Richard T Spence, Dhruvin H Hirpara, Sachin Doshi, Fayez A Quereshy, Sami A Chadi
IMPORTANCE: Failure to rescue (FTR), or death after major complications, has emerged as a marker of hospital-level quality of care. OBJECTIVE: To evaluate the predictive performance of the ACS-NSQIP modified frailty index (mFI) in determining FTR following an anastomotic leak (AL) after a colectomy for colorectal cancer. DESIGN: Retrospective cohort study. SETTING: Multicenter interrogation of the 2012-2016 American College of Surgeons (ACS) colectomy procedure targeted National Surgical Quality Improvement Program (NSQIP) database...
October 23, 2020: Annals of Surgical Oncology
Ayumi Ohara, Satoshi Konno, Kaoruko Shimizu, Masaru Suzuki, Masafumi Yamamoto, Asako Mitani, Mutsumi Nishida, Takanori Teshima, Masaharu Nishimura
Pulmonary diffusing capacity for carbon monoxide (DLCO ) is a valuable pulmonary function test to evaluate the gas exchange capacity of the lungs. Generally, DLCO values are significantly lower in patients with chronic obstructive pulmonary disease (COPD), particularly in those with a predominantly emphysema phenotype. However, it is extremely rare that DLCO values cannot be obtained for reasons other than technical errors. Herein, we report two patients with COPD in whom DLCO values were undetectable without prolonging the breath-holding time for the test...
October 21, 2020: Respiratory Investigation
Haifeng Zhou, Lei Zhang, Yang Li, Guorao Wu, He Zhu, Huilan Zhang, Jia-Kun Su, Lei Guo, Qing Zhou, Fei Xiong, Qilin Yu, Ping Yang, Shu Zhang, Jibao Cai, Cong-Yi Wang
BACKGROUND: Chronic obstructive pulmonary disease (COPD) characterized by the airway and lung inflammation, is a leading cause of morbidity and mortality worldwide, especially among smokers over 40 years of age and individuals exposed to biomass smoke. Although the detailed mechanisms of this disease remain elusive, there is feasible evidence that protein posttranslational modifications (PTMs) may play a role in its pathoetiology. We thus conducted studies to dissect the effect of cigarette smoke extracts (CSE) on the change of SUMOylated substrates in human bronchial epithelial cells (HBEs)...
October 23, 2020: BMC Pulmonary Medicine
Claudio Tantucci, Damiano Bottone, Guido Levi, Silvia Uccelli, Nicola Venturoli, Roberto Magri, Emirena Garrafa, Laura Pini
RATIONALE: The study aimed to investigate the interplay among respiratory function, autonomic dysfunction, and systemic inflammation in COPD patients. METHODS: In 19 COPD patients, functional respiratory parameters, heart rate variability (HRV), and plasma high-sensitivity-C-reactive-protein (hs-CRP) were assessed. Forced oscillation technique (FOT) was used to detect the absence (NFL) or presence (FL) of resting tidal expiratory flow limitation. Subsequently, patients underwent an incremental shuttle walking test (ISWT)...
October 19, 2020: Respiratory Physiology & Neurobiology
Maren E Shipe, Diane N Haddad, Stephen A Deppen, Benjamin D Kozower, Eric L Grogan
BACKGROUND: The novel coronavirus (COVID-19) pandemic has led surgical societies to recommend delaying diagnosis and treatment of suspected lung cancer in lesions <2 cm. Delaying diagnosis can lead to disease progression, but the impact of this delay on mortality is unknown. The COVID-19 infection rate at which immediate operative risk exceeds benefit is unknown. We sought to model immediate versus delayed surgical resection in a suspicious lung nodule <2 cm. METHODS: A decision analysis model was developed, and sensitivity analyses performed...
October 19, 2020: Annals of Thoracic Surgery
Jordan Cates, Cynthia Lucero-Obusan, Rebecca M Dahl, Patricia Schirmer, Shikha Garg, Gina Oda, Aron J Hall, Gayle Langley, Fiona P Havers, Mark Holodniy, Cristina V Cardemil
Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, although increasing evidence indicates that infection with SARS-CoV-2, the virus that causes COVID-19, can affect multiple organ systems (1). Data that examine all in-hospital complications of COVID-19 and that compare these complications with those associated with other viral respiratory pathogens, such as influenza, are lacking. To assess complications of COVID-19 and influenza, electronic health records (EHRs) from 3,948 hospitalized patients with COVID-19 (March 1-May 31, 2020) and 5,453 hospitalized patients with influenza (October 1, 2018-February 1, 2020) from the national Veterans Health Administration (VHA), the largest integrated health care system in the United States,* were analyzed...
