International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Analysis of COPD: Distinguishing Characteristics and Management of Smoking vs Never Smoking Patients.","authors":"Monika Fekete, Alpar Horvath, Balazs Santa, Zsolt Abonyi-Toth, Gabor Tomisa, Gergo Jozsef Szollosi, Andrea Lehoczki, Vince Fazekas-Pongor, Janos Tamas Varga","doi":"10.2147/COPD.S484664","DOIUrl":"10.2147/COPD.S484664","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a significant public health issue characterized by gradually worsening airflow limitation. It is a leading cause of mortality and morbidity worldwide, yet research on COPD patients who have never smoked is limited. This study aims to document the demographic, symptomatic, and therapeutic characteristics of COPD patients receiving outpatient pulmonary care in Hungary, focusing on smoking history, and evaluate their distribution according to the GOLD A/B/E classification.</p><p><strong>Methods: </strong>The study recorded demographic data, symptom severity, occurrence of severe and moderate exacerbations, treatment, comorbidities, quality of life, and COVID-19 vaccination status among COPD patients from November 2021 to January 2023. A total of 6974 patients were categorized into current smokers, former smokers, and never smokers.</p><p><strong>Results: </strong>Patients had an average age of 67.2±8.9 years, with 48.2% male and 51.8% female. Of participants, 86.1% had a smoking history, while 13.9% had never smoked. COPD patients who had never smoked showed significantly better quality of life (CAT: 15.2±7.6 vs 15.8±6.9; p=0.006), oxygen saturation (SpO₂%: 96.7±2.3 vs 95.8±2.4; p<0.001), higher body mass index (BMI: 29.4±5.9 vs 27.1±6.3; p<0.001), and better lung function (FEV₁ref%: 67.9±20.7 vs 58.9±18.1; p<0.001) compared to smokers. However, non-smoking COPD patients had a higher frequency of comorbidities (3.5±2.2 vs 2.9±2.1; p<0.05). These differences may arise from complex genetic and environmental interactions.</p><p><strong>Conclusion: </strong>COPD patients who have never smoked exhibited better quality of life, nutritional status, and lung function compared to smokers, indicating the need for tailored treatment approaches. Further long-term studies are essential to validate these differences in quality of life and lung function between smoking and non-smoking COPD patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2671-2688"},"PeriodicalIF":2.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Dietary Magnesium Intake and Frailty in Patients with Chronic Obstructive Pulmonary Disease: National Health and Nutrition Examination Survey.","authors":"Minghao Liang, Xiuhong Ren, Qiuxiang Zhang, Zhishen Ruan, Minyan Jin, Yifei Xu, Xianhai Chen, Zhanjun Qiu","doi":"10.2147/COPD.S485017","DOIUrl":"10.2147/COPD.S485017","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic obstructive pulmonary disease (COPD) are at high risk of developing frailty and need to be prevented and managed. This study aims to investigate the relationship between dietary magnesium (Mg) intake and the risk of frailty in patients with COPD.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) in the United States, focusing on patients with COPD. We used logistic regression to determine the adjusted odds ratios (OR) and 95% confidence interval (CI). Curve fitting, subgroup analysis, and sensitivity analysis were performed to further assess the relationship between dietary Mg intake and frailty in patients with COPD.</p><p><strong>Results: </strong>There were 1696 participants in this study, and the mean age was 60.4 ± 0.4 years. Weighted logistic regression and curve fitting showed a linear relationship between dietary Mg intake and frailty in patients with COPD. The risk of frailty decreased by 15% for each 100-unit increase in Mg intake (OR: 0.85, 95% CI: 0.76-0.96). Participants in the highest quartile Q4 of Mg intake had a lower risk of frailty than those in the lowest quartile Q1 (OR: 0.48, 95% CI: 0.32-0.72).</p><p><strong>Conclusion: </strong>There is a linear relationship between dietary Mg intake and frailty in patients with COPD. Increasing dietary Mg intake is associated with a decreased risk of frailty in COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2651-2660"},"PeriodicalIF":2.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the Information Contained in the Single Items of the COPD Assessment Test for Different Outcomes and Smoking Status in Patients with COPD: Results from COSYCONET.","authors":"Peter Alter, Kathrin Kahnert, Franziska C Trudzinski, Robert Bals, Henrik Watz, Tim Speicher, Sandra Söhler, Klaus F Rabe, Emiel F M Wouters, Claus F Vogelmeier, Rudolf A Jörres","doi":"10.2147/COPD.S475112","DOIUrl":"10.2147/COPD.S475112","url":null,"abstract":"<p><strong>Background: </strong>The COPD Assessment Test (CAT) comprises eight questions. We evaluated the information that each of the questions and the total score contributed to outcomes and characteristics of chronic obstructive lung disease (COPD), including their dependence on smoking status.