COMORBIDITIES AS AN ELEMENT OF MULTIDIMENSIONAL PROGNOSTIC ASSESSMENT OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
|
|
- Arron Hardy
- 5 years ago
- Views:
Transcription
1 JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2008, 59, Suppl 6, M. GRABICKI 1, H. PARYSEK 1, H. BATURA-GABRYEL 1, I. BRODNICKA 2 COMORBIDITIES AS AN ELEMENT OF MULTIDIMENSIONAL PROGNOSTIC ASSESSMENT OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE 1 Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poland; 2 Hospital of Pulmonary Diseases and Tuberculosis, Wolica, Poland Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation, some significant extrapulmonary effects, and important comorbidities. The BODE index, a multidimensional scale, has been proposed to better identify severity of the disease and to predict survival. The goal of the study was to evaluate the prevalence of concomitant diseases in patients with COPD and to assess correlations between comorbidities and the BODE index. Eighty patients with COPD were enrolled. They were at least 40 years old and had more than a 10-year history of smoking. The most frequent comorbidities were: systemic hypertension, edema of lower limbs, movement disorders, varices of lower limbs. Subjects with higher scores in BODE index had significantly greater prevalence of arrhythmias and episodes of pneumonia. Evident correlation was observed between low FEV 1 and episodes of pneumonia. We also found that patients with higher BODE scores had more exacerbations of COPD. Comorbidities are very common in COPD. Results indicate a close connection between the BODE index and some comorbidities, which suggests that these conditions may aggravate the COPD course and increase risk of mortality. Key words: BODE index, comorbidities, COPD INTRODUCTION Chronic obstructive pulmonary disease (COPD) is characterized by not fully reversible chronic airflow limitation, a range of pathological changes in the lung, and some significant extra-pulmonary effects with important comorbidities, all of which may contribute to the severity of the disease (1). COPD often develops in
2 298 long-time smokers, who often have a variety of other diseases related to either smoking or aging (2-4). COPD, itself, also has significant extrapulmonary (systemic) effects that lead to comorbid conditions (5). COPD is currently the fourth leading cause of death in the world and is projected to be the third most common cause of death by 2020 (6, 7). Some studies evaluating the cause of death in patients with COPD suggest that these patients are more likely to die of comorbid conditions than from COPD (8-10). Comorbidities can be categorized in various ways to aid in a better understanding of their impact on the patient and disease management. Therefore, it has been proposed to divide them into 4 categories: comorbid diseases with a common pathophysiology, which in the case of COPD means other smokingrelated diseases such as ischemic heart disease and lung cancer, conditions that arise as a complication of COPD such as pulmonary hypertension and consequent heart failure, co-incidental comorbidities with unrelated pathogenesis particularly related to aging such as bowel or prostate cancer, depression, diabetes mellitus, dementia, arthritis, and, finally, acute illnesses (inter-current comorbidities) that may have a more severe impact or require different treatment in patients with a given chronic disease, e.g., upper respiratory tract infections (1). All comorbid conditions become harder to manage when COPD is present, either because COPD adds to the total level of disability, or because COPD therapy adversely affects the comorbid disorder. Comorbid conditions amplify the disability associated with COPD and can potentially complicate its management. The severity of comorbid conditions and their impact on a patient health status vary between patients and in the same patient over time. To better identify severity of the disease and to predict subsequent survival of the individuals affected by COPD, the BODE index has been proposed. This is a multidimensional 10-point scale which integrates body mass index, degree of airflow obstruction (FEV 1 - forced expiratory volume in 1 second) and dyspnea, and exercise capacity measured in 6-min walk test (11). The higher scores in BODE index indicate a higher risk of death. The BODE index was designed to show that it is important to consider a range of factors, rather than just a single component in the course of comprehensive assessment of COPD patients (11, 12). Nevertheless, up to date there is limited information on comorbidities as a prognostic factor and on the correlation between comorbidities and the BODE index. The goal of the present study was to evaluate the prevalence of concomitant diseases in patients with COPD and to assess correlations between comorbidities and the BODE index, to conclusively determine what coexisting diseases have the highest negative influence on the COPD course and on the patients' general condition. MATERIAL AND METHODS The study was approved by a local Ethics Committee and informed consent was obtained from each subject. Eighty patients with COPD, diagnosed based on Global Initiative for Chronic Obstructive Lung
