Functional Predictors Discriminating Asthma Copd Overlap Aco From Chronic Obstructive Pulmonary Disease Copd
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Functional Predictors Discriminating Asthma Copd Overlap Aco From Chronic Obstructive Pulmonary Disease Copd
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Author : Fabian Luca Gardin
language : de
Publisher:
Release Date : 2023
Functional Predictors Discriminating Asthma Copd Overlap Aco From Chronic Obstructive Pulmonary Disease Copd written by Fabian Luca Gardin and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023 with categories.
Functional Predictors Discriminating Asthma Copd Overlap Aco From Chronic Obstructive Pulmonary Disease Copd
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Author : Richard Kraemer
language : en
Publisher:
Release Date : 2022
Functional Predictors Discriminating Asthma Copd Overlap Aco From Chronic Obstructive Pulmonary Disease Copd written by Richard Kraemer and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022 with categories.
Abstract: Background: A significant proportion of patients with obstructive lung disease have clinical and functional features of both asthma and chronic obstructive pulmonary disease (COPD), referred to as the asthma-COPD overlap (ACO). The distinction of these phenotypes, however, is not yet well-established due to the lack of defining clinical and/or functional criteria. The aim of our investigations was to assess the discriminating power of various lung function parameters on the assessment of ACO. Methods: From databases of 4 pulmonary centers, a total of 540 patients (231 males, 309 females), including 372 patients with asthma, 77 patients with ACO and 91 patients with COPD, were retrospectively collected, and gradients among combinations of explanatory variables of spirometric (FEV1, FEV1/FVC, FEF25-75), plethysmographic (sReff, sGeff, the aerodynamic work of breathing at rest; sWOB), static lung volumes, including trapped gases and measurements of the carbon monoxide transfer (DLCO, KCO) were explored using multiple factor analysis (MFA). The discriminating power of lung function parameters with respect to ACO was assessed using linear discriminant analysis (LDA). Results: LDA revealed that parameters of airway dynamics (sWOB, sReff, sGeff) combined with parameters of static lung volumes such as functional residual capacity (FRCpleth) and trapped gas at FRC (VTGFRC) are valuable and potentially important tools discriminating between asthma, ACO and COPD. Moreover, sWOB significantly contributes to the diagnosis of obstructive airway diseases, independent from the state of pulmonary hyperinflation, whilst the diffusion capacity for carbon monoxide (DLCO) significantly differentiates between the 3 diagnostic classes. Conclusion: The complexity of COPD with its components of interaction and their heterogeneity, especially in discrimination from ACO, may well be differentiated if patients are explored by a whole set of target parameters evaluating, interactionally, flow limitation, airway dynamics, pulmonary hyperinflation, small airways dysfunction and gas exchange disturbances assessing specific functional deficits
Asthma Copd And Overlap
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Author : Jonathan A. Bernstein
language : en
Publisher: CRC Press
Release Date : 2018-03-22
Asthma Copd And Overlap written by Jonathan A. Bernstein and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-03-22 with Medical categories.
Using illustrative case examples, this book thoroughly reviews similarities and differences between asthma, chronic obstructive pulmonary disease (COPD) and the overlap syndrome. It is important to highlight the distinctions because these commonly encountered conditions in respiratory and primary care share many similarities but have important differences often mistaken for each other. This can have serious implications for treatment, particularly as new treatments are targeted at specific phenotypes of the diseases. This practical guide shows how to distinguish between the diseases on a pathological and clinical basis so that appropriate management and treatment may be pursued.
Asthma Copd Overlap
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Author : Hiroyuki Nagase
language : en
Publisher: Springer Nature
Release Date : 2025-02-14
Asthma Copd Overlap written by Hiroyuki Nagase and has been published by Springer Nature this book supported file pdf, txt, epub, kindle and other format this book has been release on 2025-02-14 with Medical categories.
This book elucidates the diagnostic criteria and concept of asthma-COPD overlap (ACO) and provides the latest information on its epidemiology, pathophysiology, diagnostic criteria, and treatment options. It discusses the controversy-causing findings of prognosis of ACO, the novel molecular mechanism including nitrosative stress, radiological or physiological features, findings by research that used HRCT or forced oscillation technique. In addition to a recent animal model of ACO, the role of each biomarker, the latest results of ICS/LAMA/LABA combination inhalers or biologics is also debated. Asthma COPD Overlap -Updated Concept, Pathophysiology, Diagnosis, and Treatment is addressed not only to beginners, but also to physicians engaged in clinical practice, supervisors, and many basic researchers. Covering every aspect of ACO, it serves readers to improve diagnosis or treatment for patients with ACO.
Asthma And Copd Overlap An Update An Issue Of Immunology And Allergy Clinics Of North America E Book
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Author : Nicola A. Hanania
language : en
Publisher: Elsevier Health Sciences
Release Date : 2022-08-17
Asthma And Copd Overlap An Update An Issue Of Immunology And Allergy Clinics Of North America E Book written by Nicola A. Hanania and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-08-17 with Medical categories.