</p><p><strong>Methods: </strong>Patients with COPD of the COSYCONET cohort with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 and the former grade 0 were included. The evaluated outcomes included mortality, exacerbation risk, the comorbidities asthma, cardiac disease (coronary artery disease/heart failure), osteoporosis, and emphysema, for which a reduction in carbon monoxide transfer coefficient (KCO) <55% predicted was considered as marker. Analyses were performed by Cox proportional hazard or logistic multiple regression analyses separately for smokers and nonsmokers.</p><p><strong>Results: </strong>In total, 2509 patients had complete data, among them 1884 nonsmokers (ex or never; 38.4% female; mean age±SD 66.1±8.5 years) and 625 current smokers (45.1% female, 61.6±7.9 years). The pattern of responses to the single questions of the CAT differed between outcome variables, as well as between smokers and nonsmokers, but in most cases the total score was superior to the single items. The CAT total score was associated with mortality (p<0.05) only in nonsmokers, while for exacerbation frequency/severity, it was of about equal importance in smokers and nonsmokers. Regarding KCO, the total score was indicative (p<0.05) only in nonsmokers. Particularly in smokers, single items could show opposite signs of their coefficients which therefore largely cancelled in the total score.</p><p><strong>Conclusion: </strong>Our results show in detail for which outcomes single items are informative in nonsmokers and current smokers with COPD, overall being more informative in nonsmokers. Only regarding exacerbation risk, the predictive value was similar in both groups. These results might be helpful to extract as much as possible information from a COPD questionnaire that is often part of routine assessment.</p><p><strong>Trial registration: </strong>NCT01245933.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2629-2638"},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Analysis of Risk Factors for Pulmonary Function Decline in Chronic Lung Diseases Over Five Years.","authors":"Lu Li, Jiaqi Meng, Jiquan Chen","doi":"10.2147/COPD.S487178","DOIUrl":"10.2147/COPD.S487178","url":null,"abstract":"<p><strong>Objective: </strong>Chronic lung diseases (CLDs) are a major global health concern, characterized by a progressive decline in pulmonary function that severely impacts quality of life. It is essential to identify and predict the primary risk factors for CLDs. This study aims to establish a predictive model to assist healthcare providers in the early identification of high-risk patients and timely interventions and treatment options.</p><p><strong>Methods: </strong>This study utilized questionnaire data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011, 2013, and 2015. A latent class growth model (LCGM) was established using CLDs as the baseline sample. This model stratified the patients based on the extent of the decline in Δpeak expiratory flow (ΔPEF), which served as the target variable. Independent variables included age, gender, smoking status, body mass index, education level, and comorbidities. A random forest model was developed using Python, and the importance of the feature was visualized through the SHAP method. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis.</p><p><strong>Results: </strong>After screening, a total of 553 patients with CLDs were included in the study. The random forest model pinpointed grip strength, age, education level, gender, and asthma as the top five risk factors for pulmonary function decline. Specifically, the model demonstrated robust predictive performance with an area under the ROC curve (AUC) value of 0.77, affirming its accuracy and clinical applicability. Both calibration and decision curves further substantiated the reliability of the model in identifying patients at increased risk for pulmonary function decline.</p><p><strong>Conclusion: </strong>The predictive model developed in this study serves as a valuable tool for clinicians to target early interventions and optimize treatment strategies to enhance the quality of care and patient outcomes in the management of CLDs.