Stable COPD Patients Research Articles

Prevalence and consequences of Gastroesophageal Reflux Disease on COPD

Background The main determinants for COPD exacerbations are previous history of exacerbation, the severity of the disease, and the presence of comorbidities. However, the role of GER in this setting remains unclear. Aim To assess the impact of GER on COPD severity and exacerbation frequency. Methods Stable COPD patients were included.Diagnosis of GER was done by GERD questionnaire.Patients were classified into two groups (COPD with GERD & COPD without GERD). Associations of GERD with degree of airway obstruction, frequency of exacerbation ,ICU admission and mechanical ventilation in the previous year were assessed. Factors associated with exacerbation were analysed by regression analysis Results The current study included 233 COPD patients and were classified into two groups;Group A: COPD with GERD including 56 patients (24%) and Group B : COPD without GERD including 177 patients (76%).Group A had more ICU admission and mechanical ventilation events in the last year (P= 0.01&0.009 respectively).COPD patients with GERD had more severe degree of airway obstruction measured by FEV1 % (56% versus 62% in COPD patients without GERD.When comparing rate of COPD exacerbation in the last year before inclusion, 60% of COPD patients with GERD gave history of two or more exacerbations while in those without GERD, only 33% were exacerbators. . Current smoking, GERD and Severity of airway obstruction were the three independent predictors of excaerbation in the studied population. Conclusions The frequency of GER in COPD was 24%.COPD with GERD had lower FEV1%, more exacerbation and mechanical ventilation than those without GERD.

RETRACTED: Medical wireless IoT system and nursing intervention of chronic bronchitis based on clinical data

According to the WHO (World Health Organization), the chronic obstructive pulmonary disease has become the third leading cause of death in the group. The associated health sector related to 2030 based on the curve and the long-term cost of medical expenses. Age is the leading cause of a significant occurrence. The management of stable COPD patients to mitigate the attack, it is based on his system. Chronic obstructive pulmonary disease management system, portable spirometer and things mobile applications handheld, is a clinical information database. The Internet has established the configuration. The database, one of the MBOX format, through the Zhongshan hospital, collects data from the branch of the largest medical service provider in the region, located in the stable state of the 11 pieces of data from the main hospital of the patient follow-up. Lung function data is tested via a handheld portable spirometer and can be uploaded in real time. Other smartphone applications have been developed to establish direct communication between patients and physicians to improve disease management. It is worth noting that it classifies patient clinical data, sends it, stores it anonymously, and encrypts it for protection and privacy. What is useful in treating chronic diseases based on remote monitoring is that it significantly provides health information such as medical and biosensor data volume management and big data technology, this vast new medical technology. It can be increased. The application that needs to be processed. A potential solution for new services based on the Internet of Things is used to create the concept of big data processing.

Sleep quality in stable chronic obstructive pulmonary disease patients in Zagazig University Hospitals, Egypt

BackgroundChronic obstructive pulmonary disease (COPD) causes changes in sleep quality with accompanied nocturnal drops in oxygen saturation leading to cardiac dysrhythmias, pulmonary hypertension, and more arousal. However, this sleep disturbance is an aspect of COPD that is still under evaluation. Therefore, this work is designed to detect sleep quality with type and frequency of sleep-related breathing disorders in stable COPD patients.ResultsThis is a cross-sectional study that included 60 stable COPD patients. Full night polysomnographies were performed to all patients with assessment of their sleep quality and presence of sleep-disordered breathing. The studied patients were classified into two groups: group I (COPD with good sleep quality) and group II (COPD with poor sleep quality). The results revealed that the more severe the COPD degree, the worse the sleep quality parameters represented by sleep latency, sleep efficiency, and arousal index with a significant statistical difference (P < 0.05). Furthermore, a highly significant statistical difference was noticed regarding time spent in REM sleep among poor sleep quality patients with different grades of severity (P = 0.003). Additionally, obstructive sleep apnea hypopnea syndrome was the most frequent sleep-disordered breathing (65%), followed by nocturnal oxygen desaturation (17%) among poor quality sleeper.ConclusionAbnormal sleep quality is more common in moderate and severe COPD patients. Obstructive sleep apnea is the most frequent sleep-related breathing disorders among COPD patients. Increased BMI%, higher Berlin scores, and lower values of PaO2 and FOSQ-10 scores are strong predictors of poor sleep quality among COPD patients.

