scholarly journals Host-Pathogen Interaction during Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 72 (2) ◽  
pp. 818-823 ◽  
Author(s):  
Debby Bogaert ◽  
Paul van der Valk ◽  
Reshmi Ramdin ◽  
Marcel Sluijter ◽  
Evelyn Monninkhof ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Antibody Titers ◽  
Pneumococcal Colonization ◽  
Exacerbation Of Copd

ABSTRACT Acute exacerbation is a frequent complication of chronic obstructive pulmonary disease (COPD). Recent studies suggested a role for bacteria such as Streptococcus pneumoniae in the development of acute exacerbation. For this study, we investigated the following in COPD patients: (i) the epidemiology of pneumococcal colonization and infection, (ii) the effect of pneumococcal colonization on the development of exacerbation, and (iii) the immunological response against S. pneumoniae. We cultured sputa of 269 COPD patients during a stable state and during exacerbation of COPD and characterized 115 pneumococcal isolates by use of serotyping. Moreover, we studied serum immunoglobulin G (IgG) antibody titers, antibody avidities, and functional antibody titers against the seven conjugate vaccine serotypes in these patients. Colonization with only pneumococci (monocultures) increased the risk of exacerbation, with a hazard ratio of 2.93 (95% confidence interval, 1.41 to 6.07). The most prevalent pneumococcal serotypes found were serotypes 19F, 3, 14, 9L/N/V, 23A/B, and 11. We calculated the theoretical coverage for the 7- and 11-valent pneumococcal vaccines to be 60 and 73%, respectively. All patients had detectable IgG levels against the seven conjugate vaccine serotypes. These antibody titers were significantly lower than those in vaccinated healthy adults. Finally, on average, a 2.5-fold rise in serotype-specific and functional antibodies in S. pneumoniae-positive sputum cultures was observed during exacerbation. Our data indicate that pneumococcal colonization in COPD patients is frequently caused by vaccine serotype strains. Moreover, pneumococcal colonization is a risk factor for exacerbation of COPD. Finally, our findings demonstrate that COPD patients are able to mount a significant immune response to pneumococcal infection. COPD patients may therefore benefit from pneumococcal vaccination.

Serum Electrolyte in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 13 (1) ◽  
pp. 9-13
Author(s):  
Chandra Prasad Acharya ◽  
Kalpana Paudel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Serum Electrolyte ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Electrolyte Disorder ◽  
The Mean ◽  
Exacerbation Of Copd

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity worldwide. Though COPD is mainly a chronic disease, many patients experience exacerbations that are related to worst survival outcome, especially with abnormal serum electrolyte level. The objective of this study was to evaluate serum electrolyte levels among the patients with acute exacerbation of COPD. Methods: Structured questionnaire and patients’ charts were used to collect data. Data was analyzed using Statistical Package for the Social Sciences (SPSS) software version 16.0 and descriptive statistics were used to generate the research findings. Results: The mean age of the patients with Acute exacerbation of COPD was 69.57± 9.765 years. Among 100 patients, (83%) belonged to the age group of 60 years and above, (54%) were male, (74%) were married, (52%) were illiterate and (41%) were engaged in agriculture, (41%) consumed alcohol and (67%) were smokers. Dyspnoea (90%) was the most common symptom. The mean level of sodium and potassium were 133.8±4.830 mEq/L, 3.6±0.533 mmol/L, respectively. Fifty seven percent patients had electrolyte disorder. More than half (51%) had hyponatremia and (40%) had hypokalemia. The average value of pH, PaCO2 and PaO2 are 7.34 ± 0.727, 46.64 ± 9.787 mm Hg and 69.38 ± 9.255 mm Hg respectively. Among them, (18%) were in respiratory failure. Conclusion: This study concluded that hyponatremia and hypokalemia are prevalent electrolyte disorder with AE of COPD patients. Therefore, we recommend routine monitoring of the serum electrolytes for better outcomes of patients.

scholarly journals The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Xuanqi Liu ◽  
Haiyan Ge ◽  
Xiumin Feng ◽  
Jingqing Hang ◽  
Fengying Zhang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Calibration Curve ◽  
Roc Curve ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Copd Patients ◽  
Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients.Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet–lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve.Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients.Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.

scholarly journals Possibilities to prevent acute exacerbation of chronic obstructive pulmonary disease using inhalational therapy. A Report of Expert Panel of Russian Respiratory Society

2018 ◽  
Vol 28 (3) ◽  
pp. 368-380 ◽  
Author(s):  
S. N. Avdeev ◽  
A. S. Belevskiy ◽  
Z. R. Aisanov ◽  
V. V. Arkhipov ◽  
I. V. Leshchenko ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinically Significant ◽  
Long Acting ◽  
Exacerbation Of Copd ◽  
Inhalational Therapy

An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD. 

scholarly journals Chronic obstructive pulmonary disease patients electronic register analysis: the effectiveness of patient’s dynamic follow up and evaluation of treatment program

2019 ◽  
Vol 91 (1) ◽  
pp. 78-83
Author(s):  
V Ju Mishlanov ◽  
I V Shubin ◽  
K N Bekker ◽  
A V Katkova ◽  
E P Koshurnikova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Inhaled Corticosteroid ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Register Analysis ◽  
Long Acting

