• 主题
高级搜索  >
历史搜索 清空历史

您现在的位置：首页>美国卫生研究院文献>Chronic Respiratory Disease

期刊信息

  • 期刊名称：

    -

  • 刊频： Continuously updated, 2019-
  • NLM标题：
  • iso缩写： -
  • ISSN： -

年度选择

更多>>

  • 排序：
  • 显示：
  • 每页：
全选（0）
<1/12>
共224条结果
  • 1.

    【2hr】Asthma knowledge, care, and outcome during pregnancy: The QAKCOPstudy

    包量

    机译 怀孕期间的哮喘知识，护理和结局：QAKCOP研究
    摘要：Asthma is the most common chronic medical condition affecting pregnancy. Optimizing asthma management in pregnancy is paramount for the well-being of both the mother and the baby. The primary objectives of this study were to assess patient’s knowledge about asthma, the level of asthma care, and fetal and maternal outcomes among pregnant asthmatic women in this wealthy country with tremendous improvement in maternal and fetal health care. The secondary objective was to identify barriers to asthma control. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. About 56% of patients reported worsening of their asthma control during pregnancy, of which 52.3% felt this worsening in the third trimester. About 65% of patients had uncontrolled asthma during their pregnancy, and inhaler technique was incorrect in 64.4%. Only 38% of patients knew the difference between controller and reliever asthma medications, 12.7% of patients had received written asthma action plan, 17% had a spirometry done in the previous 5 years, and 3.8% had peak expiratory flow meter at home. The main reasons for uncontrolled asthma were lack of knowledge about right asthma medications in 30% and fear of side effects of inhaled corticosteroids in 19% ofpatients. No financial reason was reported. Significant associations betweentotal number of pregnancies, poor perception of asthma medications, asthmaexacerbation during delivery and poor asthma control were observed. Preeclampsiaand congenital anomalies occurred at higher rates than previously reported amonggeneral population in this country. The tremendous improvements in maternalhealth care and socioeconomic status do not seem to be a barrier to the globallyrecognized poor asthma care in pregnancy. Important strategies are muchneeded.
  • 2.

    【2hr】COPD patients in need of palliative care: Identification after hospitalization through the surprise question

    包量

    机译 需要姑息治疗的COPD患者：住院后通过出人意料的问题进行识别
    摘要：Currently, few patients suffering from chronic obstructive pulmonary disease (COPD) who might benefit from a palliative care approach are referred to a palliative care team. Tools to identify patients eligible for a palliative care approach have been found to be difficult to apply in daily practice. Therefore, there is need for a simple and easily applicable tool to identify those patients who would benefit from referral to a palliative care team. The aim of this study was to determine if the surprise question (SQ) “Would I be surprised if this patient dies within 12 months?” in a subset of recently hospitalized COPD patients identifies those subjects. Recently hospitalized COPD patients were included, and the answer to the SQ was provided by the treating pulmonologist. The gold standards framework (GSF) prognostic indicator guidance was regarded as the gold standard test and was assessed for each patient. Sensitivity, specificity, and negative and positive predictive values were calculated to determine the accuracy of the SQ plus recent hospitalization compared to the variables of the GSF. A total of 93 patients were analyzed. In 35 patients (38%), the answer to the SQ was “not surprised”; 78 patients (84%) met ≥1 criteria of the GSF (15 (16%) did not meet any criteria). Specificity and positive predictive value for the SQ were both 100% ((78.2–100) and (87.7–100), respectively). Sensitivity was 44.9% (33.7–56.5) and negative predictive value was 25.9% (22.2–29.9). The “not surprised” group fulfilled significantly more GSF criteria. The SQ after recent hospitalization for COPD has a very high specificity compared to a standardized tool and is therefore a useful tool for the quick identification of patients who are most likely to benefit from palliative care. However, this method doesn’t identify all patients who are eligible for referral to palliative care.
  • 3.