中药外用联合中医护理治疗稳定期慢阻肺患者的临床疗效研究

中药外用联合中医护理治疗稳定期慢阻肺患者的临床疗效研究

The processes of inflammation and fibrosis in patients with chronic obstructive pulmonary disease

The aim of the study was to determine the categories of COPD patients with a predominance of fibrotic or inflammatory processes. The study included 37 stable COPD patients (men – 33 (89.2%), women – 4 (10.8%), mean age – 63.5±1.18 years, the level of forced expiratory volume for the first second after the test with bronchodilators (FEV1post) – 46.7±5.81% of the proper value). To determine the categories of COPD patients with a predominance of inflammation or fibrosis, a cluster analysis was performed. For this purpose the most important indicators from a clinical point of view were selected: the number of exacerbations over the past year, dyspnea severity according to the mMRC scale, the level of FEV1 post and reversibility level in absolute values, systemic inflammation markers levels (CAA, C-RP) and profibrotic cytokine TGF-β1. Thus, according to the results of cluster analysis, two categories of patients were identified. The first category – COPD patients with a predominance of the inflammatory process with low dyspnea severity, high functional indicators (FEV1 &gt;50% of the proper value), high airway reversibility level, low level of profibrotic cytokine TGF-β1, high levels of systematic inflammation markers (C-RP and CAA). The second category – COPD patients with a predominance of the fibrosis process, with a high dyspnea severity, low functional indicators (FEV1 ≤50% of the proper value), low airway reversibility level, low levels of systematic inflammation markers (C-RP and CAA), and high profibrotic cytokine TGF-β1 levels. The prevalence of inflammatory processes was observed mainly in COPD patients, who belong to clinical group C; the prevalence of fibrotic processes – mainly in patients of clinical group B.

Serum magnesium level in acute exacerbation of the chronic obstructive pulmonary disease

In this hospital based Case Control study, the patient population consisted of 100 patients of COPD admitted as an acute exacerbation, maximum number of patients of acute exacerbation 45% was in the age of 61-70 years, mean age was 66.44 ± 8.19 years. 74 patients were males, 71% of COPD patients were chronic smokers, 45 (45%) patients were in stage II, and 72% of patients of COPD exacerbation had hypomagnesaemia. In the control group, 99% of patients had normomagnesaemia. The incidence of hypomagnesaemia was 78% with acute exacerbation. The correlation of serum magnesium levels in exacerbation patients moreover, serum magnesium level stable COPD patients was significantly important. There was a significant correlation between hypomagnesaemia and GOLD staging in stage II and stage III, with a non-significant correlation between hypomagnesaemia and stage I and stage IV. The study concludes that COPD exacerbation is associated with hypomagnesaemia. Further studies are needed to find out the correlation between the staging of COPD and serum magnesium levels, and the effect of magnesium therapy in COPD exacerbation patients with hypomagnesaemia. Also, further studies are needed to find out possible aetiology of hypomagnesaemia in COPD exacerbation.

N-Acetyl Cysteine in treatment of COPD

Introduction: In COPD excess expectoration secondary to tracheobronchial secretions contributes to symptoms, airflow obstruction and is diagnostic criterion. It also causes increased mortality, risk of hospitalizations and accelerated decline in FEV1. N-acetylcysteine (NAC) helps in liquefying mucus and DNA (via disruption of disulfide bonds) and has antioxidant effects. Aims: Evaluate add-on effect of NAC on clinical-physiological parameters in COPD patients treated according to GOLD guidelines. Material and Methods: Single labeled, randomized, parallel group prospective Observational study. In 120 stable COPD patients Modified medical research council (MMRC) dyspnoea score, COPD Assessment test (CAT score), number of exacerbations and hospitalizations in the last year were recorded and were randomized into 2 groups of 60 each. Group A received NAC 600mg twice daily along with standard treatment. Group B received standard treatment only. Mean and Standard Deviation was compared between groups using unpaired t-test. After 1 year, changes in above parameters were reassessed. Statistical Analysis: Unpaired t-test and chi square test were used. Statistical significance was set at Results: MMRC score reduced from 3.37 study group) to 2.91, difference being -0.46, and in control from 3.37 to 1.18, difference of -0.22 and p value of p

Coagulation markers as predictors for clinical events in COPD.

