European Clinical Respiratory Journal最新文献

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Automatic oxygen titration with O2matic® to patients admitted with COVID-19 and hypoxemic respiratory failure. O2matic®自动氧滴定治疗新冠肺炎合并低氧性呼吸衰竭患者
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-10-14 DOI: 10.1080/20018525.2020.1833695
Ejvind Frausing Hansen, Charlotte Sandau Bech, Jørgen Vestbo, Ove Andersen, Linette Marie Kofod
{"title":"Automatic oxygen titration with O2matic® to patients admitted with COVID-19 and hypoxemic respiratory failure.","authors":"Ejvind Frausing Hansen,&nbsp;Charlotte Sandau Bech,&nbsp;Jørgen Vestbo,&nbsp;Ove Andersen,&nbsp;Linette Marie Kofod","doi":"10.1080/20018525.2020.1833695","DOIUrl":"https://doi.org/10.1080/20018525.2020.1833695","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with coronavirus disease (COVID-19) and pneumonitis often have hypoxemic respiratory failure and a need of supplementary oxygen. Guidelines recommend controlled oxygen, for most patients with a recommended interval of SpO<sub>2</sub> between 92 and 96%. We aimed to determine if closed-loop control of oxygen was feasible in patients with COVID-19 and could maintain SpO<sub>2</sub> in the specified interval.</p><p><strong>Methods: </strong>Patients were prospectively enrolled in an observational study on a medical ward dedicated to patients with COVID-19. Closed-loop controlled oxygen was delivered by O2matic® which can deliver 0-15 liters/min and adjusts flow every second based on 15 seconds averaging of SpO<sub>2</sub> measured by pulse oximetry. Lung function parameters were measured at admission.</p><p><strong>Results: </strong>Fifteen patients (six women, nine men) participated in the study. Average age was 72 years. Lung function was severely impaired with FEV<sub>1</sub>, FVC and PEF reduced to approximately 50%. The average stay on the ward was 3.2 days and O2matic was used on average for 66 hours, providing 987 hours of observation. O2matic maintained SpO<sub>2</sub> in the desired interval for 82.9% of the time. Time with SpO<sub>2</sub> > 2% below interval was 5.1% and time with SpO<sub>2</sub> > 2% above interval was 0.6%.</p><p><strong>Conclusion: </strong>Closed-loop control of oxygen to patients with COVID-19 is feasible and can maintain SpO<sub>2</sub> in the specified interval in the majority of time. Closed-loop automated control could be of particular benefit for patients in isolation with decreased visibility, surveillance and monitoring. Further studies must examine the clinical benefits.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1833695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38659113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Improved bioavailability of cromolyn sodium using inhaled PA101 delivered via eFlow® nebulizer. 通过eFlow®喷雾器吸入PA101提高了色胺酸钠的生物利用度。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-08-20 DOI: 10.1080/20018525.2020.1809083
Khalid Abd-Elaziz, Hanneke Oude Elberink, Zuzana Diamant
{"title":"Improved bioavailability of cromolyn sodium using inhaled PA101 delivered via eFlow® nebulizer.","authors":"Khalid Abd-Elaziz,&nbsp;Hanneke Oude Elberink,&nbsp;Zuzana Diamant","doi":"10.1080/20018525.2020.1809083","DOIUrl":"https://doi.org/10.1080/20018525.2020.1809083","url":null,"abstract":"<p><p>In 1960s, cromolyn sodium (CS) has been introduced as the first non-steroidal anti-inflammatory drug for the treatment of allergic and mast-cell driven diseases. Its applicability has been limited due to a poor bioavailability. Here we present pharmacokinetic data of a novel high concentration formulation of CS (PA101) delivered via a high-efficiency nebulizer (eFlow®) in healthy volunteers (HVs), allergic asthmatics and patients with indolent systemic mastocytosis (ISM). In HVs, PA101 40 mg and 80 mg (30 L) and PA101 40 mg (40 L), Intal<sup>TM</sup> (via LC® Plus) 20 mg and Nalcrom® (oral suspension) 200 mg showed maximum measured plasma concentration (C<sub>max</sub>) of 156, 236, 88.6, 17.8 and 5.23 ng/mL, respectively, with respective areas under the plasma time-concentration curve (AUC) of 338, 526, 212, 40.6 and 33.3 h·ng/mL. Systemic exposure (AUC) to CS with PA101 40 mg was approximately 8-fold and 11-fold higher compared to Intal<sup>TM</sup> and Nalcrom® in HVs, respectively. PA101 via eFlow® yielded comparable PK profiles in HVs and patients. Systemic bioavailability of PA101 was approximately 25% compared to approximately 1% for Nalcrom® and approximately 10% for Intal<sup>TM</sup>, respectively. These data warrant further research on the therapeutic potential of PA101 (via eFlow®) in allergic and mast-cell driven diseases.