3 299 Disease recommendations - GOLD 2006, were enrolled into this cross-sectional study (1). All participants were at least 40 years old and had more than a 10-year history of smoking. To determine the presence of comorbid diseases, all participants were asked questions according to a prepared questionnaire. This questionnaire included questions concerning other than COPD pulmonary problems, cardiovascular diseases, digestive system abnormalities, neoplasm, neurological pathologies, sleep apnea syndrome symptoms, and other not specified illnesses. Every subject underwent lung function test (flow-volume spirometry) after inhalation of bronchodilator, 6-min walk test, and ECG at rest to estimate the presence and type of arrhythmias. The study group consisted of 55 male (69%) and 25 female (31%). The mean age was 63 ±8.3 years. There were 50 subjects up to 65 years old and 30 over 65 years old. The mean BMI was 27.6 ±6.4. Fifty percent of the subjects smoked between pack-years. The mean number of pack-years was 33. Fifteen patients (18.8%) were current smokers (13 male and 2 female). All data were analyzed using Statistica software. Shapiro-Wilk normality test, Spearman's rank correlation test, Kendall tau rank correlation and analysis of variance (ANOVA) were carried out. A P value of <0.05 was considered statistically significant. RESULTS The most frequent comorbidities in patients with COPD were: systemic hypertension, edema of lower limbs, movement disorders, and varices of lower limbs, sleeping disorders, angina pectoris, vertigo and digestive ulcers. The prevalence of all comorbid diseases was higher in older individuals (Table 1). Subjects with higher scores in BODE index had a significantly greater prevalence of arrhythmias, namely supraventricular tachycardia, atrial fibrillation and flutter. Table 1. Prevalence of comorbidities in patients with COPD. Comorbid disease All subjects n=80 Subjects aged <65 n 1 =50 Subjects aged 65 n 2 =30 n %n n 1 %n 1 n 2 %n 2 Hypertension Edema of lower limbs Movement disorders Varices Sleeping disorders Angina pectoris Vertigo Digestive ulcers Severe headache/ migraine Arrhythmias GERD n, n 1, n 2 - number of subjects with comorbid diseases; %n, %n 1, %n 2 - percentage of subjects with comorbid diseases in relation to the total number of subjects in each group; GERD - gastroesophageal reflux disease.
4 300 There was a significant correlation between higher scores in BODE index and the number of episodes of pneumonia, mainly in male and in a subgroup of patients of years old, regardless of the gender. Evident correlation was also observed between low FEV 1 in flow-volume spirometry and the number of episodes of pneumonia. Additionally, we noted that patients with higher BODE scores had a significantly greater prevalence of COPD exacerbations, and they were more frequently hospitalized because of pulmonary problems. DISCUSSION Comorbidities are very common in COPD. Most patients with COPD, especially older patients, suffer from other accompanying diseases (13, 14). The relevance and impact of comorbid diseases on COPD is not well understood. The results of the present study indicate close connection between BODE scores and some comorbidities (especially arrhythmias) and other pulmonary disorders, which suggests that these conditions may aggravate the COPD course and increase the risk of mortality. Therefore, there is a great need to take into special account the incidence and severity of comorbid conditions in a course of comprehensive assessment and treatment of COPD patients. A combination of BODE index and some comorbidities in one multidimensional scale seems a better way of estimating survival of COPD patients, mainly elderly individuals. Nevertheless, up to date it is not conclusively clear what comorbidities are the most predictive of a grave condition and should be included into such a new prognostic scale (14, 15). Further research is needed to elucidate the interrelationships among comorbidities, BODE index, and COPD. Moreover, the number of hospitalizations and COPD exacerbations can be well predicted based on the BODE index, which can help in choosing a better therapy regimen to avoid subsequent deterioration and a need of re-hospitalization in a short time. Acknowledgements: This study was supported by University of Medical Sciences in Poznan, Poland. Conflicts of interest: No conflicts of interest were declared with relation to this work. REFERENCES 1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006; Available from URL: 2. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005; 128: Hasnis E, Bar-Shai M, Burbea Z, Reznick AZ. Cigarette smoke-induced NF-κB activation in human lymphocytes: the effect of low and high exposure to gas phase of cigarette smoke. J Physiol Pharmacol 2007; 58 Suppl 5:
