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1.
Hiroyoshi Machida Yoko Shibata Sumito Inoue Akira Igarashi Yoshikane Tokairin Keiko Yamauchi Tomomi Kimura Kento Sato Hiroshi Nakano Michiko Nishiwaki Maki Kobayashi Sujeong Yang Yukihiro Minegishi Kodai Furuyama Tomoka Yamamoto Tetsu Watanabe Tsuneo Konta Yoshiyuki Ueno Isao Kubota 《Respiratory investigation》2018,56(1):34-39
Background
Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population.Methods
From 2004 to 2006, blood sampling and pulmonary function tests were performed on 3045 people over the age of 40 years in annual health check-ups held in Takahata, Yamagata Prefecture, Japan. Pulmonary function was re-evaluated in 2009 and 2011.Results
The prevalence of diabetes did not differ between subjects with and without airflow obstruction. Furthermore, although body mass index decreased, no increase in the prevalence of diabetes was observed with the progression of airflow obstruction. The annual changes in forced expiration volume in 1 s (FEV1) did not differ depending on the presence or absence of diabetes in the study population.Conclusion
There was no difference in the prevalence of diabetes between subjects with airflow obstruction and those without. As patients with COPD in Japan are thinner than in the West, diabetes may not be a common comorbidity in Japanese patients with COPD. 相似文献2.
Antonio Anzueto Peter M.A. Calverley Achim Mueller Norbert Metzdorf Michaela Haensel José R. Jardim Emilio Pizzichini Horacio Giraldo Alejandra Ramirez-Venegas Eduardo R. Giugno 《Archivos de bronconeumología》2018,54(3):140-148
Introduction
Geographical variations may impact outcomes in chronic obstructive pulmonary disease (COPD). We evaluated differences in baseline characteristics and outcomes between patients enrolled in Latin America compared with the rest of the world (RoW) in the TIOtropium Safety and Performance In Respimat® (TIOSPIR®) trial.Methods
TIOSPIR®, a 2–3-year, randomized, double-blind trial (n = 17 116; treated set), compared safety and efficacy of once-daily tiotropium Respimat® 5 and 2.5 μg with tiotropium HandiHaler® 18 μg. This post-hoc analysis pooled data from all treatment arms to assess mortality, exacerbations, cardiac events, and serious adverse events (SAEs) between both regions.Results
At baseline, patients enrolled in Latin America (n = 1000) versus RoW (n = 16 116) were older, with higher pack-years of smoking history and more exacerbations, but less cardiac history. In this analysis, patients in Latin America versus RoW had an increased risk of death (hazard ratio [HR] [95% confidence interval (CI)]: 1.52 [1.24–1.86]; P < .0001) or moderate-to-severe exacerbation (HR [95% CI]: 1.29 [1.18–1.41]; P < .0001), but a lower risk of severe exacerbation (HR [95% CI]: 0.82 [0.68–0.98]; P = .0333). SAE rates in Latin America were lower versus RoW (incidence rate ratio [IRR] [95% CI]: 0.82 [0.72–0.92]), including cardiac disorders (IRR [95% CI]: 0.68 [0.48–0.97]). Risk of major adverse cardiovascular events were similar (HR [95% CI]: 0.99 [0.71–1.40]; P = .9677).Conclusions
TIOSPIR® patients in Latin America had a higher risk of death or moderate-to-severe exacerbation, but a lower risk of severe exacerbation than those in RoW. Geographical differences may impact outcomes in COPD trials. 相似文献3.
