the serum high-density lipoproteincholesterol levels when compared to the untreated control values. However, the results obtained for 50 mg/kg of alkaloid fraction of H. umbellata in both normal and triton WR-1339-induced hyperlipidemic rats were comparable to that recorded for 20 mg/kg of simvastatin. Similarly, oral pretreatments with 25 and 50 mg/kg/day of alkaloid fraction of H. umbellata significantly improved the histological lesions of fatty

  13. Sex-specific effect of body weight gain on systemic inflammation in subjects with COPD: results from the SAPALDIA cohort study 2.

    Science.gov (United States)

    Bridevaux, P-O; Gerbase, M W; Schindler, C; Dietrich, D Felber; Curjuric, I; Dratva, J; Ackermann-Liebrich, U; Probst-Hensch, N M; Gaspoz, J-M; Rochat, T

    2009-08-01

    Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (COPD) and extrapulmonary comorbidities. We measured high-sensitivity C-reactive protein (hs-CRP) in COPD and quantified the effect modification by body weight change and sex. Using data from the Swiss study on Air Pollution and Lung Diseases in Adults (SAPALDIA; n = 5,479) with measurements of forced expiratory volume in 1 s (FEV(1)), body weight and hs-CRP, we examined the association of hs-CRP and categories of body weight change (lost weight and weight gained 0-5%, 5-9%, 9-14% and >14%) with fast FEV(1) decline. hs-CRP was elevated both in association with fast FEV(1) decline and body weight gain. Subjects with fast FEV(1) decline and weight gain (>14%) had higher hs-CRP (2.0 mg L(-1) for females versus 1.6 mg L(-1) for males). After adjustment for age, smoking, physical activity, hormonal therapy and diabetes, elevated hs-CRP (>3 mg) was found to be more likely in subjects with fast FEV(1) decline (OR(males) 1.38, OR(females) 1.42) and in those with weight gain >14% (OR(males) 2.04, OR(females) 4.51). The association of weight gain and fast FEV(1) decline predicts a higher level of systemic inflammation. Since the effect of weight gain on systemic inflammation is larger in females than in males, weight gain may be a risk factor for extrapulmonary comorbidities in females with COPD.

  14. Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Erkurt, E.; Tunali, C. [Cukurova University Medical Faculty, Dept. of Radiation Oncology, Balcali-Adana (Turkey); Erkisi, M. [Cukurova University Medical Faculty, Dept. of Medical Oncology (Turkey)

    2000-12-01

    The reversal of anorexia and weight loss especially in patients with advanced cancer suffering from radiation treatment (RT) -related complications and debilitated further during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with megestrol acetate (MA) in the weight-losing cancer patients increasingly experiencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT plus or minus chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. >From June 1997 to October 1998, 100 eligible patients were enrolled on a randomized, placebo-controlled clinical trial. Of the 100 patients, 46 received MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or change for each parameter of malnutrition, appetite, taste and smell developed by the researchers. At the end of the study a statistically significant weight gain was achieved in the patient group receiving MA compared to the placebo group (+ 3 to + 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen in performance status (p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compared to the placebo group. In the MA group there was no statistically significant difference related to the weight changes according to the grade of either the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the acute and late RT effects was detected on weight loss (p=0.008 and 0.007, respectively). It was observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects

  15. Biological analysis in the low-intensity aerobic exercise to lose weight%中低强度有氧运动减肥的生物学分析

    Institute of Scientific and Technical Information of China (English)

    王明阳

    2012-01-01

    that the causes of obesity,the mechanism of low-intensity aerobic exercise to lose weight in the analysis, implementation of scientific,health,weight loss to provide a theoretical basis for the weight loss crowd.%指出肥胖产生的原因,分析中低强度有氧运动减肥的机理,为减肥人群实施科学、健康减肥提供理论依据。

  16. Resistance Training With Ankle Weight Cuffs Is Feasible in Patients With Acute Exacerbation of COPD

    DEFF Research Database (Denmark)

    Kofod, Linette Marie; Døssing, Martin; Steentoft, Johnna;

    2017-01-01

    PURPOSE: Quadriceps muscle weakness is a serious complication of physical inactivity following hospitalization due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Preventing strength loss during AECOPD is therefore a high priority. We aimed to evaluate the feasibility...... of progressive knee-extension resistance training, using ankle weight cuffs on patients with AECOPD, based on prespecified criteria for feasibility. METHODS: Thirty-four patients (18 men, mean age 74 years, forced expiratory volume in 1 second = 33% predicted) with AECOPD participated in daily knee......-extension strength training. During training, the patients were seated on the bedside and performed 3 sets of 10-repetition maximum loads, using ankle weight cuffs. The primary outcome was the change in load from the first to last training sessions. The secondary outcomes were changes in maximal isometric knee...

  17. Eating Well and Losing Weight

    Science.gov (United States)

    ... Problems & Solutions for Being Active - FAQs About Physical Activity Managing Your Medicines - Introduction - Taking Control of Your Medicines - Medicine Assistance Programs - Medicine Checklist - Medication Tracker Communicating with Professionals - Introduction - Preparing for Medical Visits - ...

  18. Weight-related attitudes and behaviors of women who diet to lose weight: a comparison of black dieters and white dieters.

    Science.gov (United States)

    Striegel-Moore, R H; Wilfley, D E; Caldwell, M B; Needham, M L; Brownell, K D

    1996-03-01

    Obesity is a significant health problem among black women in the United States. Black women are two to three times more likely than white women to be obese. The present study sought to examine race difference in attitudes and beliefs about dieting, motivations underlying dieting efforts, and actual dieting strategies and behaviors. To achieve this aim, a subset of female survey respondents (n = 324) was drawn from a pool of more than 20,000 subscribers to Consumer Reports. All survey respondents had made at least one dieting effort within 3 years of the time of the study. For this study, we used all black female respondents (n = 162) and a matched sample (i.e., matched on age, educational attainment, and personal income) of white women (n = 162). Black women did weigh significantly more than Caucasian women, therefore, BMI was used as a covariate in all subsequent analyses. Black and white women were significantly different in a number of domains. Compared to white women, black women experienced less social pressure about their weight, initiated dieting later in life, and were significantly less likely to diet at each developmental milestone. However, the two groups of women did not differ in reasons for undertaking their most recent dieting efforts, or in the types of weight loss strategies they had employed. Nor were there differences between the black and white women in methods for coping responses with dietary relapse or in rates of disordered eating. These findings are discussed in terms of their implications for both treatment and prevention of obesity in black women.

  19. COPD - control drugs

    Science.gov (United States)

    Chronic obstructive pulmonary disease - control drugs; Bronchodilators - COPD - control drugs; Beta agonist inhaler - COPD - control drugs; Anticholinergic inhaler - COPD - control drugs; Long-acting inhaler - COPD - ...

  20. 吴克明教授治疗节食减肥后闭经经验介绍%Brief Introduction to Professor WU Keming′s Experience on Treatment of Amenorrhea after Losing Weight by Dieting

    Institute of Scientific and Technical Information of China (English)

    敖荣娜; 罗娟; 李晶晶; 吴克明

    2013-01-01

    从典型病例入手介绍吴克明教授运用中西医两法诊治减肥后闭经的临床经验,以期为相关临床研究提供参考.%We are discussing professor WU Keming's experience of treating amenorrhea after losing weight with western medicine and traditional Chinese medicine through analyzing classic cases, aiming to provide reference for associated clinical study.

  1. Protein-losing enteropathy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007338.htm Protein-losing enteropathy To use the sharing features on this page, please enable JavaScript. Protein-losing enteropathy is an abnormal loss of protein ...

  2. The "Biggest Loser" Expounds on the Benefits of Losing Pounds

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Special Section The "Biggest Loser" Expounds on the Benefits of Losing Pounds Past Issues / Winter 2008 ... 186 pounds, going from 361 to 175 pounds. The Twins on Losing Weight Bill: "The only way ...

  3. Effect of dry and cold environment on the weight and diet of COPD rats%寒燥对慢性阻塞性肺疾病模型大鼠体质量及饮食量的影响

    Institute of Scientific and Technical Information of China (English)

    高振; 李风森; 荆晶; 徐丹; 哈木拉提·吾甫尔

    2012-01-01

    目的:揭示寒燥对慢性阻塞性肺疾病(COPD)模型大鼠体质量及饮食量的影响,为西北特点COPD防治措施的制定提供参考.方法:利用气管滴注弹性蛋白酶结合熏烟建立COPD模型大鼠36只,在此基础上复合寒燥应激建立COPD寒燥模型18只,并设立对照组13只,每只大鼠的体质量和每组大鼠饮食量结果用SPSS 11.5分析.结果:COPD组及COPD寒燥组体质量指数(BMI)和Lee's指数均小于对照组(P<0.01),且COPD寒燥组此3项指标均小于COPD组(P<0.05,P<0.01).COPD寒燥组每10g体质量每天进食量大于对照组和COPD组.结论:寒燥可以加剧并提前COPD模型体质量减轻和营养不良的症状,并增加进食量,但此状态非仅靠增加一般饮食可以改善.%Objective: To reveal the effect of cold and dry environment on weight and diet of the COPD model, so as to provide reference for treating COPD with local peculiarity of the northwest of China. Methods: COPD model was established by dripping porcine pancreatic elastase (PEE) in trachea combination with cigarette smoking, and model of cold dryness syndrome in northwest China of COPD was also set up by dripping PEE in trachea in combination with cigarette smoking for cold-dry environmental stress. SPSS11.5 were used to analysis rat's weight and diet. Results: the weight of COPD cold and dryness group was less than the COPD group, less than the control group; for Lee's index, and BMI COPD cold and dryness group was more than the COPD group, more than the control group. Conclusion: Cold and dryness can ahead of the weight loss and malnutrition and increase food intake, but this state can't be improved only by increasing the general diet.

  4. Reflections on reducing insulin to lose weigh.

    Science.gov (United States)

    Wilson, Val

    Diabulimia is not a recognised medical condition, although it is thought to affect one-third of women with type 1 diabetes. Diabulimia involves deliberately omitting or reducing insulin dosages to lose weight. This article reports the reflections of women with long-duration type 1 diabetes who said that they had manipulated their insulin in the past to lose weight. Many were now dealing with serious heart and neuropathic complications, which they felt were a result of their diabulimia.

  5. 女大学生减肥行为及其认知现状调查与分析%Investigation and analysis of female college students' losing-weight behaviors and their cognitive status

    Institute of Scientific and Technical Information of China (English)

    姚红梅; 刘云霞; 郭璇; 廖侠; 宋戈; 鲜瑶; 李卫敏

    2015-01-01

    目的 了解女大学生对肥胖及减肥的认知状况及减肥行为,指导肥胖者科学减肥、健康减肥. 方法 采用分层整群抽样方法对西安某高校1~3年级300名女大学生进行问卷调查,内容主要包括对肥胖及减肥知识的认知情况,减肥实施情况、减肥效果和产生的不良反应等3个方面,并对结果进行分析. 结果 在300名女大学生中有30.39%为过轻体重,66.78%为标准体重;大部分女大学生对自己的期望体质量指数( BMI)小于实际数值,对减肥知识的认知相对片面,实际平均BMI值为19.53 ± 1.97kg/m2,期望平均BMI值为17.44 ±1.42kg/m2,两者比较有显著性差异(t=14.907,P<0.001),实际BMI分布与期望BMI分布比较有显著性差异(χ2 =152.205,P<0.001);有53.36%的女大学生实施过减肥行为,主要方式为调整饮食结构(60.26%)、节食(19.21%)、运动(4.64%);减肥女大学生中有56.95%的人在减肥过程中出现了不良反应. 结论 女大学生对自身体重及体型认识不正确,存在盲目减肥情况,学校和社会应加大对肥胖知识的宣传和减肥行为引导,避免盲目减肥行为的发生.%Objective To know female college students' cognitive status of obesity and weight loss and their losing-weight behaviors, so as to provide scientific guidance for their scientific and healthy weight loss.Methods A questionnair survey was conducted among 300 female college students from freshmen to juniors of one university in Xi' an selected by stratified sampling and cluster sampling.The main contents of the questionnaire mainly included cognition on obesity, weight loss knowledge, practice of losing-weight, effect of losing-weight and adverse reactions of losing-weight.Results Among the 300 female college students, 30.39%were underweight and 66.78% had standard body weight.Most of the female students' expectation on their body mass index ( BMI) was smaller than actual BMI, and their cognition on knowledge of weight loss

  6. How Is COPD Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is COPD Diagnosed? Your doctor will diagnose COPD based on ... Rate This Content: NEXT >> Featured Video What is COPD? 05/22/2014 Describes how COPD, or chronic ...

  7. How Is COPD Treated?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is COPD Treated? COPD has no cure yet. However, lifestyle ... Rate This Content: NEXT >> Featured Video What is COPD? 05/22/2014 Describes how COPD, or chronic ...

  8. Altered hepatic gluconeogenesis during L-alanine infusion in weight-losing lung cancer patients as observed by phosphorus magnetic resonance spectroscopy and turnover measurements

    NARCIS (Netherlands)

    S. Leij-Halfwerk (Susanne); J.W.O. van den Berg (Willem); P.E. Sijens; M. Oudkerk (Matthijs); P.C. Dagnelie (Pieter); J.H.P. Wilson (Paul)

    2000-01-01

    textabstractProfound alterations in host metabolism in lung cancer patients with weight loss have been reported, including elevated phosphomonoesters (PMEs) as detected by 31P magnetic resonance spectroscopy (MRS). In healthy subjects, infusion of L-alanine induced sign

  9. How to Lose Fat

    Institute of Scientific and Technical Information of China (English)

    A. Maxwell; 钱俊

    2005-01-01

    Here is yet another article about losing body fat. The Interact is riddled with such articles, Some propose complex diets; others give worth while valuable advice and most are trying to sell something.

  10. NIH Loses a Friend

    Science.gov (United States)

    ... page please turn Javascript on. NIH Loses a Friend Past Issues / Fall 2009 Table of Contents Donald ... changingthefaceofmedicine/ . Sincerely, Donald West King, M.D., Chairman Friends of the National Library of Medicine Let Us ...

  11. 调经1号治疗减肥引起闭经临床观察%Amenorrhea Which Caused by Losing Weight is Treated with TiaoJing 1th 7 Observation

    Institute of Scientific and Technical Information of China (English)

    喻佳

    2011-01-01

    闭经为妇科常见病、多发病,近些年来因减肥引发的闭经患者更是越来越多,治疗难度较大.导师梁学林教授承袭前人"经水出诸于肾"的观点,认为过度减肥脾胃功能低下,气血生化无源,日久累及肾脏,肾精亏虚,冲任失调,血海不能按时满溢而致闭经.在治疗上主张"补后天以养先天",自拟调经1号,随证加减.笔者有幸随师应诊,收集典型病例7例进行临床观察,分析如下.%For the department of gynecology common disease, frequently-occurring disease amenorrhea, in recent years for weight loss caused by the patient is more and more, which is difficult to cure.Professor LIANG Xue-lin approves the predecessor's viewpoint “the menstruation is from the kidney”,she thinks that amenorrhea because of losing weight are first with deficiency of the spleen, then inadequacy of Qi-blood supply and transference of the sickness from the spleen to kidney. Desfunction of Chong and Ren Channels, the bloodshed loses the department is he pathogenesis. In treatment she advocates “the acquiredness nourishing the innateness” and usually takes Tiao. Jing lth, increasing and decreasing some traditional medicine according symptoms. I have the pooprtunity to examine along with the teacher, collect 7cases of amenorrhea on the c1inical observation. Now, I will summarize my teacher's experience as follow.

  12. Treatment of stable COPD: antioxidants

    Directory of Open Access Journals (Sweden)

    W. MacNee

    2005-09-01

    Full Text Available There is considerable evidence that an increased oxidative burden occurs in the lungs of patients with chronic obstructive pulmonary disease (COPD and this results in an imbalance between oxidants/antioxidants or oxidative stress, which may play a role in many of the processes involved in the pathogenesis of COPD. These include enhanced proteolytic activity, mucus hypersecretion and the enhanced inflammatory response in the lungs to inhaling tobacco smoke, which is characteristic of COPD. COPD is now recognised to have multiple systemic consequences, such as weight loss and skeletal muscle dysfunction. It is now thought that oxidative stress may extend beyond the lungs and is involved in these systemic effects. Antioxidant therapy therefore would seem to be a logical therapeutic approach in chronic obstructive pulmonary disease. There is a need for more potent antioxidant therapies to test the hypothesis that antioxidant drugs may be a new therapeutic strategy for the prevention and treatment of chronic obstructive pulmonary disease.

  13. What Causes COPD?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes COPD? Long-term exposure to lung irritants that damage ... Rate This Content: NEXT >> Featured Video What is COPD? 05/22/2014 Describes how COPD, or chronic ...

  14. Smoking and COPD

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000696.htm Smoking and COPD To use the sharing features on this page, ... enable JavaScript. Smoking is the leading cause of COPD. Smoking is also a trigger for COPD flare- ...

  15. Effect of Apple Pomace Polyphenol on Weight Losing and Lipid Lowing in High-lipid Rats%苹果渣多酚对高脂大鼠减肥降脂影响

    Institute of Scientific and Technical Information of China (English)

    葛蕾

    2013-01-01

      研究苹果渣多酚对高脂大鼠体重及血清中脂代谢水平的影响。将大鼠随机分为5组,除正常对照组外,其余4组给予高脂饲料,建立高脂大鼠模型。高脂大鼠连续灌喂苹果渣多酚28 d后,观察大鼠体重、内脏脂肪、血脂变化。苹果渣多酚能显著降低高脂大鼠体重、TG、TC和LDL-C含量,明显提升HDL-C含量。苹果渣多酚对高脂大鼠具有减肥降脂作用。%  To observe the effect of apple pomace polyphone on weigh and lipid metabolism in high-lipid rats. Totally 50 rats were randomly divided into 5 groups.Four groups were fed with high fat diet except for the normal control group.The high-lipid rats were administered by gavage continually with apple pomace polyphone for 28 days,and then the body weights, instrnal organs fat and serum lipid levels of rats were measured. Apple pomace polyphone could obviously reduce the body weights of rats,the contents of TG、TC and LDL-C.In contrast,it could also improve HDL-C in serum. Apple pomace polyphone have effective function of losing weight and lowing serum lipid of high-lipid rats.

  16. How Can I Lose Weight Safely?

    Science.gov (United States)

    ... have when they overeat or whether they have unhealthy habits. Your doctor or nutritionist can give you pointers on how to do this. Eat less more often. Many people find that eating a couple of small snacks throughout the day ...

  17. Caffeine: Can It Help Me Lose Weight?

    Science.gov (United States)

    ... drinks and colas; in products containing cocoa or chocolate; and in a variety of medications and dietary ... thermogenesis and energy intake. European Journal of Clinical Nutrition. 2009;63:57. Harpaz E, et al. The ...

  18. 对体育专业女生单纯性肥胖减肥运动处方的个案研究%The Case Study on Losing Weight Exercise Prescription used by Female Physical Education Simple Obesity Student

    Institute of Scientific and Technical Information of China (English)

    唐申艳

    2014-01-01

    Taking the form of case study , in view of the presently female students , this paper develops targeted scientific exercise prescription; Movement of Excellsoftware to deal with the experimental data , the data comparison before and after the experiment conclusion .Experimental results showed that the exercise prescription in the implementation of the 8 weeks later , the subjects of body shape , physiological function , body composition and habits are improved to varying degrees , it can provide reference for other sports college female students ’ lose weight basis .%采用个案研究的形式,针对体育系女生这一特定人群,制定具有针对性的科学运动处方;运动Excel软件对实验数据进行处理,对实验前后数据进行比较得出结论。实验结果显示,此运动处方在实施8周后,受试对象的身体形态,生理机能,身体成分和生活习惯均有不同程度改善,可为其他体育院系女生减肥时提供参考依据。

  19. Role of Gastrointestinal Hormones in Energy Balance Regulatory System and Weight-losing through Exercise%胃肠激素在能量平衡调节系统及运动减肥中的作用

    Institute of Scientific and Technical Information of China (English)

    李秋雨

    2016-01-01

    食物摄入的调节是多方面的,涵盖多种复杂机制,其中基于负反馈机制的内环境稳态调节系统是其中不可缺少的一部分。在内环境稳态调节系统中,由胃肠道分泌的外周激素发挥了重要作用,我们统称其为胃肠激素。胃肠激素是营养和能量摄入情况反馈到内分泌细胞后分泌的肽类物质,直接或通过迷走神经与脑联系。胃肠激素对于调节营养摄入和能量消耗过程的平衡、维持体重的相对稳定具有重要意义。本文概述了胃肠激素在调节食欲和摄食行为以及运动减肥中发挥的作用。%Regulation of food intake is multifaceted and covers a variety of complex mechanisms.Among them, system of homeostasis which based on negative feedback mechanisms is an indispensible part.In the regulation system of homeostasis,peripheral hormones which secreted from the gastrointestinal tract plays an important role and are called gastrointestinal hormones.Gastrointestinal hormones are peptide materials secreted from enteroendocrine cells after the feedback of nutrient and energy intake,and will communicate with the brain directly or via the vagus nerve.These hormones are crucial for balancing the process of food intake and energy expenditure and maintaining a relatively stable body weight.The paper provides an overview of the role of gastrointestinal hormone in regulating appetite,food intake and weight -losing through exercise.

  20. 013. Complementary role of 6-minutes walking test (6MWT) in the assessment of functional status of patients with chronic obstructive pulmonary disease (COPD)

    Science.gov (United States)

    Mathioudakis, Alexander G.; Evangelopoulou, Efstathia I.; Karapiperis, Georgios C.; Perros, Elias I.; Simou, Georgia; Kiritsi, Evridiki; Chatzimavridou-Grigoriadou, Victoria; Mathioudakis, Georgios A.

    2015-01-01

    Background Despite its limited repeatability, spirometry is the most widely used method of assessment of the pulmonary ventilation. However, it is not a safe measure of the functional reserve of chronic obstructive pulmonary disease (COPD) patients with multiple comorbidities. Consequently, a stress test that would include cardiovascular and neuromuscular variables would be a useful complimentary test. Objective The aim of this observational study was to investigate the correlation between FEV1 and 6MWT, in patients with stable COPD (mean FEV1% pred =43.9%, SD =15.3). Methods 174 male ex-smokers with stable COPD, with a mean age of 63±6.7 years, mean height of 171.4 and weight of 73.9 were included and grouped according to their GOLD severity staging. A control group consisting of 87 healthy volunteers (mean age: 64±6.2, height: 175.2 and weight: 70.5) was also included. All the patient and controls had spirometry before and after bronchodilatation, on a daily scaled turbine spirometer, and 6MWT, on a 10-meter straight corridor. Elapsed distance (eD), haemoglobin saturation (Sats) and heart rate (HR) were continuously monitored during the 6MWT. All the data of our study were imported in an excel sheet for statistical analysis. Results Among the main results of our study, FEV1 decrease by year of age was less pronounced among healthy volunteers (21 mL/year, r2=0.4) compared to COPD patients (53 mL/year, r2=0.06). Similarly, volunteers had a significantly lower decrease by year of age in eD (2.3 m/year, r2=0.4) compared to COPD patients (7.7 m/year, r2=0.7). A more pronounced decrease of eD by year of age was recognized in patients with later COPD stages, while weight was more significantly correlated to eD compared to age. Post-bronchodilatation FEV1 was correlated to eD in COPD patients (r2=0.7); for each 1% decrease in the FEV1, COPD patients also lose approximately 7 m of walking distance in 6MWT. Conclusions 6MWT is a reliable measure of COPD progression and

  1. A validated disease specific prediction equation for resting metabolic rate in underweight patients with COPD

    Directory of Open Access Journals (Sweden)

    Anita Nordenson

    2010-09-01

    Full Text Available Anita Nordenson2, Anne Marie Grönberg1,2, Lena Hulthén1, Sven Larsson2, Frode Slinde11Department of Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden; 2Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska Academy at University of Gothenburg, SwedenAbstract: Malnutrition is a serious condition in chronic obstructive pulmonary disease (COPD. Successful dietary intervention calls for calculations of resting metabolic rate (RMR. One disease-specific prediction equation for RMR exists based on mainly male patients. To construct a disease-specific equation for RMR based on measurements in underweight or weight-losing women and men with COPD, RMR was measured by indirect calorimetry in 30 women and 11 men with a diagnosis of COPD and body mass index <21 kg/m2. The following variables, possibly influencing RMR were measured: length, weight, middle upper arm circumference, triceps skinfold, body composition by dual energy x-ray absorptiometry and bioelectrical impedance, lung function, and markers of inflammation. Relations between RMR and measured variables were studied using univariate analysis according to Pearson. Gender and variables that were associated with RMR with a P value <0.15 were included in a forward multiple regression analysis. The best-fit multiple regression equation included only fat-free mass (FFM: RMR (kJ/day = 1856 + 76.0 FFM (kg. To conclude, FFM is the dominating factor influencing RMR. The developed equation can be used for prediction of RMR in underweight COPD patients.Keywords: pulmonary disease, chronic obstructive, basal metabolic rate, malnutrition, body composition

  2. COPD flare-ups

    Science.gov (United States)

    COPD exacerbation; Chronic obstructive pulmonary disease exacerbation; Emphysema exacerbation; Chronic bronchitis exacerbation ... with your doctor on an action plan for COPD exacerbations so that you know what to do. ...

  3. Living with COPD: Nutrition

    Science.gov (United States)

    ... Diseases > Lung Disease Lookup > COPD > Living With COPD Nutrition Most people are surprised to learn that the ... asking your doctor or visiting the Academy of Nutrition and Dietetics at EatRight.org . Be sure to ...

  4. Sinonasal inflammation in COPD

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Konge, Lars; Thomsen, Sf

    2013-01-01

    In this review we demonstrate that patients with chronic obstructive pulmonary disease (COPD) frequently report sinonasal symptoms. Furthermore, we present evidence that smoking on its own can cause nasal disease, and that in COPD patients, nasal inflammation mimics that of the bronchi. All...... this evidence suggests that COPD related sinonasal disease does exist and that smoking on its own rather than systemic inflammation triggers the condition. However, COPD related sinonasal disease remains to be characterized in terms of symptoms and endoscopic findings. In addition, more studies are needed...... to quantify the negative impact of sinonasal symptoms on the quality of life in COPD patients....

  5. Antidepressants: Can They Lose Effectiveness?

    Science.gov (United States)

    ... be having the same effect. Can antidepressants lose effectiveness? Answers from Daniel K. Hall-Flavin, M.D. ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  6. Sarcopenia in COPD: relationship with COPD severity and prognosis

    Directory of Open Access Journals (Sweden)

    Tatiana Munhoz da Rocha Lemos Costa

    2015-10-01

    Full Text Available Objective: To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. Methods: A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE index. Results: We recruited 91 patients (50 females, with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6% of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction. The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001. Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009. The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. Conclusions: In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis.

  7. Sarcopenia in COPD: relationship with COPD severity and prognosis

    Science.gov (United States)

    Costa, Tatiana Munhoz da Rocha Lemos; Costa, Fabio Marcelo; Moreira, Carolina Aguiar; Rabelo, Leda Maria; Boguszewski, César Luiz; Borba, Victória Zeghbi Cochenski

    2015-01-01

    Objective: To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. Methods: A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index. Results: We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. Conclusions: In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis. PMID:26578132

  8. Choosing a Safe and Successful Weight-Loss Program

    Science.gov (United States)

    ... Healthy Moments Radio Broadcast Health tips from Dr. Griffin Rodgers, Director of the NIDDK Clinical Trials Current ... Lose weight while eating all of your favorite foods! Lose 30 pounds in 30 days! Lose weight ...

  9. COPD and other health problems

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000701.htm COPD and other health problems To use the sharing ... diabetes, and high blood pressure. Staying Healthy With COPD Work closely with your doctor to keep COPD ...

  10. Comorbidities of COPD

    Directory of Open Access Journals (Sweden)

    Arnaud Cavaillès

    2013-12-01

    Full Text Available By 2020, chronic obstructive pulmonary disease (COPD will be the third cause of mortality. Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD. The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation. All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately.

  11. Advances in understanding COPD

    Science.gov (United States)

    Anderson, Gary P.

    2016-01-01

    In recent years, thousands of publications on chronic obstructive pulmonary disease (COPD) and its related biology have entered the world literature, reflecting the increasing scientific and medical interest in this devastating condition. This article is a selective review of several important emerging themes that offer the hope of creating new classes of COPD medicines. Whereas basic science is parsing molecular pathways in COPD, its comorbidities, and asthma COPD overlap syndrome (ACOS) with unprecedented sophistication, clinical translation is disappointingly slow. The article therefore also considers solutions to current difficulties that are impeding progress in translating insights from basic science into clinically useful treatments.

  12. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  13. Genetics of COPD

    Directory of Open Access Journals (Sweden)

    Hidetoshi Nakamura

    2011-01-01

    Full Text Available Previous family studies suggested that genetic variation contributes to COPD susceptibility. The only gene proven to influence COPD susceptibility is SERPINA1, encoding α1-antitrypsin. Most studies on COPD candidate genes except SERPINA1, have not been consistently replicated. However, longitudinal studies of decline in lung function, meta-analyses of candidate gene studies, and family-based linkage analyses suggested that variants in EPHX1, GST, MMP12, TGFB1, and SERPINE2 were associated with susceptibility to COPD. A genome-wide association (GWA study has recently demonstrated that CHRNA3/5 in 15q25 was associated with COPD compared with control smokers. It was of interest that the CHRNA3/5 locus was associated with nicotine dependence and lung cancer as well. The associations of HHIP on 4q31 and FAM13A on 4q22 with COPD were also suggested in GWA studies. Another GWA study has shown that BICD1 in 12p11 was associated with the presence or absence of emphysema. Although every genetic study on COPD has some limitations including heterogeneity in smoking behaviors and comorbidities, it has contributed to the progress in elucidating the pathogenesis of COPD. Future studies will make us understand the mechanisms underlying the polygenic disease, leading to the development of a specific treatment for each phenotype.

  14. Systemic effects in COPD

    NARCIS (Netherlands)

    Wouters, E.F.M.; Creutzberg, E.C.; Schols, A.M.W.J.

    2002-01-01

    Systemic effects in COPD. Wouters EF, Creutzberg EC, Schols AM. Department of Pulmonary Diseases, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, the Netherlands. ewo@ms-azm-3.azm.nl The pathogenesis and clinical manifestations of COPD are not restricted to pulmonary inflammation an

  15. Systemic effects in COPD

    NARCIS (Netherlands)

    Wouters, E.F.M.; Creutzberg, E.C.; Schols, A.M.W.J.

    2002-01-01

    Systemic effects in COPD. Wouters EF, Creutzberg EC, Schols AM. Department of Pulmonary Diseases, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, the Netherlands. ewo@ms-azm-3.azm.nl The pathogenesis and clinical manifestations of COPD are not restricted to pulmonary inflammation an

  16. [Inhaled corticosteroids for COPD

    NARCIS (Netherlands)

    Dekhuijzen, P.N.R.

    2003-01-01

    Over 60% of patients with COPD are treated with inhaled corticosteroids (ICS), even though their use is still subject to debate. The inflammatory process in the lungs of patients with COPD is dominated by macrophages, CD8+ T-lymphocytes, neutrophilic granulocytes and mast cells, as well as an increa

  17. COPD and the microbiome.

    Science.gov (United States)

    Mammen, Manoj J; Sethi, Sanjay

    2016-05-01

    Traditional culture techniques confirm that bacteria have an important role in Chronic Obstructive Pulmonary Disease (COPD). In individuals with COPD, acquisition of novel bacterial strains is associated with onset of acute exacerbation of COPD, which leads to further lung dysfunction and enormous health-care costs. Recent study of the human microbiome, the total composite of the bacteria on the human body, posited the microbiome as the last human organ studied, as the microbiome performs a multitude of metabolic functions absent in the human genome. The largest project to study the human microbiome was the National Institutes of Health (NIH) human microbiome project (HMP) started in 2007 to understand the 'normal' microbiome. However due to the presumption that the healthy human lung was sterile, the respiratory tract was not included in that study. The advent of next-generation sequencing technologies has allowed the investigation of the human respiratory microbiome, which revealed that the healthy lung does have a robust microbiome. Subsequent studies in individuals with COPD revealed that the microbiome composition fluctuates with severity of COPD, composition of the individual aero-digestive tract microbiomes, age, during an acute exacerbation of COPD and with the use of steroids and/or antibiotics. Understanding the impact of the microbiome on COPD progression and risk of exacerbation will lead to directed therapies for prevention of COPD progression and exacerbation.

  18. Natural history of COPD

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Lange, Peter

    2016-01-01

    The natural history of chronic obstructive pulmonary disease (COPD) is usually described with a focus on change in forced expiratory volume in 1 s (FEV1 ) over time as this allows for exploration of risk factors for an accelerated decline-and thus of developing COPD. From epidemiological studies we...

  19. OCCUPATIONAL EXPOSURE AND COPD

    DEFF Research Database (Denmark)

    Würtz, Else Toft

    Chronic Obstructive Pulmonary Disease (COPD) is a common disease. The main risk factor is smoking although 15% of the COPD cases are expected to be preventable if the occupational exposures from vapour, gas, dust, and fume were eliminated; the population attributable fraction (PAF). The thesis...... addresses the association between occupational exposure and COPD in a population-based cohort of Danes aged 45-84-years. 4717 participants were included at baseline and 2624 at the four year follow-up. COPD was defined by spirometry and the occupational exposure was based on specialist defined jobs...... and questionnaires. The main occupational exposure was organic dust and 49% reported no lifetime occupational exposure. The results suggest occupational exposures to be associated to COPD also in never smokers and women. We found an exposure-response relation in the cross sectional analyses. The results...

  20. [Distinguishing asthma from COPD].

    Science.gov (United States)

    Ohara, Kouhei; Samukawa, Takuya; Inoue, Hiromasa

    2016-05-01

    Asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. Asthma is characterized by airway inflammation, airway narrowing with reversibility, and hyperresponsiveness of airways. COPD has been associated with smoking and exposure to environmental fumes, which typically characterized by persistent airflow limitation and chronic inflammation of the airways. These differences are most apparent when young non-smoker with asthma and older smokers with COPD are compared. However, it would be difficult to differentiate asthma from COPD, especially in elderly who currently smoke or have a significant history of smoking. Furthermore, some patients exhibit characteristics of both diseases, this may represent a phenotype known as asthma-COPD overlap syndrome (ACOS). Therefore, the precise understanding of these diseases is important.

  1. Global burden of COPD.

    Science.gov (United States)

    López-Campos, José Luis; Tan, Wan; Soriano, Joan B

    2016-01-01

    It is estimated that the world population will reach a record 7.3 billion in 2015, and the high burden of chronic conditions associated with ageing and smoking will increase further. Respiratory diseases in general receive little attention and funding in comparison with other major causes of global morbidity and mortality. In particular, chronic obstructive pulmonary disease (COPD) has been a major public health problem and will remain a challenge for clinicians within the 21st century. Worldwide, COPD is in the spotlight, since its high prevalence, morbidity and mortality create formidable challenges for health-care systems. This review emphasizes the magnitude of the COPD problem from a clinician's standpoint by drawing extensively from the new findings of the Global Burden of Disease study. Updated, distilled information on the population distribution of COPD is useful for the clinician to help provide an appreciation of the relative impact of COPD in daily practice compared with other chronic conditions, and to allocate minimum resources in anticipation of future needs in care. Despite recent trends in reduction of COPD standardized mortality rates and some recent successes in anti-smoking efforts in a number of Western countries, the overarching demographic impact of ageing in an ever-expanding world population, joined with other factors such as high rates of smoking and air pollution in Asia, will ensure that COPD will continue to pose an ever-increasing problem well into the 21st century.

  2. Challenge of COPD: Am I at Risk?

    Science.gov (United States)

    ... please turn JavaScript on. Feature: The Challenge of COPD Am I at Risk? Past Issues / Fall 2014 ... or the American Lung Association's COPD information section. COPD Learn More Breathe Better ® Program The COPD Learn ...

  3. Examining fatigue in COPD

    DEFF Research Database (Denmark)

    Al-Shair, Khaled; Muellerova, Hana; Yorke, Janelle

    2012-01-01

    ABSTRACT: INTRODUCTION: Fatigue is a disruptive symptom that inhibits normal functional performance of COPD patients in daily activities. The availability of a short, simple, reliable and valid scale would improve assessment of the characteristics and influence of fatigue in COPD. METHODS......: At baseline, 2107 COPD patients from the ECLIPSE cohort completed the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale. We used well-structured classic method, the principal components analysis (PCA) and Rasch analysis for structurally examining the 13-item FACIT-F. RESULTS: Four items...... were less able to capture fatigue characteristics in COPD and were deleted. PCA was applied to the remaining 9 items of the modified FACIT-F and resulted in three interpretable dimensions: i) general (5 items); ii) functional ability (2 items); and iii) psychosocial fatigue (2 items). The modified...

  4. Epidemiology of COPD

    Directory of Open Access Journals (Sweden)

    C. Raherison

    2009-12-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is responsible for early mortality, high death rates and significant cost to health systems. The projection for 2020 indicates that COPD will be the third leading cause of death worldwide (from sixth in 1990 and fifth leading cause of years lost through early mortality or handicap (disability-adjusted life years (12th in 1990. Active smoking remains the main risk factor, but other factors are becoming better known, such as occupational factors, infections and the role of air pollution. Prevalence of COPD varies according to country, age and sex. This disease is also associated with significant comorbidities. COPD is a disorder that includes various phenotypes, the continuum of which remains under debate. The major challenge in the coming years will be to prevent onset of smoking along with early detection of the disease in the general population.

  5. Managing Your COPD Medications

    Science.gov (United States)

    ... the First-Ever COPD National Action Plan Blog: Yoga, Tai Chi and Your Lungs: The Benefits of ... number of items"); $("#local_list_xml").quickPagination(); }, error: function() { console.log("An error occurred while processing XML ...

  6. [Treatment of COPD].

    Science.gov (United States)

    Roche, Nicolas; Huchon, Gérard

    2011-06-01

    COPD treatment begins with smoking cessation and influenza and pneumococcal vaccines. Bronchodilators are indicated when dyspnea on exertion is reported (usually, FEV1 COPD has to integrate treatment of comorbidities such as cardio-vascular diseases, anxiety-depression, malnutrition, muscle dysfunction, osteoporosis, anemia ... Ongoing research aims at identifying new therapeutic targets, focusing on inflammation, remodeling, protease-antiprotease balance, oxidative stress, lung regeneration/repair and mucus production.

  7. Erdosteine for COPD exacerbations.

    Science.gov (United States)

    2008-10-01

    The mucolytic drug erdosteine (Erdotin - Galen) is licensed in the UK as treatment for up to 10 days "for the symptomatic treatment of acute exacerbations of chronic bronchitis in adults". This indication differs from that for carbocisteine and mecysteine, two older mucolytic drugs that are licensed for adjunctive treatment in respiratory disorders characterised by viscous mucus, and typically used for longer to prevent exacerbations of chronic obstructive pulmonary disease (COPD). Does erdosteine have a role for people with COPD exacerbations?

  8. Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

    NARCIS (Netherlands)

    Gray, C.M.; Hunt, K.; Mutrie, N.; Anderson, A.S.; Leishman, J.; Dalgarno, L.; Wyke, S.

    2013-01-01

    BACKGROUND: The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the d

  9. Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

    NARCIS (Netherlands)

    Gray, C.M.; Hunt, K.; Mutrie, N.; Anderson, A.S.; Leishman, J.; Dalgarno, L.; Wyke, S.

    2013-01-01

    BACKGROUND: The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the

  10. COPD: the patient perspective

    Directory of Open Access Journals (Sweden)

    Jones PW

    2016-02-01

    Full Text Available Paul W Jones,1 Henrik Watz,2 Emiel FM Wouters,3 Mario Cazzola4 1Division of Clinical Science, St George’s, University of London, London, UK; 2Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North (ARCN, Member of the German Center for Lung Research (DZL, Grosshansdorf, Germany; 3CIRO+, Department of Respiratory Medicine, Maastricht University, Maastricht, the Netherlands; 4Unit of Respiratory Clinical Pharmacology, Department of Systemic Medicine, University of Rome ‘Tor Vergata,’ Rome, Italy Abstract: Chronic obstructive pulmonary disease (COPD is a highly prevalent disease characterized by nonreversible airway obstruction. Well-characterized symptoms such as exertional dyspnea and fatigue have a negative impact on patients’ quality of life (QoL and restrict physical activity in daily life. The impact of COPD symptoms on QoL is often underestimated; for example, 36% of patients who describe their symptoms as being mild-to-moderate also admit to being too breathless to leave the house. Additionally, early morning and nighttime symptoms are a particular problem. Methods are available to allow clinicians to accurately assess COPD symptoms, including patient questionnaires. Integrated approaches to COPD management, particularly pulmonary rehabilitation, are effective strategies for addressing symptoms, improving exercise capacity and, potentially, also increasing physical activity. Inhaled bronchodilators continue to be the mainstay of drug therapy in COPD, where options can be tailored to meet patients’ needs with careful selection of the inhaled medication and the device used for its delivery. Overall, an integrated approach to disease management should be considered for improving QoL and subsequent patient outcomes in COPD. Keywords: COPD, patients, physical actiity levels, pulmonary rehabilitation

  11. The many "small COPDs": COPD should be an orphan disease

    DEFF Research Database (Denmark)

    Rennard, Stephen I; Vestbo, Jørgen

    2008-01-01

    of 200,000 affected individuals; however, secondarily, is the impossibility for development costs to be recovered during the patent life of a product. COPD should qualify for the first criterion if the various conditions that comprise COPD are regarded separately. The subphenotyping of COPD into separate...

  12. Nutritional deficits in elderly smokers with respiratory symptoms that do not fulfill the criteria for COPD.

    Science.gov (United States)

    Obase, Yasushi; Mouri, Keiji; Shimizu, Hiroki; Ohue, Yoshihiro; Kobashi, Yoshihiro; Kawahara, Kazue; Oka, Mikio

    2011-01-01

    Whereas nutrition deficits are recognized as an expression of systemic inflammation in the elderly with diagnosed chronic obstructive pulmonary disease (COPD), if they occur in symptomatic elderly smokers, unfulfilled COPD criteria are not confirmed. Respiratory function, anthropometry assessment, and diet intake evaluation of 13 COPD patients (COPD group), ten symptomatic elderly smokers (SYSM group), and 27 healthy volunteers (control group) were compared. All were 70 years old or older. The SYSM group had lower body weight, body mass index, percentage ideal body weight, body fat percentage, arm muscle circumference, tricep skin fold thickness, serum albumin, prealbumin, and transferrin than the control group and were similar to the COPD group (P nutritional deficits related to insufficient energy intake that are similar to those seen in COPD patients.

  13. State Fact Sheets on COPD

    Science.gov (United States)

    ... Submit Search The CDC Chronic Obstructive Pulmonary Disease (COPD) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . COPD Homepage Data and Statistics Fact Sheets Publications Publications ...

  14. Day to day with COPD

    Science.gov (United States)

    COPD - day to day; Chronic obstructive airways disease - day to day; Chronic obstructive lung disease - day to ... Having COPD can sap your energy. These simple changes can make your days easier and preserve your strength. Ask ...

  15. COPD: Unique to Older Adults

    Science.gov (United States)

    ... care and improve or maintain quality of life. Depression and COPD When your COPD symptoms eventually become ... as reducing bright lights and noise, using soothing music, doing yoga or meditating, or taking up a ...

  16. Challenge of COPD: Getting Tested

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: The Challenge of COPD Getting Tested Past Issues / Fall 2014 ... Your Seasonal Flu Shot" here .) Read More "The Challenge of COPD" Articles Q&A: Grace Anne Koppel, ...

  17. The Mechanism of Losing Weight of Sanzhu Jianfei Decoction on Alimentary Obesity Rats%三术减肥汤对营养性肥胖大鼠减肥机制的研究

    Institute of Scientific and Technical Information of China (English)

    朱庆军; 李桓

    2014-01-01

    目的:探讨三术减肥汤对营养性肥胖大鼠的减肥作用。方法:SD 雌性大鼠60只随机分为5组,除正常空白组12只,其余48只给予高脂饲料喂养45 d,造模成功后随机分为模型空白组、月见草油对照组、三术减肥汤高剂量组、三术减肥汤低剂量组。所有大鼠继续给予原饮食标准,同时灌胃给予上述药物处理5周,并于药物处理结束时测定大鼠体质量、身长、lee′s 指数、腹腔脂肪湿质量和脂肪细胞体积以及血清生长激素、甲状腺激素的含量。结果:三术减肥汤处理营养性肥胖大鼠5周后,大鼠体质量、身长、lee′s 指数明显低于模型空白组,脂肪湿质量和脂肪细胞体积明显减少,血清生长激素、甲状腺激素水平明显提高。结论:三术减肥汤可能通过对生长激素和甲状腺激素的调节,提高代谢率,促进脂肪分解,抑制体质量的增加,对营养性肥胖大鼠有显著的治疗作用。%To investigate the mechanism of weight loss of Sanzhu Jianfei Decoction(SZJFD)on nutritional obese rats. Meth-ods:SD female rats were randomly divided into 5 groups. Except for control group,the remaining 48 rats were given high fat diet for 45 days,after the success of the modeling and the model groups were randomly divided into control group,Yuejiancaoyou control group, SZJFD high dose and SZJFD low dose groups. Rats were given the original standard diet,while giving these drugs for 5 weeks,and at the end of drug treatment,rats were measured weight,height,lee′s index,wet weight of abdominal fat and fat cell volume and serum growth hormone,thyroid hormone levels. Results:The nutritional obese rats were given SZJFD for five weeks,the rats weight,height,lee′s index was significantly lower than the model control group,fat wet weight and fat cell volume significantly decreased serum growth hormone, thyroid hormone levels were significantly increased. Conclusion

  18. Prevalence of COPD in Copenhagen

    DEFF Research Database (Denmark)

    Fabricius, Peder; Løkke, Anders; Marott, Jacob Louis

    2011-01-01

    COPD is a leading cause of death worldwide; however, prevalence estimates have varied considerably in previous studies. This study aimed to determine the prevalence and severity of COPD in Copenhagen using data from the 4th examination of The Copenhagen City Heart Study, to investigate the relati...... the relationship between tobacco consumption and COPD, and to characterize the subjects with COPD with regard to BMI, dyspnoea, treatment with respiratory medication and co-morbidities....

  19. Antioxidant therapies in COPD

    Science.gov (United States)

    Rahman, Irfan

    2006-01-01

    Oxidative stress is an important feature in the pathogenesis of COPD. Targeting oxidative stress with antioxidants or boosting the endogenous levels of antioxidants is likely to be beneficial in the treatment of COPD. Antioxidant agents such as thiol molecules (glutathione and mucolytic drugs, such as N-acetyl-L-cysteine and N-acystelyn), dietary polyphenols (curcumin, resveratrol, green tea, catechins/quercetin), erdosteine, and carbocysteine lysine salt, all have been reported to control nuclear factor-kappaB (NF-κ B) activation, regulation of glutathione biosynthesis genes, chromatin remodeling, and hence inflammatory gene expression. Specific spin traps such as α-phenyl-N-tert-butyl nitrone, a catalytic antioxidant (ECSOD mimetic), porphyrins (AEOL 10150 and AEOL 10113), and a superoxide dismutase mimetic M40419 have also been reported to inhibit cigarette smoke-induced inflammatory responses in vivo. Since a variety of oxidants, free radicals, and aldehydes are implicated in the pathogenesis of COPD, it is possible that therapeutic administration of multiple antioxidants will be effective in the treatment of COPD. Various approaches to enhance lung antioxidant capacity and clinical trials of antioxidant compounds in COPD are discussed. PMID:18046899

  20. COPD: Are You at Risk?

    Science.gov (United States)

    CoPD: the more you know, the better For you anD your loveD ones. PeoPle who have CoPD: • Become short of breath while doing everyday activities ... time goes by, these symPtoms get graDually worse. COPD develops slowly, and can worsen over time. Many ...

  1. Detection of COPD in smokers

    NARCIS (Netherlands)

    Geijer, R.M.M.

    2006-01-01

    Smoking is the main risk factor for Chronic Obstructive Pulmonary Disease (COPD), formerly known as lung emphysema or ‘chronic bronchitis’. Early detection of COPD and smoking cessation may result in significant health gain. In a thesis titled ‘Detection of COPD in smokers’ the results of 6 studies

  2. 低分子量肝素对慢性阻塞性肺疾病大鼠气道黏液分泌的影响%The Effect of Low-Molecular-Weight-Heparin on the Airway Mucus Secretion of a Rat Model of Chronic Obstructive Pulmonary Disease (COPD)

    Institute of Scientific and Technical Information of China (English)

    高光敏; 强丽霞; 王凤爽; 杨梅; 金寿德

    2013-01-01

    目的:观察低分子量肝素对慢性阻塞性肺疾病(COPD)大鼠血浆D-二聚体和气道黏液分泌的影响.方法:将30只Wistar大鼠随机分为正常对照组、COPD模型组、LMWH干预组,每组10只.采用熏吸香烟法加气管内注入脂多糖的方法建立COPD大鼠模型,LMWH干预组于COPD模型建立后皮下注射LMWH,检测各组大鼠血浆D-二聚体水平及气道黏液细胞数的变化.结果:COPD模型组血浆D-二聚体水平及气道黏液细胞数较正常对照组均明显升高(P<0.05),而低分子量肝素治疗组二者较COPD模型组均明显下降(P<0.05).血浆D-二聚体水平与气道黏液细胞数呈显著正相关(r=0.946,P=0.04).结论:低分子量肝素在改善凝血功能的同时可以减少COPD气道黏液分泌,有助于疾病的控制和转归.%Objective: To study the effect of low-molecular-weight-heparin (LMWH) on plasma D-dimer level and airway mucus secretion of COPD rats. Methods: Thirty Wistar rats were randomly divided into the control group, COPD group and LMWH group, ten rats in each group. COPD rat model was established by smoke inhalations and endointracheal instillations of lipopolysaccaride, LMWH was administered to rats 48 hours after the injection of LPS and smoke inhalations. The change of plasma D-dimer level and number of mucous cells were measured and compared between different groups. Results: The plasma D-dimer level and number of mucous cells were significantly higher in COPD group than those in the control group (P<0.05), which were significantly lower in the LMWH treated COPD rats than those in the COPD group. The plasma D-dimer level was positively related to the number of mucous cells in COPD group(r=0.946,P=0.04). Conclusion: LMWH could enhance the blood coagulation and reduce the airway mucus secretion to improve the development of COPD.

  3. [Regenerative approach for COPD].

    Science.gov (United States)

    Kubo, Hiroshi

    2011-10-01

    No treatment to cure of chronic obstructive pulmonary disease (COPD) is available. Regenerative medicine is one of promising areas for this intractable disease. Several reagents and growth factors are known to promote lung regeneration in small animal models. However, regenerative medicines for human lungs are not achieved yet. Recent advances in stem cell biology and tissue engineering have expanded our understanding of lung endogenous stem cells, and this new knowledge provides us with new ideas for future regenerative therapy for lung diseases. Although lungs are the most challenging organ for regenerative medicine, our cumulative knowledge of lung regeneration and of endogenous progenitor cells makes clear the possibilities for regenerative approach to COPD.