5 Mroz RM, Noparlik J, Chyczewska E, Braszko JJ, Holownia A. Molecular basis of chronic inflammation in lung diseases: new therapeutic approach. J Physiol Pharmacol 2007; 58 Suppl 5: Agusti AG. Systemic effects of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2: World Health Report. Geneva: World Health Organization. Available from URL: Petty TL. Definition, epidemiology, course, and prognosis of COPD. Clin Cornerstone 2003; 5: Anthonisen NR, Connett JE, Enright PL, Manfreda J. Lung Health Study Research Group. Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med 2002; 166: Vilkman S, Keistinen T, Tuuponen T, Kivela SL. Survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital. Respiration 1997; 64: McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA. Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax 2007; 62: Celli BR, Cote CG, Marin JM, Casanova C et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: Freeborne N, Lynn J, Desbiens NA. Insights about dying from the SUPPORT Project. The study to understand prognoses and preferences for outcomes and risk of treatment. J Am Geriatr Soc 2000; 48 Suppl 5: S199-S van Manen JG, Bindels PJE, Ijzermans CJ, van der Zee JS, Bottema BJAM, Schade E. Prevalence of comorbidity in patients with a chronic airway obstruction and controls over the age of 40. J Clin Epidemiol 2001; 54: Incalzi RA, Fuso L, De Rosa M, et al. Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease. Eur Respir J 1997; 10: Yeo J, Karimova G, Bansal S. Co-morbidity in older patients with COPD - its impact on health service utilization and quality of life, a community study. Age Aging 2006; 35: Received: June 15, 2008 A c c e p t e d: September 1, 2008 Author s address: M. Grabicki, Department of Pulmonology, Allergology and Respiratory Oncology, University of Medical Sciences, Szamarzewskiego 84 St., Poznan, Poland; phone/fax: ; m_vader@o2.pl
JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2008, 59, Suppl 6,
JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2008, 59, Suppl 6, 145 152 www.jpp.krakow.pl B. BRAJER 1, H. BATURA-GABRYEL 1, A. NOWICKA 1, B. KUZNAR-KAMINSKA 1, A. SZCZEPANIK 2 CONCENTRATION OF MATRIX METALLOPROTEINASE-9
More informationYuriy Feschenko, Liudmyla Iashyna, Ksenia Nazarenko and Svitlana Opimakh
2018; 7(1): 74-78 ISSN (E): 2277-7695 ISSN (P): 2349-8242 NAAS Rating: 5.03 TPI 2018; 7(1): 74-78 2018 TPI www.thepharmajournal.com Received: 11-11-2017 Accepted: 12-12-2017 Yuriy Feschenko Liudmyla Iashyna
More informationDoes the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD?
AUTHOR COPY ORIGINAL RESEARCH Does the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD? Kian-Chung Ong 1 Suat-Jin Lu 1 Cindy Seok-Chin Soh 2 1 Department
More information2/4/2019. GOLD Objectives. GOLD 2019 Report: Chapters
GOLD Objectives To provide a non biased review of the current evidence for the assessment, diagnosis and treatment of patients with COPD. To highlight short term and long term treatment objectives organized
More informationTORCH: Salmeterol and Fluticasone Propionate and Survival in COPD
TORCH: and Propionate and Survival in COPD April 19, 2007 Justin Lee Pharmacy Resident University Health Network Outline Overview of COPD Pathophysiology Pharmacological Treatment Overview of the TORCH
More informationCo-morbidity in older patients with COPD its impact on health service utilisation and quality of life, a community study
Co-morbidity in older patients with COPD Age and Ageing 2006; 35: 33 37 doi:10.1093/ageing/afj002 The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All
More informationThis is a cross-sectional analysis of the National Health and Nutrition Examination
SUPPLEMENTAL METHODS Study Design and Setting This is a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2007-2008, 2009-2010, and 2011-2012. The NHANES is
More informationBode index as a predictor of severity in patients with chronic obstructive pulmonary disease.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 5 Ver. VII (May. 2016), PP 93-100 www.iosrjournals.org Bode index as a predictor of severity
More informationCost of Non-Respiratory Drugs in Copd
Cost of Non-Respiratory Drugs in Copd Alida Sina PhD Student, Health Insurance Institute, Tirana, Albania E-mail: alida_sina@yahoo.com Zamira Shabani University of Shkoder Luigj Gurakuqi, Sheshi 2 Prilli,
More informationHealth-related quality of life is associated with COPD severity: a comparison between the GOLD staging and the BODE index
Chronic Respiratory Disease 2009; 6: 75 80 http://crd.sagepub.com ORIGINAL PAPER Health-related quality of life is associated with COPD severity: a comparison between the GOLD staging and the BODE index
More informationexacerbation has greater impact on functional status than frequency of exacerbation episodes.