    【2hr】Development of a core outcome set for trials investigating the long-term management of bronchiectasis

    包量

    机译 为研究支气管扩张的长期治疗的试验开发核心结果集
    摘要：Heterogeneity in outcomes measured in trials limits accurate comparison of bronchiectasis studies. A core outcome set (COS) is an agreed, standardized set of outcomes that should be measured in trials for specific clinical areas. A COS for bronchiectasis could encourage consistency in future studies. An overview of systematic reviews and qualitative study on outcome selection in bronchiectasis informed an initial list of outcomes. A Delphi panel (n = 86) rated the importance of each outcome from 1 to 9 in 3 sequential questionnaires, as a means to achieve consensus: 1–3 = ‘of limited importance’; 4–6 = ‘important, but not critical’; and 7–9 = ‘critical’. Outcomes rated ‘critical’ by ≥70% of the panel were added to the COS. Eighty-two participants responded to the first questionnaire. Attrition between each questionnaire was 5%. After 3 rounds of questioning, 18 outcomes exceeded the threshold for consensus and were included in the COS. This study has achieved consensus on 18 outcomes that should be measured in trials of interventions for bronchiectasis. Selection of the highest ranked outcomes may represent a pragmatic means for comparison. Further research is required to condense the number of outcomes selected and to determine its relevance to interventions.
  • 4.

    【2hr】Adherence to long-term oxygen therapy in patients with chronicobstructive pulmonary disease

    包量

    机译 长期患者坚持长期氧疗阻塞性肺疾病
    摘要：Long-term oxygen therapy (LTOT) has beneficial effects on survival in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia at rest. Two landmark trials suggested that these benefits depend on the time of exposure to oxygen. Patients are usually prescribed LTOT for at least 15–18 hours/day. The primary objective of this study was to determine the average daily exposure to supplemental oxygen in patients with severely hypoxemic COPD who were newly prescribed LTOT and the proportion of patients who were adherent to their prescription. The secondary objective was to identify predictors of compliance to LTOT. We performed a retrospective observational study of patients newly registered in a regional home oxygen program in Quebec, Canada, between July 1, 2013, and December 31, 2014. Daily exposure to oxygen was objectively measured from the concentrator’s counter clock. From 196 patients registered in the program during the study period, 115 contributed to the analysis. Most patients (n = 84; 73%) were prescribed oxygen for ≥18 hours/day. Overall, the 115 patients were exposed to home oxygen for 17.8 hours/day; 60% of the patients were compliant according to our definition. Increasing age and ambulatory oxygen utilization predicted adherence to oxygen therapy. Adherenceto home oxygen therapy is suboptimal. Behavioral and psychological interventionsto improve compliance to LTOT should be investigated.
  • 5.

    【2hr】How resources determine pulmonary rehabilitation programs: A surveyamong Belgian chest physicians

    包量

    机译 资源如何确定肺康复计划：一项调查在比利时胸科医师中
    摘要：Despite overwhelming evidence of its benefits, a widespread implementation of pulmonary rehabilitation (PR) is lacking and the landscape of multidisciplinary programs remains very scattered. The objective of this study is to assess how PR is organized in specialized care centres in Belgium and to identify which barriers may exist according to respiratory physicians. A telephone and online survey was developed by a Belgian expert panel and distributed among all active Belgian chest physicians (n = 492). Data were obtained from 200 respondents (40%). Seventy-five percentage of the chest physicians had direct access to an ambulatory rehabilitation program in their hospital. Most of these programs are organized bi or triweekly for an average period of 3–6 months. Programs focus strongly on chronic obstructive pulmonary disease patients from secondary care, have a multidisciplinary approach and provide exercise capacity and quality of life measures as main outcomes. Yet large differences were observed in process and outcome indicators between the programs of centres with standard funding and those of specialized centres with a larger allocated budget. We conclude that multidisciplinary PR programs are available in the majority of Belgian hospitals. Differences in funding determine the quality ofthe team, the diversity of the interventions and the monitoring of outcomes.More resources for rehabilitation will directly improve the utilization andquality of this essential treatment option in respiratory diseases.
  • 6.

