Survival Impact of Chronic Obstructive Pulmonary Disease or Acute Exacerbation on Patients with Rectal Adenocarcinoma Undergoing Curative Resection: A Propensity Score-Matched, Population-Based Cohort Study

Purpose: The survival effect of current smoking-related chronic obstructive pulmonary disease (COPD) and COPD with acute exacerbation (COPDAE) is unclear for patients with rectal adenocarcinoma undergoing curative resection. Methods: We recruited patients with clinical stage I–IIIC rectal adenocarcinoma from the Taiwan Cancer Registry Database who had received surgery. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into two groups by using propensity score matching based on COPD status to compare overall survival outcomes: Group 1 (current smokers with COPD) and Group 2 (nonsmokers without COPD). Results: In the multivariate Cox regression analyses, the adjusted hazard ratio (aHR; 95% confidence interval (CI)) of all-cause mortality for Group 1 compared with Group 2 was 1.25 (1.04–1.51). The aHRs (95% cis) of all-cause mortality for frequency of ≥1 hospitalizations for COPDAE or ≥2 hospitalizations within 1 year before diagnosis were 1.17 (1.05–1.51) and 1.48 (1.03–2.41) compared with no COPDAE in patients with rectal adenocarcinoma undergoing curative resection. Conclusion: In patients with rectal adenocarcinoma undergoing curative resection, being a current smoker with COPD (Group 1) was associated with worse survival outcomes than being a nonsmoker without COPD (Group 2). Being hospitalized at least once for COPDAE within 1 year before the diagnosis of rectal adenocarcinoma is an independent risk factor for poor overall survival in these patients, and a higher number of hospitalizations for COPDAE within 1 year before diagnosis was associated with poorer survival.

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Chronic Obstructive Pulmonary Disease and Its Acute Exacerbation before Colon Adenocarcinoma Treatment Are Associated with Higher Mortality: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Cancers ◽

10.3390/cancers13184728 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4728

Author(s):

Yen-Chang Chen ◽

Ming-Chang Li ◽

Ying-Hui Yu ◽

Chih-Ming Lin ◽

Szu-Yuan Wu

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Propensity Score ◽

Acute Exacerbation ◽

Curative Resection ◽

Colon Adenocarcinoma ◽

Survival Outcomes ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

All Cause Mortality ◽

Group 1

Purpose: To investigate whether chronic obstructive pulmonary disease (COPD) and COPD severity (acute exacerbation of COPD (AECOPD)) affect the survival outcomes of patients with colon adenocarcinoma receiving standard treatments. Methods: From the Taiwan Cancer Registry Database, we recruited patients with clinical stage I–III colon adenocarcinoma who had received surgery. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into COPD and non-COPD (Group 1 and 2) groups through propensity score matching. Results: In total, 1512 patients were eligible for further comparative analysis between non-COPD (1008 patients) and COPD (504 patients) cohorts. In the multivariate Cox regression analysis, the adjusted hazard ratio (aHR; 95% confidence interval (CI)) for all-cause mortality for Group 1 compared with Group 2 was 1.17 (1.03, 1.29). In patients with colon adenocarcinoma undergoing curative resection, the aHRs (95% CIs) for all-cause mortality in patients with hospitalization frequencies of ≥1 and ≥2 times for AECOPD within 1 year before adenocarcinoma diagnosis were 1.08 (1.03, 1.51) and 1.55 (1.15, 2.09), respectively, compared with those without AECOPD. Conclusion: In patients with colon adenocarcinoma undergoing curative resection, COPD was associated with worse survival outcomes. Being hospitalized at least once for AECOPD within 1 year before colon adenocarcinoma diagnosis was an independent risk factor for poor overall survival in these patients, and a higher number of hospitalizations for AECOPD within 1 year before diagnosis was associated with poorer survival. Our study highlights the importance of COPD management, particularly the identification of frequent exacerbators and the prevention of AECOPD before standard colon adenocarcinoma treatments are applied.

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How to improve the effectiveness of combination therapy of arterial hypertension in patients with concomitant chronic obstructive pulmonary disease?