Kentaro Wakamatsu Nobuhiko Nagata Hiroyuki Kumazoe Keishi Oda Hiroshi Ishimoto Michihiro Yoshimi Shohei Takata Minako Hamada Yoshifusa Koreeda Kouji Takakura Miwa Ishizu Makiko Hara Shinji Ise Miiru Izumi Takashi Akasaki Sanae Maki Masaharu Kawabata Hiroshi Mukae Masayuki Kawasaki 《Respiratory investigation》2017,55(1):16-23
Background
The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study.Methods
Medical records of 66 patients with IPF, who were not treated with pirfenidone prior to enrollment, were retrospectively reviewed for information on clinical progress, forced vital capacity (FVC), survival, and serum KL-6 levels. We assessed initial serum levels of KL-6, serial changes in serum KL-6 levels, yearly decline in FVC (ΔFVC), and the rate of decline (%ΔFVC).Results
Patients with increased serum KL-6 levels during follow-up had a significantly steeper decline in ΔFVC than those with no KL-6 increase (?201 vs. ?50.7 ml/year; p=0.0001). Patients with both initial serum KL-6 ≥1000 U/ml and serial increases in serum KL-6 had the steepest decline, while those with both initial serum KL-6 <1000 ml and no serial increases in KL-6 had the least decline in ΔFVC and %ΔFVC. Relative to the non-increased KL-6 group, survival in the increased KL-6 group tended to be poorer (p=0.0530). Patients with both initial serum KL-6 values <1000 U/ml and no serial increase in KL-6 had more favorable prognoses than those with serial increases in KL-6 or initial serum KL-6 values ≥1000 U/ml (p<0.0044). Prognosis was significantly poorer in patients with serial KL-6 changes >51.8 U/ml/year than in those with serial KL-6 changes <51.8 U/ml/year (p=0.0009).Conclusion
Thus, serial serum KL-6 measurements can be useful for assessing prognosis in patients with IPF. 相似文献4.
Luis Pérez de Llano Borja G. Cosío Marc Miravitlles Vicente Plaza 《Archivos de bronconeumología》2018,54(4):198-204
Objectives
We aimed to characterize the clinical, functional and inflammatory features of patients diagnosed diagnosed with ACO according to a new algorithm and to compare them with those of other chronic obstructive airway disease (COAD) categories (asthma and COPD).Methods
ACO was diagnosed in a cohort of COAD patients in those patients with COPD who were either diagnosed with current asthma or showed significant blood eosinophilia (≥300 cells/μl) and/or a very positive bronchodilator response (>400 ml and >15% in FEV1).Results
Eighty-seven (29.8%) out of 292 patients fulfilled the ACO diagnostic criteria (12.8% asthmatics who smoked <20 pack-years, 100% of asthmatics who smoked ≥20 pack-years, 47.7% of COPD with >200 eosinophils/μl in blood and none with non-eosinophilic COPD). ACO, asthma and COPD patients showed no differences in symptoms or exacerbation rate. Mean pre-bronchodilator FEV1 in ACO and asthma were similar (1741 vs 1771 ml), higher than in COPD (1431 ml, p < 0.05). DLCO was lower in ACO than in asthma (68.1 vs 84.1%) and similar to COPD (64.5%). Mean blood eosinophil count was similar in ACO and asthma (360 vs 305 cells/μl) and higher than in COPD (170 cells/μl). Periostin levels were similar in ACO to COPD (36.6 and 36.5 IU/ml) and lower than in asthma (41.5 IU/ml, p < 0.05), whereas FeNO levels in ACO were intermediate.Conclusion
This algorithm classifies as ACO all smoking asthmatics with non-fully reversible airway obstruction and a considerable proportion of e-COPD patients, highlighting those who can benefit from inhaled corticosteroids. 相似文献5.
Juan Antonio Riesco Miranda Bernardino Alcázar Inmaculada Alfageme Ciro Casanova Bartolomé Celli Juan P. de-Torres Carlos A. Jiménez Ruiz 《Archivos de bronconeumología》2017,53(10):574-582
Objective
To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD).Methods
Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥ 7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels.Results
A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed.Conclusions
These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD. 相似文献6.
Juan José Soler-Cataluña Luis Puente Maestu Miguel Román-Rodríguez Cristóbal Esteban Joaquín Gea Roberto Bernabeu Mora Eulogio Pleguezuelos Cobo Julio Ancochea Gema Monteagudo Ruiz Francisco Garcia Rio 《Archivos de bronconeumología》2018,54(9):467-475
Introduction
Physical activity (PA) is a significant clinical dimension in COPD, but no useful tools are available to determine this variable in routine clinical practice.Objective
To create a simple, easy-to-use, specific questionnaire to detect PA deficits.Method
A multidisciplinary panel of COPD experts was formed to review PA, its determinants, and measuring methods. The methodology for selecting specific dimensions and items was agreed in rounds, and the aspects to be included in the preliminary version were determined. The questionnaire structure was defined according to applicability of these aspects in clinical practice. Agreements were reached by consensus of the members.Results
A total of 148 items were reviewed, of which only 3 were directly selected. It was decided that the questionnaire should evaluate the intensity (low, moderate, or intense), amount, and frequency of PA, and inactivity or sedentary lifestyles. It also gathers information on the profile of inactive patients, and includes a measure of impact, defined as the patient's perception of their expectations regarding activity, their personal experience, characteristics of their environment, and their personality. The questionnaire is divided into 2 blocks, one aimed at quantifying PA, and the other at collecting data for defining the profile and impact in patients with low PA only.Conclusion
The SAQ-COPD is a simple, short, specific questionnaire, designed to evaluate PA in COPD patients in clinical practice. 相似文献7.