Activation of the blood coagulation system is a common observation in inflammatory diseases. The role of coagulation in COPD is underexplored. The study included 413 COPD patients and 49 controls from the 3-year Bergen COPD Cohort Study (BCCS). One hundred and forty-eight COPD patients were also examined during AECOPD. The plasma markers of coagulation activation, TAT complex, APC-PCI complex and D-dimer, were measured at baseline and during exacerbations by enzyme immunoassays. Differences in levels of the markers between stable COPD patients and controls, and between stable COPD and AECOPD were examined. The associations between coagulation markers and later AECOPD and mortality were examined by negative binomial and Cox regression analyses. TAT was significantly lower in stable COPD (1.03 ng/mL (0.76-1.44)) than in controls (1.28 (1.04-1.49), P = 0.002). During AECOPD, all markers were higher than in the stable state: TAT 2.56 versus 1.43 ng/mL, APC-PCI 489.3 versus 416.4 ng/mL and D-dimer 763.5 versus 479.7 ng/mL (P < 0.001 for all). Higher D-dimer in stable COPD predicted a higher mortality (HR: 1.60 (1.24-2.05), P < 0.001). Higher TAT was associated with both an increased risk of later exacerbations, with a yearly incidence rate ratio of 1.19 (1.04-1.37), and a faster time to the first exacerbation (HR: 1.25 (1.10-1.42), P = 0.001, all after adjustment). Activation of the coagulation system is increased during COPD exacerbations. Coagulation markers are potential predictors of later COPD exacerbations and mortality.

Effect of Dynamic Hyperinflation on Cardiac Response to Exercise of Patients With Chronic Obstructive Pulmonary Disease

IntroductionAlthough the major limitation to exercise performance in patients with COPD is dynamic hyperinflation (DH), little is known about its relation with cardiac response to exercise. Our objectives were to compare the exercise response of stroke volume (SV) and cardiac output (CO) between COPD patients with or without DH and control subjects, and to assess the main determinants. MethodsFifty-seven stable COPD patients without cardiac comorbidity and 25 healthy subjects were recruited. Clinical evaluation, baseline function tests, computed tomography and echocardiography were conducted in all subjects. Patients performed consecutive incremental exercise tests with measurement of operating lung volumes and non-invasive measurement of SV, CO and oxygen uptake (VO2) by an inert gas rebreathing method. Biomarkers of systemic inflammation and oxidative stress, tissue damage/repair, cardiac involvement and airway inflammation were measured. ResultsCOPD patients showed a lower SV/VO2 slope than control subjects, while CO response was compensated by a higher heart rate increase. COPD patients with DH experienced a reduction of SV/VO2 and CO/VO2 compared to those without DH. In COPD patients, the end-expiratory lung volume (EELV) increase was related to SV/VO2 and CO/VO2 slopes, and it was the only independent predictor of cardiac response to exercise. However, in the regression models without EELV, plasma IL-1β and high-sensitivity cardiac troponin T were also retained as independent predictors of SV/VO2 slope. ConclusionDynamic hyperinflation decreases the cardiac response to exercise of COPD patients. This effect is related to systemic inflammation and myocardial stress but not with left ventricle diastolic dysfunction.

A new predictor to determine the exacerbation and treatment of chronic obstructive pulmonary disease: eosinophil/neutrophil ratio.