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-7-418-424 ◽

2020 ◽

Vol 4 (7) ◽

pp. 418-424

Author(s):

N.Yu. Grigorieva ◽

◽

M.O. Samolyuk ◽

T.V. Sheshina ◽

N.B. Koroleva ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lipid Peroxidation ◽

Arterial Hypertension ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Number Of Patients ◽

Group 2 ◽

Azilsartan Medoxomil ◽

Group 1

Aim: to conduct a comparative assessment of the hypotensive effect, as well as the effect on endothelial function, oxidative stress, and pulmonary artery pressure of chlorthalidone and hydrochlorothiazide as part of combined antihypertensive therapy in patients with arterial hypertension (AH) in combination with chronic obstructive pulmonary disease (COPD).Patients and Methods: the prospective study included 66 patients divided into two groups. As the main antihypertensive therapy, group 1 was prescribed with a combination of azilsartan medoxomil 40 mg and chlortalidone 12.5 mg as a fixed combination of Edarbi® CLO. Group 2 received a free combination of azilsartan medoxomil 40 mg (Edarbi®) and hydrochlorothiazide 12.5 mg. All patients underwent 24-hour blood pressure monitoring: (ABPM), echodopplercardiography, endothelium-dependent vasodilation, lipid peroxidation (LPO), nitric oxide metabolites, and endothelin-1 levels at baseline and after 6 months of treatment. Results: target blood pressure values (<130/80 mm Hg) were achieved in 91% of patients in group 1, and 51.5% in group 2 after 1 month of the study. After 6 months of treatment, all patients in both groups reached the target BP values, but in group 2, the dose of hydrochlorothiazide had to be increased to 25 mg. According to the ABPM data, after 6 months of treatment, group 1 showed a decrease in the morning surge in SBP by 7.0±2.1% and DBP by 10±7.3%. There was also an increase in the number of patients with the daily profile of «dipper» type to 78.8%. In group 2, there was a decrease in the morning surge in SBP by 6.3±5.9% and DBP by 4.8±4.6% after 6 months of treatment. There was an increase in the number of patients with the daily profile of «dipper» type to 36.4%. After 6 months of treatment, there was more pronounced improvement in laboratory parameters of group 1 characterizing endothelial dysfunction and oxidative stress. Statistically significant results were obtained for conjugated trienes, NO2, S, Imax, and endothelin-1 when comparing groups 1 and 2.Conclusion: treatment of AH in patients with concomitant COPD in the form of a fixed combination of azilsartan medoxomil and chlorthalidone versus free combination of azilsartan medoxomil with hydrochlorothiazide has a more pronounced antihypertensive effect, positively affecting the daily BP profile, pulmonary artery pressure, endothelial function and lipid peroxidation processes after 6 months of treatment.KEYWORDS: arterial hypertension, chronic obstructive pulmonary disease, endothelial dysfunction, lipid peroxidation, azilsartan medoxomil, chlorthalidone.FOR CITATION: Grigorieva N.Yu., Samolyuk M.O., Sheshina T.V. et al. How to improve the effectiveness of combination therapy of arterial hypertension in patients with concomitant chronic obstructive pulmonary disease? Russian Medical Inquiry. 2020;4(7):418–424. DOI: 10.32364/2587-6821-2020-4-7-418-424.

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Is Chronic Obstructive Pulmonary Disease An Independent Risk Factor For Coronary and Peripheral Atherosclerosis In Heavy Smokers?

10.21203/rs.3.rs-91443/v1 ◽

2020 ◽

Author(s):

Maria Angélica Pires Ferreira ◽

Leila Beltrami Moreira ◽

Felipe Soares Torres ◽

Marli Maria Knorst

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lung Function ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Similar Distribution ◽