In the last few years new informatics methods were implemented in medicine and allowed to create big data including individual clinical markers of every patient. It is suggested that clinical electronic patient’s register analysis will present accurate information about different treatment programs effectiveness, including those whose effectiveness is not still proved today. The aim of the study. To estimate the effectiveness of clinical patients register implementation as well as to analyze different treatment and prophylactic programs on chronic obstructive pulmonary disease (COPD) patients’ structure. Materials and methods. The COPD patient’s register consists of 4257 cases. Spirometrical data were evaluated. Dynamic follow was performed on 567 COPD patients. Bronchodilator’s therapy was estimated as well as combined inhaled corticosteroid/ long acting β2-agonist medications and vaccination against pneumococcal infection. Results. Computer program “Electronic polyclinic” proposed by the authors of this article is effective in precision of diagnostic decision making in cohort study, dynamic follow up after clinical symptoms, evaluation of instrumental and laboratory results, prophylactics and treatment effectiveness, “clinical patients registers” automatic formation using syndrome or nosological principle, checking the COPD patients in the group of those with bronchial obstruction. Conclusion. Positive effects of long-acting bronchodilator treatment on COPD exacerbation decreasing and more expressed effect of inhaled corticosteroid/ long acting β2-agonists were confirmed. More interesting result was influence of vaccination against pneumococcal infection PCV13 (polyvalent conjugated vaccine) on exacerbation frequency and dyspnea severity.

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

Pilot Study to Assess the Credibility of Acupuncture in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

2009 ◽  
Vol 27 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Claudia A Whale ◽  
Sarah J A MacLaran ◽  
Christopher I Whale ◽  
Mandy Barnett
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pilot Study ◽  
Visual Analogue Scale ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Analogue Scale ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Background Exacerbation of chronic obstructive pulmonary disease (COPD) is a common reason for hospital admission, and adjunctive non-pharmacological treatments would be welcomed. A pilot study was undertaken to assess the feasibility of conducting a study of acupuncture during an acute exacerbation of COPD. We also examined the credibility of a sham device in this setting and assessed the effect of acupuncture on breathlessness and anxiety. Methods A prospective, randomised, patient- and assessor-blinded, sham controlled study was conducted on three consecutive days in a district general hospital. Credibility of both acupuncture and the Park sham device were assessed using the Borkovec and Nau questionnaire. Dyspnoea was measured on the modified Borg score and a 10 cm visual analogue scale, while anxiety was measured on a 10 cm visual analogue scale. Results 11 patients were recruited and nine completed the study. There were no adverse events with either intervention. Acupuncture was well tolerated and credibility scores were similar before and after real and sham acupuncture. Symptoms improved after both treatments, with no significant difference between groups. Conclusion In this pilot study acupuncture was well tolerated by subjects experiencing an acute exacerbation of COPD. Acupuncture treatment and the Park sham device were both credible. Although recruitment was slow, a further trial with a larger sample size is feasible and recommended.

scholarly journals The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

scholarly journals Associations Between Sputum Torque Teno Virus Load and Lung Function and Disease Severity in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yu Xie ◽  
Qing Xue ◽  
Weike Jiao ◽  
Jianhui Wu ◽  
Yan Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Viral Load ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Torque Teno Virus ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Purpose: Viral load of Torque Teno virus (TTV) is elevated in immunosuppressed patients. The weakened immune response is typical in chronic obstructive pulmonary disease (COPD) patients. However, the relationship between TTV and COPD is still unknown.Patients and Methods: We enrolled 91 patients admitted to hospitals with acute exacerbation of COPD (AECOPD) between January 2017 and August 2017 (ClinicalTrials.gov ID, NCT03236480). Sputum samples were gathered during hospitalization and the 120-day follow-up. TTV distribution and genogroups were assessed, and the associations between viral loads and clinical parameters were analyzed.Results: TTV DNA was detected in 95.6% of COPD patients, and the viral load was nearly invariable at the stable and exacerbation states. Most TTV DNA-positive patients carried four distinct genotypes. Sputum load of TTV was positively associated with RV/TLC (r = 0.378, p = 0.030), and negatively correlated with FEV1/pre and FEV1/FVC (r = −0.484, −0.432, p = 0.011, 0.024, respectively). Neutral correlation between the TTV DNA load and COPD assessment test (CAT) scores (r = 0.258, p = 0.018) was observed.Conclusion: Sputum loads of TTV DNA could be a novel indicator for lung function and disease severity assessment in COPD patients.

scholarly journals ANTIBIOTIC THERAPY IN ACUTE EXACERBATION OF COPD:AN OPTIMAL WAY TO SUCCESS

2021 ◽  
Vol 29 (2) ◽  
pp. 35-40
Author(s):  
L. V. Yudina
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Family Practitioner ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Currently, chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Acute exacerbation of the disease is associated with fast clinical deterioration, increased respiratory tract inflammation and lung function disorders. Acute exacerbation of COPD dramatically worsens patient�s prognosis and serves as an important indicator of therapy effectiveness. Family practitioner should recognize this condition and correctly chose proper antibiotic. Diagnosis of COPD exacerbation is based on clinical manifestations of the disease. Depending on presence of primary or secondary symptoms COPD exacerbations are divided into several types. Antibiotic therapy appears to be more beneficial in patients with type 2 or 3 exacerbation. Sputum purulence is considered an obligatory symptom. As a rule, in complicated course of acute exacerbation of COPD protected aminopenicillins or 3rd generation cephalosporins are the firsline antibiotics. In most cases of COPD exacerbation antibiotics are prescribed orally. If first-line antibacterial therapy fails, the respiratory fluoroquinolones (levofloxacin of moxifloxacin) are prescribed. The author, using her own experience with levofloxacin, gives an example of proper choice of antibiotic if such a situation. Successful experience of management of acute exacerbation of COPD may be useful for general practitioners, physicians, pulmonologists. Key words: chronic obstructive pulmonary disease, exacerbation, antibiotic therapy, levofloxacin.

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