  4. Prevalence of COPD in Copenhagen

    DEFF Research Database (Denmark)

    Fabricius, Peder; Løkke, Anders; Marott, Jacob Louis

    2011-01-01

    , to investigate the relationship between tobacco consumption and COPD, and to characterize the subjects with COPD with regard to BMI, dyspnoea, treatment with respiratory medication and co-morbidities. METHODS: 6236 people participated. All non-asthmatic participants aged 35 years or older with adequate lung...... experienced no dyspnoea. Only a minority of subjects with COPD received pulmonary medication. COPD was associated with cardiovascular disease and cancer. CONCLUSION: The prevalence of COPD in Denmark is among the highest in the world. It is closely correlated to smoking and age. It is accompanied...

  5. [Global therapeutic approach of muscle dysfunction in COPD].

    Science.gov (United States)

    Alvarez Hernández, J

    2006-05-01

    Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by the presence of chronic obstruction and incomplete airflow reversibility. It is a disease with increasing prevalence and high sociosanitary cost. Hyponutrition and muscle dysfunction are two determinant factors of clinical severity and disease prognosis. The close relationship between weight loss or hyponutrition and mortality has been known for several years. Today we know that muscle mass is better predictor than weight of survival in patients with moderate to severe COPD. Several factors are implicated in the development of hyponutrition and deterioration of muscle structure and function. Slowing "muscle wasting" in COPD patients requires designing new integrated therapeutic strategies. Health care programs for COPD patients include multidisciplinary care of the main areas involved in the course of the disease. The main lines address: cigarette smoking cessation, pharmacotherapy, oxygen therapy, rehabilitation, nutritional support, surgery, travels, intercurrent periods, and palliative care. Pulmonary rehabilitation (PR) should be seen as part of a multidisciplinary program in individualized care of each COPD patient, aiming at optimizing his/her physical and social autonomy. Physical training, psychosocial intervention, patient education, and support groups for patients and relatives and friends, smoking cessation, oxygen therapy, appropriate oral feeding, and nutritional support are part of that therapeutic strategy allowing for an integral approach of muscle dysfunction in COPD patients.

  6. [Assessment of nutritional status of patients with chronic obstructive pulmonary disease (COPD) and the impact of diet on COPD risk].

    Science.gov (United States)

    Posłuszna, Dominika; Doboszyńska, Anna

    2011-01-01

    It is estimated that in patients with COPD malnutrition affects 10-15% of patients with mild to moderate stage of disease and 50% of patients with advanced stage of disease. Available studies indicate that weight loss and muscle mass loss are negative prognostic indicators, therefore early diagnosis of malnutrition seems to be a key measure in the treatment of COPD. In the article the authors discuss and compare the most commonly used methods to assess nutritional status and provide information on the impact of diet on risk of COPD in the future. Nutritional status of patients with COPD is difficult to assess. To date, no published standards are available. Reliable and accurate assessment of nutritional status is essential for planning further care and may contribute to the improvement of nutritional status and contribute positively to the course of the disease.

  7. Drugs Used in COPD.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on drugs used in chronic obstructive pulmonary disease (COPD) is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first.…

  8. Heart failure in COPD

    NARCIS (Netherlands)

    Rutten, Frans Hendrik

    2005-01-01

    The main aim of the thesis was to assess the prevalence of heart failure in patients with a diagnosis of chronic obstructive pulmonary disease (COPD). Furthermore, to explore diagnostic strategies (including natriuretic peptides and cardiovascular magnetic resonance imaging (CMR)) to identify heart

  9. Beyond GWAS in COPD

    DEFF Research Database (Denmark)

    McDonald, Merry-Lynn Noelle; Mattheisen, Manuel; Cho, Michael H;

    2014-01-01

    Objectives: To use a systems biology approach to integrate genotype and protein-protein interaction (PPI) data to identify disease network modules associated with chronic obstructive pulmonary disease (COPD) and to perform traditional pathway analysis. Methods: We utilized a standard gene-set ass...

  10. COPD: Definition and Phenotypes

    DEFF Research Database (Denmark)

    Vestbo, J.

    2014-01-01

    particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. The evolution of this definition and the diagnostic criteria currently in use are discussed. COPD is increasingly divided in subgroups or phenotypes based on specific features and association...

  11. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD)

    DEFF Research Database (Denmark)

    Hallin, Runa; Gudmundsson, Gunnar; Suppli Ulrik, Charlotte

    2007-01-01

    Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality...

  12. Prognostic value of weight change in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Prescott, E; Almdal, T; Mikkelsen, K L

    2002-01-01

    the two examinations was significantly associated with level of COPD, reaching approximately 30% in subjects with severe COPD. After adjusting for age, smoking habits, baseline BMI and lung function, weight loss was associated with higher mortality in both persons with and without COPD (rate ratio (RR...

  13. Frailty syndrome in ambulatory patients with COPD

    Directory of Open Access Journals (Sweden)

    Limpawattana P

    2017-04-01

    Full Text Available Panita Limpawattana,1 Siraphong Putraveephong,2 Pratchaya Inthasuwan,2 Watchara Boonsawat,3 Daris Theerakulpisut,4 Jarin Chindaprasirt5 1Division of Geriatric Medicine, 2Department of Internal Medicine, 3Division of Respiratory System, Department of Internal Medicine, 4Division of Nuclear Medicine, Department of Radiology, 5Division of Oncology Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Abstract: Frailty is a state of increased risk of unfavorable outcomes when exposed to stressors, and COPD is one of the several chronic illnesses associated with the condition. However, few studies have been conducted regarding the prevalence of COPD and its related factors in Southeast Asia. The objectives of this study were to determine the prevalence of frailty in COPD patients and to identify the associated factors in these populations. A cross-sectional study of COPD patients who attended a COPD clinic was conducted from May 2015 to December 2016. Baseline characteristics were collected, and the diagnosis of frailty was based on the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight scale. Descriptive statistics were used to analyze baseline data. Factors associated with frailty were analyzed using univariate and multivariate regression analyses. The results showed that the prevalence rates of frailty and pre-frailty were 6.6% (eight out of 121 cases and 41.3% (50 out of 121 cases, respectively, among COPD patients. Fatigue was the most common component of the FRAIL scale that was found more frequently in frail patients than in non-frail patients (odds ratio [OR] 91.9. Factors associated with frailty according to multivariate analyses were comorbid cancer (adjusted OR [AOR] 45.8, at least two instances of nonelective admission over the past 12 months (AOR 112.5, high waist circumference (WC (AOR 1.3, and presence of sarcopenia (AOR 29.5. In conclusion, frailty affected 6.6% of

  14. Getting Past a Weight-Loss Plateau

    Science.gov (United States)

    ... lose weight, you lose some muscle along with fat. Muscle helps keep the rate at which you burn ... more calories. Adding exercises such as weightlifting to increase your muscle mass will help you burn more calories. Pack ...

  15. Proven Weight Loss Methods

    Science.gov (United States)

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. ... limiting calories) usually isn’t enough to cause weight loss. But exercise plays an important part in helping ...

  16. BMI AS A MARKER OF SEVERITY IN PATIENTS WITH COPD

    Directory of Open Access Journals (Sweden)

    Mohammed Soheb Sadath Ansari

    2017-02-01

    Full Text Available BACKGROUND COPD has evolved overtime as a clinical syndrome rather than a disease that is limited to respiratory system and presently the systemic manifestations and comorbid illnesses are much better understood and known. Globally, as well as in India, the burden of COPD continues to increase and by 2030 it is expected to be the third leading cause of death. Although, the back bone of therapy is pharmacotherapy, the role of rehabilitation and management of systemic problems in COPD is increasing. One of the components of management of COPD other than the lungs include maintenance of nutrition and body weight of COPD patients as it has been shown in many studies that BMI tends to fall as the disease progresses and can be considered as a marker of severity. In this study, we have tried to study the nutritional state of COPD patients and correlate it with disease severity. In this study, the COPD patients were graded into three groups and percentage of patients with low normal and below normal BMI were studied in each group. MATERIALS AND METHODS A total of 108 COPD (chronic obstructive pulmonary disease patients diagnosed based on smoking history and spirometry with post bronchodilator FEV1/FVC <0.7 were taken into the study at Bhaskar Medical College between 2015 and 2016. The severity of COPD was graded based on FEV1 (forced expiratory volume in first second values recorded from spirometry after calibrating the spirometer daily with 3 litre syringe. The height and weight were recorded and BMI calculated by dividing weight in kilograms by height in metre square and then the BMI was graded as per WHO guidelines. RESULTS The BMI was low normal and below normal in 18.75% of patients with mild and moderate disease group (FEV1 50-80%. In patients with severe disease group (FEV1 30-50%, the BMI was low normal and below normal in 43.3% and in very severe disease group (FEV1 <30%, the BMI was low normal and below normal in 57.14%. The results has shown

  17. What is COPD? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn JavaScript on. Feature: The Challenge of COPD What is COPD? Past Issues / Fall 2014 Table of Contents COPD ... a walk, even washing and dressing. What Is COPD? Watch an animation at: NIH's COPD website How ...

  18. COPD -- managing stress and your mood

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000700.htm COPD - managing stress and your mood To use the ... you manage COPD and feel better in general. COPD and Your Emotions Having chronic obstructive pulmonary disease ( ...

  19. Study on Lipid - lowering and Losing Weight of Traditional Chinese Medicine Slimming Prescription on Nutritional Obese Rats%中药纤体方对营养性肥胖大鼠降脂减肥作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    邓拥军; 肖银生; 徐海涛; 邓芬; 黄开秀; 吕丽萍

    2012-01-01

    目的 观察中药纤体方对营养肥胖型大鼠的降脂减肥作用.方法 建立营养性肥胖大鼠模型,特大鼠分为空白对照组、模型对照组、阿托伐他汀组和中药纤体方低、中、高剂量组,各组分别灌胃给药,每天1次,连续45d.检测血清中甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的含量以及丙二醛(MDA)、总抗氧化能力(T-AOC),记录体重、摄食量,并计算食物利用率、Lee’s指数、脂体比及全视野中脂肪细胞个数.结果 中药纤体方高、中剂量组能显著提高HDL -C水平和全视野脂肪细胞数量(P<0.01),降低肥胖大鼠的体重(P<0.05);高、低剂量组能显著降低肥胖大鼠的脂肪重量和脂体比(P <0.05或P<0.01).此外,高剂量组显著降低了大鼠血清TG含量、食物利用率和Lee's指数(P<0.05或P<0.01);中剂量组显著降低了大鼠血清MDA含量(P<0.05),提高了T-AOG水平(P<0.05).结论 中药纤体方对营养性胆胖大鼠有降脂减肥和抗脂质过氧化作用.%Objective To study the role of lipid - lowering and losing weight of traditional Chinese medicine slimming prescription (ZYXTF) on the nutritional obese rats. Methods After made the model of nutritional obesity rat, the experiment was divided into 6 groups as normal control group, model group, atorvastatin group, and ZYXTF group (high - dose, medium - dose and low - dose). Those groups were given medicine for 45 days. The content of serum triglyceride (TC), total cholesterol (TC), high - density lipoprotein (HDL-C), low density lipoprotein (LDL -C) and levels of malondialdehyde (MDA) , total antioxidation capacity (T - AOC) were assayed. The amount of increasing the body weight, food intake, food utilization, Lee's index, body fat ratio, and the quantities of fat cell in a view were observed. Results After the nutritional obesity rats were administered ZYXTF, compared with model group, the

  20. Year in Review 2014: COPD.

    Science.gov (United States)

    Restrepo, Ruben D

    2015-07-01

    Clinicians responsible for treating pulmonary disease often encounter challenges in the management of patients with COPD. This is due in part to the number of drugs now available to ameliorate COPD symptoms and the complexity of adhering to good disease management programs. Each aspect of treatment is a critical component in improving outcomes for these patients. The purpose of this article is to review some of the most significant findings regarding the treatment of COPD, with emphasis on disease management and pharmacotherapy.

  1. Low-Carb Diet: Could It Help You Lose Weight?

    Science.gov (United States)

    ... al. Position of the Academy of Nutrition and Dietetics: Interventions for the treatment of overweight and obesity ... adults. Journal of the Academy of Nutrition and Dietetics. 2016;116:129. Duyff RL. Carbs: Sugars, starches, ...

  2. The gastric sleeve: losing weight as fast as micronutrients?

    NARCIS (Netherlands)

    Aarts, E.O.; Janssen, I.M.; Berends, F.J.

    2011-01-01

    BACKGROUND: Recently, the laparoscopic sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched. METHODS: From January 2005 to October

  3. Mucoactive therapy in COPD

    Directory of Open Access Journals (Sweden)

    M. Decramer

    2010-06-01

    Full Text Available It has been shown that mucus hypersecretion is associated with greater susceptibility for chronic obstructive pulmonary disease (COPD, excess forced expiratory volume in 1 s decline, hospitalisations and excess mortality. The effects of mucoactive drugs on outcomes have been reviewed in several meta-analyses, the largest one including 26 studies. 21 studies were performed in patients with chronic bronchitis and five in patients with COPD. The majority of these trials were performed with N-acetylcysteine (n = 13 and carbocysteine (n = 3. Overall, there was a significant reduction in exacerbations (0.05 per patient per month and the number of days with disability (0.56 days per patient per month. Mucolytics were well tolerated and the number of adverse events was lower than with placebo (odds ratio 0.78. In the largest and best designed study with N-acetylcysteine in 523 patients with COPD, the reduction in exacerbations was only observed in patients not taking inhaled corticosteroids. In addition, a 374 mL reduction in functional residual capacity was found. A recent large study (n = 709 with high-dose carbocysteine (1,500 mg·day–1 demonstrated a significant effect on exacerbations (25% reduction and also reported an improvement in health-related quality of life (-4.06 units in St George's Respiratory Questionnaire. It is unclear what the mechanisms underlying these effects may be and which phenotypes benefit from this treatment. On the basis of this evidence mucoactive drugs may deserve consideration in the long-term treatment of COPD.

  4. Mucoactive therapy in COPD.

    Science.gov (United States)

    Decramer, M; Janssens, W

    2010-06-01

    It has been shown that mucus hypersecretion is associated with greater susceptibility for chronic obstructive pulmonary disease (COPD), excess forced expiratory volume in 1 s decline, hospitalisations and excess mortality. The effects of mucoactive drugs on outcomes have been reviewed in several meta-analyses, the largest one including 26 studies. 21 studies were performed in patients with chronic bronchitis and five in patients with COPD. The majority of these trials were performed with N-acetylcysteine (n = 13) and carbocysteine (n = 3). Overall, there was a significant reduction in exacerbations (0.05 per patient per month) and the number of days with disability (0.56 days per patient per month). Mucolytics were well tolerated and the number of adverse events was lower than with placebo (odds ratio 0.78). In the largest and best designed study with N-acetylcysteine in 523 patients with COPD, the reduction in exacerbations was only observed in patients not taking inhaled corticosteroids. In addition, a 374 mL reduction in functional residual capacity was found. A recent large study (n = 709) with high-dose carbocysteine (1,500 mg·day⁻¹) demonstrated a significant effect on exacerbations (25% reduction) and also reported an improvement in health-related quality of life (-4.06 units in St George's Respiratory Questionnaire). It is unclear what the mechanisms underlying these effects may be and which phenotypes benefit from this treatment. On the basis of this evidence mucoactive drugs may deserve consideration in the long-term treatment of COPD.

  5. Acute exacerbation of COPD.

    Science.gov (United States)

    Ko, Fanny W; Chan, Ka Pang; Hui, David S; Goddard, John R; Shaw, Janet G; Reid, David W; Yang, Ian A

    2016-10-01

    The literature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is fast expanding. This review focuses on several aspects of acute exacerbation of COPD (AECOPD) including epidemiology, diagnosis and management. COPD poses a major health and economic burden in the Asia-Pacific region, as it does worldwide. Triggering factors of AECOPD include infectious (bacteria and viruses) and environmental (air pollution and meteorological effect) factors. Disruption in the dynamic balance between the 'pathogens' (viral and bacterial) and the normal bacterial communities that constitute the lung microbiome likely contributes to the risk of exacerbations. The diagnostic approach to AECOPD varies based on the clinical setting and severity of the exacerbation. After history and examination, a number of investigations may be useful, including oximetry, sputum culture, chest X-ray and blood tests for inflammatory markers. Arterial blood gases should be considered in severe exacerbations, to characterize respiratory failure. Depending on the severity, the acute management of AECOPD involves use of bronchodilators, steroids, antibiotics, oxygen and noninvasive ventilation. Hospitalization may be required, for severe exacerbations. Nonpharmacological interventions including disease-specific self-management, pulmonary rehabilitation, early medical follow-up, home visits by respiratory health workers, integrated programmes and telehealth-assisted hospital at home have been studied during hospitalization and shortly after discharge in patients who have had a recent AECOPD. Pharmacological approaches to reducing risk of future exacerbations include long-acting bronchodilators, inhaled steroids, mucolytics, vaccinations and long-term macrolides. Further studies are needed to assess the cost-effectiveness of these interventions in preventing COPD exacerbations.

  6. Airway Hydration and COPD

    Science.gov (United States)

    Ghosh, Arunava; Boucher, R.C.; Tarran, Robert

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the prevalent causes of worldwide mortality and encompasses two major clinical phenotypes, i.e., chronic bronchitis (CB) and emphysema. The most common cause of COPD is chronic tobacco inhalation. Research focused on the chronic bronchitic phenotype of COPD has identified several pathological processes that drive disease initiation and progression. For example, the lung’s mucociliary clearance (MCC) system performs the critical task of clearing inhaled pathogens and toxic materials from the lung. MCC efficiency is dependent on: (i) the ability of apical plasma membrane ion channels such as the cystic fibrosis transmembrane conductance regulator (CFTR) and the epithelial Na+ channel (ENaC) to maintain airway hydration; (ii) ciliary beating; and, (iii) appropriate rates of mucin secretion. Each of these components is impaired in CB and likely contributes to the mucus stasis/accumulation seen in CB patients. This review highlights the cellular components responsible for maintaining MCC and how this process is disrupted following tobacco exposure and with CB. We shall also discuss existing therapeutic strategies for the treatment of chronic bronchitis and how components of the MCC can be used as biomarkers for the evaluation of tobacco or tobacco-like-product exposure. PMID:26068443

  7. Medical Mystery: Losing the sense of smell

    Science.gov (United States)

    ... Hearing Disorders Medical Mystery: Losing the sense of smell Past Issues / Fall 2008 Table of Contents For ... a teenager that took away her sense of smell. Photo courtesy of Malone University Imagine, if you ...

  8. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  9. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  10. Enteral nutrition in the chronic obstructive pulmonary disease (COPD) patient.

    Science.gov (United States)

    DeBellis, Heather F; Fetterman, James W

    2012-12-01

    Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

  11. Lose-weight effect to high fat diet-induced obese mice of an analogue of rimonabant%利莫那班改构物对高脂饮食诱导肥胖小鼠的减肥效应及机制

    Institute of Scientific and Technical Information of China (English)

    杨海冬; 高静; 李静; 范如霖; 姚虎; 冯建科

    2012-01-01

    目的:从新合成的利莫那班改构物中筛选对饮食诱导的肥胖小鼠具有减肥作用的化合物,探讨其减肥效应及机制.方法:采用放射性受体配体结合试验测定利莫那班改构物对CB1受体的IC50,高脂饮食法诱导建立肥胖小鼠模型,给予改构物ZH 10 mg/kg和30 mg/k治疗4周,检测体质量变化以及生殖器周围脂肪含量、脂肪细胞形态和血清胆固醇、三酰甘油含量的变化.结果:改构物ZH对CB1受体具有抑制作用,可显著减少小鼠的食物摄入量和体质量,降低生殖器周围脂肪、血清胆固醇及三酰甘油的含量.结论:ZH可通过抑制CB1受体,降低食欲产生减肥作用,同时能降低血脂水平.%Objective: A series of analogues of rimonabant were synthesized to investigate their lose-weight effect and mechanisms. Methods: The IC50 of analogues on the CB1 were determined by Radioactive-ligand receptor binding assay, male ICR mice were fed with high fat diet to build the obese mice model and treated with 10 mg/kg or 30 mg/kg ZH per day for 4 weeks. Body weight and the content/morphology of genital peripheral adipose tissue were detected, the content of total cholesterol (TC) and triacylglycerol (TG) in serum were also estimated. Results; ZH had the inhibition on the CB1, it could significantly reduce the food intake and body weight, the content of genital peripheral adipose tissue, TC and TG in serum were reduced. Conclusion; ZH could suppress the CB1, ZH reduced the weight through inhibiting appetite and blood lip-id levels.

  12. The many "small COPDs": COPD should be an orphan disease

    DEFF Research Database (Denmark)

    Rennard, Stephen I; Vestbo, Jørgen

    2008-01-01

    status, therefore, could facilitate the development of treatments for both phenotypic subsets of COPD patients as well as aid the development of agents to alter the natural history of the disease. Post-drug approval regulations could require that agents approved under the orphan provisions......COPD is one of the most common causes of morbidity and mortality. Perhaps paradoxically, COPD also should be an orphan disease. Importantly, this could advance the development of treatments for COPD. There are two criteria for orphan status in the United States. Most widely known is the criterion...... groups based on mechanism sets the stage for the rational development of therapeutics. In addition, many candidate treatments may alter the natural history of COPD. Testing them, however, will require large studies for a duration that will compromise the commercial life of any resulting product. Orphan...

  13. COPD exacerbations, inflammation and treatment

    NARCIS (Netherlands)

    Bathoorn, Derk

    2007-01-01

    This thesis describes investigations into the inflammation in COPD, and its treatment. Inflammation in COPD is a central factor in the onset of the disease and its progression. During acute deteriorations of the disease, exacerbations, the inflammation is more severe, and depending on the cause of t

  14. COPD: balancing oxidants and antioxidants

    Science.gov (United States)

    Fischer, Bernard M; Voynow, Judith A; Ghio, Andrew J

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most common chronic illnesses in the world. The disease encompasses emphysema, chronic bronchitis, and small airway obstruction and can be caused by environmental exposures, primarily cigarette smoking. Since only a small subset of smokers develop COPD, it is believed that host factors interact with the environment to increase the propensity to develop disease. The major pathogenic factors causing disease include infection and inflammation, protease and antiprotease imbalance, and oxidative stress overwhelming antioxidant defenses. In this review, we will discuss the major environmental and host sources for oxidative stress; discuss how oxidative stress regulates chronic bronchitis; review the latest information on genetic predisposition to COPD, specifically focusing on oxidant/antioxidant imbalance; and review future antioxidant therapeutic options for COPD. The complexity of COPD will necessitate a multi-target therapeutic approach. It is likely that antioxidant supplementation and dietary antioxidants will have a place in these future combination therapies. PMID:25673984

  15. Prevalence characteristics of COPD in never smokers

    Directory of Open Access Journals (Sweden)

    Ramadan M. Bakr

    2012-07-01

    Conclusions: This study revealed that never smokers constitute a significant proportion of the Egyptian COPD patients. When dealing with COPD management, clinicians must be oriented with the different risk factors, other than tobacco smoke, that play a key role in the development and pathogenesis of COPD, because despite smoking is the most important risk factor, its absence doesn’t exclude COPD diagnosis.

  16. Diagnostic imaging in COPD; Radiologische Diagnostik bei COPD

    Energy Technology Data Exchange (ETDEWEB)

    Owsijewitsch, Michael; Ley-Zaporozhan, Julia [Universitaetsklinik Heidelberg (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Eichinger, Monika [Deutsches Krebsforschungszentrum (DKFZ), Heidelberg (Germany). Abt. Radiologie

    2011-03-15

    COPD is a heterogeneous disease defined by expiratory airflow limitation. Airflow limitation is caused by a variable combination of emphysematous destruction of lung parenchyma and small airway obstruction. Only advanced emphysema can be diagnosed by chest X-ray. Less severe emphysema and changes in small airways are commonly diagnosed by computed tomography. Typical visual appearance of pathologic changes in lung parenchyma and airways of COPD patients are presented, furthermore methods for quantitative assessment of these changes and the crucial role of imaging for surgical and bronchoscopic treatment in COPD are discussed. (orig.)

  17. [COPD-nonpharmacological treatment].

    Science.gov (United States)

    Pfeifer, Michael

    2006-04-15

    The modern concept of chronic obstructive pulmonary disease (COPD) goes far beyond pure medical therapy. Solely treating obstruction and inflammation of the airways does not correspond to the complexity of this illness which now is considered a systemic disease. Therapeutic planning comprises prevention, early physiotherapy and physical training, educational measures, and, in advanced stages, long-term oxygen therapy, mechanical support of the ventilatory muscular system by noninvasive ventilation and surgical measures. To stop smoking is the most important preventive measure which succeeds in up to 40% when carried through consequently. COPD will eventually lead to a steadily decreasing cardiopulmonary performance. Physical training therefore is of utmost importance. Physical training will be accompanied by ventilatory and physiotherapy, a sophisticated dietary treatment, as well as education and motivation of the patient in order to develop competence in self-management. Further treatments in advanced stages consist of long-term oxygen therapy and intermittent noninvasive ventilation. The latter is the treatment of choice for acute respiratory insufficiency. Operative treatments like lung volume reduction and lung transplantation are only indicated in selected cases.

  18. A simplified score to quantify comorbidity in COPD.

    Directory of Open Access Journals (Sweden)

    Nirupama Putcha

    Full Text Available Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score that reflects comorbidity burden on patient-centered outcomes.Using the COPDGene study (GOLD II-IV COPD, we developed comorbidity scores to describe patient-centered outcomes employing three techniques: 1 simple count, 2 weighted score, and 3 weighted score based upon statistical selection procedure. We tested associations, area under the Curve (AUC and calibration statistics to validate scores internally with outcomes of respiratory disease-specific quality of life (St. George's Respiratory Questionnaire, SGRQ, six minute walk distance (6MWD, modified Medical Research Council (mMRC dyspnea score and exacerbation risk, ultimately choosing one score for external validation in SPIROMICS.Associations between comorbidities and all outcomes were comparable across the three scores. All scores added predictive ability to models including age, gender, race, current smoking status, pack-years smoked and FEV1 (p<0.001 for all comparisons. Area under the curve (AUC was similar between all three scores across outcomes: SGRQ (range 0·7624-0·7676, MMRC (0·7590-0·7644, 6MWD (0·7531-0·7560 and exacerbation risk (0·6831-0·6919. Because of similar performance, the comorbidity count was used for external validation. In the SPIROMICS cohort, the comorbidity count performed well to predict SGRQ (AUC 0·7891, MMRC (AUC 0·7611, 6MWD (AUC 0·7086, and exacerbation risk (AUC 0·7341.Quantifying comorbidity provides a more thorough understanding of the risk for patient-centered outcomes in COPD. A comorbidity count performs well to quantify comorbidity in a diverse population with COPD.

  19. New drug therapies for COPD.

    Science.gov (United States)

    Ross, Clare L; Hansel, Trevor T

    2014-03-01

    Clinical trials with new drugs for chronic obstructive pulmonary disease (COPD) have been performed. Viruses exacerbate COPD and bacteria may play a part in severe COPD; therefore, antibiotic and antiviral approaches have a sound rationale. Antiinflammatory approaches have been studied. Advances in understanding the molecular basis of other processes have resulted in novel drugs to target reactive oxidant species, mucus, proteases, fibrosis, cachexia, and muscle wasting, and accelerated aging. Studies with monoclonal antibodies have been disappointing, highlighting the tendency for infections and malignancies during treatment. Promising future directions are lung regeneration with retinoids and stem cells.

  20. On k-hypertournament losing scores

    CERN Document Server

    Pirzada, Shariefuddin

    2010-01-01

    We give a new and short proof of a theorem on k-hypertournament losing scores due to Zhou et al. [G. Zhou, T. Yao, K. Zhang, On score sequences of k-tournaments, European J. Comb., 21, 8 (2000) 993-1000.

  1. "Losing Battles": The Tests of Endurance.

    Science.gov (United States)

    Rienstra, Phillis

    The works of Eudora Welty challenge the abilities of the oral reader who wishes to interpret them properly. Her novel, "Losing Battles," requires careful attention to the narrative point of view as a guide to its various dimensions of meaning. The narrative shifts through the consciousnesses of various characters of four generations in a rural…

  2. Vaccines for Patients with COPD.

    Science.gov (United States)

    Moreno, Dolores; Barroso, Judith; Garcia, Alexis

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow limitation. This disease is currently the fourth higher cause of death in the world, and it is predicted to be the third by the year 2020. Patients with COPD are frequently exposed to Human Rhinovirus, Respiratory Syncytial and Influenza Virus, as well as to Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. These infectious agents are responsible for exacerbations increasing morbidity and mortality in COPD patients. Prevention of infectious exacerbations by vaccination would improve quality of life and patient survival. A literature search: "vaccination of COPD patients" was performed using Medline, the Cochrane Library and other Non-Indexed Citations for this review. This article presents a brief overview of the different studies found, on the new patents, and the future strategies on the field.

  3. [Cell based therapy for COPD].

    Science.gov (United States)

    Kubo, Hiroshi

    2007-04-01

    To develop a new cell based therapy for chronic obstructive pulmonary disease (COPD), we need to understand 1) the role of tissue-specific and bone marrow-derived stem cells, 2) extracellular matrix, and 3) growth factors. Recently, bronchioalveolar stem cells were identified in murine distal lungs. Impairment of these stem cells may cause improper lung repair after inflammation, resulting in pulmonary emphysema. Bone marrow-derived cells are necessary to repair injured lungs. However, the long term role of these cells is not understood yet. Although we need more careful analysis and additional experiments, growth factors, such as hepatocyte growth factor, are good candidates for the new cell based therapy for COPD. Lung was believed as a non-regenerative organ. Based on these recent reports about lung regeneration and stem cells, however, new strategies to treat COPD and a new point of view to understand the pathophysiology of COPD are rising.

  4. Impact of exacerbations on COPD

    Directory of Open Access Journals (Sweden)

    A. Anzueto

    2010-06-01

    Full Text Available Exacerbations of chronic obstructive pulmonary disease (COPD determine disease-associated morbidity, mortality, resource burden and healthcare costs. Acute exacerbation care requirements range from unscheduled primary care visits to emergency room, inpatient or intensive care, generating significant costs in COPD. Even after an exacerbation resolves, respiratory, physical, social and emotional impairment may persist for prolonged time. Frequent exacerbations, mainly in patients with severe COPD, accelerate disease progression and mortality. Thus, patients with frequent exacerbations have a more rapid decline in lung function, worse quality of life and decreased exercise performance. Management of COPD directed to reduce incidence and severity of exacerbations improves long-term health status and conserves health care resources and costs.

  5. Maximal exercise in obese patients with COPD: the role of fat free mass

    OpenAIRE

    Aiello, Marina; Teopompi, Elisabetta; Tzani, Panagiota; Ramponi, Sara; Gioia, Maria Rosaria; Marangio, Emilio; Chetta, Alfredo

    2014-01-01

    Background Obese patients (OB) with COPD may better tolerate exercise as compared to normal weight (NW) COPD patients, even if the reason for this is not yet fully understood. We investigated the interactions between obesity, lung hyperinflation, fat-free mass (FFM) and exercise capacity in COPD. Methods Forty-four patients (16 females; age 65 ± 8 yrs) were assessed by resting lung function and body composition and exercised on a cycle-ergometer to exhaustion. Results Twenty-two OB and 22 NW ...

  6. Weight loss - unintentional

    Science.gov (United States)

    ... of your weight loss. When to Contact a Medical Professional Call your health care provider if: You or a family member loses more ... to Expect at Your Office Visit The ... be asked questions about your medical history and symptoms, including: How much weight have ...

  7. Losing Items in the Psychogeriatric Nursing Home

    Directory of Open Access Journals (Sweden)

    J. van Hoof PhD

    2016-09-01

    Full Text Available Introduction: Losing items is a time-consuming occurrence in nursing homes that is ill described. An explorative study was conducted to investigate which items got lost by nursing home residents, and how this affects the residents and family caregivers. Method: Semi-structured interviews and card sorting tasks were conducted with 12 residents with early-stage dementia and 12 family caregivers. Thematic analysis was applied to the outcomes of the sessions. Results: The participants stated that numerous personal items and assistive devices get lost in the nursing home environment, which had various emotional, practical, and financial implications. Significant amounts of time are spent on trying to find items, varying from 1 hr up to a couple of weeks. Numerous potential solutions were identified by the interviewees. Discussion: Losing items often goes together with limitations to the participation of residents. Many family caregivers are reluctant to replace lost items, as these items may get lost again.

  8. Role of autophagy in COPD skeletal muscle dysfunction.

    Science.gov (United States)

    Hussain, Sabah N A; Sandri, Marco

    2013-05-01

    Chronic obstructive pulmonary disease (COPD) is a debilitating disease caused by parenchymal damage and irreversible airflow limitation. In addition to lung dysfunction, patients with COPD develop weight loss, malnutrition, poor exercise performance, and skeletal muscle atrophy. The latter has been attributed to an imbalance between muscle protein synthesis and protein degradation. Several reports have confirmed that enhanced protein degradation and atrophy of limb muscles of COPD patient is mediated in part through activation of the ubiquitin-proteasome pathway and that this activation is triggered by enhanced production of reactive oxygen species. Until recently, the importance of the autophagy-lysosome pathway in protein degradation of skeletal muscles has been largely ignored, however, recent evidence suggests that this pathway is actively involved in recycling of cytosolic proteins, organelles, and protein aggregates in normal skeletal muscles. The protective role of autophagy in the regulation of muscle mass has recently been uncovered in mice with muscle-specific suppression of autophagy. These mice develop severe muscle weakness, atrophy, and decreased muscle contractility. No information is yet available about the involvement of the autophagy in the regulation of skeletal muscle mass in COPD patients. Pilot experiments on vastus lateralis muscle samples suggest that the autophagy-lysosome system is induced in COPD patients compared with control subjects. In this review, we summarize recent progress related to molecular structure, regulation, and roles of the autophagy-lysosome pathway in normal and diseased skeletal muscles. We also speculate about regulation and functional importance of this system in skeletal muscle dysfunction in COPD patients.

  9. Correlation of BMI and oxygen saturation in stable COPD in Northern India

    Directory of Open Access Journals (Sweden)

    Shiv Sagar Gupta

    2014-01-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is associated with clinically relevant extra pulmonary manifestations; one of them is weight loss. However, there are very few studies from North India available in relation to body mass index (BMI and Oxygen saturation (SpO 2 with COPD. Aims: To study the prevalence of undernutrition among stable COPD patients and correlation of COPD severity with SpO 2 and BMI. Settings and Design: A prospective study was carried out at a tertiary care hospital. Subjects and Methods: COPD patients were diagnosed and staged as per global initiative for chronic obstructive lung disease (GOLD guidelines. SpO 2 was measured using pulse oxymeter and BMI categorization was done as per new classification for Asian Indians (2009. Statistical analysis was done using Statistical Package for Social Sciences Version 15.0. Results: Out of 147 COPD patients, 85 (57.8% were undernourished. The prevalence of undernourished BMI was 25%, 50.8%, 61.7%, and 80% in stage I, II, III and IV respectively; statistically significant (P < 0.050. The mean SpO 2 was 95.50 ± 1.41, 95.05 ± 2.42, 94.37 ± 2.28 and 93.05 ± 1.39 in stage I, II, III and IV respectively; statistically significant (F = 4.723; P = 0.004. Conclusions: The overall prevalence of under nutrition among COPD patients was 57.8%. With increasing COPD stage the BMI and median SpO 2 value decreased in progressive manner. Association of SpO 2 and COPD stages could be explored further in order to suggest an additional marker of disease severity that would add a new dimension in the management of COPD.

  10. Nutritional deficits in elderly smokers with respiratory symptoms that do not fulfill the criteria for COPD

    Directory of Open Access Journals (Sweden)

    Obase Y

    2011-12-01

    Full Text Available Yasushi Obase1, Keiji Mouri1, Hiroki Shimizu1, Yoshihiro Ohue1, Yoshihiro Kobashi1, Kazue Kawahara2, Mikio Oka11Department of Respiratory Medicine, Kawasaki Medical School, 2Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, JapanBackground and objective: Whereas nutrition deficits are recognized as an expression of systemic inflammation in the elderly with diagnosed chronic obstructive pulmonary disease (COPD, if they occur in symptomatic elderly smokers, unfulfilled COPD criteria are not confirmed.Methods: Respiratory function, anthropometry assessment, and diet intake evaluation of 13 COPD patients (COPD group, ten symptomatic elderly smokers (SYSM group, and 27 healthy volunteers (control group were compared. All were 70 years old or older.Results: The SYSM group had lower body weight, body mass index, percentage ideal body weight, body fat percentage, arm muscle circumference, tricep skin fold thickness, serum albumin, prealbumin, and transferrin than the control group and were similar to the COPD group (P < 0.05 each and nonsignificant each. Resting energy expenditure was no different among the groups. Intake of energy, vitamins (A, B1, B2, and C, calcium, iron, fiber, and sodium was also lower in the SYSM group than in the control group (P < 0.05 all and was similar to the COPD group.Conclusion: Elderly smokers who are symptomatic but who do not fulfill the COPD diagnostic criteria have nutritional deficits related to insufficient energy intake that are similar to those seen in COPD patients.Keywords: chronic obstructive pulmonary disease (COPD, nutritional status, body composition, resting energy expenditure (REE

  11. ANTIOXIDANT THERAPEUTIC ADVANCES IN COPD

    Science.gov (United States)

    Rahman, Irfan

    2009-01-01

    Chronic obstructive pulmonary disease (COPD) is associated with high incidence of morbidity and mortality. Oxidative stress is intimately associated with the progression and exacerbation of COPD and therefore targeting oxidative stress with antioxidants or boosting the endogenous levels of antioxidants is likely to have beneficial outcome in the treatment of COPD. Among the various antioxidants tried so far, thiol antioxidants and mucolytic agents, such as glutathione, N-acetyl-L-cysteine, N-acystelyn, erdosteine, fudosteine, and carbocysteine; Nrf2 activators, and dietary polyphenols (curcumin, resveratrol, green tea, and catechins/quercetin) have been reported to increase intracellular thiol status alongwith induction of GSH biosynthesis. Such an elevation in the thiol status in turn leads to detoxification of free radicals and oxidants as well as inhibition of ongoing inflammatory responses. In addition, specific spin traps, such as a-phenyl-N-tert-butyl nitrone, a catalytic antioxidant (ECSOD mimetic), porphyrins (AEOL 10150 and AEOL 10113), and a SOD mimetic M40419 have also been reported to inhibit cigarette smoke-induced inflammatory responses in vivo in the lung. Since a variety of oxidants, free radicals and aldehydes are implicated in the pathogenesis of COPD; it is possible that therapeutic administration of multiple antioxidants and mucolytics will be effective in management of COPD. However, a successful outcome will critically depend upon the choice of antioxidant therapy for a particular clinical phenotype of COPD, whose pathophysiology should be first properly understood. This article will review the various approaches adopted to enhance lung antioxidant levels, antioxidant therapeutic advances and recent past clinical trials of antioxidant compounds in COPD. PMID:19124382

  12. COPD -- how to use a nebulizer

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000699.htm COPD - how to use a nebulizer To use the ... page, please enable JavaScript. A nebulizer turns your COPD medicine into a mist. It is easier to ...

  13. Sleep Problems in Asthma and COPD

    Science.gov (United States)

    ... Mini Series #5 Sleep Problems in Asthma and COPD NORMAL AIRWAY Good quality sleep is important for ... with asthma and/or Chronic Obstructive Pulmonary Disease (COPD) may have sleep issues that can lead to ...

  14. CD4-regulatory cells in COPD patients

    DEFF Research Database (Denmark)

    Smyth, Lucy J C; Starkey, Cerys; Vestbo, Jørgen

    2007-01-01

    BACKGROUND: The numbers of airway CD8 and B lymphocytes are increased in COPD patients, suggesting an autoimmune process. CD4-regulatory T cells control autoimmunity but have not been studied in patients with COPD. OBJECTIVE: To compare T-regulatory cell numbers in the BAL from COPD patients, smo...

  15. COPD exacerbation: anthropometric characteristics of patients and the frequency of hospital admissions

    Directory of Open Access Journals (Sweden)

    Gashynova K.Y.

    2014-11-01

    Full Text Available Exceptional importance of exacerbations for COPD course prognosing was reflected in the GOLD, 2011, where the number of exacerbations during the past year has been recognized as one of the main criteria of the future risks for patients. The aim of study was to determine the anthropometric indicators that increase the risk of re-hospitalization due to acute exacerbation of COPD. A retrospective analysis of medical records of inpatients who were hospitalized with COPD exacerbation to therapeutic department of CI "Dnipropetrovs’k sixth municipal clinical hospital" of Dnipropetrovsk regional council" during three years was done. It was established that neither sex, nor height, nor weight affect the rate of hospitalization due to COPD exacerbations. Older age is not a factor that increases the risk of hospitalization due to COPD exacerbation (despite the fact that the majority of hospitalized patients were elderly patients, 37% of them were persons of potentially working age. Severe exacerbation of COPD may occur in any patients with, even one year, experience of the disease. Among anthropometric indices, the most important predictor of re-hospitalization due to exacerbation of COPD is BMI<18.5, so its calculation is advisable in long-term observation of patients.

  16. Protein-losing enteropathies in dogs.

    Science.gov (United States)

    Dossin, Olivier; Lavoué, Rachel

    2011-03-01

    Protein-losing enteropathy is common in dogs but rare in cats. In the vast majority of cases, it is associated with inflammatory bowel disease, intestinal lymphoma, or intestinal lymphangiectasia. The diagnosis is based on identification of hypoalbuminemia and ruling out urinary loss and liver failure. Identification of the intestinal lesion with appropriate biopsy method is important to rule out neoplasm or infectious causes. The treatment is based on intensive nutritional support, therapy for the causative condition, and early monitoring of possibly life-threatening complications, such as hypocobalaminemia, massive pleural or abdominal fluid collection, thromboembolism, and hypocalcemia or hypomagnesemia.

  17. The effect of losing the twin and losing the partner on mortality

    DEFF Research Database (Denmark)

    Tomassini, Cecilia; Rosina, Alessandro; Billari, Francesco C

    2002-01-01

    Several studies have explored the impact of marital bereavement on mortality, while increasing emphasis has recently been placed on genetic factors influencing longevity - in this paper, we study the impact of losing the spouse and losing the co-twin, for twins aged 50 to 70. We use data from...... is similar for men and women, and it is higher for monozygotic twins. The latter confirms the influence of genetic factors on survival, while the mortality trajectory with a peak in the second year after the death of the co-twin is consistent with the existence of a twin bereavement effect....

  18. Novel anti-inflammatory agents in COPD

    DEFF Research Database (Denmark)

    Loukides, Stelios; Bartziokas, Konstantinos; Vestbo, Jørgen

    2013-01-01

    Inflammation plays a central role in chronic obstructive pulmonary disease (COPD). COPD related inflammation is less responsive to inhaled steroids compared to asthma. There are three major novel anti-inflammatory approaches to the management of COPD. The first approach is phosphodiesterase...... on these strategies exist at the moment. A third potential approach involves novel agents whose mechanism of action is closely related to COPD mechanisms and pathophysiology. Such novel treatments are of great interest since they may treat both COPD and co-morbidities. Several novel agents are currently under...

  19. Characteristics of reversible and nonreversible COPD and asthma and COPD overlap syndrome patients: an analysis of salbutamol Easyhaler data.

    Science.gov (United States)

    Müller, Veronika; Gálffy, Gabriella; Orosz, Márta; Kováts, Zsuzsanna; Odler, Balázs; Selroos, Olof; Tamási, Lilla

    2016-01-01

    The choice of inhaler device for bronchodilator reversibility is crucial since suboptimal inhalation technique may influence the result. On the other hand, bronchodilator response also varies from time to time and may depend on patient characteristics. In this study, patients with airway obstruction (forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] ratio salbutamol dry powder inhaler (Buventol Easyhaler, Orion Pharma Ltd, Espoo, Finland). Demographic data and patients' perceptions of Easyhaler compared with β2-agonist pressurized metered dose inhalers (pMDIs) were analyzed. American Thoracic Society/European Respiratory Society guideline defined reversibility was found in 21 out of 63 COPD patients and in two out of 12 ACOS patients. Airway obstruction was more severe in COPD patients as compared with controls (mean FEV1 and FEV1% predicted both Psalbutamol was significantly lower in COPD patients compared with asthma controls (Psalbutamol dry powder inhaler. Nonreversible patients with COPD were characterized by higher weight and body mass index, and a higher FEV1/FVC ratio. Most patients preferred Easyhaler compared with a pMDI.

  20. Land-losing Farmers’ Citizenization in the Process of Urbanization

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Starting from the status of citizenization of land-losing farmers,problems in the citizenization are analyzed,such as the difficulty in land-losing farmers’ economic life after turning into citizens,employment difficulties of land-losing farmers after living in the city,and the prominent problems in social security of land-losing farmers.Causations for the citizenization problems of land-losing farmers are analyzed.Firstly,institutionalized rejection is the root of the obstacle in citizenization of land-losing farmers.Secondly,exclusion from social security system is a fundamental reason.Thirdly,exclusion of land-losing farmers from both urban citizens and themselves is the subjective factor.Fourthly,exclusion of land-losing farmers from urban employment is the objective factor.Based on these,countermeasures are put forward:formulating a reasonable price of land transfer;establishing a reasonable land compensation and benefit-sharing mechanism;setting up a multi-level social security system for land-losing farmers;increasing the human capital investment in land-losing farmers to enhance their employment status;and improving the cultural quality of land-losing farmers to realize the change in lifestyle.

  1. Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    ... term that is used to include chronic bronchitis, emphysema, or a combination of both conditions. Asthma is also a disease where it is difficult ... with COPD to also have some degree of asthma. What is chronic ... back to their original size. In emphysema, the walls of some of the alveoli have ...

  2. ANTIOXIDANT PHARMACOLOGIAL THERAPIES FOR COPD

    Science.gov (United States)

    Rahman, Irfan; MacNee, William

    2013-01-01

    Increased oxidative stress occurs in the lungs and systemically in COPD, which plays a role in many of the pathogenic mechanisms in COPD. Hence, targeting local lung and systemic oxidative stress with agents that modulate the antioxidants/redox system or boost endogenous antioxidants would be a useful therapeutic approach in COPD. Thiol antioxidants (N-acetyl-L-cysteine and N-acystelyn, carbocysteine, erdosteine, and fudosteine have been used to increase lung thiol content. Modulation of cigarette smoke induced oxidative stress and its consequent cellular changes have also been reported to be effected by synthetic molecules, such as spin traps (α-phenyl-N-tert-butyl nitrone), catalytic antioxidants (superoxide dismutase [ECSOD] mimetics), porphyrins, and lipid peroxidation and protein carbonylation blockers/inhibitors (edaravone and lazaroids/tirilazad). Pre-clinical and clinical trials have shown that these antioxidants can reduce oxidative stress, affect redox and glutathione biosynthesis genes, and pro-inflammatory gene expression. In this review the approaches to enhance lung antioxidants in COPD and the potential beneficial effects of antioxidant therapy on the course of the disease are discussed. PMID:22349417

  3. Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients

    Science.gov (United States)

    Dhamane, Amol D; Schwab, Phil; Hopson, Sari; Moretz, Chad; Annavarapu, Srinivas; Burslem, Kate; Renda, Andrew; Kaila, Shuchita

    2017-01-01

    Background Patients with COPD often have multiple comorbidities requiring use of multiple medications, and adherence rates for maintenance COPD (mCOPD) medications are already known to be suboptimal. Presence of comorbidities in COPD patients, and use of medications used to treat those comorbidities (non-COPD medications), may have an adverse impact on adherence to mCOPD medications. Objective The objective of the study was to evaluate the association between non-adherence to mCOPD medications and non-COPD medications in COPD patients. Methods COPD patients were identified using a large administrative claims database. Selected patients were 40–89 years old and continuously enrolled for 12 months prior to and 24 months after the first identified COPD diagnosis (index date) during January 1, 2009 to December 31, 2010. Patients were required to have ≥1 prescription for a mCOPD medication within 365 days of the index date and ≥1 prescription for one of 12 non-COPD medication classes within ±30 days of the first COPD prescription. Adherence (proportion of days covered [PDC]) was measured during 365 days following the first COPD prescription. The association between non-adherence (PDC <0.8) to mCOPD and non-adherence to non-COPD medications was determined using logistic regression, controlling for baseline patient characteristics. Results A total of 14,117 patients, with a mean age of 69.9 years, met study criteria. Of these, 40.9% were males and 79.2% were non-adherent to mCOPD medications with a mean PDC of 0.47. Non-adherence to mCOPD medications was associated with non-adherence to 10 of 12 non-COPD medication classes (odds ratio 1.38–1.78, all P<0.01). Conclusion Adherence to mCOPD medications is low. Non-adherence (or adherence) to mCOPD medications is positively related to non-adherence (or adherence) to non-COPD medications, implying that the need to take medications prescribed for comorbid conditions does not adversely impact adherence to mCOPD

  4. Positioning new pharmacotherapies for COPD

    Directory of Open Access Journals (Sweden)

    Barjaktarevic IZ

    2015-07-01

    Full Text Available Igor Z Barjaktarevic,1 Anthony F Arredondo,1 Christopher B Cooper1,2 1Department of Medicine, 2Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA Abstract: COPD imposes considerable worldwide burden in terms of morbidity and mortality. In recognition of this, there is now extensive focus on early diagnosis, secondary prevention, and optimizing medical management of the disease. While established guidelines recognize different grades of disease severity and offer a structured basis for disease management based on symptoms and risk, it is becoming increasingly evident that COPD is a condition characterized by many phenotypes and its control in a single patient may require clinicians to have access to a broader spectrum of pharmacotherapies. This review summarizes recent developments in COPD management and compares established pharmacotherapy with new and emerging pharmacotherapies including long-acting muscarinic antagonists, long-acting β-2 sympathomimetic agonists, and fixed-dose combinations of long-acting muscarinic antagonists and long-acting β-2 sympathomimetic agonists as well as inhaled cortiocosteroids, phosphodiesterase inhibitors, and targeted anti-inflammatory drugs. We also review the available oral medications and new agents with novel mechanisms of action in early stages of development. With several new pharmacological agents intended for the management of COPD, it is our goal to familiarize potential prescribers with evidence relating to the efficacy and safety of new medications and to suggest circumstances in which these therapies could be most useful. Keywords: COPD phenotypes, once-daily inhalers, fixed-combination inhalers, long-acting muscarinic antagonist, LAMA, long-acting β-2 sympathomimetic agonist, LABA

  5. As Weight Goes Up, So Does Death Risk

    Science.gov (United States)

    ... 164419.html As Weight Goes Up, So Does Death Risk Heart disease, cancer, other illnesses start to ... frequently lose a lot of weight prior to death, he said. "Some people have unintentional weight loss ...

