scholarly journals Thyroid Gland Disease as a Comorbid Condition in COPD

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Aziz Gumus ◽  
Neslihan Ozcelik ◽  
Bilge Yilmaz Kara ◽  
Songul Ozyurt ◽  
Unal Sahin
Keyword(s):  
Thyroid Gland ◽  
Multinodular Goiter ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
Thyroid Function Tests ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Euthyroid Sick Syndrome ◽  
Artery Disease

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the most common causes of morbidity and mortality worldwide. The disease is characterized by progressive airway inflammation, which not only affects the airways but also has systemic effects that are associated with comorbidities. Although comorbid conditions such as hypertension and coronary artery disease are very well-known in COPD patients, diseases of the thyroid gland have not been sufficiently studied. Therefore, thyroid diseases are not considered among the comorbid conditions of COPD. The purpose of this study was to determine the thyroid gland disease (TGD) prevalence in COPD and associated factors. Materials and Method. The study included 309 (297 (96%) male) patients. The patients were subjected to spirometry and thyroid function tests (TFT) in the stable period. The thyroid gland disease they were diagnosed with was recorded after face-to-face meetings and examining their files. Results. The mean age of the patients who were included in the study was 65.9 ± 9.8 (40-90). Thyroid disease was determined in 68 (22%) individuals. There were hypothyroidism in 7 (2%), euthyroidism in 45 (15%), and hyperthyroidism in 16 (%5) patients. No relationship was found between the severity of airflow limitation and the prevalence of TGD. Conclusion. Thyroid abnormalities are commonly observed in COPD. The most frequently encountered TGDs are euthyroid multinodular goiter, euthyroid sick syndrome (ESS), and toxic multinodular goiter.

scholarly journals Predicting COVID-19—Comorbidity Pathway Crosstalk-Based Targets and Drugs: Towards Personalized COVID-19 Management

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 556
Author(s):  
Debmalya Barh ◽  
Alaa A. Aljabali ◽  
Murtaza M. Tambuwala ◽  
Sandeep Tiwari ◽  
Ángel Serrano-Aroca ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Management Strategies ◽  
Drug Repurposing ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Hub Gene ◽  
Personalized Management ◽  
Pathway Crosstalk

It is well established that pre-existing comorbid conditions such as hypertension, diabetes, obesity, cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), cancers, and chronic obstructive pulmonary disease (COPD) are associated with increased severity and fatality of COVID-19. The increased death from COVID-19 is due to the unavailability of a gold standard therapeutic and, more importantly, the lack of understanding of how the comorbid conditions and COVID-19 interact at the molecular level, so that personalized management strategies can be adopted. Here, using multi-omics data sets and bioinformatics strategy, we identified the pathway crosstalk between COVID-19 and diabetes, hypertension, CVDs, CKDs, and cancers. Further, shared pathways and hub gene-based targets for COVID-19 and its associated specific and combination of comorbid conditions are also predicted towards developing personalized management strategies. The approved drugs for most of these identified targets are also provided towards drug repurposing. Literature supports the involvement of our identified shared pathways in pathogenesis of COVID-19 and development of the specific comorbid condition of interest. Similarly, shared pathways- and hub gene-based targets are also found to have potential implementations in managing COVID-19 patients. However, the identified targets and drugs need further careful evaluation for their repurposing towards personalized treatment of COVID-19 cases having pre-existing specific comorbid conditions we have considered in this analysis. The method applied here may also be helpful in identifying common pathway components and targets in other disease-disease interactions too.

scholarly journals Novel Association Between Asthma and Osteoarthritis: A Nationwide Health and Nutrition Examination Survey

2020 ◽  
Author(s):  
Hyeon-Kyoung Koo ◽  
Pamela Song ◽  
Joo-Hyun Lee
Keyword(s):  
Smoking Status ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
Nutrition Examination Survey ◽  
Obstructive Pulmonary Disease ◽  
Knee Oa ◽  
Health And Nutrition ◽  
High Prevalence ◽  
Asthma Patients