COPD is an inflammatory disease characterized by persistent respiratory symptoms and airflow limitation. Currently, it has been demonstrated in some studies that eosinophil and T helper-2 mediated inflammation play a role in the pathophysiology of COPD. It was planned to evaluate eosinophilia, eosinophil/ neutrophil ratio (ENR), distribution of ENR according to GOLD groups, number of exacerbations in last year, relationship between ENR and the rate of ICS use in COPD patients, and the ENR cut-off value that predicts eosinophilic COPD. This study was planned prospectively in stable COPD patients between July 2017 and December 2017. All patients were divided into two groups as eosinophilic and non-eosinophilic group. Eosinophilia was considered to be > 2% of peripheric blood eosinophils. A total of 206 stable COPD patients (127 eosinophilic and 79 noneosinophilic) were included. Age, gender, BMI, smoking history, mMrc score were statistically similar while average pack-year of smoking was significantly higher in eosinophilic group. ENR was significantly higher in eosinophilic group as expected (p<0.001). High positive correlation was found between ENR and eosinophilic COPD (r= 0.8, p<0.001). In Group D, the number of eosinophilic COPD patients is significantly higher than the non-eosinophilic group while the distribution of patients in group A, B, C was similar. Although the PFT findings were similar in both groups, the use of ICS was significantly lower and the number of exacerbations was significantly higher in eosinophilic group. In the ROC analysis, the ENR cut-off value that predicts eosinophilic COPD was found to be 0.32 in all COPD patients (Sens: 93.7%, Specif: 92.4%, AUC= 0.97, p<0.001). Based on these findings, it is considered that more priority should be given to the use of ICS in COPD patients with high ENR and it can be used as a marker for predicting COPD exacerbation as COPD exacerbations are higher in patients with ENR.

Serum Amyloid A in Stable COPD Patients is Associated with the Frequent Exacerbator Phenotype.

BackgroundWe sought to determine whether circulating inflammatory biomarkers were associated with the frequent exacerbator phenotype in stable COPD patients ie, those with two or more exacerbations in the previous year.MethodsEighty-eight stable, severe, COPD patients (4 females) were assessed for exacerbation frequency, pulmonary function, fraction of expired nitric oxide (FENO); inflammatory variables were measured in venous blood. Logistic regression assessed associations between the frequent exacerbator phenotype and systemic inflammation.ResultsCompared with infrequent exacerbators, frequent exacerbators (n=10; 11.4%) had greater serum concentration (median (25th-75th quartile)) of serum amyloid A (SAA; 134 (84–178) vs 71 (38–116) ng/mL; P=0.024), surfactant protein D (SP-D; 15.6 (9.0–19.3) vs 8.5 (3.6–14.9) ng/mL; P=0.049) and interleukin-4 (IL-4; 0.12 (0.08–1.44) vs 0.03 (0.01–0.10) pg/mL; P=0.001). SAA, SP-D and IL-4 were not significantly correlated with FEV1%predicted or FVC %predicted. After adjusting for sex, age, BMI, FEV1/FVC and smoking pack-years, only SAA remained independently associated with the frequent exacerbator phenotype (OR 1.49[1.09–2.04]; P=0.012). The odds of being a frequent exacerbator was 18-times greater in the highest SAA quartile (≥124.1 ng/mL) than the lowest SAA quartile (≤44.1 ng/mL) (OR 18.34[1.30–258.81]; P=0.031), and there was a significant positive trend of increasing OR with increasing SAA quartile (P=0.008). For SAA, the area under the receiver operating characteristic curve was 0.721 for identification of frequent exacerbators; an SAA cut-off of 87.0 ng/mL yielded an 80% sensitivity and 61.5% specificity.ConclusionIn stable COPD patients, SAA was independently associated with the frequent exacerbator phenotype, suggesting that SAA may be a useful serum biomarker to inform progression or management in COPD.

Stable Clinical Course of Chronic Obstructive Pulmonary Disease Patients in the Era of Double Bronchodilator Therapy: A Single Referral Center Experience.