    【2hr】Comparison of procalcitonin, C-reactive protein, white blood cellcount and clinical status in diagnosing pneumonia in patients hospitalized withacute exacerbations of COPD: A prospective observational study

    包量

    机译 降钙素原，C反应蛋白，白细胞的比较住院肺炎患者肺炎的数量和临床状况诊断;COPD急性加重：一项前瞻性观察研究
    摘要：Lower respiratory tract infection is the most common cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The aim of the present study was to compare the accuracy of procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC) as single diagnostic tests and in combination with clinical signs and symptoms to diagnose pneumonia in patients hospitalized with AECOPD. This was a prospective, single centre observational study. Patients with spirometry-confirmed COPD who were hospitalized due to AECOPD were consecutively recruited at the hospital’s Emergency Unit. Pneumonia was defined as a new pulmonary infiltrate on chest X-ray. The values of PCT, CRP and WBC were determined at admission. Receiver operating characteristic (ROC) curve analysis was used to study the accuracy of various diagnostic tests. Of the 113 included patients, 35 (31%) had pneumonia at admission. Area under the ROC curve (AUC) for PCT, CRP and WBC as a single test to distinguish between patients with and without pneumonia was 0.67 (95% CI 0.55–0.79), 0.73 (95% CI 0.63–0.84) and 0.67 (95% CI 0.55–0.79), respectively (p = 0.42 for the test of difference). The AUC for a model of clinical signs and symptoms was 0.84 (95% CI 0.76–0.92). When biomarkers were added to the clinical model, the AUCs of thecombined models were not significantly different from that of the clinical modelalone (p = 0.54). PCT had about the same accuracy as CRP andWBC in predicting pneumonia in patients hospitalized with AECOPD both as asingle test and in combination with clinical signs and symptoms.
  • 7.

    【2hr】Prospective risk of osteoporotic fractures in patients with advancedchronic obstructive pulmonary disease

    包量

    机译 晚期患者骨质疏松性骨折的前瞻性风险慢性阻塞性肺疾病
    摘要：Despite the high prevalence of osteoporosis in chronic obstructive pulmonary disease (COPD) patients, the fracture risk prediction tools are not routinely undertaken in the management of COPD. We quantified fracture risk using a validated risk prediction tool (Fracture Risk Assessment (FRAX®)) and determined potential bone-protection treatment needs in patients with advanced COPD. The 10-year probability of major osteoporotic or hip fracture was calculated using the FRAX tool in a cohort of patients attending a hospital complex COPD service. Patients were identified to be at low, intermediate and high risk based on their FRAX scores, in accordance with the National Osteoporosis Guideline Group recommendations, to assess the number of patients requiring bone mineral density (BMD) testing or bone protection therapy. Two hundred forty-seven patients [mean (standard deviation (SD)) age 66 (9.1) years, 26% current smokers, 40% women and median (interquartile range (IQR)) Medical Research Council (MRC) breathlessness scale 4 (0)] had a 10-year probability of 9.5% (6.1) and 3.8% (4.6) for major osteoporotic and hip fractures, respectively. Thirty-six percentage of patients were identified to be at intermediate risk of developing fragility fracture, requiring BMD assessment, while 9% were at high risk, requiring treatment.Thirty-two percentage of high-risk patients were on bisphosphonates. The FRAXscore can be used to assess the fracture risk within the COPD cohort and assistwith decision-making about BMD measurement and provision of bone protectiontherapy.
  • 8.

    【2hr】Chronic bronchitis: High prevalence in never smokers andunderdiagnosis— A population-based study in Colombia

    包量

    机译 慢性支气管炎：从未吸烟者和诊断不足—哥伦比亚的一项基于人群的研究
    摘要：The objective of the article was to establish the prevalence, underdiagnosis, and risk factors of chronic bronchitis (CB) in a general population in five Colombian cities. Cross-sectional study using a probabilistic sampling technique in five Colombian cities was adopted. The CB definition was “cough and expectoration for three or more months per year for at least two consecutive years.” Underdiagnosis was considered in subjects with clinical definition without previous medical diagnosis. Univariate χ 2 or Student’s t-test and logistic regression analysis were used. The study included 5539 subjects. The prevalence was 5.5%, the underdiagnosis 50.3%, and 33.7% of the cases were in nonsmokers (53.6% in women vs. 16.9% in men, p < 0.001). The adjusted risk factors were living in Bogota, current smoking, male, age ≥ 64 years, low education, indoor wood smoke exposure, and occupational exposure to vapors, gases, dust, and fumes. CB is a common disease among adults in Colombia. The underdiagnosis was high and there were a large proportion of cases in nonsmokers, particularly in women. Our findings support the association of CB with indoor wood smoke and occupational exposures.
  • 9.