Original Article Singapore Med J 2011, 52(12) 894 Changes in the BODE index, exacerbation duration and hospitalisation in a cohort of COPD patients Bu X N, Yang T, Thompson M A, Hutchinson A F, Irving
More informationLife-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton
Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary
More informationSydney, AUSTRALIA Beijing, CHINA Hyderabad, INDIA Oxford, UK. Affiliated with
Sydney, AUSTRALIA Beijing, CHINA Hyderabad, INDIA Oxford, UK Affiliated with COPD and Comorbidities Norbert Berend Professor Emeritus University of Sydney Head, Respiratory Research The George Institute
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationCOPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases
COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases «If you test one smoker with cough every day You will diagnose
More informationOPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING 10/16/2018 DISCLOSURES I have no financial or other disclosures
OPTIMIZING MANAGEMENT OF COPD IN THE PRACTICE SETTING J. Michael Fuller, MD, MEd, FACP, FCCP Associate Professor of Medicine University of South Carolina Greenville DISCLOSURES I have no financial or other
More informationChronic Obstructive Pulmonary Disease (COPD) Comorbidities Network
Chronic Obstructive Pulmonary Disease (COPD) Comorbidities Network Miguel J. Divo MD, Ciro Casanova MD, Jose M. Marin MD, Victor M. Pinto-Plata MD, Juan P. de-torres MD, Javier Zulueta MD, Carlos Cabrera
More informationDirect and indirect CV effects of current drugs and those in development
Direct and indirect CV effects of current drugs and those in development Heribert Staudinger CSRC MARCH 201 Cardiac Manifestations of COPD Cardiovascular Disease is probably the most frequent and most
More informationCOPD Bronchiectasis Overlap Syndrome.
COPD Bronchiectasis Overlap Syndrome. John R Hurst 1, J Stuart Elborn 2, and Anthony De Soyza 3 on Behalf of the BRONCH-UK Consortium (D Bilton, J Bradley, JS Brown, J Duckers, F Copeland, A Floto, J Foweraker,
More informationEpidemiology of COPD Prof. David M. Mannino, M.D.
Epidemiology of COPD David M. Mannino, M.D. Professor Department of Preventive Medicine and Environmental Health College of Public Health University of Kentucky 1 Outline Definitions Severity Progression
More informationReduced lung function in midlife and cognitive impairment in the elderly
Page 1 of 5 Reduced lung function in midlife and cognitive impairment in the elderly Giuseppe Verlato, M.D. Ph.D Department of Diagnostics and Public Health University of Verona Verona, Italy Mario Olivieri,
More informationDisclosure and Conflict of Interest 8/15/2017. Pharmacist Objectives. At the conclusion of this program, the pharmacist will be able to:
Digging for GOLD Rebecca Young, PharmD, BCACP, Roosevelt University College of Pharmacy Assistant Professor of Clinical Sciences Practice Site Advocate Medical Group-Nesset Pavilion Disclosure and Conflict
More informationDecramer 2014 a &b [21]
Buhl 2015 [19] Celli 2014 [20] Decramer 2014 a &b [21] D Urzo 2014 [22] Maleki-Yazdi 2014 [23] Inclusion criteria: Diagnosis of chronic obstructive pulmonary disease; 40 years of age or older; Relatively
More informationAsthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research
Asthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research Concord Hospital Woolcock Institute of Medical Research Joe has asthma What
More informationIndication: Treatment: Objectives: Primary Outcome/Efficacy Variable: Secondary Outcome/Efficacy Variable(s): Statistical Methods:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationรศ. นพ. ว ชรา บ ญสว สด M.D., Ph.D. ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยขอนแก น
รศ. นพ. ว ชรา บ ญสว สด M.D., Ph.D. ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยขอนแก น COPD Guideline Changing concept in COPD management Evidences that we can offer COPD patients better life COPD Guidelines
More informationUMEC/VI vs. UMEC in subjects who responded to UMEC UMEC/VI vs. VI in subjects who responded to VI
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationDepression, anxiety and health status after hospitalisation for COPD: A multicentre study in the Nordic countries
Respiratory Medicine (2006) 100, 87 93 Depression, anxiety and health status after hospitalisation for COPD: A multicentre study in the Nordic countries Gunnar Gudmundsson a,, Thorarinn Gislason a, Christer
More informationCourse Handouts & Disclosure
COPD: Disease Trajectory and Hospice Eligibility Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Hospice Education Network Course Handouts & Disclosure To download presentation
More informationClinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene
Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene Emily S. Wan, John E. Hokanson, James R. Murphy, Elizabeth A. Regan, Barry J. Make, David A. Lynch, James D. Crapo, Edwin K.
