scholarly journals Maintaining Quality of Care among Dialysis Patients in Affected Areas after Typhoon Morakot

2021 ◽  
Vol 18 (14) ◽  
pp. 7400
Author(s):  
Chia-Ming Chang ◽  
Tzu-Yuan Stessa Chao ◽  
Yi-Ting Huang ◽  
Yi-Fang Tu ◽  
Tzu-Ching Sung ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cerebrovascular Disease ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Chronic Obstructive ◽  
Dialysis Patients ◽  
Typhoon Morakot ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Basic Infrastructure

Natural disasters have negative health impacts on patients who need dialysis in affected areas. Severely affected areas are usually rural, with limited basic infrastructure and a population without optimal dialysis-specific care after a disaster. A population-based longitudinal case–cohort study enrolled 715,244 adults from the National Health Insurance Registry who lived in areas affected by a major natural disaster, Typhoon Morakot, in 2009. The observation period was from 2008 to 2011. A total of 13,268 patients (1.85%) had a history of end-stage renal disease (ESRD). Of the ESRD patients, 1264 patients (9.5%) received regular dialysis. Only eight patients missed dialysis sessions in the first month after the disaster. Compared to the moderately affected areas, the incidences of acute cerebrovascular and cardiovascular diseases were higher in patients in severely affected areas. Male dialysis patients aged 45–75 years had a higher mortality rate than that of the general population. Among the affected adults receiving regular dialysis, patients with diabetes (adjusted hazard ratio (aHR): 1.58, 95% confidence interval (CI): 1.20–2.08) or a history of cerebrovascular disease (aHR: 1.58, 95% CI: 1.12–2.21), chronic obstructive pulmonary disease (COPD) or asthma (aHR: 1.99, 95% CI: 1.24–3.17) in moderately affected areas had significantly elevated mortality rates. Additionally, among dialysis patients living in severely affected areas, those with a history of cerebrovascular disease (aHR: 4.52 95% CI: 2.28–8.79) had an elevated mortality rate. Early evacuation plans and high-quality, accessible care for cardiovascular and cerebrovascular diseases are essential to support affected populations before and after disasters to improve dialysis patients’ health outcomes.

scholarly journals The prevalence of chronic obstructive pulmonary disease in hookah smokers

2017 ◽  
Vol 15 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Mehrzad Bahtouee ◽  
Nasrollah Maleki ◽  
Fatemeh Nekouee
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Population Based ◽  
Older Age ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Hookah Smoking ◽  
History Of ◽  
Global Burden Of Diseases ◽  
The Relationship

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Hookah smoking is growing worldwide and particularly in Iran. The aim of this study was to determine the prevalence of obstructive pulmonary dysfunction in hookah smokers. We conducted a population-based study in Bushehr Province, Iran. A total of 245 subjects aged 35 years or older who were taking hookah for at least 15 years and 245 healthy controls were enrolled in the study and spirometry was done. Statistical analyses were performed using SPSS for windows software version 19. The prevalence of COPD among the exposed group of hookah smoke was 10.2%, with the rate being significantly higher in the patients with older age ( p < 0.001), duration of hookah smoking ( p < 0.001), men ( p = 0.026), ≥3 hookahs/day ( p = 0.006), history of cough for ≥2 years ( p = 0.002), in patients with a history of sputum for ≥2 years ( p = 0.031), and in patients with a history of dyspnea for ≥2 years ( p = 0.001). The results of the logistic regression analysis demonstrated that older age, male gender, smoking, and occupational exposure were independent predictive factors for COPD. The results of our study suggest that hookah smoking significantly increases the risk of COPD. Given the importance of COPD in the global burden of diseases, it is necessary to carry out further studies on the relationship between hookah use and COPD.