Despite clinical benefits of long-acting muscarinic antagonist (LAMA)/long-acting beta2-agonist (LABA) double bronchodilator therapy, there has been limited evidence for treatment change from LAMA/LABA to inhaled corticosteroid (ICS)-containing therapy. This study aimed to assess the rate of ICS-containing therapy from LAMA/LABA and investigate the factors associated with ICS addition. Between October 2015 and March 2019, consecutive patients prescribed with a LAMA/LABA fixed-dose combinations (FDCs) therapy without ICS were retrospectively identified from a single-referral hospital. The primary outcome was addition of ICS. During LAMA/LABA FDCs therapy (median, 12.4 months), 47 (17.7%) out of 266 patients had ICS addition. Most patients maintained bronchodilators without addition of ICS at 12 (86.5%) or 24 (76.8%) months. Patients with dyspnea (mMRC ≥ 2) at baseline, previous ICS use, and exacerbation in the previous year were at a higher risk of ICS addition. Especially, exacerbation in the previous year and dyspnea were associated with the development of frequent exacerbations during LAMA/LABA FDCs therapy, which might have led to ICS addition. Double bronchodilator therapy could be well-maintained in stable COPD patients. However, patients with exacerbation in the previous year, dyspnea, and previous ICS use should be closely approached and monitored with initiation of LAMA/LABA FDCs therapy without ICS.

Is group C really needed as a separate group from D in COPD? A single-center cross-sectional study

IntroductionGOLD 2017 report proposed that the combined COPD assessment should be done according only to symptom burden and exacerbation history in the previous year. ObjectiveThis study aims to investigate the change in the COPD groups after the GOLD 2017 revision and also to discuss the evaluation of group C and D as a single group after the GOLD 2019 report. MethodThe study was designed as a cross-sectional. 251 stable COPD patients admitted to our out-patient clinic; aged ...40 years, at least one-year diagnosis of COPD and ...10 pack-year smoking history were consecutively recruited for the study. ResultsIn GOLD 2017, a significant difference was found between the distribution of all groups compared to GOLD 2011 (P...=...0,001). 31 patients included in group C were reclassified into group A and 37 patients in group D were reclassified into group B. The FEV1 values of group A and B patients were significantly low and group C and D patients had had exacerbations in more frequently the previous year in GOLD 2017 compared to GOLD 2011. ConclusionAfter the GOLD 2017 revision, the rate of group C patients decreased even more compared to GOLD 2011 and the group C and D may be considered as a single group in terms of the treatment recommendations with the GOLD 2019 revision. We think that future prospective studies are needed to support this suggestion.

The Association Between Eosinophil Variability Patterns and the Efficacy of Inhaled Corticosteroids in Stable COPD Patients.

IntroductionBlood eosinophils are a predictive marker for the use of inhaled corticosteroids (ICS). However, there is concern over whether a single measure of blood eosinophils is sufficient for outlining a treatment plan. Here, we evaluated the association between variability in blood eosinophils and the effects of ICS in stable COPD cohorts.MethodsCOPD patients in the Korean COPD Subtype Study and the Seoul National University Airway Registry from 2011 to 2018 were analyzed. Based on blood eosinophils at baseline and at 1-year follow-up, the patients were classified into four groups with 250/μL as a cutoff value: consistently high (CH), consistently low (CL), variably increasing (VI), and variably decreasing (VD). We compared rates of acute exacerbations (AEs) according to ICS use in each group after calibration of severity using propensity score matching.ResultsOf 2,221 COPD patients, 618 were analyzed and a total of 125 (20%), 355 (57%), 63 (10%), and 75 (12%) patients were classified into the CH, CL, VI, and VD groups, respectively. After calibration, we found that ICS users tended to have a lower AE rate in the CH group (RR 0.41, 95% CI 0.21–0.74) and VI group (RR 0.45, 95% CI 0.22–0.88), but not in the CL group (RR 1.42, 95% CI 1.08–1.89) and VD group (RR 1.71, 95% CI 1.00–2.96).ConclusionMore than one-fifth of patients had an inconsistent blood eosinophil level after the 1-year follow-up, and the AE-COPD rate according to ICS differed based on variability in eosinophils. Regular follow-up of blood eosinophils is required for COPD patients.