Abstract Backgrounds: Asthma and osteoarthritis (OA) are medical conditions that disable physical activity and deteriorate patients’ quality of life. Despite the high prevalence, there are limited studies focusing on the comorbid condition and association between asthma and OA. The aim of study was to assess the prevalence and identify the clinical considerations for this special population.Methods: Adult patients aged over 40 years who completed questionnaire assessments and spirometry were enrolled from Korean National Health and Nutrition Examination Survey. Asthma and OA were defined on the history of doctor-diagnosed disease. Radiographic severities of OA were measured using the Kellgren/Lawrence grading system. Chronic obstructive pulmonary disease (COPD) as a comparative respiratory disease was diagnosed on the basis of spirometric results.Results: A total of 9344 subjects were enrolled, and the prevalence of asthma and COPD were 4.6%±0.3% and 12.0%±0.5%, respectively. The prevalence of OA in the asthma group was 31.9%±2.8%, which was significantly higher than those in the COPD (17.8%±1.5%) or control (16.2%±0.6%) groups. OA was more prevalent in asthma patients after adjusting for age, sex, body mass index, and smoking status (OR, 1.65; 95% CI, 1.27-2.13). After further adjustment of this model for prescription of OA medication, OA was still independently associated with asthma (OR, 1.56; 95% CI, 1.10-2.20). In contrast, the relationship of OA medication with asthma was not significant (P=0.64). This relationship was evident in subjects with asthma without airflow limitation measured by spirometry (OR, 1.97; 95% CI, 1.32-2.93). Moreover, radiographic severity of knee OA correlated with asthma (OR, 1.10; 95% CI, 1.0-1.21). Conclusions: OA shows a high prevalence in patients with asthma, with the prevalence being higher than that in COPD patients or controls. The comorbid characteristics of these two conditions need to be considered in clinical practice.

scholarly journals Novel association between asthma and osteoarthritis: a nationwide health and nutrition examination survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyeon-Kyoung Koo ◽  
Pamela Song ◽  
Joo-Hyun Lee
Keyword(s):  
Smoking Status ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
Nutrition Examination Survey ◽  
Obstructive Pulmonary Disease ◽  
Knee Oa ◽  
Health And Nutrition ◽  
High Prevalence ◽  
Novel Association

Abstract Background Asthma and osteoarthritis (OA) are medical conditions that inhibit physical activity and adversely affect quality of life. Despite the high prevalence, there are limited studies focusing on the comorbid condition and association between asthma and OA. The aim of this study was to assess the prevalence of OA co-occurring with asthma and to identify the relevant clinical considerations. Methods Adult participants aged over 40 years who completed questionnaire assessments and spirometry tests were enrolled from the Korean National Health and Nutrition Examination Survey. Asthma and OA were defined based on the medical history of a diagnosis made by a doctor. Radiographic severities of OA were measured using the Kellgren–Lawrence grading system. Chronic obstructive pulmonary disease (COPD), as a comparative respiratory disease, was diagnosed based on the spirometric results. Results A total of 9344 subjects were enrolled, and the prevalence of asthma and COPD were 4.6% ± 0.3% and 12.0% ± 0.5%, respectively. The prevalence of OA in the asthma group was 31.9% ± 2.8%, which was significantly higher than that in the COPD (17.8% ± 1.5%) or control (16.2% ± 0.6%) groups. OA was more prevalent in patients with asthma after adjusting for age, sex, body mass index, and smoking status (OR 1.65; 95% CI 1.27–2.13). Furthermore, after adjustment of this model for the prescription of OA medication, OA remained independently associated with asthma (OR 1.56; 95% CI 1.10–2.20). Conversely, the relationship of OA medication with asthma was not significant (P = 0.64). This relationship was evident in patients with asthma without airflow limitation measured by spirometry (OR 1.97; 95% CI 1.32–2.93). Moreover, the radiographic severity of knee OA correlated with asthma (OR 1.10; 95% CI 1.0–‍‍1.21). Conclusions OA shows a high prevalence in patients with asthma, higher than in patients with COPD or the controls. The comorbid characteristics of these two conditions need to be considered in clinical practice.

scholarly journals Carotid Artery Disease and Lower Extremities Artery Disease in Patients with Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 7 (13) ◽  
pp. 2102-2107
Author(s):  
Daniela Buklioska-Ilievska ◽  
Jordan Minov ◽  
Nade Kochovska-Kamchevska ◽  
Irena Gigovska ◽  
Ana Doneva ◽  
...  
Keyword(s):  
Carotid Artery Disease ◽  
Mean Value ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Vascular Changes ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference ◽  
Artery Disease ◽  
Serum Crp

