International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2011
Geographic disparities in chronic obstructive pulmonary disease (COPD) hospitalization among Medicare beneficiaries in the United States.
Hospitalizations for persons with chronic obstructive pulmonary disease (COPD) result in significant health care resource use and excess expenditures. Despite well-documented sociodemographic disparities in COPD outcomes, no study has characterized geographic variations in COPD hospitalization across the US. ⋯ We discovered distinct geographic patterns in COPD hospitalization rates and risks attributed to both regionally-shared environmental risk factors and HSA-unique environmental contexts. The correlates of these geographic patterns remain to be determined. Geographic comparisons of COPD hospitalization risk provide insights for better public health practice, policies, and programs for COPD prevention.
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Int J Chron Obstruct Pulmon Dis · Jan 2011
Chronic airflow limitation in a rural Indian population: etiology and relationship to body mass index.
Respiratory conditions remain a source of morbidity globally. As such, this study aimed to explore factors associated with the development of airflow obstruction (AFO) in a rural Indian setting and, using spirometry, study whether underweight is linked to AFO. ⋯ In a rural Indian setting, AFO was related to advancing age, current or previous smoking, male gender, reduced BMI, and occupation. The data also suggest that being under-weight is linked with AFO and that a mechanistic relationship exists between low body weight, smoking tobacco, and development of AFO.
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Int J Chron Obstruct Pulmon Dis · Jan 2011
Haemophilus influenzae and smoking-related obstructive airways disease.
Intralumenal bacteria play a critical role in the pathogenesis of acute infective episodes and airway inflammation. Antigens from colonizing bacteria such as nontypeable Haemophilus influenzae (NTHi) may contribute to chronic lung disease through an immediate hypersensitivity response. The objective of this study was to determine the presence of specific NTHi-IgE antibodies in subjects with chronic bronchitis (CB) and COPD who had smoked. ⋯ The detection of IgE antibody to colonizing bacteria in all subjects with CB or moderate-severe COPD identifies a possible mechanism of bronchospasm in these subjects amenable to specific intervention therapy.
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Int J Chron Obstruct Pulmon Dis · Jan 2011
Prevalence and risk factors for unrecognized obstructive lung disease among urban drug users.
Obstructive lung disease (OLD) is frequently unrecognized and undertreated. Urban drug users are at higher risk for OLD due to race, behavioral, and socioeconomic characteristics, yet little data exist on prevalence and risk factors associated with unrecognized OLD in this population. ⋯ In a cohort of current and former urban drug users, OLD is substantially underrecognized and associated with lack of respiratory symptoms. Relying on the presence of respiratory symptoms as a trigger to perform spirometry may result in a substantial underdiagnosis of OLD in this population. HIV-infected individuals receiving ART are a population particularly vulnerable to unrecognized OLD.
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Int J Chron Obstruct Pulmon Dis · Jan 2011
Vitamin D and responses to inhaled fluticasone in severe chronic obstructive pulmonary disease.
Patients with chronic obstructive pulmonary disease (COPD) demonstrate variable responses to inhaled corticosteroids (ICS). The factors contributing to this variability are not well understood. Data from patients with asthma have suggested that low 25-hydroxyvitamin D [25(OH)D] levels contribute to a lack of ICS response in asthma. The objective of this study was to determine whether serum levels of 25(OH)D were related to ICS responses in patients with COPD. ⋯ Baseline 25(OH)D does not contribute to the variation in short-term FEV(1) responses to ICS in patients with severe COPD.