    【2hr】Depression is a major determinant of both disease-specific andgeneric health-related quality of life in people with severeCOPD

    包量

    机译 抑郁是特定疾病和疾病的主要决定因素重症患者与一般健康相关的生活质量慢性阻塞性肺病
    摘要：The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score (p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations (p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety (p < 0.05). Depression is a significant determinant ofboth the disease-specific and generic HRQL in patients with severe COPD.Screening and early intervention for depression in patients with severe COPDcould improve the HRQL.
  • 10.

    【2hr】Relationship of spirometric, body plethysmographic, and diffusingcapacity parameters to emphysema scores derived from CT scans

    包量

    机译 肺活量测定，人体体积描记和弥散的关系CT扫描得出的肺气肿评分的容量参数
    摘要：Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evaluated using a qualitative binary emphysema score. The binary score was positive for emphysema in 52.5% of patients, and there were significant differences between the positive/negative groups regarding forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), intrathoracic gas volume (ITGV), residual volume (RV), specific airway resistance (sRaw), transfer coefficient (KCO), transfer factor for carbon monoxide (TLCO), age, pack-years, and body mass index (BMI). Stepwise discriminant analyses revealed the combination of FEV1/FVC, RV, sRaw,and KCO to be significantly related to the binary emphysema score. Theadditional positive predictive value of body plethysmography, however, was onlyslightly higher than that of the conventional combination of spirometry anddiffusing capacity, which if taken alone also achieved high predictive values,in contrast to body plethysmography. The additional information on the presenceof CT-diagnosed emphysema as conferred by body plethysmography appeared to beminor compared to the well-known combination of spirometry and CO diffusingcapacity.
  • 11.

    【2hr】Health-related quality of life, treatment adherence and psychosocial supportin patients with pulmonary arterial hypertension or chronic thromboembolic pulmonaryhypertension

    包量

    机译 与健康有关的生活质量，治疗依从性和社会心理支持在患有肺动脉高压或慢性血栓栓塞性肺的患者中高血压
    摘要：Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) share similar quality of life impairment. The aim of the present study was to investigate health-related quality of life (HRQoL) and its relation to the perception of treatment and psychosocial support among PAH and CTEPH patients. All adult PAH or CTEPH patients in the Swedish Pulmonary Arterial Hypertension Register were invited to participate in a national cohort survey. The survey included the EuroQol 5-dimensions (EQ-5D) instrument that measures an individual’s HRQoL; the Beliefs about Medicines Questionnaire-Specific Scale that assesses the perception of PAH-specific treatment; the Mastery scale that evaluates the feeling of control and ability to cope with the disease; and the Social Network and Support Scale that maps the social support network. Of the 440 invited patients, 74% responded. Mean age was 66 ± 14 years, 58% were female and 69% diagnosed with PAH. Patients with PAH were younger, more often female and had a lower EQ-5D index (0.67 ± 0.29 vs. 0.73 ± 0.25, p = 0.050) than patients with CTEPH. Patients with a low EQ-5D index had more concerns about treatment (p = 0.004), lower coping ability (p < 0.001), less emotional support (p = 0.003) and less accessible social network (p = 0.002). In conclusion, patients with an impaired HRQoL alsoreported negative effects on their social support network, ability to handle stressors andconcerns about treatment.
  • 12.

    【2hr】Inhaler usability of a pressurized metered dose inhaler and a softmist inhaler in patients with COPD: A simulated-use study

    包量

    机译 加压定量吸入器和软质吸入器的可用性COPD患者的雾状吸入器：一项模拟使用研究
    摘要：The objective of this study was to evaluate task performance and handling errors with soft mist inhalers (SMIs) or pressurized metered-dose inhalers (pMDIs) among patients with chronic obstructive pulmonary disease (COPD) experienced with, but not recently trained in, using these devices. This exploratory, noninterventional, simulated-use study (D5970R00004) assessed handling/usability of SMIs and pMDIs in inhaler-experienced patients with COPD (40–78 years; diagnosis ≥6 months). Patients received a device and instruction-for-use leaflet but no training and were recorded while performing tasks required for checking the device, priming, and dosing. Errors that could substantially affect the lung-delivered dose were considered critical. Sixteen of 61 patients (52% male) had used SMIs and 55 had used pMDIs. Thirty-one patients received an SMI and 30 a pMDI. Overall, 79% made ≥5 performance errors (SMI 94%; pMDI 63%) and 49% made ≥5 critical errors (SMI 68%; pMDI 30%). All patients made ≥1 error; three (all pMDI) made no critical errors. Regardless of the device used and previous inhaler experience, patient-centered training, education, and continuous retraining on correct inhaler use should be key aspects of routine patient care in COPD.
  • 13.