Min Yu Tingting Chen Shuang Hu Shan Zou Cantian Wang Chujuan Zeng Weijie Chen Xuerui Tan 《The American journal of the medical sciences》2018,355(1):44-47
Background
Recently, the R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating wide QRS complex tachycardias with a RWPT ≥ 50 ms for ventricular tachycardia diagnosis. Our previous study showed that the duration of RWPT at lead II in adults was ≈29 ms. However, the effects of ventricular premature beats (VPBs), bundle branch block (BBB) or left anterior fascicular block (LAFB) on RWPT at lead II remain unknown.Methods
The study was conducted in the First Affiliated Hospital of Shantou University Medical College in Southern China. Adults with VPBs, BBB or LAFB were included. RWPT at lead II was determined.Results
Compared with the control groups, the right BBB, LAFB, RWPT were longer in groups with left BBB and VPBs. Compared with the group with left BBB, the group with VPBs had a significantly longer RWPT at lead II (54.20 ± 18.52 versus 84.76 ± 16.38 ms, P < 0.01).Conclusion
Our study showed that there is a significant difference in the RWPT at lead II between groups with left BBB, ventricular premature beat, right BBB and LAFB. A RWPT of 50 ms may be optimal to differentiate between ventricular tachycardia and supraventricular tachycardia with right left BBB and LAFB, but not with left BBB. 相似文献8.
Guidong Shen Hongmin Zhu Hong Ding Chaoyang Sun Kun Zhou Yan Fan Tao Li Min Men Yuewu Chen Qun Lu Aiqun Ma 《The American journal of the medical sciences》2018,355(6):530-536
Background
The study aimed to evaluate the prognostic value of cystatin C in ST-elevation acute myocardial infarction (STEMI) patients who underwent elective percutaneous coronary intervention (PCI).Methods
A retrospective study was conducted on 664 STEMI patients from 7 centers who were treated with elective PCI. These patients were divided into 3 groups according their admission cystatin C levels as < 0.84, 0.84-1.03 and ≥1.04 mg/L. The all-cause mortalities and the composite endpoints, including mortality, reinfarction, rehospitalization for heart failure and angina or repeat target vessel revascularization were observed for up to 5 years.Results
As cystatin C levels from low to high, all-cause mortalities were progressively increased 0.9%, 3.7% and 9.5% (P < 0.001), as well as the composite endpoints, 11.1%, 21.7% and 40.7%, respectively (P < 0.001). When patients had the level of cystatin C ≥0.84 mg/L, their risks of composite endpoints increased 2- to 3-fold of those with <0.84 mg/L, with the adjusted hazard ratio of 2.096 (95% CI: 1.047-4.196, P = 0.037) and 3.608 (95% CI: 1.939-6.716, P < 0.001), respectively.Conclusions
Increased cystatin C levels may be associated with enhanced risks of composite endpoints in patients with STEMI undergoing elective PCI. 相似文献9.
Pedro J. Marcos Irene Nieto-Codesido Santiago de Jorge Dominguez-Pazos Arturo Huerta Eduardo Márquez Alejandro Maiso Rodrigo Verdeal Isabel Otero-González Marina Blanco-Aparicio Carmen Montero-Martínez 《Archivos de bronconeumología》2017,53(11):611-615
Introduction
It is not known whether clinical practice guidelines for the treatment of COPD exacerbations with short coursesofsystemic corticosteroids(SC-SCS) are followed in clinical practice.Method
Prospective, observational cohort study in patients admitted due to severe COPD exacerbation. The primary endpoint was the percentage of patients who received SC-SCS as treatment for severe exacerbation (doses of 200-300 mg for 5-6 days). Secondary variables were percentageof patients with duration or reduced dose, dose in the first 24 hours, days of intravenous systemic corticosteroids (SCS), and duration of hospital length of stay (LOS). Simple linear regression was performed with LOS as a dependent variable and multivariate analysis with factors associated with LOS.Results
158 patients were evaluated. 4.4% (7) patients received SC-SCS, 8.7% received a reduced dose and duration was reduced in 15.8%. The median dose and duration of SCS were 602.5 mg (200-1625) and 14 (4-36) days, respectively. We observed an association between days of SCSand LOS (P < .001) and doses of intrahospitalSCSand LOS (P < .001). Factors associated with LOS were doses of intrahospitalSCS received (.01 [95% CI:.007-.013]; P < 0.001), days of steroid treatment (.14 [95% CI .03-.25], P = .009) and PAFI (pO2/FiO2 ratio) at admission (-.012 [95% CI: -.012 to -.002], P = .015).Conclusions
The SCS schedules used in routine clinical practice are longer and administered at a higher dose than recommended, leading toa longer hospital stay. 相似文献10.