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1809083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38392254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in management of idiopathic pulmonary fibrosis: impact on disease severity and mortality. 特发性肺纤维化治疗的改变:对疾病严重程度和死亡率的影响
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-08-12 DOI: 10.1080/20018525.2020.1807682
Charlotte Hyldgaard, Janne Møller, Elisabeth Bendstrup
{"title":"Changes in management of idiopathic pulmonary fibrosis: impact on disease severity and mortality.","authors":"Charlotte Hyldgaard,&nbsp;Janne Møller,&nbsp;Elisabeth Bendstrup","doi":"10.1080/20018525.2020.1807682","DOIUrl":"https://doi.org/10.1080/20018525.2020.1807682","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a serious interstitial lung disease (ILD) with a median survival of 3-5 years. The aim of the present study was to evaluate disease severity and survival in patients diagnosed with IPF in the era of antifibrotic therapies compared with an earlier IPF cohort.</p><p><strong>Methods: </strong>We identified all patients with fibrotic ILD in the hospital electronic case record system between 2011 and 2016, and reviewed each case in order to identify incident patients with IPF. We used the GAP-index to compare disease severity and mortality to previous findings in patients with IPF diagnosed at our center between 2003 and 2009.</p><p><strong>Results: </strong>260 patients were diagnosed with IPF between 2011 and 2016. Mean age was 72.6 years, 79% were male, mean forced vital capacity (FVC) was 80%, and mean diffusing capacity for carbon monoxide (DLco) was 44%. Age, FVC and DLco were significant predictors of mortality, but the presence of a typical usual interstitial pneumonia pattern on HRCT was not. Eighty percent of patients in GAP stage I received antifibrotic therapy, 73% in GAP stage II, and 29% in GAP stage III.The median survival was four years in the 2011-2016 cohort compared with three years in the 2003-2009 cohort. The distribution of patients between GAP stages was unchanged in 2011-2016 compared with 2003-2009, (stage I 34% vs. 32%, stage II 49% vs. 48% and stage III 20% vs. 16%). One-year mortality was 13% in 2011-2016 and 26% in 2003-2009. In severe disease (GAP stage III), one-year mortality was 26% and 54%, respectively, (p=0.019).</p><p><strong>Conclusion: </strong>Short-term mortality was significantly lower in the 2011-2016 cohort compared with 2003-2009. This improvement may be linked to changes in treatment strategies towards limited use of corticosteroids. Although early diagnosis of IPF still needs increased focus, the improvement is encouraging.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1807682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38394403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Acute exacerbations of COPD and risk of lung cancer in COPD patients with and without a history of asthma. 有或无哮喘史的COPD患者的COPD急性加重和肺癌风险
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-08-07 DOI: 10.1080/20018525.2020.1799540
Ane Aamli Gagnat, Miriam Gjerdevik, Stein Atle Lie, Amund Gulsvik, Per Bakke, Rune Nielsen
{"title":"Acute exacerbations of COPD and risk of lung cancer in COPD patients with and without a history of asthma.","authors":"Ane Aamli Gagnat,&nbsp;Miriam Gjerdevik,&nbsp;Stein Atle Lie,&nbsp;Amund Gulsvik,&nbsp;Per Bakke,&nbsp;Rune Nielsen","doi":"10.1080/20018525.2020.1799540","DOIUrl":"https://doi.org/10.1080/20018525.2020.1799540","url":null,"abstract":"<p><strong>Rationale: </strong>There is limited knowledge on the effect of acute exacerbations in chronic obstructive pulmonary disease (AECOPD) on lung cancer risk in COPD patients with and without a history of asthma. This study aims to examine whether AECOPD is associated with risk of lung cancer, and whether the effect depends on a history of asthma.