    【2hr】Variation in treatment strategies for the eradication ofPseudomonas aeruginosa in primary ciliary dyskinesia acrossEuropean centers

    包量

    机译 消除根除的治疗策略的差异铜绿假单胞菌在原发性睫状运动障碍中欧洲中心
    摘要：Primary ciliary dyskinesia (PCD) is a rare disease causing motile cilia dysfunction, recurrent airway infection, and bronchiectasis. Airway infection management strategies are borrowed from cystic fibrosis. The aim of this study is to describe the management of airway infection with Pseudomonas aeruginosa (PA) in children and adults with PCD across European centers. An online survey questionnaire was sent electronically using SurveyMonkey® to 55 PCD centers in 36 European countries. Fifty-two responded from 43 centers in 26 countries, a response rate of 70%. Most (89%) countries did not have written guidelines for PCD management. Airway sampling for infection detection at each clinic visit was more likely when follow-up was frequent. Eighty-seven percent of centers chose to treat the first PA isolate, most prescribing combined oral ciprofloxacin and inhaled colistimethate sodium (43%, n = 18). The preferred treatment for chronic infection with PA was nebulized colistimethate in 51% (n = 22). In summary, considerable variation exists across European centers in the frequency of patient follow-up and airway sampling for infection, treatment goals, and the management ofPA infection. Few centers had written guidelines for PCDmanagement. Clinical trials to determine optimal treatment ofPA in PCD patients are urgently needed.
  • 14.

    【2hr】Flow and airway pressure analysis for detecting ineffective effortduring mechanical ventilation in neuromuscular patients

    包量

    机译 流量和气道压力分析，以检测无效的努力神经肌肉患者机械通气期间
    摘要：Ineffective efforts (IEs) are among the most common types of patient–ventilator asynchrony. The objective of this study is to validate IE detection during expiration using pressure and flow signals, with respiratory effort detection by esophageal pressure (Pes) measurement as the reference, in patients with neuromuscular diseases (NMDs). We included 10 patients diagnosed with chronic respiratory failure related to NMD. Twenty-eight 5-minute recordings of daytime ventilation were studied for IE detection. Standard formulas were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of IE detection using pressure and flow signals compared to Pes measurement. Mean sensitivity and specificity of flow and pressure signal-based IE detection versus Pes measurement were 97.5% ± 5.3% and 91.4% ± 13.7%, respectively. NPV was 98.1% ± 8.2% and PPV was 67.6% ± 33.8%. Spearman’s rank correlation coefficient indicated a moderately significant correlation between frequencies of IEs and controlled cycles (ρ = 0.50 and p = 0.01). Among respiratory cycles, 311 (11.2%) were false-positive IEs overall. Separating false-positive IEs according to their mechanisms, we observed premature cycling in 1.2% of cycles, delayedventilator triggering in 0.1%, cardiac contraction in 9.2%, and upper airwayinstability during expiration in 0.3%. Using flow and pressure signals to detectIEs is a simple and rapid method that produces adequate data to support clinicaldecisions.
  • 15.

    【2hr】Azithromycin or erythromycin? Macrolides for non-cystic fibrosisbronchiectasis in adults: A systematic review and adjusted indirect treatmentcomparison