H.S. Bajaj R.E. Brown L. Bhullar N. Sohi S. Kalra R. Aronson 《Diabetes & metabolism》2018,44(6):493-499
Aim
The impact of new classes of glucose lowering medications on markers of non-alcoholic fatty liver disease (NAFLD) associated with type 2 diabetes (T2D) have been inconsistent in their magnitude and independence. This large retrospective study investigates changes in alanine aminotransferase (ALT) levels among subjects initiated on newer classes of T2D medications in comparison to a reference control group.Methods
We studied people with T2D from a large Canadian diabetes register, who had canagliflozin, dapagliflozin, liraglutide, sitagliptin or no further treatment added to their diabetes treatments. Stepwise multiple regression was used to determine the association of A1c and weight change on ALT. Propensity score weighting was used to balance baseline characteristics between treatment groups.Results
A total of 3667 subjects met study criteria. ALT levels (mean follow-up 4.8 months) were lower after treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin (?4.3 U/L, P < 0.01) and dapagliflozin (?3.5 U/L, P < 0.01), compared to incretin agents, liraglutide (?2.1 U/L, P < 0.01) and sitagliptin (?1.8 U/L, P < 0.01), each greater than the control group. Only the SGLT2 inhibitor treatment groups maintained a significant ALT reduction vs. control following multivariable adjustment and propensity score weighting. Greater ALT reductions were seen with higher baseline ALT for both the SGLT2 inhibitor treatment groups.Conclusion
SGLT2 inhibitors canagliflozin and dapagliflozin resulted in a weight and A1c-independent reduction of ALT levels compared to incretin agents, with a dose-response observed at higher baseline ALT levels. Further studies investigating the differential effects of these drug classes on NAFLD, and insulin/glucagon levels as potential mechanism explaining these differences, should be performed. 相似文献11.
Mariana Meireles Ana Machado Juliana Lopes Sara Abreu Inês Furtado João Gonçalves Ana Rita Costa Andrea Mateus João Neves 《Archivos de bronconeumología》2018,54(10):503-509
Introduction
Comorbidities are thought to have prognostic impact on outcomes of patients submitted to noninvasive ventilation (NIV). Our goal was to determine if age-adjusted Charlson comorbidity index (ACCI) could predict outcomes in patients undergoing NIV due to acute respiratory failure.Methods
Patients in respiratory failure submitted to NIV were prospective evaluated comparing patient's characteristics and outcomes according to ACCI ≤ median vs. ACCI > median. Each comorbidity composing the index was tested as predictor of NIV failure and readmission/mortality risk at 30 and 90 days, using logistic regression analysis. NIV failure was defined as need for invasive mechanical ventilation and/or death.Results
177 patients were enrolled. Median ACCI score was 5 points. Comparing patients with ACCI > 5 with ACCI ≤ 5, the former group was older but APACHE II was similar. Time to first NIV disconnection was inferior for ACCI > 5 patients (OR 0.46, 95% CI 0.23–0.89, p = 0.021), after gender and age adjustment. No differences were found in length of stay, time on NIV, NIV complications or failure, and 30 and 90-day hospital readmission or death, before and after adjustment. None of the single comorbidities was predictive of NIV failure and readmission risk, when adjusted to sex and age.Conclusion
ACCI is not a good predictor for short and medium-term outcomes in patients submitted to NIV. 相似文献12.