October 23, 2020: MMWR. Morbidity and Mortality Weekly Report
Christoph Gross, Dario Kohlbrenner, Christian F Clarenbach, Adam Ivankay, Thomas Brunschwiler, Yves Nordmann, Florian V Wangenheim
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common disorders in the world. COPD is characterized by airflow obstruction, which is not fully reversible. Patients usually experience breathing-related symptoms with periods of acute worsening and a substantial decrease in the health-related quality-of-life. Active and comprehensive disease management can slow down the progressive course of the disease and improve patients' disabilities. Technological progress and digitalization of medicine have the potential to make elaborate interventions easily accessible and applicable to a broad spectrum of patients with COPD without increasing the costs of the intervention...
October 22, 2020: JMIR Research Protocols
Fei Xiao, Jue Yang, Ruixin Fan
BACKGROUND: Comorbid chronic obstructive pulmonary disease (COPD) increases morbidity and mortality among aortic valve replacement patients undergoing conventional surgery. The impact of COPD in patients undergoing less invasive transcatheter aortic valve insertion (TAVI) is unclear. HYPOTHESIS: This study evaluates the in-hospital outcomes of TAVI in patients with and without COPD. METHODS: This population-based, retrospective study of 8466 TAVI patients (29...
October 22, 2020: Clinical Cardiology
Charlie Strange, Chelsea L Richard, Shuxiang Shan, Barbara A Phillips, Sarojini Kanotra, M Bradley Drummond, Lindsay Megenhardt, Chitra Lal, Roy A Pleasants
STUDY OBJECTIVES: Population based estimates of obstructive sleep apnea (OSA) frequency and health impact are incomplete. The aim of this study was to determine the prevalence of risk factors for physician and sleep study diagnosed OSA among individuals in a state-based surveillance program. METHODS: Using questions inserted into the 2016 (N=5564) and 2017 (N=10884) South Carolina Behavioral Risk Factor Surveillance System (BRFSS) of the Centers for Disease Control and Prevention, we analyzed the prevalence of physician diagnosed OSA and associated comorbidities...
October 22, 2020: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Eimir Hurley, Sarah-Jo Sinnott, Tim McDonnell, Tim Delaney, Maire O'Connor, Charles Normand
BACKGROUND: Ireland has the highest rates of overnight hospitalisations for COPD in the OECD, yet lacks estimates of the prevalence of this disease or its pharmacological management. We aimed to estimate the age and sex-specific prevalence of symptomatic COPD and to identify patterns of respiratory medication use to inform interventions to improve pharmacotherapy in this condition. METHODS: We used the national pharmacy claims database, with data on a publically insured cohort in 2016...
October 21, 2020: Irish Journal of Medical Science
Manas K Akmatov, Tatiana Ermakova, Jakob Holstiege, Annika Steffen, Dominik von Stillfried, Jörg Bätzing
The aim of this study was to estimate the prevalence of concurrent diagnoses of asthma/COPD and examine its full spectrum of comorbid disorders in Germany. We used nationwide outpatient claims data comprising diagnoses of all statutory health insurees (40+ years) in 2017 (N = 40,477,745). The ICD-10 codes J44 (COPD) and J45 (asthma) were used to identify patients. The odds of 1,060 comorbid disorders were examined in a case-control study design. Of all insurees, 4,632,295 (11%) were diagnosed with either asthma or COPD...
October 21, 2020: Scientific Reports
Desheng Sun, Hongyan Liu, Yao Ouyang, Xiansheng Liu, Yongjian Xu
BACKGROUND One of the most important factors in the pathogenesis of COPD (chronic obstructive pulmonary disease) is oxidative stress. GGT (gamma-glutamyltransferase) has been regarded as a novel marker of oxidative stress over the last few years. This study aimed to compare the serum levels of GGT during stable and acute exacerbations of COPD at a single center. MATERIAL AND METHODS The research included 117 patients with AECOPD (acute exacerbation of chronic obstructive pulmonary disease), 107 patients with stable COPD, and 112 control subjects...
October 22, 2020: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Peter Hanlon, Elaine Butterly, Jim Lewsey, Stefan Siebert, Frances S Mair, David A McAllister
BACKGROUND: Frailty is common in clinical practice, but trials rarely report on participant frailty. Consequently, clinicians and guideline-developers assume frailty is largely absent from trials and have questioned the relevance of trial findings to frail people. Therefore, we examined frailty in phase 3/4 industry-sponsored clinical trials of pharmacological interventions for three exemplar conditions: type 2 diabetes mellitus (T2DM), rheumatoid arthritis (RA), and chronic obstructive pulmonary disease (COPD)...