  6. Misinformed leaders lose influence over pigeon flocks.

    Science.gov (United States)

    Watts, Isobel; Nagy, Máté; Burt de Perera, Theresa; Biro, Dora

    2016-09-01

    In animal groups where certain individuals have disproportionate influence over collective decisions, the whole group's performance may suffer if these individuals possess inaccurate information. Whether in such situations leaders can be replaced in their roles by better-informed group mates represents an important question in understanding the adaptive consequences of collective decision-making. Here, we use a clock-shifting procedure to predictably manipulate the directional error in navigational information possessed by established leaders within hierarchically structured flocks of homing pigeons (Columba livia). We demonstrate that in the majority of cases when leaders hold inaccurate information they lose their influence over the flock. In these cases, inaccurate information is filtered out through the rearrangement of hierarchical positions, preventing errors by former leaders from propagating down the hierarchy. Our study demonstrates that flexible decision-making structures can be valuable in situations where 'bad' information is introduced by otherwise influential individuals.

  7. Weight Management | Smokefree.gov

    Science.gov (United States)

    Fear of gaining weight is a common reason people give for not quitting smoking. Learn healthy ways to avoid weight gain and shed unwanted pounds. These weight management strategies can help you feel better while quitting smoking and let you take control of your health for the rest of your life. Remember that losing weight can be challenging and takes time, but being a healthy weight reduces the risk of many diseases and helps you look and feel better.

  8. Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients.

    Science.gov (United States)

    Dhamane, Amol D; Schwab, Phil; Hopson, Sari; Moretz, Chad; Annavarapu, Srinivas; Burslem, Kate; Renda, Andrew; Kaila, Shuchita

    2017-01-01

    Patients with COPD often have multiple comorbidities requiring use of multiple medications, and adherence rates for maintenance COPD (mCOPD) medications are already known to be suboptimal. Presence of comorbidities in COPD patients, and use of medications used to treat those comorbidities (non-COPD medications), may have an adverse impact on adherence to mCOPD medications. The objective of the study was to evaluate the association between non-adherence to mCOPD medications and non-COPD medications in COPD patients. COPD patients were identified using a large administrative claims database. Selected patients were 40-89 years old and continuously enrolled for 12 months prior to and 24 months after the first identified COPD diagnosis (index date) during January 1, 2009 to December 31, 2010. Patients were required to have ≥1 prescription for a mCOPD medication within 365 days of the index date and ≥1 prescription for one of 12 non-COPD medication classes within ±30 days of the first COPD prescription. Adherence (proportion of days covered [PDC]) was measured during 365 days following the first COPD prescription. The association between non-adherence (PDC non-adherence to non-COPD medications was determined using logistic regression, controlling for baseline patient characteristics. A total of 14,117 patients, with a mean age of 69.9 years, met study criteria. Of these, 40.9% were males and 79.2% were non-adherent to mCOPD medications with a mean PDC of 0.47. Non-adherence to mCOPD medications was associated with non-adherence to 10 of 12 non-COPD medication classes (odds ratio 1.38-1.78, all PAdherence to mCOPD medications is low. Non-adherence (or adherence) to mCOPD medications is positively related to non-adherence (or adherence) to non-COPD medications, implying that the need to take medications prescribed for comorbid conditions does not adversely impact adherence to mCOPD medications.

  9. Air pollution and COPD in China.

    Science.gov (United States)

    Hu, Guoping; Zhong, Nanshan; Ran, Pixin

    2015-01-01

    Recently, many researchers paid more attentions to the association between air pollution and chronic obstructive pulmonary disease (COPD). Haze, a severe form of outdoor air pollution, affected most parts of northern and eastern China in the past winter. In China, studies have been performed to evaluate the impact of outdoor air pollution and biomass smoke exposure on COPD; and most studies have focused on the role of air pollution in acutely triggering symptoms and exacerbations. Few studies have examined the role of air pollution in inducing pathophysiological changes that characterise COPD. Evidence showed that outdoor air pollution affects lung function in both children and adults and triggers exacerbations of COPD symptoms. Hence outdoor air pollution may be considered a risk factor for COPD mortality. However, evidence to date has been suggestive (not conclusive) that chronic exposure to outdoor air pollution increases the prevalence and incidence of COPD. Cross-sectional studies showed biomass smoke exposure is a risk factor for COPD. A long-term retrospective study and a long-term prospective cohort study showed that biomass smoke exposure reductions were associated with a reduced decline in forced expiratory volume in 1 second (FEV1) and with a decreased risk of COPD. To fully understand the effect of air pollution on COPD, we recommend future studies with longer follow-up periods, more standardized definitions of COPD and more refined and source-specific exposure assessments.

  10. EVALUATION OF NOCTURNAL OXYGEN DESATURATION IN COPD

    Directory of Open Access Journals (Sweden)

    Vaddadi Sailendra

    2016-09-01

    Full Text Available BACKGROUND Patients of COPD become hypoxic during sleep to a significant extent. Florid hypoxic episodes occur during REM sleep secondary to central diminution in respiratory output, accentuated by hypotonia of postural muscles, intercostals and accessory muscles of respiration. MATERIALS AND METHODS This is a cross-sectional study carried out prospectively in Gayathri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam, AP, India, to evaluate breathing disorders during sleep in COPD patients and to correlate them with the stage of the disease. SAMPLE SIZE A total of 36 COPD patients were enrolled into the study. They are classified into Mild, Moderate and Severe COPD categories in accordance to the Indian guidelines. The study was conducted between April 2014 and May 2016. POLYSOMNOGRAPHY Overnight sleep study was conducted using Compumedics Profusion Polysomnographic Machine. A total of 20 leads were utilised for the study. The sleep data recorded by the computer was manually scored for analysing Sleep stages, Apnoeas and Hypopnoeas. Sleep scoring was done according to R and K classification. Nocturnal oxygen desaturation is defined as >30% of total recording time with a SaO2 <90% (or nocturnal SaO2 <85% for at least 5 minutes. RESULTS Out of the 36 patients enrolled into the study, 6 were having mild COPD, 22 had moderate COPD and 8 had severe COPD. Total number of patients who had significant oxygen desaturation during sleep were 5 (13.9%. Out of these, 1 patient (16.67% belonged to Mild COPD, 1 (4.54% belonged to Moderate COPD and 3 (37.5% belonged to Severe COPD. CONCLUSION We conclude that in patients with COPD, daytime SpO2 is the single most useful determinant that contributes to NOD; daytime hypercapnia being the other important factor. In Severe COPD group, daytime PaO2 contributes to NOD whereas in Mild COPD, a raised AHI might explain the occurrence of NOD.

  11. Marginal Zone Lymphoma Complicated by Protein Losing Enteropathy

    Directory of Open Access Journals (Sweden)

    Nadine Stanek

    2016-01-01

    Full Text Available Protein losing enteropathy (PLE refers to excessive intestinal protein loss, resulting in hypoalbuminemia. Underlying pathologies include conditions leading to either reduced intestinal barrier or lymphatic congestion. We describe the case of a patient with long-lasting diffuse abdominal problems and PLE. Repetitive endoscopies were normal with only minimal lymphangiectasia in biopsies. Further evaluations revealed an indolent marginal zone lymphoma with minor bone marrow infiltration. Monotherapy with rituximab decreased bone marrow infiltration of the lymphoma but did not relieve PLE. Additional treatments with steroids, octreotide, a diet devoid of long-chain fatty-acids, and parenteral nutrition did not prevent further clinical deterioration with marked weight loss (23 kg, further reduction in albumin concentrations (nadir 8 g/L, and a pronounced drop in performance status. Finally, immunochemotherapy with rituximab and bendamustine resulted in hematological remission and remarkable clinical improvement. 18 months after therapy the patient remains free of gastrointestinal complaints and has regained his body weight with normal albumin levels. We demonstrate a case of PLE secondary to indolent marginal zone lymphoma. No intestinal pathologies were detected, contrasting a severe and almost lethal clinical course. Immunochemotherapy relieved lymphoma and PLE, suggesting that a high suspicion of lymphoma is warranted in otherwise unexplained cases of PLE.

  12. [Pulmonary medicine. Two new drugs for the treatment of COPD].

    Science.gov (United States)

    Rochat, Thierry

    2011-01-19

    Roflumilast is a new anti-inflammatory drug for the treatment of COPD. Studies have reported modest, but significant increase of FEV1 with roflumilast, as well as decreased rate of exacerbations. Its use is limited by drug-related nausea and weight lost occurring in some patients. Currently it is only available in Germany. Indacaterol is a new beta-2-adrenergic bronchodilator that needs only one inhalation per day. Studies with indacaterol report a good therapeutic window and the preparation is available in Switzerland. There is no reason that prevents prescription of indacaterol together with tiotropium, a once-a-day anti-cholinergic bronchodilator. However, no studies have specifically evaluated the combination of indacaterol and tiotropium in COPD.

  13. Sputum cell count: biomarkers in the differentiation of asthma, COPD and asthma-COPD overlap

    National Research Council Canada - National Science Library

    Gao J; Zhou WT; Chen BD; Lin WM; Wu SF; Wu F

    2017-01-01

    .... Accordingly, sputum cell counts are extensively used in the treatment of asthma and COPD. Nevertheless, the clinical application of sputum cell counts in patients with asthma-COPD overlap (ACO) remains elusive...

  14. Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD).

    Science.gov (United States)

    Hallin, Runa; Koivisto-Hursti, Ulla-Kaisa; Lindberg, Eva; Janson, Christer

    2006-03-01

    Loss of body weight, as a result of imbalance between increased energy demand and/or reduced dietary intake, is a common problem in patients with COPD. The aim of this investigation was to examine the relationship between nutritional intake, change in body weight and the risk of exacerbation in patients with COPD. The study comprised 41 patients who were hospitalised because of an exacerbation of COPD. The follow-up period was 12 months. Weight, height and lung function were measured at baseline. At the 12-month follow-up, weight change and current weight were assessed by an interview and nutritional intake was recorded in a food diary for 7 days. An acute exacerbation was defined as having been admitted to hospital and/or making an emergency visit to hospital, due to COPD during the follow-up period. At baseline, 24% of the patients were underweight (body mass index (BMI)25 kg/m2). Energy intake was lower than the calculated energy demand for all groups. During the follow-up period, 24 of the 41 patients had an exacerbation. A low BMI at inclusion and weight loss during the follow-up period were independent risk factors for having an exacerbation (P=0.003 and 0.006, respectively). We conclude that, in patients who are hospitalised because of COPD, underweight and weight loss during the follow-up period are related to a higher risk of having new exacerbations.

  15. What Causes COPD? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn JavaScript on. Feature: The Challenge of COPD What Causes COPD? Past Issues / Fall 2014 Table of Contents Long- ... and the airways usually is the cause of COPD. In the United States, the most common irritant ...

  16. COPD Quiz | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn JavaScript on. Feature: The Challenge of COPD COPD Quiz Past Issues / Fall 2014 Table of Contents ... Only one answer is correct . Questions Question 1. COPD is a lung disease that: usually starts during ...

  17. Characterisation of COPD heterogeneity in the ECLIPSE cohort

    DEFF Research Database (Denmark)

    Agusti, Alvar; Calverley, Peter M A; Celli, Bartolome

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE)....

  18. Characterisation of COPD heterogeneity in the ECLIPSE cohort

    DEFF Research Database (Denmark)

    Agusti, Alvar; Calverley, Peter M A; Celli, Bartolome

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE)....

  19. Modelling body weight, dieting and obesity traps

    Science.gov (United States)

    Barbieri, Paolo Nicola

    2017-02-01

    This paper presents a theoretical investigation into why losing weight is so difficult even in the absence of rational addiction, time-inconsistent preferences or bounded rationality. We add to the existing literature by focusing on the role that individual metabolism has on weight loss. The results from the theoretical model provide multiple steady states and a threshold revealing a situation of "obesity traps" that the individual must surpass in order to successfully lose weight. Any weight-loss efforts that the individual undertakes have to surpass such threshold in order to result in permanent weight loss, otherwise the individual will gradually regain weight and converge to his or her previous body weight.

  20. Diagnosis, assessment, and phenotyping of COPD

    DEFF Research Database (Denmark)

    Lange, Peter; Halpin, David M; O'Donnell, Denis E

    2016-01-01

    COPD is now widely recognized as a complex heterogeneous syndrome, having both pulmonary and extrapulmonary features. In clinical practice, the diagnosis of COPD is based on the presence of chronic airflow limitation, as assessed by post-bronchodilator spirometry. The severity of the airflow...... limitation, as measured by percent predicted FEV1, provides important information to the physician to enable optimization of management. However, in order to accurately assess the complexity of COPD, there need to be other measures made beyond FEV1. At present, there is a lack of reliable and simple blood...... biomarkers to confirm and further assess the diagnosis of COPD. However, it is possible to identify patients who display different phenotypic characteristics of COPD that relate to clinically relevant outcomes. Currently, validated phenotypes of COPD include alpha-1 antitrypsin deficiency, and "frequent...

  1. CD4-regulatory cells in COPD patients

    DEFF Research Database (Denmark)

    Smyth, Lucy J C; Starkey, Cerys; Vestbo, Jørgen

    2007-01-01

    BACKGROUND: The numbers of airway CD8 and B lymphocytes are increased in COPD patients, suggesting an autoimmune process. CD4-regulatory T cells control autoimmunity but have not been studied in patients with COPD. OBJECTIVE: To compare T-regulatory cell numbers in the BAL from COPD patients......, smokers with normal lung function, and healthy nonsmokers (HNS). METHODS: BAL and peripheral blood mononuclear cell (PBMC) samples were obtained from 26 COPD patients, 19 smokers, and 8 HNS. Flow cytometry was performed for regulatory phenotypic markers. RESULTS: COPD patients had increased BAL CD8...... numbers compared to smokers and HNS. CD4 numbers were similar between groups. There was increased BAL CD4CD25(bright) expression in smokers (median 28.8%) and COPD patients (median 23.1%) compared to HNS (median 0%). Increased FoxP3 expression was confirmed in BAL CD4CD25(bright) cells. BAL CD4CD25 cells...

  2. [Smoking cessation in patients with COPD].

    Science.gov (United States)

    Andreas, S; Batra, A; Behr, J; Chenot, J-F; Gillissen, A; Hering, T; Herth, F J F; Kreuter, M; Meierjürgen, R; Mühlig, S; Nowak, D; Pfeifer, M; Raupach, T; Schultz, K; Sitter, H; Walther, J W; Worth, H

    2014-04-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. Cigarette smoking is the main cause of COPD. Quitting smoking is thus the most effective treatment strategy and central in COPD prevention. A number of guidelines on prevention, diagnosis, therapy and rehabilitation of COPD have been published. To help implementing and standardizing smoking cessation in COPD a guideline was published 2008 in Germany focusing on this complex issue. The present guideline is an update of the 2008 guideline and has a high grade of evidence (S3 according to the AWMF; Arbeitsgemeinschaft wissenschaftlicher medizinischer Fachgesellschaften). The guideline gives comprehensive and practical information on how to integrate smoking cessation as an central part of COPD therapy.

  3. Characterisation of COPD heterogeneity in the ECLIPSE cohort

    DEFF Research Database (Denmark)

    Agusti, Alvar; Calverley, Peter M A; Celli, Bartolome

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE).......Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE)....

  4. The effect of losing the twin and losing the partner on mortality

    DEFF Research Database (Denmark)

    Tomassini, Cecilia; Rosina, Alessandro; Billari, Francesco C;

    2002-01-01

    Several studies have explored the impact of marital bereavement on mortality, while increasing emphasis has recently been placed on genetic factors influencing longevity - in this paper, we study the impact of losing the spouse and losing the co-twin, for twins aged 50 to 70. We use data from...... the Danish Twin Registry and the Population Register of Denmark for the period 1968 through 1999. Firstly, we use survival analysis to study mortality after the death of the spouse or the co-twin. We find that the risk of dying is highest in the first year after the death of the spouse, as well...... as in the second year after the death of the co-twin. We then use event history analysis techniques to show that there is a strong impact of the event 'losing the co-twin' even after controlling for age, sex and zygosity and that this effect is significantly higher in the second year of bereavement. The effect...

  5. Living with chronic obstructive pulmonary disease (COPD): part II. RNs' experience of nursing care for patients with COPD and impaired nutritional status.

    Science.gov (United States)

    Odencrants, Sigrid; Ehnfors, Margareta; Grobe, Susan J

    2007-03-01

    This study is the second part of a project with the main purpose of obtaining a deeper understanding of the consequences of living with chronic obstructive pulmonary disease (COPD) concerning meal-related situations and an impaired nutritional status. COPD is a slowly progressive lung disease that results in several complications, including malnutrition. Nutritional status is an important part of COPD treatment, and there are criteria recommended for nutritional assessment and interventions among patients with COPD. Despite this, patients with extreme malnutrition and unnoticed weight loss are reported. The aim of the study was to investigate how Registered Nurses (RNs) in primary care describe nutritional assessment practices and interventions in COPD patients with impaired nutritional status. An interview approach using semistructured questions and case vignettes was chosen. The sample included 19 RNs working specifically with COPD patients. Data from interviews were analysed using qualitative content analysis, and nine categories corresponding to the aim were identified. The RNs reported that their assessment of nutritional status was based largely on intuition. Assessment also included detection of the patients' current beliefs and being sensible about information provision - When and How. Interventions were supportive eating interventions, practical and cognitive participation, and making patients aware of the illness trajectory. An overall category that influenced nursing was respecting patients' feelings of shame and guilt about a self-inflicted disease. It seems that RNs use intuition because of a lack of knowledge of systematic methods of nutritional assessment. The findings also indicate that the RNs attempted to build a relationship of trust with the patients rather than provide early information on sensitive topics (e.g. nutritional information). The study reports areas of nursing care for COPD patients that must be improved in the future.

  6. COPD and PE: A clinical dilemma

    Science.gov (United States)

    Moua, Teng; Wood, Kenneth

    2008-01-01

    Dyspnea in patients with known chronic obstructive pulmonary disease (COPD) can be a clinical challenge due to the nonspecific nature of atypical presentations. Typical features of fever, productive cough, and wheezing on presentation support COPD exacerbation, while absence of such findings may warrant further evaluation for underlying etiologies, including pulmonary embolism (PE). It is suspected that one in four patients with atypical COPD exacerbation may have PE as an underlying or concomitant cause of acute dyspnea. This review discusses the clinical presentation of COPD and PE, and presents an overview of the rationale for pursuing work-up for thromboembolic disease in the setting of known obstructive lung diseases. PMID:18686736

  7. The cost of treating patients with COPD in Denmark--a population study of COPD patients compared with non-COPD controls

    DEFF Research Database (Denmark)

    Bilde, L; Rud Svenning, A; Dollerup, J;

    2007-01-01

    population than in the control group. COPD patients contacted their general practitioner 12 times more per year than non-COPD controls, but for specialist and paramedic treatment in the primary care sector there was no significant difference between COPD patients and non-COPD controls. Only one third...

  8. Distribution of body mass index among subjects with COPD in the Middle East and North Africa region: data from the BREATHE study

    Directory of Open Access Journals (Sweden)

    Koniski ML

    2015-08-01

    Full Text Available Marie-Louise Koniski,1 Hocine Salhi,2 Aïcha Lahlou,3 Nauman Rashid,4 Abdelkader El Hasnaoui4 1Respiratory Division, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon; 2Foxymed, Paris, France; 3MS Health, Rabat, Morocco; 4GlaxoSmithKline, Dubai, United Arab Emirates Background: Data describing the potential relationship between chronic obstructive pulmonary disease (COPD and body mass index (BMI are limited within the Middle East and North Africa (MENA region. Objective: To evaluate the distribution of BMI among subjects with COPD in the general population of the MENA region. Methods: This study was a subanalysis of the BREATHE study, a cross-sectional survey of COPD conducted in the general population of ten countries in the MENA region and Pakistan. The study population consisted of subjects screened for COPD who documented their weight and height. A COPD questionnaire was administered to subjects who screened positively for COPD in order to collect data on patient characteristics, symptom severity, management and burden of disease, comorbidities, and health care resource utilization and data allowing calculation of the BMI. The COPD Assessment Test (CAT was administered to those screened positively for COPD to collect data on the impact of respiratory symptoms. Results: Nine hundred and ninety-six subjects with COPD, who completed the detailed COPD questionnaire and documented their weight and height, were included in this analysis. The mean BMI was 27.7±5.7 kg/m2. The proportion of COPD patients with a BMI ≥25 kg/m2 is significantly higher than the proportion with a BMI <25 kg/m2 (64.6% [n=643] vs 35.4% [n=353], respectively; P<0.0001. There were no significant differences between the distribution of BMI, ages, sex, COPD symptoms, exacerbations, CAT scores, COPD-associated health care resource consumption, and GOLD severity groups. However, the occurrence of comorbidities such as diabetes and cardiovascular

  9. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD).

    Science.gov (United States)

    Hallin, Runa; Gudmundsson, Gunnar; Suppli Ulrik, Charlotte; Nieminen, Markku M; Gislason, Thorarinn; Lindberg, Eva; Brøndum, Eva; Aine, Tiina; Bakke, Per; Janson, Christer

    2007-09-01

    Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality in this patient group. In a multicentre study conducted at four university hospitals (Reykjavik, Uppsala, Tampere and Copenhagen) hospitalised patients with COPD were investigated. Patient height, weight and lung function was recorded. Health status was assessed with St. George's Hospital Respiratory Questionnaire. After 2 years, mortality data was obtained from the national registers in each country. Of the 261 patients in the study 19% where underweight (BMI <20), 41% were of normal weight (BMI 20-25), 26% were overweight (BMI 25-30) and 14% were obese. FEV(1) was lowest in the underweight and highest in the overweight group (p=0.001) whereas the prevalence of diabetes and cardio-vascular co-morbidity went the opposite direction. Of the 261 patients 49 (19%) had died within 2 years. The lowest mortality was found among the overweight patients, whereas underweight was related to increased overall mortality. The association between underweight in COPD-patients, and mortality remained significant after adjusting for possible confounders such as FEV(1) (hazard risk ratio (95% CI) 2.6 (1.3-5.2)). We conclude that COPD patients that are underweight at admission to hospital have a higher risk of dying within the next 2 years. Further studies are needed in order to show whether identifying and treating weight loss and depletion of fat-free mass (FFM) is a way forward in improving the prognosis for hospitalised COPD patients.

  10. Empowerment in people with COPD

    Directory of Open Access Journals (Sweden)

    Disler RT

    2015-12-01

    Full Text Available Rebecca T Disler,1–3 Jessica Appleton,1 Tracy A Smith,4,5 Matthew Hodson,6 Sally C Inglis,1,2 DorAnne Donesky,7 Patricia M Davidson8 1Faculty of Health, University of Technology Sydney, 2Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, 3Improving Palliative Care through Clinical Trials (ImPACCT, Sydney, 4Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, 5Faculty of Medicine, University of NSW, Sydney, NSW, Australia; 6ACERS, Integrated Medicine and Rehabilitation Services Division, Homerton University Hospital NHS Foundation Trust, London, UK; 7Department of Physiological Nursing, UCSF School of Nursing, San Francisco, CA, 8School of Nursing, Johns Hopkins University, Baltimore, MD, USA Background: Patient empowerment is recognized as an important aspect of chronic disease management. There is an increasing expectation that health providers engage patients as active participants in their own self-management. This engagement is crucial to the chronic care model as patients with COPD and their families manage the majority of the care in the community. Understanding what influences empowerment will help health care professionals to better engage in collaborative care planning and decision making that meet the needs of this new generation of health consumers. Aim: The aim of the present study was to identify interventions or approaches that empower patients in the management of COPD. Methods: An integrative review was undertaken following the preferred reporting items for systematic reviews and meta-analyses approach. Papers were included if they 1 provided a definition or conceptualization of empowerment, and 2 reported interventions or approaches fostering empowerment in patients with COPD. Thematic analysis was used to develop conceptual themes on patient empowerment in COPD. These conceptual themes were validated by a panel of specialists in COPD, chronic disease

  11. Balance impairment in patients with COPD.

    Directory of Open Access Journals (Sweden)

    Alexandru Florian Crişan

    Full Text Available Chronic obstructive pulmonary disease (COPD is a respiratory disease that results in progressive airflow limitation and respiratory distress. Physiopathological features of COPD suggest that people who suffer from this disease have many risk factors for falls that have been identified in older individuals. The aim of the study was to compare and quantify functional balance between COPD patients and healthy subjects; to investigate the risk of falls in acute stages of the disease and to identify risk factors that could lead to falls.We studied 46 patients with moderate-severe COPD (29 stable and 17 in acute exacerbation--AECOPD and 17 healthy subjects (control group having similar demographic data. We analyzed the difference in Berg Balance Scale (BBS, Single Leg Stance (SLS and Timed Up and Go test (TUG between these three groups and the correlation of these scores with a number of incriminatory factors.The presence of COPD was associated with significant worsening of balance tests: BBS (55 control, vs. 53 COPD, vs. 44 AECOPD points p<0.001, TUG (8.6 control vs. 12.3 COPD vs. 15.9 AECOPD seconds. p<0.001, SLS (31.1 control vs. 17.7 COPD vs. 7.2 AECOPD seconds p<0.001 which may be associated with an increased risk of falls. Anxiety and depression were significantly associated with decreased balance test scores; anxiety (2 control vs. 6 COPD vs. 9 AECOPD points p<0.001 depression (2 control vs. 7 COPD vs. 12 AECOPD points p<0.001.According to our results COPD patients in moderate-severe stages and especially those in exacerbation have a high risk of falls.

  12. Research on the Urban Integration of Land-losing Farmers

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Fishbone chart is used to analyze the status of the living ability of land-losing farmers, as well as its causation from the aspects of system layer, social support network, land-losing farmer themselves, and economic layer. Result shows that the system layer includes the unreasonable land compensation, the lack of social security for land-losing farmers, and the employment exclusion of land-losing farmers. Small scale and low heterogeneity are the causations for social support network. Low willingness to become citizens, low cultural quality and difficulty in role change are the causations of land-losing farmers themselves. The low expected return and high living cost are the causations for economic layer. Based on the above analysis, countermeasures to improve the urban-living ability of land-losing farmers are put forward, such as improving the land expropriation system, establishing a multi-level social security system, enhancing the training and employment mechanism of land-losing farmers, and improving the quality of land-losing farmers.

  13. Breathing Better with a COPD Diagnosis

    Science.gov (United States)

    Now that you kNow it’s CoPD, here’s how to breathe better. You have taken the important step of being aware of your symptoms, and seeing your doctor ... care provider for testing and a diagnosis. While COPD (Chronic Obstructive Pulmonary Disease) is a serious lung ...

  14. Lung microbiology and exacerbations in COPD

    Directory of Open Access Journals (Sweden)

    Beasley V

    2012-08-01

    Full Text Available Victoria Beasley,2 Priya V Joshi,2 Aran Singanayagam,1,2 Philip L Molyneaux,1,2 Sebastian L Johnston,1,2 Patrick Mallia,1,21National Heart and Lung Institute, Imperial College London, London, UK; 2Imperial College Healthcare NHS Trust, London, UKAbstract: Chronic obstructive pulmonary disease (COPD is the most common chronic respiratory condition in adults and is characterized by progressive airflow limitation that is not fully reversible. The main etiological agents linked with COPD are cigarette smoking and biomass exposure but respiratory infection is believed to play a major role in the pathogenesis of both stable COPD and in acute exacerbations. Acute exacerbations are associated with more rapid decline in lung function and impaired quality of life and are the major causes of morbidity and mortality in COPD. Preventing exacerbations is a major therapeutic goal but currently available treatments for exacerbations are not very effective. Historically, bacteria were considered the main infective cause of exacerbations but with the development of new diagnostic techniques, respiratory viruses are also frequently detected in COPD exacerbations. This article aims to provide a state-of-the art review of current knowledge regarding the role of infection in COPD, highlight the areas of ongoing debate and controversy, and outline emerging technologies and therapies that will influence future diagnostic and therapeutic pathways in COPD.Keywords: COPD, exacerbations, bacteria, viruses

  15. Optimizing care of your patients with COPD

    Directory of Open Access Journals (Sweden)

    Garvey C

    2014-02-01

    Full Text Available Chris Garvey,1 Nicola A Hanania,2 Pablo Altman3 1Seton Pulmonary and Cardiac Rehabilitation, Daly City, CA, USA; 2Asthma Clinical Research Center, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA; 3Mylan Specialty LP, Basking Ridge, NJ, USA (formerly Abstract: Chronic obstructive pulmonary disease (COPD is now the third-leading cause of death in the US. The primary risk factor for COPD is smoking. COPD is underdiagnosed, and spirometry, the main method for its diagnosis, is underutilized. Nurses can play an essential role in improving patient outcomes, in part by helping to apply clinical guidelines for care. Management of COPD consists of reduction of risk factor exposure (for example, smoking cessation, influenza vaccination, pharmacotherapy, and pulmonary rehabilitation. Comorbidities may pose a special challenge in patients with COPD and they may compete with COPD for attention during office visits. Of particular note with regard to pharmacotherapy is the choice of delivery system. Handheld inhalers form the mainstay of treatment of COPD; however, some patients have difficulty using inhalers because of an inability to generate sufficient inspiratory flow, impaired manual dexterity, or cognitive impairment that leads to difficulties in following instructions concerning how to use the inhaler. In such patients, nebulization may be an effective alternative. In this review, we provide a list of best practices that can assist nurses in the optimal care of patients with COPD. Keywords: chronic obstructive pulmonary disease, exacerbation, long-acting beta-agonist, bronchodilators, nebulization

  16. Gait patterns in COPD: the Rotterdam Study.

    Science.gov (United States)

    Lahousse, Lies; Verlinden, Vincentius J A; van der Geest, Jos N; Joos, Guy F; Hofman, Albert; Stricker, Bruno H C; Brusselle, Guy G; Ikram, M Arfan

    2015-07-01

    Gait disturbances in patients with chronic obstructive pulmonary disease (COPD) may lead to disability and falls. As studies assessing gait kinematics in COPD are sparse, we investigated associations of COPD with various gait domains and explored a potential link with falling. Gait was measured within the prospective, population-based Rotterdam Study (age ≥55 years) using an electronic walkway and summarised into seven gait domains: Rhythm, Variability, Phases, Pace, Tandem, Turning and Base of Support. Rhythm is a temporal gait aspect that includes cadence and reflects how quickly steps are taken. Persons with COPD (n=196) exhibited worse Rhythm (-0.21 SD, 95% CI -0.36- -0.06 SD) compared with persons with normal lung function (n=898), independent of age, sex, height, education, smoking or analgesic use, especially when dyspnoea and severe airflow limitation or frequent exacerbations (Global Initiative for Chronic Obstructive Lung Disease group D: -0.83 SD, 95% CI -1.25- -0.41 SD) were present. A lower forced expiratory volume in 1 s was associated with worse Rhythm and Pace, including lower cadence and gait velocity, respectively. Importantly, fallers with COPD had significantly worse Rhythm than nonfallers with COPD. This study demonstrates that persons with COPD exhibit worse Rhythm, especially fallers with COPD. The degree of Rhythm deterioration was associated with the degree of airflow limitation, symptoms and frequency of exacerbations.

  17. Improving the Management of COPD in Women

    NARCIS (Netherlands)

    Jenkins, Christine R.; Chapman, Kenneth R.; Donohue, James F.; Roche, Nicolas; Tsiligianni, Ioanna; Han, MeiLan K.

    2017-01-01

    COPD is a highly debilitating disease that represents a substantial and growing health burden in women. There is increasing evidence for sex-related differences in COPD risk, progression, and outcomes. However, the disease receives scant attention as a women's health issue. Thus, a multifaceted appr

  18. Cognitive performance in patients with COPD

    NARCIS (Netherlands)

    Liesker, JJW; Postma, DS; Beukema, RJ; ten Hacken, NHT; van der Molen, T; Riemersma, RA; van Zomeren, EH; Kerstjens, HAM

    2004-01-01

    Background: Hypoxemic patients with Chronic Obstructive Pulmonary Disease (COPD) have impaired cognitive performance. These neuropsychological impairments are related to the degree of hypoxemia. So far, cognitive performance has not been tested in non-hypoxemic patients with COPD. Methods: We recrui

  19. On phenotyping in asthma and COPD

    NARCIS (Netherlands)

    Telenga, Evert Dirk

    2013-01-01

    Roken beïnvloedt de respons van astmapatiënten op medicijnen Geïnhaleerde corticosteroïden (ICS) zijn veelgebruikte medicijnen in de behandeling van astma en COPD, maar astmapatiënten reageren over het algemeen beter op de behandeling met deze medicijnen dan COPD-patiënten. Eef Telenga ging in zijn

  20. General practitioners' perceptions of COPD treatment

    DEFF Research Database (Denmark)

    Molin, Katrine Rutkær; Egerod, Ingrid; Staun Valentiner, Laura

    2016-01-01

    BACKGROUND: In Denmark, the treatment of COPD is mainly managed by general practitioners (GPs). Pulmonary rehabilitation (PR) is available to patients with COPD in the local community by GP referral, but in practice, many patients do not participate in rehabilitation. The aim of our study...... was to explore 1) GPs' perceptions of their role and responsibility in the rehabilitation of patients with COPD, and 2) GPs' perceptions of how patients manage their COPD. METHODS: The study was based on a qualitative design with semi-structured key-informant interviews with GPs. Investigator triangulation...... the resources to discuss rehabilitation and follow up on individual plans. CONCLUSION: Our study suggested a potential self-reinforcing problem with the treatment of COPD being mainly focused on medication rather than on PR. Neither GPs nor patients used a proactive approach. Further, GPs were not fully...

  1. Adherence to COPD guidelines in general practice

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Sørensen, Tina Brandt; Højmark, Torben Brunse

    2013-01-01

    BACKGROUND: The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). AIMS: To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD...... guidelines. METHODS: A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted...... were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. RESULTS: Data for 102 participating GP practices were analysed...

  2. Vital prognosis after hospitalization for COPD

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1998-01-01

    STUDY AIM: To examine survival after admission due to chronic obstructive pulmonary disease (COPD) in a population sample over a time span of 15 years. DESIGN: Linkage between a prospective population cohort and register information on hospitalization and mortality. SETTING: The Copenhagen City...... Heart Study (CCHS). PARTICIPANTS: A total of 267 men and 220 women who had participated in the CCHS and who were hospitalized with a discharge diagnosis of COPD (ICD-8 491-2). MAIN RESULTS: The crude 5-yr survival rate after a COPD admission was 45% (37% for men and 52% for women). Mortality risk...... associated with prognosis. Survival after admission due to COPD did not change significantly over time. CONCLUSION: Compared to previous studies of COPD patients, the present study indicates that prognosis after hospital admission remains virtually unchanged over the last decades. FEV1 is still the strongest...

  3. Bacterial microbiome of lungs in COPD.

    Science.gov (United States)

    Sze, Marc A; Hogg, James C; Sin, Don D

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is currently the third leading cause of death in the world. Although smoking is the main risk factor for this disease, only a minority of smokers develop COPD. Why this happens is largely unknown. Recent discoveries by the human microbiome project have shed new light on the importance and richness of the bacterial microbiota at different body sites in human beings. The microbiota plays a particularly important role in the development and functional integrity of the immune system. Shifts or perturbations in the microbiota can lead to disease. COPD is in part mediated by dysregulated immune responses to cigarette smoke and other environmental insults. Although traditionally the lung has been viewed as a sterile organ, by using highly sensitive genomic techniques, recent reports have identified diverse bacterial communities in the human lung that may change in COPD. This review summarizes the current knowledge concerning the lung microbiota in COPD and its potential implications for pathogenesis of the disease.

  4. Managing your weight gain during pregnancy

    Science.gov (United States)

    ... quickly during their pregnancy. Either way, a pregnant woman should not go on a diet or try to lose weight during pregnancy. It is better to focus on eating the right foods and staying active. If you do not ...

  5. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  6. Increased leptin/leptin receptor pathway affects systemic and airway inflammation in COPD former smokers

    Directory of Open Access Journals (Sweden)

    Bruno A

    2011-05-01

    Full Text Available Andreina Bruno1, Marinella Alessi2, Simona Soresi2, Anna Bonanno1, Loredana Riccobono1, Angela Marina Montalbano1, Giusy Daniela Albano1, Mark Gjomarkaj1, Mirella Profita11Institute of Biomedicine and Molecular Immunology, Italian National Research Council, Palermo, Italy; 2Dipartimento Biomedico di Biomedicina Interna e Specialistica, University Palermo, ItalyBackground: Leptin, a hormone produced mainly by adipose tissue, regulates food intake and energy expenditure. It is involved in inflammatory diseases such as chronic obstructive pulmonary disease (COPD and its deficiency is associated with increased susceptibility to the infection. The leptin receptor is expressed in the lung and in the neutrophils.Methods: We measured the levels of leptin, tumor necrosis factor alpha (TNF-a and soluble form of intercellular adhesion molecule-1 (sICAM-1 in sputum and plasma from 27 smoker and former smoker patients with stable COPD using ELISA methods. Further we analyzed leptin and its receptor expression in sputum cells from 16 COPD patients using immunocytochemistry.Results: In plasma of COPD patients, leptin was inversely correlated with TNF-a and positively correlated with the patient weight, whereas the levels of sICAM-1 were positively correlated with TNF-a. In sputum of COPD patients leptin levels were correlated with forced expiratory volume in 1 second/forced vitality capacity. Additionally, increased levels of sputum leptin and TNF-a were observed in COPD former smokers rather than smokers. Further the expression of leptin receptor in sputum neutrophils was significantly higher in COPD former smokers than in smokers, and the expression of leptin and its receptor was positively correlated in neutrophils of COPD former smokers.Conclusion: Our findings suggest a role of leptin in the local and systemic inflammation of COPD and, taking into account the involvement of neutrophils in this inflammatory disease, describe a novel aspect of the leptin

  7. Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD Audit.

    Science.gov (United States)

    Hartl, Sylvia; Lopez-Campos, Jose Luis; Pozo-Rodriguez, Francisco; Castro-Acosta, Ady; Studnicka, Michael; Kaiser, Bernhard; Roberts, C Michael

    2016-01-01

    Studies report high in-hospital and post-discharge mortality of chronic obstructive pulmonary disease (COPD) exacerbations varying depending upon patient characteristics, hospital resources and treatment standards. This study aimed to investigate the patient, resource and organisational factors associated with in-hospital and 90-day post-discharge mortality and readmission of COPD exacerbations within the European COPD Audit. The audit collected data of COPD exacerbation admissions from 13 European countries.On admission, only 49.7% of COPD patients had spirometry results available and only 81.6% had blood gases taken. Using logistic regression analysis, the risk associated with in-hospital and post-discharge mortality was higher age, presence of acidotic respiratory failure, subsequent need for ventilatory support and presence of comorbidity. In addition, the 90-day risk of COPD readmission was associated with previous admissions. Only the number of respiratory specialists per 1000 beds, a variable related to hospital resources, decreased the risk of post-discharge mortality.The European COPD Audit identifies risk factors associated with in-hospital and post-discharge mortality and COPD readmission. Addressing the deficiencies in acute COPD care such as making spirometry available and measuring blood gases and providing noninvasive ventilation more regularly would provide opportunities to improve COPD outcomes.

  8. Weight Self-Regulation Process in Adolescence: The Relationship between Control Weight Attitudes, Behaviors, and Body Weight Status

    OpenAIRE

    Jordi ePich; Maria del Mar eBibiloni; Antoni ePons; Tur, Josep A

    2015-01-01

    Adolescents’ self-control weight behaviors were assessed (N = 1961; 12–17 years old; 2007–2008) in the Balearic Islands, Spain. The study analyzed the relationships between body weight status, body image, and self-weight concern, and actual attempts to lose weight by restrained eating and/or increased exercising. In terms of regulatory focus theory (RFT), we considered that efforts to lose or to maintain weight (successful or failed) would be motivated either by a “promotion focus” (to show a...

  9. The extent of emphysema in patients with COPD

    DEFF Research Database (Denmark)

    Shaker, Saher Burhan; Stavngaard, Trine; Hestad, Marianne

    2009-01-01

    BACKGROUND AND AIMS: The global initiative for COPD (GOLD) adopted the degree of airway obstruction as a measure of the severity of the disease. The objective of this study was to apply CT to assess the extent of emphysema in patients with chronic obstructive pulmonary disease (COPD) and relate...... this extent to the GOLD stage of airway obstruction. MATERIALS AND METHODS: We included 209 patients with COPD. COPD was defined as FEV(1)/FVC or=20 pack-years. Patients were assessed by lung function...... increases with increasing severity of COPD and most patients with COPD have emphysema. Tissue destruction by emphysema is therefore an important determinant of disease severity in COPD....

  10. Incident opioid drug use and adverse respiratory outcomes among older adults with COPD.

    Science.gov (United States)

    Vozoris, Nicholas T; Wang, Xuesong; Fischer, Hadas D; Bell, Chaim M; O'Donnell, Denis E; Austin, Peter C; Stephenson, Anne L; Gill, Sudeep S; Rochon, Paula A

    2016-09-01

    We evaluated risk of adverse respiratory outcomes associated with incident opioid use among older adults with chronic obstructive pulmonary diseases (COPD).This was a retrospective population-based cohort study using a validated algorithm applied to health administrative data to identify adults aged 66 years and older with COPD. Inverse probability of treatment weighting using the propensity score was used to estimate hazard ratios comparing adverse respiratory outcomes within 30 days of incident opioid use compared to controls.Incident opioid use was associated with significantly increased emergency room visits for COPD or pneumonia (HR 1.14, 95% CI 1.00-1.29; p=0.04), COPD or pneumonia-related mortality (HR 2.16, 95% CI 1.61-2.88; p<0.0001) and all-cause mortality (HR 1.76, 95% CI 1.57-1.98; p<0.0001), but significantly decreased outpatient exacerbations (HR 0.88, 95% CI 0.83-0.94; p=0.0002). Use of more potent opioid-only agents was associated with significantly increased outpatient exacerbations, emergency room visits and hospitalisations for COPD or pneumonia, and COPD or pneumonia-related and all-cause mortality.Incident opioid use, and in particular use of the generally more potent opioid-only agents, was associated with increased risk for adverse respiratory outcomes, including respiratory-related mortality, among older adults with COPD. Potential adverse respiratory outcomes should be considered when prescribing new opioids in this population.

  11. Fat-Free Mass Index for Evaluating the Nutritional Status and Disease Severity in COPD.

    Science.gov (United States)

    Luo, Yuwen; Zhou, Luqian; Li, Yun; Guo, Songwen; Li, Xiuxia; Zheng, Jingjing; Zhu, Zhe; Chen, Yitai; Huang, Yuxia; Chen, Rui; Chen, Xin

    2016-05-01

    Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with exercise capacity, dyspnea, respiratory muscle function, and pulmonary function and may be a useful predictor of COPD severity

  12. Treatment after a COPD exacerbation

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A couple of years ago I was consulted about a patient at the Phoenix VA who had been admitted for the third time for a COPD exacerbation in two months. Each time the patient was treated with inhaled short-acting bronchodilators, corticosteroids and an antibiotic; rapidly improved; and was discharged after only one or two days in the hospital. The discharge medications were albuterol, ipratropium, and rapidly tapering doses of prednisone. Apparently, no consideration was given to adding long-acting beta agonists (LABA, long-acting muscarinic antagonists (LAMA, and/or inhaled corticosteroids (ICS. These later medications have been shown to reduce exacerbations in most studies (1,2. I was reminded of this incident by a recent article published by Melzer et al. in the Journal of Internal Medicine (3. The authors examined 2760 patients with exacerbations of COPD admitted to hospitals in the VA Northwest Health Network (VISN 20 to determine if a LABA and/or …

  13. COPD, Body Mass, Fat Free Body Mass and prognosis in Patients from a Random Population Sample

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Prescott, E; Almdal, Thomas Peter;

    2006-01-01

    RATIONALE: Low body mass index (BMI) is a marker of poor prognosis in chronic obstructive pulmonary disease (COPD). In the general population, the harmful effect of low BMI is due to the deleterious effects of a low fat-free mass index (FFMI; fat-free mass/weight(2)). OBJECTIVES: We explored...... distribution of low FFMI and its association with prognosis in a population-based cohort of patients with COPD. METHODS: We used data on 1,898 patients with COPD identified in a population-based epidemiologic study in Copenhagen. FFM was measured using bioelectrical impedance analysis. Patients were followed...... 10th percentile of the general population. BMI and FFMI were significant predictors of mortality, independent of relevant covariates. Being in the lowest 10th percentile of the general population for FFMI was associated with a hazard ratio of 1.5 (95% confidence interval, 1.2-1.8) for overall...

  14. COPD in Taiwan: a National Epidemiology Survey

    Directory of Open Access Journals (Sweden)

    Cheng SL

    2015-11-01

    Full Text Available Shih-Lung Cheng,1,2 Ming-Cheng Chan,3 Chin-Chou Wang,4 Ching-Hsiung Lin,5 Hao-Chien Wang,6 Jeng-Yuan Hsu,3 Liang-Wen Hang,7,8 Chee-Jen Chang,9 Diahn-Warng Perng,10,* Chong-Jen Yu6,* On behalf of the Taiwan COPD Consortium 1Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 2Department of Chemical Engineering and Materials Science, Yuan Ze University, Chung-Li City, Taoyuan County, 3Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 4Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 5Division of Chest Medicine, Changhua Christian Hospital, Changhua City, Changhua County, 6Department of Internal Medicine, National Taiwan University Hospital, Taipei, 7Department of Pulmonary and Critical Care Medicine, Sleep Medicine Center, China Medical University Hospital, 8Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, 9Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Linkou Branch, Guishan Township, Taoyuan County, 10Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China *These authors contributed equally to this work Objectives: To determine the prevalence of COPD in Taiwan and to document the disease characteristics and associated risk factors.Methods: We conducted a random cross-sectional national survey of adults older than 40 years in Taiwan. Respiratory health screening questions identified subjects with diagnosed COPD or whose reported symptoms also fulfilled an epidemiological case definition; these were eligible to complete the survey, which also included indices of symptom severity and disability and questions on comorbidities, medical treatments, smoking habits, and occupations potentially harmful to respiratory health. Subjects with diagnosed COPD were subdivided by smoking status. Subjects who fulfilled the case definition

  15. Diaphragm adaptations in patients with COPD

    Directory of Open Access Journals (Sweden)

    Heunks Leo MA

    2008-01-01

    Full Text Available Abstract Inspiratory muscle weakness in patients with COPD is of major clinical relevance. For instance, maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally, inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm shortening. However, more recently, invasive evaluation of diaphragm contractile function, structure, and biochemistry demonstrated that cellular and molecular alterations occur, of which several can be considered pathologic of nature. Whereas the fiber type shift towards oxidative type I fibers in COPD diaphragm is regarded beneficial, rendering the overloaded diaphragm more resistant to fatigue, the reduction of diaphragm fiber force generation in vitro likely contributes to diaphragm weakness. The reduced diaphragm force generation at single fiber level is associated with loss of myosin content in these fibers. Moreover, the diaphragm in COPD is exposed to oxidative stress and sarcomeric injury. This review postulates that the oxidative stress and sarcomeric injury activate proteolytic machinery, leading to contractile protein wasting and, consequently, loss of force generating capacity of diaphragm fibers in patients with COPD. Interestingly, several of these presumed pathologic alterations are already present early in the course of the disease (GOLD I/II, although these patients appear not limited in their daily life activities. Treatment of diaphragm dysfunction in COPD is complex since its etiology is unclear, but recent findings indicate the ubiquitin-proteasome pathway as a prime target to attenuate diaphragm wasting in COPD.

  16. Cognitive impairment in COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Irene Torres-Sánchez

    2015-04-01

    Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  17. ▼Umeclidinium: another LAMA for COPD.

    Science.gov (United States)

    2015-07-01

    Chronic obstructive pulmonary disease (COPD) affects around 64 million people worldwide and is the fourth leading cause of death.(1) It is thought that 3 million people have COPD in the UK, with about 900,000 having been diagnosed and an estimated 2.1 million with disease that remains undiagnosed.(2) In addition, premature mortality from COPD in the UK is almost double the European average and as a result there has been considerable focus on improving outcomes for patients.(3)One of the options for maintenance pharmacological treatment of COPD is a long-acting muscarinic antagonist (LAMA).(4) DTB has previously reviewed three inhaled LAMAs licensed in the UK for use by people with COPD: tiotropium and ▼glycopyrronium (both administered once daily), and ▼aclidinium bromide (administered twice daily).(5-8) ▼Umeclidinium bromide (Incruse) is another once daily LAMA, delivered using the Ellipta inhaler device, and is indicated as maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD.(9) Here we review the evidence for its use in the management of COPD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Sarcopenia correlates with systemic inflammation in COPD

    Science.gov (United States)

    Byun, Min Kwang; Cho, Eun Na; Chang, Joon; Ahn, Chul Min; Kim, Hyung Jung

    2017-01-01

    Background Muscle wasting and chronic inflammation are predominant features of patients with COPD. Systemic inflammation is associated with an accelerated decline in lung function. In this study, the prevalence of sarcopenia and the relationships between sarcopenia and systemic inflammations in patients with stable COPD were investigated. Materials and methods In a cross-sectional design, muscle strength and muscle mass were measured by handgrip strength (HGS) and bioelectrical impedance analysis in 80 patients with stable COPD. Patients (≥40 years old) diagnosed with COPD were recruited from outpatient clinics, and then COPD stages were classified. Sarcopenia was defined as the presence of both low muscle strength (by HGS) and low muscle mass (skeletal muscle mass index [SMMI]). Levels of circulating inflammatory biomarkers (IL-6 and high-sensitivity TNFα [hsTNFα]) were measured. Results Sarcopenia was prevalent in 20 (25%) patients. Patients with sarcopenia were older, had lower body mass index, and a higher percentage of cardiovascular diseases. In addition, they had significantly higher modified Medical Research Council scores and lower 6-minute walk distance than those without sarcopenia. HGS was significantly correlated with age, modified Medical Research Council score, and COPD Assessment Test scores. Both HGS and SMMI had associations with IL-6 and hsTNFα (HGS, r=−0.35, P=0.002; SMMI, r=−0.246, P=0.044) level. In multivariate analysis, old age, lower body mass index, presence of cardiovascular comorbidities, and higher hsTNFα levels were significant determinants for sarcopenia in patients with stable COPD. Conclusion Sarcopenia is very common in patients with stable COPD, and is associated with more severe dyspnea-scale scores and lower exercise tolerance. Systemic inflammation could be an important contributor to sarcopenia in the stable COPD population. PMID:28255238

  19. Diabetic Foot and Risk: How to Prevent Losing Your Leg

    Science.gov (United States)

    ... Site Content AOFAS / FootCareMD / Conditions / Diabetic Foot The Diabetic Foot and Risk: How to Prevent Losing Your ... Page Content Don't deny you are a diabetic Anyone who has ever had an elevated blood ...

  20. Hydrography - MO 2014 Losing and Gaining Stream Segments (SHP)

    Data.gov (United States)

    NSGIC State | GIS Inventory — This data set depicts stream segments classified as either losing or gaining by the Missouri Department of Natural Resources (DNR), Missouri Geological Survey (MGS)....