Louise H. Rayner Andrew P. McGovern Julian Sherlock Piers Gatenby Ana Correa Ben Creagh-Brown Simon de Lusignan 《Primary Care Diabetes》2018,12(5):438-444
Background
Chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2DM) are common comorbidities. COPD is a known risk factor for incident T2DM, however few studies have examined the relationship in reverse. The primary aim of this study was to compare the incidence of COPD in people with and without T2DM.Materials and methods
We conducted a retrospective case-control study using a long-established English general practice network database (n = 894,646). We matched 29,217 cases of T2DM with controls, adjusting for age, gender, smoking status, BMI and social deprivation, to achieve 1:1 propensity matching and compared the rate of incident COPD over eight years of follow-up. We performed a secondary analysis to investigate the effect of insulin, metformin and sulphonylureas on COPD incidence.Results
People with T2DM had a reduced risk of COPD compared to matched controls over the follow-up period (HR 0.89, 95%CI 0.79–0.93). 48.5% of those with T2DM were ex-smokers compared with 27.3% of those without T2DM. Active smoking rates were 20.4% and 23.7% respectively. Insulin, metformin and sulphonylureas were not associated with incident COPD.Conclusions
People with T2DM are less likely to be diagnosed with COPD than matched controls. This may be due to positive lifestyle changes, such as smoking cessation in those with T2DM. 相似文献13.
Jinfeng Li Bing Wang Guangjie Zhou Xiujuan Yan Yuan Zhang 《The American journal of the medical sciences》2018,355(6):588-596
Background
Tetrahydroxy stilbene glucoside (TSG) is an active ingredient of Heshouwu and is an antioxidant. The underlying mechanisms of the renoprotective effect of TSG in diabetic nephropathy have not been previously reported. In this study, we investigated the mechanisms of TSG in preventing podocytes injury in high glucose (HG) condition.Methods
Cultured mouse podocytes (MPC5) were incubated in HG (30 mmol/L) plus various concentration of TSG (0.1, 1 and 10 μM) for 48 hours. Reactive oxygen species (ROS) production, malondialdehyde (MDA) levels, terminal deoxynucleotidyl-transferase (TdT)-mediated dUTP-biotin nick end-labeling (TUNEL) fluorescence intensity, caspase-3 activity and the mRNA expression of nephrin in cultured podocytes were determined. The protein expression of Nod-like receptor protein 3 (NLRP3) inflammsome, interleukin-1β (IL-1β) and nephrin was detected by Western blot.Results
When the podocytes were incubated with various concentrations of TSG under HG conditions for 48 hours, TSG decreased ROS production, MDA levels, TUNEL fluorescence intensity and caspase-3 activity, but increased cell viability and the expression of nephrin in HG-induced podocytes in a dose-dependent manner. Subsequently, the podocytes treated with TSG at 10 μΜ decreased the expression of NLRP3 inflammasome and IL-1β compared with that of control. Furthermore, the podocytes transfected with NLRP3- small interfering RNA (siRNA) exhibited a significant decrease in the expression of caspase-1 and IL-1β, but exhibited a significant increase in the expression of nephrin. Eventually, TSG significantly increased the expression of nephrin in IL-1β-treated podocytes.Conclusions
TSG attenuates high glucose-induced cell apoptosis in vitro partly through the suppression of NLRP3 inflammasome signaling. 相似文献14.
T.-T. Li A.-P. Wang J.-X. Lu M.-Y. Chen C.-C. Zhao Z.-H. Tang L.-X. Li W.-P. Jia 《Diabetes & metabolism》2018,44(5):437-443
Aim
As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.Methods
This cross-sectional study was performed with newly diagnosed Chinese patients with diabetes, including 39 T1D, 165 ketosis-onset and 173 non-ketotic T2D, with 30 non-diabetics included as controls. NAFLD was determined by hepatic ultrasonography, then its clinical features were analyzed and its associated risk factors evaluated.Results
NAFLD prevalence in patients with ketosis-onset diabetes (61.8%) was significantly higher than in controls (23.3%; P = 0.003) and in T1D patients (15.4%; P < 0.001). However, there was no difference in prevalence between ketosis-onset and non-ketotic T2D patients (52.6%; P = 0.229), although BMI and alanine aminotransferase (ALT) proved to be independent risk factors for the presence of NAFLD in both these groups whereas, in T1D patients, serum uric acid levels were independent risk factors.Conclusion
NAFLD prevalence and risk factors in ketosis-onset diabetes were similar to those in non-ketotic T2D, but different from those in T1D. These data provide further evidence that ketosis-onset diabetes should be classified as a subtype of T2D rather than idiopathic T1D. 相似文献15.
