scholarly journals Eosinophilia and fractional exhaled nitric oxide levels in chronic obstructive lung disease

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-214644
Author(s):  
Srinadh Annangi ◽  
Snigdha Nutalapati ◽  
Jamie Sturgill ◽  
Eric Flenaugh ◽  
Marilyn Foreman
Keyword(s):  
Surrogate Marker ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
P Value ◽  
Eosinophilic Inflammation ◽  
Peripheral Eosinophilia ◽  
Health And Nutrition ◽  
Resource Limited ◽  
Receiver Operator Curve Analysis ◽  
History Of

IntroductionCOPD is a heterogeneous disorder with varied phenotypes. We aimed to determine the prevalence of asthma history, peripheral eosinophilia and elevated FeNO levels along with the diagnostic utility of peripheral eosinophilia in identifying airway eosinophilic inflammation.MethodsNational Health and Nutrition Examination Survey data were analysed for the study period 2007–2010. Subjects aged ≥40 years with postbronchodilator FEV1/FVC ratio <0.70 were included. Receiver operator curve analysis was performed for sensitivity analysis. A p value of <0.001 is considered statistically significant.ResultsA total of 3 110 617 weighted COPD cases were identified; predominantly male (64.4%) and non-Hispanic whites (86.1%). Among our COPD subjects, 14.6% had a history of doctor diagnosed asthma, highest among females and other race Americans. The overall prevalence of peripheral eosinophilia is 36%, 38.3% among COPD subjects with asthma history, and 35.6% among COPD without asthma history. The overall prevalence of elevated FeNO ≥25 ppb is 14.3%; 28.7% among COPD subjects with asthma history and 13.0% among COPD without asthma history.DiscussionThe prevalence of FeNO levels ≥25 ppb and peripheral eosinophilia was significantly higher among COPD subjects with asthma compared with COPD without asthma history. Not all COPD subjects with peripheral eosinophilia and elevated FeNO levels have a reported history of asthma. Our study supports clinically phenotyping COPD subjects with eosinophilic inflammation be independent of their asthma history and peripheral eosinophilia can be used as a surrogate marker in resource-limited settings.

scholarly journals High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000848 ◽  
Author(s):  
Andreas Jönsson ◽  
Artur Fedorowski ◽  
Gunnar Engström ◽  
Per Wollmer ◽  
Viktor Hamrefors
Keyword(s):  
Myocardial Ischaemia ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Clinical Factors ◽  
Obstructive Pulmonary Disease ◽  
Presenting Symptoms ◽  
High Prevalence ◽  
History Of ◽  
Artery Disease ◽  
Global Initiative

ObjectiveChronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.MethodsAmong 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.ResultsA total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.ConclusionsAmong middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.

scholarly journals Chronic Obstructive Lung Disease in young: Alpha 1 anti trypsin deficiency

2015 ◽  
Vol 3 (2) ◽  
pp. 65-67
Author(s):  
S.S. Dhakal ◽  
K.K. Agrawaal ◽  
N.K. Bhatta
Keyword(s):  
Bronchial Asthma ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Deficiency ◽  
History Of ◽  
Pulmonary Arterial ◽  
Alpha 1 Antitrypsin

Alpha-1 antitrypsin (AAT) deficiency is a clinically under recognized inherited disorder. The main clinical manifestations relate to three separate organs: the lung, the liver, and the skin. In the lung, severe deficiency of AAT predisposes to chronic obstructive pulmonary disease. We present a case of 34 years male with a history of recurrent chest infections in past and treated in the line of bronchial asthma but not relieved. He was admitted on 22nd May 2011 at BPKIHS. He presented with type 2 respiratory failure and had features of severe pulmonary arterial hypertension and left lower lobe pneumonia. The patient got improved with the treatment and is doing well on follow up. The diagnosis should be strongly suspected in patients with history suggestive of bronchial asthma and with obstructive features.Journal of Advances in Internal Medicine 2014;3(2):65-67

scholarly journals Role of BAP 65 (Blood Urea Nitrogen, Altered Mental Status, Pulse, Age 65 Years) Scoring System in Risk Stratification of Patients with Acute Exacerbation of Chronic Obstructive Lung Disease in Tertiary Care Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 5-10
Author(s):  
Ashish Thapa
Keyword(s):  
Mechanical Ventilation ◽  
Acute Exacerbation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Institutional Review Boards ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
P Value ◽  
Care Hospital

