scholarly journals Comparison of clinical characteristics between mild chronic bronchitis and severe chronic bronchitis in patients with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
Joon Young Choi ◽  
Hyoung Kyu Yoon ◽  
Sang Yeub Lee ◽  
Jin Woo Kim ◽  
Hye Sook Choi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Lung Function Tests ◽  
Exacerbation Rate ◽  
Obstructive Pulmonary Disease ◽  
Function Tests

Abstract Background Chronic bronchitis (CB) is associated with poor outcomes in patients with chronic obstructive pulmonary disease. The aim of this study was to identify the characteristics that distinguish chronic bronchitis (CB) from non-CB. In addition, the features of mild CB vs. severe CB were compared and a cut-off level was defined according to CAT1 and CAT2 scores. Methods This study was based on the Korea COPD Subgroup Study (KOCOSS) database, constructed in a multicenter COPD cohort study that recruited patients from 54 centers. CB was defined as CAT1 and CAT2 scores ≥3; severe CB was defined as CAT1 and CAT2 scores ≥4, while mild CB was defined as either a CAT1 or a CAT2 score < 4. Baseline characteristics, 1-year exacerbation rate, and 3-year FEV1 decline were compared in non-CB vs. CB patients and in patients with mild CB vs. severe CB. Results Among the 2,162 patients enrolled in this study, 497 (23%) had CB. These patients were more likely than non-CB patients to be current smokers; they also had higher symptom and depression/anxiety scores. Lung function tests showed lower FEV1, FEV1/FVC, and DLco values in CB patients. Among CB patients, 67.6% had mild disease. Symptom and depression/anxiety scores were worse in patients with severe CB than in patients with mild CB. There were no significant differences in the lung function tests of the two groups. Analysis of 1-year exacerbation rates in CB patients and non-CB patients revealed that patients with CB more frequently had moderate-to-severe exacerbations (OR = 1.46, p < 0.01). More severe exacerbation was also present in patients with severe CB than in patients with mild CB (OR = 2.52, p = 0.01). The difference in annual FEV1 decline rate did not significantly differ either between CB patients and non-CB patients or between patients with severe CB and patients with mild CB. Conclusions CB patients had worse symptoms and lung function than non-CB patients; CB patients also had more frequent moderate-to-severe exacerbation. Patients with severe CB had higher symptom scores and more frequent severe exacerbation than did patients with mild CB.

scholarly journals Pro: Inhaled corticosteroids for chronic obstructive pulmonary disease

2019 ◽  
Vol 2 (1) ◽  
pp. 35-40
Author(s):  
Donald A. Mahler
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Mechanisms Of Action ◽  
Phase Iii ◽  
Chronic Obstructive ◽  
Exacerbation Rate ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Background: Controversy exists about the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD). Although ICS are not approved as monotherapy for COPD, four ICS molecules, beclomethasone, budesonide, fluticasone furoate, and fluticasone propionate, are used widely in combination with long-acting bronchodilators to treat patients with this disease. Objectives: (1) To review the mechanisms of action of ICS therapy that contribute to the clinical benefits in COPD; and (2) to describe improvements in lung function, relief of dyspnea, increase in exercise tolerance, and the reduction in exacerbations with ICS use in COPD. Methods: A critical review of phase III and IV randomized clinical trials that evaluated ICS therapy in patients with COPD. Results: ICS have two major mechanisms of action in human airways: a reduction in edema and inflammation, and a decrease in airway hyperresponsiveness. ICS monotherapy significantly increases the morning peak expiratory flow rate and forced expiratory volume in 1 second (peak and trough) as early as the first day of treatment. Discontinuation of ICS therapy leads to deterioration in lung function. Treatment with ICS, alone and in combination with a long-acting bronchodilator, reduces dyspnea related to daily activities, whereas withdrawal increases breathing difficulty. Patients with COPD exhibit a significant increase in exercise duration with ICS therapy. The combination of ICS with one or more bronchodilators significantly reduces the exacerbation rate compared with bronchodilator therapy alone. The major serious adverse effect is an increased risk of pneumonia. Conclusion: Randomized controlled trials demonstrate that ICS therapy improves both physiologic and clinical outcomes in patients with COPD. These benefits are enhanced when ICS molecules are combined with one or more long-acting bronchodilators.

scholarly journals How do patients conceptualize chronic obstructive pulmonary disease?