Soghra Rabizadeh Fatemeh Dehghani Firouzabadi Sina Noshad Sadaf Esteghamati Mohsen Afarideh Alireza Ghajar Morsaleh Ganji Mohammad Saadat Behnam Heidari Mohammad Taghi Najafi Manouchehr Nakhjavani Alireza Esteghamati 《The American journal of the medical sciences》2018,355(5):442-448
Background
This study was designed to comparatively assess the effects of add-on pentoxifylline to losartan versus increasing the dose of losartan on serum N-terminal pro-brain natriuretic peptide (NT-proBNP), serum highly sensitive C-reactive protein (hsCRP) and the urinary albumin excretion (UAE) rate in patients with type 2 diabetes and nephropathy.Methods
In an open-label, single-center, parallel-group, randomized clinical trial (NCT03006952), 30 patients received b.i.d. dose of pentoxifylline 400 mg plus daily dose of losartan 50 mg (pentoxifylline arm) and 29 patients received b.i.d. dose of losartan 50 mg (losartan arm) during a 12-week follow-up period.Results
Serum NT-proBNP, serum hsCRP and UAE levels all significantly decreased from baseline in both trial arms. The pentoxifylline and losartan trial arms were equally effective in reducing serum NT-proBNP levels during the course of trial (multivariable adjusted model P value = 0.864, effect size = 0.2%). There was a greater decrease in UAE and serum hsCRP levels in the pentoxifylline arm (P = 0.034, effect size = 7.8%; P = 0.009, effect size = 11.7%, respectively). Conversely, patients in the losartan arm achieved better systolic and diastolic blood pressure control (P < 0.001, effect size = 25.4%; P = 0.010, effect size = 11.3%, respectively).Conclusions
Circulating NT-proBNP levels equally and significantly reduced from baseline in the pentoxifylline and losartan treatment arms, in parallel with comparatively superior decreases of UAE and serum hsCRP in the pentoxifylline arm, and larger decreases of systolic and diastolic blood pressures in the losartan arm. 相似文献16.
Mariana R. Gazzotti Carolina M. Roco Cristiane O. Pradella Oliver A. Nascimento Elias F. Porto Mariana Adas Marise Lazaretti-Castro José R. Jardim 《Archivos de bronconeumología》2019,55(5):252-257
Background
Osteoporosis is a systemic skeletal disease characterized by low bone mass and/or microarchitectural deterioration of bone. Osteoporosis is a risk factor for fractures specially in patients with advanced COPD. The aim of this cross-sectional study was to determine the frequency of osteoporosis and vertebral fracture in COPD patients.Methods
We evaluated 91 COPD patients and compared to 82 healthy subjects (control group) matched for gender and age. We measured the bone mineral density by means of dual energy X-ray absorptiometry (DXA), evaluating the lumbar vertebra (L1–L4), proximal femur and total femur and evaluated vertebral fractures in thoracic and lumbar spine using X-ray. We questioned patients whether they had had any fall that resulted in any fracture in the past five years.Results
Males comprised 60.4% of COPD group and 57.3% of the control group. Mean age was 66.2 ± 9.2 years for COPD group and 64.2 ± 8.8 for the control group. The frequency of osteoporosis in the COPD group was 29.7% and 18.3% in control group (p = 0.007). The frequency of vertebral fractures was 18.6% in the COPD group and 9.0% in control group (p = 0.06). The frequency of reported falls at resulting in any fracture was 36.3% in the COPD group and 7.3% in control group (p = 0.001).Conclusions
Our data indicate that COPD patients present a high frequency of osteoporosis and falls seem to be an important factor for vertebral fracture. 相似文献17.