  1. Could symptoms and risk factors diagnose COPD? Development of a Diagnosis Score for COPD

    Directory of Open Access Journals (Sweden)

    Salameh P

    2012-09-01

    Full Text Available Pascale Salameh,1 Georges Khayat,2 Mirna Waked31Faculties of Pharmacy and of Public Health, Lebanese University, Beirut, 2Faculty of Medicine, Hôtel Dieu de France Hospital, Beirut and Saint Joseph University, Beirut, 3Faculty of Medicine, Saint George Hospital, Beirut and Balamand University, Beirut, LebanonBackground: Diagnosing chronic obstructive pulmonary disease (COPD without spirometry is still a challenge. Our objective in this study was to develop a scale for diagnosis of COPD.Methods: Data were taken from a cross-sectional epidemiological study. After reducing chronic respiratory symptoms, a logistic regression was used to select risk factors for and symptoms of COPD. The rounded coefficients generated a Diagnosis Score for COPD (DS-COPD, which was dichotomized and differentiated between COPD and other individuals with respiratory symptoms.Results: We constructed a tool for COPD diagnosis with good properties, comprising 12 items. The area under the curve was 0.849; the positive predictive value was 76% if the DS-COPD was >20 and the negative predictive value was 97% if the DS-COPD was <10. A DS-COPD of 10–19 represented a zone mostly suggestive of no COPD (77%. The score was also inversely correlated with forced expiratory volume in 1 second/forced vital capacity.Conclusion: In this study, a tool for diagnosis of COPD was constructed with good properties for use in the epidemiological setting, mainly in cases of low or high scoring. It would be of particular interest in the primary care setting, where spirometry may not be available. Prospective studies and application in clinical settings would be necessary to validate this scale further.Keywords: diagnosis, scale, development, spirometry

  2. Should we treat obesity in COPD? The effects of diet and resistance exercise training.

    Science.gov (United States)

    McDonald, Vanessa M; Gibson, Peter G; Scott, Hayley A; Baines, Penelope J; Hensley, Michael J; Pretto, Jeffrey J; Wood, Lisa G

    2016-07-01

    Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pulmonary disease (COPD), it is associated with improved survival and lung function. A major evidence gap exisits to inform treatment recommendations for patients with COPD who are obese. We aimed to determine the effect of weight reduction involving a low-energy diet utilizing a partial meal replacement plan, coupled with resistance exercise training in obese COPD patients. In a proof of concept before-after clinical trial, obese (body mass index ≥30 kg/m(2) ) COPD patients received a 12 week weight reduction programme involving meal replacements, dietary counselling by a dietitian and resistance exercise training prescribed and supervised by a physiotherapist. Patients were reviewed face to face by the dietitian and physiotherapist every 2 weeks for counselling. Twenty-eight participants completed the intervention. Mean (standard deviation) body mass index was 36.3 kg/m(2) (4.6) at baseline and reduced by 2.4 kg/m(2) ((1.1) P exercise capacity, health status, dyspnea, strength and functional outcomes. There was also a significant reduction in the body mass index, obstruction, dyspnea and exercise score (BODE). Systemic inflammation measured by C-reactive protein however did not change. In obese COPD patients, dietary energy restriction coupled with resistance exercise training results in clinically significant improvements in body mass index, exercise tolerance and health status, whilst preserving skeletal muscle mass. This novel study provides a framework for development of guidelines for the management of obese COPD patients and in guiding future research. © 2016 Asian Pacific Society of Respirology.

  3. ▼Olodaterol--another LABA for COPD.

    Science.gov (United States)

    2015-04-01

    ▼Olodaterol solution for inhalation (Striverdi Respimat-Boehringer Ingelheim) is a long-acting beta2 agonist (LABA) licensed for once-daily use as maintenance bronchodilator therapy for chronic obstructive pulmonary disease (COPD). This is the third LABA to be licensed in the UK for once-daily use for patients with COPD. DTB has previously reviewed the use of indacaterol and vilanterol in combination with fluticasone furoate (▼Relvar Ellipta).1,2 In this article we consider the evidence for olodaterol and whether it offers any advantages in the management of COPD.

  4. Texture-based analysis of COPD

    DEFF Research Database (Denmark)

    Sørensen, Lauge; Nielsen, Mads; Lo, Pechin Chien Pau

    2012-01-01

    This study presents a fully automatic, data-driven approach for texture-based quantitative analysis of chronic obstructive pulmonary disease (COPD) in pulmonary computed tomography (CT) images. The approach uses supervised learning where the class labels are, in contrast to previous work, based...... on measured lung function instead of on manually annotated regions of interest (ROIs). A quantitative measure of COPD is obtained by fusing COPD probabilities computed in ROIs within the lung fields where the individual ROI probabilities are computed using a k nearest neighbor (kNN ) classifier. The distance...

  5. The COPD Biomarker Qualification Consortium (CBQC)

    DEFF Research Database (Denmark)

    Casaburi, Richard; Celli, Bartolome; Crapo, James

    2013-01-01

    , and no interested party has been in a position to undertake such a process. In order to facilitate the development of novel tools to assess new treatments, the Food and Drug Administration, in collaboration with the COPD Foundation, the National Heart Lung and Blood Institute and scientists from the pharmaceutical...... industry and academia conducted a workshop to survey the available information that could contribute to new tools. Based on this, a collaborative project, the COPD Biomarkers Qualification Consortium, was initiated. The Consortium in now actively preparing integrated data sets from existing resources...... that can address the problem of drug development tools for COPD....

  6. Dynamic hyperinflation during activities of daily living in COPD patients.

    Science.gov (United States)

    Silva, Cláudia S; Nogueira, Fabiana R; Porto, Elias F; Gazzotti, Mariana R; Nascimento, Oliver A; Camelier, Aquiles; Jardim, José R

    2015-08-01

    The objective of this study was to investigate whether some activities of daily living (ADLs) usually related to dyspnea sensation in patients with chronic obstructive pulmonary disease (COPD) are associated with dynamic lung hyperinflation (DH) and whether the use of simple energy conservation techniques (ECTs) might reduce this possible hyperinflation. Eighteen patients (mean age: 65.8 ± 9.8 years) with moderate-to-severe COPD performed six ADLs (walking on a treadmill, storing pots, walking 56 meters carrying a 5-kilogram weight, climbing stairs, simulating taking a shower, and putting on shoes) and had their inspiratory capacity (IC) measured before and after each task. The patients were moderately obstructed with forced expiratory volume in 1 second (FEV1): 1.4 ± 0.4 L (50% ± 12.4); FEV1/forced vital capacity: 0.4 ± 8.1; residual volume/total lung capacity: 52.7 ± 10.2, and a reduction in IC was seen after all six activities (p < 0.05): (1) going upstairs, 170 mL; (2) walking 56 meters carrying 5 kilogram weight, 150 mL; (3) walking on a treadmill without and with ECT, respectively, 230 mL and 235 mL; (4) storing pots without and with ECT, respectively, 170 mL and 128 mL; (5) taking a shower without and with ECT, respectively, 172 mL and 118 mL; and (6) putting on shoes without and with ECT, respectively, 210 mL and 78 mL). Patients with moderate to severe COPD develop DH after performing common ADLs involving the upper and lower limbs. Simple ECTs may avoid DH in some of these ADLs.

  7. Revision of the new formula for book losing rate

    Institute of Scientific and Technical Information of China (English)

    TANG Zhen-yu; GENG Xiao-bing

    2005-01-01

    While the amount of book borrowing is overlooked in the calculation of book losing rate in a closed system, there are also other important overlooked elements, factors such as reader groups and the reading timetable in open book stacks. On the basis of concrete evidence, this paper revised a new formula for book losing rate with the purpose of making the estimation in management more objective and more accurate.

  8. Up-to-date on mortality in COPD - report from the OLIN COPD study

    Directory of Open Access Journals (Sweden)

    Lindberg Anne

    2012-01-01

    Full Text Available Abstract Background The poor recognition and related underdiagnosis of COPD contributes to an underestimation of mortality in subjects with COPD. Data derived from population studies can advance our understanding of the true burden of COPD. The objective of this report was to evaluate the impact of COPD on mortality and its predictors in a cohort of subjects with and without COPD recruited during the twenty first century. Methods All subjects with COPD (n = 993 defined according to the GOLD spirometric criteria, FEV1/FVC 1 % predicted and reported heart disease. Results The mortality was significantly higher among subjects with COPD, 10.9%, compared to subjects without COPD, 5.8% (p 1 % predicted in the multivariate model resulted in the decreasing level of FEV1 being a significant risk factor for death, while heart disease was not a significant risk factor for death in any of the models. Conclusions In this cohort COPD and decreased FEV1 were significant risk factors for death when adjusted for age, gender, smoking habits and reported heart disease.

  9. Validation of the Spanish Version of the COPD-Q Questionnaire on COPD Knowledge.

    Science.gov (United States)

    Puente-Maestu, Luis; Chancafe-Morgan, Jorge; Calle, Myriam; Rodríguez-Hermosa, Juan L; Malo de Molina, Rosa; Ortega-González, Ángel; Fuster, Antonia; Márquez-Martín, Eduardo; Marcos, Pedro J; Ramírez, Laura; Ray, Shaunta'; Franks, Andrea

    2016-01-01

    Although recognition of the importance of educating chronic obstructive pulmonary disease (COPD) patients has grown in recent years, their understanding of this disease is not being measured due to a lack of specific instruments. The aim of this study was to validate the COPD-Q questionnaire, a 13-item instrument for determining COPD knowledge. The COPD-Q was translated and backtranslated, and subsequently submitted to logic and content validation by a group of COPD experts and 8 COPD patients. Reliability was studied in an independent group of 59 patients with severe COPD seen in the pulmonology ward or clinics of 6 hospitals in Spain (Andalusia, Baleares, Castilla-La Mancha, Galicia and Madrid). This sample was also used for other internal and external validations. The mean age of the group was approximately 70 years and their health awareness was low-to-medium. The number of correct answers was 8.3 (standard deviation: 1.9), median 8, range 3-13. Floor and ceiling effects were 0% and 1.5%, respectively. Internal consistency of the questionnaire was good (Cronbach's alpha=0.85) and reliability was also high, with a kappa coefficient >0.6 for all items and an intraclass correlation efficient of 0.84 for the total score. The 13-item COPD-Q is a valid, applicable and reliable instrument for determining patients' knowledge of COPD. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  10. Recommendations for epidemiological studies on COPD

    DEFF Research Database (Denmark)

    Bakke, P S; Rönmark, E; Eagan, T

    2011-01-01

    The prevalence of chronic obstructive pulmonary disease (COPD) has been extensively studied, especially in Western Europe and North America. Few of these data are directly comparable because of differences between the surveys regarding composition of study populations, diagnostic criteria...... of the disease and definitions of the risk factors. Few community studies have examined phenotypes of COPD and included other ways of characterising the disease beyond that of spirometry. The objective of the present Task Force report is to present recommendations for the performance of general population...... studies in COPD in order to facilitate comparable and valid estimates on COPD prevalence by various risk factors. Diagnostic criteria in epidemiological settings, and standardised methods to examine the disease and its potential risk factors are discussed. The paper also offers practical advice...

  11. Smoking cessation strategies in patients with COPD

    DEFF Research Database (Denmark)

    Warnier, Miriam J; van Riet, Evelien E S; Rutten, Frans H

    2013-01-01

    Smoking cessation is the cornerstone of treatment of chronic obstructive pulmonary disease (COPD) patients. This systematic review evaluates the effectiveness of behavioural and pharmacological smoking cessation strategies in COPD patients. MEDLINE was searched from January 2002 to October 2011....... Randomised controlled trials evaluating the effect of smoking cessation interventions for COPD patients, published in English, were selected. The methodological quality of included trials was assessed using the Delphi list by two reviewers independently. The relative risks of smoking cessation due...... to be of acceptable quality. Pharmacological therapy combined with behavioural counselling was more effective than each strategy separately. In COPD patients, the intensity of counselling did not seem to influence the results, nor did the choice of drug therapy make a difference. This systematic review makes clear...

  12. COPD phenotype description using principal components analysis

    DEFF Research Database (Denmark)

    Roy, Kay; Smith, Jacky; Kolsum, Umme

    2009-01-01

    BACKGROUND: Airway inflammation in COPD can be measured using biomarkers such as induced sputum and Fe(NO). This study set out to explore the heterogeneity of COPD using biomarkers of airway and systemic inflammation and pulmonary function by principal components analysis (PCA). SUBJECTS...... AND METHODS: In 127 COPD patients (mean FEV1 61%), pulmonary function, Fe(NO), plasma CRP and TNF-alpha, sputum differential cell counts and sputum IL8 (pg/ml) were measured. Principal components analysis as well as multivariate analysis was performed. RESULTS: PCA identified four main components (% variance...... associations between the variables within components 1 and 2. CONCLUSION: COPD is a multi dimensional disease. Unrelated components of disease were identified, including neutrophilic airway inflammation which was associated with systemic inflammation, and sputum eosinophils which were related to increased Fe...

  13. COPD Deaths Down for Most Americans

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_160856.html COPD Deaths Down for Most Americans: CDC But rates up for ... than 6 percent. When the numbers were broken down by race, white women saw little change during ...

  14. Early detection of COPD in general practice

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Løkke, Anders; Dahl, Ronald

    2011-01-01

    Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early...... detection of COPD. The aim, therefore, was to provide evidence for the feasibility and impact of doing spirometry in this target population....

  15. STRUCTURAL ALTERATIONS OF SKELETAL MUSCLE IN COPD

    Directory of Open Access Journals (Sweden)

    Sunita eMathur

    2014-03-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is a respiratory disease associated with a systemic inflammatory response. Peripheral muscle dysfunction has been well characterized in individuals with COPD and results from a complex interaction between systemic and local factors. Objective: In this narrative review, we will describe muscle wasting in people with COPD, the associated structural changes, muscle regenerative capacity and possible mechanisms for muscle wasting. We will also discuss how structural changes relate to impaired muscle function and mobility in people with COPD. Key Observations: Approximately 30-40% of individuals with COPD experience muscle mass depletion. Furthermore, muscle atrophy is a predictor of physical function and mortality in this population. Associated structural changes include a decreased proportion and size of type-I fibers, reduced oxidative capacity and mitochondrial density mainly in the quadriceps. Observations related to impaired muscle regenerative capacity in individuals with COPD include a lower proportion of central nuclei in the presence or absence of muscle atrophy and decreased maximal telomere length, which has been correlated with reduced muscle cross-sectional area. Potential mechanisms for muscle wasting in COPD may include excessive production of reactive oxygen species, altered amino acid metabolism and lower expression of peroxisome proliferator-activated receptors-gamma-coactivator 1-alpha mRNA. Despite a moderate relationship between muscle atrophy and function, impairments in oxidative metabolism only seems weakly related to muscle function. Conclusion: This review article demonstrates the cellular modifications in the peripheral muscle of people with COPD and describes the evidence of its relationship to muscle function. Future research will focus on rehabilitation strategies to improve muscle wasting and maximize function.

  16. Viral infections in asthma and COPD.

    Science.gov (United States)

    Matsumoto, Koichiro; Inoue, Hiromasa

    2014-03-01

    Airway viral infections are associated with the pathogenesis of asthma and COPD. It has been argued that respiratory syncytial virus (RSV) infection in infancy is a probable causal factor in the development of pediatric asthma. RSV infections tend to induce Th2-biased immune responses in the host airways. RSV infection, atopy, and low pulmonary function in neonates may work synergistically toward the development of pediatric asthma. Human rhinovirus (HRV) is a representative virus associated with the exacerbation of asthma in both children and adults. Viral infections trigger innate immune responses including granulocytic inflammation and worsen the underlying inflammation due to asthma and COPD. The innate immune responses involve type-I and -III interferon (IFN) production, which plays an important role in anti-viral responses, and the airway epithelia of asthmatics reportedly exhibit defects in the virus-induced IFN responses, which renders these individuals more susceptible to viral infection. A similarly impaired IFN response is seen in COPD, and several investigators propose that latent adenoviral infection may be involved in COPD development. Persistent RSV infections were detected in a sub-population of patients with COPD and were associated with the accelerated decline of lung function. The virus-induced upregulation of co-inhibitory molecules in the airway epithelium partly accounts for the persistent infections. Experimental animal models for virus-asthma/COPD interactions have shed light on the underlying immune mechanisms and are expected to help develop novel approaches to treat respiratory diseases.

  17. Evaluation of atopy in patients with COPD*

    Science.gov (United States)

    Neves, Margarida Célia Lima Costa; Neves, Yuri Costa Sarno; Mendes, Carlos Mauricio Cardeal; Bastos, Monalisa Nobre; Camelier, Aquiles Assunção; Queiroz, Cleriston Farias; Mendoza, Bernardo Fonseca; Lemos, Antônio Carlos Moreira; Junior, Argemiro D'Oliveira

    2013-01-01

    OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood. PMID:23857681

  18. Early detection of COPD in primary care--the Copenhagen COPD Screening Project

    DEFF Research Database (Denmark)

    Lyngsø, Anne Marie; Backer, Vibeke; Gottlieb, Vibeke

    2010-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of death in the world, and further increases in the prevalence and mortality are predicted. Delay in diagnosing COPD appears frequently even though current consensus guidelines emphasize the importance of early detection...

  19. Weight-loss practices among university students in Mexico.

    Science.gov (United States)

    Méndez-Hernández, Pablo; Dosamantes-Carrasco, Darina; Lamure, Michel; López-Loyo, Perla; Hernández-Palafox, Corín; Pineda-Pérez, Dayana; Flores, Yvonne; Salmerón, Jorge

    2010-06-01

    To evaluate the prevalence of weight-loss practices among university students from Tlaxcala, Mexico. A cross-sectional study of 2,651 university students was conducted. Logistic regression tests were used to estimate the probability of students trying to lose weight and successfully achieving weight loss. Nearly 40% of students attempted to lose weight, though only about 7% lost more than 10% of their body weight and maintained this weight loss during the time of the study. The methods used most were exercise and dieting, and those who dieted were more successful at losing weight. The high prevalence of weight-loss attempts and the poor outcomes with these weight-loss methods among this sample of university students is a public health concern. Universities should provide students with healthy weight-control approaches, which include offering information about healthier lifestyles, access to healthy food and opportunities to be physically active.

  20. Cytokine inhibition in the treatment of COPD

    Directory of Open Access Journals (Sweden)

    Caramori G

    2014-04-01

    Full Text Available Gaetano Caramori,1 Ian M Adcock,2,3 Antonino Di Stefano,4 Kian Fan Chung2,3 1Dipartimento di Scienze Mediche, Centro Interdipartimentale per lo Studio delle Malattie Infiammatorie delle Vie Aeree e Patologie Fumo-correlate (CEMICEF; formerly Centro di Ricerca su Asma e BPCO, Sezione di Medicina Interna e Cardiorespiratoria, Università di Ferrara, Ferrara, Italy; 2Airway Diseases Section, National Heart and Lung Institute, Imperial College London, UK; 3Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK; 4Divisione di Pneumologia e Laboratorio di Citoimmunopatologia dell'Apparato Cardio-Respiratorio, Fondazione Salvatore Maugeri, IRCCS, Veruno, Italy Abstract: Cytokines play an important part in many pathobiological processes of chronic obstructive pulmonary disease (COPD, including the chronic inflammatory process, emphysema, and altered innate immune response. Proinflammatory cytokines of potential importance include tumor necrosis factor (TNF-α, interferon-γ, interleukin (IL-1β, IL-6, IL-17, IL-18, IL-32, and thymic stromal lymphopoietin (TSLP, and growth factors such as transforming growth factor-β. The current objectives of COPD treatment are to reduce symptoms, and to prevent and reduce the number of exacerbations. While current treatments achieve these goals to a certain extent, preventing the decline in lung function is not currently achievable. In addition, reversal of corticosteroid insensitivity and control of the fibrotic process while reducing the emphysematous process could also be controlled by specific cytokines. The abnormal pathobiological process of COPD may contribute to these fundamental characteristics of COPD, and therefore targeting cytokines involved may be a fruitful endeavor. Although there has been much work that has implicated various cytokines as potentially playing an important role in COPD, there have been very few studies that have examined the effect of specific cytokine blockade in

  1. Awareness of COPD in a high risk Korean population.

    Science.gov (United States)

    Seo, Jae Yong; Hwang, Yong Il; Mun, So Yeong; Kim, Jin Hee; Kim, Joo Hee; Park, Sung Hoon; Jang, Seung Hun; Park, Yong Bum; Shim, Jae Jung; Jung, Ki-Suck

    2015-03-01

    Increased awareness and understanding of chronic obstructive pulmonary disease (COPD) is an important aspect of disease management. The aim of this study was to explore COPD awareness among smokers participating in a smoking cessation program. Face-to-face interviews were conducted with 289 subjects in three smoking cessation clinics, using a structured questionnaire. A total of 68.2% of subjects had COPD-related symptoms, and 19.7% were in poor health. Only 1.0% of the subjects knew that COPD was a respiratory disease. A total of 2.4% of subjects had been diagnosed with COPD and received treatment. Television was the most common source of information about COPD, with 57.1% of the subjects receiving information in this way. After being informed about COPD, smoking-cessation willingness increased in 84.1% of the study group. It increased in 86.3% of the subjects without awareness of COPD and in 81.2% of subjects with COPD-related symptoms. We found that awareness of COPD is very poor among current smokers in Korea. Many smokers perceived their health status as good, despite the presence of COPD-related symptoms. As the level of smoking-cessation willingness was different between those with and without awareness of COPD or COPD-related symptoms, a personalized education program with various educational tools may be needed to enhance awareness of the disease and to motivate smokers to quit.

  2. Living with clipped wings - patients’ experience of losing a leg

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Martinsen, Bente; Kjaer-Petersen, Klaus

    2013-01-01

    This study explores the lived experience of losing a leg as described by the patients themselves post-discharge. Studies have documented that regardless of aetiology patients are faced with severe physical as well as psychosocial challenges post-amputation. However, only few studies explore in....... The essential meaning of losing a leg is a radical and existential upheaval, which restricts patients' lifestyle and irretrievably alters their lifeworld. Life after the operation is associated with despair, and a painful sense of loss, but also with the hope of regaining personal independence. The consequences...... of losing a leg gradually materialize as the patients realize how the loss of mobility limits their freedom. Patients experience the professional help as primarily directed towards physical care and rehabilitation. The findings show that the loss of a leg and, subsequently, the restricted mobility carry...

  3. Efficacy and safety of fluticasone furoate/vilanterol or tiotropium in subjects with COPD at cardiovascular risk

    Science.gov (United States)

    Covelli, Henry; Pek, Bonavuth; Schenkenberger, Isabelle; Scott-Wilson, Catherine; Emmett, Amanda; Crim, Courtney

    2016-01-01

    Background Fluticasone furoate/vilanterol (FF/VI) is a novel, once-daily, inhaled corticosteroid/long-acting β2-agonist combination approved for the treatment of COPD and asthma. We compared the safety and efficacy of FF/VI and tiotropium (TIO) in subjects with moderate-to-severe COPD with greater risk for comorbid cardiovascular disease (CVD). Methods This randomized, blinded, double-dummy, parallel-group study compared a once-daily morning dose of FF/VI 100/25 mcg delivered via ELLIPTA™ with TIO 18 mcg via HandiHaler® for 12 weeks in subjects with diagnosed COPD, forced expiratory volume in 1 second (FEV1) 30%–70% predicted, and CVD or CVD risk. The primary endpoint was change from baseline in 24-hour weighted mean FEV1 on Day 84. Other efficacy endpoints included time to onset of bronchodilation, trough FEV1, other spirometry measures, rescue medication use, symptoms, quality of life (St George’s Respiratory Questionnaire-COPD [SGRQ-C]), and health status (COPD Assessment Tests [CAT]) measures. Safety endpoints included cardiovascular monitoring, cortisol excretion, COPD exacerbations, and adverse events, including prespecified drug effects. Results Both FF/VI and TIO improved the 24-hour weighted mean FEV1 from baseline after 12 weeks with no significant difference between treatments. Other endpoints favored FF/VI for time to onset of bronchodilation, rescue medication use, dyspnea, SGRQ-C and CAT scores, or favored TIO for change from baseline in forced vital capacity and inspiratory capacity. Pneumonia occurred more frequently in the FF/VI group, and two TIO-treated subjects died following cardiovascular events. Other safety measures were similar between groups, and cardiovascular monitoring did not reveal increased CVD risk. Conclusion Both FF/VI and TIO were efficacious in improving lung function in subjects with COPD and comorbid CVD or CVD risk factors, with minor differences in efficacy and safety profiles. PMID:26730183

  4. Global scientific collaboration in COPD research

    Science.gov (United States)

    Su, Yanbing; Long, Chao; Yu, Qi; Zhang, Juan; Wu, Daisy; Duan, Zhiguang

    2017-01-01

    Purpose This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions) across the world in COPD research. Materials and methods Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years. Results The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC) have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA) studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region) but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions) and low-income countries (regions). Growing attention has been generated toward research on COPD from more and more different academic domains. Conclusion Despite the rapid development in COPD research, collaboration in the field of COPD research still has room to grow, especially between different institutions or countries (regions), which would promote the progress of global COPD research.

  5. Global scientific collaboration in COPD research.

    Science.gov (United States)

    Su, Yanbing; Long, Chao; Yu, Qi; Zhang, Juan; Wu, Daisy; Duan, Zhiguang

    2017-01-01

    This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions) across the world in COPD research. Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years. The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC) have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA) studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region) but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions) and low-income countries (regions). Growing attention has been generated toward research on COPD from more and more different academic domains. Despite the rapid development in COPD research, collaboration in the field of COPD research still has room to grow, especially between different institutions or countries (regions), which would promote the progress of global COPD research.

  6. Chronic Obstructive Pulmonary Disease (COPD): Data and Statistics

    Science.gov (United States)

    ... about the Work-Related Lung Disease Surveillance System . COPD Death Rates in the United States Printable Version [ ... 100,000 in 2010). Printable Version [PDF 137kb] COPD Prevalence in the United States Printable Version [PDF ...

  7. Can an Apple a Day Keep COPD Away?

    Science.gov (United States)

    ... 163759.html Can an Apple a Day Keep COPD Away? See which fruits, veggies may be linked ... vegetables and peppers appear to offer protection against COPD (chronic obstructive pulmonary disease), said researchers led by ...

  8. COPD: When You Learn More, You'll Breathe Better

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues COPD: When You Learn More, You'll Breathe Better ... Trial to Look at Home Oxygen Therapy for COPD The National Heart, Lung, and Blood Institute (NHLBI) ...

  9. Occupational Therapy intervention for patiens with COPD, Rehabilitation at home

    DEFF Research Database (Denmark)

    Larsen, Stina Meyer; Petersen, Anne Karin

    2011-01-01

    Describe and demonstrate Occupational Therapy (OT) intervention for patients with Chronic Obstructive Pulmonary Disease (COPD).......Describe and demonstrate Occupational Therapy (OT) intervention for patients with Chronic Obstructive Pulmonary Disease (COPD)....

  10. Reduced HDAC2 in skeletal muscle of COPD patients

    National Research Council Canada - National Science Library

    Masako To; Elisabeth B Swallow; Kenich Akashi; Kosuke Haruki; S Amanda Natanek; Michael I Polkey; Kazuhiro Ito; Peter J Barnes

    2017-01-01

    Background Skeletal muscle weakness in chronic obstructive pulmonary disease (COPD) is an important predictor of poor prognosis, but the molecular mechanisms of muscle weakness in COPD have not been fully elucidated...

  11. Q&A: Grace Anne Koppel, Living Well with COPD

    Science.gov (United States)

    ... Mary's Hospital COPD has had something of a stigma attached to it because of smoking as a ... the United States and causes serious, long-term disability. COPD kills more than 130,000 Americans each ...

  12. Altered mitochondrial regulation in quadriceps muscles of patients with COPD

    DEFF Research Database (Denmark)

    Naimi, Ashley I; Bourbeau, Jean; Perrault, Helene

    2011-01-01

    to complex I (COPD 38·28 ± 3·58 versus control 42·85 ± 3·10 pmol s(-1) mg tissue(-1) ), but O(2) flux with addition of succinate was lower in COPD patients (COPD 63·72 ± 6·33 versus control 95·73 ± 6·53 pmol s(-1) mg tissue(-1) ); (iii) excess capacity of cytochrome c oxidase in COPD patients was only ~50...

  13. Plasma brain natriuretic peptide levels in COPD without pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Ahmed G. El Gazzar

    2017-01-01

    Conclusion: Plasma BNP can be used as a useful prognostic biomarker of COPD and a good predictor of exacerbation, As BNP level was significantly higher in COPD patients than in control groups, (p < 0.005 and also significantly higher in grade (IV, III than grade (II and was significantly higher in grade (II than grade (I COPD patients, BNP level significantly higher (p < 0.005 during exacerbation than during remission of COPD patients.

  14. Sputum microbiology predicts health status in COPD

    Directory of Open Access Journals (Sweden)

    Braeken DCW

    2016-11-01

    Full Text Available Dionne CW Braeken,1,2 Sarah Houben-Wilke,1 Dionne E Smid,1 Gernot GU Rohde,2 Jesse JC Drijkoningen,2 Emiel FM Wouters,1,2 Martijn A Spruit,1 Frits ME Franssen1,2 1Department of Research and Education, CIRO, Horn, the Netherlands; 2Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+, Maastricht, the Netherlands Background: Spontaneous sputum production occurs in a subset of COPD patients; however, its clinical relevance has not been established. Differences in health status and clinical outcomes between patients with and without positive sputum cultures are unknown.Objective: To compare clinical characteristics and health status of spontaneous sputum producers with a positive culture (SC+ and negative culture (SC- with nonsputum producers (NP in a cohort of COPD patients referred for pulmonary rehabilitation.Methods: In total, 518 clinically stable patients with mild-to-very severe COPD were recruited (mean age: 64.1±9.1 years, 55.6% males, forced expiratory volume in 1 second 48.6%±20.0% predicted. Health status was measured using COPD Assessment Test, St George’s Respiratory Questionnaire, and the Clinical COPD Questionnaire. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Exercise capacity was measured using the 6-minute walking distance. Spontaneously expectorated sputum was cultured for microbiology.Results: Almost one-third of patients spontaneously produced sputum (n=164, 31.7%. Despite comparable lung function, SC+ reported more frequent exacerbations than NP (≥2 exacerbations <1 year: 43 [81.1%] vs 179 [50.6%], P<0.001. COPD Assessment Test total score and the Clinical COPD Questionnaire total score were significantly worse in SC+ than NP (23.9±6.1 vs 21.1±6.7, P=0.012; 3.1±1.0 vs 2.5±1.0, P=0.002; respectively. Hospital Anxiety and Depression Scale-D score was significantly higher in SC+ than NP (8.7±4.1 vs 7.2±4.3, P=0.046.Conclusion

  15. Central airways remodeling in COPD patients

    Directory of Open Access Journals (Sweden)

    Pini L

    2014-09-01

    Full Text Available Laura Pini,1 Valentina Pinelli,2 Denise Modina,1 Michela Bezzi,3 Laura Tiberio,4 Claudio Tantucci1 1Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, 2Department of Respiratory Medicine, Spedali Civili di Brescia, 3Department Bronchoscopy, Spedali Civili di Brescia, 4Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy Background: The contribution to airflow obstruction by the remodeling of the peripheral airways in chronic obstructive pulmonary disease (COPD patients has been well documented, but less is known about the role played by the large airways. Few studies have investigated the presence of histopathological changes due to remodeling in the large airways of COPD patients. Objectives: The aim of this study was to verify the presence of airway remodeling in the central airways of COPD patients, quantifying the airway smooth muscle (ASM area and the extracellular matrix (ECM protein deposition, both in the subepithelial region and in the ASM, and to verify the possible contribution to airflow obstruction by the above mentioned histopathological changes. Methods: Biopsies of segmental bronchi spurs were performed in COPD patients and control smoker subjects and immunostained for collagen type I, versican, decorin, biglycan, and alpha-smooth muscle actin. ECM protein deposition was measured at both subepithelial, and ASM layers. Results: The staining for collagen I and versican was greater in the subepithelial layer of COPD patients than in control subjects. An inverse correlation was found between collagen I in the subepithelial layer and both forced expiratory volume in 1 second and ratio between forced expiratory volume in 1 second and forced vital capacity. A statistically significant increase of the ASM area was observed in the central airways of COPD patients versus controls. Conclusion: These findings indicate that airway remodeling also affects

  16. Bacterial microbiome of lungs in COPD

    Directory of Open Access Journals (Sweden)

    Sze MA

    2014-02-01

    Full Text Available Marc A Sze,1 James C Hogg,2 Don D Sin1 1Department of Medicine, 2Department of Pathology and Laboratory Medicine, The James Hogg Research Centre, Providence Heart-Lung Institute, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada Abstract: Chronic obstructive pulmonary disease (COPD is currently the third leading cause of death in the world. Although smoking is the main risk factor for this disease, only a minority of smokers develop COPD. Why this happens is largely unknown. Recent discoveries by the human microbiome project have shed new light on the importance and richness of the bacterial microbiota at different body sites in human beings. The microbiota plays a particularly important role in the development and functional integrity of the immune system. Shifts or perturbations in the microbiota can lead to disease. COPD is in part mediated by dysregulated immune responses to cigarette smoke and other environmental insults. Although traditionally the lung has been viewed as a sterile organ, by using highly sensitive genomic techniques, recent reports have identified diverse bacterial communities in the human lung that may change in COPD. This review summarizes the current knowledge concerning the lung microbiota in COPD and its potential implications for pathogenesis of the disease. Keywords: chronic obstructive pulmonary disease, bacterial microbiome, lungs

  17. Improving adherence with inhaler therapy in COPD

    Directory of Open Access Journals (Sweden)

    Suzanne C Lareau

    2010-11-01

    Full Text Available Suzanne C Lareau1, Barbara P Yawn21College of Nursing, University of Colorado Denver, Aurora, Colorado; 2Department of Research, Olmsted Medical Center, Rochester, Minnesota, USAAbstract: Chronic obstructive pulmonary disease (COPD is a major public health problem, associated with considerable morbidity and health care costs. The global burden of COPD morbidity is predicted to rise substantially in the coming decade, but could be moderated by better use of existing management strategies. Smoking cessation, medication therapy, and pulmonary rehabilitation have all been shown to diminish morbidity and improve patient outcomes. But each of these strategies requires adherence. Adherence is crucial for optimizing clinical outcomes in COPD, with nonadherence resulting in a significant health and economic burden. Suboptimal medication adherence is common among COPD patients, due to a number of factors that involve the medication, the delivery device, the patient, and the health professionals caring for the patient. Lack of medication adherence needs to be identified and addressed by using simplified treatment regimens, increasing patient knowledge about self-management, and enhancing provider skills in patient education, communication, and adherence counseling. This article reports some of the challenges of medication nonadherence faced by the clinician in the management of COPD, and suggests ways to evaluate and improve adherence effectively in primary care.Keywords: chronic obstructive pulmonary disease, adherence, clinician

  18. Caregivers' burden in patients with COPD.

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions.

  19. Clinical issues of mucus accumulation in COPD

    Directory of Open Access Journals (Sweden)

    Osadnik CR

    2014-03-01

    Full Text Available Christian R Osadnik,1,2 Christine F McDonald,2,3 Anne E Holland2,4,51Department of Physiotherapy, Monash University, 2Institute for Breathing and Sleep, Austin Health, 3Department of Respiratory and Sleep Medicine, Austin Health, 4Department of Physiotherapy, La Trobe University, 5Department of Physiotherapy, Alfred Health, Melbourne, VIC, AustraliaWe wish to thank Ramos et al for presenting a succinct and up-to-date synthesis of the evidence relating to the important issue of mucus hypersecretion in COPD.1 The authors highlight the association of mucus hypersecretion with poor outcomes, including increased risk of exacerbations, hospitalization and mortality. These associations have led to interest in the potential benefits of mucus clearance techniques in COPD. As Ramos et al1 point out, although the physiological rationale for airway clearance techniques (ACTs in COPD is strong, clinical efficacy has historically been difficult to establish, perhaps due to the variety of techniques and outcomes that have been employed in small studies. We have recently synthesized this body of evidence in a Cochrane systematic review of ACTs for individuals with COPD. The review demonstrated ACTs are safe and meta-analysis showed they confer small beneficial effects on a limited range of important clinical outcomes, such as the need for and duration of ventilatory assistance during an acute exacerbation of COPD (AECOPD.2View original paper by Ramos and colleagues.

  20. Phenotypes in COPD visualized by changes in neutrophil activation

    NARCIS (Netherlands)

    Lo Tam Loi, A.T.

    2014-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is ranked number 3 by the WHO list of important diseases worldwide and is the only major disease with increasing mortality. 15-20% of the smokers will develop COPD. The pathogenesis of this (cigarette) smoke induced COPD is still unclear. It is becoming c

  1. Relevance of human metapneumovirus in exacerbations of COPD

    Directory of Open Access Journals (Sweden)

    Bauer TT

    2005-12-01

    Full Text Available Abstract Background and methods Human metapneumovirus (hMPV is a recently discovered respiratory virus associated with bronchiolitis, pneumonia, croup and exacerbations of asthma. Since respiratory viruses are frequently detected in patients with acute exacerbations of COPD (AE-COPD it was our aim to investigate the frequency of hMPV detection in a prospective cohort of hospitalized patients with AE-COPD compared to patients with stable COPD and to smokers without by means of quantitative real-time RT-PCR. Results We analysed nasal lavage and induced sputum of 130 patients with AE-COPD, 65 patients with stable COPD and 34 smokers without COPD. HMPV was detected in 3/130 (2.3% AE-COPD patients with a mean of 6.5 × 105 viral copies/ml in nasal lavage and 1.88 × 105 viral copies/ml in induced sputum. It was not found in patients with stable COPD or smokers without COPD. Conclusion HMPV is only found in a very small number of patients with AE-COPD. However it should be considered as a further possible viral trigger of AE-COPD because asymptomatic carriage is unlikely.

  2. Increased systemic inflammation is a risk factor for COPD exacerbations

    NARCIS (Netherlands)

    K.H. Groenewegen (Karin); D.S. Postma (Dirkje); W.C.J. Hop (Wim); P.L.M.L. Wielders (Pascal); N.J.J. Schlösser (Noel); E.F.M. Wouters (Emiel)

    2008-01-01

    textabstractBackground: COPD is characterized by episodic increases in respiratory symptoms, so-called exacerbations. COPD exacerbations are associated with an increase in local and systemic inflammation. Data of a previously published study in a well-characterized COPD cohort were analyzed to defin

  3. Increased systemic inflammation is a risk factor for COPD exacerbations

    NARCIS (Netherlands)

    Groenewegen, Karin H.; Postma, Dirkje S.; Hop, Wim C. J.; Wielders, Pascal L. M. L.; Schlosser, Noel J. J.; Wouters, Entiel F. M.

    2008-01-01

    Background: COPD is characterized by episodic increases in respiratory symptoms, so-called exacerbations. COPD exacerbations are associated with an increase in local and systemic inflammation. Data of a previously published study in a well-characterized COPD cohort were analyzed to define predictive

  4. Multicenter study of the COPD-6 screening device

    DEFF Research Database (Denmark)

    Kjeldgaard, Peter; Lykkegaard Karlsen, Jesper; Spillemose, Heidi

    2017-01-01

    BACKGROUND AND AIM: Early detection of COPD may reduce the future burden of the disease. We aimed to investigate whether prescreening with a COPD-6 screening device (measuring FEV1 and FEV6) facilitates early detection of COPD in primary care. METHODS: In primary care, individuals at high risk of...

  5. Determinants of Depression in the ECLIPSE COPD Cohort

    DEFF Research Database (Denmark)

    Hanania, Nicola A; Müllerova, Hana; Locantore, Nicholas W

    2010-01-01

    with COPD. METHODS: The Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study is an observational three-year multicenter study that enrolled smokers with and without COPD and non-smoker controls. At baseline, several patient-reported outcomes were measured including...

  6. Successful Smoking Cessation in COPD : Association with Comorbidities and Mortality

    NARCIS (Netherlands)

    Kupiainen, H; Kinnula, V L; Lindqvist, A; Postma, D S; Boezen, H M; Laitinen, T; Kilpeläinen, M

    2012-01-01

    Smoking cessation is the cornerstone of COPD management, but difficult to achieve in clinical practice. The effect of comorbidities on smoking cessation and risk factors for mortality were studied in a cohort of 739 COPD patients recruited in two Finnish University Hospitals. The diagnosis of COPD w

  7. We're Losing Our Minds: Rethinking American Higher Education

    Science.gov (United States)

    Keeling, Richard P.; Hersh, Richard H.

    2011-01-01

    America is being held back by the quality and quantity of learning in college. This is a true educational emergency! Many college graduates cannot think critically, write effectively, solve problems, understand complex issues, or meet employers' expectations. We are losing our minds--and endangering our social, economic, and scientific leadership.…

  8. 'At Least I Didn't Lose Money'

    DEFF Research Database (Denmark)

    Stephens, Thomas Alexander; Tyran, Jean-Robert Karl

    (monetary) values. Real losses may therefore loom larger in people’s minds when they lose money than when real losses are hidden by purely nominal gains. Using a survey experiment with a large and heterogeneous sample, we show that evaluations of housing transactions are systematically biased by purely...

  9. Clinical practice - Protein-losing enteropathy in children

    NARCIS (Netherlands)

    Braamskamp, M.J.A.M.; Dolman, K.M.; Tabbers, M.M.

    2010-01-01

    Protein-losing enteropathy (PLE) is a rare complication of a variety of intestinal disorders characterized by an excessive loss of proteins into the gastrointestinal tract due to impaired integrity of the mucosa. The clinical presentation of patients with PLE is highly variable, depending upon the

  10. Analysis of "Babar Loses His Crown." Technical Report No. 169.

    Science.gov (United States)

    Green, G. M.; And Others

    This report presents the text analysis of "Babar Loses His Crown," a story for beginning readers. (The techniques used in arriving at the analysis are presented in a Reading Center Technical Report, Number 168, "Problems and Techniques of Text Analysis.") Tables are given for a statistical lexical analysis and for a syntactic…

  11. "Wagging the dog": How service delivery can lose its way in the procurement maze -- and could find it again

    CSIR Research Space (South Africa)

    Wall, K

    2012-09-01

    Full Text Available delivery can lose its way in the procurement maze -- and could find it again Kevin Wall, Ron Watermeyer and Graham Pirie Kevin Wall (CSIR); Ron Watermeyer (Soderlund and Schutte); Graham Pirie (Consulting Engineers South Africa (CESA... with the provisions of the Preferential Policy Framework Act, 2000 and points for quality scored out of maximum of 100 points. The points for the preference points system are added to the points for quality in terms of the weightings stipulated in the procurement...

  12. Application of Proteomics and Peptidomics to COPD

    Directory of Open Access Journals (Sweden)

    Girolamo Pelaia

    2014-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a complex disorder involving both airways and lung parenchyma, usually associated with progressive and poorly reversible airflow limitation. In order to better characterize the phenotypic heterogeneity and the prognosis of patients with COPD, there is currently an urgent need for discovery and validation of reliable disease biomarkers. Within this context, proteomic and peptidomic techniques are emerging as very valuable tools that can be applied to both systemic and pulmonary samples, including peripheral blood, induced sputum, exhaled breath condensate, bronchoalveolar lavage fluid, and lung tissues. Identification of COPD biomarkers by means of proteomic and peptidomic approaches can thus also lead to discovery of new molecular targets potentially useful to improve and personalize the therapeutic management of this widespread respiratory disease.

  13. Antibiotics as immunomodulant agents in COPD.

    Science.gov (United States)

    Blasi, Francesco; Mantero, Marco; Aliberti, Stefano

    2012-06-01

    It is widely accepted that some antibiotics have activities beyond their direct antibacterial effects. Macrolide is the antibiotic class with more convincing studies and evidence on its immunomodulatory and anti-inflammatory activities. Different clinical studies have shown that macrolide prophylaxis in patients with moderate-severe chronic obstructive pulmonary disease (COPD) can have a significant impact on the exacerbation rate reducing morbidity and, potentially, mortality of the disease. Other antibiotics, such as fluoroquinolones, demonstrate a variety of immunomodulatory effects but only few clinical data are available in COPD. New macrolide derivatives devoid of antibacterial activity have been synthetized. This review analyses the relevance of immunomodulatory and anti-inflammatory effects of antibiotics in the management of COPD.

  14. Ethnic Differences in Persistence with COPD Medications

    DEFF Research Database (Denmark)

    Hu, Yusun; Cantarero-Arévalo, Lourdes; Frølich, Anne

    2017-01-01

    : A cohort of COPD patients diagnosed in 2003-2007 in Copenhagen, Denmark, was followed for 2 years in the Danish national registers. According to the number of the LABD medications dispensed, individuals were categorized into three therapy groups: monotherapy, drug combination therapy, and multiple drug...... therapy. Persistence was defined as the period from the first prescription date to the date of discontinuation. Treatment was considered discontinued if the interval between the two prescriptions was longer than the number of days of cumulative medication supply according to defined daily doses plus 7...... days. RESULTS: In total, 1129 incident COPD patients using LABDs were included; 6.7% had other than Danish ethnic background. Survival analyses showed that in the cases where LABD medication combination presented COPD maintenance therapy, ethnic background was associated with the higher risk...

  15. The effect of conjugated linoleic acid supplementation on the nutritional status of COPD patients.

    Science.gov (United States)

    Ghobadi, Hassan; Matin, Somaieh; Nemati, Ali; Naghizadeh-Baghi, Abbas

    2016-01-01

    COPD patients are susceptible to anorexia, reduction of caloric intake, weight loss, and malnutrition. One of the possible mechanisms is the increase of inflammatory markers such as interleukin 1β (IL1β), is highly correlated with anorexia. Considering the anti-inflammatory role of conjugated linoleic acid (CLA), this study aimed to investigate the effect of CLA supplementation on the nutritional status of COPD patients. In a double-blind clinical trial, 93 COPD patients who volunteered to participate in the study and who filled out a written consent form, were randomly assigned to control or supplementation groups. The patients in the supplementation group received 3.2 g of CLA on a daily basis for 6 weeks, while those in the control group received placebo on a daily basis for 6 weeks. For IL1β assessment, the patients' anthropometric indices and appetite score were checked and their blood samples were collected both before and after the treatment. Moreover, in order to investigate the changes in the caloric intake trend during the study, their dietary intake levels were assessed using 24-hour dietary recall, 3 days a week at the onset, in the 4th week, and at the end of the study. Eventually, 90 patients completed the study. The results demonstrated a significant increase in appetite score (P=0.001), average caloric intake (P=0.01), and macronutrient intake (Pnutritional status of patients suffering from COPD through adjusting the serum level of IL1β.

  16. Promoting Healthy Weight with "Stability Skills First": A Randomized Trial

    Science.gov (United States)

    Kiernan, Michaela; Brown, Susan D.; Schoffman, Danielle E.; Lee, Katherine; King, Abby C.; Taylor, C. Barr; Schleicher, Nina C.; Perri, Michael G.

    2013-01-01

    Objective: Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current satisfaction…

  17. Promoting Healthy Weight with "Stability Skills First": A Randomized Trial

    Science.gov (United States)

    Kiernan, Michaela; Brown, Susan D.; Schoffman, Danielle E.; Lee, Katherine; King, Abby C.; Taylor, C. Barr; Schleicher, Nina C.; Perri, Michael G.

    2013-01-01

    Objective: Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current…

  18. Development of the Assessment of Burden of COPD tool : an integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    Slok, Annerika H. M.; in 't Veen, Johannes C. C. M.; Chavannes, Niels H.; van der Molen, Thys; Rutten-van Molken, Maureen P. M. H.; Kerstjens, Huib A. B.; Salome, Philippe L.; Holverda, Sebastiaan; Dekhuijzen, P. N. Richard; Schuiten, Denise; Asijee, Guus M.; van Schayck, Onno C. P.

    2014-01-01

    In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communicatio

  19. Development of the assessment of burden of COPD tool: An integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    A.H.M. Slok (Annerika); J.C.C.M. in 't Veen (Johannes); N.H. Chavannes (Nicolas); T. van der Molen (Thys); M.P.M.H. Rutten-van Mölken (Maureen); H.A.M. Kerstjens (Huib); J. Salomé; S. Holverda (Sebastiaan); P.N.R. Dekhuijzen (Richard); D. Schuiten (Denise); G.M. Asijee (Guus); O.C.P. Schayck (Onno)

    2014-01-01

    textabstractIn deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate

  20. Development of the Assessment of Burden of COPD tool: an integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    Slok, A.H.; Veen, J.C. In 't; Chavannes, N.H.; Molen, T. van der; Molken, M.P. Rutten-van; Kerstjens, H.A.; Salome, P.L.; Holverda, S.; Dekhuijzen, P.N.R.; Schuiten, D.; Asijee, G.M.; Schayck, O.C.P. van

    2014-01-01

    In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communicatio

  1. Physical inactivity and arterial stiffness in COPD

    Directory of Open Access Journals (Sweden)

    Sievi NA

    2015-09-01

    Full Text Available Noriane A Sievi,1 Daniel Franzen,1 Malcolm Kohler,1,2 Christian F Clarenbach1 1Division of Pulmonology, University Hospital of Zurich, 2Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland Background: Arterial stiffness is an important predictor of cardiovascular risk besides classic cardiovascular risk factors. Previous studies showed that arterial stiffness is increased in patients with COPD compared to healthy controls and exercise training may reduce arterial stiffness. Since physical inactivity is frequently observed in patients with COPD and exercise training may improve arterial stiffness, we hypothesized that low daily physical activity may be associated with increased arterial stiffness. Methods: In 123 patients with COPD (72% men; mean [standard deviation] age: 62 [7.5] years; median [quartile] forced expiratory volume in 1 second 35 [27/65] %predicted, arterial stiffness was assessed by augmentation index (AI. Daily physical activity level (PAL was measured by an activity monitor (SenseWear Pro™ >1 week. The association between AI and PAL was investigated by univariate and multivariate regression analysis, taking into account disease-specific characteristics and comorbidities. Results: Patients suffered from moderate (35%, severe (32%, and very severe (33% COPD, and 22% were active smokers. Median (quartile PAL was 1.4 (1.3/1.5 and mean (standard deviation AI 26% (9.2%. PAL showed a negative association with AI (B=-9.32, P=0.017 independent of age, sex, blood pressure, and airflow limitation. Conclusion: In COPD patients, a higher PAL seems to favorably influence arterial stiffness and therefore may reduce cardiovascular risk. Clinical Trial Registration: www.ClinicalTrials.gov, NCT01527773 Keywords: activity monitor, airflow limitation, COPD, physical activity level

  2. Recommendations for epidemiological studies on COPD

    DEFF Research Database (Denmark)

    Bakke, P S; Rönmark, E; Eagan, T

    2011-01-01

    The prevalence of chronic obstructive pulmonary disease (COPD) has been extensively studied, especially in Western Europe and North America. Few of these data are directly comparable because of differences between the surveys regarding composition of study populations, diagnostic criteria...... for planning and performing an epidemiological study on COPD. The main message of the paper is that thorough planning is worth half the study. It is crucial to stick to standardised methods and good quality control during sampling. We recommend collecting biological markers, depending on the specific...

