International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Comparative StudyComparison of impedance measured by the forced oscillation technique and pulmonary functions, including static lung compliance, in obstructive and interstitial lung disease.
Objective: To examine whether the parameters of impedance measured by the broadband frequency forced oscillation technique (FOT) were reflected by changes in lung compliance induced by emphysema and fibrosis, we retrospectively compared the parameters of FOT and pulmonary functions, including static lung compliance (Cst), in obstructive lung disease (OLD) and interstitial lung disease (ILD). Patients and methods: The data of 18 patients with OLD (16 with COPD, two with asthma COPD overlap), 11 with ILD, and 24 healthy volunteers, whose respiratory impedance was measured using a MostGraph-01 and other pulmonary functions including Cst and lung resistance (RL) were measured on the same day and were retrospectively collected and compared. Results: The parameters of resistance, reactance, and resonant frequency showed good correlations with ventilation unevenness (r=0.63, -0.89, 0.77, respectively) and lung elastic resistance (r=0.59, -0.80, 0.73, respectively) in all groups (N=53). ⋯ The differences in mean X5 in the expiratory phase relative to those in the inspiratory phase (within-breath changes in X5) were associated with airflow obstruction (P<0.002) and lung elastic resistance (P<0.001). However, no significant correlations between Cst and any parameters of respiratory impedance were observed. Conclusions: These findings suggest that the impedance parameters measured by FOT are reflected by airway obstruction, ventilation unevenness, and lung resistance, but hardly reflected by changes in lung compliance due to emphysema or fibrosis in both CLD and ILD.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
CAT Score and SGRQ Definitions of Chronic Bronchitis as an Alternative to the Classical Definition.
Previous studies have used various definitions to classify chronic obstructive pulmonary disease (COPD) patients into chronic bronchitis (CB) and non-CB patients. This study was performed to identify differences among three definitions of CB based on the classical method, St. George's Respiratory Questionnaire (SGRQ), and the CAT (COPD Assessment Test) score. ⋯ Patients with CB according to the new definitions based on SGRQ or CAT score showed similar clinical characteristics to those defined according to the classical definition. The new CB definitions may be used as alternatives to the classical definition.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Metabolic Syndrome in Early Chronic Obstructive Pulmonary Disease: Gender Differences and Impact on Exacerbation and Medical Costs.
Metabolic syndrome (MetS) is a well-known comorbidity of chronic obstructive pulmonary disease (COPD). However, their interrelationship, particularly in early COPD, remains unclear. Therefore, we aimed to assess the prevalence and clinical characteristics of MetS in patients with early COPD, and to explore the impact of MetS on the frequency of COPD exacerbations and associated medical costs. ⋯ MetS is more prevalent in women with early COPD. MetS increased the frequency of exacerbations and the medical costs in women with early COPD.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Randomized Controlled Trial Multicenter Study Comparative StudyNasal high-flow versus noninvasive ventilation in patients with chronic hypercapnic COPD.
Despite the encouraging results of noninvasive ventilation (NIV) in chronic hypercapnic COPD patients, it is also evident that some patients do not tolerate NIV or do not benefit from it. We conducted a study in which COPD patients with stable, chronic hypercapnia were treated with NIV and nasal high-flow (NHF) to compare effectiveness. ⋯ NHF may constitute an alternative to NIV in COPD patients with stable chronic hypercapnia, eg, those not tolerating or rejecting NIV with respect to pCO2 reduction and improvement in QoL.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Multicenter Study Comparative Study Observational StudyComparative analysis of medical expenditure with nebulized budesonide versus systemic corticosteroids in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease in China.
Purpose: Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and is a leading cause of disability in China. Acute exacerbations of COPD (AECOPD) are a leading cause of hospitalizations, and account for a substantial proportion of medical expenditure. Corticosteroids are commonly used to manage AECOPD in hospitalized patients, so our objective was to analyze the total medical expenditure associated with nebulized budesonide (nBUD) vs. systemic corticosteroids (SCS) in this population. ⋯ Conclusion: AECOPD is a leading cause of hospitalization in China, which places substantial burden on the healthcare system. This post-hoc analysis suggests that nBUD regimens are associated with lower medical expenditure than SCS regimens in hospitalized patients with AECOPD, and may reduce the financial burden of COPD. However, prospective studies evaluating the effectiveness of nBUD therapies are warranted.