AIM: To assess the frequency of carotid artery disease (CAD) and lower extremities artery disease (LEAD) in patients with chronic obstructive pulmonary disease (COPD) and their relation to the severity of airflow limitation and the level of C-reactive protein (CRP). METHODS: We performed a cross-sectional study including 60 patients with COPD (52 male, 8 female), aged 40 to 80 years, initially diagnosed according to the actual criteria. Also, 30 subjects in whom COPD was excluded, matched to COPD patients by sex, age, body mass index and smoking status, served as controls. All study subjects completed questionnaire and underwent pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray), angiological evaluation by Doppler ultrasonography and measurement of serum CRP level. RESULTS: We found a statistically significant difference between the frequency of carotid plaques in COPD patients as compared to their frequency in controls (65% vs 30%; P = 0.002). The mean value of intima-media thickness (IMT) in COPD patients with CAD was significantly higher than its mean value in controls (0.8 ± 0.2 vs. 0.7 ± 0.2; P = 0.049). IMT value in COPD patients with CAD was significantly related to the degree of airflow limitation, i.e. to the degree of FEV1 decline (P = 0.000), as well as to the serum CRP level (P = 0.001). We found a statistically significant difference between the frequency of COPD patients with LEAD as compared to the frequency of LEAD in controls (78.3% vs 43.3%; P = 0.001). According to the Fontaine classification, COPD patients with LEAD were categorized in the stages I, IIA and IIB (53.3%, 30% and 16.7%, respectively), whereas all controls with LEAD were categorized in the Fontaine stage I. Among COPD patients with LEAD there was significant association between disease severity and clinical manifestations due to the vascular changes (P = 0.001) and serum CRP level (P = 0.001). CONCLUSION: Our findings suggest higher prevalence and higher severity of vascular changes in COPD patients as compared to their prevalence and severity in non-COPD subjects. Prevalence and severity of vascular changes in COPD patients were significantly related to the severity of airflow limitation and serum CRP levels.

scholarly journals Adenomatous, Unilateral, Retrosternal Extension of the Thyroid Gland presenting as a Mediastinal Mass

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A918-A919
Author(s):  
Aisling Glass ◽  
Margaret Elizabeth Griffin ◽  
Carla M Moran
Keyword(s):  
Thyroid Gland ◽  
Mediastinal Mass ◽  
Thyroid Tissue ◽  
Chronic Obstructive ◽  
Thyroid Function Tests ◽  
Posterior Aspect ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Angiogram ◽  
Thymus Tissue ◽  
The Right

Abstract Background: Thyroid-related causes of mediastinal masses include retrosternal goiters and thymic enlargement associated with Graves’ disease. Here, we present a case of significant unilateral retrosternal growth of the thyroid gland, presenting as an incidental mediastinal mass, without any evidence of contralateral disease. Associated subclinical hyperthyroidism presents a therapeutic challenge. Clinical Case: A 68-year old gentleman presented to the emergency department with a non-infective exacerbation of known Chronic Obstructive Pulmonary Disease. CT Pulmonary Angiogram revealed a right sided 5.6cm paratracheal mass, which seemed to originate from the posterior aspect of the right lobe of the thyroid and extended to the subcarinal region. The mass displaced the oesophagus and was close to, but did not compress, the trachea. The left thyroid lobe was normal. Thyroid ultrasound was reported as normal, but was later acknowledged to be suboptimal at visualization of the posterior aspect of the gland. Thyroid scintigraphy confirmed increased radionuclide uptake within the mass. Thyroid function tests showed subclinical thyrotoxicosis [TSH 0.04 (0.4-4.0mIU/mL), FT4 17.4 (10-22pmol/L) and FT3 3.36 (2.89-4.88 pmol/L)]. TSH receptor antibody was negative [< 1.1 (<1.75 IU/L)]. On review of prior imaging from other hospitals, the mass had been present since 1999 and was stable in size for at least the past 7 years. The patient was discharged on carbimazole with a plan to perform interval scanning to monitor size. Discussion: Although technetium uptake can be seen in thymus tissue, the identification on imaging that the mass is contiguous with the thyroid gland leads us to believe this is an adenomatous extension of the thyroid gland. Ectopic thyroid tissue is possible, but the size of the mass suggests some prior period of growth. Thyroid carcinoma seems unlikely given the current stability in size, and there are no compressive symptoms, so there is no clear indication for surgery at present. However, given the subnormal TSH level, there is evidence of autonomy, so treatment is indicated. Radio-iodine treatment may be associated with thyroiditis, with attendant swelling of the gland and risk of compression of vital structures, so treatment with ATDs and regular imaging surveillance was deemed most appropriate in his case.

