International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2007
Comparative StudyCOPD heterogeneity: gender differences in the multidimensional BODE index.
The BODE index was recently validated as a multidimensional tool for the evaluation of patients with COPD. The influence of gender on the BODE index has not been studied. ⋯ The contribution of each component to the BODE index differs by gender in subjects with similar BODE scores. Long term longitudinal studies will help determine the significance of our findings.
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Int J Chron Obstruct Pulmon Dis · Jan 2007
Tobacco consumption in relation to causes of death in an urban population of north India.
Noncommunicable diseases have become a public heath problem in India concomitant with economic development, leading to increases in tobacco consumption, obesity, and changes in diet and lifestyle. Although observation suggests that tobacco consumption is a major risk factor for deaths due to circulatory, pulmonary, and malignant diseases, such studies are not available from most populations in developing countries. ⋯ This study shows that tobacco consumption appears to be a major contributor to deaths due to circulatory diseases and malignant diseases in India. Social class status had little impact on tobacco consumption in male decedents. Rapid changes in diet and lifestyle, increases in tobacco consumption, and possibly aging of the population, appear to be strongly associated with mortality due to cardiovascular diseases and cancer in this middle-income country.
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Int J Chron Obstruct Pulmon Dis · Jan 2007
ReviewReview of ventilatory techniques to optimize mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a major global healthcare problem. Studies vary widely in the reported frequency of mechanical ventilation in acute exacerbations of COPD. Invasive intubation and mechanical ventilation may be associated with significant morbidity and mortality. ⋯ The basic pathophysiology in COPD exacerbation is the critical expiratory airflow limitation with consequent dynamic hyperinflation. These changes lead to further derangement in ventilatory mechanics, muscle function and gas exchange which may result in respiratory failure. This review discusses the altered respiratory mechanics in COPD, ways to detect these changes in a ventilated patient and formulating ventilatory techniques to optimize management of respiratory failure due to exacerbation of COPD.
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Int J Chron Obstruct Pulmon Dis · Jan 2007
Volumetric capnography and chronic obstructive pulmonary disease staging.
Spirometry is difficult for some COPD patient to perform. Volumetric capnography could be a second choice test to evaluate the severity of functional disturbances. The aim of this work is to test this hypothesis. ⋯ In ANOCOVA analysis IAH showed the greatest association with stage (F >40), with no significant covariant dependence on V(T). A receiver operating characteristics curve analysis showed values of the area under the curve greater than 0.9 for IAH and IVE at all stage levels, with a sensitivity = specificity value greater than 80%. We conclude that IAH and IVE can be used when spirometry cannot be reliably performed, as an alternative test to evaluate the degree of functional involvement in COPD patients.