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2639-2650"},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability and Validity of the \"Bronchiectasis Severity Index\" (BSI) and \"FACED\" Score in Adult Aboriginal Australians.","authors":"Timothy Howarth, Claire Gibbs, Asanga Abeyaratne, Subash S Heraganahally","doi":"10.2147/COPD.S482848","DOIUrl":"10.2147/COPD.S482848","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of bronchiectasis is significantly higher among adult Aboriginal Australians (the Indigenous peoples of Australia) compared to non-Aboriginal Australians. Currently, there is no well-established tool to assess bronchiectasis severity specific to Indigenous peoples. Nor has the applicability and validity of the two well-established bronchiectasis severity assessment tools - The \"Bronchiectasis Severity Index\" (BSI) and \"FACED\" scale been vigorously tested in an Indigenous population. This retrospective study evaluated the validity of the BSI and FACED amongst an adult Aboriginal Australian cohort with bronchiectasis in the Top End Northern Territory (NT) of Australia.</p><p><strong>Methods: </strong>Patients with CT confirmed bronchiectasis identified between 2011 and 2020, residing in the Top End of the NT were eligible to be enrolled. The primary endpoint of 4-year mortality was assessed via hospital records, and sensitivity and specificity of the BSI and FACED assessed against this using area under the curve (AUC) receiver operating characteristics analysis. For patients with missing data, a relative BSI / FACED score was used which divided the score recorded for that patient by the total potential score based on their available clinical data.</p><p><strong>Results: </strong>A total of 456 adult Aboriginal Australian patients >18 years of age were included (55.5% female, median age 49 years). According to the BSI score 43.4% of patients were assessed to have mild, 30.5% moderate and 26.1% severe bronchiectasis (median score 4 (IQR 2, 8)). According to the FACED 80.9% were assessed to have mild, 17.8% moderate and 1.3% severe (median score of 1 (IQR 0, 2)). Four-year mortality was 11.2% (median age of death 55.6 years). Sensitivity and specificity of the BSI combining moderate and severe were 86.3 and 47.2% respectively, and for severe alone 51% and 77%. Sensitivity and specificity of the FACED combining moderate and severe were 21.6% and 81.2%, respectively, and for severe alone 2% and 98.8%. The AUC for the continuous total BSI was 0.703, and the FACED 0.515. Utilising a relative score, based only on data available for patients with missing data (ie lung function or BMI) resulted in slightly improved AUCs for both the BSI (0.717) and FACED (0.571).</p><p><strong>Conclusion: </strong>Both BSI and FACED bronchiectasis assessment tools may not be ideal in an Indigenous/Aboriginal people's context. However, it may be reasonable to utilise the relative BSI score in this population until Indigenous people's specific bronchiectasis severity assessment tools are developed.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2611-2628"},"PeriodicalIF":2.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Variants in the Adhesive G Protein-Coupled Receptor ADGRG6 are Associated with Increased Susceptibility to COPD in the Elderly Han Chinese Population of Southern China.","authors":"Fei Chen, Jie Zhao, Rubing Mo, Xiuxiu Ding, Yue Zhang, Linhui Huang, Tian Xie, Yipeng Ding","doi":"10.2147/COPD.S478095","DOIUrl":"10.2147/COPD.S478095","url":null,"abstract":"<p><strong>Background: </strong>Mutations in ADGRG6 are associated with a variety of cancers and multiple types of diseases. However, the impact of genetic variations in ADGRG6 on chronic obstructive pulmonary disease (COPD) susceptibility has not yet been evaluated.</p><p><strong>Methods: </strong>Considering the high prevalence of COPD among the elderly population in China, this study specifically targets the elderly Han population in Southern China as the study subject. Following the acquisition of participants' whole-genome DNA, genotyping was conducted using the Agena MassARRAY platform. The online tool 'SNPStats', which utilizes logistic regression, was employed to analyze and assess the correlation. Multi-factor dimensionality reduction was utilized to clarify the impact of \"SNP-SNP\" interactions on COPD risk. The False-Positive Report Probability (FPRP) was applied to determine whether significant results are noteworthy findings.</p><p><strong>Results: </strong>The mutant allele \"C\" of rs11155242 was a protective genetic factor against COPD susceptibility (OR = 0.57, 95% CI = 0.36 to 0.91, p = 0.017). The heterozygous mutant genotype \"CA\" of rs11155242 was found to be significantly associated with reduced COPD risk (CA Vs AA: OR = 0.53, 95% CI = 0.32 to 0.90, p = 0.018). ADGRG6-rs11155242 was found to be strongly associated with a reduced risk of COPD in males, non-smokers, and subjects with a BMI below 24 kg/m² (OR < 1, p < 0.05). The FPRP analysis indicated that the positive results identified in this study are noteworthy new findings.