scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

Asthma ◽  
2014 ◽  
pp. 80-91
Author(s):  
Stephen P. Peters

Patients with fixed airflow obstruction, whether from asthma or chronic obstructive pulmonary disease (COPD), or an overlap phenotype, represent an especially difficult group of patients to both categorize and manage. Many of the current research activities in both asthma and COPD are designed to subclassify patients with asthma and COPD into different endotypes and phenotypes, with the hope that the results will have implications for both the natural history of disease and the response to different therapies. Data outlined in this review, particularly the genetic findings, help strengthen the “Dutch hypothesis” Orie put forth more than 50 years ago about the commonalities of obstructive airways diseases operating under a variety of environmental influences. The identification of targets distinct from inflammation in both asthma and COPD, through different mechanisms—atopy, important in asthma, and smoking, important COPD–could lead to novel treatments for both of these diseases with fixed airflow obstruction. In the meantime, the use of bronchodilators, antiinflammatory agents, and environmental control and intervention, including smoking cessation, weight loss and control, and exercise and pulmonary rehabilitation, remain the foundation of the therapeutic approach for these diseases, regardless of their origin.


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nguefeu Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


2020 ◽  
Vol 15 (2) ◽  
pp. 85-95
Author(s):  
Mohamed Faisal Abdul Hamid ◽  

Pulmonary tuberculosis (PTB) and chronic obstructive pulmonary disease (COPD) are important causes of mortality and morbidity in Malaysia. The number of tuberculosis (TB) cases in Malaysia appears to be increasing and there were 500,000 Malaysians diagnosed with COPD in 2016. A substantial number of PTB patients go on to develop post tubular airway disease. Past infection with TB has been shown to contribute to the aetiology of COPD. We conducted a one year cross-sectional study in outpatient setting involving adult subjects in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with a history of pulmonary tuberculosis three years prior to the study. We excluded subjects with bronchial asthma, COPD, interstitial lung disease and bronchiectasis. Airflow obstruction was defined as FEV1: FVC ratio <0.70. The COPD Assessment Test (CAT) questionnaire was used. Eighty-two subjects were recruited with a median age of 52.5 years (IQR 36-62). Male predominance (56.1%) with 29 (35.4%) smokers. Eighteen (22%) subjects had airflow obstruction. Six (33%) out of these subjects were smokers. Fourteen(17%) had restrictive pattern and 50 (61%) had normal spirometry results. Five subjects (22.22%) had mild obstruction, 7 (44.44%) moderate obstruction, and 6 (33.33%) had severe obstruction. There was a positive correlation between chest X-ray abnormalities and age with airflow obstruction (P<0.05). Abnormal spirometry pattern was found in 39% of subjects. Post TB-COPD incidence was 22% in those who completed TB treatment. There appeared to be an association between abnormal chest radiograph findings with airflow obstruction in subjects with history of PTB.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nguefeu Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco. Results The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nguefeu Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco. Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients.Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


Author(s):  
OJS Admin

Chronic obstructive pulmonary disorder (COPD) is an aggravating and major health concern throughout the world. It is estimated that in upcoming years chronic obstructive pulmonary disease will be rankedas third common reason of mortality and fifth common cause of disablement worldwide.


Author(s):  
Uma Rani Adhikari ◽  
Soma Roy

Chronic obstructive pulmonary disease (COPD) is recently the most common chronic lung disease and presents a serious medical, economic, and social problem for people. A correlational survey research was adopted to identify relationship between quality of life and disease severity among Chronic Obstructive Pulmonary Disease (COPD) clients attending Pulmonary Medicine OPD in a selected hospital, Kolkata with the objectives to assess the quality of life of Chronic Obstructive Pulmonary Disease (COPD) clients and to find out correlation between disease severity and quality of life among Chronic Obstructive Pulmonary Disease (COPD) clients. Purposive sampling technique was adapted to select 138 Chronic Obstructive Pulmonary Disease (COPD) clients attending Pulmonary Medicine OPD in a tertiary care hospital, Kolkata. The structured interview schedule was used to collect on demographic data and standardized WHO QOL BREF tool was used to assess Quality of Life. Standardized GOLD criteria were used to assess disease severity of COPD clients. Reliability of the demographic data collection tool was established by inter- rater method and r was 0.77. All the tools were tried out before final data collection. The finding of the study revealed statistically non-significant relationship between all the domain of QOL and disease severity of COPD patients. Total Quality of Life score is also not significantly related with COPD Disease severity score. The study results also showed that QOL is not associated with sociodemographic characteristics. The study concluded that, there is no correlation between quality of life and disease severity.


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