Respiratory medicine
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Respiratory medicine · Jul 2012
ReviewAirway bacterial colonization: the missing link between COPD and cardiovascular events?
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and, according to the World Health Organization, its prevalence will double by 2020. COPD is a chronic inflammatory disease of the lung characterized by poorly reversible airflow limitation and, frequently, by extrapulmonary manifestations. In particular, the cardiovascular manifestations are responsible for high morbidity and mortality. ⋯ COPD is associated with an increased burden of atherosclerotic disease. Systemic inflammation and oxidative stress play key roles in this association. COPD patients with airway bacterial colonization, as compared to patients without airway colonization, generally present more frequent exacerbations and higher levels of both airway and systemic inflammation. This COPD subgroup should be considered at particularly increased risk of developing cardiovascular complications and receive more attention concerning diagnosis, treatment, prevention and research.
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Baseline values for daily step counts in US adults with COPD and knowledge of its accurate measurement, natural change over time, and independent relationships with measures of COPD severity are limited. ⋯ These findings will aid the design of future studies using daily step counts in COPD. Accurately measured, daily step counts decline over time partly due to season and capture unique information about COPD status.
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Respiratory medicine · Jul 2012
Lung disease with anti-CCP antibodies but not rheumatoid arthritis or connective tissue disease.
We sought to characterize a novel cohort of patients with lung disease, anti-cyclic citrullinated peptide (CCP) antibody positivity, without rheumatoid arthritis (RA) or other connective tissue disease (CTD). ⋯ We have described a unique cohort of patients with anti-CCP antibody positivity and lung disease in the absence of existing RA or other CTD. The lung phenotypic characteristics of this cohort resemble those of established RA and a few of these patients have developed articular RA within a short period of follow-up. The implications of a positive anti-CCP antibody among patients with lung disease but not RA are not yet known, but we believe requires further investigation.
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The prevalence and characteristics of pain are not known in COPD patients. The purposes of this study were to determine if pain is more common in COPD patients than in healthy people and if it was related to self-reported physical activity, health related quality of life (HRQoL) and comorbidities. ⋯ COPD patients demonstrate more pain which interferes with activities more so than healthy people of similar age. Pain is also negatively associated with HRQoL in COPD.
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Respiratory medicine · Jul 2012
COPD among non-smokers - report from the obstructive lung disease in Northern Sweden (OLIN) studies.
In westernized countries smoking and increasing age are the most important risk factors for COPD. Prevalence and risk factors of COPD among non-smokers are not well studied. ⋯ The prevalence of airway obstruction among non-smokers was close to 7% and was associated with increasing age. One out of seven men with airway obstruction, defined using the fixed ratio, versus one out of four women had never smoked.