</p><p><strong>Methods: </strong>In the GenKOLS study of 2003-2005, 852 subjects with COPD performed spirometry, and filled out questionnaires on smoking habits, symptoms and disease history. These data were linked to lung cancer data from the Cancer Registry of Norway through 2013. AECOPD, measured at baseline was the main predictor. To quantify differences in lung cancer risk, we performed Cox-proportional hazards regression. We adjusted for sex, age, smoking variables, body mass index, and lung function.</p><p><strong>Measurements and results: </strong>During follow-up, 8.8% of the subjects with, and 5.9% of the subjects without exacerbations were diagnosed with lung cancer. Cox regression showed a significant increased risk of lung cancer with one or more exacerbations in COPD patients without a history of asthma, HRR = 2.77 (95% CI 1.39-5.52). We found a significant interaction between a history of asthma and AECOPD on lung cancer.</p><p><strong>Conclusions: </strong>AECOPD is associated with an increased risk of lung cancer in COPD patients without a history of asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1799540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38394402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Evaluating the effect on asthma quality of life of added reflexology or homeopathy to conventional asthma management - an investigator-blinded, randomised, controlled parallel group study. 评估在传统哮喘治疗基础上增加反射疗法或顺势疗法对哮喘患者生活质量的影响--一项由研究者盲法随机对照的平行小组研究。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-07-14 DOI: 10.1080/20018525.2020.1793526
Ayfer Topcu, Anders Løkke, Leila Eriksen, Lars Peter Nielsen, Ronald Dahl
{"title":"Evaluating the effect on asthma quality of life of added reflexology or homeopathy to conventional asthma management - an investigator-blinded, randomised, controlled parallel group study.","authors":"Ayfer Topcu, Anders Løkke, Leila Eriksen, Lars Peter Nielsen, Ronald Dahl","doi":"10.1080/20018525.2020.1793526","DOIUrl":"10.1080/20018525.2020.1793526","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a common chronic disease worldwide without any known cure. Despite remarkable improvement in asthma treatment, better education and guideline implementation strategies, there is growing interest in using complementary and alternative medicine, like reflexology and homeopathy. However, evidence supporting the effectiveness of homeopathy and reflexology in asthma treatment is not available.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the effect of reflexology and homeopathy as adjunctive therapies in asthma.</p><p><strong>Methods: </strong>In a single centre, randomised, investigator blinded, controlled study 86 asthma patients were enrolled. They were assigned to one of three study groups (conventional treatment alone or conventional treatment with addition of either homeopathy or reflexology). All patients received their asthma treatment during the study and were followed as usual by their general practitioner. The study assignment group of individual patients were blinded to the investigators, who made the clinical evaluation of asthma control. The primary outcome was the change in the asthma quality of life questionnaire (AQLQ) scores after 26 weeks. Secondary outcomes included asthma control questionnaire, EuroQol, forced expiratory volume in 1 sec, morning and evening peak expiratory flow, asthma symptoms, rescue medication use, and total medication score.</p><p><strong>Results: </strong>Minor improvements in the AQLQ score were observed in all three groups. However, no statistically significant changes in AQLQ scores were seen within or between groups. Likewise, secondary outcomes did not differ between groups.</p><p><strong>Conclusions: </strong>In this study, the addition of homeopathy or reflexology to conventional treatment did not result in improved quality of life in asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38394401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disease self-management in patients with moderate COPD: a thematic analysis. 中度慢性阻塞性肺病患者的疾病自我管理:专题分析。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-05-31 DOI: 10.1080/20018525.2020.1762376