Leading air pollution related reasons of death

2020 ◽  
Vol 99 (4) ◽  
pp. 337-343
Author(s):  
Marina M. Saltykova ◽  
A. V. Balakaeva ◽  
T. P. Fedichkina ◽  
I. P. Bobrovnitskii
Keyword(s):  
Air Pollution ◽  
Mortality Rate ◽  
Circulatory System ◽  
Pairwise Comparison ◽  
Cerebrovascular Diseases ◽  
Economic Conditions ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Oncological Diseases ◽  
Working Age

The aim of this study was to analyze the effect of air pollution on the structure of reasons of death from major non communicable diseases in cities of the Russian Federation Material and methods. The study analyzed the mortality of people of working age (with stratification by gender and causes of death) in pairs of cities, with matching the cities of each pair by the climatic and socio-economic conditions, but the level of air pollution in one city significantly exceeded the level of pollution in another. The following pairs of cities were formed (“dirty” - “relatively clean”): Bratsk-Kirov; Nizhny Tagil-Kirov; Novokuznetsk-Tomsk; Chita-Tomsk; Magnitogorsk - Orenburg, Cherepovets-Vologda. The analysis included data on the mortality from diseases of the circulatory system, respiratory system, and oncological diseases, since according to WHO, air pollution primarily affects mortality from coronary heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. Results. The mortality rate of people of working age from diseases of the circulatory system, primarily from cardiovascular diseases, is significantly higher in cities with a high level of pollution compared with cities with a lower level of pollution and similar climatic and socio-economic conditions. The mortality rate of men from cerebrovascular diseases in the group of dirty cities is higher than in compared cities in 4 out of 6 studied pairs. Moreover, differences in the mortality rate in women were less pronounced, they were revealed in 2 out of 6 compared pairs. The differences in mortality from oncological diseases were detected in 4 out of 6 comparison pairs for women and 2 out of 6 compared pairs for men. Conclusion. An analysis of the mortality used pairwise comparison of cities showed air pollution to most affect on the mortality from diseases of the circulatory system.

scholarly journals Factors affecting mortality in patients with COPD exacerbations requiring ICU admission

2013 ◽  
Vol 1 (2) ◽  
pp. 3 ◽  
Author(s):  
Chok Limsuwat ◽  
Nopakoon Nantsupawat ◽  
Elvira Umyarova ◽  
Kamonpun Ussavarungsi ◽  
Kenneth Nugent
Keyword(s):  
Mortality Rate ◽  
Hospital Death ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Copd Exacerbations ◽  
Survival Result ◽  
Arterial Blood ◽  
Organ Systems ◽  
History Of

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often require hospital admission and have a significant mortality rate. Patients with AECOPD who need intensive care (ICU) have higher mortality rates. Identifying factors associated with increased mortality might change approaches to treatment and improve communication with patients’ families about prognosis. Methods: Patients with AECOPD (ICD 9 code 491.21) directly admitted to the ICU between 1/1/2006 and 12/31/2010 were retrospectively reviewed. The inclusion criteria were age 45 years or older, diagnosis of AECOPD, and admission to an ICU. The exclusion criteria included any history of another respiratory disease or decompensated cardiac disease. The primary goal was to determine factors which affect survival. Result: Two hundred and seventeen patients were included this study. The mean ages were 70.4±10.4 years in the in-hospital death group and 66.4±10.9 years in the survivors. The overall mortality rate was 12%.  Multivariate analysis showed that the mortality rate was significantly associated with a low mean arterial blood pressure (MAP) (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.96), an intubation event (OR 6.12, 95% CI 1.24-30.87), and an elevated blood urea nitrogen (BUN) (OR 1.06, 95% CI 1.01-1.12) (p<0.05 for each factor). Conclusion: This study identified clinical parameters associated with increased mortality in patients with AECOPD admitted to an ICU. These factors include a low MAP, intubation, and a high BUN and are easily obtained during the initial evaluation of the patient. They reflect the severity of the acute exacerbation and complications in other organ systems.