October 22, 2020: BMC Medicine
Miroslav Kovarik, Simona Najpaverova, Vladimir Koblizek, Zdenek Zadak, Miloslav Hronek
While increase in resting energy expenditure (REE) of COPD patients is generally accepted, there is a lack of information about nutritional substrates oxidation (NSO) in this specific population. The aim of this study was comparison of REE and NSO from indirect calorimetry between COPD patients and control subjects and to evaluate possible associations with the disease stage and prediction indexes. In this observational study, 50 consecutive outpatients with stable COPD (COPD group) were examined and compared with 25 volunteers without respiratory problems (control group)...
October 7, 2020: Respiratory Medicine
Megan E Summers, Bradley W Richmond, Jonathan A Kropski, Sarah A Majka, Julie A Bastarache, Antonis K Hatzopoulos, Jeffery Bylund, Moumita Ghosh, Irina Petrache, Robert F Foronjy, Patrick Geraghty, Susan M Majka
The well described Wnt inhibitor Dickkopf-1 (DKK1) plays a role in angiogenesis as well as regulation of growth factor signaling cascades in pulmonary remodeling associated with chronic lung diseases including emphysema and fibrosis. However, the specific mechanisms by which DKK1 influences mesenchymal vascular progenitor (MVPC), endothelial and smooth muscle cells within the microvascular niche have not been elucidated. In this study, we show that knock down of DKK1 in Abcg2pos lung mouse adult tissue resident MVPC alters lung stiffness, parenchymal collagen deposition, microvessel muscularization and density as well as loss of tissue structure in response to hypoxia exposure...
October 21, 2020: American Journal of Physiology. Cell Physiology
Kaj E C Blokland, Simon D Pouwels, Michael Schuliga, Darryl A Knight, Janette K Burgess
The extracellular matrix (ECM) is a complex network of macromolecules surrounding cells providing structural support and stability to tissues. The understanding of the ECM and the diverse roles it plays in development, homoeostasis and injury have greatly advanced in the last three decades. The ECM is crucial for maintaining tissue homoeostasis but also many pathological conditions arise from aberrant matrix remodelling during ageing. Ageing is characterised as functional decline of tissue over time ultimately leading to tissue dysfunction, and is a risk factor in many diseases including cardiovascular disease, diabetes, cancer, dementia, glaucoma, chronic obstructive pulmonary disease (COPD) and fibrosis...
October 30, 2020: Clinical Science (1979-)
Paola Rogliani, Beatrice Ludovica Ritondo, Rossella Laitano, Alfredo Chetta, Luigino Calzetta
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) represents a serious global health issue that is commonly associated with cardiovascular (CV) disease (CVD). The close relationship between COPD and CVD could be explained by different factors, first and foremost a chronic low-grade systemic inflammation implicated in the pathogenesis of both diseases and several stimuli enhancing the inflammatory processes and causing a mixed condition with worse outcomes than either disorder alone...
October 21, 2020: Expert Review of Respiratory Medicine
Jie Zhu, Deng Xu, Lu-Jia Ding, Pengcheng Wang
In this work, a series of MOF-derived CoPd nanoalloys have been prepared. The nanocatalysts exhibited excellent activities in the hydrogenation of nitroarenes and alkenes in green solvent (ethanol/water) under mild conditions (H 2 balloon, room temperature). Using ZIF-67 as template for both carbon matrix and cobalt precursor coating with a mesoporous SiO 2 layer, the catalyst CoPd/NC@SiO 2 were smoothly constructed. Catalytic results revealed the synergistic effect between Co and Pd components in the hydrogenation process due to the enhanced electron density...
October 20, 2020: Chemistry: a European Journal
Cuiping Fu, Xin Liu, Qingqing Zhu, Xu Wu, Shengyu Hao, Liang Xie, Shanqun Li
Introduction: The clinical benefit of high-flow nasal cannula (HFNC) on factors related to pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients remains unclear. This meta-analysis aimed at synthesizing the available evidence on the efficacy of HFNC on exercise capacity, lung function, and other factors related to pulmonary rehabilitation in COPD patients. Methods: Electronic databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science) were searched for randomized trials comparing with conventional oxygen therapy (COT) or noninvasive ventilation (NIV)...
2020: BioMed Research International
Jørgen Vestbo, Christer Janson, Javier Nuevo, David Price
Randomised controlled trials (RCTs) are the gold standard for evaluating treatment efficacy in patients with obstructive lung disease. However, due to strict inclusion criteria and the conditions required for ascertaining statistical significance, the patients included typically represent as little as 5% of the general obstructive lung disease population. Thus, studies in broader patient populations are becoming increasingly important. These can be randomised effectiveness trials or observational studies providing data on real-world treatment effectiveness and safety data that complement efficacy RCTs...
October 2020: ERJ Open Research
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