scholarly journals An Investigation of Construct Validity and Responsiveness of the Danish ICECAP-A

2020 ◽  
Author(s):  
Annette Willemoes Holst-Kristensen ◽  
Paul Mark Mitchell ◽  
Myles-Jay Linton ◽  
Joanna Coast ◽  
Kirsten Fonager ◽  
...  
Keyword(s):  
Construct Validity ◽  
General Health ◽  
Item Analysis ◽  
A Priori ◽  
Age Groups ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chi Squared ◽  
Responsiveness To Change

Abstract BackgroundThis study aimed to provide the first assessment of construct validity of ICECAP-A in patients with cardiovascular disease, chronic obstructive pulmonary disease and diabetes, and to assess the responsiveness of the measure in this group. MethodData were provided from patients attending rehabilitation in the municipality of Aalborg, Denmark, from March 2018 to March 2019. Patients answered a questionnaire from the healthcare centre and the ICECAP-A at baseline and 12 weeks follow-up. To assess construct validity, a priori hypotheses were developed. Based on these hypotheses, associations between sociodemographic characteristics, ‘general health’, a freedom dimension, and ICECAP-A were analysed through chi-squared tests and Spearman rank correlations for categorical and ordinal variables, respectively. To investigate responsiveness, the anchor-based method was used. Patients were divided into improved, worsened or no change, based on changes between baseline and follow-up on the anchor measures (‘general health’ and ‘freedom’). To quantify responsiveness, both the weighted and un-weighted ICECAP-A scores’ effect sizes, standardised response means and t-tests were used. Findings were explored across different age groups.ResultOf all the hypothesised associations, 16 of 26 (62%) were in the expected direction. The expected relationships were found between ICECAP-A scores and general health and freedom to do things. ICECAP-A was responsive in terms of capturing the effects on general health and the freedom to do things. Differences were found across age groups, with greater responsiveness to change in those aged under 65 years. The item-by-item analysis showed that capability was mainly driven by stability and autonomy.ConclusionThis study has shown that the Danish ICECAP-A is a valid and responsive measure of the effects of an exercise and education-based rehabilitation programme.

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

THE USE OF BIOCHEMICAL MARKERS IN THE FOLLOW UP OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2018 ◽  
Vol 42 (2) ◽  
pp. 33-57
Author(s):  
Fathy, Shadya, A. ◽  
Elattar, Mai. M. ◽  
Abdel Wahab, Hanan, M. F. ◽  
Fahmy, Fifi, A.
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Biochemical Markers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

scholarly journals COVID-19 Shuts Doors to Flu but Keeps Them Open to Rhinoviruses

Biology ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 733
Author(s):  
Irina Kiseleva ◽  
Andrey Ksenafontov
Keyword(s):  
Influenza Pandemic ◽  
Age Groups ◽  
Influenza Viruses ◽  
Interferon Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mild Disease ◽  
Viral Interference ◽  
The Common

It is well known that rhinoviruses are distributed across the globe and are the most common cause of the common cold in all age groups. Rhinoviruses are widely considered to be harmless because they are generally perceived as respiratory viruses only capable of causing mild disease. However, they may also infect the lower respiratory tract, inducing chronic obstructive pulmonary disease and exacerbations of asthma, bronchiolitis, etc. The role of rhinoviruses in pathogenesis and the epidemiological process is underestimated, and they need to be intensively studied. In the light of recent data, it is now known that rhinoviruses could be one of the key epidemiological barriers that may influence the spread of influenza and novel coronaviruses. It has been reported that endemic human rhinoviruses delayed the development of the H1N1pdm09 influenza pandemic through viral interference. Moreover, human rhinoviruses have been suggested to block SARS-CoV-2 replication in the airways by triggering an interferon response. In this review, we summarized the main biological characteristics of genetically distinct viruses such as rhinoviruses, influenza viruses, and SARS-CoV-2 in an attempt to illuminate their main discrepancies and similarities. We hope that this comparative analysis will help us to better understand in which direction research in this area should move.

