scholarly journals The relation of atherosclerotic lesions of BCA against the background of COPD in patients aged 40-60 years. Review of the literature and retrospective analysis

2021 ◽  
pp. 10-14
Author(s):  
Iryna Andrusyshyna ◽  
Viktoria Batashova-Galinska ◽  
Tetiana Horbenko ◽  
Leonid Kholopov

The aim: to determine the possible relationship between chronic obstructive pulmonary disease and the presence of atherosclerosis of the brachiocephalic vessels in persons aged 40–60 years for the possibility of early prevention of cardiovascular events. Materials and methods: to do this, we reviewed articles using open sources such as PubMED, Medscape and Cochrane library, highlighting the relationship between the development of atherosclerosis and the presence and severity of COPD. Also, based on the University Clinic of ONMedU and Military Clinical Center of the Southern Region, a retrospective analysis of patients with an inconclusively confirmed diagnosis of COPD and conducted biochemical blood tests was carried out in order to study changes in the lipid profile and the presence of BCS in these patients. Result: In the course of a retrospective analysis of patients, a relationship was found between the presence of BCA atherosclerosis and the presence of COPD, and based on the literature data, a parallel was drawn between changes in the lipid profile in patients with COPD. But, in view of the insufficient number of patients, this topic requires additional research. Conclusions: thus, based on the obtained data, it can be concluded that there is a connection between the presence of COPD, changes in the lipid profile, and the presence of BCА atherosclerosis. This connection can become one of the key mechanisms of early diagnosis of BCА atherosclerosis

2013 ◽  
Vol 10 (2) ◽  
pp. 69-74 ◽  
Author(s):  
B M Nazarov ◽  
K A Zykov ◽  
L G Ratova ◽  
O Yu Agapova ◽  
Yu A Dolgusheva ◽  
...  

In recent decades cardiovascular (CVD) and COPD diseases are widespread around the world, leading to a high prevalence of patients with comorbidity, especially arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) and/or bronchial asthma (BA). The growing number of patients with this comorbidity is due to increased hypertension, COPD, and asthma comorbidities, with the increase of the geriatric population of patients with these pathologies. Epidemiological studies have shown that the deterioration of lung function is as strong a predictor of cardiovascular mortality, as well as major cardiovascular risk factors. However, spirometry in patients with CVD is carried out infrequently. Inadequate spirometric diagnostics of COPD and asthma, especially in patients with cardiovascular disease, affects the clinical course of both diseases, leading to inappropriate treatment and poor prognosis for the patient. The need for extensive screening spirometry in all patients with CVD is not proven. Thera are no spirometry reference values in patients with CVD, which makes it almost impossible to use these parameters in stratification of CV risk. This dictates the need for further research to clarify the relationship between the severity and characteristics of the various CVD and spirometric parameters.


Thorax ◽  
2007 ◽  
Vol 63 (6) ◽  
pp. 493-499 ◽  
Author(s):  
E Sapey ◽  
D Bayley ◽  
A Ahmad ◽  
P Newbold ◽  
N Snell ◽  
...  

Background:Measurements of pulmonary biomarkers can be used to monitor airway inflammation in chronic obstructive pulmonary disease (COPD), but the variability of sampled biomarkers and their inter-relationships are poorly understood. A study was undertaken to examine the intra- and inter-patient variability in spontaneous sputum samples from patients in the stable state and to describe the relationship between biomarkers, cell counts and markers of disease.Methods:Sputum interleukin-1β, tumour necrosis factor α, interleukin 8, myeloperoxidase, leucotriene B4, growth-related oncogene α and differential cell counts were measured in patients with moderate to severe stable COPD (n = 14) on 11 occasions over a 1-month period.Results:There was significant variability in all inflammatory indices (median intra-patient coefficient of variation (CV) 35% (IQR 22–69), median inter-patient CV 102% (IQR 61–145)). Variability could be reduced by using a rolling mean of individual patient data points. Sample size calculations were undertaken to determine the number of patients required to detect a 50% reduction in neutrophil count. Using a crossover design of a putative effective treatment, the number needed using one data point per patient was 72, reducing to 23 when a mean of three data points was used. Significant correlations were demonstrated both between the inflammatory biomarkers themselves and between inflammatory biomarkers and markers of disease. Some relationships were not apparent when results from a single sample were used. The reliability of inter-relationships improved as more data points were used for each patient.Conclusions:Clear relationships exist between inflammatory biomarkers in patients with stable COPD. Sequential sampling reduced the variability of individual mediators and the potential number of patients needed to power proof of concept interventional studies.