Introduction: Exacerbations are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. COPD AE is one of the commonest case presenting to the TUTH Emergency, average being 5 patients a day. The aim of the study was to co-relate the BAP 65 score, mortality and mechanical ventilation in patients with acute exacerbation of COPD. Methods: It was an observational study, 648 patients from emergency of TUTH were screened for the study from Magh 2073 to Asar 2074 after getting approval from the institutional review boards, among them 114 were included after applying inclusion and exclusion criteria and BAP 65 score was calculated. The patients were followed till discharge, mechanical ventilation or mortality. Data entry was done in MS EXCEL and statistical analysis was done using SPSS version 24. Results: Total of 114 patients enrolled for the study from the emergency of TUTH. There were total 16 mortality and 12 patients were mechanically ventilated. Most of the mortality and mechanical ventilation were from severe group ie BAP class IV and V. We used Pearson Chi-squared test to compare between BAP 65 class and Mortality, and found that mortality rate increased with increasing BAP 65 class with a p value of < 0.0001. The need of Mechanical Ventilation increased as well, as the BAP 65 Class increased, less than 1% of the patients with BAP class I needed MV, the cause being Type II Respiratory Failure, while around 50% of the patients with BAP class V needed MV. Conclusions: BAP 65 score is an effective and simple tool to classify the patients presenting with AECOPD, it correlated well with both the need of mechanical ventilation and mortality. Higher the score higher the chances of severe disease.

scholarly journals Risk factors of bronchial asthma, chronic obstructive lung disease and «OVERLAP» syndrome asthma-COPD among adults in Ekaterinburg

2018 ◽  
Vol 15 (4) ◽  
pp. 26-29
Author(s):  
V C Abdullaev ◽  
E K Beltyukov ◽  
V V Naumova
Keyword(s):  
Risk Factors ◽  
Bronchial Asthma ◽  
Chronic Obstructive Lung Disease ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Actual Risk ◽  
History Of ◽  
Definition Of ◽  
The Impact ◽  
Over 40 Years

Topicality. Prevalence of bronchial asthma (BA) and COPD achieves in different countries 18 and 20% respectively. The prevalence of «OVERLAP» syndrome - ASTHMA/COPD in Russia is unknown. Objective. To determine the prevalence ofBA, COPD and «OVERLAP» syndrome - ASTHMA/COPD. Materials and methods. The study included a survey using a specially developed questionnaire to identify asthma-like symptoms (ALS), risk factors for BA, COPD, and the definition of FEV^ FEV^FVC in adults in Ekaterinburg. Results. The study has revealed that the risk factors for developing ALS are exposure to tobacco smoke and age over 40 years. The impact of allergens and family history of allergy are less significant. Decrease of spirometry indices is associated with smoking, age over 40 years and the presence of ALS. The diagnostic criteria for the «OVERLAP» syndrome - ASTHMA/COPD were developed based on the answers to the questionnaire on ALS, risk factors and the results of the screening spirometry. Conclusions. Preliminary prevalence ofBA, COPD, «OVERLAP» syndrome - ASTHMA/COPD and actual risk factors have been established in Ekaterinburg in 2018. Unfavorable situation with prevalence of smoking in Ekaterinburg has been showing.