scholarly journals Leading air pollution related reasons of death

2020 ◽  
Vol 99 (4) ◽  
pp. 337-343
Author(s):  
Марина Михайловна Салтыкова ◽  
А. В. Балакаева ◽  
Т. П. Федичкина ◽  
И. П. Бобровницкий
Keyword(s):  
Air Pollution ◽  
Mortality Rate ◽  
Circulatory System ◽  
Pairwise Comparison ◽  
Cerebrovascular Diseases ◽  
Economic Conditions ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Oncological Diseases ◽  
Working Age

The aim of this study was to analyze the effect of air pollution on the structure of reasons of death from major non communicable diseases in cities of the Russian Federation Material and methods. The study analyzed the mortality of people of working age (with stratification by gender and causes of death) in pairs of cities, with matching the cities of each pair by the climatic and socio-economic conditions, but the level of air pollution in one city significantly exceeded the level of pollution in another. The following pairs of cities were formed (“dirty” - “relatively clean”): Bratsk-Kirov; Nizhny Tagil-Kirov; Novokuznetsk-Tomsk; Chita-Tomsk; Magnitogorsk - Orenburg, Cherepovets-Vologda. The analysis included data on the mortality from diseases of the circulatory system, respiratory system, and oncological diseases, since according to WHO, air pollution primarily affects mortality from coronary heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. Results. The mortality rate of people of working age from diseases of the circulatory system, primarily from cardiovascular diseases, is significantly higher in cities with a high level of pollution compared with cities with a lower level of pollution and similar climatic and socio-economic conditions. The mortality rate of men from cerebrovascular diseases in the group of dirty cities is higher than in compared cities in 4 out of 6 studied pairs. Moreover, differences in the mortality rate in women were less pronounced, they were revealed in 2 out of 6 compared pairs. The differences in mortality from oncological diseases were detected in 4 out of 6 comparison pairs for women and 2 out of 6 compared pairs for men. Conclusion. An analysis of the mortality used pairwise comparison of cities showed air pollution to most affect on the mortality from diseases of the circulatory system.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

scholarly journals Occupational cold exposure is associated with increased reporting of airway symptoms

2021 ◽  
Author(s):  
Albin Stjernbrandt ◽  
Nikolai Stenfors ◽  
Ingrid Liljelind
Keyword(s):  
Cold Exposure ◽  
Leisure Time ◽  
Rating Scales ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Postal Survey ◽  
Chronic Obstructive ◽  
Northern Sweden ◽  
Obstructive Pulmonary Disease ◽  
Airway Symptoms

Abstract Objective To determine if exposure to cold environments, during work or leisure time, was associated with increased reporting of airway symptoms in the general population of northern Sweden. Methods Through a population-based postal survey responded to by 12627 subjects, ages 18–70, living in northern Sweden, the occurrence of airway symptoms was investigated. Cold exposure during work or leisure time was self-reported on numerical rating scales. Binary logistic regression was used to determine the statistical association between cold exposure and airway symptoms. Results For currently working subjects (N = 8740), reporting any occupational cold exposure was associated to wheeze (OR 1.3; 95% CI 1.1–1.4); chronic cough (OR 1.2; 95% CI 1.1–1.4); and productive cough (OR 1.3; 95% CI 1.1–1.4), after adjusting for gender, age, body mass index, daily smoking, asthma, and chronic obstructive pulmonary disease. Leisure-time cold exposure was not significantly associated to reporting airway symptoms. Conclusions Occupational cold exposure was an independent predictor of airway symptoms in northern Sweden. Therefore, a structured risk assessment regarding cold exposure could be considered for inclusion in the Swedish workplace legislation.

scholarly journals Imaging in alpha-1 antitrypsin deficiency: a window into the disease

2021 ◽  
Vol 12_suppl ◽  
pp. 204062232110245
Author(s):  
Yuh-Chin Tony Huang ◽  
Marion Wencker ◽  
Bastiaan Driehuys
Keyword(s):  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Essential Information ◽  
Plain Chest Radiograph ◽  
Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin Deficiency ◽  
History Of ◽  
Detailed Assessment ◽  
Alpha 1 Antitrypsin ◽  
Magnetic Resonance Imaging Mri

Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

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