Obstructive Pulmonary Disease ◽

The Mean ◽

Group 2 ◽

Heavy Smokers ◽

Group 1

Abstract BACKGROUNDThere is a high prevalence of cardiovascular disease (CVD) and atherosclerosis in people with chronic obstructive pulmonary disease (COPD); sharing of risk factors could not be the only cause of the association.OBJECTIVESTo verify whether coronary atherosclerosis and peripheral vascular disease are independently associated with COPD in heavy smokers. We also investigated whether inflammation and poor lung function were related with atherosclerosis findings.METHODSHeavy smokers (≥ 20 pack-years) with COPD (group 1) or normal spirometry (group 2) were recruited. Clinical, laboratory, and anthropometric data were obtained. Main interest variables were prevalence of CCS > 75th percentile (P75), and rates of ABI < 0,9 by Doppler ultrasound. CVD risk was calculated using the Framingham risk score. Serum C-reactive protein (CRP) was measured, and lung function was assessed by spirometry. Differences between groups were compared using parametric and nonparametric tests as adequate.RESULTSWere included 87 patients, 49 with COPD (group 1). The mean ± SD age was 57.2 ± 6.0 years (58.7 ± 5.1 in group 1, 55.2 ± 6.6 in group 2, p=0.006). The mean FEV 1 % was 45.8 ± 17.24 vs. 91.7 ± 15.9 in groups 1 and 2, respectively; p<0.05. The mean smoking index was 48.6 ± 25.4, higher in the COPD group (p=0.037). Stratification by Framingham score yielded a similar distribution in both groups. The frequency of patients with CCS > P75 was 55% vs. 66% in groups 1 and 2, respectively (p=0.823); ABI <9.0 ocurred in 6,3% vs 2,6%, respectivelly ( p=0.555) . CCS and ABI were not associated to FEV 1 %. CRP was inversely associated with VEF 1 ( r s= -0.419; p<0.001), but unrelated to CCS ( r s= 0.136; p=0.265) and ABI ( r s= -0.51; p=0.677).CONCLUSIONSThe studied coronary and peripheral atherosclerosis markers were similar between heavy smokers with COPD and those with normal spirometry. Nor serum CRP neither poor lung function related to CCS or ABI. Our results suggest absence of a independent association between COPD and atherosclerosis.

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The role of presepsin in the diagnosis of chronic obstructive pulmonary disease acute exacerbation with pneumonia

Biomarkers in Medicine ◽

10.2217/bmm-2019-0183 ◽

2020 ◽

Vol 14 (1) ◽

pp. 31-41

Author(s):

Ali Halıcı ◽

İzzettin Hür ◽

Kerim Abatay ◽

Esra Çetin ◽

Filiz Halıcı ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Acute Exacerbation Of Copd ◽

Group 3 ◽

Group 2 ◽

Exacerbation Of Copd ◽

Group 1

Aim: In this study, we aimed to investigate the role of presepsin in detecting concomitant pneumonia in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in the emergency department. Patients & methods: Three groups were formed in the study. Group 1: patients diagnosed with acute exacerbation of COPD; group 2: patients with acute exacerbation of COPD + pneumonia; group 3: healthy individuals. Results: Presepsin levels of the patients in group 2 were significantly higher than those of group 1 and group 3 (p < 0.05). There was a statistically significant difference in erythrocyte sedimentation rate, CRP, procalcitonin and presepsin values between two patient groups (p < 0.05). Conclusion: Presepsin can be used to diagnose pneumonia in patients with acute exacerbation of COPD admitted to the emergency department.

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Comparison of Lung Flute and threshold positive expiratory pressure devices for airway clearance in patients with chronic obstructive pulmonary disease: a randomised clinical trial

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2020.0028 ◽

2021 ◽

Vol 28 (11) ◽

pp. 1-7

Author(s):

Orein Fernandes ◽

Cherishma D'Silva ◽

Don Gregory Mascarenhas ◽

Sydney Roshan Rebello

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Forced Expiratory Volume ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Pulmonary Functions ◽

Airway Clearance ◽

Group 2 ◽

Group 1 ◽

Positive Expiratory Pressure

Background/Aims Mucus hypersecretion and altered lung functions leads to adverse clinical outcomes in chronic obstructive pulmonary disease. The aim of this study was to compare the effects of the Lung Flute and threshold positive expiratory pressure devices on sputum quantity and pulmonary functions in chronic obstructive pulmonary disease patients. Methods A total of 50 patients with chronic obstructive pulmonary disease were randomly divided into two groups. Group 1 used the Lung Flute device and group 2 used a threshold positive expiratory pressure device. Sputum quantity was measured post-intervention on a daily basis. Forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow rate were evaluated on day 1 and day 6. Results The mean sputum quantity in group 1 was 11.40 ml and it was 11.04 ml in group 2. Between-group comparison demonstrated a significant improvement in forced expiratory volume in the first second for group 1 compared to group 2 (P<0.005). Conclusions The Lung Flute was found to be slightly more effective than the threshold positive expiratory pressure device for airway clearance and also had a positive effect on pulmonary functions in patients with chronic obstructive pulmonary disease.