scholarly journals Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaojie Dong ◽  
Xin Du ◽  
Shangxin Lu ◽  
Chao Jiang ◽  
Shijun Xia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Diseases ◽  
Risk Model ◽  
Age Groups ◽  
Gastrointestinal Disorder ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Unique Identifier ◽  
Clinical Registry

Abstract Background Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which has not been paid much attention to in practice. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients. Methods From August 2011 to December 2017, a total number of 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were prospectively selected for this study. We described the incidence, causes of hospitalization by age groups and sex. The Fine-Gray competing risk model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total hospitalizations); while patients aged 65–74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). We found patients complicated with heart failure (HF)[hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.02–1.18], established coronary artery disease (CAD) (HR 1.24, 95%CI 1.17–1.33), ischemic stroke/transient ischemic attack (TIA) (HR 1.22, 95%CI 1.15–1.30), diabetes (HR 1.14, 95%CI 1.08–1.20), chronic obstructive pulmonary disease (COPD) (HR 1.28, 95%CI 1.02–1.62), gastrointestinal disorder (HR 1.37, 95%CI 1.21–1.55), and renal dysfunction (HR 1.24, 95%CI 1.09–1.42) had higher risks of hospitalization. Conclusions More than one-third of AF patients included in this study were hospitalized at least once during over 3-year follow-up. The main cause for hospitalization among the elderly patients (≥ 65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated to reduce hospitalization in AF patients older than 65 years old. Clinical Registryhttp://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. The registration date is October 22, 2013.

Patterns of use and trends in the use of medications for the control of COPD in a cohort of Colombian patients, 2017-2019 v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Population Database ◽  
Obstructive Pulmonary Disease ◽  
Prescription Patterns ◽  
Short Acting ◽  
Patterns Of Use ◽  
Long Acting

Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-acting β-agonists (2997, 31.6%) and inhaled corticosteroids (ICS) (2239, 23.6%), but 5083 (53.6%) patients received a long-acting bronchodilator. At the beginning of the follow-up, 645 (6.8%) patients were put on triple therapy with antimuscarinics, β-agonists, and ICS, and at 12 months, this rose to 1388 (20.6%). A total of 57.9% had comorbidities, most often hypertension (44.4%). Conclusions: This group of patients with COPD treated in Colombia frequently received short-acting bronchodilators and ICS, but a growing proportion are undergoing controlled therapy with long-acting bronchodilators, a situation that can improve the indicators of morbidity, exacerbations, and hospitalization.

scholarly journals Functionality of patients with Chronic Obstructive Pulmonary Disease at 3 months follow-up after elastic resistance training: a randomized clinical trial

Pulmonology ◽  
2018 ◽  
Vol 24 (6) ◽  
pp. 354-357
Author(s):  
Isis Grigoletto Silva ◽  
Bruna Spolador de Alencar Silva ◽  
Ana Paula Coelho Figueira Freire ◽  
Ana Paula Soares dos Santos ◽  
Fabiano Francisco de Lima ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Resistance Training ◽  
Randomized Clinical Trial ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Elastic Resistance

scholarly journals β2-Adrenergic genotypes and risk of severe exacerbations in COPD: a prospective cohort study

Thorax ◽  
2019 ◽  
Vol 74 (10) ◽  
pp. 934-940 ◽  
Author(s):  
Truls Sylvan Ingebrigtsen ◽  
Jørgen Vestbo ◽  
Line Rode ◽  
Jacob Louis Marott ◽  
Peter Lange ◽  
...  
Keyword(s):  
Adrenergic Receptor ◽  
Vital Capacity ◽  
Genetic Factors ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
General Population Study ◽  
Heart Study ◽  
Acute Admissions

