scholarly journals Comparison of the Association between Circulating Vitamin D3 Levels and Clinical Outcomes in Patients with Asthma and Chronic Obstructive Pulmonary Disease: A Prospective Observational Study

2019 ◽  
Vol 42 (11) ◽  
pp. 1861-1866
Author(s):  
Keita Hirai ◽  
Toshihiro Shirai ◽  
Yuya Suzuki ◽  
Tatsuki Shimomura ◽  
Kunihiko Itoh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Vitamin D ◽  
Observational Study ◽  
Pulmonary Disease ◽  
Clinical Outcomes ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Prospective observational study of respiratory Aspergillus colonization or disease in patients with various stages of chronic obstructive pulmonary disease utilizing culture versus nonculture techniques

2020 ◽  
Author(s):  
Sarmad Waqas ◽  
Katie Dunne ◽  
Alida Fe Talento ◽  
Graham Wilson ◽  
Ignacio Martin-Loeches ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Observational Study ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Fungal Culture ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Chronic obstructive pulmonary disease (COPD) patients have been recognized to be at increased risk of Aspergillus spp. colonization, which may progress to invasive pulmonary aspergillosis (IPA). The objective of this study was to determine the frequency of Aspergillus colonization, or disease, in a cohort of COPD patients. A prospective observational study was undertaken to determine Aspergillus colonization, or disease, in consecutive COPD patients undergoing bronchoscopy. Fungal culture as well as galactomannan antigen (GM) and Aspergillus nucleic acid detection (PCR) were performed on bronchoalveolar lavage fluid (BAL) samples. One hundred and fifty patients were recruited. One hundred and twelve (74.7%) were outpatients, 38 (25.33%) were inpatients, of whom 6 (4%) were in the intensive care unit. Most patients (N = 122, 81.3%) were either COPD GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages 1 or 2. Nine (6%) patients were on systemic steroids, 64 (42.7%) on inhaled steroids, and 9 (6%) on both. Seventeen patients (11.3%) had at least one positive test for Aspergillus detection (culture ± galactomannan ± polymerase chain reaction [PCR]), 13 (76.4%) of whom were COPD GOLD stages 1 or 2.  Five patients had probable or putative IPA. Aspergillus sp. was detected in five patients (3.3%) by culture, but detection increased to 17 (11.3%) by the additional testing for GM or Aspergillus DNA. The frequency of Aspergillus detection in this cohort of COPD patients may reflect the predominance of early GOLD stages among the study population but deserves further investigation to determine its relevance as a predictive risk factor for IPA. Lay Summary COPD is a risk factor for Aspergillus spp. colonization. Bronchoalveolar lavage samples of 150 COPD patients were tested for presence of Aspergillus fumigatus, which was detected in five patients (3.3%) by culture, but detection of Aspergillus increased to 17 (11.3%) by additional GM and PCR testing.

Application of BAP-65 Score for Risk Stratification of Acute Exacerbation of Chronic Obstructive Pulmonary Disease - A Prospective Observational Study in a Tertiary Care Institute in Telangana

2021 ◽  
Vol 8 (29) ◽  
pp. 2667-2673
Author(s):  
Deepika Shree Balaram ◽  
Narendra Kumar Narahari ◽  
Bhaskar Kakarla ◽  
Rajasekhar Varma Gande ◽  
Paramjyothi Kruparao Gongati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Observational Study ◽  
Risk Stratification ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Prospective Observational Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Group 4

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a significant morbidity and mortality with a need for frequent hospitalizations and mechanical ventilation. Thus, a model was searched that required simple information that was consistently available in emergency department, upon the presentation of the patient which allowed risk stratification and to identify patients who might potentially benefit from early intervention. METHODS This was a prospective observational study conducted over a period of 6 months, from May 2018 to December 2018 with a study sample of 136 patients. The primary objective was aimed to validate the BAP-65 score system in predicting the need for ventilatory support and mortality in patients who presented with acute exacerbation of COPD. RESULTS Mean age of the study population was 64.13 ± 9.7 and 29 (21.32 %) were females with obvious male predominance. It was observed that as the BAP-65 score increases, the mortality increases. Mortality among the score groups 0, 1 and 2 was one, zero, one respectively. The mortality is about 37.5 % in the score group 3 and it increased to 90.9 % in the score group 4. The patients who needed mechanical ventilation were about 4 % in the score group 2 and it increased to 100 % in the score group 4. BAP-65 scoring system had a sensitivity of 88.89 % and specificity of 90.68 % in predicting the in-hospital mortality, and a sensitivity of 84 % and specificity of 94.59 % in predicting the need for mechanical ventilation during hospital stay. CONCLUSIONS The BAP-65 scoring system seems to be a promising tool which is simple and accurate. The score correlated well with both the mortality and also the need for mechanical ventilation, thus helping in decision making at triage level and also in prognostication of the disease. KEYWORDS Chronic Obstructive Pulmonary Disease, Acute Exacerbation, BAP-65, AECOPD, Mortality, Mechanical Ventilation

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