  3. Global scientific collaboration in COPD research

    Directory of Open Access Journals (Sweden)

    Su YB

    2017-01-01

    Full Text Available Yanbing Su,1 Chao Long,2 Qi Yu,1 Juan Zhang,1 Daisy Wu,3 Zhiguang Duan1 1School of Management, Shanxi Medical University, Taiyuan, People’s Republic of China; 2School of Medicine, Stanford University, Palo Alto, CA, 3Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA Purpose: This study aimed to investigate the multiple collaboration types, quantitatively evaluate the publication trends and review the performance of institutions or countries (regions across the world in COPD research.Materials and methods: Scientometric methods and social network analysis were used to survey the development of publication trends and understand current collaboration in the field of COPD research based on the Web of Science publications during the past 18 years.Results: The number of publications developed through different collaboration types has increased. Growth trends indicate that the percentage of papers authored through multinational and domestic multi-institutional collaboration (DMIC have also increased. However, the percentage of intra-institutional collaboration and single-authored (SA studies has reduced. The papers that produced the highest academic impact result from international collaboration. The second highest academic impact papers are produced by DMIC. Out of the three, the papers that are produced by SA studies have the least amount of impact upon the scientific community. A handful of internationally renowned institutions not only take the leading role in the development of the research within their country (region but also play a crucial role in international research collaboration in COPD. Both the amount of papers produced and the amount of cooperation that occurs in each study are disproportionally distributed between high-income countries (regions and low-income countries (regions. Growing attention has been generated toward research on COPD from more and more different

  4. Association of plasma adiponectin levels with cellular hydration state measured using bioelectrical impedance analysis in patients with COPD

    Directory of Open Access Journals (Sweden)

    Yoshikawa T

    2012-08-01

    Full Text Available Takahiro Yoshikawa,1 Hiroshi Kanazawa21Department of Sports Medicine, Osaka City University Graduate School of Medicine, 2Department of Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, JapanBackground: It is widely recognized that chronic obstructive pulmonary disease (COPD includes a variety of extra pulmonary complications and comorbidities. Recently, adiponectin was shown to regulate cellular metabolism in humans. Cellular hydration state is affected by a variety of hormonal factors and regulates cellular metabolic state. Therefore, this study was designed to determine whether adiponectin is a possible factor involved in cellular hydration state in COPD.Methods: Thirty patients with COPD and 41 age-matched controls participated in the study. Plasma levels of total and high molecular weight (HMW adiponectin were measured and anthropometry and pulmonary function tests were conducted. Intracellular water (ICW, extracellular water (ECW, and ECW/ICW ratio, which are parameters of cellular hydration state, were measured using bioelectrical impedance analysis.Results: Higher levels of total and HMW adiponectin in plasma were found in patients with COPD compared with levels in controls. A significant inverse correlation was observed between body mass index and plasma levels of total and HMW adiponectin in the control group. However, this significant correlation was not observed in patients with COPD. The plasma levels of total and HMW adiponectin were also not significantly correlated with any pulmonary function parameters in patients with COPD. Regarding the state of cellular hydration, the plasma levels of total adiponectin were inversely correlated with the ECW/ICW ratio and positively with ICW values in patients with COPD. Moreover, closer correlations were found between these parameters and plasma HMW adiponectin levels.Conclusion: The results of the present study suggest a novel association of the plasma

  5. [Effect of lung volume reduction surgery (LVRS) on nutritional status in patients with COPD].

    Science.gov (United States)

    Kobayashi, Atsushi; Yoshikawa, Masanori; Kushibe, Keiji; Takenaka, Hideaki; Hukuoka, Atsuhiko; Tamaki, Shinji; Kimura, Hiroshi

    2003-12-01

    The beneficial effects of lung volume reduction surgery (LVRS) on patients with severe chronic obstructive pulmonary disease (COPD) on pulmonary function and exercise performance has been established. However, the impact on nutritional status and prognosis has not been demonstrated. In the present study, we investigated the changes in nutritional status in COPD patients undergoing bilateral thoracoscopic LVRS and also analyzed the relationship between nutritional status and postoperative complications and prognosis. After LVRS, body weight, fat-free mass (FFM) and caloric intake were significantly increased. Increase in FFM correlated significantly with improvement in exercise performance. In underweight patients before LVRS, the incidence of post-operative complications was significantly higher than in normal-weight patients, and a patient who was moderately-to-severely underweight (% ideal body weight nutritional status after LVRS contributes to improvement in exercise performance, and that preoperative nutritional status has a significant impact on postoperative morbidity and mortality. From our data, we concluded that preoperative nutritional assessment is an important part of the preoperative evaluation of LVRS, and that LVRS provides nutritional benefits for underweight patients with severe COPD.

  6. Clinical definition of COPD exacerbations and classification of their severity.

    Science.gov (United States)

    Caramori, Gaetano; Adcock, Ian M; Papi, Alberto

    2009-03-01

    A standardized definition of chronic obstructive pulmonary disease (COPD) exacerbation still represents an unmet need in respiratory medicine; definitions currently rely on clinical empiricism with little evidence-based scientific support. Exacerbations of COPD are certainly clear events in the mind of practicing physicians. However, when one tries to provide simple concepts such as their definition and classification of severity, one realizes how little we know. Current symptom- and event-based definitions of a COPD exacerbation, as well as the classifications of the severity of COPD exacerbations, all have their own limitations. Efforts to assess the efficacy of new therapies in the treatment and prevention of COPD exacerbations have been hampered by the lack of a widely agreed upon and consistently used definition. There is a need for greater investment in research on COPD exacerbations in order to promote a better understanding of COPD exacerbations.

  7. Dopamine release in ventral striatum of pathological gamblers losing money

    DEFF Research Database (Denmark)

    Linnet, J; Peterson, E; Doudet, D J;

    2010-01-01

    Linnet J, Peterson E, Doudet DJ, Gjedde A, Møller A. Dopamine release in ventral striatum of pathological gamblers losing money. Objective: To investigate dopaminergic neurotransmission in relation to monetary reward and punishment in pathological gambling. Pathological gamblers (PG) often continue...... gambling despite losses, known as 'chasing one's losses'. We therefore hypothesized that losing money would be associated with increased dopamine release in the ventral striatum of PG compared with healthy controls (HC). Method: We used Positron Emission Tomography (PET) with [(11)C]raclopride to measure...... dopamine release in the ventral striatum of 16 PG and 15 HC playing the Iowa Gambling Task (IGT). Results: PG who lost money had significantly increased dopamine release in the left ventral striatum compared with HC. PG and HC who won money did not differ in dopamine release. Conclusion: Our findings...

  8. Energy and Protein Intake and Its Relationship with Pulmonary Function in Chronic Obstructive Pulmonary Disease (COPD Patients

    Directory of Open Access Journals (Sweden)

    Leila Yazdanpanah

    2010-12-01

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC (r=0.2, P=0.02 and Vital Capacity (VC (r=0.3, P=0.008. The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients.

  9. Learning COPD Sensitive Filters in Pulmonary CT

    DEFF Research Database (Denmark)

    Sørensen, Lauge Emil Borch Laurs; Lo, Pechin Chien Pau; Ashraf, Haseem

    2009-01-01

    textural differences that discriminate subjects with chronic obstructive pulmonary disease (COPD) from healthy smokers, and it is expected that emphysema plays a major part in this. The proposed texture based approach achieves an 69% classification accuracy which is significantly better than RA’s 55...

  10. Why Do Patients with COPD Decline Rehabilitation

    DEFF Research Database (Denmark)

    Mathar, Helle; Fastholm, Pernille; Hansen, Ida Rode

    2016-01-01

    AIM: This paper aimed to suggest possible answers to the question: Why do patients with COPD decline pulmonary rehabilitation (PR)? METHOD: The study is a metasynthesis inspired by Noblit of the existing qualitative research on the area. The data were collected during 2014. Six studies were found...

  11. Early detection of COPD in general practice

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Løkke, Anders; Dahl, Ronald

    2011-01-01

    Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early detect...

  12. Pathophysiology of muscle dysfunction in COPD.

    Science.gov (United States)

    Gea, Joaquim; Agustí, Alvar; Roca, Josep

    2013-05-01

    Muscle dysfunction often occurs in patients with chronic obstructive pulmonary disease (COPD) and may involve both respiratory and locomotor (peripheral) muscles. The loss of strength and/or endurance in the former can lead to ventilatory insufficiency, whereas in the latter it limits exercise capacity and activities of daily life. Muscle dysfunction is the consequence of complex interactions between local and systemic factors, frequently coexisting in COPD patients. Pulmonary hyperinflation along with the increase in work of breathing that occur in COPD appear as the main contributing factors to respiratory muscle dysfunction. By contrast, deconditioning seems to play a key role in peripheral muscle dysfunction. However, additional systemic factors, including tobacco smoking, systemic inflammation, exercise, exacerbations, nutritional and gas exchange abnormalities, anabolic insufficiency, comorbidities and drugs, can also influence the function of both respiratory and peripheral muscles, by inducing modifications in their local microenvironment. Under all these circumstances, protein metabolism imbalance, oxidative stress, inflammatory events, as well as muscle injury may occur, determining the final structure and modulating the function of different muscle groups. Respiratory muscles show signs of injury as well as an increase in several elements involved in aerobic metabolism (proportion of type I fibers, capillary density, and aerobic enzyme activity) whereas limb muscles exhibit a loss of the same elements, injury, and a reduction in fiber size. In the present review we examine the current state of the art of the pathophysiology of muscle dysfunction in COPD.

  13. Calprotectin - A Marker of Mortality in COPD?

    DEFF Research Database (Denmark)

    Holmgaard, Dennis B; Mygind, Lone; Titlestad, Ingrid

    2013-01-01

    Abstract Calprotectin comprises more than 45% of the cytosolic content of neutrophil granulocytes. Because pathogenesis, disease activity and disease progression in COPD are believed to be partly dependent of neutrophil driven inflammation we decided to investigate whether plasma level of calprot......Abstract Calprotectin comprises more than 45% of the cytosolic content of neutrophil granulocytes. Because pathogenesis, disease activity and disease progression in COPD are believed to be partly dependent of neutrophil driven inflammation we decided to investigate whether plasma level...... of calprotectin (p-calprotectin) was associated with all-cause mortality in patients with COPD. We measured p-calprotectin in blood samples from 460 patients with moderate to very severe COPD in stable phase. Patients were stratified into three groups according to p-calprotectin level. Outcome measure was all......-cause mortality. Analyses were adjusted for factors known to influence mortality using a Cox regression analysis. We found a time dependent correlation between p-calprotectin levels and mortality during the first 5 years of follow-up. Increasing levels of p-calprotectin were associated with concomitant increases...

  14. Clinically relevant subgroups in COPD and asthma

    Directory of Open Access Journals (Sweden)

    Alice M. Turner

    2015-06-01

    Full Text Available As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called “phenotypes”; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely. In this review, we describe subgroups of COPD and asthma patients whose clinical characteristics we believe have therapeutic or major prognostic implications specific to the lung, and whether these subgroups are constant over time. Finally, we will discuss whether the subgroups we describe are common to both asthma and COPD, and give some examples of how treatment might be tailored in patients where the subgroup is clear, but the label of asthma or COPD is not.

  15. Lung microbiome dynamics in COPD exacerbations.

    Science.gov (United States)

    Wang, Zhang; Bafadhel, Mona; Haldar, Koirobi; Spivak, Aaron; Mayhew, David; Miller, Bruce E; Tal-Singer, Ruth; Johnston, Sebastian L; Ramsheh, Mohammadali Yavari; Barer, Michael R; Brightling, Christopher E; Brown, James R

    2016-04-01

    Increasing evidence suggests that the lung microbiome plays an important role in chronic obstructive pulmonary disease (COPD) severity. However, the dynamics of the lung microbiome during COPD exacerbations and its potential role in disease aetiology remain poorly understood.We completed a longitudinal 16S ribosomal RNA survey of the lung microbiome on 476 sputum samples collected from 87 subjects with COPD at four visits defined as stable state, exacerbation, 2 weeks post-therapy and 6 weeks recovery.Our analysis revealed a dynamic lung microbiota where changes appeared to be associated with exacerbation events and indicative of specific exacerbation phenotypes. Antibiotic and steroid treatments appear to have differential effects on the lung microbiome. We depict a microbial interaction network for the lung microbiome and suggest that perturbation of a few bacterial operational taxonomic units, in particular Haemophilus spp., could greatly impact the overall microbial community structure. Furthermore, several serum and sputum biomarkers, in particular sputum interleukin-8, appear to be highly correlated with the structure and diversity of the microbiome.Our study furthers the understanding of lung microbiome dynamics in COPD patients and highlights its potential as a biomarker, and possibly a target, for future respiratory therapeutics.

  16. Choosing a Safe and Successful Weight-Loss Program

    Science.gov (United States)

    ... to lose weight bring a pen and paper, smartphone, or other mobile device to read your questions ... other aspects of care, such as improving the quality of life for people with chronic illnesses. Find ...

  17. Nothing to lose: why early career scientists make ideal entrepreneurs.

    Science.gov (United States)

    Thon, Jonathan N

    2014-12-01

    An entrepreneurial movement within science strives to invert the classical trajectory of academic research careers by positioning trainees at the apex of burgeoning industries. Young scientists today have nothing to lose and everything to gain by pursuing this 'third road', and academic institutes and established companies only stand to benefit from supporting this emerging movement of discovery research with economic purpose. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Losing Thomas & Ella: A Father's Story (A Research Comic).

    Science.gov (United States)

    Weaver-Hightower, Marcus B

    2015-10-14

    "Losing Thomas & Ella" presents a research comic about one father's perinatal loss of twins. The comic recounts Paul's experience of the hospital and the babies' deaths, and it details the complex grieving process afterward, including themes of anger, distance, relationship stress, self-blame, religious challenges, and resignation. A methodological appendix explains the process of constructing the comic and provides a rationale for the use of comics-based research for illness, death, and grief among practitioners, policy makers, and the bereaved.

  19. Determining prognosis in acute exacerbation of COPD

    Directory of Open Access Journals (Sweden)

    Flattet Y

    2017-01-01

    Full Text Available Yves Flattet,1 Nicolas Garin,1,2 Jacques Serratrice,1 Arnaud Perrier,1 Jérome Stirnemann,1 Sebastian Carballo1 1Department of Internal Medicine, Service of General Internal Medicine, Geneva University Hospitals, Geneva, 2Service of Internal Medicine, Riviera Chablais Hospital, Monthey, Switzerland Background: Acute exacerbations are the leading causes of hospitalization and mortality in patients with COPD. Prognostic tools for patients with chronic COPD exist, but there are scarce data regarding acute exacerbations. We aimed to identify the prognostic factors of death and readmission after exacerbation of COPD.Methods: This was a retrospective study conducted in the Department of Internal Medicine of Geneva University Hospitals. All patients admitted to the hospital with a diagnosis of exacerbation of COPD between 2008 and 2011 were included. The studied variables included comorbidities, Global Initiative for Chronic Obstructive Lung Disease (GOLD severity classification, and biological and clinical parameters. The main outcome was death or readmission during a 5-year follow-up. The secondary outcome was death. Survival analysis was performed (log-rank and Cox.Results: We identified a total of 359 patients (195 men and 164 women, average age 72 years. During 5-year follow-up, 242 patients died or were hospitalized for the exacerbation of COPD. In multivariate analysis, age (hazard ratio [HR] 1.03, 95% CI 1.02–1.05; P<0.0001, severity of airflow obstruction (forced expiratory volume in 1 s <30%; HR 4.65, 95% CI 1.42–15.1; P=0.01, diabetes (HR 1.47, 95% CI 1.003–2.16; P=0.048, cancer (HR 2.79, 95% CI 1.68–4.64; P<0.0001, creatinine (HR 1.003, 95% CI 1.0004–1.006; P=0.02, and respiratory rate (HR 1.03, 95% CI 1.003–1.05; P=0.028 on admission were significantly associated with the primary outcome. Age, cancer, and procalcitonin were significantly associated with the secondary outcome.Conclusion: COPD remains of ominous prognosis

  20. Losing a valued member of the medical practice team.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    Losing a valued member of your staff can be disruptive, painful, and costly to your medical practice. And despite your best intentions and impeccable employee management policies and skills, things will happen beyond your control, and people move on. Being prepared for that possibility will help you minimize and contain the damage and move your practice forward. This article suggests 15 strategies that you can use to mitigate the effects of losing a valued employee. These include strategies to protect your practice's interests and several that will smooth the transition for your remaining staff. This article also describes 10 ways that losing a valued employee can impact a practice. It offers 10 additional strategies to help you cope with the death of an employee, one of the most difficult challenges a practice manager may ever face. This article further suggests several easy-to-implement practice management techniques that will help you soften the blow of employee turnover. It offers a sample farewell letter to announce an employee's departure from your practice and suggests six knowledge transfer questions to ask before the employee leaves. Finally, this article provides a comprehensive list of more than 30 thoughtful, eye-opening, and revealing questions that you can ask in an employee exit interview or exit survey.

  1. Body composition and functional limitation in COPD

    Directory of Open Access Journals (Sweden)

    Katz Patricia P

    2007-01-01

    Full Text Available Abstract Background Low body mass index has been associated with increased mortality in severe COPD. The impact of body composition earlier in the disease remains unclear. We studied the impact of body composition on the risk of functional limitation in COPD. Methods We used bioelectrical impedance to estimate body composition in a cohort of 355 younger adults with COPD who had a broad spectrum of severity. Results Among women, a higher lean-to-fat ratio was associated with a lower risk of self-reported functional limitation after controlling for age, height, pulmonary function impairment, race, education, and smoking history (OR 0.45 per 0.50 increment in lean-to-fat ratio; 95% CI 0.28 to 0.74. Among men, a higher lean-to-fat ratio was associated with a greater distance walked in 6 minutes (mean difference 40 meters per 0.50 ratio increment; 95% CI 9 to 71 meters. In women, the lean-to-fat ratio was associated with an even greater distance walked (mean difference 162 meters per 0.50 increment; 95% CI 97 to 228 meters. In women, higher lean-to-fat ratio was also associated with better Short Physical Performance Battery Scores. In further analysis, the accumulation of greater fat mass, and not the loss of lean mass, was most strongly associated with functional limitation among both sexes. Conclusion Body composition is an important non-pulmonary impairment that modulates the risk of functional limitation in COPD, even after taking pulmonary function into account. Body composition abnormalities may represent an important area for screening and preventive intervention in COPD.

  2. Caregivers’ burden in patients with COPD

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Objective Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. Methods We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. Results A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. Conclusion The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions. PMID:25709429

  3. Sputum cell count: biomarkers in the differentiation of asthma, COPD and asthma-COPD overlap

    Directory of Open Access Journals (Sweden)

    Gao J

    2017-09-01

    Full Text Available Jie Gao, Wutie Zhou, Bida Chen, Weiming Lin, Sifang Wu, Feng Wu Department of Respiratory Medicine, The Third People’s Hospital, Guangzhou Medical College, Huizhou, People’s Republic of China Introduction: Cell count in induced sputum is a noninvasive biomarker to assess airway inflammation phenotypes. Accordingly, sputum cell counts are extensively used in the treatment of asthma and COPD. Nevertheless, the clinical application of sputum cell counts in patients with asthma–COPD overlap (ACO remains elusive. The aim of this study was to investigate sputum cell counts in patients with ACO which are different from those in patients with asthma and COPD and also to examine the relationship between sputum cell counts in bronchial reversibility and bronchial hyperresponsiveness (BHR. Patients and methods: A total of 374 patients participated in the study, including 142 patients with asthma, 160 patients with COPD and 72 patients with ACO. All patients underwent the following tests on the same day: pulmonary function test (PFT, BHR test or bronchodilator reversibility test and inducing sputum. They were classified into the asthma group, COPD group or ACO group based on a clinical history, PFT values and BHR test or bronchodilator reversibility test. Results: The three groups had different PFT values (p<0.001 except for forced vital capacity (FVC between the asthma and ACO groups (p=0.378. The sputum levels of eosinophil% were decreased in patients with COPD when compared with those in patients with asthma and ACO (p<0.001 and p<0.001, respectively. There was a difference in sputum neutrophil% and macrophage% counts among the three groups (p<0.001 and p<0.001, respectively; there was no difference in sputum eosinophil% counts between patients with ACO and asthma (p=0.668 and there was no difference in the percentage of induced sputum cells between the stage of airway obstruction and the stage of BHR. Conclusion: The clinical relevance of this

  4. The downside of weight loss: realistic intervention in body-weight trajectory.

    Science.gov (United States)

    Bosomworth, N John

    2012-05-01

    To explore the reasons why long-term weight loss is seldom achieved and to evaluate the consequences of various weight trajectories, including stability, loss, and gain. Studies evaluating population weight metrics were mainly observational. Level I evidence was available to evaluate the influence of weight interventions on mortality and quality of life. Sustained weight loss is achieved by a small percentage of those intending to lose weight. Mortality is lowest in the high-normal and overweight range. The safest body-size trajectory is stable weight with optimization of physical and metabolic fitness. With weight loss there is evidence for lower mortality in those with obesity-related comorbidities. There is also evidence for improved health-related quality of life in obese individuals who lose weight. Weight loss in the healthy obese, however, is associated with increased mortality. Weight loss is advisable only for those with obesity-related comorbidities. Healthy obese people wishing to lose weight should be informed that there might be associated risks. A strategy that leads to a stable body mass index with optimized physical and metabolic fitness at any size is the safest weight intervention option.

  5. "Lose ten lbs in two weeks" Motivation for weight loss affects autobiographical memory in dieters

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

      The purpose of the present study was to examine the connection between motivation and autobiographical memories. Autobiographical memories recalled in response to dieting related versus neutral cue words were compared between a dieting and non-dieting group. Memories recalled in response...... higher on Beck's depression scale and had more recall errors in terms of overgeneral memories than the non-dieting group. The results can be seen to support the concept of current concerns (Klinger, 1978) and the theory of the working self (Conway & Pleydell-Pearce, 2000)....

  6. 减肥药膳粥%Medicated Porridges for Lose Weight

    Institute of Scientific and Technical Information of China (English)

    潘东原

    2011-01-01

    @@ 体重超过正常标准20%以上者为肥胖,肥胖者常有动则气短、心悸、自汗、疾多、肢倦乏力、嗜睡等症状,肥胖者还容易患冠心病、高血压病、糖尿病、痛风、胆结石等疾病,平均寿命比正常人短.也有碍形体美.中医认为肥胖是气虚和痰湿内蕴所致,因此,食疗保健应从健脾益气,化痰除湿入手.

  7. Cumulative Weight Exposure Is Associated with Different Weight Loss Strategies and Weight Loss Success in Adults Age 50 or Above

    OpenAIRE

    Martin Sénéchal; Jana Slaght; Bouchard, Danielle R.

    2015-01-01

    Objectives. To evaluate if cumulative weight exposure is associated with weight loss strategy choices and weight loss success. Methods. Data from the National Health and Nutrition Examination Survey were used; a total of 4,562 people age 50 years or older who reported trying to lose weight in the last year were studied. Cumulative weight exposure (CWE) score was defined as the sum of body mass index points above 25 kg/m2 at the age of 25, 10 years ago, 1 year ago, and now. Weight loss strateg...

  8. Effect of obesity on respiratory mechanics during rest and exercise in COPD.

    Science.gov (United States)

    Ora, Josuel; Laveneziana, Pierantonio; Wadell, Karin; Preston, Megan; Webb, Katherine A; O'Donnell, Denis E

    2011-07-01

    The presence of obesity in COPD appears not to be a disadvantage with respect to dyspnea and weight-supported cycle exercise performance. We hypothesized that one explanation for this might be that the volume-reducing effects of obesity convey mechanical and respiratory muscle function advantages. Twelve obese chronic obstructive pulmonary disease (COPD) (OB) [forced expiratory volume in 1 s (FEV(1)) = 60%predicted; body mass index (BMI) = 32 ± 1 kg/m(2); mean ± SD] and 12 age-matched, normal-weight COPD (NW) (FEV(1) = 59%predicted; BMI = 23 ± 2 kg/m(2)) subjects were compared at rest and during symptom-limited constant-work-rate exercise at 75% of their maximum. Measurements included pulmonary function tests, operating lung volumes, esophageal pressure, and gastric pressure. OB vs. NW had a reduced total lung capacity (109 vs. 124%predicted; P exercise endurance times were similar in OB and NW. Pulmonary resistance fell (P exercise in OB but not in NW. Resting inspiratory capacity, dyspnea/ventilation plots, and the ratio of respiratory muscle effort to tidal volume displacement were similar, as was the dynamic performance of the respiratory muscles including the diaphragm. In conclusion, the lack of increase in dyspnea and exercise intolerance in OB vs. NW could not be attributed to improvement in respiratory muscle function. Potential contributory factors included alterations in the elastic properties of the lungs, raised intra-abdominal pressures, reduced lung hyperinflation, and preserved inspiratory capacity.

  9. Relation between physical capacity, nutritional status and systemic inflammation in COPD.

    Science.gov (United States)

    Hallin, Runa; Janson, Christer; Arnardottir, Ragnheiður Harpa; Olsson, Roger; Emtner, Margareta; Branth, Stefan; Boman, Gunnar; Slinde, Frode

    2011-07-01

    Decreased physical capacity, weight loss, fat-free mass depletion and systemic inflammation are frequently observed in patients with chronic obstructive pulmonary disease (COPD). Our aim was to examine relations between physical capacity, nutritional status, systemic inflammation and disease severity in COPD. Forty nine patients with moderate to severe COPD were included in the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom limited cycle ergo meter test, incremental shuttle walking test, 12-minute walk distance and hand grip strength test. Nutritional status was investigated by anthropometric measurements, (weight, height, arm and leg circumferences and skinfold thickness) and bioelectrical impedance assessment was performed. Blood samples were analyzed for C-reactive protein (CRP) and fibrinogen. Working capacity was positively related to forced expiratory volume in 1 s (FEV(1) ) (p chronic obstructive pulmonary disease is related to lung function, body composition and systemic inflammation. A depiction of all three aspects of the disease might be important when targeting interventions in chronic obstructive pulmonary disease. © 2010 Blackwell Publishing Ltd.

  10. Weight and weddings. Engaged men's body weight ideals and wedding weight management behaviors.

    Science.gov (United States)

    Klos, Lori A; Sobal, Jeffery

    2013-01-01

    Most adults marry at some point in life, and many invest substantial resources in a wedding ceremony. Previous research reports that brides often strive towards culturally-bound appearance norms and engage in weight management behaviors in preparation for their wedding. However, little is known about wedding weight ideals and behaviors among engaged men. A cross-sectional survey of 163 engaged men asked them to complete a questionnaire about their current height and weight, ideal wedding body weight, wedding weight importance, weight management behaviors, formality of their upcoming wedding ceremony, and demographics. Results indicated that the discrepancy between men's current weight and reported ideal wedding weight averaged 9.61 lb. Most men considered being at a certain weight at their wedding to be somewhat important. About 39% were attempting to lose weight for their wedding, and 37% were not trying to change their weight. Attempting weight loss was more frequent among men with higher BMI's, those planning more formal weddings, and those who considered being the right weight at their wedding as important. Overall, these findings suggest that weight-related appearance norms and weight loss behaviors are evident among engaged men. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. COPD management costs according to the frequency of COPD exacerbations in UK primary care

    Directory of Open Access Journals (Sweden)

    Punekar YS

    2014-01-01

    Full Text Available Yogesh Suresh Punekar,1 Amit Shukla,2 Hana Müllerova31Global Health Outcomes, GlaxoSmithKline R&D, Uxbridge, UK; 2Worldwide Epidemiology, GlaxoSmithKline R&D, Upper Providence, PA, USA; 3Worldwide Epidemiology, GlaxoSmithKline R&D, Uxbridge, UKBackground: The economic burden of chronic obstructive pulmonary disease (COPD exacerbations is significant, but the impact of other sources on the overall cost of COPD management is largely unknown. We aimed to estimate overall costs for patients experiencing none, one, or two or more exacerbations per year in the UK.Methods: A retrospective cohort of prevalent COPD patients was identified in the Clinical Practice Research Datalink UK database. Patients with information recorded for at least 12 months before and after cohort entry date were included (first prevalent COPD diagnosis confirmed by spirometry on/after April 1, 2009. Patients were categorized as having none, one, or two or more moderate-to-severe COPD exacerbations in the 12 months after cohort entry and further classified by the Global initiative for chronic Obstructive Lung Disease (GOLD category of airflow obstruction and the Medical Research Council dyspnea scale. Study outcomes included counts of general practitioner interactions, moderate-severe COPD exacerbations, and non-COPD hospitalizations. Estimated resource use costs were calculated using National Health Service reference costs for 2010–2011.Results: The cohort comprised 58,589 patients (mean age 69.5 years, mean dyspnea grade 2.5, females 46.6%, current smokers 33.1%. The average total annual per patient cost of COPD management, excluding medications, was £2,108 for all patients and £1,523, £2,405, and £3,396 for patients experiencing no, one, or two or more moderate-to-severe exacerbations, respectively. General practitioner interactions contributed most to these annual costs, accounting for £1,062 (69.7%, £1,313 (54.6%, and £1,592 (46.9% in patients with no, one, or

  12. Efficacy and safety of fluticasone furoate/vilanterol or tiotropium in subjects with COPD at cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Covelli H

    2015-12-01

    Full Text Available Henry Covelli,1 Bonavuth Pek,2 Isabelle Schenkenberger,3 Catherine Scott-Wilson,4 Amanda Emmett,5 Courtney Crim4 1Kootenai Health, Coeur d’Alene, ID, USA; 2Clinique de Pneumologie et de Sommeil de Lanaudière, Quebec, Canada; 3Klinische Forschung, Berlin, Germany; 4GlaxoSmithKline Inc., Research Triangle Park, 5PAREXEL International, Durham, NC, USA Background: Fluticasone furoate/vilanterol (FF/VI is a novel, once-daily, inhaled corticosteroid/long-acting β2-agonist combination approved for the treatment of COPD and asthma. We compared the safety and efficacy of FF/VI and tiotropium (TIO in subjects with moderate-to-severe COPD with greater risk for comorbid cardiovascular disease (CVD.Methods: This randomized, blinded, double-dummy, parallel-group study compared a once-daily morning dose of FF/VI 100/25 mcg delivered via ELLIPTA™ with TIO 18 mcg via HandiHaler® for 12 weeks in subjects with diagnosed COPD, forced expiratory volume in 1 second (FEV1 30%–70% predicted, and CVD or CVD risk. The primary endpoint was change from baseline in 24-hour weighted mean FEV1 on Day 84. Other efficacy endpoints included time to onset of bronchodilation, trough FEV1, other spirometry measures, rescue medication use, symptoms, quality of life (St George’s Respiratory Questionnaire-COPD [SGRQ-C], and health status (COPD Assessment Tests [CAT] measures. Safety endpoints included cardiovascular monitoring, cortisol excretion, COPD exacerbations, and adverse events, including prespecified drug effects.Results: Both FF/VI and TIO improved the 24-hour weighted mean FEV1 from baseline after 12 weeks with no significant difference between treatments. Other endpoints favored FF/VI for time to onset of bronchodilation, rescue medication use, dyspnea, SGRQ-C and CAT scores, or favored TIO for change from baseline in forced vital capacity and inspiratory capacity. Pneumonia occurred more frequently in the FF/VI group, and two TIO-treated subjects died

  13. Cardiovascular morbidity in COPD: A study of the general population

    DEFF Research Database (Denmark)

    Lange, Peter; Møgelvang, Rasmus; Marott, Jacob Louis

    2010-01-01

    ventricular ejection fraction (LVEF) are sparse. We used data from the 4th examination of The Copenhagen City Heart Study, which comprises 5,890 individuals with data on pulmonary and cardiac symptoms, risk factors for cardiovascular diseases, pulmonary function tests, ECG and relevant medical history. Among.......4% for moderate COPD (GOLD stage 2) and 2.5% for severe and very severe COPD (GOLD stages 3+4). Individuals with COPD were older and had a higher prevalence of cardiovascular risk factors and a higher prevalence of cardiovascular diseases. Among the echocardiographical findings, only the presence of left...... ventricular hyperthrophy was significantly more frequent among individuals with COPD (17.7%) than among participants without COPD (12.1%.), yet this relationship was no longer significant after statistical adjustment for age and gender. In the general population, subjects with COPD have a higher prevalence...

  14. [Role of ICS/LABA on COPD treatment].

    Science.gov (United States)

    Shibata, Yoko

    2016-05-01

    In the treatment of chronic obstructive pulmonary disease (COPD), bronchodilators such as long acting muscarinic antagonist (LAMA) and long acting β agonist(LABA) play key roles for improving respiratory function and symptoms, and reducing risk of exacerbation. However, inhaled corticosteroid (ICS), a key medicine for bronchial asthma, is limitedly used in COPD treatment. Japanese Respiratory Society recommends to use ICS for severe COPD patients who have been frequently exacerbated, because previous clinical studies indicated that ICS reduces exacerbation in moderate to severe COPD patients. Asthma sometimes overlaps with COPD, and symptoms of those patients are not well controlled by the bronchodilation therapy alone. Therefore, ICS/LABA or ICS/LAMA should be prescribed to those overlapped patients. Concentration of exhaled nitrogen oxide and percentage of peripheral eosinophil may be good biomarkers for discriminating the COPD patients who have good response to ICS treatment.

  15. Instability in the COPD Diagnosis upon Repeat Testing Vary with the Definition of COPD

    Science.gov (United States)

    Perez-Padilla, Rogelio; Wehrmeister, Fernando C.; Montes de Oca, Maria; Lopez, Maria Victorina; Jardim, Jose R.; Muino, Adriana; Valdivia, Gonzalo; Pertuze, Julio; Menezes, Ana Maria B.

    2015-01-01

    Background A low FEV1/FVC from post-bronchodilator spirometry is required to diagnose COPD. Both the FEV1 and the FVC can vary over time; therefore, individuals can be given a diagnosis of mild COPD at one visit, but have normal spirometry during the next appointment, even without an intervention. Methods We analyzed two population-based surveys of adults with spirometry carried out for the same individuals 5-9 years after their baseline examination. We determined the factors associated with a change in the spirometry interpretation from one exam to the next utilizing different criteria commonly used to diagnose COPD. Results The rate of an inconsistent diagnosis of mild COPD was 11.7% using FEV1/FVC <0.70, 5.9% using FEV1/FEV6 COPD. Further improvement could be obtained by defining a borderline zone around the LLN (e.g. plus or minus 0.6 SD), or repeating the test in patients with borderline results. PMID:25811461

  16. Cool and luminous transients from mass-losing binary stars

    Science.gov (United States)

    Pejcha, Ondřej; Metzger, Brian D.; Tomida, Kengo

    2016-02-01

    We study transients produced by equatorial disc-like outflows from catastrophically mass-losing binary stars with an asymptotic velocity and energy deposition rate near the inner edge which are proportional to the binary escape velocity vesc. As a test case, we present the first smoothed-particle radiation-hydrodynamics calculations of the mass loss from the outer Lagrange point with realistic equation of state and opacities. The resulting spiral stream becomes unbound for binary mass ratios 0.06 ≲ q ≲ 0.8. For synchronous binaries with non-degenerate components, the spiral-stream arms merge at a radius of ˜10a, where a is the binary semi-major axis, and the accompanying shock thermalizes about 10 per cent of the kinetic power of the outflow. The mass-losing binary outflows produce luminosities reaching up to ˜106 L⊙ and effective temperatures spanning 500 ≲ Teff ≲ 6000 K, which is compatible with many of the class of recently discovered red transients such as V838 Mon and V1309 Sco. Dust readily forms in the outflow, potentially in a catastrophic global cooling transition. The appearance of the transient is viewing angle-dependent due to vastly different optical depths parallel and perpendicular to the binary plane. We predict a correlation between the peak luminosity and the outflow velocity, which is roughly obeyed by the known red transients. Outflows from mass-losing binaries can produce luminous (105 L⊙) and cool (Teff ≲ 1500 K) transients lasting a year or longer, as has potentially been detected by Spitzer surveys of nearby galaxies.

  17. 'At Least I Didn't Lose Money'

    DEFF Research Database (Denmark)

    Stephens, Thomas Alexander; Tyran, Jean-Robert Karl

    (monetary) values. Real losses may therefore loom larger in people’s minds when they lose money than when real losses are hidden by purely nominal gains. Using a survey experiment with a large and heterogeneous sample, we show that evaluations of housing transactions are systematically biased by purely......Loss aversion is one of the most robust findings to have emerged from behavioral economics. Surprisingly little attention, however, has been devoted to nominal loss aversion, the interaction of loss aversion and money illusion. People tend to think of transactions in terms of their nominal...

  18. Protein losing enteropathy secondary to a pulmonary artery stent

    Directory of Open Access Journals (Sweden)

    Narayanswami Sreeram

    2012-01-01

    Full Text Available A 2-year-old patient with hypoplastic left heart syndrome presented 6 months following Fontan completion with protein-losing enteropathy (PLE. He had undergone stent implantation in the left pulmonary artery after the Norwood procedure, followed by redilation of the stent prior to Fontan completion. Combined bronchoscopic and catheterization studies during spontaneous breathing confirmed left bronchial stenosis behind the stent, and diastolic systemic ventricular pressure during expiration of 25 mm Hg. We postulate that the stent acts as a valve, against which the patient generates high expiratory pressures, which are reflected in the ventricular diastolic pressure. This may be the cause of PLE.

  19. Losing the boxes: fragmentation as a source of system complexity

    CSIR Research Space (South Africa)

    Baumbach, J

    2015-09-01

    Full Text Available stream_source_info Baumbach2_2015_ABSTRACT.pdf.txt stream_content_type text/plain stream_size 856 Content-Encoding UTF-8 stream_name Baumbach2_2015_ABSTRACT.pdf.txt Content-Type text/plain; charset=UTF-8 Losing the Boxes...: Fragmentation as a Source of System Complexity Johannes Baumbach, André Marais, Dr Duarte P. Gonçalves Council for Scientific and Industrial Research (CSIR) P.O Box 395 Pretoria, South Africa 0001 Abstract. Despite the advances in mature engineering...

  20. Fibrinogen and alpha(1)-antitrypsin in COPD exacerbations

    DEFF Research Database (Denmark)

    Sylvan Ingebrigtsen, Truls; Marott, J. L.; Rode, L.

    2015-01-01

    Background We tested the hypotheses that fibrinogen and alpha(1)-antitrypsin are observationally and genetically associated with exacerbations in COPD. Methods We studied 13 591 individuals with COPD from the Copenhagen General Population Study (2003-2013), of whom 6857 were genotyped for FGB -455...... and exacerbations in instrumental variable analyses. Results Elevated fibrinogen and alpha(1)-antitrypsin levels were associated with increased risk of exacerbations in COPD, HR=1.14 (1.07 to 1.22, p...

  1. Recommendations for Diagnosis and Management of Osteoporosis in COPD Men

    OpenAIRE

    Mazokopakis, Elias E; Starakis, Ioannis K.

    2011-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis and fractures because of lifestyle factors, systemic effects of the disease, side effects of treatment, and comorbidities. The initial evaluation of COPD men for osteoporosis must include a detailed medical history and physical examination, assessment of COPD severity, and additional tests, as suggested by results of clinical evaluation. Osteoporosis is diagnosed on the basis of bone mineral dens...

  2. Role of club cells and CCSP in COPD

    OpenAIRE

    Knabe, Lucie

    2016-01-01

    A defective in Club Cell Secretory Protein (CCSP) produced by nonciliated Club cells was observed in COPD (Chronic Obstructive Pulmonary Disease) airways. Our aim was to understand CCSP biological mechanisms of action and its dysregulation in COPD and whether it might be a therapeutic axis in COPD.First, the influence of the CCSP G38A polymorphism on CCSP transcription levels and its regulatory mechanisms were analyzed. Our in vivo study conducted in a 1 year prospective cohort consisting of ...

  3. A challenge to the seven widely believed concepts of COPD

    Directory of Open Access Journals (Sweden)

    Al-Kassmimi FA

    2013-01-01

    Full Text Available Feisal A Al-Kassimi, Esam H AlhamadDivision of Pulmonology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi ArabiaAbstract: This review proposes a critical reassessment (based entirely on published evidence of the following seven common beliefs about chronic obstructive pulmonary disease (COPD: (1 COPD is one disease. (2 There is a valid definition for COPD. (The current definition includes cases of irreversible asthma and bronchiectasis, and occasionally, other obstructive lung conditions. (3 Irreversible asthma in smokers and COPD cannot be differentiated. (4 A “chronic bronchitis” form of COPD exists and is characterized by blue bloater status and normal carbon monoxide diffusion studies. (5 Phenotyping has no bearing on medication choice in COPD. (6 Computerized scoring of lung attenuation on CT scans can diagnose emphysema. (Emphysema scores overlap in irreversible asthma and COPD; however, qualitative visual changes may be useful for differentiation. (7 A definable entity called the overlap (of COPD and asthma syndrome exists. Conflict over the abovementioned points denies patients proper phenotype-guided therapy and encourages a multidrug approach to COPD management. The recently coined term, overlap syndrome, invites a double-barreled therapy aimed at asthma and COPD, despite the absence of any agreement about how to define the syndrome and the lack of any related drug trials (in the area of inhaled corticosteroids. A diagnosis of COPD is associated with high morbidity and escalating costs, suggesting the need for a thorough new examination of the evidence.Keywords: asthma, computerized tomography, COPD, global initiative for chronic obstructive lung disease, overlap syndrome

  4. COPD and exercise: does it make a difference?

    OpenAIRE

    Spruit, Martijn A.; Chris Burtin; Patrick De Boever; Daniël Langer; Ioannis Vogiatzis; Wouters, Emiel F.M.; Frits M.E. Franssen

    2016-01-01

    Key points Physiological changes are observed following a structured exercise training programme in patients with COPD, without changes in resting lung function.; Exercise training is the cornerstone of a comprehensive pulmonary rehabilitation programme in patients with COPD.; Most comorbidities in patients referred for pulmonary rehabilitation remain undiagnosed and untreated.; After careful screening, it is safe for COPD patients with comorbidities to obtain significant and clin...

  5. Weight Management

    Science.gov (United States)

    ... Anger Weight Management Weight Management Smoking and Weight Healthy Weight Loss Being Comfortable in Your Own Skin Your Weight Loss Expectations & Goals Healthier Lifestyle Healthier Lifestyle Physical Fitness Food & Nutrition Sleep, Stress & Relaxation Emotions & Relationships HealthyYouTXT ...

  6. ▼Relvar Ellipta for COPD.

    Science.gov (United States)

    2014-06-01

    ▼Relvar Ellipta 92 μg/22 μg (GSK) is a dry powder inhaler that contains a corticosteroid (fluticasone furoate) and a long-acting beta2 agonist (vilanterol trifenatate).1 Neither ingredient is currently marketed as a single-ingredient inhalation product, although fluticasone furoate is available as a nasal spray for the treatment of allergic rhinitis. Relvar Ellipta 92 μg/22 μg is licensed for once-daily use as maintenance therapy for chronic obstructive pulmonary disease (COPD) and asthma. In this article we consider the evidence for its use in the management of patients with COPD. An article in a future issue will review its use in the management of patients with asthma.

  7. [Tobacco smoking treatment strategy in COPD].

    Science.gov (United States)

    Pamplona, Paula; Mendes, Berta

    2009-01-01

    Smoking cessation is one of the most important ways of improving the prognosis of COPD patients. Based on currently available evidence professional health workers should take a proactive and continuous role with smokers, motivating them to stop smoking and providing treatment to aid smoking cessation. The treatment should include pharmacotherapy in addition to behavioural support and should be part of management of the patient's chronic respiratory condition, as the COPD National Prevention and Treatment Programme recommends. Respiratory physicians and other professional health workers should receive training to ensure they have the necessary knowledge, attitude and skills to undertake these initiatives or to refer the smokers to a suitable qualified specialist. In the near future specialised smoking units should provide specific support, promote training, improve research and awareness and establish tobacco control measures in hospitals and primary health care centres.

  8. [Do we define the COPD correctly?].

    Science.gov (United States)

    de la Fuente Cid, R; González Barcala, F J; Pose Reino, A; Valdés Cudrado, L

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is a very common disease which prevalence is increasing and in a nearly future it will represent a socio-sanitary problem. This article s objective is to make a reflexion about the concept COPD, for the physicians contribute to their divulgation to the population and very specially to help to the tobacco desertion. Besides we want to reveal that the term has been well-finished due to the advance in the knowledge of aetiology, physiopathology, and radiology techniques. Although, we think that the acronym still includes entities with a very different features. We hope to clarify this concept in the future, establishing different phenotypes and mainly with molecular biology.

  9. Ain’t no mountain high enough? Setting high weight loss goals predicts effort and short-term weight loss

    NARCIS (Netherlands)

    Vet, de E.; Nelissen, R.M.A.; Zeelenberg, M.; Ridder, de D.T.D.

    2013-01-01

    Although psychological theories outline that it might be beneficial to set more challenging goals, people attempting to lose weight are generally recommended to set modest weight loss goals. The present study explores whether the amount of weight loss individuals strive for is associated with more p

  10. Ain’t no mountain high enough? Setting high weight loss goals predicts effort and short-term weight loss

    NARCIS (Netherlands)

    Vet, de E.; Nelissen, R.M.A.; Zeelenberg, M.; Ridder, de D.T.D.

    2013-01-01

    Although psychological theories outline that it might be beneficial to set more challenging goals, people attempting to lose weight are generally recommended to set modest weight loss goals. The present study explores whether the amount of weight loss individuals strive for is associated with more

  11. Convergence of the epidemiology and pathology of COPD

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Hogg, J C

    2006-01-01

    The epidemiology of chronic obstructive pulmonary disease (COPD) has been dominated by one hypothesis stating that cigarette smoking and chronic bronchitis were the key to pathogenesis and another that asthma, chronic bronchitis, and even emphysema are related to different expressions of a primary...... airway abnormality. The first hypothesis was rejected in the late 1960s based on a longitudinal study of working men where only a fraction of smokers developed COPD and where development of COPD was independent of the absence or presence of chronic bronchitis. Chronic bronchitis in more advanced COPD...

  12. Diagnostic values of electrocardiogram in chronic obstructive pulmonary disease (COPD

    Directory of Open Access Journals (Sweden)

    Agarwal R

    2008-01-01

    Full Text Available Background : Chronic obstructive pulmonary diseases (COPD, a broad spectrum of respiratory diseases represents a worldwide problem. Electrocardiographic (ECG findings may help in clinical decision making regarding this disease entity. Aims: To evaluate the extent and diagnostic values of ECG changes among COPD patients suffering from broad spectrum of respiratory diseases. Material & Methods : A hos-pital based cross-sectional study was conducted in Sworoop Rani Nehru Hospital, Allahabad in Eastern Uttar Pradesh (UP, India. A sample of 60 patients attending respiratory diseases OPD for treatment of various respiratory problems including 14 COPD patients was selected randomly during 2000-2001. Patients of respiratory diseases were also evaluated electrocardiographically along with other investiga-tions. Results : Respiratory problems were more common among rural males of low socio-economic group. COPD particularly chronic bronchitis was the commonest respiratory problem next to pulmonary tuberculosis. Inspite of normal heart rate observed in 71.4% COPD patients, ECG changes were present in 35.7% COPD patients. Peaked P-wave was observed in 35.7% COPD patients, whereas duration of QRS complex was abnormal in only 8.1% of the patients. None of the COPD patients showed abnormal P-wave duration. ECG changes were found less sensitive (35.7% but highly specific (95.6%. Conclusion : Diagnostic values of ECG among patients with respiratory problems suggest that COPD patients should be screened electrocardiographically in addition to other clinical investigations.

  13. Danish version of 'The COPD self-efficacy scale'

    DEFF Research Database (Denmark)

    Emme, Christina; Mortensen, Erik L; Rydahl-Hansen, Susan

    2012-01-01

    Scand J Caring Sci; 2012; 26; 615-623 Danish version of 'The COPD self-efficacy scale': translation and psychometric properties The aim of the study was to translate 'The COPD self-efficacy scale' (CSES) into Danish and to evaluate the psychometric properties of the Danish version (CSES-DK). CSES...... enables assessment of self-efficacy in individuals with chronic obstructive pulmonary disease (COPD). The scale consists of 34 items, describing situations which may cause dyspnoea in patients with COPD. The CSES was translated into Danish using a standard forward-backward translation procedure...

  14. Determinants of underdiagnosis of COPD in national and international surveys.

    Science.gov (United States)

    Bernd, Lamprecht; Joan, B Soriano; Michael, Studnicka; Bernhard, Kaiser; Lowie, E Vanfleteren; Louisa, Gnatiuc; Peter, Burney; Marc, Miravitlles; Francisco, García-Rio; Kaveh, Akbari; Julio, Ancochea; Ana, M Menezes; Rogelio, Perez-Padilla; Maria, Montes de Oca; Carlos, A Torres-Duque; Andres, Caballero; Mauricio, González-García; Sonia, Buist

    2015-10-01

    COPD ranks within the top three causes of mortality in the global burden of disease, yet it remains largely underdiagnosed. We assessed the underdiagnosis of COPD and its determinants in national and international surveys of general populations. We analyzed representative samples of adults aged ≥ 40 years randomly selected from well-defined administrative areas worldwide (44 sites from 27 countries). Postbronchodilator FEV1/FVC Barranquilla, Colombia, to 19.0% in Cape Town, South Africa. Only 26.4% reported a previous lung function test, and only 5.0% reported a previous diagnosis of COPD, whereas 9.7% had a postbronchodilator FEV1/FVC < LLN. Overall, 81.4% of (spirometrically defined) COPD cases were undiagnosed, with the highest rate in Ile-Ife, Nigeria (98.3%) and the lowest rate in Lexington, Kentucky (50.0%). In multivariate analysis, a greater probability of underdiagnosis of COPD was associated with male sex, younger age, never and current smoking, lower education, no previous spirometry, and less severe airflow limitation. Even with substantial heterogeneity in COPD prevalence, COPD underdiagnosis is universally high. Because effective management strategies are available for COPD, spirometry can help in the diagnosis of COPD at a stage when treatment will lead to better outcomes and improved quality of life.

  15. Undernutrition in Patients with COPD and Its Treatment

    Directory of Open Access Journals (Sweden)

    Hiroyuki Nakamura

    2013-04-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a chronic inflammatory disorder of the lung and whole body caused mainly by tobacco smoking. Patients with advanced COPD are in a state of undernutrition, referred to as pulmonary cachexia; the exercise performance and quality of life (QOL of these patients are deteriorated, the vital prognosis is unfavorable, and the medico-economic burden posed by poorly nourished COPD patients is high. The mainstays of COPD treatment are pharmacotherapy, mainly with bronchodilators, and non-pharmacotherapeutic approaches such as respiratory rehabilitation and nutrition counseling. Nutritional supplement therapy, consisting primarily of high calorie intake, has been demonstrated to be effective for maintaining and improving the muscle strength and exercise tolerance in poorly nourished COPD patients. The efficacy of intake of various nutrients, besides a high calorie intake, for amelioration of the disease state of COPD has also been reported. The roles of adipokines in the pathophysiology of COPD have begun to receive attention recently, and not only their regulatory effects on appetite and nutritional status, but also their influence on systemic inflammation have been increasingly clarified. We review the papers on COPD and nutrition and discuss the role of nutritional supplement therapy in the treatment of COPD.