Adverse Dermatologic Reaction to Transdermal Nitroglycerin

1984 ◽  
Vol 18 (1) ◽  
pp. 69-70 ◽  
Author(s):  
Peter W. Letendre ◽  
Charles Barr ◽  
Kim Wilkens
Keyword(s):  
Transdermal Delivery ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Adult Onset ◽  
Ulcer Disease ◽  
History Of ◽  
Adult Onset Diabetes ◽  
Transdermal Delivery System

The incidence of adverse effects from transdermal nitroglycerin systems is reported to be very low. A cutaneous reaction from Transderm-Nitro is described. The patient in this case was a 63-year-old male with a history of chronic obstructive lung disease, adult onset diabetes mellitus, peptic ulcer disease, congestive heart failure, and angina pectoris. Seven weeks after having used a Transderm-Nitro-5 patch daily, the patient was found to have two macular erythematous areas on his chest that corresponded to the exact sites of the nitroglycerin patch. Follow-up with the same patient, using a placebo Transderm-Nitro, elicited a reaction similar in appearance. The exact causative agent is unknown, but it is believed to be from the transdermal delivery system and not the nitroglycerin.

La granulomatosi eosinofilica con poliangioite: dalla pelle al cuore

2020 ◽  
Vol 39 (9) ◽  
pp. 569-574
Author(s):  
Matteo Pavan ◽  
Anna Agrusti ◽  
Andrea Trombetta ◽  
Serena Pastore ◽  
Alberto Tommasini ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Immunosuppressive Treatment ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Eosinophilic Inflammation ◽  
Peripheral Eosinophilia ◽  
Churg Strauss Syndrome ◽  
History Of ◽  
Strauss Syndrome ◽  
Eosinophilic Granulomatosis ◽  
Churg Strauss

Key words: Churg-strauss syndrome, Eosinophilic granulomatosis with polyangiitis in childhood, Vasculitis, Asthma, Hypereosinophilia Background - Eosinophilic granulomatosis with polyangiitis, formerly known as Churg-Strauss syndrome, is an extremely rare systemic vasculitis in the paediatric population. The hallmarks of eosinophilic granulomatosis with polyangiitis are a long history of asthma and peripheral eosinophilia with eosinophilic inflammation that may involve several organs. Findings - The paper reports the clinical characteristics, courses, and outcomes of the four patients diagnosed with eosinophilic granulomatosis with polyangiitis at IRCCS Burlo Garofolo (Trieste, Italy) from 1996 to 2015. The mean age at diagnosis was 11.5 years. All the patients presented a history of asthma and peripheral eosinophilia at diagnosis. 3/4 of the children presented upper airway and pulmonary disease. Skin and heart involvement was present in half of the patients, whereas gastrointestinal and neurological symptoms were reported in 25% of the cases. When performed, tissue biopsy revealed eosinophilic inflammation in all the cases. Anti-neutrophil cytoplasmic antibodies were negative in 66% patients. One young child died shortly after presentation, one remitted after immunosuppressive treatment and two patients needed low-dose corticosteroid therapy to maintain the remission. Conclusion - Comparison with an updated review of the series and cases of childhood-onset eosinophilic granulomatosis with polyangiitis reported in the literature showed similar demographic characteristics, clinical features and outcomes. Cardiac disease represents the poorer prognostic factor, leading to the 60% of the deaths reported.

scholarly journals Virus infections and the natural history of chronic obstructive lung disease

Lung ◽  
1970 ◽  
Vol 142 (1) ◽  
pp. 1-6
Author(s):  
W. Klaer ◽  
Bergith Reinert ◽  
F. Trendelenburg ◽  
R. Wigand
Keyword(s):  
Natural History ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Virus Infections ◽  
History Of

scholarly journals Identification of Klebsiella pneumoniae carbapenemase in Sweden

2007 ◽  
Vol 12 (51) ◽  
Author(s):  
K Tegmark-Wisell ◽  
S Hæggman ◽  
L Gezelius ◽  
O Thompson ◽  
I Gustafsson ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Intensive Care Treatment ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
History Of

A Klebsiella pneumoniae expressing carbapenemase type 2 (KPC-2) enzyme has been identified in Sweden. The patient, who had a history of chronic obstructive lung disease, developed a respiratory tract infection while on holiday in Greece. After initial intensive care treatment in Greece, the patient was transferred to Sweden.

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