</p><p><strong>Conclusion: </strong>The mutant allele \"C\" and mutant genotype \"CA\" of rs11155242 act as protective genetic factors against COPD susceptibility. This study will provide a new research direction for the personalized prevention and treatment of COPD in the elderly Han population in southern China, and lay a potential scientific basis.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2599-2610"},"PeriodicalIF":2.7,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Small Airway Epithelial-Mesenchymal Transition and CXCL13 in Pulmonary Lymphoid Follicle Formation in Chronic Obstructive Pulmonary Disease.","authors":"Xia Yang, Ning Zhou, Jie Cao","doi":"10.2147/COPD.S487539","DOIUrl":"10.2147/COPD.S487539","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by inflammation and airway remodeling. Lymphoid follicles play a crucial role in acquired immunity and the development of COPD. However, the precise mechanisms of lymphoid follicle formation in COPD and the effects of cigarette smoke (CS) exposure on this process remain unclear. Epithelial-mesenchymal transition (EMT) is implicated in the progression of COPD and may serves as a source of stromal cells that produce chemokines crucial for lymphoid follicle formation. This study aims to clarify the contributions and mechanisms of EMT in lymphoid follicle genesis in COPD, focusing specifically on the role of CXCL13.</p><p><strong>Methods: </strong>Lung tissue samples were obtained from patients with COPD, smokers, and non-smokers. Immunohistochemistry was performed to assess the lymphoid follicles, EMT-related markers, and CXCL13 expression. In vitro experiments were conducted using CS extract (CSE)-stimulated immortalized human bronchial epithelial cells (iHBECs) to induce EMT. The expression of EMT-related markers and CXCL13 in CSE-stimulated iHBECs was analyzed using Western blotting, real-time PCR, and immunofluorescence staining. The effect of an EMT inhibitor on CXCL13 expression was also examined.</p><p><strong>Results: </strong>Patients with COPD and lymphoid follicles exhibited significantly lower forced expiratory volume in 1 s (% predicted) values than those without lymphoid follicles. Enhanced EMT changes were observed in patients with COPD and lymphoid follicles. Increased EMT-related markers and CXCL13 expression were observed in CSE-stimulated iHBECs, and CXCL13 expression gradually increased over time. Inhibiting EMT downregulated CXCL13 expression in iHBECs.</p><p><strong>Conclusion: </strong>Lymphoid follicles are associated with enhanced EMT in COPD. EMT may act as a key driver of the adaptive immune response in COPD by promoting a microenvironment conducive to lymphoid follicles formation through the production of CXCL13. This study provides valuable insights into the mechanisms underlying lymphoid follicle formation in COPD and identifies potential therapeutic targets.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2559-2569"},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The D-Dimer to Albumin Ratio Could Predict Hospital Readmission Within One Year in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.","authors":"Li Li, Qinsheng Feng, Chunsong Yang","doi":"10.2147/COPD.S481483","DOIUrl":"10.2147/COPD.S481483","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the association of D-dimer-to-albumin ratio (DAR) with hospital readmission within one year in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).</p><p><strong>Patients and methods: </strong>From January 2019 to October 2022, 509 patients with COPD were enrolled in Baise People's Hospital for this retrospective cohort study. Baseline data and blood samples were collected, and patients were followed up for one year after inclusion. The AECOPD hospital readmission within one year was the outcome. Receiver operating characteristics (ROC) curves were conducted to determine the prognostic performance of DAR for predicting readmission within one year. The relationships between DAR, neutrophil-to-lymphocyte ratio (NLR), and AECOPD hospital readmission were conducted using univariate and multivariate logistic regression models, with odds ratios (ORs) and 95% confidence intervals (CIs). The relationship was further explored in different modified Medical Research Council (mMRC), COPD assessment test (CAT), COPD course, pneumonia, glucocorticoid, antibiotic subgroups.