scholarly journals An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

2021 ◽  
Vol 18 (6) ◽  
pp. 3111
Author(s):  
Emmanuel Peprah ◽  
Mari Armstrong-Hough ◽  
Stephanie H. Cook ◽  
Barbara Mukasa ◽  
Jacquelyn Y. Taylor ◽  
...  
Keyword(s):  
Current Evidence ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Cardiopulmonary Disease ◽  
Current Trends ◽  
Significant Public Health ◽  
Artery Disease ◽  
Living With Hiv

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

scholarly journals COPD Guidelines in the Asia-Pacific Regions: Similarities and Differences

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1153
Author(s):  
Shih-Lung Cheng ◽  
Ching-Hsiung Lin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Global Strategy ◽  
Airflow Limitation ◽  
Asia Pacific ◽  
Pharmacologic Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Country Level ◽  
Similarities And Differences

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is associated with significant morbidity and mortality, giving rise to an enormous social and economic burden. The Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) report is one of the most frequently used documents for managing COPD patients worldwide. A survey was conducted across country-level members of Asia-Pacific Society of Respiratory (APSR) for collecting an updated version of local COPD guidelines, which were implemented in each country. This is the first report to summarize the similarities and differences among the COPD guidelines across the Asia-Pacific region. The degree of airflow limitation, assessment of COPD severity, management, and pharmacologic therapy of stable COPD will be reviewed in this report.

scholarly journals Alternative methods for assessing bronchodilator reversibility in chronic obstructive pulmonary disease

Thorax ◽  
2001 ◽  
Vol 56 (9) ◽  
pp. 713-720
Author(s):  
J Hadcroft ◽  
P M A Calverley
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Lung Volume ◽  
Tidal Flow ◽  
Airflow Limitation ◽  
Alternative Methods ◽  
Chronic Obstructive ◽  
Flow Limitation ◽  
Inspiratory Capacity ◽  
Obstructive Pulmonary Disease

BACKGROUNDBronchodilator reversibility testing is recommended in all patients with chronic obstructive pulmonary disease (COPD) but does not predict improvements in breathlessness or exercise performance. Two alternative ways of assessing lung mechanics—measurement of end expiratory lung volume (EELV) using the inspiratory capacity manoeuvre and application of negative expiratory pressure (NEP) during tidal breathing to detect tidal airflow limitation—do relate to the degree of breathlessness in COPD. Their usefulness as end points in bronchodilator reversibility testing has not been examined.METHODSWe studied 20 patients with clinically stable COPD (mean age 69.9 (1.5) years, 15 men, forced expiratory volume in one second (FEV1) 29.5 (1.6)% predicted) with tidal flow limitation as assessed by their maximum flow-volume loop. Spirometric parameters, slow vital capacity (SVC), inspiratory capacity (IC), and NEP were measured seated, before and after nebulised saline, and at intervals after 5 mg nebulised salbutamol and 500 μg nebulised ipratropium bromide. The patients attended twice and the treatment order was randomised.RESULTSMean FEV1, FVC, SVC, and IC were unchanged after saline but the degree of tidal flow limitation varied. FEV1 improved significantly after salbutamol and ipratropium (0.11 (0.02) l and 0.09 (0.02) l, respectively) as did the other lung volumes with further significant increases after the combination. Tidal volume and mean expiratory flow increased significantly after all bronchodilators but breathlessness fell significantly only after the combination treatment. The initial NEP score was unrelated to subsequent changes in lung volume.CONCLUSIONSNEP is not an appropriate measurement of acute bronchodilator responsiveness. Changes in IC were significantly larger than those in FEV1and may be more easily detected. However, our data showed no evidence for separation of “reversible” and “irreversible” groups whatever outcome measure was adopted.

scholarly journals A Midwest COVID-19 Cohort for the Evaluation of Multimorbidity and Adverse Outcomes from COVID-19

2021 ◽  
Vol 12 ◽  
pp. 215013272110109
Author(s):  
Sanjeev Nanda ◽  
Loren Toussaint ◽  
Ann Vincent ◽  
Karen M. Fischer ◽  
Ryan Hurt ◽  
...  
Keyword(s):  
Mayo Clinic ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Prevalence Data ◽  
Obstructive Pulmonary Disease ◽  
Morbidity Score ◽  
Process And Outcome ◽  
Comorbidity Index ◽  
Risk Factor Score

Objective To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19. Patients and Methods A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020. Results Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score. Conclusion In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.

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