2021 ◽  
Vol 12 ◽  
pp. 204062232110287
Author(s):  
Tao Liu ◽  
Zi-Jian Xiang ◽  
Xiao-Meng Hou ◽  
Jing-Jing Chai ◽  
Yan-Li Yang ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and dyspnea, as well as an increase in the number of leukocytes in the airways, lungs, and pulmonary vessels. A ‘One size fits all’ approach to COPD patients with different clinical features may be considered outdated. The following are the two major objectives of this meta-analysis: the first is to determine if blood eosinophil counts (BEC) can serve as a prognostic biomarker of COPD outcomes, and the second is to determine which level of BEC is effective for inhaled corticosteroid (ICS) treatment. Methods: We searched articles published before 15 May 2021 in the following four electronic databases: Web of Science, Cochrane Library, EMBASE, and PubMed. Results: A total of 42 studies, comprising a sampling of 188,710 subjects, were summarized and compared in this meta-analysis. The rate ratio (RR) of exacerbations of COPD (ECOPD) between ICS and non-ICS treatment was statistically significant for the COPD patients with a baseline BEC ⩾ 2% or ⩾ 200 cells/μl, RR = 0.82 (0.73, 0.93) or 0.79 (0.70, 0.89) respectively, while the RR of ECOPD between ICS and non-ICS treatment was statistically insignificant for the COPD patients with baseline BEC < 2% or <200 cells/μl, RR = 0.97 (0.87, 1.08) or 0.97 (0.86, 1.08), suggested that ICS therapy was beneficial to the improvement of ECOPD in patients with a baseline BEC ⩾ 2% or BEC ⩾ 200 cells/μl. Conclusion: Our research shows that a BEC ⩾ 200 cells/μl or ⩾2% is likely to become the cutoff value of ICS treatment for ECOPD. Moreover, we believe that the baseline BEC can be used as a biomarker for predicting ECOPD. The stability of BEC requires special attention.


BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e037509
Author(s):  
Kimberley Sonnex ◽  
Hanna Alleemudder ◽  
Roger Knaggs

ObjectivesInhaled corticosteroids (ICS) reduce exacerbation rates and the decline in lung function in people with chronic obstructive pulmonary disease (COPD). There is evidence that smoking causes ‘steroid resistance’ and thus reduces the effect of ICS. This systematic review aimed to investigate the effect of smoking on efficacy of ICS in COPD in terms of lung function and exacerbation rates.DesignSystematic review.Data sourcesAn electronic database search of PubMed, Ovid MEDLINE, Ovid Embase and Cochrane Library (January 2000 to January 2020).Eligibility criteriaFully published randomised controlled trials (RCTs), in the English language, evaluating the use of ICS in COPD adults that stratified the participants by smoking status. Trials that included participants with asthma, lung cancer and pneumonia were excluded. The primary outcome measures were changes in lung function and yearly exacerbation rates.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias using the Cochrane Collaboration’s tool.ResultsSeven studies were identified. Four trials (17 892 participants) recorded change in forced expiratory volume in one second (FEV1) from baseline to up to 30 months after starting treatment. Heavier smokers (>36 pack years) using ICS had a greater decline in FEV1that ranged from −22 mL to −75 mL in comparison to lighter smokers. Smokers using ICS had mixed results in FEV1change: −8 mL to +77 mL in comparison to ex-smokers. Four trials (21 270 participants) recorded difference in COPD exacerbation rates at 52 weeks. The rate ratios favoured more exacerbations in ICS users who were current or heavier smokers than those who were ex-smokers or lighter smokers (0.81 to 0.99 vs 0.92 to 1.29).ConclusionsIn COPD, heavier or current smokers do not gain the same benefit from ICS use on lung function and exacerbation rates as lighter or ex-smokers do, however effects may not be clinically important.PROSPERO registration numberCRD42019121833


2015 ◽  
Vol 4 (42) ◽  
pp. 7287-7296
Author(s):  
Modini Venkata Rao ◽  
Srikanti Raghu ◽  
Surya Kiran P ◽  
Hanumanth Rao Ch

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 31-36
Author(s):  
Ioana Cojocaru ◽  
Livia Luculescu ◽  
Daniela Negoescu ◽  
Irina Strâmbu