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APPLICATION OF EXERCISE COMBINED WITH LUNG REHABILITATION IN RESPIRATORY DISEASE

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-8692202228012021_0451 ◽

2022 ◽

Vol 28 (1) ◽

pp. 17-19

Author(s):

Guangheng Wang ◽

Yuqi Cai

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Educational Interventions ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Breathing Training ◽

Group 2 ◽

Experimental Group ◽

Group 1

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by incomplete reversibility of airflow obstruction and persistent respiratory symptoms. Objective: To explore the therapeutic effect of physical exercise on patients with chronic obstructive pulmonary disease in pulmonary rehabilitation. Methods: Forty-eight experimental subjects were divided into control group, experimental group 1, and experimental group 2 for research. The control group received normal medical-related treatment without any other means of intervention. In addition to normal medical-related treatment, experimental group 1 received breathing training and educational interventions and experimental group 2 received exercise, breathing training and educational interventions. Results: The vital capacity of female subjects before and during the experiment ranged from 2.23±0.01 to 2.26±0.04, the FVC ranged from 2.00±0.02 to 2.01±0.03, the FEV1 ranged from 1.03±0.01 to 1.03±0.01,the FEV1% ranged from 55.50±1.29 to 55.25±1.71,the FEV1/FVC ranged from 51.44±0.24 to 50.84±1.00, andthe heart rate ranges from 65.00±0.82 to 65.50±1.29. Conclusions: Exercise training can increase the exercise tolerance of patients with COPD, relieve dyspnea, and improve the quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.

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Comorbidities of Primary Care patients with COVID-19 during the first wave of the SARS-CoV-2 pandemic in the Community of Madrid

Revista Española de Quimioterapia ◽

10.37201/req/114.2021 ◽

2021 ◽

Author(s):

José-Luis Puerta ◽

Macarena Torrego-Ellacuría ◽

Ángel Del Rey-Mejías ◽

César Biénzobas López

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Blood Pressure ◽

Chronic Obstructive Pulmonary Disease ◽

Primary Care ◽

High Blood Pressure ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Group 2 ◽

Group 1

Objectives. Recent publications on inpatients with COVID-19 describing their comorbidities and demographic profile exists, but data from large populations requiring only primary care (PC) are scarce. This paper aims to fill this gap and report the prevalence of eight comorbidities (high blood pressure, diabetes mellitus, cancer, cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and chronic heart failure) among patients attending PC during the onset of the SARS-CoV-2 pandemic in the Community of Madrid (CoM), Spain. Patients and methods. This is an observational retrospective study that collects data registered in the CoM between February 25th and May 31st, 2020. Data are divided in two groups: Group-1 (N=339,890) consist of all patients with suspected or proven SARS-CoV-2 infection; and Group-2 is the subgroup (N=48,556, 14.3% of Group-1) of individuals with COVID-19 confirmed by positive RT-PCR test. Results. Comparing Group-1 with Group-2, 339,890/48,556 patients, respectively, the main results were as follows: average age (60.9/69.9 years), presence of at least one comorbidity (33.51%/47.69%), high blood pressure (19.74%/32.74%), diabetes mellitus (7.13%/13.75%), cancer (6.56%/10.6%), cardiovascular disease (4.52%/9.26%), asthma (7.98%/6.56%), chronic kidney disease (1.84%/4.41%), chronic obstructive pulmonary disease (2%/4.03%), and chronic heart failure (1.14%/2.77%). High blood pressure and diabetes mellitus were seen to be the most frequent (6.56%/8.38%) association. Conclusions. Patients requiring PC attention during the first wave of the COVID-19 pandemic in the CoM presented with a very high rate of comorbidities, with marked differences among those with or without a confirmed SARS-CoV-2 infection.

