Respiratory medicine
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Respiratory medicine · Dec 2012
Multicenter StudyManagement of chronic obstructive pulmonary disease in the Middle East and North Africa: results of the BREATHE study.
Chronic obstructive pulmonary disease (COPD) is a potentially severe chronic progressive respiratory condition requiring long-term treatment and frequently involving episodic hospitalisations to manage exacerbations. The objective of this analysis was to document diagnosis, evaluation, treatment and management of COPD-related respiratory symptoms in 1,392 subjects fulfilling an epidemiological definition of COPD identified in a general population sample of 62,086 individuals aged ≥ 40 years in ten countries in the Middle East and North Africa region (Algeria, Egypt, Jordan, Lebanon, Morocco, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates), together with Pakistan. 442 subjects (31.8%) claimed to have received a diagnosis of COPD from a physician and 287 (20.6%) had undergone spirometry in the previous year. Use of specific treatments for respiratory symptoms was reported by 218 subjects (15.7%). ⋯ Use of all healthcare resources was significantly higher (p < 0.001) in subjects with CAT scores ≥ 10 than in those with scores < 10, and greater in those with exacerbations than in those without. In conclusion, COPD in the region is under-diagnosed, inadequately evaluated and inadequately treated. Nonetheless, COPD symptoms are responsible for considerable healthcare consumption, with high levels of physician consultation and hospitalisation.
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Respiratory medicine · Dec 2012
Clinical TrialShort term and long term effects of pulmonary rehabilitation on physical activity in COPD.
The central purpose of pulmonary rehabilitation is to reduce morbidity by improving functional capacity through exercise. It is still unknown if improvements in functional capacity are maintained in the long-term and if this leads to increased physical activity levels as measured by a free-living activity monitor. The hypothesis of this study was that pulmonary rehabilitation would lead to a sustained increase in standard outcome measures and in daily physical activity. ⋯ These findings show that while pulmonary rehabilitation increased exercise capacity this was not transmitted into increased daily physical activity. Hence, alternative methods to alter/affect behavioural change need to be addressed.
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Respiratory medicine · Dec 2012
Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system.
To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients. ⋯ Length of stay, rate of admission, mortality and readmission in elderly Danish patients with community-acquired pneumonia follows international findings. There are regional differences between hospitals. In depth investigation in regional differences could reveal potential feasible clinical interventions with an improvement of readmission-, mortality rates and cost.
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Respiratory medicine · Dec 2012
Diagnostic and prognostic role of biomarkers for pulmonary hypertension in interstitial lung disease.
Pulmonary hypertension (PH) is an important complication to interstitial lung disease (ILD). The aim of the present study was to investigate the relation of NT-proBNP, fibrin D-dimer, troponin-T, uric acid and exhaled nitric oxide (NO) to the presence of PH and mortality in ILD. ⋯ A value of NT-proBNP below 95 ng/l may be used as a rule-out test for PH in ILD, while an abnormal value of uric acid is a risk factor for PH. NT-proBNP, troponin-T, uric acid and fibrin D-dimer have prognostic value in ILD patients, while exhaled levels of NO do not seem to predict PH or mortality.
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Respiratory medicine · Dec 2012
BTNL2 gene polymorphism associations with susceptibility and phenotype expression in sarcoidosis.
A functional polymorphism within butyrophilin-like 2 (BTNL2) gene has been described as a potential risk factor for sarcoidosis. The association between chronicity and the rs2076530 SNP A allele has also been reported. This study evaluates the BTNL2 rs2076530 G/A allele associations with sarcoidosis susceptibility and disease evolution in a Portuguese cohort of patients. ⋯ HLA-DRB1*03, besides the association with Löfgren syndrome was significantly related with disease resolution. Our data confirms the association of BTNL2 rs2076530 A allele with sarcoidosis susceptibility in a Portuguese population. We found independent genetic risk factors in clinically distinct disease phenotypes: BTNL2 rs2076530 A allele in patients without Löfgren syndrome or with isolated thoracic disease, and HLA-DRB1*03 in Löfgren syndrome or disease resolution.