Abstract Clostridium difficile is an anaerobic bacterium than can colonise the lower intestine and cause enterocolitis in susceptible patients. Clostridium difficile infection (CDI) is typically a nosocomial infection, favoured by treatment with antibiotics (especially with broad-spectrum drugs), proton pump inhibitors, but also comorbidities, old age and prolonged hospitalisation. Based on the observation that in the past years, the frequency of nosocomial CDI has increased in the Institute of Pulmonology, Bucharest, this retrospective observational study aimed to analyse the characteristics of admitted patients who develop CDI, in order to identify possible particular features and risk factors. Accordingly, medical files from 80 patients admitted from January 2015 to August 2017 were analysed for demographic data, respiratory diagnosis, comorbidities, blood tests, treatments prescribed, time of CDI onset, evolution and outcome. The number of patients studied was 29 in 2015, 16 in 2016 and 35 in 2017, with slight male predominance. Totally, 54 patients (67.5%) had tuberculosis (pulmonary or pleural), 12 had lung cancer, five had respiratory infections, two had chronic obstructive pulmonary disease and seven had other diseases. All patients but nine were receiving antibiotics: tuberculosis drugs, cephalosporins, fluoroquinolones and beta-lactams. About half of the patients received proton pump inhibitors. Most patients had several comorbidities. Mean time since admittance to onset of diarrhoea was 20 days. CDI was treated with metronidazole or vancomycin. The evolution was favourable in 90% of patients, but eight patients (10%) died This study highlights a high frequency of CDI in patients treated for tuberculosis. Due to insufficient data, no epidemiological consideration could be made. Further studies are needed to assess the relationship among tuberculosis, tuberculosis treatment and CDI.


Background: Cardiovascular complications caused by Chronic Obstructive Pulmonary Disease (COPD) will affect structure and function of heart’s normal anatomy. This study aims to determine the relationship between the abnormality of NT Pro BNP levels and echocardiographic features of right ventricular (RV) dysfunction in COPD. Method: A cross-sectional study to assess the association between the abnormality of NT Pro BNP levels and echocardiographic features of right ventricular dysfunction in COPD in the outpatient unit of the Integrated Heart Center H. Adam Malik Hospital Medan. COPD patients were grouped based on GOLD criteria from spirometry examination into severe COPD (GOLD III) and very severe COPD (GOLD IV). Subjects then performed NT pro BNP and echocardiography examination to assess pathological changes in cardiac. Result: NT Pro BNP was higher in GOLD IV. Cut off value of NT Pro BNP > 172 pg/nl is the initial parameter of right ventricular dysfunction. Pulmonary hypertension was found in 93% of cases. The most common cardiac pathological findings were RV hypertrophy (71%), RV dysfunction (86.7%) and pulmonary regurgitation (87.5%). Pathological findings on echocardiography were more common in the GOLD IV group. COPD severity was associated with NT Pro BNP abnormalities (p <0.001) and associated with pathologic echocardiographic findings (p <0.001). Conclusion: Severe COPD is associated with increased NT pro-BNP abnormalities and pathological findings on echocardiography. Echocardiography facilitates early detection of cardiovascular complications in patients with severe and very severe COPD (GOLD III and IV).


2021 ◽  
Vol 9 (1) ◽  
pp. 45-56
Author(s):  
Ghorban Asgari ◽  
◽  
Ramin Khoshniyat ◽  
Farhad Karimi ◽  
Kamal Ebrahimi ◽  
...  

Background: Particulate or particle mattes in term of air pollution are particles with a diameter of 2.5 μm or less (PM2.5). PM2.5 is a natural source of air pollution and has harmful effects on citizens in Sanandaj City, located in the west of Iran. Methods: In this study, the hourly data of concentration of PM2.5 were taken from the Kurdistan Environmental Protection Agency. During the study period (2018-2019), the 24-hour concentration of PM2.5 exceeded 339 times the average level. By AirQ+ software, the relationship between data and Relative Risk (RR), Baseline Incidence (BI), and Attributable Proportion (AP) were estimated. Then chronic obstructive pulmonary disease, lung cancer, ischemic heart disease, and brain stroke in the range of over 30 years were estimated. Results: The main target of this study was to survey the relationship between PM2.5 concentration and the death rate of citizens of this non-industrial city. The long-term health effect (more than 6 months) of PM2.5 caused 326 deaths on average (except for accidents and poisoning). Conclusion: Increase the concentration of PM2.5 is one factor that affects a high percentage of mortality rate.


Lung ◽  
2020 ◽  
Vol 198 (4) ◽  
pp. 617-628
Author(s):  
Peter S. P. Cho ◽  
Hannah V. Fletcher ◽  
Richard D. Turner ◽  
Irem S. Patel ◽  
Caroline J. Jolley ◽  
...  

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