  16. Experimental rhinovirus infection in COPD: implications for antiviral therapies.

    Science.gov (United States)

    Gunawardana, Natasha; Finney, Lydia; Johnston, Sebastian L; Mallia, Patrick

    2014-02-01

    Chronic obstructive pulmonary disease (COPD) is a major public health problem and will be one of the leading global causes of mortality over the coming decades. Much of the morbidity, mortality and health care costs of COPD are attributable to acute exacerbations, the commonest causes of which are respiratory infections. Respiratory viruses are frequently detected in COPD exacerbations but direct proof of a causative relationship has been lacking. We have developed a model of COPD exacerbation using experimental rhinovirus infection in COPD patients and this has established a causative relationship between virus infection and exacerbations. In addition it has determined some of the molecular mechanisms linking virus infections to COPD exacerbations and identified potential new therapeutic targets. This new data should stimulate research into the role of antiviral agents as potential treatments for COPD exacerbations. Testing of antiviral agents has been hampered by the lack of a small animal model for rhinovirus infection and experimental rhinovirus infection in healthy volunteers has been used to test treatments for the common cold. Experimental rhinovirus infection in COPD subjects offers the prospect of a model that can be used to evaluate the effects of new treatments for virus-induced COPD exacerbations, and provide essential data that can be used in making decisions regarding large scale clinical trials.

  17. Optimizing antibiotic selection in treating COPD exacerbations

    Directory of Open Access Journals (Sweden)

    Attiya Siddiqi

    2008-03-01

    Full Text Available Attiya Siddiqi, Sanjay SethiDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Veterans Affairs Western New York Health Care System and University of Buffalo, State University of New York, Buffalo, New York, USAAbstract: Our understanding of the etiology, pathogenesis and consequences of acute exacerbations of chronic obstructive pulmonary disease (COPD has increased substantially in the last decade. Several new lines of evidence demonstrate that bacterial isolation from sputum during acute exacerbation in many instances reflects a cause-effect relationship. Placebo-controlled antibiotic trials in exacerbations of COPD demonstrate significant clinical benefits of antibiotic treatment in moderate and severe episodes. However, in the multitude of antibiotic comparison trials, the choice of antibiotics does not appear to affect the clinical outcome, which can be explained by several methodological limitations of these trials. Recently, comparison trials with nontraditional end-points have shown differences among antibiotics in the treatment of exacerbations of COPD. Observational studies that have examined clinical outcome of exacerbations have repeatedly demonstrated certain clinical characteristics to be associated with treatment failure or early relapse. Optimal antibiotic selection for exacerbations has therefore incorporated quantifying the risk for a poor outcome of the exacerbation and choosing antibiotics differently for low risk and high risk patients, reserving the broader spectrum drugs for the high risk patients. Though improved outcomes in exacerbations with antibiotic choice based on such risk stratification has not yet been demonstrated in prospective controlled trials, this approach takes into account concerns of disease heterogeneity, antibiotic resistance and judicious antibiotic use in exacerbations.Keywords: COPD, exacerbation, bronchitis, antibiotics

  18. Longitudinal changes in lung hyperinflation in COPD

    Science.gov (United States)

    Park, Jimyung; Lee, Chang-Hoon; Lee, Yeon Joo; Park, Jong Sun; Cho, Young-Jae; Lee, Jae Ho; Lee, Choon-Taek; Yoon, Ho Il

    2017-01-01

    Purpose COPD is characterized by an accelerated and progressive decline in forced expiratory volume in 1 second (FEV1) and lung hyperinflation. Although lung hyperinflation is the hallmark of COPD, data on the longitudinal changes in lung hyperinflation and any association with the decline in FEV1 are lacking. The aim of this study was to evaluate the longitudinal changes in lung hyperinflation and to investigate its relationship with FEV1 decline. Patients and methods We conducted a prospective cohort study and studied 176 COPD patients with annual lung volume measurements over a period of 5 years or more. We used a random coefficient model to calculate the annual changes in lung volumes and to evaluate the factors associated with changes in lung hyperinflation. Additionally, the relationship between the change in lung hyperinflation and FEV1 was assessed. Results Residual volume (RV), inspiratory capacity (IC), and total lung capacity (TLC) declined at a mean rate of 39.5, 49.6, and 63.8 mL/year, respectively. While IC/TLC declined at 0.70%/year, RV/TLC also declined at 0.35%/year. Changes in both IC/TLC and RV/TLC varied significantly. Frequent exacerbations led to an increase in RV/TLC and faster decline in IC/TLC over time. RV/TLC declined in 59.7% and increased in 40.3% of the patients. A significant negative correlation was found between the rates of change in FEV1 and RV/TLC, and the rate of decline in FEV1 was greater in patients with an increase in RV/TLC than in those with a decline in RV/TLC (54.2 vs 10.7 mL/year, Prate of change in lung hyperinflation varied greatly among COPD patients. Progression of hyperinflation was associated with frequent exacerbations and a faster decline in FEV1. PMID:28223790

  19. Incidence and long-term outcome of severe asthma-COPD overlap compared to asthma and COPD alone

    DEFF Research Database (Denmark)

    Baarnes, Camilla Boslev; Andersen, Zorana Jovanovic; Tjønneland, Anne

    2017-01-01

    in the Danish Diet, Cancer, and Health cohort (1993-1997) were followed in the National Patients Registry for admissions for asthma (DJ45-46) and COPD (DJ40-44) and vital status. Asthma-COPD overlap was defined as at least one hospital admission for asthma and one for COPD (different time points), and incident...... asthma-COPD overlap as at least one of the diagnoses occurring after enrollment into the Diet, Cancer, and Health cohort. RESULTS: A total of 1,845 (3.2%) and 4,037 (7.1%) participants had admissions for asthma and COPD, respectively, with 662 (1.2%) participants with asthma-COPD overlap. Incidence rate...

  20. Elevated ACE activity is not associated with asthma, COPD, and COPD co-morbidity

    DEFF Research Database (Denmark)

    Lee, Julie; Nordestgaard, Børge G; Dahl, Morten

    2009-01-01

    with COPD, the odds ratio for ischemic heart disease was 1.1 (0.8-1.6) for ID individuals and 1.2 (0.8-1.7) for DD individuals compared with II individuals; corresponding odds ratios for hypertension were 1.1 (0.7-1.5) and 0.8 (0.5-1.2), and for low physical activity 0.9 (0.5-1.4) and 0.7 (0.......4-1.2). The results were similar upon adjustment for sex, age, smoking status, body mass index, total cholesterol, and ACE inhibitor/angiotensin II type 1 receptor blocker use. These data suggest that lifelong genetically elevated ACE activity is not a major risk factor for asthma or COPD, or for ischemic heart...... disease, hypertension, and low physical activity in COPD patients....

  1. Huge Pericardial Cyst Misleading Symptoms of COPD

    Directory of Open Access Journals (Sweden)

    Göktürk Fındık

    2012-04-01

    Full Text Available Pericardial cysts are rare benign congenital mediastinal lesions. It accounts 30% of all mediastinal cysts. They are usually asemptomatic. They can produce the compression of the mediastinal structures typically caused the symptoms of dyspnea, thoracic pain, tachicardia and cough due to the unusual large size of the cyst. It can performed symptoms of lung atelectasia. The case was a sixty-five years old woman followed with a diagnosis of COPD for seven years. The patient was admitted to our center with the diagnosis of elevation of the right hemidiaphragm on chest radiography. The computed tomography revealed a cystic lesion adjacent to the right hemidiaphragm and cyst excision was performed via right thoracotomy. Patient%u2019s postoperative clinical findings indicated that the symptoms of COPD regressed completely and the patient did not require any further bronchodilator therapy. The aim of this case report is to demonstrate that the pericardial cysts can be missed in chest radiographs and impression of cysts may cause COPD like symptoms in these patients.

  2. Heliox, dyspnoea and exercise in COPD

    Directory of Open Access Journals (Sweden)

    T. Hunt

    2010-03-01

    Full Text Available One of the most important determinants of physical and mental well-being of people with chronic obstructive pulmonary disease (COPD is participation in physical activity. The ability to alter the sensation of dyspnoea during exercise may improve both exercise duration and intensity. Despite the low density, inert nature, strong safety profile and multiple applications of helium gas, the potential benefit of helium–oxygen gas mixtures as an adjunct therapy to modify disease symptoms and exercise capabilities in obstructive lung diseases has only recently been explored. This is a systematic review of the available peer-reviewed evidence exploring whether symptom modification (perceived levels of dyspnoea and exercise performance in COPD (either intensity or duration of work are modified by inhalation of Heliox. Eight experimental studies met inclusion for this review. A variety of methodologies and outcome variables were used negating meta-analysis and hampering direct comparison between interventions. Overall, there was high level of evidence with a low risk of bias supporting Heliox's effectiveness in improving the intensity and endurance of exercise when compared to room air for people with COPD. Little conclusive evidence was found to determine whether Heliox altered the sensation of dyspnoea during exercise.

  3. Patient needs and medication styles in COPD

    Directory of Open Access Journals (Sweden)

    L. M. Osman

    2005-12-01

    Full Text Available Patient self-care in illnesses such as chronic obstructive pulmonary disease (COPD is influenced by "trade-offs" that patients make between their social and psychological needs, and the "best practice" clinical management of their illness. Patients weigh the benefits of taking medication against the costs, such as symptoms. Personal styles of medication use and decision-making also affect how well COPD patients respond to treatment plans and their acceptance of particular treatments, including inhalers. The large amount of information now available may have made patients more autonomous than before, but the actual locus of control varies widely between patients. Patients seem to take a pragmatic approach when assessing inhaler devices, basing preference on how effective they perceive the device to be. Patients with COPD show loyalty to devices and, in the main, try to comply with instructions given by the healthcare provider. The health path for chronic obstructive pulmonary disease, which describes the course the disease typically takes, is a progressive deterioration. Patients therefore adopt a conservative attitude to their health goals and what they expect to gain from treatment and management plans. An understanding of these influences will help healthcare providers support the patient better and give the appropriate advice at each phase of a patient's health path.

  4. Diet Pills, Powders, and Liquids: Predictors of Use by Healthy Weight Females

    Science.gov (United States)

    Thorlton, Janet; Park, Chang; Hughes, Tonda

    2014-01-01

    About 35% of healthy weight adolescent females describe themselves as overweight, and 66% report planning to lose weight. Body weight dissatisfaction is associated with unhealthy weight loss practices including diet pill/powder/liquid (PPL) use. Few studies have examined diet PPL use in healthy weight adolescent females; therefore, Youth Risk…

  5. Diet Pills, Powders, and Liquids: Predictors of Use by Healthy Weight Females

    Science.gov (United States)

    Thorlton, Janet; Park, Chang; Hughes, Tonda

    2014-01-01

    About 35% of healthy weight adolescent females describe themselves as overweight, and 66% report planning to lose weight. Body weight dissatisfaction is associated with unhealthy weight loss practices including diet pill/powder/liquid (PPL) use. Few studies have examined diet PPL use in healthy weight adolescent females; therefore, Youth Risk…

  6. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999–2008

    Directory of Open Access Journals (Sweden)

    Schnell Kerry

    2012-07-01

    Full Text Available Abstract Background Treatment of chronic diseases such as chronic obstructive pulmonary disease (COPD is complicated by the presence of comorbidities. The objective of this analysis was to estimate the prevalence of comorbidity in COPD using nationally-representative data. Methods This study draws from a multi-year analytic sample of 14,828 subjects aged 45+, including 995 with COPD, from the National Health and Nutrition Examination Survey (NHANES, 1999–2008. COPD was defined by self-reported physician diagnosis of chronic bronchitis or emphysema; patients who reported a diagnosis of asthma were excluded. Using population weights, we estimated the age-and-gender-stratified prevalence of 22 comorbid conditions that may influence COPD and its treatment. Results Subjects 45+ with physician-diagnosed COPD were more likely than subjects without physician-diagnosed COPD to have coexisting arthritis (54.6% vs. 36.9%, depression (20.6% vs. 12.5%, osteoporosis (16.9% vs. 8.5%, cancer (16.5% vs. 9.9%, coronary heart disease (12.7% vs. 6.1%, congestive heart failure (12.1% vs. 3.9%, and stroke (8.9% vs. 4.6%. Subjects with COPD were also more likely to report mobility difficulty (55.6% vs. 32.5%, use of >4 prescription medications (51.8% vs. 32.1, dizziness/balance problems (41.1% vs. 23.8%, urinary incontinence (34.9% vs. 27.3%, memory problems (18.5% vs. 8.8%, low glomerular filtration rate (16.2% vs. 10.5%, and visual impairment (14.0% vs. 9.6%. All reported comparisons have p  Conclusions Our study indicates that COPD management may need to take into account a complex spectrum of comorbidities. This work identifies which conditions are most common in a nationally-representative set of COPD patients (physician-diagnosed, a necessary step for setting research priorities and developing clinical practice guidelines that address COPD within the context of comorbidity.

  7. Disseminated Langerhans' cell histiocytosis and massive protein-losing enteropathy

    Directory of Open Access Journals (Sweden)

    Santos-Machado T.M.

    1999-01-01

    Full Text Available Symptomatic involvement of the gastrointestinal (GI tract as a prominent symptom in Langerhans' cell histiocytosis (LCH is uncommon, occurring in less than 1 to 5% of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7%, protein-losing enteropathy (33.3% and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management.

  8. Cool and Luminous Transients from Mass-Losing Binary Stars

    CERN Document Server

    Pejcha, Ondrej; Tomida, Kengo

    2015-01-01

    We study transients produced by equatorial disk-like outflows from catastrophically mass-losing binary stars with an asymptotic velocity and energy deposition rate near the inner edge which are proportional to the binary escape velocity v_esc. As a test case, we present the first smoothed-particle radiation-hydrodynamics calculations of the mass loss from the outer Lagrange point with realistic equation of state and opacities. The resulting spiral stream becomes unbound for binary mass ratios 0.06 < q < 0.8. For synchronous binaries with non-degenerate components, the spiral-stream arms merge at a radius of ~10a, where a is the binary semi-major axis, and the accompanying shock thermalizes 10-20% of the kinetic power of the outflow. The mass-losing binary outflows produce luminosities proportional to the mass loss rate and v_esc, reaching up to ~10^6 L_Sun. The effective temperatures depend primarily on v_esc and span 500 < T_eff < 6000 K. Dust readily forms in the outflow, potentially in a catast...

  9. Statins and morbidity and mortality in COPD in the COMIC study: a prospective COPD cohort study.

    Science.gov (United States)

    Citgez, Emanuel; van der Palen, Job; Koehorst-Ter Huurne, Kirsten; Movig, Kris; van der Valk, Paul; Brusse-Keizer, Marjolein

    2016-01-01

    Both chronic inflammation and cardiovascular comorbidity play an important role in the morbidity and mortality of patients with chronic obstructive pulmonary disease (COPD). Statins could be a potential adjunct therapy. The additional effects of statins in COPD are, however, still under discussion. The aim of this study is to further investigate the association of statin use with clinical outcomes in a well-described COPD cohort. 795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not. Statin use was defined as having a statin for at least 90 consecutive days after inclusion. Outcome parameters were 3-year survival, based on all-cause mortality, time until first hospitalisation for an acute exacerbation of COPD (AECOPD) and time until first community-acquired pneumonia (CAP). A sensitivity analysis was performed without patients who started a statin 3 months or more after inclusion to exclude immortal time bias. Statin use resulted in a better overall survival (corrected HR 0.70 (95% CI 0.51 to 0.96) in multivariate analysis), but in the sensitivity analysis this association disappeared. Statin use was not associated with time until first hospitalisation for an AECOPD (cHR 0.95, 95% CI 0.74 to 1.22) or time until first CAP (cHR 1.1, 95% CI 0.83 to 1.47). In the COMIC study, statin use is not associated with a reduced risk of all-cause mortality, time until first hospitalisation for an AECOPD or time until first CAP in patients with COPD.

  10. Statins and morbidity and mortality in COPD in the COMIC study: a prospective COPD cohort study

    Science.gov (United States)

    Citgez, Emanuel; van der Palen, Job; Koehorst-ter Huurne, Kirsten; Movig, Kris; van der Valk, Paul; Brusse-Keizer, Marjolein

    2016-01-01

    Background Both chronic inflammation and cardiovascular comorbidity play an important role in the morbidity and mortality of patients with chronic obstructive pulmonary disease (COPD). Statins could be a potential adjunct therapy. The additional effects of statins in COPD are, however, still under discussion. The aim of this study is to further investigate the association of statin use with clinical outcomes in a well-described COPD cohort. Methods 795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not. Statin use was defined as having a statin for at least 90 consecutive days after inclusion. Outcome parameters were 3-year survival, based on all-cause mortality, time until first hospitalisation for an acute exacerbation of COPD (AECOPD) and time until first community-acquired pneumonia (CAP). A sensitivity analysis was performed without patients who started a statin 3 months or more after inclusion to exclude immortal time bias. Results Statin use resulted in a better overall survival (corrected HR 0.70 (95% CI 0.51 to 0.96) in multivariate analysis), but in the sensitivity analysis this association disappeared. Statin use was not associated with time until first hospitalisation for an AECOPD (cHR 0.95, 95% CI 0.74 to 1.22) or time until first CAP (cHR 1.1, 95% CI 0.83 to 1.47). Conclusions In the COMIC study, statin use is not associated with a reduced risk of all-cause mortality, time until first hospitalisation for an AECOPD or time until first CAP in patients with COPD. PMID:27403321

  11. Primary care COPD patients compared with large pharmaceutically-sponsored COPD studies: an UNLOCK validation study.

    Directory of Open Access Journals (Sweden)

    Annemarije L Kruis

    Full Text Available BACKGROUND: Guideline recommendations for chronic obstructive pulmonary disease (COPD are based on the results of large pharmaceutically-sponsored COPD studies (LPCS. There is a paucity of data on disease characteristics at the primary care level, while the majority of COPD patients are treated in primary care. OBJECTIVE: We aimed to evaluate the external validity of six LPCS (ISOLDE, TRISTAN, TORCH, UPLIFT, ECLIPSE, POET-COPD on which current guidelines are based, in relation to primary care COPD patients, in order to inform future clinical practice guidelines and trials. METHODS: Baseline data of seven primary care databases (n=3508 from Europe were compared to baseline data of the LPCS. In addition, we examined the proportion of primary care patients eligible to participate in the LPCS, based on inclusion criteria. RESULTS: Overall, patients included in the LPCS were younger (mean difference (MD-2.4; p=0.03, predominantly male (MD 12.4; p=0.1 with worse lung function (FEV1% MD -16.4; p<0.01 and worse quality of life scores (SGRQ MD 15.8; p=0.01. There were large differences in GOLD stage distribution compared to primary care patients. Mean exacerbation rates were higher in LPCS, with an overrepresentation of patients with ≥ 1 and ≥ 2 exacerbations, although results were not statistically significant. Our findings add to the literature, as we revealed hitherto unknown GOLD I exacerbation characteristics, showing 34% of mild patients had ≥ 1 exacerbations per year and 12% had ≥ 2 exacerbations per year. The proportion of primary care patients eligible for inclusion in LPCS ranged from 17% (TRISTAN to 42% (ECLIPSE, UPLIFT. CONCLUSION: Primary care COPD patients stand out from patients enrolled in LPCS in terms of gender, lung function, quality of life and exacerbations. More research is needed to determine the effect of pharmacological treatment in mild to moderate patients. We encourage future guideline makers to involve primary care

  12. The COPD Knowledge Base: enabling data analysis and computational simulation in translational COPD research.

    Science.gov (United States)

    Cano, Isaac; Tényi, Ákos; Schueller, Christine; Wolff, Martin; Huertas Migueláñez, M Mercedes; Gomez-Cabrero, David; Antczak, Philipp; Roca, Josep; Cascante, Marta; Falciani, Francesco; Maier, Dieter

    2014-11-28

    Previously we generated a chronic obstructive pulmonary disease (COPD) specific knowledge base (http://www.copdknowledgebase.eu) from clinical and experimental data, text-mining results and public databases. This knowledge base allowed the retrieval of specific molecular networks together with integrated clinical and experimental data. The COPDKB has now been extended to integrate over 40 public data sources on functional interaction (e.g. signal transduction, transcriptional regulation, protein-protein interaction, gene-disease association). In addition we integrated COPD-specific expression and co-morbidity networks connecting over 6 000 genes/proteins with physiological parameters and disease states. Three mathematical models describing different aspects of systemic effects of COPD were connected to clinical and experimental data. We have completely redesigned the technical architecture of the user interface and now provide html and web browser-based access and form-based searches. A network search enables the use of interconnecting information and the generation of disease-specific sub-networks from general knowledge. Integration with the Synergy-COPD Simulation Environment enables multi-scale integrated simulation of individual computational models while integration with a Clinical Decision Support System allows delivery into clinical practice. The COPD Knowledge Base is the only publicly available knowledge resource dedicated to COPD and combining genetic information with molecular, physiological and clinical data as well as mathematical modelling. Its integrated analysis functions provide overviews about clinical trends and connections while its semantically mapped content enables complex analysis approaches. We plan to further extend the COPDKB by offering it as a repository to publish and semantically integrate data from relevant clinical trials. The COPDKB is freely available after registration at http://www.copdknowledgebase.eu.

  13. Physical activity intensity and weight control status among U.S. Adults with diabetes.

    Science.gov (United States)

    Loprinzi, Paul D; Pariser, Gina

    2014-01-01

    We have a limited understanding of the objectively determined physical activity levels by weight control status (i.e., trying to lose weight, trying to maintain weight, and neither trying to lose or maintain weight) among U.S. adults with diabetes. Therefore, this study assessed the association between physical activity and weight control status among U.S. adults with diabetes. Cross-sectional survey. The 2003-2006 National Health and Nutrition Examination Survey (NHANES) was used, which is representative of the U.S. population. Subjects were 733 adults (≥20 years) with diabetes. Participants wore an accelerometer to assess physical activity, and questionnaires were used to assess weight control status and covariates. Multivariate negative binomial regressions were used. After adjustments, and compared to those not trying to lose or maintain their weight, women trying to lose weight engaged in 74% more physical activity (rate ratio = 1.74; 95% confidence interval [CI]: 1.14 to 2.65). Although findings were not significant for men, men were more likely than women to meet physical activity recommendations. Diabetic women trying to lose weight engaged in more physical activity than did their female counterparts not trying to lose or maintain their weight. Although men were more active than women, no differences in activity estimates occurred across weight control status for men.

  14. Biomarker-based detection of asthma–COPD overlap syndrome in COPD populations

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    Tamada T

    2015-10-01

    Full Text Available Tsutomu Tamada,1 Hisatoshi Sugiura,1 Tsuneyuki Takahashi,2 Kazuto Matsunaga,3 Keiji Kimura,4 Uichiro Katsumata,5 Daisuke Takekoshi,1 Toshiaki Kikuchi,1 Ken Ohta,6 Masakazu Ichinose1 1Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, 2Nippon Telegraph and Telephone East Corporation Tohoku Hospital, Sendai, 3Division of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, 4Hiraka General Hospital, Yokote, 5Iwate Prefectural Isawa Hospital, Oshu, 6National Hospital Organization, Tokyo National Hospital, Kiyose, Tokyo, Japan Abstract: Asthma–chronic obstructive pulmonary disease (COPD overlap syndrome (ACOS was proposed by the science committees of both Global Initiative for Asthma (GINA and Global Initiative for Chronic Obstructive Lung Disease (GOLD. However, the definition of ACOS has remained unclear all over the world, and the prevalence rate of ACOS is basically dependent on the patient’s symptoms or the physician’s opinion, based on questionnaire testing. In the current case report, we investigated the prevalence rate of COPD patients with high levels of fractional exhaled nitric oxide (FENO or immunoglobulin E (IgE as candidate markers of ACOS in COPD, as a multicenter, cross-sectional study. Outpatients with COPD were enrolled from Tohoku University Hospital, Sendai, Japan, and five hospitals (Tohoku University Hospital, Sendai, Japan; NTT East Tohoku Hospital, Sendai, Japan; Wakayama Medical University Hospital, Kimiidera, Japan; Hiraka General Hospital, Yokote, Japan; Iwate Prefectural Isawa Hospital, Oshu, Japan with pulmonary physicians from March 1, 2013 to February 28, 2014. When they were estimated using 35 ppb as the cutoff value of FENO, the prevalence rate of ACOS was 16.3% in COPD. When estimated by both FENO and IgE, the high-FENO/high-IgE group was 7.8% in COPD. To the best of our knowledge, this study is the first to detect the

  15. Assessing weight perception accuracy to promote weight loss among U.S. female adolescents: A secondary analysis

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    Yost Jennifer

    2010-08-01

    Full Text Available Abstract Background Overweight and obesity have become a global epidemic. The prevalence of overweight and obesity among U.S. adolescents has almost tripled in the last 30 years. Results from recent systematic reviews demonstrate that no single, particular intervention or strategy successfully assists overweight or obese adolescents in losing weight. An understanding of factors that influence healthy weight-loss behaviors among overweight and obese female adolescents promotes effective, multi-component weight-loss interventions. There is limited evidence demonstrating associations between demographic variables, body-mass index, and weight perception among female adolescents trying to lose weight. There is also a lack of previous studies examining the association of the accuracy of female adolescents' weight perception with their efforts to lose weight. This study, therefore, examined the associations of body-mass index, weight perception, and weight-perception accuracy with trying to lose weight and engaging in exercise as a weight-loss method among a representative sample of U.S. female adolescents. Methods A nonexperimental, descriptive, comparative secondary analysis design was conducted using data from Wave II (1996 of the National Longitudinal Study of Adolescent Health (Add Health. Data representative of U.S. female adolescents (N = 2216 were analyzed using STATA statistical software. Descriptive statistics and survey weight logistic regression were performed to determine if demographic and independent (body-mass index, weight perception, and weight perception accuracy variables were associated with trying to lose weight and engaging in exercise as a weight-loss method. Results Age, Black or African American race, body-mass index, weight perception, and weight perceptions accuracy were consistently associated with the likeliness of trying to lose weight among U.S. female adolescents. Age, body-mass index, weight perception, and weight

  16. Symptom variability in COPD: a narrative review

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    Lopez-Campos JL

    2013-05-01

    Full Text Available Jose Luis Lopez-Campos,1,2 Carmen Calero,1,2 Esther Quintana-Gallego1,21Unidad Medico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS, Hospital Universitario Virgen del Rocio, Seville, Spain; 2CIBER de Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, SpainAbstract: Chronic obstructive pulmonary disease (COPD has traditionally been considered an inexorably progressive disease, associated with a constant increase of symptoms that occur as the forced expiratory volume in 1 second (FEV1 worsens, only intermittently interrupted by exacerbations. However, this paradigm has been challenged in recent decades by the available evidence. Recent studies have pointed out that COPD-related symptoms are not consistently perceived by patients in the same way, showing not only seasonal variation, but also changes in symptom perception during a week or even within a single day. According to the available data, patients experience the biggest increase in respiratory symptoms during the first hours of the early morning, followed by the nighttime. This variation over time is of considerable importance, since it impacts on daily life activities and health-related quality of life, as measured by a recently developed ad hoc questionnaire. Additionally, recent clinical trials have suggested that the use of rapid-onset long-acting bronchodilators may have an impact on morning symptoms, despite their current use as maintenance treatment for a determined period. Although this hypothesis is to be validated in future long-term clinical trials comparing fast-onset versus slow-onset inhaled drugs in COPD, it may bring forward a new concept of long-term bronchodilator therapy. At the present time, the two available long-acting, fast-onset bronchodilators used in the treatment of COPD are formoterol and the recently marketed indacaterol. Newer drugs have also been shown to have a rapid onset of action in preclinical

  17. Evaluation of body composition in COPD patients using multifrequency bioelectrical impedance analysis

    Science.gov (United States)

    de Blasio, Francesca; de Blasio, Francesco; Miracco Berlingieri, Giulia; Bianco, Andrea; La Greca, Marta; Franssen, Frits M E; Scalfi, Luca

    2016-01-01

    Background Multifrequency bioelectrical impedance analysis (MF-BIA) is a technique that measures body impedance (Z) at different frequencies (5, 10, 50, 100, and 250 kHz). Body composition may be estimated using empirical equations, which include BIA variables or, alternatively, raw BIA data may provide direct information on water distribution and muscle quality. Objectives To compare raw MF-BIA data between COPD patients and controls and to study their relationship with respiratory and functional parameters in COPD patients. Methods MF-BIA was performed (Human Im-Touch analyzer) in 212 COPD patients and 115 age- and BMI-matched controls. Fat-free mass (FFM) and fat mass were estimated from BIA data, and low- to high-frequency (5 kHz/250 kHz) impedance ratio was calculated. Physical fitness, lung function and respiratory muscle strength were also assessed in COPD patients. Results After adjusting for age, weight, and body mass index, FFM and the 5/250 impedance ratio were lower in COPD patients (P<0.001) and were negatively affected by disease severity. In both male and female patients, the 5/250 impedance ratio was significantly correlated mainly with age (r=−0.316 and r=−0.346, respectively). Patients with a 5/250 impedance ratio below median value had lower handgrip strength (P<0.001), 6-minute walk distance (P<0.005), respiratory muscle strength (P<0.005), forced expiratory volume in 1 second (P<0.05) and vital capacity (P<0.005). Finally, the 5/250 impedance ratio was reduced (P<0.05) in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) III and IV (compared to those with GOLD I and II) or a BODE index between 6 and 10 points (compared to those with BODE index between 1 and 5 points). Conclusion MF-BIA may be a useful tool for assessing body composition and nutritional status in COPD patients. In particular, the impedance ratio could give valuable information on cellular integrity and muscle quality.

  18. Novel aspects of pathogenesis and regeneration mechanisms in COPD

    Directory of Open Access Journals (Sweden)

    Bagdonas E

    2015-06-01

    Full Text Available Edvardas Bagdonas, Jovile Raudoniute, Ieva Bruzauskaite, Ruta Aldonyte State Research Institute Center for Innovative Medicine, Vilnius, Lithuania Abstract: Chronic obstructive pulmonary disease (COPD, a major cause of death and morbidity worldwide, is characterized by expiratory airflow limitation that is not fully reversible, deregulated chronic inflammation, and emphysematous destruction of the lungs. Despite the fact that COPD is a steadily growing global healthcare problem, the conventional therapies remain palliative, and regenerative approaches for disease management are not available yet. We aim to provide an overview of key reviews, experimental, and clinical studies addressing lung emphysema development and repair mechanisms published in the past decade. Novel aspects discussed herein include integral revision of the literature focused on lung microflora changes in COPD, autoimmune component of the disease, and environmental risk factors other than cigarette smoke. The time span of studies on COPD, including emphysema, chronic bronchitis, and asthmatic bronchitis, covers almost 200 years, and several crucial mechanisms of COPD pathogenesis are described and studied. However, we still lack the holistic understanding of COPD development and the exact picture of the time-course and interplay of the events during stable, exacerbated, corticosteroid-treated COPD states, and transitions in-between. Several generally recognized mechanisms will be discussed shortly herein, ie, unregulated inflammation, proteolysis/antiproteolysis imbalance, and destroyed repair mechanisms, while novel topics such as deviated microbiota, air pollutants-related damage, and autoimmune process within the lung tissue will be discussed more extensively. Considerable influx of new data from the clinic, in vivo and in vitro studies stimulate to search for novel concise explanation and holistic understanding of COPD nowadays. Keywords: dysbiosis in COPD, autoimmune

  19. Lower corticosteroid skin blanching response is associated with severe COPD.

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    Susan J M Hoonhorst

    Full Text Available BACKGROUND: Chronic obstructive pulmonary disease (COPD is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive to steroids in COPD than in asthma. The underlying mechanisms are yet unclear. This study aimed to assess whether skin corticosteroid insensitivity is associated with COPD and COPD severity using the corticosteroid skin blanching test. METHODS: COPD patients GOLD stage I-IV (n = 27, 24, 22, and 16 respectively and healthy never-smokers and smokers (n = 28 and 56 respectively were included. Corticosteroid sensitivity was assessed by the corticosteroid skin blanching test. Budesonide was applied in 8 logarithmically increasing concentrations (0-100 μg/ml on subject's forearm. Assessment of blanching was performed after 7 hours using a 7-point scale (normal skin to intense blanching. All subjects performed spirometry and body plethysmography. RESULTS: Both GOLD III and GOLD IV COPD patients showed significantly lower skin blanching responses than healthy never-smokers and smokers, GOLD I, and GOLD II patients. Their area under the dose-response curve values of the skin blanching response were 586 and 243 vs. 1560, 1154, 1380, and 1309 respectively, p<0.05. Lower FEV1 levels and higher RV/TLC ratios were significantly associated with lower skin blanching responses (p = 0.001 and p = 0.004 respectively. GOLD stage I, II, III and IV patients had similar age and packyears. CONCLUSIONS: In this study, severe and very severe COPD patients had lower skin corticosteroid sensitivity than mild and moderate COPD patients and non-COPD controls with comparable age and packyears. Our findings together suggest that the reduced skin blanching response fits with a subgroup of COPD patients that has an early-onset COPD phenotype.

  20. On $\\alpha$-roughly weighted games

    CERN Document Server

    Freixas, Josep

    2011-01-01

    Very recently Gvozdeva, Hemaspaandra, and Slinko (2011) have introduced three hierarchies for simple games in order to measure the distance of a given simple game to the class of weighted voting games or roughly weighted voting games. Their third class $\\mathcal{C}_\\alpha$ consists of all simple games permitting a weighted representation such that each winning coalition has a weight of at least 1 and each losing coalition a weight of at most $\\alpha$. We continue their work and contribute some new results on the possible values of $\\alpha$ for a given number of voters.

  1. Relation between clinical and anthropometric data and systemic inflammation in patients with COPD

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    Pertseva Т.А.

    2015-11-01

    Full Text Available Recently, much attention is devoted to systemic inflammation in patients with chronic obstructive pulmonary disease (COPD. The aim of our study was to determine the relationship between clinical and anthropometric data with systemic inflammation in stable COPD patients. According to the study CRP levels were raised in 44% of patients (7.9 [7,1-10,9. Serum CRP was significantly higher in stable COPD patients than in control subjects (p=0.04. CRP correlated well with the pack/years index(p = 0,032 and disease duration (p=0,01. It wasn’t established link between CRP levels and height, weight, stage, disease category. CRP level affected the frequency of exacerbations (r=0,50; p=0,01. Patients with high CRP level had significantly more exacerbations in the past year (p=0.01. Patients who received any type of therapy for a long period of time had lower CRP levels, than patients who did not reseive any therapy.

  2. Functional and psychosocial effects of health qigong in patients with COPD: a randomized controlled trial.

    Science.gov (United States)

    Ng, Bobby H P; Tsang, Hector W H; Jones, Alice Y M; So, C T; Mok, Thomas Y W

    2011-03-01

    The initial gain from a Pulmonary Rehabilitation Program (PRP) among patients with chronic obstructive pulmonary disease (COPD) begins to fade away 6 months after the completion of a rehabilitation program. One possible reason may be due to the poor compliance of the patients to the existing forms of home exercise program (e.g., walking, weight training activities, etc.). This study tested the efficacy of health qigong (HQG), a traditional Chinese exercise, as an adjunct home exercise program in optimizing the gains obtained from PRP until 6 months after discharge. This was a randomized controlled trial (RCT) on a mind-body exercise intervention. Eighty (80) patients with COPD receiving conventional PRP pulmonary rehabilitation program were randomized to the HQG intervention group (n = 40) and control group (n = 40). Assessments were undertaken by blinded assessors at baseline, discharge from training, and follow-up (FU) at 3 and 6 months. Primary outcomes involved functional capacity scales and secondary outcomes involved quality-of-life scales. Intention-to-treat analysis identified trends of improvement in all outcome measures in the HQG group, whereas lesser improvement and trends of deteriorations were identified in the control group. Ancillary analysis using a per-protocol method, however, identified significantly better improvements in functional capacity measures among the HQG at the 6-month FU. This RCT provided some evidence to support the positive effect of HQG as an adjunct home exercise for rehabilitation among people with COPD and to support further related research.

  3. Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment effective?

    Science.gov (United States)

    Alison, Jennifer A; McKeough, Zoe J

    2014-11-01

    Pulmonary rehabilitation is an essential component of chronic obstructive pulmonary disease (COPD) management with strong evidence supporting the efficacy of pulmonary rehabilitation to improve exercise capacity and quality of life, as well as reduce hospital admissions. However, it is estimated that only 2-5% of people with COPD who could benefit from pulmonary rehabilitation have access to programs. Most research on the benefits of pulmonary rehabilitation has used equipment such as cycle ergometers and treadmills for endurance training and weight machines for resistance training. To enable greater availability of pulmonary rehabilitation, the efficacy of exercise training using minimal equipment needs to be evaluated. Randomised controlled trials that used minimal, low cost equipment for endurance (eight trials) and strength training (three trials) compared to no training in people with COPD were evaluated. Statistically and clinically significant differences in functional exercise capacity and quality of life, as well as improvements in strength were demonstrated when exercise training with minimal equipment was compared to no training [six-minute walk test: mean difference 40 (95% CI: 13 to 67) metres; St George's Respiratory Questionnaire: mean difference -7 (95% CI: -12 to -3) points]. While the number of studies is relatively small and of variable quality, there is growing evidence that exercise training using minimal, low cost equipment may be an alternative to equipment-intensive pulmonary rehabilitation programs.

  4. Weight Self-Regulation Process in Adolescence: The Relationship between Control Weight Attitudes, Behaviors, and Body Weight Status.

    Science.gov (United States)

    Pich, Jordi; Bibiloni, Maria Del Mar; Pons, Antoni; Tur, Josep A

    2015-01-01

    Adolescents' self-control weight behaviors were assessed (N = 1961; 12-17 years old; 2007-2008) in the Balearic Islands, Spain. The study analyzed the relationships between body weight status, body image, and self-weight concern, and actual attempts to lose weight by restrained eating and/or increased exercising. In terms of regulatory focus theory (RFT), we considered that efforts to lose or to maintain weight (successful or failed) would be motivated either by a "promotion focus" (to show an attractive body), or a "prevention focus" (to avoid social rejection of fatness), or both. Results showed that 41% of overweight boys and 25% of obese boys stated that they had never made any attempt to lose weight, and 13 and 4% in females. Around half of overweight boys and around a quarter of obese boys stated that they were "Not at all" concerned about weight gain, and girls' percentages decreased to 13 and 11%, respectively. By contrast, 57% of normal weight girls monitored their weight and stated that they had tried to become slim at least once. Weight self-regulation in females attempted to combine diet and exercise, while boys relied almost exclusively on exercise. Apparent lack of consciousness of body weight status among overweight boys, and more important, subsequent absence of behaviors to reduce their weight clearly challenges efforts to prevent obesity. We argue that several causes may be involved in this outcome, including unconscious, emotional (self-defense), and cognitive (dissonance) mechanisms driven by perceived social stigmatization of obesity. The active participation of social values of male and female body image (strong vs. pretty), and the existence of social habituation to overweight are suggested. A better knowledge of psychosocial mechanisms underlying adolescent weight self-control may improve obesity epidemics.

  5. Weight self-regulation process in adolescence: the relationship between control weight attitudes, behaviors and body weight status

    Directory of Open Access Journals (Sweden)

    Jordi ePich

    2015-05-01

    Full Text Available Adolescents’ self-control weight behaviors were assessed (n= 1961; 12-17 years old; 2007-2008 in the Balearic Islands, Spain. The study analyzed the relationships between body weight status, body image and self-weight concern, and actual attempts to lose weight by restrained eating and/or increased exercising. In terms of regulatory focus theory (RFT, we considered that efforts to lose or to maintain weight (successful or failed would be motivated either by a promotion focus (to show an attractive body, a prevention focus (to avoid social rejection of fatness, or both. Results showed that 41% of overweight boys and 25% of obese boys stated that they had never made any attempt to lose weight, and 13% and 4% in females. Around half of overweight boys and around a quarter of obese boys stated that they were Not at all concerned about weight gain, and girls’ percentages decreased to 13% and 11% respectively. By contrast 57% of normal weight girls monitored their weight and stated that they had tried to slim at least once. Weight self-regulation in females attempted to combine diet and exercise, while boys relied almost exclusively on exercise. Apparent lack of consciousness of body weight status among overweight boys, and more important, subsequent absence of behaviors to reduce their weight clearly challenges efforts to prevent obesity. We argue that several causes may be involved in this outcome, including unconscious emotional (self-defense and cognitive (dissonance mechanisms driven by perceived social stigmatization of obesity. The active participation of social values of male and female body image (strong vs. pretty and the existence of social habituation to overweight are suggested. A better knowledge of psychosocial mechanisms underlying adolescent weight self-control may improve obesity epidemics.

  6. Collagenous Colitis Associated with Protein Losing Enteropathy in a Toddler

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    Osama F. Almadhoun

    2014-01-01

    Full Text Available Collagenous mucosal inflammatory disease is a rare gastrointestinal disorder that involves the columnar lining of gastric and intestinal mucosa and is characterized by a distinct subepithelial collagen deposition. Recent clinical and pathological evidence have indicated that collagenous mucosal inflammatory disease can be extensive disease that may concomitantly involve several gastrointestinal sites at the same time. This entity, however, occurs infrequently in children. It is even less common to find concomitant depositions of collagen in the mucosa of gastrointestinal sites other than the colon. Only two cases in pediatric literature reported concomitant involvement, one with gastric and colonic involvement and the other one with gastroduodenocolitis. We are reporting a 15-month-old boy who presented with severe diarrhea and diffuse edema secondary to hypoalbuminemia. Further testing documented protein losing enteropathy (PLE associated with collagenous colitis.

  7. Who will benefit and who will lose from Obamacare?

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    Mathew M

    2013-08-01

    Full Text Available No abstract available. Article truncated at 150 words. The debate continues over the Patient Protection and Affordable Care Act (ACA, Obamacare (1. One the one hand the White House and their Democratic supporters say the law will: 1. Expand coverage to the poor; 2. Control costs; and 3. Improve care. On the other hand, opponents say the law is a job killer. Employers will be forced to eliminate positions, or reduce staffers to part-time hours to save costs. A recent article stated that Obamacare is certain to create a number of new positions but that seemed to be only part of the story (2. Below we offer our short lists of who will benefit and who will lose under Obamacare. Who Will Benefit 1.Uninsured patients. Many patients who are uninsured or underinsured will benefit because their lack of health insurance results in delays in diagnosis and treatment. Uninsured patients often seek care in the hospital emergency department…

  8. Old dilemma: asthma with irreversible airway obstruction or COPD.

    Science.gov (United States)

    Fattahi, Fatemeh; Vonk, Judith M; Bulkmans, Nicole; Fleischeuer, Ruth; Gouw, Annette; Grünberg, Katrien; Mauad, Thais; Popper, Helmut; Felipe-Silva, Aloisio; Vrugt, Bart; Wright, Joanne L; Yang, Hui-Min; Kocks, Janwillem W H; Hylkema, Machteld N; Postma, Dirkje S; Timens, Wim; Ten Hacken, Nick H T

    2015-11-01

    Older asthmatic patients may develop fixed airway obstruction and clinical signs of chronic obstructive pulmonary disease (COPD). We investigated the added value of pathological evaluation of bronchial biopsies to help differentiate asthma from COPD, taking into account smoking, age, and inhaled corticosteroid (ICS) use. Asthma and COPD patients (24 of each category) were matched for ICS use, age, FEV(1), and smoking habits. Five pulmonary and five general pathologists examined bronchial biopsies using an interactive website, without knowing patient information. They were asked to diagnose asthma or COPD on biopsy findings in both a pairwise and randomly mixed order of cases during four different phases, with intervals of 4-6 weeks, covering a maximal period of 36 weeks. Clinically concordant diagnoses of asthma or COPD varied between 63 %-73 %, without important differences between pairwise vs randomly mixed examination or between general vs pulmonary pathologists. The highest percentage of concordant diagnoses was in young asthmatic patients without ICS use and in COPD patients with ICS use. In non ICS users with fixed airway obstruction, a COPD diagnosis was favored if abnormal presence of glands, squamous metaplasia, and submucosal infiltrate was present and an asthma diagnosis in case of abnormal presence of goblet cells. In ICS users with fixed airway obstruction, abnormal presence of submucosal infiltrates, basement membrane thickening, eosinophils, and glands was associated with asthma. Histological characteristics in bronchial biopsies are reproducibly recognized by pathologists, yet the differentiation by histopathology between asthma and COPD is difficult without information about ICS use.

  9. Maatschappelijke kosten van astma, COPD en respiratoire allergie.

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; Wit, G.A. de; Wijga, A.H.; Heijmans, M.J.W.M.; Hoogendoorn, M.; Rutten-van Mölken, M.P.M.H.; Maurits, E.E.M.; Hoogeveen, R.T.; Feenstra, T.L.

    2013-01-01

    Doel: Schatten van de maatschappelijke kosten voor astma, COPD en respiratoire allergie in 2007 en van toekomstige zorguitgaven voor de periode 2007-2032. Opzet: Beschrijvend onderzoek. Methode: Representatieve registratiebestanden zijn gebruikt om de zorgkosten voor astma, COPD en respiratoire alle

  10. Characterisation of COPD heterogeneity in the ECLIPSE cohort

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    Agusti Alvar

    2010-09-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE. Methods We studied 2164 clinically stable COPD patients, 337 smokers with normal lung function and 245 never smokers. In these individuals, we measured clinical parameters, nutritional status, spirometry, exercise tolerance, and amount of emphysema by computed tomography. Results COPD patients were slightly older than controls and had more pack years of smoking than smokers with normal lung function. Co-morbidities were more prevalent in COPD patients than in controls, and occurred to the same extent irrespective of the GOLD stage. The severity of airflow limitation in COPD patients was poorly related to the degree of breathlessness, health status, presence of co-morbidity, exercise capacity and number of exacerbations reported in the year before the study. The distribution of these variables within each GOLD stage was wide. Even in subjects with severe airflow obstruction, a substantial proportion did not report symptoms, exacerbations or exercise limitation. The amount of emphysema increased with GOLD severity. The prevalence of bronchiectasis was low (4% but also increased with GOLD stage. Some gender differences were also identified. Conclusions The clinical manifestations of COPD are highly variable and the degree of airflow limitation does not capture the heterogeneity of the disease.

  11. Chronic obstructive pulmonary disease (COPD and occupational exposures

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    Zeni Elena

    2006-06-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is one of the leading causes of morbidity and mortality in both industrialized and developing countries. Cigarette smoking is the major risk factor for COPD. However, relevant information from the literature published within the last years, either on general population samples or on workplaces, indicate that about 15% of all cases of COPD is work-related. Specific settings and agents are quoted which have been indicated or confirmed as linked to COPD. Coal miners, hard-rock miners, tunnel workers, concrete-manufacturing workers, nonmining industrial workers have been shown to be at highest risk for developing COPD. Further evidence that occupational agents are capable of inducing COPD comes from experimental studies, particularly in animal models. In conclusion, occupational exposure to dusts, chemicals, gases should be considered an established, or supported by good evidence, risk factor for developing COPD. The implications of this substantial occupational contribution to COPD must be considered in research planning, in public policy decision-making, and in clinical practice.

  12. Virus-induced exacerbations in asthma and COPD

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    Daisuke eKurai

    2013-10-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is characterized by chronic airway inflammation and/or airflow limitation due to pulmonary emphysema. Chronic bronchitis, pulmonary emphysema, and bronchial asthma may all be associated with airflow limitation; therefore, exacerbation of asthma may be associated with the pathophysiology of COPD. Furthermore, recent studies have suggested that the exacerbation of asthma, namely virus-induced asthma, may be associated with a wide variety of respiratory viruses.COPD and asthma have different underlying pathophysiological processes and thus require individual therapies. Exacerbation of both COPD and asthma, which are basically defined and diagnosed by clinical symptoms, is associated with a rapid decline in lung function and increased mortality. Similar pathogens, including human rhinovirus, respiratory syncytial virus, influenza virus, parainfluenza virus and coronavirus, are also frequently detected during exacerbation of asthma and/or COPD. Immune response to respiratory viral infections, which may be related to the severity of exacerbation in each disease, varies in patients with both COPD and asthma. In this regard, it is crucial to recognize and understand both the similarities and differences of clinical features in patients with COPD and/or asthma associated with respiratory viral infections, especially in the exacerbative stage.In relation to definition, epidemiology, and pathophysiology, this review aims to summarize current knowledge concerning exacerbation of both COPD and asthma by focusing on the clinical significance of associated respiratory virus infections.

  13. Detection of COPD in a high-risk population

    DEFF Research Database (Denmark)

    Kjeldgaard, Peter; Dahl, Ronald; Løkke, Anders

    2015-01-01

    BACKGROUND: Underdiagnosis of chronic obstructive pulmonary disease (COPD) is widespread. Early detection of COPD may improve the outcome by timely smoking cessation, a change in lifestyle, and treatment with an inhaled bronchodilator (BD). The objective of this study was to evaluate the diagnost...

  14. Characterization of inflammation in COPD : clinical and experimental approach

    NARCIS (Netherlands)

    Vernooy, J.H.J.

    2003-01-01

    Chronic inflammation is an important feature of COPD. This inflammatory response is not restricted to the local compartment - including airways, lung parenchyma, and pulmonary vasculature - but is also present in the circulation. However, the origin of the systemic inflammation present in COPD patie

  15. Nursing process in ill with chronic pulmonary obstructive disease (COPD)

    OpenAIRE

    Baráková, Eva

    2007-01-01

    The topic of my bachelor project is the nursing process in patient with chronic obstructive pulmonary disease (COPD). My patient is female, 68 years oldo I describe the anatomy, physiology of the lungs, etiology, patophysiology, epidemiology, symptoms, prognosis and prevention of COPD. I nursed the patient in accordance with the Majora Gordonova's model. Powered by TCPDF (www.tcpdf.org)

  16. Markers of early disease and prognosis in COPD

    Directory of Open Access Journals (Sweden)

    Morten Dahl

    2009-04-01

    Full Text Available Morten Dahl, Børge G NordestgaardDepartment of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkAbstract: COPD is a complex disease with multiple pathological components, which we unfortunately tend to ignore when spirometry is used as the only method to evaluate the disorder. Additional measures are needed to allow a more complete and clinically relevant assessment of COPD. The earliest potential risk factors of disease in COPD are variations in the genetic background. Genetic variations are present from conception and can determine lifelong changes in enzyme activities and protein concentrations. In contrast, measurements in blood, sputum, exhaled breath, broncho-alveolar lavage, and lung biopsies may vary substantially over time. This review explores potential markers of early disease and prognosis in COPD by examining genetic markers in the α1-antitrypsin, cystic fibrosis transmembrane conductance regulator (CFTR, and MBL-2 genes, and by examining the biochemical markers fibrinogen and C-reactive protein (CRP, which correlate with degree of pulmonary inflammation during stable conditions of COPD. Chronic lung inflammation appears to contribute to the pathogenesis of COPD, and markers of this process have promising predictive value in COPD. To implement markers for COPD in clinical practice, besides those already established for the α1-antitrypsin gene, further research and validation studies are needed.Keywords: chronic obstructive pulmonary disease, biomarker, pathogenesis, prognosis, genetics

  17. Novel aspects of pathogenesis and regeneration mechanisms in COPD.

    Science.gov (United States)

    Bagdonas, Edvardas; Raudoniute, Jovile; Bruzauskaite, Ieva; Aldonyte, Ruta

    2015-01-01

    Chronic obstructive pulmonary disease (COPD), a major cause of death and morbidity worldwide, is characterized by expiratory airflow limitation that is not fully reversible, deregulated chronic inflammation, and emphysematous destruction of the lungs. Despite the fact that COPD is a steadily growing global healthcare problem, the conventional therapies remain palliative, and regenerative approaches for disease management are not available yet. We aim to provide an overview of key reviews, experimental, and clinical studies addressing lung emphysema development and repair mechanisms published in the past decade. Novel aspects discussed herein include integral revision of the literature focused on lung microflora changes in COPD, autoimmune component of the disease, and environmental risk factors other than cigarette smoke. The time span of studies on COPD, including emphysema, chronic bronchitis, and asthmatic bronchitis, covers almost 200 years, and several crucial mechanisms of COPD pathogenesis are described and studied. However, we still lack the holistic understanding of COPD development and the exact picture of the time-course and interplay of the events during stable, exacerbated, corticosteroid-treated COPD states, and transitions in-between. Several generally recognized mechanisms will be discussed shortly herein, ie, unregulated inflammation, proteolysis/antiproteolysis imbalance, and destroyed repair mechanisms, while novel topics such as deviated microbiota, air pollutants-related damage, and autoimmune process within the lung tissue will be discussed more extensively. Considerable influx of new data from the clinic, in vivo and in vitro studies stimulate to search for novel concise explanation and holistic understanding of COPD nowadays.