2016 ◽  
Vol 14 (3) ◽  
pp. 245-255 ◽  
Author(s):  
RE Goldman ◽  
L Mennillo ◽  
P Stebbins ◽  
DR Parker
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
The United States ◽  
Current Smoker ◽  
Social Consequences ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Behavioral Adaptations

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States, yet even at risk or diagnosed patients misunderstand COPD and its consequences for their quality of life and mortality. This study explored how patients conceptualize the causes, symptoms, consequences, treatment, and risk for developing COPD. The study consisted of six focus groups: 39 participants who were adults > 40 and current smoker or have COPD symptoms, family history, or exposures. Although many participants had some familiarity with the breathing, lung function, physical, emotional, and social consequences of COPD, confusion and misunderstanding prevailed. Few knew that COPD, chronic bronchitis, and emphysema are synonymous. Some participants claimed that they “only” had bronchitis and/or emphysema and not COPD. Some participants described behavioral adaptations to decrease symptom impact and others expressed strong interest in learning how to increase daily functioning. Insufficient knowledge and persisting misconceptions about COPD can prevent patients from accessing life-enhancing strategies. Patients can benefit from (1) providers clarifying COPD’s connection to chronic bronchitis and emphysema to aid them in recognizing the need for mitigating action; (2) encouraging smoking cessation, specifically to stem worsening of disease; and (3) explaining lifestyle adaptations for easing daily life despite decreased lung function.

scholarly journals Number 2: Chronic Obstructive Pulmonary Disease: The Importance of Exercise

2000 ◽  
Vol 7 (2) ◽  
pp. 138-139 ◽  
Author(s):  
Norman L Jones
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Muscle Fatigue ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Muscle Function ◽  
Common Factors ◽  
Chronic Obstructive ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease

Patients with chronic obstructive pulmonary disease (COPD - chronic bronchitis, emphysema, asthma) are often limited in their capacity to exercise, mainly because they experience shortness of breath or muscle fatigue. The reasons for shortness of breath are dealt with in another patient page (Can Respir J 2000;7(1):35-36), and include narrowing of the airways, poor lung function leading to falls in the amount of oxygen carried in the blood and weak muscles for breathing. Easy fatiguability may be because of muscle weakness or changes in muscle function, related to inactivity and ageing. Other less common factors include heart problems associated with COPD, and other coexisting health problems, such as anemia and arthritis.

Screening of High-risk Patients for Chronic Obstructive Pulmonary Disease in Primary Care: A Narrative Review (Preprint)

2020 ◽  
Author(s):  
Ponrathi Athilingam ◽  
Andrew Bugajski ◽  
Usha Menon
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Current Knowledge ◽  
Screening Tools ◽  
Chronic Obstructive ◽  
Early Screening ◽  
Obstructive Pulmonary Disease ◽  
Impaired Lung Function ◽  
Risk Patients

UNSTRUCTURED Chronic obstructive pulmonary disease (COPD) predominantly affects older adults, and claimed 3 million lives in 2016, making it the third leading cause of death worldwide. Over 35 million Americans aged 40 or older have lung function consistent with diagnosable COPD. COPD and cardiovascular disease (CVD) have a bidirectional relationship, in that one is a risk factor for developing the other. National and international consortiums recommend early screening of adults at risk of COPD, such as those with CVD. Recommended screening strategies include screening tools to assess symptoms, medical history, and handheld spirometry. Handheld spirometry has high diagnostic accuracy and if impaired lung function is indicated, these patients are referred for pulmonary function testing (PFT), the diagnostic gold standard for COPD. However, there is no clinical consensus for pulmonary screening in people with CVD. Current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence is key in combating the global burden of COPD.

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