Vitamin D&lt;sub&gt;3&lt;/sub&gt; supplementation on plasma antioxidant enzymes in D&lt;sub&gt;3&lt;/sub&gt; deficient patients with COPD - a randomized controlled trial

Background: Free radical is a crucial factor for progression of COPD. Antioxidant enzymes, including superoxide dismutase (SOD) and catalase (CAT) have been well known to reduce morbidity of chronic disease. Vitamin D3 has antioxidant effect in human body.&#x0D; Objectives: To assess the effects of D3 supplementation on plasma SOD and CAT levels in D3 deficient COPD patients.&#x0D; Method: A double blinded placebo controlled randomized clinical trial was carried out on 30 vitamin D3 deficient male, smoker and stable COPD patients of age &gt;40 years. All the patients were randomly allocated to ‘Study’ (n=15) or ‘Control’ (n=15) and their baseline plasma SOD and CAT were measured. Study patients received 80,000 IU (2 oral capsules) of D3 per week for first 13 weeks. Subsequently, after checking their serum 25(OH)D or Ca2+, they received 40,000 IU (1 oral capsule) of D3 either per 1 week or per 2 weeks or per 6 weeks or no further supplementation for next 13 weeks. All the ‘Control’ patients received two oral capsules of placebo weekly for consecutive 26 weeks. Additionally, all patients of both groups were also advised to have sunlight exposure (within 11 to 14 hrs) at least for 5 to 15 minutes daily. After 26 weeks of follow up, both enzymes, serum 25(OH)D or Ca2+of all patients were measured by spectrophotometry. Data were analyzed by paired sample and independent sample ‘t’ test.&#x0D; Results: The baseline plasma SOD (14.80±3.86U/ml vs 11.95±4.03U/ml) and CAT (11.0±7.59U/ml vs14.41±4.83U/ml) in study and control was almost similar (p&gt;0.05). However, the mean SOD (18.98±2.98U/ml) and CAT (32.75±9.70U/ml) significantly increased (p&lt;0.01; p&lt;0.001) after 26 weeks of follow up only in ‘Study’ patients. In addition, both enzymes were significantly (p&lt;0.001) higher in the D3 supplemented patients than those of placebo treated patients after 26 weeks of follow up.&#x0D; Conclusion: The present study reveals that vitamin D3 supplementation increases the plasma antioxidant enzymes in D3 deficient patients with COPD.&#x0D; Trial registration: www.clinicaltrials.gov identifier NCT04011930&#x0D; J Bangladesh Soc Physiol. 2020, June; 15(1): 23-32

Measurement of maximal respiratory static pressure in stable COPD patients and their co-rrelation with various physiological anthropometric and spirometry parpmeters and arterial blood gas tension

The strength of respiratory muscles can be evaluated from static measurement (PImax and PEmax) or inferred from dynamic measurement such as maximal voluntary ventilation. Maximal inspiratory pressure and Maximal expiratory pressure are simple, convenient and non-invasive measurement of respiratory muscle strength. Respiratory muscle strength decreases in COPD patients due to multiple factors. The primary aim of this study is to obtain mean PImax and PEmax values in Indian COPD patients and its co-rrelation with anthropomatric, physiological, spirometric parameters and arterial blood gas tension.

The effect of 50% oxygen on PtCO2 in patients with stable COPD, bronchiectasis, and neuromuscular disease or kyphoscoliosis: randomised cross-over trials