More informationN.G. Gorovenko, G.Y. Stupnytska, S.V. Podolskaya
2014; 3(8): 10-14 ISSN: 2277-7695 TPI 2014; 3(8): 10-14 2013 TPI www.thepharmajournal.com Received: 19-08-2014 Accepted: 26-09-2014 N.G. Gorovenko (a)department of Genetic Diagnosis, State Institute of
More informationCoexistence of confirmed obstruction in spirometry and restriction in body plethysmography, e.g.: COPD + pulmonary fibrosis
Volumes: IRV inspiratory reserve volume Vt tidal volume ERV expiratory reserve volume RV residual volume Marcin Grabicki Department of Pulmonology, Allergology and Respiratory Oncology Poznań University
More informationThe impacts of cognitive impairment on acute exacerbations of chronic obstructive pulmonary disease
The impacts of cognitive impairment on acute exacerbations of chronic obstructive pulmonary disease Dr. Lo Iek Long Department of Respiratory Medicine C.H.C.S.J. Chronic Obstructive Pulmonary Disease (COPD)
More informationChronic obstructive pulmonary disease in over 16s: diagnosis and management
National Institute for Health and Care Excellence Final Chronic obstructive pulmonary disease in over 16s: diagnosis and management [D] Diagnosing COPD and predicting outcomes NICE guideline NG115 Evidence
More informationAsma, BPCO ed Esercizio Fisico Ferrara, 6 e 7 Novembre Overlap asma BPCO. Dr. Marco Contoli
Asma, BPCO ed Esercizio Fisico Ferrara, 6 e 7 Novembre 2015 Overlap asma BPCO Dr. Marco Contoli Sezione di Medicina Interna e Cardio-Respiratoria Dipartimento di Scienze Mediche Università di Ferrara (Sept.
More informationComorbidities in chronic obstructive pulmonary disease: Results of a national multicenter research project
Original papers Comorbidities in chronic obstructive pulmonary disease: Results of a national multicenter research project Renata Rubinsztajn 1,A F, Tadeusz Przybyłowski 1,A F, Marcin Grabicki 2,A,B,E,
More informationDIAGNOSTIC NOTE TEMPLATE
DIAGNOSTIC NOTE TEMPLATE SOAP NOTE TEMPLATE WHEN CONSIDERING A DIAGNOSIS OF IDIOPATHIC PULMONARY FIBROSIS (IPF) CHIEF COMPLAINT HISTORY OF PRESENT ILLNESS Consider IPF as possible diagnosis if any of the
More informationCOPD-Related Musculoskeletal Disease. Jessica Bon Field, MD, MS 2017 Update in Internal Medicine October 20, 2017
COPD-Related Musculoskeletal Disease Jessica Bon Field, MD, MS 2017 Update in Internal Medicine October 20, 2017 A 60-year old man with COPD comes into your office for a routine office visit. He is a former
More informationMood disorders in elderly patients hospitalized for acute exacerbation of COPD
7;5:7 Original investigation Mood disorders in elderly patients hospitalized for acute exacerbation of COPD I. Bonfitto, G. Moniello, M. Pascucci, A. D Urso, A. Trecca, M.D. Zanasi, A. Bellomo Department
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationUpdate on heterogeneity of COPD, evaluation of COPD severity and exacerbation
Update on heterogeneity of COPD, evaluation of COPD severity and exacerbation Yung-Yang Liu, MD Taipei Veterans General Hospital Aug 29, 2015 G O lobal Initiative for Chronic bstructive L D ung isease
More informationCOPD. Breathing Made Easier
COPD Breathing Made Easier Catherine E. Cooke, PharmD, BCPS, PAHM Independent Consultant, PosiHleath Clinical Associate Professor, University of Maryland School of Pharmacy This program has been brought
More informationCOPD: Preventable and Treatable. Lecture Outline. Diagnosis of COPD. COPD: Defining Terms
COPD: Preventable and Treatable Christopher H. Fanta, M.D. Partners Asthma Center Pulmonary and Critical Care Division Brigham and Women s Hospital Harvard Medical School Lecture Outline I. Diagnosis and
More informationResearch in Real Life
Research in Real Life Study 1: Exploratory study - identifying the benefits of pmdi versus Diskus for delivering fluticasone/salmeterol combination therapy in patients with chronic obstructive pulmonary
More informationPrognostic evaluation of COPD patients: GOLD 2011 versus BODE and the COPD comorbidity index COTE
For numbered affiliations see end of article. Correspondence to Dr Juan P de Torres, Pulmonary Department, Clínica Universidad de Navarra, Avda Pio XII, 36, Pamplona 31200, Spain; jpdetorres@unav.es Received
More informationSupplementary Online Content
Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published
More informationCOPD Management in LTC: Presented By: Jessica Denney RRT
COPD Management in LTC: Presented By: Jessica Denney RRT Sponsored by Z & D Medical Services, Diamond Sponsor Seizing Opportunities to Provide Individualized Treatment and Device Selection for your COPD
More informationEvaluation of efficacy and utility of spirometry data in elderly
International Journal of Advances in Medicine http://www.ijmedicine.com pissn 2349-3925 eissn 2349-3933 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3933.ijam20185109 Evaluation of efficacy
More informationCOMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP)
European Medicines Agency Pre-Authorisation Evaluation of Medicines for Human Use London, 19 February 2009 Doc. Ref. EMEA/CHMP/EWP/8197/2009 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) CONCEPT
More informationDifferential diagnosis
Differential diagnosis The onset of COPD is insidious. Pathological changes may begin years before symptoms appear. The major differential diagnosis is asthma, and in some cases, a clear distinction between
More informationDIABETES MELLITUS TYPE 2 IN HOSPITALIZED COPD PATIENTS
Доклади на Българската академия на науките Comptes rendus de l Académie bulgare des Sciences Tome 68, No 8, 2015 MEDECINE Médecine clinique DIABETES MELLITUS TYPE 2 IN HOSPITALIZED COPD PATIENTS Evgeni
More informationTurning Science into Real Life Roflumilast in Clinical Practice. Roland Buhl Pulmonary Department Mainz University Hospital
Turning Science into Real Life Roflumilast in Clinical Practice Roland Buhl Pulmonary Department Mainz University Hospital Therapy at each stage of COPD I: Mild II: Moderate III: Severe IV: Very severe
More informationRESPIRATORY CARE IN GENERAL PRACTICE
RESPIRATORY CARE IN GENERAL PRACTICE Definitions of Asthma and COPD Asthma is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they
More informationPulmonary Pathophysiology
Pulmonary Pathophysiology 1 Reduction of Pulmonary Function 1. Inadequate blood flow to the lungs hypoperfusion 2. Inadequate air flow to the alveoli - hypoventilation 2 Signs and Symptoms of Pulmonary
More informationAvailable online at Scholars Research Library
Available online at www.scholarsresearchlibrary.com Annals of Biological Research, 2010, 1 (4) : 248-253 (http://scholarsresearchlibrary.com/archive.html) ISSN 0976-1233 CODEN (USA): ABRNBW A study on
More informationPrevalence of undetected persistent airflow obstruction in male smokers years old
2 Prevalence of undetected persistent airflow obstruction in male smokers 40-65 years old Geijer RMM Sachs APE Hoes AW Salomé PL Lammers J-WJ Verheij TJM Published in: Family Practice 2005;22:485-489 Abstract
More informationCOPD UPDATE ıdr Shitrit David ıhead of the Pulmonary Department ımeir Medical Center
COPD UPDATE 2012 ıdr Shitrit David ıhead of the Pulmonary Department ımeir Medical Center Definition of COPD COPD is a preventable and treatable disease with some significant extra pulmonary effects that
More informationDefining COPD. Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist
Defining COPD Georgina Grantham Community Respiratory Team Leader/ Respiratory Nurse Specialist Defining COPD Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease
More informationChronic Obstructive Pulmonary Disease (COPD) Measures Document
Chronic Obstructive Pulmonary Disease (COPD) Measures Document COPD Version: 3 - covering patients discharged between 01/10/2017 and present. Programme Lead: Jo Higgins Clinical Lead: Dr Paul Albert Number
More informationCenter for Respiratory and Sleep Medicine COPD Chronic Disease Management Program
Center for Respiratory and Sleep Medicine COPD Chronic Disease Management Program Cristina Ashworth, NP Khalil Diab,MD Center for Respiratory and Sleep Medicine Subgroup of Indiana Internal Medicine Consultants
More informationTHE PHARMA INNOVATION - JOURNAL Clinical Characteristics of Chronic Obstructive Pulmonary Disease
Received: 09012014 Accepted: 30032014 ISSN: 2277 7695 CODEN Code: PIHNBQ ZDBNumber: 26630382 IC Journal No: 7725 Vol. 3 No. 2. 2014 Online Available at www.thepharmajournal.com THE PHARMA INNOVATION JOURNAL
More informationCigarette Smoking and Lung Obstruction Among Adults Aged 40 79: United States,
NCHS Data Brief No. 8 January 25 Cigarette Smoking and Lung Obstruction Among Adults Aged 4 79: United States, 27 22 Ryne Paulose-Ram, Ph.D., M.A.; Timothy Tilert, B.S.; Charles F. Dillon, M.D., Ph.D.;
More informationSurvey on Chronic Respiratory Diseases at the PrimaryHealth Care Level
Survey on Chronic Respiratory Diseases at the PrimaryHealth Care Level Nikolai Khaltaev MD, PhD GARD General Meeting Istanbul, Turkey, 30-31 May 2008 Burden of major respiratory diseases Respiratory diseases
More informationD ue to the irreversible nature of chronic obstructive pulmonary
412 ORIGINAL ARTICLE Risk of depression in patients with chronic obstructive pulmonary disease and its determinants J G van Manen, PJEBindels, F W Dekker, C J IJzermans, J S van der Zee, E Schadé... See
More informationChronic obstructive pulmonary disease in over 16s: diagnosis and management
National Institute for Health and Care Excellence Draft for consultation Chronic obstructive pulmonary disease in over 16s: diagnosis and management [D] Diagnosing COPD and predicting outcomes NICE guideline
More informationChronic Obstructive Pulmonary Disease (COPD) Clinical Guideline