BackgroundIndividual susceptibility to exacerbations in chronic obstructive pulmonary disease (COPD) is likely influenced by genetic factors; however, most such variance is unexplained. We hypothesised that β2-adrenergic receptor genotypes, Gly16Arg (rs1042713, c.46G>A) and Gln27Glu (rs1042714, c.79C>G) influence risk of severe exacerbations in COPD.MethodsAmong 96 762 individuals in the Copenhagen General Population Study, we identified 5262 with COPD (forced expiratory volume in one second divided by forced vital capacity, FEV1/FVC, below 0.7, FEV1 less than 80% of predicted value, age above 40 years and no asthma) who had genotyping performed. Severe exacerbations were defined as acute admissions due to COPD during 5 years of follow-up (mean 3.4 years). 923 individuals with COPD diagnosed similarly in the Copenhagen City Heart Study (CCHS) were used for replication analyses.ResultsWe recorded 461 severe exacerbations in 5262 subjects. The HRs for severe exacerbations were 1.62 (95% CI 1.30 to 2.03, p=0.00002) for 16Gly/Arg heterozygotes and 1.41 (1.04 to 1.91, p=0.03) for 16Arg homozygotes, compared with 16Gly homozygotes. HRs were 1.35 (1.03 to 1.76, p=0.03) for 27Gln/Glu heterozygotes and 1.49 (1.12 to 1.98, p=0.006) for 27Gln homozygotes, compared with 27Glu homozygotes. Similar trends were observed in the CCHS. Among 27Gln homozygotes only, HRs were 5.20 (1.81 to 14.9, p=0.002) for 16Gly/Arg heterozygotes and 4.03 (1.40 to 11.6, p=0.01) for 16Arg homozygotes, compared with 16Gly homozygotes.ConclusionCommon β2-adrenergic receptor genotypes influence risk of severe exacerbations in COPD, potentially mainly by genetic influence of the 16Arg allele in rs1042713.

Appendicitis in Diabetics: Predictors of Complications and Their Incidence

2016 ◽  
Vol 82 (8) ◽  
pp. 753-758 ◽  
Author(s):  
Lindsay Bach ◽  
Andrew Donovan ◽  
Whitney Loggins ◽  
Stephanie Thompson ◽  
Bryan Richmond
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Univariate Analysis ◽  
Multivariate Regression Analysis ◽  
General Surgeon ◽  
Management Approach ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cell Counts ◽  
Chi Squared

Appendicitis is the most common surgical emergency encountered by the general surgeon. Literature has demonstrated that diabetics may manifest atypical signs of infection, often clouding the diagnostic picture. We conducted a 3-year retrospective analysis of adults with appendicitis to determine differences in presentation, diagnosis, treatment, and outcomes for diabetic versus nondiabetic patients. Demographics, symptoms, imaging, procedure(s), complications, and length of stay (LOS) were obtained via chart review. Factors were compared between patients with and without diabetes using chi-squared test, t test, or Mann-Whitney U test (significance at P ≤ 0.05). Multivariate regression analysis identified variables predicting longer LOS or perforation at diagnosis. Overall, 339 patients met inclusion criteria [303 were nondiabetic (ND), 36 were diabetic (D)]. On univariate analysis, diabetics were more likely to have other comorbid illnesses: obesity ( P < 0.001), chronic kidney disease ( P = 0.003), hypertension ( P < 0.001), coronary artery disease ( P < 0.001), peripheral vascular disease (PVD, P = 0.31), and chronic obstructive pulmonary disease ( P = 0.002). Diabetics presented with lower white blood cell counts (mean 14.2 ND, 11.9 D, P = 0.02), and were more likely to present with perforation (18.5% ND, 38.9% D, P = 0.008). LOS was longer in diabetics (1.0 day for ND, 3.0 day for D, P < 0.001). Complications were more frequent in diabetics (19.4% D vs 8.6% ND), which trended toward but failed to reach significance ( P = 0.066). On multivariate analysis, however, old age was the only characteristic associated with perforation [odds ratio: 1.05 (1.02–1.06), P < 0.001], whereas diabetes, chronic obstructive pulmonary disease, and older age predicted longer LOS ( P ≤ 0.001). Diabetics present a more complicated clinical picture having significantly more comorbidities and a trend toward postoperative complications necessitating a higher index of suspicion to detection complications. Further study is needed to evaluate the optimal diagnostic and management approach in this challenging population.

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