BackgroundHigh-concentration oxygen therapy causes increased arterial partial pressure of carbon dioxide (PaCO2) in patients with COPD, asthma, pneumonia, obesity and acute lung injury. The objective of these studies was to investigate whether this physiological response to oxygen therapy occurs in stable patients with neuromuscular disease or kyphoscoliosis, and bronchiectasis.MethodsThree randomised cross-over trials recruited stable patients with neuromuscular disease or kyphoscoliosis (n = 20), bronchiectasis (n = 24), and COPD (n = 24). Participants were randomised to receive 50% oxygen and 21% oxygen (air), each for 30 min, in randomly assigned order. The primary outcome was transcutaneous partial pressure of carbon dioxide (PtCO2) at 30 min. The primary analysis was a mixed linear model.ResultsSixty six of the 68 participants had baseline PtCO2 values < 45 mmHg. The intervention baseline adjusted PtCO2 difference (95% CI) between oxygen and room air after 30 min was 0.2 mmHg (− 0.4 to 0.9), P = 0.40; 0.5 mmHg (− 0.2 to 1.2), P = 0.18; and 1.3 mmHg (0.7 to 1.8), P < 0.001, in the neuromuscular/kyphoscoliosis, bronchiectasis and COPD participants respectively.ConclusionsThe small increase in PtCO2 in the stable COPD patients with high-concentration oxygen therapy contrasts with the marked increases in PaCO2 seen in the setting of acute exacerbations of COPD. This suggests that the model of studying the effects of high-concentration oxygen therapy in patients with stable respiratory disease is not generalisable to the use of oxygen therapy in the acute clinical setting. Appropriate studies of high-concentration compared to titrated oxygen in acute clinical settings are needed to determine if there is a risk of oxygen-induced hypercapnia in patients with neuromuscular disease, kyphoscoliosis or bronchiectasis.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12615000970549 Registered 16/9/15, ACTRN12615000971538 Registered 16/9/15 and ACTRN12615001056583 Registered 7/10/15.

Circulating Low Density Neutrophils In Advanced Lung Cancer Patients Exhibit Unique Immune Signatures and affect prognosis

Abstract The role of innate immunity, in especially neutrophils, in supporting anti-tumor immunity in lung cancer is understudied. Neutrophil "flavors", such as low-density neutrophils (LDN) and high-density neutrophils (HDNs), have been described in cancer patients and associated with tumor-supportive properties. Nevertheless, HDN and LDN phenotypic properties and their cancer-driven modulations are still largely unknown. Here, we aimed to evaluate the clinical relevance and significance of circulating LDN in lung cancer patients, and by using data-driven artificial intelligence supported analysis tools evaluated phenotypic states of circulating neutrophils subsets during lung cancer progression. COPD patients and healthy volunteers served as controls. Using mass cytometry (CyTOF), we aimed to identify major sub-populations within circulating LDN and HDN subsets and determine a possible change in phenotype due to cancer. LDN were highly enriched in advanced lung cancer patients (12.9±2.4%), but not in early stage patients (1.2±0.2%), healthy individuals (1.3±1.1%), or stable COPD patients (2.2±0.6%). Elevated LDN (&amp;gt;10% of LDF) showed a remarkable correlation with poorer prognosis in advanced patients. Our CyTOF analysis revealed the presence of three main neutrophil subsets with a great variability in the presence of CD10+ vs. CD10− LDNs between patients. We further demonstrated that both HDN and LDN retain a degree of inherent spontaneous plasticity. Deep characterization of cancer-related circulating neutrophils, as well as their modulation along tumor progression, will assist in suggesting new biomarkers and novel targets to improve response to current conventional therapies and immunotherapies.

Evidence Based Faktor yang Berhubungan Dengan Kualitas Hidup Pasien PPOK Stabil: A Systematic Review