  18. Epidemiological studies on the relation between diet and COPD

    NARCIS (Netherlands)

    Tabak, C.

    2000-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is an important cause of morbidity and mortality around the world. In the early 1990's several dietary factors were suggested to protect against COPD, based on proposed biological mechanisms and a small number of epidemiological studies. Antioxidants (e.g

  19. Diagnosing and treating COPD: understanding the challenges and finding solutions

    Directory of Open Access Journals (Sweden)

    Fromer L

    2011-10-01

    Full Text Available Len Fromer David Geffen School of Medicine at UCLA, Los Angeles, California, USA Abstract: Chronic obstructive pulmonary disease (COPD is characterized by airflow obstruction that is not fully reversible; symptoms include chronic cough, sputum production, and dyspnea with exertion. An estimated 50% of the 24 million adults in the USA who have COPD are thought to be misdiagnosed or undiagnosed. Factors contributing to this include a low awareness of COPD and the initial symptoms of the disease among the general population, acceptance of these symptoms as a consequence of aging or smoking, some symptomatic similarity to asthma, and failure of health care personnel to use spirometry for diagnosis. Increased familiarization with COPD diagnosis and treatment guidelines, and proactive identification of patients with increased risk of developing COPD through occupational, environmental, or lifestyle exposures, will assist in a timely, accurate diagnosis and effective treatment, which will consequently improve patient outcomes. This review addresses the issues surrounding the diagnosis and misdiagnosis of COPD, their consequences, and how COPD can be better managed within primary care, including consideration of COPD care in patient-centered medical home and chronic care models. Keywords: primary care, undiagnosed, misdiagnosed, chronic care model, patient-centered medical home

  20. Exacerbations in the pre- and post-COPD diagnosis periods.

    Science.gov (United States)

    Yawn, Barbara P; Wollan, Peter; Rank, Matthew

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is usually recognized in its later stages, delaying therapeutic opportunities. Screening questionnaires have modest sensitivities and specificities. Adding questions about prior respiratory events might improve screening characteristics. Using administrative data from all health care facilities in Olmsted County, Minnesota USA, we identified all adults with an initial diagnosis of COPD from 2005 through 2007. For each individual we identified all coded lower and upper respiratory events in the 2 years before and the 2 years after the COPD diagnosis and categorized them as probable or possible COPD exacerbations. 356 women and 346 men (N = 702) with a mean age of 67.5 years and 66.6 years respectively had a first diagnosis of COPD during the study period. Respiratory events in the 2 years prior to a COPD diagnosis were common with a range of 0 to 16 events per individual and a mean (SD) of 2.04 (2.14), 1.38 (1.86) all of which were probable COPD exacerbations. Prediagnostic respiratory events were predictive of similar events in the post diagnostic period (odds ratio = 1.6, 95% confidence interval [CI] 1.3 to 1.8). Inquiring about the number and type of upper or lower respiratory events in the 2 past years may be a useful addition to the "screening" criteria to improve COPD identification, especially those at risk of frequent exacerbations.

  1. Old dilemma : asthma with irreversible airway obstruction or COPD

    NARCIS (Netherlands)

    Fattahi, Fatemeh; Vonk, Judith M.; Bulkmans, Nicole; Fleischeuer, Ruth; Gouw, Annette; Grunberg, Katrien; Mauad, Thais; Popper, Helmut; Felipe-Silva, Aloisio; Vrugt, Bart; Wright, Joanne L.; Yang, Hui-Min; Kocks, Janwillem W. H.; Hylkema, Machteld N.; Postma, Dirkje S.; Timens, Wim; ten Hacken, Nick H. T.

    2015-01-01

    Older asthmatic patients may develop fixed airway obstruction and clinical signs of chronic obstructive pulmonary disease (COPD). We investigated the added value of pathological evaluation of bronchial biopsies to help differentiate asthma from COPD, taking into account smoking, age, and inhaled cor

  2. [Inhaled corticosteroids in patients with COPD: maintain current guidelines

    NARCIS (Netherlands)

    Heijdra, Y.F.

    2007-01-01

    The use of inhaled corticosteroids (ICS) is one of the most controversial issues in COPD treatment. There is evidence that ICS with or without long-acting beta-2-adrenergics (LABA) reduce exacerbation rates and improve the health status of severe COPD patients. The effects on FEV1 are limited and th

  3. Maatschappelijke kosten van astma, COPD en respiratoire allergie

    NARCIS (Netherlands)

    Suijkerbuijk, Anita W M; de Wit, G A Ardine; Wijga, Alet H; Heijmans, Monique J W M; Hoogendoorn, Martine; Rutten-van Mölken, Maureen P M H; Maurits, Erica E M; Hoogenveen, Rudolf T; Feenstra, Talitha L

    2013-01-01

    OBJECTIVE: To estimate the societal costs of asthma, COPD and respiratory allergy for the year 2007 and future healthcare costs for the period 2007-2032. DESIGN: Descriptive study. METHODS: Representative registries were used to estimate the healthcare costs of asthma, COPD and respiratory allergy f

  4. COPD and microalbuminuria: a 12-year follow-up study.

    Science.gov (United States)

    Romundstad, Solfrid; Naustdal, Thor; Romundstad, Pål Richard; Sorger, Hanne; Langhammer, Arnulf

    2014-04-01

    Chronic obstructive pulmonary disease (COPD), low lung function independent of diagnosis and markers of inflammation are all associated with increased morbidity and mortality. Microalbuminuria, reflecting endothelial dysfunction, could be a relevant inflammatory marker of potential systemic effects of COPD. We hypothesised that there was a positive association between microalbuminuria and mortality in individuals with COPD. We conducted a 12-year follow-up study of 3129 participants in the second survey of the Nord-Trøndelag Health Study (HUNT), Norway. At baseline, albuminuria was analysed in three urine samples and spirometry was performed. Among the participants, 136 had COPD and microalbuminuria, defined as a urinary albumin/creatinine ratio between 2.5 and 30.0 mg·mmol(-1). The main outcome measures were hazard ratio of all-cause mortality according to microalbuminuria. Compared to those with COPD without microalbuminuria, the adjusted hazard ratio for all-cause mortality in those with COPD and microalbuminuria was 1.54, 95% CI 1.16-2.04. This result was similar after excluding cardiovascular disease at baseline. Classifying COPD severity by Global Initiative for Chronic Obstructive Lung Disease, there was a positive association trend with increasing severity stages. Microalbuminuria is associated with all-cause mortality in individuals with COPD and could be a relevant tool in identification of patients with poor prognosis.

  5. Should mild COPD be treated? Evidence for early pharmacological intervention.

    Science.gov (United States)

    Elbehairy, Amany F; Webb, Katherine A; Neder, J Alberto; Alberto Neder, J; O'Donnell, Denis E

    2013-12-01

    Chronic obstructive pulmonary disease (COPD) is a common and often progressive inflammatory disease of the airways that is both preventable and treatable. It is well established that those with mild-to-moderate disease severity represent the majority of patients with COPD, yet this subpopulation is relatively under-studied. Because of an insidious pre-clinical phase, COPD is both under-diagnosed and under-treated. Recent studies have confirmed that even patients with mild, grade 1 COPD [i.e. those with a reduced forced expiratory volume in one second (FEV1)/forced vital capacity ratio but normal FEV1], have measurable physiological impairment with increased morbidity and a higher risk of mortality compared with non-smoking healthy controls. Beyond the imperative of smoking cessation-the pivotal intervention in all COPD stages-the role of pharmacotherapy for prevention of disease progression has yet to be established. The main objective of this review is to provide a concise overview of the heterogeneous pathophysiology of COPD with only mild airway obstruction on spirometry and obstacles for early diagnosis. We emphasize that the absence of sufficiently powered trials involving a large number of patients precludes definitive recommendations in support of (or against) long-term pharmacological treatment in mild COPD. Despite these limitations, we present a rationale for earlier pharmacological intervention derived from recent physiological studies performed in symptomatic patients with mild COPD.

  6. An Overview of Chronic Obstructive Pulmonary Disease (COPD ...

    African Journals Online (AJOL)

    DATONYE ALASIA

    39, 40 smoke and COPD . Occupational exposure: Data from the USNational Health and Nutrition. Examination ... 44. COPD, especially in females . Often, the stoves being used have poor combustion capacity and can utilize ..... 22 Bentazzo MG, Gile LS, Bombieri C, Malerba ... 32 Summerhill E, Leavitt SA, Gidley H, Parry.

  7. How do COPD patients distribute their daily activities?

    NARCIS (Netherlands)

    Tabak, Monique; Vollenbroek-Hutten, Miriam Marie Rosé; van der Valk, P.; van der Palen, Jacobus Adrianus Maria; Tönis, Thijs; Hermens, Hermanus J.

    2011-01-01

    Better insight in daily activity behaviour of COPD patients is needed as a first step to enable a tailoring of their treatment. The objective of this study was to measure the daily activity of COPD patients and to compare the daily activity distribution with asymptomatic controls, using triaxial acc

  8. Clinical implications of blood eosinophil count in patients with non-asthma–COPD overlap syndrome COPD

    Directory of Open Access Journals (Sweden)

    Song JH

    2017-08-01

    Full Text Available Jin Hwa Song,1 Chang-Hoon Lee,1 Jin Woo Kim,2 Won-Yeon Lee,3 Ji Ye Jung,4 Joo Hun Park,5 Ki Suck Jung,6 Kwang Ha Yoo,7 Yong Bum Park,8 Deog Keom Kim9 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 2Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 3Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, 4Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 5Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, 6Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Gyeonggi-do, 7Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea Background: Recent studies that assessed the relevance of the blood eosinophil count as a biomarker in patients with COPD may have overestimated it because they included patients with asthma–COPD overlap syndrome (ACOS. We investigated the clinical implications of the blood eosinophil count in patients with non-ACOS COPD.Patients and methods: From a Korean COPD Subtype Study (KOCOSS cohort, we selected patients with non-ACOS COPD after excluding ACOS patients according to Spanish criteria. Clinical characteristics and the incidence of moderate-to-severe exacerbation were compared

  9. Determinants of elevated healthcare utilization in patients with COPD

    Directory of Open Access Journals (Sweden)

    Bernhard-Scharf Barbara J

    2011-01-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD imparts a substantial economic burden on western health systems. Our objective was to analyze the determinants of elevated healthcare utilization among patients with COPD in a single-payer health system. Methods Three-hundred eighty-nine adults with COPD were matched 1:3 to controls by age, gender and area of residency. Total healthcare cost 5 years prior recruitment and presence of comorbidities were obtained from a computerized database. Health related quality of life (HRQoL indices were obtained using validated questionnaires among a subsample of 177 patients. Results Healthcare utilization was 3.4-fold higher among COPD patients compared with controls (p Conclusion Comorbidity burden determines elevated utilization for COPD patients. Decision makers should prioritize scarce health care resources to a better care management of the "most costly" patients.

  10. Circulating monocytes from healthy individuals and COPD patients

    Directory of Open Access Journals (Sweden)

    Piitulainen Eeva

    2003-09-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is characterized by incompletely reversible airflow obstruction associated with inflammation in which monocytes/macrophages are the predominant inflammatory cells. The only known genetic factor related to COPD is inherited PiZZ deficiency of α1-antitrypsin (AAT, an inhibitor of serine proteases. Methods We investigated the basal and LPS-stimulated release of pro-inflammatory molecules from blood monocytes isolated from age and gender matched healthy (n = 30 and COPD (n = 20 individuals with and without AAT deficiency. Results After 18 h of cell culture the basal release of MMP-9 was 2.5-fold, p Conclusions The basal and LPS-stimulated secretion of specific pro-inflammatory molecules from circulating monocytes differs between healthy and COPD subjects. These findings may be valuable for further studies on the mechanisms involved in recruitment and activation of inflammatory cells in COPD.

  11. Association between Weight and Smoking Not Mediated by Weight Loss Attempts or Bullying.

    Science.gov (United States)

    Minaker, Leia M; Leatherdale, Scott T

    2016-01-01

    Youth smoking and obesity may both be mediated by weight control behaviors and experiences of bullying. This study examines associations between smoking and obesity among youth, and explores whether associations are mediated by weight loss attempts or bullying experiences. Data from 24,173 grade 9 to 12 students in the COMPASS study (2012-13) were used to examine the prevalence of self-reported smoking, weight status, attempting to lose weight, and being a victim of bullying. Generalized linear mixed effects models were used to examine correlates of smoking. Among youth, 11% reported currently smoking, 20% were overweight or obese, 42% reported attempting to lose weight, and 18% reported being bullied. Girls who reported attempting to lose weight had higher odds of smoking (OR = 1.42, p = .0039), and students who reported being bullied had higher odds of smoking (OR = 1.85, p bullied was associated with smoking, independent of weight status. Programs attempting to reduce smoking among youth should consider the effects of weight control behaviors and bullying irrespective of weight status.

  12. Treatment of respiratory failure in COPD

    Directory of Open Access Journals (Sweden)

    Stephan Budweiser

    2008-12-01

    Full Text Available Stephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, GermanyAbstract: Patients with advanced COPD and acute or chronic respiratory failure are at high risk for death. Beyond pharmacological treatment, supplemental oxygen and mechanical ventilation are major treatment options. This review describes the physiological concepts underlying respiratory failure and its therapy, as well as important treatment outcomes. The rationale for the controlled supply of oxygen in acute hypoxic respiratory failure is undisputed. There is also a clear survival benefit from long-term oxygen therapy in patients with chronic hypoxia, while in mild, nocturnal, or exercise-induced hypoxemia such long-term benefits appear questionable. Furthermore, much evidence supports the use of non-invasive positive pressure ventilation in acute hypercapnic respiratory failure. It application reduces intubation and mortality rates, and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failure became a major indication for domiciliary mechanical ventilation, based on pathophysiological reasoning and on data regarding symptoms and quality of life. Still, however, its relevance for long-term survival has to be substantiated in prospective controlled studies. Such studies might preferentially recruit patients with repeated hypercapnic decompensation or a high risk for death, while ensuring effective ventilation and the patients’ adherence to therapy.Keywords: respiratory failure, COPD, mechanical ventilation, non-invasive ventilation long-term oxygen therapy, chronic

  13. Management and prevention of exacerbations of COPD.

    Science.gov (United States)

    Aaron, Shawn D

    2014-09-22

    Patients with chronic obstructive pulmonary disease (COPD) are prone to acute respiratory exacerbations, which can develop suddenly or subacutely over the course of several days. Exacerbations have a detrimental effect on patients' health status and increase the burden on the healthcare system. Initial treatment is unsuccessful in 24-27% of patients, who have a relapse or a second exacerbation within 30 days of the initial event. No obvious benefit has been seen in recent clinical trials of anti-tumour necrosis factor therapy, anti-leukotriene therapy, intensive chest physiotherapy, or early inpatient pulmonary rehabilitation for treatment of exacerbations. By contrast, clinical trials of prevention rather than acute treatment have shown promising results. Long acting β agonist (LABA) or long acting anti-muscarinic (LAMA) bronchodilators and inhaled corticosteroid-LABA combinations prevent exacerbations in patients at risk, with relative risk reductions averaging 14-27% for each of these drugs relative to placebo. Triple therapy with inhaled corticosteroid-LABA plus LAMA may provide additional benefit, although study results to date are heterogeneous and more studies are needed. Pneumonia is an important complication of treatment with inhaled corticosteroid-LABA products, and the risk of pneumonia seems to be doubled in patients with COPD who use fluticasone. The addition of azithromycin to usual COPD therapy prevents exacerbations, although it may prolong the Q-T interval and increase the risk of death from cardiovascular disease in patients prone to arrhythmia. New potential drugs--including mitogen activated protein kinase inhibitors, phosphodiesterase 3 inhibitors, and monoclonal antibodies to the interleukin 1 receptor--offer additional hope for treatments that may prevent exacerbations in the future.

  14. Self-perception of body weight status and weight control practices among adolescents in Malaysia.

    Science.gov (United States)

    Zainuddin, Ahmad Ali; Manickam, Mala A; Baharudin, Azli; Omar, Azahadi; Cheong, Siew Man; Ambak, Rashidah; Ahmad, Mohamad Hasnan; Ghaffar, Suhaila Abdul

    2014-09-01

    The prevalence of overweight and obesity among adolescents is rising rapidly in many countries, including Malaysia. This article aims to present the associations between body mass index-based body weight status, body weight perception, and weight control practices among adolescents in Malaysia. The Malaysia School Based Nutrition Survey 2012, which included a body weight perception questionnaire and anthropometric measurements, was conducted on a representative sample of 40 011 students from Standard 4 until Form 5, with a 90.5% response rate. Comparing actual and perceived body weight status, the findings show that 13.8% of adolescents underestimated their weight, 35.0% overestimated, and 51.2% correctly judged their own weight. Significantly more normal weight girls felt they were overweight, whereas significantly more overweight boys perceived themselves as underweight. The overall appropriateness of weight control practices to body weight was 72.6%. Adolescents attempting to lose or gain weight need to have better understanding toward desirable behavioral changes.

  15. Use of mortality within 30 days of a COPD hospitalisation as a measure of COPD care in UK hospitals.

    Science.gov (United States)

    Walker, P P; Thompson, E; Crone, H; Flatt, G; Holton, K; Hill, S L; Pearson, M G

    2013-10-01

    Mortality rate has been proposed as a metric of hospital chronic obstructive pulmonary disease (COPD) care in light of variation seen in national COPD audits. Using Hospital Episode Statistics (hospital 'coding') we examined 30-day mortality after COPD hospitalisation in 150 UK hospitals during 2006-2007 and 2007-2008. Mean and median 30-day mortalities were similar each year but the coefficient of variation was >20% and hospitals could change from a low or high quartile to the median by chance. We could not detect any reasons for hospitals being at the extremes. 30-day mortality after COPD hospitalisation is a complex variable and unlikely to be useful as a primary annual COPD metric.

  16. Seasonal variability in clinical care of COPD outpatients: results from the Andalusian COPD audit

    Directory of Open Access Journals (Sweden)

    López-Campos JL

    2017-03-01

    Full Text Available Jose Luis López-Campos,1,2 Maria Abad Arranz,1 Carmen Calero-Acuña,1,2 Fernando Romero-Valero,3 Ruth Ayerbe-García,4 Antonio Hidalgo-Molina,3 Ricardo I Aguilar-Pérez-Grovas,4 Francisco García-Gil,5 Francisco Casas-Maldonado,6 Laura Caballero-Ballesteros,5 María Sánchez-Palop,6 Dolores Pérez-Tejero,7 Alejandro Segado Soriano,7 Jose Calvo-Bonachera,8 Bárbara Hernández-Sierra,8 Adolfo Doménech,9 Macarena Arroyo-Varela,9 Francisco González-Vargas,10 Juan J Cruz-Rueda10 1Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, 2CIBER de Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, 3Sección de Neumología, Hospital Puerta del Mar, Cádiz, 4Servicio de Neumología, Hospital Juan Ramón Jiménez, Huelva, 5Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, 6Servicio de Neumología, Hospital Universitario San Cecilio, Granada, 7Sección de Neumología, Hospital Infanta Margarita, Cabra, Córdoba, 8Servicio de Neumología, Hospital Torrecárdenas, Almería, 9Servicio de Neumología, Hospital Regional Universitario de Málaga, Málaga, 10Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain Objectives: Clinical practice in chronic obstructive pulmonary disease (COPD can be influenced by weather variability throughout the year. To explore the hypothesis of seasonal variability in clinical practice, the present study analyzes the results of the 2013–2014 Andalusian COPD audit with regard to changes in clinical practice according to the different seasons.Methods: The Andalusian COPD audit was a pilot clinical project conducted from October 2013 to September 2014 in outpatient respiratory clinics of hospitals in Andalusia, Spain (8 provinces with more than 8 million inhabitants with retrospective data gathering. For the present analysis

  17. Heterogeneity of asthma–COPD overlap syndrome

    Science.gov (United States)

    Joo, Hyonsoo; Han, Deokjae; Lee, Jae Ha; Rhee, Chin Kook

    2017-01-01

    Many patients suffering from asthma or COPD have overlapping features of both diseases. However, a phenotypical approach for evaluating asthma–COPD overlap syndrome (ACOS) has not been established. In this report, we examined the phenotypes in patients with ACOS. Patients diagnosed with ACOS between 2011 and 2015 were identified and classified into four phenotype groups. Group A was composed of patients who smoked <10 pack years and had blood eosinophil counts ≥300. Group B was composed of patients who smoked <10 pack years and had blood eosinophil counts <300. Group C was composed of patients who smoked ≥10 pack years and had blood eosinophil counts ≥300. Group D was composed of patients who smoked <10 pack years and had blood eosinophil counts <300. Clinical characteristics were analyzed and compared among groups. Comparisons were made among 103 ACOS patients. Patients in group D were oldest, while patients in group A were youngest. There were relatively more female patients in groups A and B; the majority of patients in groups C and D were male. The degree of airflow obstruction was most severe in group C. The rate of being free of severe exacerbation was significantly lower in group C than in the other groups. In this study, each ACOS phenotype showed different characteristics. The proportion of patients free of severe exacerbation differed significantly among groups. At this time, further studies on the phenotypes of ACOS are required.

  18. Drugs (including oxygen) in severe COPD.

    Science.gov (United States)

    Albert, P; Calverley, P M A

    2008-05-01

    Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials. Drug therapy is a key component of an individual patient's management plan, particularly in more severe disease. During the past few years, a number of new drug treatments have become available, although these are not always appropriately prescribed; this is particularly the case for oxygen. For patients with a history of exacerbations, there is good evidence for the use of inhaled long-acting anticholinergic agents or combined inhaled steroids and long-acting beta-agonists. Evidence for prophylactic antibiotics and antioxidant agents is lacking. Nutritional and calorie supplementation have not been shown to improve exercise capacity. Statins may improve outcomes in COPD, but prospective trials are needed to confirm this. The evidence for the use of long-term oxygen therapy in hypoxaemic patients is robust. Ambulatory oxygen improves exercise capacity, but whether it is used appropriately is in doubt. Overall, short burst oxygen therapy does not offer a benefit and therefore cannot be recommended.

  19. Detecting exacerbations using the Clinical COPD Questionnaire

    Directory of Open Access Journals (Sweden)

    Trappenburg Jaap CA

    2010-09-01

    Full Text Available Abstract Background Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment. Little is known whether (low burden strategies are able to capture these unreported exacerbations. Methods The Clinical COPD Questionnaire (CCQ is a short questionnaire with great evaluative properties in measuring health status. The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations. Results In a multicentre prospective cohort study, 121 patients, age 67.4 ± 10.5 years, FEV1 47.7 ± 18.5% pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment. Weeks were retrospectively labeled as stable or exacerbation (onset weeks using the Anthonisen symptom diary-card algorithm. Change in CCQ total scores are significantly higher in exacerbation-onset weeks, 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks (p Conclusions Weekly CCQ assessment is a promising, low burden method to detect unreported exacerbations. Further research is needed to validate discriminative performance and practical implications of the CCQ in detecting exacerbations in daily care.

  20. COPD, COOP and BREATH at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-02-01

    Full Text Available No abstract available. Article truncated at 150 words. The February 2011 Pulmonary Journal Club reviews a study by Rice and colleagues (1 of high-risk COPD patients (click here for Pulmonary Journal Club. This review was authored by Kevin Park who also authored an ACP Journal Club review (2. In Rice’s study a single educational session, an individualized care plan, and monthly case-manager telephone calls, resulted in a 41% decrease in hospitalizations and emergency room visits and a nonsignficant trend toward decreased mortality.Rice’s study was supported and conducted in the Veterans Integrated Service Network (VISN 23 (Minnesota, Iowa, Nebraska and the Dakotas. The COPD patients in this study were recruited and followed primarily using the VA computer system. The study represents a potential model of data-based management leading to improved patient outcomes. The authors; Robert Petzel MD, then VISN 23 Director (now Veterans Healthcare Administration Undersecretary; and Janet Murphy, then VISN Primary Care Service Line CEO (now VISN …

  1. A Comparison of the Effectiveness of Three Group Treatments for Weight Loss

    Science.gov (United States)

    Byom, Tianna K.

    2009-01-01

    Rising overweight and obesity rates in the United States and the accompanying health issues underscore the need for an effective treatment for weight loss. While most people tend to lose weight as a result of cognitive-behavioral treatment, the weight is often regained after treatment ends. Possible reasons for weight regain include not fully…

  2. A Comparison of the Effectiveness of Three Group Treatments for Weight Loss

    Science.gov (United States)

    Byom, Tianna K.

    2009-01-01

    Rising overweight and obesity rates in the United States and the accompanying health issues underscore the need for an effective treatment for weight loss. While most people tend to lose weight as a result of cognitive-behavioral treatment, the weight is often regained after treatment ends. Possible reasons for weight regain include not fully…

  3. Evaluating inhaler use technique in COPD patients

    Directory of Open Access Journals (Sweden)

    Pothirat C

    2015-07-01

    Full Text Available Chaicharn Pothirat, Warawut Chaiwong, Nittaya Phetsuk, Sangnual Pisalthanapuna, Nonglak Chetsadaphan, Woranoot Choomuang Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: Poor inhalation techniques are associated with decreased medication delivery and poor disease control in chronic obstructive pulmonary disease (COPD. The purpose of this study was to evaluate techniques for using inhaler devices in COPD patients.Methods: A prospective cross-sectional study was conducted to assess patient compliance with correct techniques for using inhaler devices across four regimens, ie, the pressurized metered-dose inhaler (pMDI, the pMDI with a spacer, the Accuhaler®, and the Handihaler®. The percentage of compliance with essential steps of correct device usage for each regimen was recorded without prior notification when COPD patients presented for a routine visit, and 1 month after receiving face-to-face training. We compared the percentage of compliance between the devices and risk factors related to incorrect techniques using logistic regression analysis. Percentage of patient compliance with correct techniques was compared between the two visits using the chi-square test. Statistical significance was set at P<0.05.Results: A total of 103 COPD patients (mean age 71.2±9.2 years, males 64.1%, low education level 82.5%, and percent predicted forced expiratory volume in 1 second 51.9±22.5 were evaluated. Seventy-seven patients (74.8% performed at least one step incorrectly. Patients using the Handihaler had the lowest compliance failure (42.5%, and the odds ratio for failure with the other devices compared with the Handihaler were 4.6 (95% confidence interval [CI] 1.8–11.8 for the pMDI, 3.1 (95% CI 1.2–8.2 for the pMDI with a spacer, and 2.4 (95% CI 1.1–5.2 for the Accuhaler. Low education level was the single most important factor related

  4. COPD diagnosis related to different guidelines and spirometry techniques

    Directory of Open Access Journals (Sweden)

    Nathell Madelene

    2007-12-01

    Full Text Available Abstract The aim was to compare the diagnosis of COPD among smokers according to different international guidelines and to compare the outcome when using slow (SVC and forced vital capacity (FVC. In order to find current smokers a questionnaire was sent to persons who had been on sick leave for more than two weeks. Those who smoked more than 8 cigarettes per day were invited to perform a spirometry. Totally 3,887 spirometries were performed. In this sample 10.2% fulfilled the NICE COPD-criteria, 14.0% the GOLD COPD-criteria and 21.7% the ERS COPD criteria. The diagnosis according to NICE and GOLD guidelines is based on FVC and in the ERS guidelines the best value of either SVC or FVC is used. Thus, substantially more subjects with COPD were found when the best of either SVC or FVC was used. Forced VC tended to be higher than SVC when lung function was normal and in those with mild obstruction prior to bronchodilatation whereas SVC exceeded FVC after bronchodilatation in those who had severe bronchial obstruction. The diagnosis of COPD is highly depending on which guidelines are used for defining the disease. If FVC and not the best of SVC and FVC is used when defining COPD the diagnosis will be missed in a substantial number of patients.

  5. Night-time symptoms: a forgotten dimension of COPD

    Directory of Open Access Journals (Sweden)

    A. Agusti

    2011-09-01

    Full Text Available Sleep quality is often poor in patients with chronic obstructive pulmonary disease (COPD, but these night-time symptoms are frequently unnoticed by physicians and/or not reported by patients themselves. Therefore, the prevalence and clinical impact of sleep disturbances and night-time symptoms in COPD is not well understood and has not been a clinical focus to date. To address this gap, an expert panel meeting was convened in Barcelona, Spain, in March 2011 to discuss the aetiology, evolution, burden, long-term clinical consequences and optimal management of night-time symptoms in COPD. The term “night-time symptoms” in COPD has not been distinctly defined in an objective sense but epidemiological data suggests that the prevalence of nocturnal symptoms and symptomatic sleep disturbance may exceed 75% in patients with COPD. The panel concluded that night-time symptoms in COPD are prevalent and bothersome; that their cause(s are multiple and include demographic factors, such as age and obesity, pharmacotherapy, disease-specific symptoms and the presence of comorbid sleep disorders, and other medical conditions; and that potential long-term consequences can include lung function changes, increased exacerbation frequency, emergence or worsening of cardiovascular disease, cognitive effects, depression, impaired quality of life and increased mortality. To date, few interventional studies have investigated them, but emerging data suggest that bronchodilator therapy can improve them if deployed appropriately. In summary, night-time symptoms in COPD warrant further clinical investigation with validated tools.

  6. Airflow obstruction: is it asthma or is it COPD?

    Directory of Open Access Journals (Sweden)

    Rogliani P

    2016-11-01

    Full Text Available Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Mario Cazzola Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy Abstract: Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating asthma from COPD in the presence of fixed airflow obstruction. Nonetheless, the presentations of asthma and COPD can converge and mimic each other, making it difficult to give these patients a diagnosis of either condition. The association of asthma and COPD in the same patient has been designated mixed asthma–COPD phenotype or overlap syndrome. However, since the absence of a clear definition and the inclusion of patients with different characteristics under this umbrella term, it may not facilitate treatment decisions, especially in the absence of clinical trials addressing this heterogeneous population. We are realizing that neither asthma nor COPD are single diseases, but rather syndromes consisting of several endotypes and phenotypes, consequently comprising a spectrum of diseases that must be recognized and adequately treated with targeted therapy. Therefore, we must treat patients by personalizing therapy on the basis of those treatable traits present in each subject. Keywords: airway obstruction, asthma, ACOS, chronic obstructive pulmonary disease

  7. Trend of cost and utilization of COPD medication in Korea

    Science.gov (United States)

    Lee, Jongmin; Lee, Jae Ha; Kim, Jee-Ae; Rhee, Chin Kook

    2017-01-01

    Background There are only a few longitudinal studies regarding medical utilization and costs for patients with COPD. The purpose of this study was to analyze the trend of medical utilization and costs on a long-term basis. Methods Using the Korean Health Insurance Review and Assessment Service (HIRA) data from 2008 to 2013, COPD patients were identified. The trend of medical utilization and costs was also analyzed. Results The number of COPD patients increased by 13.9% from 2008 to 2013. During the same period, the cost of COPD medication increased by 78.2%. Methylxanthine and systemic beta agonists were most widely prescribed between 2008 and 2013. However, inhaled medications such as long-acting beta-2 agonist (LABA), long-acting muscarinic agonist, and inhaled corticosteroid plus LABA were dispensed to a relatively low proportion of patients with COPD. The number of patients who were prescribed inhaled medications increased gradually from 2008 to 2013, while the number of patients prescribed systemic beta agonist and methylxanthine has decreased since 2010. Conclusion This study shows that there is a large gap between the COPD guidelines and clinical practice in Korea. Training programs for primary care physicians on diagnosis and guideline-based treatment are needed to improve the management of COPD. PMID:28031708

  8. The burden and impact of COPD in Asia and Africa

    Energy Technology Data Exchange (ETDEWEB)

    Chan-Yeung, M.; Ait-Khaled, N.; White, N.; Ip, M.S.; Tan, W.C. [University of Hong Kong, Hong Kong (China). Department of Medicine, Division of Respiratory and Critical Care Medicine

    2004-07-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The World Health Organization (WHO) estimated that COPD is currently the 7th leading cause of death and disability worldwide, but will rise to the 5th position by 2020. The estimated prevalence of COPD worldwide in 2001 was 1013/100000 population; it was highest in the Western Pacific Region and lowest in Africa. The mortality from COPD followed the same pattern. The prevalence of smoking is slowly decreasing in the industrialized world and rising in developing countries, especially in Asia and Africa. Cigarette consumption per adult has also decreased in the Americas, remained the same in Europe but increased in all other regions, especially the Western Pacific. Indoor air pollution from combustion of biomass/traditional fuels and coal, previous tuberculous infection, outdoor air pollution and childhood respiratory infections are other important risk factors for COPD in developing countries. The rise in morbidity and mortality from COPD will be most dramatic in Asian and African countries over the next two decades, mostly due to progressive increase in the prevalence of smoking. As developing countries can ill afford the added economic burden of COPD and other smoking-related diseases, there is an urgent need for multidimensional actions in reducing the main risk factor of cigarette smoking. 94 refs.

  9. Family Food Choices: A Guide to Weight and Diabetes Control.

    Science.gov (United States)

    Indian Health Service (PHS/HSA), Rockville, MD.

    Written for American Indians who have diabetes, this folder explains diabetes and outlines a weight control program and diet. The folder discusses the five things diabetics can do to help control their disease: lose weight, watch the amount and kind of fat eaten, eat more food with fiber, avoid sugar, and avoid alcohol. Charts for foods containing…

  10. Exercise Beats Weight Loss At Helping Seniors' Hearts

    Science.gov (United States)

    ... in older adults than losing weight does. "Any physical activity is positive for cardiovascular health, and in elderly people of all weights, walking, ... physical activity plays a crucial role in the health of middle age to elderly ... disease." Expert guidelines currently recommend 150 minutes a ...

  11. Acute kidney injury in stable COPD and at exacerbation

    Directory of Open Access Journals (Sweden)

    Barakat MF

    2015-09-01

    Full Text Available MF Barakat,1 HI McDonald,1 TJ Collier,1 L Smeeth,1 D Nitsch,1 JK Quint1,2 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 2Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK Background: While acute kidney injury (AKI alone is associated with increased mortality, the incidence of hospital admission with AKI among stable and exacerbating COPD patients and the effect of concurrent AKI at COPD exacerbation on mortality is not known.Methods: A total of 189,561 individuals with COPD were identified from the Clinical Practice Research Datalink. Using Poisson and logistic regressions, we explored which factors predicted admission for AKI (identified in Hospital Episode Statistics in this COPD cohort and concomitant AKI at a hospitalization for COPD exacerbation. Using survival analysis, we investigated the effect of concurrent AKI at exacerbation on mortality (n=36,107 and identified confounding factors.Results: The incidence of AKI in the total COPD cohort was 128/100,000 person-years. The prevalence of concomitant AKI at exacerbation was 1.9%, and the mortality rate in patients with AKI at exacerbation was 521/1,000 person-years. Male sex, older age, and lower glomerular filtration rate predicted higher risk of AKI or death. There was a 1.80 fold (95% confidence interval: 1.61, 2.03 increase in adjusted mortality within the first 6 months post COPD exacerbation in patients suffering from AKI and COPD exacerbation compared to those who were AKI free.Conclusion: In comparison to previous studies on general populations and hospitalizations, the incidence and prevalence of AKI is relatively high in COPD patients. Coexisting AKI at exacerbation is prognostic of poor outcome. Keywords: acute renal failure, mortality, emphysema, chronic bronchitis, prognosis

  12. The concept of control of COPD in clinical practice

    Directory of Open Access Journals (Sweden)

    Soler-Cataluña JJ

    2014-12-01

    Full Text Available Juan José Soler-Cataluña,1,2 Bernardino Alcázar-Navarrete,3 Marc Miravitlles2,4 1Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain; 2CIBER de Enfermedades Respiratorias (CIBERES, 3Respiratory Department, Hospital de Alta Resolucion, Granada, Spain; 4Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Abstract: Treatment of chronic obstructive pulmonary disease (COPD requires a personalized approach according to the clinical characteristics of the patients, the level of severity, and the response to the different therapies. Furthermore, patients with the same level of severity measured by the degree of airflow obstruction or even with multidimensional indices may have very different symptoms and limitations for daily activities. The concept of control has been extensively developed in asthma but has not been defined in COPD. Here, we propose a definition of COPD control based on the concepts of impact and stability. Impact is a cross-sectional concept that can be measured by questionnaires such as the COPD Assessment Test or the Clinical COPD Questionnaire. Alternatively, impact can be assessed by the degree of dyspnea, the use of rescue medication, the level of physical activity, and sputum color. Stability is a longitudinal concept that requires the absence of exacerbations and deterioration in the aforementioned variables or in the COPD Assessment Test or Clinical COPD Questionnaire scores. Control is defined by low impact (adjusted for severity and stability. The concept of control in COPD can be useful in the decision making regarding an increase or decrease in medication in the stable state. Keywords: COPD, control, CAT, CCQ, exacerbations, prognosis

  13. Identifying individuals with physcian diagnosed COPD in health administrative databases.

    Science.gov (United States)

    Gershon, A S; Wang, C; Guan, J; Vasilevska-Ristovska, J; Cicutto, L; To, T

    2009-10-01

    Chronic Obstructive Pulmonary Disease (COPD) is a common chronic respiratory disease responsible for significant morbidity and mortality. Population-based health administrative databases provide a powerful and unbiased way of studying COPD in the population, however, their ability to accurately identify patients with this disease must first be confirmed. The objective was to validate population-based health administrative definitions of COPD. Previously abstracted medical records of adults over the age of 35 randomly selected from primary care practices in Ontario, Canada were reviewed by an expert panel to establish if an individual did or did not have a diagnosis of COPD. These reference designations were then linked to each individual's respective health administrative database record and compared with predefine health administrative data definitions of COPD. Concepts of diagnostic test evaluation were used to calculate and compare their test characteristics. The most sensitive health administrative definition of COPD was 1 or more ambulatory claims and/or 1 or more hospitalizations for COPD that yielded a sensitivity of 85.0% (95% confidence interval 77.0 to 91.0) and a specificity of 78.4% (95% confidence interval 73.6 to 82.7). As number of ambulatory claims in the definition increased, sensitivity decreased and specificity increased. Individuals with COPD can be accurately identified in health administrative data, and therefore it may be used to create an unbiased population cohort for surveillance and research. This offers a powerful means of generating evidence to inform strategies that optimize the prevention and management of COPD.

  14. Optimising treatment for COPD--new strategies for combination therapy.

    Science.gov (United States)

    Welte, T

    2009-08-01

    Chronic obstructive pulmonary disease (COPD) is a multi-component disease characterised by airflow limitation and airway inflammation. Exacerbations of COPD have a considerable impact on the quality of life, daily activities and general well-being of patients and are a great burden on the health system. Thus, the aims of COPD management include not only relieving symptoms and preventing disease progression but also preventing and treating exacerbations. Attention towards the day-to-day burden of the disease is also required in light of evidence that suggests COPD may be variable throughout the day with morning being the time when symptoms are most severe and patients' ability to perform regular morning activities the most problematic. While available therapies improve clinical symptoms and decrease airway inflammation, they do not unequivocally slow long-term progression or address all disease components. With the burden of COPD continuing to increase, research into new and improved treatment strategies to optimise pharmacotherapy is ongoing - in particular, combination therapies, with a view to their complementary modes of action enabling multiple components of the disease to be addressed. Evidence from recent clinical trials indicates that triple therapy, combining an anticholinergic with an inhaled corticosteroid and a long-acting beta(2)-agonist, may provide clinical benefits additional to those associated with each treatment alone in patients with more severe COPD. This article reviews the evidence for treatment strategies used in COPD with a focus on combination therapies and introduces the 3-month CLIMB study (Evaluation of Efficacy and Safety of Symbicort as an Add-on Treatment to Spiriva in Patients With Severe COPD) which investigated the potential treatment benefits of combining tiotropium with budesonide/formoterol in patients with COPD with regard to lung function, exacerbations, symptoms and morning activities.

  15. Sex differences in reported and objectively measured sleep in COPD

    Directory of Open Access Journals (Sweden)

    Theorell-Haglöw J

    2016-01-01

    Full Text Available Jenny Theorell-Haglöw,1 Inga Sif Ólafsdóttir,1–3 Bryndís Benediktsdóttir,2,3 Thórarinn Gíslason,2,3 Eva Lindberg,1 Christer Janson1 1Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden; 2Department of Respiratory Medicine and Sleep, Landspitali University Hospital, 3Medical Faculty, University of Iceland, Reykjavík, Iceland Background: The aim was to assess and compare reported sleep disturbances and objectively measured sleep in men and women with COPD compared with controls and also explore sex differences. Methods: A total of 96 patients with COPD and 90 age- and sex-matched controls answered a sleep questionnaire, underwent ambulatory polysomnography, a post-bronchodilatory spirometry, and blood sampling. Results: Of the patients with COPD, 51% reported sleep disturbances as compared with 31% in controls (P=0.008. Sleep disturbances were significantly more prevalent in males with COPD compared with controls, whereas there was no significant difference in females. The use of hypnotics was more common among patients with COPD compared with controls, both in men (15% vs 0%, P=0.009 and women (36% vs 16%, P=0.03. The men with COPD had significantly longer recorded sleep latency than the male control group (23 vs 9.3 minutes, P<0.001, while no corresponding difference was found in women. In men with COPD, those with reported sleep disturbances had lower forced vital capacity, higher C-reactive protein, myeloperoxidase, and higher prevalence of chronic bronchitis. Conclusion: The COPD was associated with impaired sleep in men while the association was less clear in women. This was also confirmed by recorded longer sleep latency in male subjects with COPD compared with controls. Keywords: chronic obstructive pulmonary disease, sleep, polysomnography, quality of sleep, sex

  16. Losing track of time through delayed body representations

    Directory of Open Access Journals (Sweden)

    Thomas Hans Fritz

    2015-04-01

    Full Text Available The ability to keep track of time is perceived as crucial in most human societies. However, to lose track of time may also serve an important social role, associated with recreational purpose. To this end a number of social technologies are employed, some of which may relate to a manipulation of time perception through a modulation of body representation. Here we investigated an influence of real-time or delayed videos of own-body representations on time perception in an experimental setup with virtual mirrors. Seventy participants were asked to either stay in the installation until they thought that a defined time (90 s had passed, or they were encouraged to stay in the installation as long as they wanted and after exiting were asked to estimate the duration of their stay. Results show that a modulation of body representation by time-delayed representations of the mirror-video displays influenced time perception. Furthermore, these time-delayed conditions were associated with a greater sense of arousal and intoxication. We suggest that feeding in references to the immediate past into working memory could be the underlying mental mechanism mediating the observed modulation of time perception. We argue that such an influence on time perception would probably not only be achieved visually, but might also work with acoustic references to the immediate past (e.g., with music.

  17. Pathophysiology and clinical presentations of salt-losing tubulopathies.

    Science.gov (United States)

    Seyberth, Hannsjörg W

    2016-03-01

    At least three renal tubular segments are involved in the pathophysiology of salt-losing tubulopathies (SLTs). Whether the pathogenesis starts either in the thick ascending limb of the loop of Henle (TAL) or in the distal convoluted tubule (DCT), it is the function of the downstream-localized aldosterone sensitive distal tubule (ASDT) to contribute to the adaptation process. In isolated TAL defects (loop disorders) ASDT adaptation is supported by upregulation of DCT, whereas in DCT disorders the ASDT is complemented by upregulation of TAL function. This upregulation has a major impact on the clinical presentation of SLT patients. Taking into account both the symptoms and signs of primary tubular defect and of the secondary reactions of adaptation, a clinical diagnosis can be made that eventually leads to an appropriate therapy. In addition to salt wasting, as occurs in all SLTs, characteristic features of loop disorders are hypo- or isosthenuric polyuria and hypercalciuria, whereas characteristics of DCT disorders are hypokalemia and (symptomatic) hypomagnesemia. In both SLT categories, replacement of urinary losses is the primary goal of treatment. In loop disorders COX inhibitors are also recommended to mitigate polyuria, and in DCT disorders magnesium supplementation is essential for effective treatment. Of note, the combination of a salt- and potassium-rich diet together with an adequate fluid intake is always the basis of long-term treatment in all SLTs.

  18. Microbiota fingerprints lose individually identifying features over time.

    Science.gov (United States)

    Wilkins, David; Leung, Marcus H Y; Lee, Patrick K H

    2017-01-09

    Humans host individually unique skin microbiota, suggesting that microbiota traces transferred from skin to surfaces could serve as forensic markers analogous to fingerprints. While it is known that individuals leave identifiable microbiota traces on surfaces, it is not clear for how long these traces persist. Moreover, as skin and surface microbiota change with time, even persistent traces may lose their forensic potential as they would cease to resemble the microbiota of the person who left them. We followed skin and surface microbiota within households for four seasons to determine whether accurate microbiota-based matching of individuals to their households could be achieved across long time delays. While household surface microbiota traces could be matched to the correct occupant or occupants with 67% accuracy, accuracy decreased substantially when skin and surface samples were collected in different seasons, and particularly when surface samples were collected long after skin samples. Most OTUs persisted on skin or surfaces for less than one season, indicating that OTU loss was the major cause of decreased matching accuracy. OTUs that were more useful for individual identification persisted for less time and were less likely to be deposited from skin to surface, suggesting a trade-off between the longevity and identifying value of microbiota traces. While microbiota traces have potential forensic value, unlike fingerprints they are not static and may degrade in a way that preferentially erases features useful in identifying individuals.

  19. Towards a No-Lose Theorem for Naturalness

    CERN Document Server

    Curtin, David

    2015-01-01

    We derive a phenomenological no-lose theorem for naturalness up to the TeV scale, which applies when quantum corrections to the Higgs mass from top quarks are canceled by perturbative BSM particles (top partners) of similar multiplicity due to to some symmetry. Null results from LHC searches already seem to disfavor such partners if they are colored. Any partners with SM charges and ~TeV masses will be exhaustively probed by the LHC and a future 100 TeV collider. Therefore, we focus on neutral top partners. While these arise in Twin Higgs theories, we analyze neutral top partners as model-independently as possible using EFT and Simplified Model methods. We classify all perturbative neutral top partner structures in order to compute their irreducible low-energy signatures at proposed future lepton and hadron colliders, as well as the irreducible tunings suffered in each scenario. Central to our theorem is the assumption that SM-charged BSM states appear in the UV completion of neutral naturalness, which is the...

  20. Indemnification: Win/lose or win/win

    Energy Technology Data Exchange (ETDEWEB)

    Booth, G.M.

    1996-08-01

    Some of you may be wondering how an oil company employee came to be speaking on indemnity. I`ve been wondering that myself and have even considered the possibility that the conference thought it might be interesting to have a presentation in which the sacrificial lamb is led to the slaughter. I hope that`s not the case. I am not speaking today as a representative of Conoco or as a spokesperson for the operator perspective. I do not intend to tell you what position to take with respect to contractual indemnification. My purpose is to share with you some of my thoughts on indemnification and provide you with some perspective in which to consider your own objectives in structuring indemnities and evaluate whether your current positions meet those objectives. What is contractual indemnification? To some, it is a vehicle by which to transfer all the risk inherent in their operations to another party. Others view it as a means of protecting a deductible or self-insured retention. Some think of it as a bloodbath. There are a few who believe that it is a game in which the only way to win is to ensure the other party loses. The states of Texas and Louisiana believe contractual indemnities are {open_quotes}inequities foisted on certain contractors.{close_quotes} I would like to propose that indemnity can be nothing more than an economic transaction which attempts to allocate risk in a cost effective manner.

  1. Self-reported receipt of healthcare professional’s weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

    OpenAIRE

    Mogre, Victor; Wanaba, Peter; Apala, Peter; Nsoh, Jonas A.

    2016-01-01

    Background Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional’s weight management counselling and the weight management behaviours of type 2 diabetes patients. Methods This cross-sectional study was conducted among 378 type 2 ...

  2. Weight Management

    Science.gov (United States)

    ... Health Information Weight Management English English Español Weight Management Obesity is a chronic condition that affects more ... Liver (NASH) Heart Disease & Stroke Sleep Apnea Weight Management Topics About Food Portions Bariatric Surgery for Severe ...

  3. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD).

    Science.gov (United States)

    Ingadottir, Arora Ros; Beck, Anne Marie; Baldwin, Christine; Weekes, C Elizabeth; Geirsdottir, Olof Gudny; Ramel, Alfons; Gislason, Thorarinn; Gunnarsdottir, Ingibjorg

    2017-06-08

    Low fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Subjects were COPD patients (n = 121) admitted to Landspitali University Hospital from March 2015 to March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. The prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p 7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p = 0.074) and increased risk of 6 and 9 months' mortality (OR 2.72 95% CI 0.88, 8.39, P = 0.082 and OR 2.72 95% CI 0.94, 7.87, P = 0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. This study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  4. The quality of COPD care in general practice

    DEFF Research Database (Denmark)

    Rasmussen, F.V.; Borgeskov, H.; Dollerup, J.;

    2008-01-01

    We investigated whether the quality of management of COPD in general practice could be improved by the participation of general practitioners and their staff in a COPD-specific educational programme. One-hundred and fifty-four doctors participated in the study, and 2549 patient record forms were...... included in the first audit and 2394 in the second audit. We observed a significantly increased utilisation of spirometry from the first (52.7%) to the second audit (71.4%) (p quality of management. We conclude that participation in an educational...... programme can improve the quality of COPD care in general practice Udgivelsesdato: 2008/8/25...