Katrine Rutkær Molin, Henning Langberg, Peter Lange, Ingrid Egerod
{"title":"Disease self-management in patients with moderate COPD: a thematic analysis.","authors":"Katrine Rutkær Molin, Henning Langberg, Peter Lange, Ingrid Egerod","doi":"10.1080/20018525.2020.1762376","DOIUrl":"10.1080/20018525.2020.1762376","url":null,"abstract":"<p><strong>Background: </strong>Treatment of patients with moderate chronic obstructive pulmonary disease (COPD) is challenged by the low priority of the disease by patients and general practitioners (GPs) affecting the extent of self-management. The aim of this study was to explore (i) attitudes to COPD self-management in patients with moderate COPD, (ii) perceptions of GP commitment to pulmonary rehabilitation in patients with moderate COPD, and (iii) COPD knowledge in patients with moderate COPD.</p><p><strong>Methods: </strong>The study had a qualitative design using semi-structured interviews to explore the views of 14 patients diagnosed with moderate COPD. We applied strategic sampling to obtain maximum variation and conducted a thematic analysis of the data.</p><p><strong>Results: </strong>Our main findings were that the degree of COPD self-management was linked to the resources of the informants. Further, the patients experienced that GPs only availed themselves of selected parts of the recommendations for COPD treatment by focusing on medical treatment and smoking cessation rather than physical activity and diet. Many patients lacked knowledge regarding the tolerated level of physical activity and therefore avoided activity increasing their heart rate. Finally, many patients were reluctant to accept the diagnosis because the disease is known to be self-inflicted.</p><p><strong>Conclusion: </strong>Our study suggests that patients with moderate COPD need more information, especially regarding the positive effects of physical activity. GPs might need to devote more time to the three main elements of COPD treatment, smoking cessation, medical treatment, and physical activity, to promote self-management and a healthier lifestyle in patients with COPD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/37/ZECR_7_1762376.PMC7655073.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting. 非重症监护环境中 COVID-19 患者入院管理指南。
IF 1.8
European Clinical Respiratory Journal Pub Date : 2020-05-28 DOI: 10.1080/20018525.2020.1761677
Klaus Nielsen Jeschke, Barbara Bonnesen, Ejvind Frausing Hansen, Jens-Ulrik Stæhr Jensen, Therese Sophie Lapperre, Ulla Møller Weinreich, Ole Hilberg
{"title":"Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting.","authors":"Klaus Nielsen Jeschke, Barbara Bonnesen, Ejvind Frausing Hansen, Jens-Ulrik Stæhr Jensen, Therese Sophie Lapperre, Ulla Møller Weinreich, Ole Hilberg","doi":"10.1080/20018525.2020.1761677","DOIUrl":"10.1080/20018525.2020.1761677","url":null,"abstract":"<p><strong>Introduction: </strong>Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities.</p><p><strong>Aim: </strong>The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards.</p><p><strong>Results: </strong>Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead.</p><p><strong>Conclusion: </strong>Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/86/ZECR_7_1761677.PMC7655082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and daily respiratory care and clinical trials within the COVID-19 era. 新冠肺炎时代的临床和日常呼吸护理及临床试验。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-05-25 DOI: 10.1080/20018525.2020.1766817
Zuzana Diamant, Vibeke Backer, Leif Bjermer
{"title":"Clinical and daily respiratory care and clinical trials within the COVID-19 era.","authors":"Zuzana Diamant,&nbsp;Vibeke Backer,&nbsp;Leif Bjermer","doi":"10.1080/20018525.2020.1766817","DOIUrl":"https://doi.org/10.1080/20018525.2020.1766817","url":null,"abstract":"Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden; Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Centre for Physical Activity Research, Rigshospitalet and Copenhagen University, Copenhagen, Denmark","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1766817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38376158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations. 睡眠呼吸暂停与血糖升高是COPD恶化的预测因素。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-05-22 DOI: 10.1080/20018525.2020.1765543