; amin.fkua@gmail.com &#x0D; Makhfudli &#x0D; Fakultas Keperawatan, Universitas Airlangga; ievut_rz@yahoo.com (koresponden)&#x0D; &#x0D; ABSTRACT&#x0D; &#x0D; Background: Low quality of life in chronic obstructive pulmonary disease is crucial because leads to a high risk to reduced activity of daily and mortality. Objective: To identify determine factors that influence with health-related quality of life on stable COPD patients. Method: The database was performed article from Science Direct, CINAHL, Scopus dan PubMed is limited to the last 5 years of publication from 2014 to 2019, full-text article in English. The keywords used ”Health-Related Quality of Life”, “AND”, “Stable”, “AND”, “COPD”. Results: Fourteen articles with 8401 participants were included in the review. Most studies were cross sectional design. COPD Assasment Test (CAT) was to assess health-related quality of life in stable COPD. There was symptoms and exacerbation, functional capacity exercise, psychology, sociodemography, biomolecular, comorbidity, and pulmonary function affecting health-related quality of life on stable COPD patients. Conclusion: Factors might affect with poor HRQOL because the condition of COPD itself which then give an effect to whole body. Suggestion: Health worker need to be aware and control of the complexity of factors influence health-related quality of life to impove outcomes for COPD patients.&#x0D; Keywords: health-related quality of life; chronic obstructive pulmonary disease&#x0D; &#x0D; ABSTRAK&#x0D; &#x0D; Latar belakang: Kualitas hidup yang rendah pada pasien Penyakit Paru Obstruktif Kronik (PPOK) menjadi penting karena dapat menyebabkan penurunan aktivitas sehari-hari dan kematian. Tujuan: Untuk mengetahui determinan faktor yang dapat mempengaruhi kualitas hidup pasien PPOK yang stabil Metode: Database yang digunakan dalam penelitian ini adalah Science Direct, CINAHL, Scopus dan PubMed terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, full text article dengan berbahasa Inggris. Kata kunci yang digunakan adalah “”Health-Related Quality of Life”, “AND”, “Stable”, “AND”, “COPD”. Hasil: Systematic review ini menggunakan 14 artikel dengan 8401 responden. Kuesioner yang digunakan dalam studi adalah COPD Assasment Test (CAT). Tanda gejala dan eksaserbasi, kapasitas latihan fungsional, psikologi, sosiodemografi, biomolekul, komorbiditas dan faal paru mempengaruhi kualitas hidup pasien PPOK stabil. Kesimpulan: Banyak faktor yang mungkin memiliki hubungan dengan kualitas hidup pasien buruk karena kondisi penyakit PPOK itu sendiri yang kemudian berdampak pada seluruh tubuh. Saran: Petugas kesehatan perlu menyadari dan mengontrol kompleksnya dari faktor-faktor yang mempengaruhi kualitas hidup pasien PPOK sehingga menjadi membaik.&#x0D; Kata kunci: kualitas hidup; penyakit paru obstruktif kronik

Relationship between the COPD assessment test (CAT) and respiratory function characteristics of North African stable COPD patients

Introduction: The COPD Assessment Test (CAT) is a simple method for assessing the impact of COPD on the patient`s health which is not validated with North African COPD patients. Objective: To determine the relationship between the CAT score and the SGRQ, anthropometric, dyspnea, severity of airflow obstruction and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages in stable COPD patients. Material and Methods: It is a cross-sectional observational study. It consists of a convenience sample of COPD and Smokers subjects aged more than 30 years. Dyspnea was evaluated according to the modified British medical research council (mMRC) 4). Arabic versions of the SGRQ and CAT questionnaires were used. Spirometry was performed in accordance with international standards. Obstructive ventilator defect (OVD) grades and GOLD grades were identified. Results: A total sample of 150 (121 COPD) was collected. A negative correlation was found between CAT score and anthropometric and all functional parameters in the total sample. Correlations between CAT score and mMRC score, pulmonary age and SGRQ score were found in COPD group (p&lt;0.01). CAT score correlated with OVD and GOLD grades, severe COPD (GOLD 3 and 4) had higher CAT scores. Conclusion: There is a strong relationship between CAT score and clinical and functional COPD components. Impact of this research on clinical medicine and basic science: COPD is a complex disease with multiple consequences which can impede the quality of life of patients. The latter can be evaluated by specific questionnaires. The most used questionnaire is St. George’s Respiratory Questionnaire (SGRQ). However, this health status measure is long and not practical for clinical routine use. Therefore, recently a new simple system evaluating health status was developed. It is the COPD Assessment Test (CAT), which was approved, in its French, English and Arabic version. It is a simple method for assessing the impact of COPD on the patient`s health. CAT is composed of only eight questions and a key is not needed to calculate a score. To our own knowledge, there are no studies about CAT scoring in and its relation with clinical and respiratory function characteristics in North Africa. Keywords: COPD- CAT score- SGRQ-FEV1- Spirometry