    包量

    机译 阿奇霉素还是红霉素？大环内酯类药物用于非囊性纤维化成人支气管扩张：系统评价和调整后的间接治疗比较
    摘要：Non-cystic fibrosis (non-CF) bronchiectasis is a condition characterized by an airway inflammatory response to bacterial pathogens. Frequent exacerbations have a major influence on the quality of life. Macrolide antibiotics have not only antibacterial but also immune-regulation effects. It is proved that macrolides have a benefit in preventing exacerbations. However, it is still uncertain whether azithromycin or erythromycin is more effective and safe. The purpose of this study was to answer the following question: Which kind of macrolide antibiotic is more effective and safe in preventing non-CF bronchiectasis exacerbation? We conducted a systematic review to identify randomized clinical trials published up to May 2017 that reported on macrolides for non-CF bronchiectasis and an adjusted indirect treatment comparison (AITC) between macrolides to evaluate their efficacy and safety. The direct comparison meta-analysis found that macrolides decreased the rate of exacerbation of non-CF bronchiectasis (risk ratio (RR) = 0.45; 95% confidence interval (CI) 0.36–0.55) with heterogeneity (I 2 = 63.7%, p = 0.064). The AITC showed that azithromycin had a significantly lower bronchiectasis exacerbation rate thanerythromycin (RR = 0.35; 95% CI: 0.403–0.947). Azithromycin increased the riskof diarrhea and abnormal pain. This meta-analysis suggested that long-termtreatment with macrolides significantly reduced the incidence of non-CFbronchiectasis exacerbation. Moreover, azithromycin is more efficient thanroxithromycin and erythromycin in preventing exacerbation.
  • 16.

    【2hr】Testosterone replacement therapy and hospitalization rates in menwith COPD

    包量

    机译 男性睾丸激素替代疗法和住院率与COPD
    摘要：Testosterone deficiency is common in men with chronic obstructive pulmonary disease (COPD) and may exacerbate their condition. Research suggests that testosterone replacement therapy (TRT) may have a beneficial effect on respiratory outcomes in men with COPD. To date, however, no large-scale nationally representative studies have examined this association. The objective of the study was to assess whether TRT reduced the risk of respiratory hospitalizations in middle-aged and older men with COPD. We conducted two retrospective cohort studies. First, using the Clinformatics Data Mart—a database of one of the largest commercially insured populations in the United States—we examined 450 men, aged 40–63 years, with COPD who initiated TRT between 2005 and 2014. Second, using the national 5% Medicare database, we examined 253 men, aged ≥66 years, with COPD who initiated TRT between 2008 and 2013. We used difference-in-differences (DID) statistical modeling to compare pre- versus post-respiratory hospitalization rates in TRT users versus matched TRT nonusers over a parallel time period. DID analyses showed that TRT users had a greater relative decrease in respiratory hospitalizations compared with nonusers. Specifically, middle-aged TRT users had a 4.2% greater decrease inrespiratory hospitalizations compared with nonusers (−2.4 decrease vs. 1.8increase; p = 0.03); and older TRT users had a 9.1% greaterdecrease in respiratory hospitalizations compared with nonusers (−0.8 decreasevs. 8.3 increase; p = 0.04). These findings suggest that TRTmay slow disease progression in patients with COPD. Future studies shouldexamine this association in larger cohorts of patients, with particularattention to specific biological pathways.
  • 17.

    【2hr】Cluster analysis identifying patients with COPD at high risk of 2-year all-cause mortality

    包量

    机译 聚类分析确定患有高危2年全因死亡率的COPD患者
    摘要：The objective of the article is to identify clusters of patients with COPD according to factors known to be associated with mortality and to verify whether clusters’ assignment is associated with 2-year mortality. Patients (n = 141) were evaluated by bioelectrical impedance, maximal inspiratory pressure (MIP), one-repetition maximum test of the quadriceps femoris (1RMQF) and BODE index (body mass index; airflow obstruction (spirometry); dyspnea (modified Medical Research Council scale); and exercise capacity (6-minute walk test (6MWT) distance). Vital status was retrospectively checked 2 years after the assessments, and time to death was quantified for those deceased in this period. K-means analysis identified two clusters. Patients in cluster one (CL I, n = 69) presented an impaired clinical status in comparison to cluster two (CL II, n = 72). Receiver operating characteristics curves identified the cutoffs discriminating patients composing CL I: forced expiratory volume in the first second <44%pred; 6MWT <479 m; 1RMQF <19 kg; and maximum inspiratory pressures <73 cmH2O (area under the curve range 0.750–0.857). During the follow-up, 19 (13%) patients deceased, 15 in CL I (22%) and 4 in CL II (0.06%) (p = 0.005). CL I was associated with a higher risk of 2-year mortality (hazard ratio (95% confidence interval): 4.3 (1.40–12.9), p = 0.01). A cluster of patients with COPD highly associated with 2-year mortality was statistically identified, and cutoffs to identify these subjects were provided.
  • 18.