  5. Patients with COPD have low adherence to inhaled medicine

    DEFF Research Database (Denmark)

    Lange, Peter; Toettenborg, Sandra; Topp, Marie

    2014-01-01

    describe results of previous studies on prevalence of adherence to inhaled medicine in COPD, and define characteristics of the patients and treatment associated with degree of adherence. We conclude that health professionals should always consider non-adherence, strive to simplify regiments......Medicine adherence in patients with obstructive pulmonary disease (COPD), has not been studied in Denmark. Studies from other countries, however, unequivocally report low prevalence of patients who follow their doctor's advice and have sufficient adherence to inhaled medicine. In this review we......, and that there is an urgent need of studies aiming at improving adherence in patients with COPD....

  6. ICS and COPD: Time to clear the air

    Directory of Open Access Journals (Sweden)

    Paul A Ford

    2009-07-01

    Full Text Available Paul A Ford, Richard EK Russell, Peter J BarnesAirway Disease Section, National Heart and Lung Institute, Imperial College, London, UKThe debate about what constitutes the correct treatment for COPD has recently intensified. This discussion has grumbled on ever since the first multicenter trials using inhaled corticosteroids (ICS in chronic obstructive pulmonary disease (COPD such as the European Respiratory Society study on chronic obstructive pulmonary disease (EUROSCOP and Inhaled Steroids in Obstructive Lung Disease (ISOLDE were published in the late 1990’s and the results of trials such as TORCH (TOwards a Revolution in COPD Health using combination products has only added to the confusion.

  7. The effect of conjugated linoleic acid supplementation on the nutritional status of COPD patients

    Directory of Open Access Journals (Sweden)

    Ghobadi H

    2016-10-01

    Full Text Available Hassan Ghobadi,1 Somaieh Matin,2 Ali Nemati,3 Abbas Naghizadeh-baghi4 1Pulmonary Division, 2Internal Medicine Department, 3Biochemistry and Nutrition Department, 4Basic Sciences Department, Ardabil University of Medical Sciences, Ardabil, Iran Background: COPD patients are susceptible to anorexia, reduction of caloric intake, weight loss, and malnutrition. One of the possible mechanisms is the increase of inflammatory markers such as interleukin 1β (IL1β, is highly correlated with anorexia. Considering the anti-inflammatory role of conjugated linoleic acid (CLA, this study aimed to investigate the effect of CLA supplementation on the nutritional status of COPD patients.Patients and methods: In a double-blind clinical trial, 93 COPD patients who volunteered to participate in the study and who filled out a written consent form, were randomly assigned to control or supplementation groups. The patients in the supplementation group received 3.2 g of CLA on a daily basis for 6 weeks, while those in the control group received placebo on a daily basis for 6 weeks. For IL1β assessment, the patients’ anthropometric indices and appetite score were checked and their blood samples were collected both before and after the treatment. Moreover, in order to investigate the changes in the caloric intake trend during the study, their dietary intake levels were assessed using 24-hour dietary recall, 3 days a week at the onset, in the 4th week, and at the end of the study. Eventually, 90 patients completed the study.Results: The results demonstrated a significant increase in appetite score (P=0.001, average caloric intake (P=0.01, and macronutrient intake (P<0.05, while a significant decrease was observed in the serum level of IL1β among the patients of the supplementation group (P=0.008. Meanwhile, although the supplementation group’s body mass index was also higher on completion, compared to their own initial state as well as to that in the control

  8. Pulmonary rehabilitation for COPD improves exercise time rather than exercise tolerance: effects and mechanisms

    Directory of Open Access Journals (Sweden)

    Miki K

    2017-04-01

    positive correlation with the baseline body mass index (BMI (r=0.496, P=0.002 were obtained.Conclusions: PR in COPD patients improves Tex rather than exercise tolerance, economizing oxygen requirements, resulting in reduced ventilatory requirements without cardiac loads followed by reduced exertional dyspnea. In addition, the time–slope and BMI could be used to predict PR responses beforehand. Keywords: cardiopulmonary exercise testing, oxygen requirement, ventilatory equivalents, body weight, carbon dioxide output

  9. Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study

    Science.gov (United States)

    2011-01-01

    Background Patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known. The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management. Methods A qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited. Ambulatory oxygen systems comprised cylinders weighing 3.4 kg, a shoulder bag and nasal cannulae. Results Participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge); were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house. Conclusions These participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed. Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group. Increased user involvement in both system development and service provision

  10. Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study

    Directory of Open Access Journals (Sweden)

    Fenwick Angela

    2011-02-01

    Full Text Available Abstract Background Patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known. The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management. Methods A qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited. Ambulatory oxygen systems comprised cylinders weighing 3.4 kg, a shoulder bag and nasal cannulae. Results Participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge; were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house. Conclusions These participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed. Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group. Increased user involvement in both system development

  11. Continuing to Confront COPD International Physician Survey: physician knowledge and application of COPD management guidelines in 12 countries.

    Science.gov (United States)

    Davis, Kourtney J; Landis, Sarah H; Oh, Yeon-Mok; Mannino, David M; Han, MeiLan K; van der Molen, Thys; Aisanov, Zaurbek; Menezes, Ana M; Ichinose, Masakazu; Muellerova, Hana

    2015-01-01

    Utilizing data from the Continuing to Confront COPD (chronic obstructive pulmonary disease) International Physician Survey, this study aimed to describe physicians' knowledge and application of the GOLD (Global initiative for chronic Obstructive Lung Disease) Global Strategy for the Diagnosis, Management and Prevention of COPD diagnosis and treatment recommendations and compare performance between primary care physicians (PCPs) and respiratory specialists. Physicians from 12 countries were sampled from in-country professional databases; 1,307 physicians (PCP to respiratory specialist ratio three to one) who regularly consult with COPD, emphysema, or chronic bronchitis patients were interviewed online, by telephone or face to face. Physicians were questioned about COPD risk factors, prognosis, diagnosis, and treatment, including knowledge and application of the GOLD global strategy using patient scenarios. Physicians reported using spirometry routinely (PCPs 82%, respiratory specialists 100%; Psurvey of physicians in 12 countries practicing in the primary care and respiratory specialty settings showed high awareness of COPD-management guidelines. Frequent use of guideline-recommended COPD diagnostic practices was reported; however, gaps in the application of COPD-treatment recommendations were observed, warranting further evaluation to understand potential barriers to adopt guideline recommendations.

  12. Identifying possible asthma–COPD overlap syndrome in patients with a new diagnosis of COPD in primary care

    Science.gov (United States)

    Baarnes, Camilla Boslev; Kjeldgaard, Peter; Nielsen, Mia; Miravitlles, Marc; Ulrik, Charlotte Suppli

    2017-01-01

    The asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) remains poorly characterised. Our aim was to describe an algorithm for identifying possible ACOS in adults with newly diagnosed COPD in primary care. General practitioners (n=241) consecutively recruited subjects ⩾35 years, with tobacco exposure, at least one respiratory symptom and no previous diagnosis of obstructive lung disease. Possible ACOS was defined as chronic airflow obstruction, i.e., post-bronchodilator (BD) forced expiratory volume 1/forced vital capacity (FEV1/FVC) ratio<0.70, combined with wheeze (ACOS wheeze) and/or significant BD reversibility (ACOS BD reversibility). Of 3,875 (50% females, mean age 57 years) subjects screened, 700 (18.1%) were diagnosed with COPD, i.e., symptom(s), tobacco exposure and chronic airflow obstruction. Indications for ACOS were found in 264 (38%) of the COPD patients. The prevalence of ACOS wheeze and ACOS BD reversibility was 27% (n=190) and 16% (n=113), respectively (P<0.001), and only 6% (n=39) of the COPD patients fulfilled both criteria for ACOS. Patients with any ACOS were younger (P=0.04), had more dyspnoea (P<0.001), lower FEV1%pred (67% vs. 74%; P<0.001) and lower FEV1/FVC ratio (P=0.001) compared with COPD-only patients. Comparing subjects fulfilling both criteria for ACOS with those fulfilling criteria for ACOS wheeze only (n=151) and those fulfilling criteria for ACOS BD reversibility only (n=74) revealed no significant differences. Irrespective of the applied ACOS definition, no significant difference in life-time tobacco exposure was found between ACOS- and COPD-only patients. In subjects with a new diagnosis of COPD, the prevalence of ACOS is high. When screening for COPD in general practice among patients with no previous diagnosis of obstructive lung disease, patients with possible ACOS may be identified by self-reported wheeze and/or BD reversibility. PMID:28055002

  13. Risk factors for cardiovascular disease in patients with COPD: mild-to-moderate COPD versus severe-to-very severe COPD

    Directory of Open Access Journals (Sweden)

    Laura Miranda de Oliveira Caram

    Full Text Available ABSTRACT Objective: To assess and compare the prevalence of comorbidities and risk factors for cardiovascular disease (CVD in COPD patients according to disease severity. Methods: The study included 25 patients with mild-to-moderate COPD (68% male; mean age, 65 ± 8 years; mean FEV1, 73 ± 15% of predicted and 25 with severe-to-very severe COPD (males, 56%; mean age, 69 ± 9 years; mean FEV1, 40 ± 18% of predicted. Comorbidities were recorded on the basis of data obtained from medical charts and clinical evaluations. Comorbidities were registered on the basis of data obtained from medical charts and clinical evaluations. The Charlson comorbidity index was calculated, and the Hospital Anxiety and Depression Scale (HADS score was determined. Results: Of the 50 patients evaluated, 38 (76% had been diagnosed with at least one comorbidity, 21 (42% having been diagnosed with at least one CVD. Twenty-four patients (48% had more than one CVD. Eighteen (36% of the patients were current smokers, 10 (20% had depression, 7 (14% had dyslipidemia, and 7 (14% had diabetes mellitus. Current smoking, depression, and dyslipidemia were more prevalent among the patients with mild-to-moderate COPD than among those with severe-to-very severe COPD (p < 0.001, p = 0.008, and p = 0.02, respectively. The prevalence of high blood pressure, diabetes mellitus, alcoholism, ischemic heart disease, and chronic heart failure was comparable between the two groups. The Charlson comorbidity index and HADS scores did not differ between the groups. Conclusions: Comorbidities are highly prevalent in COPD, regardless of its severity. Certain risk factors for CVD, themselves classified as diseases (including smoking, dyslipidemia, and depression, appear to be more prevalent in patients with mild-to-moderate COPD.

  14. Are normal-weight adolescents satisfied with their weight?

    Directory of Open Access Journals (Sweden)

    Mariana Contiero San Martini

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: The high prevalence of obesity has led to public policies for combating it. People with normal weight may gain greater awareness of this issue and change their perceptions of their weight. The aim of this study was to evaluate the prevalence of body weight dissatisfaction among normal-weight adolescents, according to demographic and socioeconomic variables, health-related behavior and morbidities. DESIGN AND SETTING: Population-based cross-sectional study that used data from a health survey conducted in the city of Campinas, São Paulo, in 2008-2009. METHODS: The prevalence and prevalence ratios of weight dissatisfaction were estimated according to independent variables, by means of simple and multiple Poisson regression. RESULTS: 573 normal-weight adolescents aged 10 to 19 years (mean age 14.7 years were analyzed. The prevalence of weight dissatisfaction was 43.7% (95% confidence interval, CI: 37.8-49.8. Higher prevalences of weight dissatisfaction were observed among females, individuals aged 15 to 19 years, those whose households had eight or more domestic appliances, former smokers, individuals who reported alcohol intake and those who had one or more chronic diseases. Lower prevalence of dissatisfaction was observed among adolescents living in substandard housing. Among the normal-weight adolescents, 26.1% wished to lose weight and 17.6% wished to gain weight. CONCLUSION: The results from this study indicate that even when weight is seen to be within the normal range, a high proportion of adolescents express dissatisfaction with their weight, especially females, older adolescents and those of higher socioeconomic level.

  15. Leaders as combat fighter pilots. Research project targets leaders who support money-losing business strategies.

    Science.gov (United States)

    Mitlyng, J W; Francis, D M; Wenzel, F J

    2001-01-01

    When strategic plans go awry and begin losing money, the smart thing to do is change course. But some leaders get so involved with the plan, they fail to navigate properly and fly right into the target. The organization can lose millions. Examine why this happens and what you can do to prevent it from happening in your organization.

  16. 25 CFR 115.808 - Could trust fund investments made by OTFM lose money?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Could trust fund investments made by OTFM lose money? 115.808 Section 115.808 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES... § 115.808 Could trust fund investments made by OTFM lose money? The value of trust fund investments...

  17. Fontan-associated protein-losing enteropathy and plastic bronchitis.

    Science.gov (United States)

    Schumacher, Kurt R; Stringer, Kathleen A; Donohue, Janet E; Yu, Sunkyung; Shaver, Ashley; Caruthers, Regine L; Zikmund-Fisher, Brian J; Fifer, Carlen; Goldberg, Caren; Russell, Mark W

    2015-04-01

    To characterize the medical history, disease progression, and treatment of current-era patients with the rare diseases Fontan-associated protein-losing enteropathy (PLE) and plastic bronchitis. A novel survey that queried demographics, medical details, and treatment information was piloted and placed online via a Facebook portal, allowing social media to power the study. Participation regardless of PLE or plastic bronchitis diagnosis was allowed. Case control analyses compared patients with PLE and plastic bronchitis with uncomplicated control patients receiving the Fontan procedure. The survey was completed by 671 subjects, including 76 with PLE, 46 with plastic bronchitis, and 7 with both. Median PLE diagnosis was 2.5 years post-Fontan. Hospitalization for PLE occurred in 71% with 41% hospitalized ≥ 3 times. Therapy varied significantly. Patients with PLE more commonly had hypoplastic left ventricle (62% vs 44% control; OR 2.81, 95% CI 1.43-5.53), chylothorax (66% vs 41%; OR 2.96, CI 1.65-5.31), and cardiothoracic surgery in addition to staged palliation (17% vs 5%; OR 4.27, CI 1.63-11.20). Median plastic bronchitis diagnosis was 2 years post-Fontan. Hospitalization for plastic bronchitis occurred in 91% with 61% hospitalized ≥ 3 times. Therapy was very diverse. Patients with plastic bronchitis more commonly had chylothorax at any surgery (72% vs 51%; OR 2.47, CI 1.20-5.08) and seasonal allergies (52% vs 36%; OR 1.98, CI 1.01-3.89). Patient-specific factors are associated with diagnoses of PLE or plastic bronchitis. Treatment strategies are diverse without clear patterns. These results provide a foundation upon which to design future therapeutic studies and identify a clear need for forming consensus approaches to treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Triathletes Lose Their Advantageous Pain Modulation under Acute Psychosocial Stress.

    Science.gov (United States)

    Geva, Nirit; Pruessner, Jens; Defrin, Ruth

    2017-02-01

    Triathletes, who constantly engage in intensely stressful sport, were recently found to exhibit greater pain tolerance and more efficient pain inhibition capabilities than nonathletes. However, pain inhibition correlated negatively with retrospective reports of mental stress during training and competition. The aim of the current study was to test pain inhibition capabilities of triathletes under acute, controlled psychological stress manipulation. Participants were 25 triathletes and ironman triathletes who underwent the measurement of pain threshold, pain intolerance, tonic suprathreshold pain, and conditioned pain modulation before and during exposure to the Montreal Imaging Stress Task (MIST). Perceived ratings of stress and anxiety, autonomic variables, and salivary cortisol levels were obtained as indices of stress. The MIST induced a significant stress reaction manifested in the subjective and objective indices. Overall, a significant reduction in pain threshold and in conditioned pain modulation efficacy was observed after the MIST, which reached the baseline levels observed previously in nonathletes. Paradoxically, the magnitude of this stress-induced hyperalgesia (SIH) correlated negatively with the magnitude of the stress response; low-stress responders exhibited greater SIH than high-stress responders. The results suggest that under acute psychological stress, triathletes not only react with SIH and a reduction in pain modulation but also lose their advantageous pain modulation over nonathletes. The stronger the stress response recorded, the weaker the SIH. It appears that triathletes are not resilient to stress, responding with an increase in the sensitivity to pain as well as a decrease in pain inhibition. The possible effects of athletes' baseline pain profile and stress reactivity on SIH are discussed.

  19. RISKS OF LOSING CONTROLLABILITY WHILE LIBERALIZING THE ELECTRIC POWER INDUSTRY

    Directory of Open Access Journals (Sweden)

    Yu. S. Petrusha

    2015-01-01

    Full Text Available The paper analyses controllability qua a reliability characteristic of the electric-power grid controlling system. The following notions are used: the object (environment susceptibility towards the control stimuli, the controlling system adequacy, environment of the secure functioning. The author points to the necessity of accounting for the limitations of technological and organizational character. While liberalizing the electric-power industry, the backbone control-principle “the industry functioning reliability” is being replaced with the principle of “profit-making” that requires complete restatement of the control philosophy.The conflict between commercial benefit gaining and the reliability assurance expenses leads to losing controllability in all the managerial links and to probable catastrophic consequences. The recapitulation of the Russian Federation power industry privatization substantiates concerns of the liberal ideas poor survivability in the ex-Soviet territories. The results of degradation of the secure-functioning environment demonstrate affinity of the mechanisms that triggered the Chernobyl NPP, Fukusima NPP, and Sayan-Shushenskya HPP disasters. Securing reliability of the strategic objects leaves the competence boundaries of the electricpower industry.The topical issue of Belorussian electric-power industry functioning and developing is the combination of technical re-equipment (developing the operational dispatch management and the control-system organizational modernizing in general with gradual and controllable transition to the market mechanisms of functioning. Herewith, preserving the state monopoly on regime provision for the operation of the electric-power system should not leave out the industry appeal for outside investment and is regulated by the optimal degree and intensity of the state participation in governing the electric-power supply industry. The distinction of privatization models and the stages

  20. Potential misclassification of causes of death from COPD

    DEFF Research Database (Denmark)

    Jensen, Henriette Hvide; Godtfredsen, Nina Skavlan; Lange, Peter;

    2006-01-01

    Little is known about causes of death in chronic obstructive pulmonary disease (COPD) and the validity of mortality statistics in COPD. The present authors examined causes of death using data from the Copenhagen City Heart Study. Of the 12,979 subjects with sufficient data from the baseline...... COPD, CMH and smoking were predictors of COPD as underlying cause of death, ORs 2.3 (1.5-3.7) and 2.2 (1.4-3.6), respectively. It was concluded that chronic obstructive pulmonary disease is underreported on death certificates, that biases in the use of chronic obstructive pulmonary disease as cause...... of death can be assessed, and that possible "over-diagnosis" of chronic obstructive pulmonary disease on death certificates in subjects unlikely to have significant disease should initiate caution when using causes of mortality in chronic obstructive pulmonary disease epidemiology....

  1. Accelerated extracellular matrix turnover during exacerbations of COPD

    DEFF Research Database (Denmark)

    Sand, Jannie M B; Knox, Alan J; Lange, Peter

    2015-01-01

    BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) contribute significantly to disease progression. However, the effect on tissue structure and turnover is not well described. There is an urgent clinical need for biomarkers of disease activity associated with disease...... progression. Extracellular matrix (ECM) turnover reflects activity in tissues and consequently assessment of ECM turnover may serve as biomarkers of disease activity. We hypothesized that the turnover of lung ECM proteins were altered during exacerbations of COPD. METHODS: 69 patients with COPD hospitalised......, respectively), and degradation of elastin (ELM7 and EL-NE) and versican (VCANM). RESULTS: Circulating levels of C3M, C4M, C6M, ELM7, and EL-NE were elevated during an exacerbation of COPD as compared to follow-up (all P

  2. L-Arginine Pathway in COPD Patients with Acute Exacerbation

    DEFF Research Database (Denmark)

    Ruzsics, Istvan; Nagy, Lajos; Keki, Sandor

    2016-01-01

    (ADMA, SDMA) is related to hypoxia. In COPD, a rise in ADMA results in a shift of L-arginine breakdown, contributing to airway obstruction. We aimed to compare serum levels of ADMA, SDMA and L-arginine in patients with and without AECOPD. METHODS: L-arginine metabolites quantified by high......-performance liquid chromatography in venous blood samples and partial capillary oxygen pressure were prospectively investigated in 32 patients with COPD, 12 with AECOPD and 30 healthy subjects. RESULTS: Both ADMA and SDMA were significantly higher in AECOPD compared to stable COPD (p = 0.004 and p ....001, respectively). Oxygen content in capillaries correlated with serum ADMA concentration. However, the concentration of L-arginine was not different between AECOPD and stable COPD. Both ADMA and SDMA separated AECOPD with high sensitivity and specificity (AUC: 0.81, p = 0.001; AUC: 0.91, p

  3. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    Science.gov (United States)

    ... Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook Tweet Share Compartir ... U.S. Morbidity Number of adults with diagnosed chronic bronchitis in the past year: 9.3 million Percent ...

  4. Impact of diagnostic criteria on the prevalence of COPD

    DEFF Research Database (Denmark)

    Çolak, Yunus; Løkke, Anders; Marott, Jacob Louis;

    2013-01-01

    INTRODUCTION: The reduction in the ratio between forced expiratory volume in 1 s (FEV(1) ) and forced vital capacity (FVC) is used for the diagnosis of chronic obstructive pulmonary disease (COPD). The choice between a simple fixed cut-off ratio (FEV(1) /FVC LLN had well-preserved FEV(1) . CONCLU......INTRODUCTION: The reduction in the ratio between forced expiratory volume in 1 s (FEV(1) ) and forced vital capacity (FVC) is used for the diagnosis of chronic obstructive pulmonary disease (COPD). The choice between a simple fixed cut-off ratio (FEV(1) /FVC LLN had well-preserved FEV(1......) . CONCLUSION: Using the fixed ratio for diagnosing COPD in an epidemiological setting results in a higher prevalence than if the LLN is used. Time seems ripe for studying if the same is seen when diagnosing COPD in the clinical setting....

  5. Chronic Obstructive Pulmonary Disease (COPD): A Review of the ...

    African Journals Online (AJOL)

    DATONYE ALASIA

    Pulmonary disease (COPD) is one of the most common chronic ... airway exposures such as dust, chemicals or fumes, which are ... from biomass fuel is relevant in developing. 4 countries ..... is evidence of pulmonary hypertension, congestive ...

  6. New and existing pharmacotherapeutic options for persistent asthma and COPD

    NARCIS (Netherlands)

    Diamant, Z.; Tarasevych, S.; Clarke, G. W.

    2011-01-01

    Asthma and COPD are chronic inflammatory airway disorders with systemic manifestations. The two diseases have different airway inflammation, features of airway remodelling with subsequent pathophysiology and clinical presentation. The international management guidelines recommend stepwise pharmacoth

  7. Immune response to exercise in patients with COPD

    NARCIS (Netherlands)

    Helvoort, H.A.C. van

    2006-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is increasingly being recognized as systemic rather than only a pulmonary disease. Increasing amounts of activated inflammatory cells, mediators and oxidative stress are not restricted to the local compartment- including airways, lung parenchyma, and pulm

  8. Lower Corticosteroid Skin Blanching Response Is Associated with Severe COPD

    NARCIS (Netherlands)

    Hoonhorst, Susan J. M.; ten Hacken, Nicolaas; Loi, Adele T. Lo Tam; Koenderman, Leo; Lammers, Jan Willem J.; Telenga, Eef D.; Boezen, Hendrika; van den Berge, Maarten; Postma, Dirkje S.

    2014-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive t

  9. Physiology and consequences of lung hyperinflation in COPD

    Directory of Open Access Journals (Sweden)

    D. E. O'Donnell

    2006-12-01

    Full Text Available Lung hyperinflation commonly accompanies expiratory flow limitation in patients with chronic obstructive pulmonary disease (COPD and contributes importantly to morbidity and an impoverished quality of life. It is not surprising, therefore, that lung hyperinflation has become an important therapeutic target in symptomatic COPD patients. Acute dynamic increases in lung hyperinflation under conditions of worsening expiratory flow limitation and increased ventilatory demand (or both can seriously stress cardiopulmonary reserves in patients with more advanced disease. The present understanding of the physiological mechanisms of dynamic hyperinflation during exacerbations of COPD and during physical activity continues to grow, together with an appreciation of its negative mechanical and sensory consequences. In this brief overview, definitions and measurement of lung hyperinflation during rest and exercise will be discussed and its potential clinical importance will be considered. The focus will mainly be on current concepts of the mechanisms of air trapping and its role in inducing respiratory discomfort and activity limitation in COPD.

  10. COPD is a systemic disease – the ex trapulmonary manifestations

    African Journals Online (AJOL)

    COPD is defined as a preventable and treatable respiratory disease ... inhalation of noxious particles, particularly cigarette smoke. Although ... Depression and anxiety .... Cruetzberg E. Leptin in relation to systemic inflammation and regulation.

  11. Cardiovascular morbidity in COPD: A study of the general population

    DEFF Research Database (Denmark)

    Lange, Peter; Møgelvang, Rasmus; Marott, Jacob Louis

    2010-01-01

    Although there are a number of studies on the coexistence of heart disease and COPD among patients acutely admitted to hospital, this relationship has not been accurately described in the general population. Especially data on the prevalence of both reduced lung function and impaired left...... ventricular ejection fraction (LVEF) are sparse. We used data from the 4th examination of The Copenhagen City Heart Study, which comprises 5,890 individuals with data on pulmonary and cardiac symptoms, risk factors for cardiovascular diseases, pulmonary function tests, ECG and relevant medical history. Among...... ventricular hyperthrophy was significantly more frequent among individuals with COPD (17.7%) than among participants without COPD (12.1%.), yet this relationship was no longer significant after statistical adjustment for age and gender. In the general population, subjects with COPD have a higher prevalence...

  12. Lessons from ECLIPSE: a review of COPD biomarkers.

    Science.gov (United States)

    Faner, Rosa; Tal-Singer, Ruth; Riley, John H; Celli, Bartolomé; Vestbo, Jørgen; MacNee, William; Bakke, Per; Calverley, Peter M A; Coxson, Harvey; Crim, Courtney; Edwards, Lisa D; Locantore, Nick; Lomas, David A; Miller, Bruce E; Rennard, Stephen I; Wouters, Emiel F M; Yates, Julie C; Silverman, Edwin K; Agusti, Alvar

    2014-07-01

    The Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study was a large 3-year observational controlled multicentre international study aimed at defining clinically relevant subtypes of chronic obstructive pulmonary disease (COPD) and identifying novel biomarkers and genetic factors. So far, the ECLIPSE study has produced more than 50 original publications and 75 communications to international meetings, many of which have significantly influenced our understanding of COPD. However, because there is not one paper reporting the biomarker results of the ECLIPSE study that may serve as a reference for practising clinicians, researchers and healthcare providers from academia, industry and government agencies interested in COPD, we decided to write a review summarising the main biomarker findings in ECLIPSE.

  13. Fine particulate matter in acute exacerbation of COPD

    Directory of Open Access Journals (Sweden)

    Lei eNi

    2015-10-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a common airway disorder. In particular, acute exacerbations of COPD (AECOPD can significantly reduce pulmonary function. The majority of AECOPD episodes are attributed to infections, although environmental stress also plays a role. Increasing urbanization and associated air pollution, especially in developing countries, have been shown to contribute to COPD pathogenesis. Elevated levels of particulate matter (PM in polluted air are strongly correlated with the onset and development of various respiratory diseases. In this review, we have conducted an extensive literature search of recent studies of the role of PM2.5 (fine PM in AECOPD. PM2.5 leads to AECOPD via inflammation, oxidative stress, immune dysfunction, and altered airway epithelial structure and microbiome. Reducing PM2.5 levels is a viable approach to lower AECOPD incidence, attenuate COPD progression and decrease the associated healthcare burden.

  14. The implication of telehealthcare in COPD management of China.

    Science.gov (United States)

    Lao, Xiangda; Zhang, Jing; Bai, Chunxue

    2013-10-01

    Chronic obstructive pulmonary disease (COPD) is a very common disease all around the world and has become an increasing public health concern to the Chinese medical community. In the past decades, telehealthcare technology has become a good way to manage COPD but current evidence makes it hard to determine the effectiveness of this technology. Internet of things (Iot) is a recent breakthrough in communication technology, which links the virtual world to the real world through connection between sensors and working devices. It relates people and items in any ways so that data collection and management become more flexible. Our review concentrates on the effectiveness and potential application of telehealthcare in COPD management and how IoT technology may stimulate COPD healthcare delivery through telehealthcare technology.

  15. Not all COPD is caused by cigarette smoking

    African Journals Online (AJOL)

    of occupational COPD, using methods ... and nuclear energy, and are burned to release stored chemical energy. ... in a cost-effective and environmentally safe ... (in diesel engines); waste vegetable oils (in diesel engines); and biodiesel from ...

  16. Care bundles reduce readmissions for COPD.

    Science.gov (United States)

    Matthews, Healther; Tooley, Cathy; Nicholls, Carol; Lindsey-Halls, Anna

    In 2011, the respiratory nursing team at the James Paget University Hospital Foundation Trust were considering introducing a discharge care bundle for patients admitted with an acute exacerbation of chronic obstructive pulmonary disease. At the same time, the trust was asking for applications for Commissioning for Quality and Innovation schemes (CQUINs). These are locally agreed packages of quality improvement goals and indicators, which, if achieved in total, enable the provider to earn its full CQUIN payment. A CQUIN scheme should address the three domains of quality, safety and effectiveness, patient experience and also show innovation. This article discusses how the care bundle was introduced and how, over a 12-month period, it showed tangible results in improving the care pathway for COPD patients as well as reducing readmissions and saving a significant amount of money.

  17. Weighted Clustering

    CERN Document Server

    Ackerman, Margareta; Branzei, Simina; Loker, David

    2011-01-01

    In this paper we investigate clustering in the weighted setting, in which every data point is assigned a real valued weight. We conduct a theoretical analysis on the influence of weighted data on standard clustering algorithms in each of the partitional and hierarchical settings, characterising the precise conditions under which such algorithms react to weights, and classifying clustering methods into three broad categories: weight-responsive, weight-considering, and weight-robust. Our analysis raises several interesting questions and can be directly mapped to the classical unweighted setting.

  18. Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Iepsen, Ulrik Winning; Topperup, Randi;

    2015-01-01

    Background and aims Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL......, or meta-analyses from existing guidelines or systematic reviews were adapted. The results were used for labeling and wording of the recommendations. Results Data from 12 randomized controlled trials were included in a systematic review, which formed the basis for our recommendations as no new primary...... studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7 kg (95% confidence interval: 1.3 to 2.2 kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were...

  19. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    Science.gov (United States)

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  20. [Quality of life according to self-perceived weight, weight control behaviors, and gender among adolescent university students in Mexico].

    Science.gov (United States)

    Hidalgo-Rasmussen, Carlos Alejandro; Hidalgo-San Martín, Alfredo; Rasmussen-Cruz, Bettylú; Montaño-Espinoza, Rosa

    2011-01-01

    The aim of this study was to analyze quality of life (QoL) according to self-perceived weight and weight control behaviors, by gender. The sample consisted of 2,401 adolescent students (17-19 years of age) enrolled from 2007 to 2009 at a Mexican university; 61.9% were women, 19.4% worked, and 99.2% were single. An online self-administered questionnaire was used that included the perceptual module of the YQOL-R and seven items on body weight, adapted from YRBS 2007. 52% of women and 31.7% of men were attempting to lose weight. The highest QoL scores were in students who felt they were near the right weight, those who were attempting to maintain the same weight, and those who exercised. Lowest QoL was reported by those who considered themselves overweight, were trying to lose weight, were eating less, were skipping meals, or were using unsupervised dieting, vomiting, or laxatives. In women, QoL differed between those maintaining the same weight, gaining weight, and losing weight, while QoL in men only differed for those attempting to gain weight. The findings could be useful in educational processes, preventive programs, and assessment of interventions.

  1. The impact of treatment with indacaterol in patients with COPD

    DEFF Research Database (Denmark)

    Kerstjens, Huib A M; Deslée, Gaëtan; Dahl, Ronald

    2015-01-01

    BACKGROUND: Indacaterol is an inhaled, once-daily, ultra-long-acting β2-agonist for the treatment of chronic obstructive pulmonary disease (COPD). We report on the effectiveness of indacaterol and other bronchodilators compared with placebo in patients across the Global Initiative for Chronic...... treatment of COPD. Indacaterol 150 and 300 μg effectively improved lung function and symptoms in patients across all GOLD 2011 categories....

  2. Evaluation of von Willebrand factor in COPD patients

    Directory of Open Access Journals (Sweden)

    Thiago Prudente Bártholo

    2014-08-01

    Full Text Available OBJECTIVE: To compare the absolute serum von Willebrand factor (vWF levels and relative serum vWF activity in patients with clinically stable COPD, smokers without airway obstruction, and healthy never-smokers. METHODS: The study included 57 subjects, in three groups: COPD (n = 36; smoker (n = 12; and control (n = 9. During the selection phase, all participants underwent chest X-rays, spirometry, and blood testing. Absolute serum vWF levels and relative serum vWF activity were obtained by turbidimetry and ELISA, respectively. The modified Medical Research Council scale (cut-off score = 2 was used in order to classify COPD patients as symptomatic or mildly symptomatic/asymptomatic. RESULTS: Absolute vWF levels were significantly lower in the control group than in the smoker and COPD groups: 989 ± 436 pg/mL vs. 2,220 ± 746 pg/mL (p < 0.001 and 1,865 ± 592 pg/mL (p < 0.01. Relative serum vWF activity was significantly higher in the COPD group than in the smoker group (136.7 ± 46.0% vs. 92.8 ± 34.0%; p < 0.05, as well as being significantly higher in the symptomatic COPD subgroup than in the mildly symptomatic/asymptomatic COPD subgroup (154 ± 48% vs. 119 ± 8%; p < 0.05. In all three groups, there was a negative correlation between FEV1 (% of predicted and relative serum vWF activity (r2 = −0.13; p = 0.009. CONCLUSIONS: Our results suggest that increases in vWF levels and activity contribute to the persistence of systemic inflammation, as well as increasing cardiovascular risk, in COPD patients.

  3. COPD and osteoporosis: links, risks, and treatment challenges

    OpenAIRE

    Inoue D; Watanabe R; Okazaki R

    2016-01-01

    Daisuke Inoue, Reiko Watanabe, Ryo Okazaki Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan Abstract: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis and its related fractures are common and have significant impacts on quality of life and even respiratory function in patients with COPD....

  4. Gastroesophageal reflux disease in COPD: links and risks

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    Lee AL

    2015-09-01

    Full Text Available Annemarie L Lee,1–3 Roger S Goldstein1,2,4 1West Park Healthcare Centre, 2Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; 3Institute for Breathing and Sleep, Austin Hospital, Melbourne, VIC, Australia; 4Department of Medicine, University of Toronto, Toronto, ON, Canada Abstract: COPD is a long-term condition associated with considerable disability with a clinical course characterized by episodes of worsening respiratory signs and symptoms associated with exacerbations. Gastroesophageal reflux disease (GERD is one of the most common gastrointestinal conditions in the general population and has emerged as a comorbidity of COPD. GERD may be diagnosed by both symptomatic approaches (including both typical and atypical symptoms and objective measurements. Based on a mix of diagnostic approaches, the prevalence of GERD in COPD ranges from 17% to 78%. Although GERD is usually confined to the lower esophagus in some individuals, it may be associated with pulmonary microaspiration of gastric contents. Possible mechanisms that may contribute to GERD in COPD originate from gastroesophageal dysfunction, including altered pressure in the lower esophageal sphincter (which normally protect against GERD and changes in esophageal motility. Proposed respiratory contributions to the development of GERD include respiratory medications that may alter esophageal sphincter tone and changes in respiratory mechanics, with increased lung hyperinflation compromising the antireflux barrier. Although the specific cause and effect relationship between GERD and COPD has not been fully elucidated, GERD may influence lung disease severity and has been identified as a significant predictor of acute exacerbations of COPD. Further clinical effects could include a poorer health-related quality of life and an increased cost in health care, although these factors require further clarification. There are both medical and surgical options available for the

  5. Budesonide/formoterol combination in COPD: a US perspective

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    Amir Sharafkhaneh

    2010-10-01

    Full Text Available Amir Sharafkhaneh1,2, Amarbir S Mattewal1, Vinu M Abraham1, Goutham Dronavalli1, Nicola A Hanania11Section of Pulmonary, Critical Care Medicine and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; 2Section of Pulmonary, Critical Care Medicine and Sleep Medicine, Medical Care Line, Michael E DeBakey VA Medical Center, Houston, Texas, USAAbstract: Chronic obstructive pulmonary disease (COPD is a preventable and treatable disease of the lung caused primarily by exposure to cigarette smoke. Clinically, it presents with progressive cough, sputum production, dyspnea, reduced exercise capacity, and diminished quality of life. Physiologically, it is characterized by the presence of partially reversible expiratory airflow limitation and hyperinflation. Pathologically, COPD is a multicomponent disease characterized by bronchial submucosal mucous gland hypertrophy, bronchiolar mucosal hyperplasia, increased luminal inflammatory mucus, airway wall inflammation and scarring, and alveolar wall damage and destruction. Management of COPD involves both pharmacological and nonpharmacological approaches. Bronchodilators and inhaled corticosteroids are recommended medications for management of COPD especially in more severe disease. Combination therapies containing these medications are now available for the chronic management of stable COPD. The US Food and Drug Administration, recently, approved the combination of budesonide/formoterol (160/4.5 µg; Symbicort™, AstraZeneca, Sweden delivered via a pressurized meter dose inhaler for maintenance management of stable COPD. The combination also is delivered via dry powder inhaler (Symbicort™ and Turbuhaler™, AstraZeneca, Sweden but is not approved for use in the United States. In this review, we evaluate available data of the efficacy and safety of this combination in patients with COPD.Keywords: inhaled steroid, bronchodilator, ß2-agonist, lung function, quality of life

  6. Rapid fall in lung density following smoking cessation in COPD

    DEFF Research Database (Denmark)

    Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian

    2011-01-01

    Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD.......Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD....

  7. ICS and COPD: Time to clear the air

    OpenAIRE

    Russell, Richard

    2009-01-01

    Paul A Ford, Richard EK Russell, Peter J BarnesAirway Disease Section, National Heart and Lung Institute, Imperial College, London, UKThe debate about what constitutes the correct treatment for COPD has recently intensified. This discussion has grumbled on ever since the first multicenter trials using inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD) such as the European Respiratory Society study on chronic obstructive pulmonary disease (EUROSCOP) and Inhaled Stero...

  8. Novel aspects of pathogenesis and regeneration mechanisms in COPD

    OpenAIRE

    Bagdonas E; Raudoniute J; Bruzauskaite I; Aldonyte R

    2015-01-01

    Edvardas Bagdonas, Jovile Raudoniute, Ieva Bruzauskaite, Ruta Aldonyte State Research Institute Center for Innovative Medicine, Vilnius, Lithuania Abstract: Chronic obstructive pulmonary disease (COPD), a major cause of death and morbidity worldwide, is characterized by expiratory airflow limitation that is not fully reversible, deregulated chronic inflammation, and emphysematous destruction of the lungs. Despite the fact that COPD is a steadily growing global healthcare problem, the conven...

  9. A ferret model of COPD-related chronic bronchitis

    OpenAIRE

    Raju, S. Vamsee; Kim, Hyunki; Byzek, Stephen A.; Tang, Li Ping; Trombley, John E; Jackson, Patricia; Rasmussen, Lawrence; Wells, J. Michael; LIBBY, EMILY FALK; Dohm, Erik; Winter, Lindy; Samuel, Sharon L.; Kurt R. Zinn; Blalock, J. Edwin; Schoeb, Trenton R.

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the US. The majority of COPD patients have symptoms of chronic bronchitis, which lacks specific therapies. A major impediment to therapeutic development has been the absence of animal models that recapitulate key clinical and pathologic features of human disease. Ferrets are well suited for the investigation of the significance of respiratory diseases, given prior data indicating similarities to human airway p...

  10. Knowledge about COPD among users of primary health care services

    Science.gov (United States)

    de Queiroz, Maria Conceição de Castro Antonelli Monteiro; Moreira, Maria Auxiliadora Carmo; Jardim, Jose R; Barbosa, Maria Alves; Minamisava, Ruth; Gondim, Heicilainy Del Carlos; Velasco, Flávia Castro; Penhavel, Maria Vitoria Carmo

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) is often underdiagnosed, which might be attributable to a lack of knowledge about the disease among the general population. The objective of this study was to evaluate COPD-related knowledge among primary care users in an urban area in Brazil. Methods This study was carried out at primary care clinics (PCCs), including 12 general PCCs and 26 family health PCCs, in the city of Goiânia, Brazil. Between May 2013 and February 2014, we interviewed 674 PCC users, applying a questionnaire designed to assess COPD-related knowledge. Satisfactory knowledge of COPD was defined as knowing at least two of its symptoms and that smoking is a risk factor for the disease. Results Of the 674 users interviewed, only 9.2% recognized the term “COPD”, 75.1% recognized the term “emphysema”, and 15.7% did not recognize either term. We found that recognizing either term was associated with a higher level of education (P<0.001). The prevalence of satisfactory knowledge of COPD was 16.2%, and having such knowledge was associated with being over 60 years of age. The COPD symptom known by the greatest proportion of users (70.6%) was dyspnea, and most (87.5%) knew that smoking is a risk factor, whereas only a few (4.9%) knew that exposure to wood smoke is also a risk factor. The most frequently cited sources of knowledge were the media (43.1%) and a relative with COPD (36.4%). Conclusion Most of the PCC users evaluated did not know the term “COPD” but were familiar with the term “emphysema”. The level of basic knowledge about the disease was low in this population. These results should alert health care administrators to the need for interventions aimed at increasing the diagnosis rate and thus promoting the early treatment of COPD. PMID:25565794

  11. Directly measured secondhand smoke exposure and COPD health outcomes

    Directory of Open Access Journals (Sweden)

    Balmes John

    2006-06-01

    Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

  12. Rapid fall in lung density following smoking cessation in COPD

    DEFF Research Database (Denmark)

    Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian;

    2011-01-01

    Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD.......Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD....

  13. Knowledge and attitudes of family physicians coming to COPD continuing medical education

    Directory of Open Access Journals (Sweden)

    Barbara P Yawn

    2008-06-01

    Full Text Available Barbara P Yawn, Peter C WollanOlmsted Medical Center, Research Department, Rochester, MN, USAPurpose: COPD remains under-recognized and under-treated. Much of early COPD care is given by primary care physicians but only when COPD is recognized. This survey explores the attitudes, beliefs, and knowledge related to COPD recognition, diagnosis, and treatment from family physicians and nurse practitioners (NPs and physician assistants (PAs working in primary care.Methods: We completed a survey of family physicians, and NPs/PAs attending one of three CME programs on five common chronic conditions including COPD.Results: Return rate was 62% (n = 284 including 178 physicians and 100 NPs/PAs. Fewer than half of the respondents reported knowledge of or use of COPD guidelines. The barriers to recognition and diagnosis of COPD they reported included the multiple morbidities of most COPD patients, failure of patients to report COPD symptoms, as well as lack of knowledge and inadequate training in COPD diagnosis and management. Three quarters (74% of respondents reported use of spirometry to diagnose COPD but only 32% said they included reversibility assessment. COPD was incorrectly assessed as a disease primarily of men (78% of respondents that appeared after age 60 (61%. Few respondents reported that they believed COPD treatment was useful or very useful for improving symptoms (15% or decreasing exacerbations (3% or that pulmonary rehabilitation was helpful (3%, but 13% reported they thought COPD treatment could extend longevity.Conclusions: Primary care physicians and NPs/PAs working in primary care continue to report lack of awareness and use of COPD guidelines, as well as correct information related to COPD epidemiology or potential benefits of available treatments including pulmonary rehabilitation. It is unlikely that diagnosis and management of COPD will improve in primary care until these knowledge gaps and discrepancies with published efficacy of

  14. The protease inhibitor PI*S allele and COPD

    DEFF Research Database (Denmark)

    Hersh, C P; Ly, N P; Berkey, C S

    2005-01-01

    In many countries, the protease inhibitor (SERPINA1) PI*S allele is more common than PI*Z, the allele responsible for most cases of chronic obstructive pulmonary disease (COPD) due to severe alpha 1-antitrypsin deficiency. However, the risk of COPD due to the PI*S allele is not clear. The current...... authors located studies that addressed the risk of COPD or measured lung function in individuals with the PI SZ, PI MS and PI SS genotypes. A separate meta-analysis for each genotype was performed. Aggregating data from six studies, the odds ratio (OR) for COPD in PI SZ compound heterozygotes compared...... with PI MM (normal) individuals was significantly increased at 3.26 (95% confidence intervals (CI): 1.24-8.57). In 17 cross-sectional and case-control studies, the OR for COPD in PI MS heterozygotes was 1.19 (95%CI: 1.02-1.38). However, PI MS genotype was not associated with COPD risk after correcting...

  15. The disruption of the epithelial mesenchymal trophic unit in COPD.

    Science.gov (United States)

    Behzad, Ali R; McDonough, John E; Seyednejad, Nazgol; Hogg, James C; Walker, David C

    2009-12-01

    Progression of COPD is associated with a measurable increase in small airway wall thickness resulting from a repair and remodeling process that involves fibroblasts of the epithelial mesenchymal trophic unit (EMTU). The present study was designed to examine the organization of fibroblasts within the lamina propria of small airways with respect to their contacts with the epithelium and with each other in persons with COPD. Transmission electron microcopy (TEM) and three-dimensional (3D) reconstructions of serial TEM sections were used to estimate the frequency and determine the nature of the contacts between the epithelium and fibroblasts within the EMTU in small airways from 5 controls (smokers with normal lung function), from 6 persons with mild (GOLD-1) and 5 with moderate (GOLD-2) COPD. In airways from control lungs fibroblasts make frequent contact with cytoplasmic extensions of epithelial cells through apertures in the epithelial basal lamina, but the frequency of these fibroblast-epithelial contacts is reduced in both mild and moderate COPD compared to controls (p < 0.01). The 3D reconstructions showed that the cytoplasmic extensions of lamina propria fibroblasts form a reticulum with fibroblast-fibroblast contacts in an airway from a control subject but this reticulum may be reorganized in airways of COPD patients. Development of COPD is associated with significant disruption of the EMTU due to a reduction of contacts between fibroblasts and the epithelium.

  16. The clinical features of the overlap between COPD and asthma

    Directory of Open Access Journals (Sweden)

    Schroeder Joyce D

    2011-09-01

    Full Text Available Abstract Background The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results 119 (13% of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001 with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001. More African-Americans reported a history of asthma (33.6% vs 15.6%, p Conclusion Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration ClinicalTrials.gov: NCT00608764

  17. Optimising pharmacological maintenance treatment for COPD in primary care.

    Science.gov (United States)

    Jones, Rupert; Østrem, Anders

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) is a multi-faceted disease that is a major cause of morbidity and mortality worldwide, and is a significant burden in terms of healthcare resource utilisation and cost. Despite the availability of national and international guidelines, and effective, well-tolerated pharmacological treatments, COPD remains substantially under-diagnosed and under-treated within primary care. As COPD is both preventable and treatable there is an urgent need to raise the awareness and profile of the disease among primary care physicians and patients. Increasing evidence suggests that initiation of long-acting bronchodilator treatment at an early stage can significantly improve the patient's long-term health and quality of life (QoL). Recent large-scale trials in COPD have confirmed the longterm benefits of maintenance treatment with long-acting bronchodilators. A wide range of benefits have been shown in selected patient groups including improved lung function and QoL, reduced exacerbations and, in some studies, delayed disease progression and improved survival. In this review, we consider recent developments in our understanding of COPD, including current and emerging pharmacological treatment options, and identify steps for optimising early diagnosis and pharmacological treatment of COPD within the primary care environment.

  18. Attitudes and beliefs about COPD: data from the BREATHE study.

    Science.gov (United States)

    Sayiner, Abdullah; Alzaabi, Ashraf; Obeidat, Nathir M; Nejjari, Chakib; Beji, Majed; Uzaslan, Esra; Nafti, Salim; Khan, Javaid Ahmed; Tageldin, Mohamed Awad; Idrees, Majdy; Rashid, Nauman; El Hasnaoui, Abdelkader

    2012-12-01

    Although COPD is a debilitating pulmonary condition, many studies have shown awareness of the disease to be low. This article presents data on attitudes and beliefs about COPD in subjects with respiratory symptoms participating in the BREATHE study in the Middle East and North Africa region. This study was a large general population survey of COPD conducted in ten countries of the region (Algeria, Egypt, Jordan, Lebanon, Morocco, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates), together with Pakistan, using a standardised methodology. A total of 62,086 subjects were screened, of whom 2,187 fulfilled the "epidemiological" definition of COPD. A detailed questionnaire was administered to these subjects, which documented knowledge about the disease, attitudes to care, beliefs about COPD and satisfaction with treatment. 1,392 subjects were analysable. Overall, 58.6% of subjects claimed to be very well or adequately informed about their respiratory condition. Two-thirds of subjects reported receiving information about COPD from their physician and 10.6% from television; the internet was cited by 6% and other health professionals or patient associations by education and more effective patient-physician communication are clearly required. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Animal models of COPD: What do they tell us?

    Science.gov (United States)

    Jones, Bernadette; Donovan, Chantal; Liu, Gang; Gomez, Henry M; Chimankar, Vrushali; Harrison, Celeste L; Wiegman, Cornelis H; Adcock, Ian M; Knight, Darryl A; Hirota, Jeremy A; Hansbro, Philip M

    2017-01-01

    COPD is a major cause of global mortality and morbidity but current treatments are poorly effective. This is because the underlying mechanisms that drive the development and progression of COPD are incompletely understood. Animal models of disease provide a valuable, ethically and economically viable experimental platform to examine these mechanisms and identify biomarkers that may be therapeutic targets that would facilitate the development of improved standard of care. Here, we review the different established animal models of COPD and the various aspects of disease pathophysiology that have been successfully recapitulated in these models including chronic lung inflammation, airway remodelling, emphysema and impaired lung function. Furthermore, some of the mechanistic features, and thus biomarkers and therapeutic targets of COPD identified in animal models are outlined. Some of the existing therapies that suppress some disease symptoms that were identified in animal models and are progressing towards therapeutic development have been outlined. Further studies of representative animal models of human COPD have the strong potential to identify new and effective therapeutic approaches for COPD.

  20. The future of combining inhaled drugs for COPD.

    Science.gov (United States)

    Bjerg, Anders; Lundbäck, Bo; Lötvall, Jan

    2012-06-01

    Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality globally, and its prevalence is projected to continue to increase owing to trends in smoking. Treatment of COPD has evolved from the initial adaptations of drugs and treatment strategies successfully used in asthma into more specific pharmacological strategies following global guidelines. Bronchodilating anticholinergic and beta-2-stimulating agents and anti-inflammatory corticosteroid drugs delivered by inhalators are the mainstay of COPD treatment. Despite significant progress, current pharmacotherapies neither fully alleviate the airway obstruction in COPD, nor reverse the progressive nature of the disease. This review discusses inhalation therapies which have recently become clinically available or are being developed, with focus on combination therapies. There is accumulating evidence that the combination of two or all three drug classes, triple therapy, is superior to single drug therapy. Several fixed combinations of both currently available and novel molecules will be launched for clinical use within the next few years. Also, improved understanding of subgroups within the clinical spectrum of COPD, is likely to offer new potentials to improve COPD care.