Chronic Obstructive Pulmonary Disease (COPD) Clinical These clinical guidelines are designed to assist clinicians by providing an analytical framework for the evaluation and treatment of patients. They
More informationChronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease 07 Contributor Dr David Tan Hsien Yung Definition, Diagnosis and Risk Factors for (COPD) Differential Diagnoses Goals of Management Management of COPD THERAPY AT EACH
More informationThe Changes of Arterial Blood Gases in COPD During Four-year Period
ORIGINAL ARTICLE doi: 10.5455/medarh.2014.68.14-18 The Changes of Arterial Blood Gases in COPD During Four-year Period Vesna Cukic Clinic for pulmonary diseases and TB Podhrastovi, Clinical Centre of Sarajevo
More informationInternational Journal of Medical and Health Sciences
International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Original article Level of C-Reactive Protein in Stable Chronic Obstructive Pulmonary Disease
More informationCOPD and Asthma Update. April 29 th, 2017 Rachel M Taliercio, DO Staff, Respiratory Institute
COPD and Asthma Update April 29 th, 2017 Rachel M Taliercio, DO Staff, Respiratory Institute What we ll be talking about COPD: diagnosis, management of stable COPD, COPD exacerbations Asthma: diagnosis,
More informationGlobal Strategy for the Diagnosis, Management and Prevention of COPD 2016 Clinical Practice Guideline. MedStar Health
Global Strategy for the Diagnosis, Management and Prevention of COPD 2016 Clinical Practice Guideline MedStar Health These guidelines are provided to assist physicians and other clinicians in making decisions
More informationComparison between Spirometry and BODE Index for Clinical Assessment in Chronic Obstructive Pulmonary Disease Patients
Trends in Medical Research 10 (1): 12-18, 2015 ISSN 1819-3587 / DOI: 10.3923/tmr.2015.12.18 2015 Academic Journals Inc. Comparison between Spirometry and BODE Index for Clinical Assessment in Chronic Obstructive
More informationDouglas W. Mapel MD, MPH, Melissa Roberts PhD
Original Article Spirometry, the St. George s Respiratory Questionnaire, and other clinical measures as predictors of medical costs and COPD exacerbation events in a prospective cohort Douglas W. Mapel
More informationThe Aging Lung. Sidney S. Braman MD FACP FCCP Professor of Medicine Brown University Providence RI
The Aging Lung Sidney S. Braman MD FACP FCCP Professor of Medicine Brown University Providence RI Is the respiratory system of the elderly different when compared to younger age groups? Respiratory Changes
More informationO R I G I N A L A R T I C L E
ORIGINAL ARTICLE C-reactive protein levels are raised in stable Chronic obstructive pulmonary disease patients independent of smoking behavior and biomass exposure Funda Aksu 1, Nermin Çapan 1, Kurtuluş
More informationKian-Chung Ong, FRCP (Edin); Arul Earnest, MSc; and Suat-Jin Lu, MBBS
A Multidimensional Grading System (BODE Index) as Predictor of Hospitalization for COPD* Kian-Chung Ong, FRCP (Edin); Arul Earnest, MSc; and Suat-Jin Lu, MBBS Study objectives: We hypothesized that the
More informationProductivity losses in chronic obstructive pulmonary disease a population-based survey.
Online supplement to Productivity losses in chronic obstructive pulmonary disease a population-based survey. Running head: Productivity losses in COPD. Authors: Marta Erdal, Department of Thoracic Medicine,
More informationAdvances in the management of chronic obstructive lung diseases (COPD) David CL Lam Department of Medicine University of Hong Kong October, 2015
Advances in the management of chronic obstructive lung diseases (COPD) David CL Lam Department of Medicine University of Hong Kong October, 2015 Chronic obstructive pulmonary disease (COPD) COPD in Hong
More informationPulmonary Function Testing The Basics of Interpretation
Pulmonary Function Testing The Basics of Interpretation Jennifer Hale, M.D. Valley Baptist Family Practice Residency Objectives Identify the components of PFTs Describe the indications Develop a stepwise
More informationPulmonary Pearls. Medical Pearls. Case 1: Case 1 (cont.): Case 1: What is the Most Likely Diagnosis? Case 1 (cont.):
Pulmonary Pearls Christopher H. Fanta, MD Pulmonary and Critical Care Division Brigham and Women s Hospital Partners Asthma Center Harvard Medical School Medical Pearls Definition: Medical fact that is
More informationCOPD as a comorbidity of heart failure in elderly patients
COPD as a comorbidity of heart failure in elderly patients Professor Mitja Lainscak, MD, PhD, FESC, FHFA Departments of Cardiology and Research&Education, General Hospital Celje Faculty of Medicine, University
More informationPulmonary Rehabilitation in Chronic Lung Disease; Components and Organization. Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept.