Truls S Ingebrigtsen, Jacob L Marott, Peter Lange
{"title":"Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations.","authors":"Truls S Ingebrigtsen,&nbsp;Jacob L Marott,&nbsp;Peter Lange","doi":"10.1080/20018525.2020.1765543","DOIUrl":"https://doi.org/10.1080/20018525.2020.1765543","url":null,"abstract":"<p><strong>Objective: </strong>Sleep apnea and elevated plasma glucose associates with inflammation which associates with the risk of COPD exacerbations. We investigated the risk of exacerbations in individuals with COPD, witnessed sleep apneas, and elevated plasma glucose.</p><p><strong>Methods: </strong>From the Copenhagen City Heart Study cohort, we identified 564 individuals with COPD (forced expiratory volume in 1 sec divided by forced vital capacity, FEV<sub>1</sub>/FVC<0.70), no asthma, above 40 years of age, and more than 10 pack-years of smoking history, with information on witnessed apneas and levels of plasma glucose. We prospectively recorded hospital admissions with COPD exacerbations during maximum available follow-up (26.3 years; mean 10.7 years). Cox-regression analyses were used to analyze the risk of COPD exacerbations.</p><p><strong>Results: </strong>We identified 74 (13%) individuals with sleep apnea without elevated plasma glucose, 70 (12%) had elevated plasma glucose (above 6.9 mM (>125 mg/dL)) without sleep apnea and 11 individuals had the presence of both conditions. In univariable analysis, witnessed apneas together with elevated plasma glucose had a high risk of exacerbations, hazard ratio (HR) = 5.81 (2.34-14.4, <i>p</i> = 0.0001) compared to those without sleep apnea and without elevated plasma glucose. Multivariable analysis, adjusting for several risk factors of exacerbations, showed a similar result, HR = 3.45 (1.13-10.5, <i>p</i> = 0.03). Both presence of sleep apnea without elevated plasma glucose and the presence of elevated plasma glucose without sleep apnea showed no associations with the risk of exacerbations.</p><p><strong>Conclusions: </strong>Witnessed sleep apneas in COPD are associated with increased risk of exacerbations, but only among those with elevated plasma glucose.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1765543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The risk of osteoporosis in patients with asthma. 哮喘患者骨质疏松的风险。
IF 1.9
European Clinical Respiratory Journal Pub Date : 2020-05-19 eCollection Date: 2020-01-01 DOI: 10.1080/20018525.2020.1763612
Indumathi Kumarathas, Torben Harsløf, Charlotte Uggerhøj Andersen, Bente Langdahl, Ole Hilberg, Leif Bjermer, Anders Løkke
{"title":"The risk of osteoporosis in patients with asthma.","authors":"Indumathi Kumarathas,&nbsp;Torben Harsløf,&nbsp;Charlotte Uggerhøj Andersen,&nbsp;Bente Langdahl,&nbsp;Ole Hilberg,&nbsp;Leif Bjermer,&nbsp;Anders Løkke","doi":"10.1080/20018525.2020.1763612","DOIUrl":"https://doi.org/10.1080/20018525.2020.1763612","url":null,"abstract":"<p><p>It is well-known that use of continuous systemic corticosteroids (SG) affects bone metabolism, bone mineral density (BMD), and ultimately increases the risk of osteoporosis. In patients with asthma, on the other hand, the effects of long-term high-dose inhaled corticosteroids (ICS) on BMD and risk of osteoporotic fractures is controversial. The reasons for this inconsistency could be explained by the fact that only few long-term studies investigating the effect of ICS in patients with asthma exist. The studies are characterized by different study designs and duration of ICS exposure, small study populations, and differences between the used ICS. The aim of this article is to unravel which factors, if any, that contribute to an increased risk of osteoporosis in patients with asthma and to summarize the evidence regarding adverse effects of ICS on bone metabolism, BMD and osteoporotic fractures in patients with asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20018525.2020.1763612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38099121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
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