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Comorbidity and polymorbidity of the patient with chronic obstructive pulmonary disease and cardiovascular diseases

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.01.000027 ◽

2019 ◽

Vol 91 (1) ◽

pp. 43-47 ◽

Cited By ~ 2

Author(s):

N Yu Grigoryeva ◽

M V Maiorova ◽

M E Korolyova ◽

M O Samolyuk

Keyword(s):

Myocardial Infarction ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Clinical Course ◽

Chronic Obstructive ◽

Case Histories ◽

Obstructive Pulmonary Disease ◽

Cardiology Department ◽

Group 2 ◽

Group 1

Aim: the study of comorbid status and characteristics of clinical course of ischemic heart disease (IHD) in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We conducted a retrospective analysis of case histories of 958 IHD patients aged 32 to 93 years (mean age of 60.8±10.2 years), including men - 525 (54.8%), women - 433 (45.2%) who were treated in the cardiology Department of city clinical hospital №5 of Nizhny Novgorod. Related COPD was diagnosed in 251 patients (26.3%). We compared two groups patients: with IHD and COPD, and the second - persons suffering from only IHD (without COPD). Results. Myocardial infarction was transferred by 62.2% of patients in Group 1, which is 16.3% more than in Group 2 (p

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Clinical effects of cognitive impairment in patients with chronic obstructive pulmonary disease

Chronic Respiratory Disease ◽

10.1177/1479972317743757 ◽

2017 ◽

Vol 15 (3) ◽

pp. 306-314 ◽

Cited By ~ 4

Author(s):

Esra Ertan Yazar ◽

Senay Aydin ◽

Gulsah Gunluoglu ◽

Sadettin Kamat ◽

Adil Can Gungen ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Cognitive Impairment ◽

Cognitive Functions ◽

Daily Living ◽

Chronic Obstructive ◽

Clinical Effects ◽

Obstructive Pulmonary Disease ◽

Arterial Partial Pressure ◽

Group 2 ◽

Group 1

The aim of this study was to evaluate the clinical effects of cognitive impairment in patients with chronic obstructive pulmonary disease (COPD). A total of 91 patients with stable moderate to very severe COPD were included in this study. Cognitive functions of the patients were evaluated using the mini-mental state examination (MMSE) tool and clock-drawing test. The Brody’s Instrumental Activities of Daily Living (IADL) Questionnaire; COPD assessment test (CAT); body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE); and Charlson comorbidity index were assessed. The patients were divided into two groups as those who were diagnosed with cognitive impairment (group 1, n = 16) and those with normal cognitive functions (group 2, n = 75). Group 1 had a lower arterial partial pressure of oxygen , shorter 6-min walking distance, and higher arterial partial pressure of carbon dioxide (PaCO2) than group 2 ( p = 0.01, p = 0.024, p = 0.018, respectively). In group 1, the IADL score was lower, and CAT and BODE scores were higher than group 2 ( p = 0.002, p = 0.037, p = 0.012, respectively). When we considered all the patients, there was an independent correlation between the IADL score and MMSE score ( p = 0.03). This study revealed that COPD patients with cognitive impairment may have more hypoxemia and limited activities of daily living.

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Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: A comparative study

Journal of Medical Biochemistry ◽

10.2478/jomb-2018-0050 ◽

2019 ◽

Vol 38 (4) ◽

pp. 503-511 ◽

Cited By ~ 4

Author(s):

Füsun Şahin ◽

Ayşe Filiz Koşar ◽

Ayşe Feyza Aslan ◽

Burcu Yiğitbaş ◽

Berat Uslu

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Distribution Width ◽

Lymphocyte Ratio ◽

Group 3 ◽

Group 2 ◽

Group 1

Summary Background Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have all been investigated as novel inflammatory markers of cardiac and oncological diseases, while there is only a limited number of studies investigating these markers in chronic obstructive pulmonary disease (COPD). In the present study we examine NLR, PLR; and other markers, such as eosinophil, MPV, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width (RDW), and C-reactive protein (CRP) in patients with stable and acute exacerbation of COPD. Methods Stable COPD (Group 1, n=140), COPD with acute exacerbation (Group 2, n=110), and healthy controls (Group 3, n=50) were included in the study. Leukocyte, CRP, hemoglobin (HB), RDW, platelet, MPV, PCT, PDW, neutrophil, lymphocyte, eosinophil, NLR, and PLR were analyzed in all groups. Results HB, leukocyte, platelet, neutrophil, eosinophil, MPV, PCT, CRP, NLR, and PLR were significantly higher, while the lymphocyte was lower in Group 1 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while lymphocyte was lower in Group 2 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while HB, platelet, MPV, PCT, and lymphocyte were significantly lower in Group 2 than in Group 1. NLR and PLR increased significantly in patients with bronchiectasis when compared to those without in Group 1. Conclusions Our study results suggest that NLR, PLR and RDW can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with COPD.

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