Impact of time between diagnosis and treatment for nontuberculous mycobacterial pulmonary disease on culture conversion and all-cause mortality

CHEST Journal ◽  
2021 ◽  
Author(s):  
Yunjoo Im ◽  
Na Young Hwang ◽  
Kyunga Kim ◽  
Hojoong Kim ◽  
O Jung Kwon ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Diagnosis And Treatment ◽  
All Cause Mortality ◽  
Culture Conversion

Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease

Respiration ◽  
2021 ◽  
pp. 1-8
Author(s):  
Clemens F. Hinke ◽  
Rudolf A. Jörres ◽  
Peter Alter ◽  
Robert Bals ◽  
Florian Bornitz ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Predictive Value ◽  
Hemoglobin Concentration ◽  
Blood Gas Analysis ◽  
Study Data ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Acute Exacerbations ◽  
All Cause Mortality

<b><i>Background:</i></b> Oxygenated hemoglobin(OxyHem) is a simple-to-measure marker of oxygen content capable of predicting all-cause mortality in stable chronic obstructive pulmonary disease (COPD). <b><i>Objectives:</i></b> We aimed to analyze its predictive value during acute exacerbations of COPD (AECOPD). <b><i>Methods:</i></b> In this retrospective study, data from 227 patients discharged after severe AECOPD at RoMed Clinical Center Rosenheim, Germany, between January 2012 and March 2018, was analyzed. OxyHem (hemoglobin concentration [Hb] × fractional SpO<sub>2</sub>, g/dL) was calculated from oxygen saturation measured by pulse oximetry and hemoglobin assessed within 24 h after admission. The follow-up (1.7 ± 1.5 years) covered all-cause mortality, including readmissions for severe AECOPD. <b><i>Results:</i></b> During the follow-up period, 127 patients died, 56 due to AECOPD and 71 due to other reasons. Survivors and non-survivors showed differences in age, FVC % predicted, C-reactive protein, hemoglobin, Cr, Charlson Comorbidity Index (CCI), and OxyHem (<i>p</i> &#x3c; 0.05 each). Significant independent predictors of survival were BMI, Cr or CCI, FEV<sub>1</sub> % predicted or FVC % predicted, Hb, or OxyHem. The predictive value of OxyHem (<i>p</i> = 0.006) was superior to that of Hb or SpO<sub>2</sub> and independent of oxygen supply during blood gas analysis. OxyHem was also predictive when using a cutoff value of 12.1 g/dL identified via receiver operating characteristic curves in analyses including either the CCI (hazard ratio 1.85; 95% CI 1.20, 2.84; <i>p</i> = 0.005) or Cr (2.04; 95% CI 1.35, 3.10; <i>p</i> = 0.001) as covariates. <b><i>Conclusion:</i></b> The concentration of OxyHem provides independent, easy-to-assess information on long-term mortality risk in COPD, even if measured during acute exacerbations. It therefore seems worth to be considered for broader clinical use.

scholarly journals Impact of susceptibility to injectable antibiotics on the treatment outcomes of Mycobacterium abscessus pulmonary disease

2021 ◽  
Author(s):  
Youngmok Park ◽  
Yea Eun Park ◽  
Byung Woo Jhun ◽  
Jimyung Park ◽  
Nakwon Kwak ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Pulmonary Disease ◽  
Drug Susceptibility ◽  
Mycobacterium Abscessus ◽  
Beta Lactams ◽  
In Vitro Susceptibility ◽  
Referral Hospitals ◽  
Microbiological Cure ◽  
Culture Conversion

Abstract Objectives Current guidelines recommend a susceptibility-based regimen for Mycobacterium abscessus subspecies abscessus pulmonary disease (MAB-PD), but the evidence is weak. We aimed to investigate the association between treatment outcomes and in vitro drug susceptibility to injectable antibiotics in MAB-PD patients. Methods We enrolled MAB-PD patients treated with intravenous amikacin and beta-lactams for ≥4 weeks at four referral hospitals in Seoul, South Korea. Culture conversion and microbiological cure at one year were evaluated based on susceptibility to injectable antibiotics among patients treated with those antibiotics for ≥ 2 weeks. Results A total of 82 patients were analysed. The mean age was 58.7 years, and 65.9% were women. Sputum culture conversion and microbiological cure were achieved in 52.4% and 41.5% of patients, respectively. Amikacin was the most common agent to which the M. abscessus subspecies abscessus isolates were susceptible (81.7%); 9.8% and 24.0% of the isolates were resistant to cefoxitin and imipenem, respectively. The clarithromycin-inducible resistance (IR) group (n = 65) had a lower microbiological cure rate than the clarithromycin-susceptible group (35.4% vs. 64.7%). The treatment outcomes appeared to be similar regardless of in vitro susceptibility results with regard to intravenous amikacin, cefoxitin, imipenem, and moxifloxacin. In the subgroup analysis of the clarithromycin-IR group, the treatment outcomes did not differ according to antibiotic susceptibility. Conclusions We did not find evidence supporting the use of susceptibility-based treatment with intravenous amikacin and beta-lactams in patients with MAB-PD. Further research would be required.

scholarly journals Chronic obstructive pulmonary disease in heart failure: accurate diagnosis and treatment

2014 ◽  
Vol 16 (12) ◽  
pp. 1273-1282 ◽  
Author(s):  
Gülmisal Güder ◽  
Susanne Brenner ◽  
Stefan Störk ◽  
Arno Hoes ◽  
Frans H. Rutten
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Accurate Diagnosis ◽  
Diagnosis And Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Platypnea: оne more type position shortness of breath

2020 ◽  
Vol 92 (3) ◽  
pp. 92-97
Author(s):  
L. I. Dvoretskiy ◽  
V. V. Rezvan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Liver Diseases ◽  
Hepatopulmonary Syndrome ◽  
Diagnosis And Treatment ◽  
Chronic Obstructive ◽  
Shortness Of Breath ◽  
Severe Liver ◽  
Obstructive Pulmonary Disease ◽  
Cardiac Pathology

The article presents modern data on the causes of platypnea, methods of its diagnosis and treatment. The data on the development of platypnea syndrome are given not only in cardiac pathology, but also in severe liver diseases with the development of hepatopulmonary syndrome and chronic obstructive pulmonary disease of a severe course.

Point-of-Care COPD Diagnostics: Biomarkers, Sampling, Paper-based Analytical Devices, and Perspectives

The Analyst ◽  
2022 ◽  
Author(s):  
Guozhen He ◽  
Tao Dong ◽  
Zhaochu Yang ◽  
Are Branstad ◽  
Lan Huang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Early Diagnosis ◽  
Pulmonary Disease ◽  
Economic Burden ◽  
Point Of Care ◽  
Diagnosis And Treatment ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
The Third

Chronic Obstructive pulmonary disease (COPD) has become the third leading causes of global death. Insufficiency in early-diagnosis and treatment of COPD, especially COPD exacerbation, leads to tremendous economic burden and...

Sign in / Sign up

Export Citation Format

Share Document