COPD
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Under-diagnosis of COPD is a widespread problem. This study aimed to identify previously undiagnosed cases of COPD in a high-risk population identified through general practice. ⋯ Of the at-risk subjects studied, 22% were diagnosed with COPD. A case-finding strategy providing questionnaire assessment and diagnostic spirometry to high-risk subjects in primary care, and therefore, identifies a large proportion of undiagnosed COPD patients, especially in the early stages of the disease.
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Multicenter Study
Is the CAT questionnaire sensitive to changes in health status in patients with severe COPD exacerbations?
The COPD Assessment Test (CAT) was validated in English showing good psychometric properties. The objective of this study is to assess the capacity of the CAT to detect changes in health status in patients experiencing COPD exacerbations (ECOPD) and to further explore the validity of the Spanish version. An observational study was conducted in 49 Spanish centres. ⋯ Change in CAT correlated well with Δ SGRQ (r = 0.63; p < 0.01). The CAT showed to be sensitive to the change in health status associated with ECOPD. We also provide evidence of the validity of the Spanish version.
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Comparative Study Clinical Trial
Streptococcus pneumoniae urinary antigen test and acute exacerbations of chronic obstructive pulmonary disease.
Streptococcus pneumoniae is one of the most common bacteria identified in sputum obtained from subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). ⋯ The results of the pneumococcal urinary antigen test were similar for AECOPD subjects with and without pneumonia. This test may be a useful method for preventing the under-diagnosis of S. pneumoniae-related exacerbations of COPD. The detection of pneumococcal antigen in the urine is not related to the persistent colonization of the respiratory mucosa by S. pneumoniae.
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Fibrinogen is a marker of systemic inflammation and may represent an important biomarker for the progression of chronic obstructive pulmonary disease (COPD). ⋯ In the nationally representative NHANES III data, impaired lung function is a correlate of fibrinogen levels and the presence of higher fibrinogen levels increases the risk of mortality both in the overall population and among subjects with COPD.