</p><p><strong>Results: </strong>Totally, 117 (22.99%) COPD patients were hospital readmission due to AECOPD. The area under the curve (AUC) for the DAR was 0.726. DAR ≥2.21 (OR=1.80, 95% CI: 1.05-3.17) was associated with elevated odds of AECOPD hospital readmission within one year. DAR ≥2.21 was related to increased odds of AECOPD hospital readmission in patients of those mMRC ≥2, CAT >20, COPD course <10 years, and pneumonia. NLR ≥3.69 was associated with higher odds of AECOPD hospital readmission in patients of those mMRC ≥2 and COPD course ≥10 years.</p><p><strong>Conclusion: </strong>In patients with AECOPD, DAR showed a better predictive value in predicting the risk of hospital readmission in patients with AECOPD within one year. The findings of our study might help identify patients with a high risk of readmission within one year and provide timely treatment to prevent the reoccurrence of AECOPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2587-2597"},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.","authors":"Rajiv Dhand, Michael W Hess, Abebaw Mengistu Yohannes","doi":"10.2147/COPD.S491275","DOIUrl":"10.2147/COPD.S491275","url":null,"abstract":"<p><p>Aerosol therapy administered via handheld inhaler or nebulizer device has long been standard for the treatment of chronic obstructive pulmonary disease (COPD), both for maintenance therapy and for management of acute exacerbations. Of the 2 options for drug delivery, inhaler devices are the most widely used for ambulatory patients with COPD as they are small, portable, and convenient and offer an array of medication options. They are, however, prone to suboptimal inhalation technique and use errors, which decrease the amount of medication delivered, compromise efficacy, and adversely affect clinical outcomes. Nebulizers are less often employed for aerosol delivery than inhalers, particularly in the home environment. Considered bulky and expensive, nebulizers have historically had limited medication options compared with inhalers. Nonetheless, nebulizers may be preferred over inhalers in specific patient populations, such as in patients with poor lung function, lack of hand-breath coordination, or cognitive impairment. Furthermore, technological advances and development of new nebulizer-compatible medications are shifting the benefit equation for nebulizers versus inhalers in a way that merits reconsideration of the role of nebulizers in the maintenance treatment of COPD. Using the available literature, this state-of-the-art review critically evaluates the benefits and limitations of aerosol therapy delivery via inhaler or nebulizer for patients with COPD; describes the factors that may influence the benefit equation, including current advances in nebulizer technology and future developments; and provides insights on implementation of nebulizer therapy in clinical practice.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2571-2586"},"PeriodicalIF":2.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Life Essential 8 Score as a Risk Factor for Long-Term Mortality in Chronic Obstructive Pulmonary Disease: A Study Based on the Analysis of NHANES Data from 2007 to 2012.","authors":"Chang Sun, Xin Xin Zhang, Jie Cao","doi":"10.2147/COPD.S469584","DOIUrl":"https://doi.org/10.2147/COPD.S469584","url":null,"abstract":"<p><strong>Aims: </strong>The purpose of this prospective cohort study was to examine the association of Life Essential 8 (LE8), the recently updated algorithm for quantifying cardiovascular health (CVH) by the American Heart Association (AHA), with the risk of mortality in Chronic Obstructive Pulmonary Disease (COPD) patients.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2012 and the National Death Index mortality data up to December 31, 2019, were included in this cohort analysis. To characterize the relationship between LE8 and CVD and all-cause mortality as well as assess any potential nonlinear relationships, the limited cubic spline mixed with the Cox proportional hazards model was used.</p><p><strong>Results: </strong>The final analysis included 785 subjects. The weighted mean age of the study population was 59 years, and 479 were male. In the overall population, every 10-point increase in the LE8 score was individuals with associated with reduced risks of 4% for CVD mortality; moderate CVH had a 23% lower risk of COPD, while high CVH was linked to a 40% lower risk compared to low CVH. Among the COPD individuals, every 10-point increase in the LE8 score was associated with reduced risks of 4% for all-cause mortality,8% for CLRD mortality, and 12% for cancer mortality.</p><p><strong>Conclusion: </strong>This study demonstrates that low levels of LE8 were associated with increased risks of all-cause and cause-specific mortality in COPD individuals.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"19 ","pages":"2545-2557"},"PeriodicalIF":2.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}