Pulmonary Rehabilitation in Chronic Lung Disease; Components and Organization Prof. Dr. Müzeyyen Erk Cerrahpaşa Medical Faculty Chest Disease Dept. Plan Chronic Respiratory Disease Definition Factors Contributing
More informationWhat s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university
What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university Management stable COPD Relieve symptoms Improve exercise tolerance Improve health status Prevent
More informationPre-op Clinical Triad - Pulmonary. Sammy Pedram, MD FCCP Assistant Professor of Medicine Pulmonary & Critical Care Medicine March 16, 2018
Pre-op Clinical Triad - Pulmonary Sammy Pedram, MD FCCP Assistant Professor of Medicine Pulmonary & Critical Care Medicine March 16, 2018 Disclosures none Case Mr. G is a 64 year-old man who presents to
More informationUNDERSTANDING COPD MEDIA BACKGROUNDER
UNDERSTANDING COPD MEDIA BACKGROUNDER What is COPD? Chronic Obstructive Pulmonary Disease (COPD) also called emphysema and/or chronic obstructive bronchitis* is a preventable lung disease caused by the
More informationASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss?
ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? Randall W. Brown, MD MPH AE-C Association of Asthma Educators Annual Conference July 20, 2018 Phoenix, Arizona FACULTY/DISCLOSURES Randall Brown,
More informationABF and Implications for Coding Helen Nolan
ABF and Implications for Coding Helen Nolan 11 th May 2017 1 ABF explained What is ABF What are DRGs What are MDCs 2 What is Activity Based Funding (ABF) ABF is a way of funding hospitals for the number
More informationAnalysis of nutritional status disturbances in patients with chronic obstructive pulmonary disease
ORIGINAL ARTICLE Barbara Kuźnar-Kamińska 1, Halina Batura-Gabryel 1, Beata Brajer 1, Jacek Kamiński 2 1 Department of Pulmonology, Allergology and Respiratory Oncology, Poznań University of Medical Sciences,
More informationChronic obstructive pulmonary disease
0 Chronic obstructive pulmonary disease Implementing NICE guidance June 2010 NICE clinical guideline 101 What this presentation covers Background Scope Key priorities for implementation Discussion Find
More informationPrevalence of anemia in patients with chronic obstructive pulmonary disease
Original Article 1. Marzieh Nojomi, MD, MPH. Professor of Community Medicine, Fellow, Clinical Epidemiology, Department of Community Medicine, School of Medicine, 2. Arash Ehteshami Afshar, MD, 3. Amin
More informationJMSCR Vol 05 Issue 03 Page March 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i3.173 A Study on BODE Index as a Predictor
More informationCOPD. Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS
IN THE NAME OF GOD COPD Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS Definition of COPD* COPD is a preventable and treatable chronic lung disease characterized by airflow limitation that is not fully
More informationChronic Systemic Inflammatory Syndrome in patients with AECOPD presenting to Emergency Department
European Review for Medical and Pharmacological Sciences Chronic Systemic Inflammatory Syndrome in patients with AECOPD presenting to Emergency Department O. PIRAS, F. TRAVAGLINO, A. AUTUNNO, E. BRESCIANI*,
More informationHQO s Episode of Care for Chronic Obstructive Pulmonary Disease
HQO s Episode of Care for Chronic Obstructive Pulmonary Disease Dr. Chaim Bell, MD PhD FRCPC Ontario Hospital Association Webcast October 23, 2013 Objectives 1. Describe the rationale and methodology for
More informationHow to treat COPD? What is the mechanism of dyspnea? Smoking cessation
: The Increasing Role of the FP Alan Kaplan, MD, CCFP(EM) Presented at the Primary Care Today: Education Conference and Medical Exposition, Toronto, Ontario, May 2006. Chronic obstructive pulmonary disease
More informationDisclosures. Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease May 14, 2016 Orlando, FL COPD (Chronic obstructive pulmonary disease) is a major cause of mortality and morbidity in the United States. Alarmingly, COPD recently became
More informationThe study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationThe Relationship among COPD Severity, Inhaled Corticosteroid Use, and the Risk of Pneumonia.
The Relationship among COPD Severity, Inhaled Corticosteroid Use, and the Risk of Pneumonia. Rennard, Stephen I; Sin, Donald D; Tashkin, Donald P; Calverley, Peter M; Radner, Finn Published in: Annals
More informationThree s Company - The role of triple therapy in chronic obstructive pulmonary disease (COPD)
Three s Company - The role of triple therapy in chronic obstructive pulmonary disease (COPD) Zahava Picado, PharmD PGY1 Pharmacy Practice Resident Central Texas Veterans Healthcare System Temple, TX October
More information