Kento Sato Yoko Shibata Sumito Inoue Akira Igarashi Yoshikane Tokairin Keiko Yamauchi Tomomi Kimura Takako Nemoto Masamichi Sato Hiroshi Nakano Hiroyoshi Machida Michiko Nishiwaki Maki Kobayashi Sujeong Yang Yukihiro Minegishi Kodai Furuyama Tomoka Yamamoto Tetsu Watanabe Isao Kubota 《Respiratory investigation》2018,56(2):120-127
Background
Few studies are available regarding the annual decline of forced expiratory volume in 1 s (FEV1) in chronic obstructive pulmonary disease patients with mild airflow obstruction. This study sought to clarify to what extent cigarette-smoking individuals with mild airflow obstruction lose pulmonary function annually.Methods
From 2004 to 2006, pulmonary function tests were performed on people >40 years of age, during the annual health checkup held in Takahata, Yamagata, Japan (initial study population, n=3253). In 2011, pulmonary function tests were performed again on participants who agreed to undergo reexamination (follow-up study population, n=838).Results
Smokers have decreased pulmonary function in terms of percent forced vital capacity (FVC), %FEV1, and FEV1/FVC; the stages of airflow obstruction were also more severe in smokers than never-smokers. The annual decline in FEV1 was significantly greater in smokers than in never-smokers. The median annual decline in FEV1 was most significant in individuals with mild airflow obstruction. The annual decline in FEV1 was greater in smokers with mild airflow obstruction than in smokers with moderate airflow obstruction. In analyzing the decline in %FEV1, the annual change in smokers with mild airflow obstruction was greater than that in smokers with normal spirometric values.Conclusion
The annual decline in FEV1 was most significant in smokers with mild airflow obstruction in a Japanese general population. This highlights the importance of early detection of chronic obstructive pulmonary disease patients among the general population in order to prevent disease progression in undiagnosed patients. 相似文献18.
Sergio J. Arias Hugo Neffen Juan Carlos Bossio Carina A. Calabrese Alejandro J. Videla Gustavo A. Armando Joseph M. Antó 《Archivos de bronconeumología》2018,54(3):134-139
Objective
To investigate the burden of asthma in a young adult population in urban areas of Argentina.Design
A nationwide telephone survey in subjects aged 20-44 years was performed in urban areas in Argentina. The European Community Respiratory Health Survey questionnaire was used. Asthma was defined as an exacerbation in the last year or use of asthma medications.Results
In total, 1,521 subjects responded (62.4% females, mean age 33 years), of whom 91 were classified as asthmatics (5.9%, 95% CI 4.7-7.1). Prevalence adjusted for age, sex and education level was 6.4% (95% CI 5.1-7.7). Wheezing was reported by 13.9% (95% CI 15.6-12.2) and a diagnosis of asthma by 9.5% (95% CI 8.0-11.0). Among individuals with a diagnosis of asthma (n = 154), 71.3% had undergone spirometry. Among those treated (n = 77), 51.9% used medications daily and 46.8% as a rescue measure. Of those reporting an exacerbation in the last year (n = 60), 55% had attended an emergency department and 23% were admitted. Asthma was associated with rhinitis (OR 11.1, 95% CI 6.2-19.9) and family history (OR 3.6, 95% CI 2.3-5.5).Conclusion
Asthma prevalence in young adults in Argentina is similar to Europe. Although attacks and admissions were common, regular use of medications was reported by half of those treated. These results may be useful for other Latin American countries. 相似文献19.
Qingyan Zhang Chunming Jiang Tianfeng Tang Hengjin Wang Yangyang Xia Qiuyuan Shao Miao Zhang 《The American journal of the medical sciences》2018,355(4):314-321
Background
Focal segmental glomerulosclerosis (FSGS) is often accompanied with tubulointerstitial lesion. This study aimed to assess the role of urinary biomarkers in predicting tubulointerstitial lesion and treatment response in FSGS patients.Methods
Urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-d-glucosaminidase (NAG) and retinol-binding protein (RBP) were measured in 32 FSGS patients and 22 patients with minimal change nephrotic syndrome. Patients with FSGS were followed up to investigate the value of these markers in predicting treatment response.Results
FSGS patients had higher urinary NGAL, NAG and RBP than patients with minimal change nephrotic syndrome with comparable proteinuria. A cutoff value of 15.87 ng/mL NGAL demonstrated 87.1% sensitivity and 59.1% specificity for the diagnosis of FSGS, with an area under the receiver operator characteristic curve of 0.801. In FSGS, these markers correlated significantly with the degree of acute tubulointerstitial damage but not with chronic tubulointerstitial lesion. Response to immunosuppressive therapy was significantly different in patients with KIM-1, NAG and RBP levels below and above the cutoff values.Conclusions
Urinary NGAL, KIM-1, NAG and RBP are reliable biomarkers of tubulointerstitial lesion in FSGS patients. The measurements of these markers may be useful in diagnosing FSGS, detecting acute tubulointerstitial lesion and predicting treatment response. 相似文献20.
Kun-Ta Chou Kang-Cheng Su Yi-Han Hsiao Shiang-Fen Huang Hsin-Kuo Ko Ching-Min Tseng Vincent Yi-Fong Su Diahn-Warng Perng 《Archivos de bronconeumología》2017,53(10):547-553