    【2hr】Pain in patients with chronic obstructive pulmonary disease indicated for post-acute pulmonary rehabilitation

    包量

    机译 慢性阻塞性肺疾病患者的疼痛提示急性后肺康复
    摘要：Pain is a significant problem in stable chronic obstructive pulmonary disease (COPD) and is associated with other symptoms, worse health status and lower functional status. Not much is known about pain in unstable disease. The primary aim of the present study is to investigate prevalence, characteristics and relationships of pain in patients with COPD hospitalized for an acute exacerbation (AECOPD) and indicated for post-acute pulmonary rehabilitation (PR). This cross-sectional observational study included 149 patients (mean age 70.8 (±7.9) years, 49% male, mean forced expiratory volume in one second as percentage of predicted value 35.3 (±12.6)). Pain was assessed using the brief pain inventory. Functional status and health status were measured using the six-minute walking test (6MWT), the Barthel index (BI) and the clinical COPD questionnaire (CCQ), respectively. Pain was prevalent in 39.6% of all patients. Symptom burden was high, especially in patients with pain. Although we found no difference in objective measurements of functional status (6MWT, BI), patients with pain had clinically relevant lower health status (CCQ), attributed to the functional domain. Pain in patients hospitalized for AECOPD and indicated for post-acute PR is a relevant problem and needs more attention. Incorporation of standard pain assessment during exacerbations and post-acute PR is recommended.
  • 19.

    【2hr】The effect of comorbidity severity on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients

    包量

    机译 合并症严重程度对慢性阻塞性肺疾病患者肺康复结果的影响
    摘要：Chronic obstructive pulmonary disease (COPD) is not only associated with respiratory system involvement but also with systemic consequences leading to chronic comorbidities. In this study, we aimed to investigate the effect of comorbidity severity on pulmonary rehabilitation (PR) outcomes in COPD patients. We conducted a retrospective cohort study to compare the effectiveness of PR in COPD patients who completed an 8-week PR program. There were at least one comorbid in 120 of 211 patients and we divided them into the groups according to Charlson Comorbidity Index (CCI) scores (1 points, group 1 (n = 54); 2 points, group 2 (n = 41); 3 points, group 3 (n = 25)). We compared 6-minute walk distance (MWD), dyspnea perception, pulmonary function tests, blood gases analysis, quality of life, anxiety, and depression scores which were recorded before and after PR between the groups. Before PR 6-MWD distance was significantly lower in group 2 (p = 0.033). Improvements in 6-MWD, blood gas values, dyspnea perception, quality of life, and anxiety were determined in all groups after PR (p < 0.05). When the gains after PR were compared, there were no significant differences between groups (p > 0.05). COPD patients benefit from PR independent from their comorbidity severity. Comorbidity severity has no effect on PR gains. Therefore, patients with comorbidities should not be excluded from PR programs and encouraged to participate.Clinical Trial Number:.
  • 20.

    【2hr】Differences in clinical features of acute exacerbation between connective tissue disease-associated interstitial pneumonia and idiopathic pulmonary fibrosis

    包量

    机译 结缔组织病相关性间质性肺炎与特发性肺纤维化之间急性加重的临床特征差异
    摘要：Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a devastating condition that frequently occurs in the advanced stage of IPF. However, the clinical features in AE of connective tissue disease-associated interstitial pneumonia (AE-CTD-IP) have not been well-established. The aim of this study was to clarify the clinical features of AE-CTD-IP and to compare them with those of AE-IPF. Fifteen AE-CTD-IP patients and 48 AE-IPF patients who were diagnosed and treated at our hospital were retrospectively studied. Compared with AE-IPF patients, AE-CTD-IP patients had a significantly higher %FVC (median, 94.8 vs. 56.3%; p < 0.001) and a lower extent of honeycombing on HRCT (p = 0.020) within 1 year before AE. At AE, AE-CTD-IP patients showed higher white blood cell counts (12.0 vs. 9.9 × 103/μL; p = 0.023), higher CRP (10.2 vs. 6.7 mg/dL; p = 0.027), and longer period from admission to the beginning of AE treatment (4 vs. 1 days; p = 0.003) than AE-IPF patients. In addition, patients with AE-CTD-IP had poor prognosis as in those with AE-IPF (log-rank; p = 0.171). In conclusion, AE-CTD-IP occurred even in the early stage of IP and had more inflammatory status than in AE-IPF.
题名 作者 来源 发表时间

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号