In this issue, guest editors bring their considerable expertise to this important topic.Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.
Assessment Of Questionnaire Derived Predictors In Identifying Persons With Chronic Obstructive Pulmonary Diseases
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Author : Marc Rosenthal
language : en
Publisher:
Release Date : 1982
Assessment Of Questionnaire Derived Predictors In Identifying Persons With Chronic Obstructive Pulmonary Diseases written by Marc Rosenthal and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1982 with Mathematical models categories.
Diagnosis Treatment And Management Of Copd And Asthma
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Author : Koichi Nishimura
language : en
Publisher: Mdpi AG
Release Date : 2023-11-03
Diagnosis Treatment And Management Of Copd And Asthma written by Koichi Nishimura and has been published by Mdpi AG this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-11-03 with categories.
Chronic obstructive pulmonary disease (COPD) is a disorder characterized by airflow limitation and is one of the major causes of mortality and morbidity across the globe. Although several guidelines have been published over the past three decades, they were generated in response to the fact that COPD is a major cause of mortality and morbidity and remains an important social problem. In the 20th century, forced expiratory volume in one second (FEV1) was the single most important measure in patients with COPD from discriminative, evaluative, and predictive standpoints. We found that dyspnea is a better mortality predictor than FEV1 in 2002 and exercise capacity in 2003. Subsequently, it has become apparent that physical activity is more predictive of mortality. Furthermore, we have recently developed the tendency to use the reduction of the future risk of exacerbation as the endpoint of relatively large-scale clinical trials rather than the improvement of FEV1. Many researchers have continued to seek better outcome markers and have also discussed what should be used as primary or secondary endpoints in clinical trials in subjects with COPD. We have undoubtedly made great progress but still have a lot of work to do for the best interests of patients.
Fractional Exhaled Nitric Oxide Feno As Inflammatory Biomarker In Chronic Obstructive Pulmonary Disease Copd And Asthma Copd Overlap Aco
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Author : Seyed MohammadYousof Mostafavi PourManshadi
language : en
Publisher:
Release Date : 2018
Fractional Exhaled Nitric Oxide Feno As Inflammatory Biomarker In Chronic Obstructive Pulmonary Disease Copd And Asthma Copd Overlap Aco written by Seyed MohammadYousof Mostafavi PourManshadi and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018 with categories.
"Background and Objectives: Chronic obstructive pulmonary disease (COPD) and asthma are the most common inflammatory airway diseases. Some individuals share features of both asthma and COPD called asthma-COPD overlap (ACO) syndrome (ACOS). These individuals have worse symptoms and health status as well as lower pulmonary function than COPD-only. There is a remarkable need to have access to a biomarker that could be used in a clinical setting to be able to differentiate ACO(S) from COPD-only. Fractional exhaled nitric oxide (FeNO) is a promising biomarker identifying eosinophilic and T-helper cell 2 (Th2)-mediated airway inflammation in asthma. Its measurement is easy, sensitive, reproducible, and non-invasive. The exact role of FeNO in COPD and in differentiating COPD from ACO(S) is still unclear and needs to be defined. We aimed to systematically search the literature to present an overview of the existing literature in a field of interest, i.e., FeNO in COPD, and as well synthesize and aggregate findings from different studies. Furthermore, we conducted a study embedded in the Canadian Cohort Obstructive Lung Disease (CanCOLD) to evaluate the role of FeNO and determine if there is a cut-off value that can differentiate ACO(S) from COPD-only. Methods: Firstly, we conducted a systematic scoping review to determine key concepts, and to explore gaps within a developing field of research. Secondly, we carried out a study embedded in CanCOLD with new measurement including FeNO level. The COPD participants were divided into ACO and COPD-only (non-ACO). The different levels of FeNO and its utility were assessed between ACO and COPD-only. The optimal cut-off values and the receiver operating characteristic (ROC) curves were obtained to evaluate the clinical utility of FeNO in diagnosing ACO(S). Results: From the scoping review, 38 studies were selected, 24 were on modifying factors in FeNO measurement in COPD patients, 18 were on FeNO in COPD and compared to healthy subjects, 22 on FeNO and disease severity or progression, 7 on FeNO and ACO(S), 12 on FeNO and biomarkers, and 8 on FeNO and treatment response. From the original study embedded in CanCOLD, a total of 169 subjects were enrolled, of those 95 were COPD with ACO, N=46, and COPD-only, N=49. The mean FeNO level was higher but not statistically significant between ACO and COPD-only. The significant optimal cut-off values to differentiate ACO from COPD-only was for Def 1 FeNO ≥36 ppb with the sensitivity of 39%, specificity of 88% and AUC of 0.63, p=0.046, and Def 3 FeNO ≥23.5 ppb with the sensitivity of 80% and specificity of 50%, and area under the curve of 0.65, p=0.047.Conclusion: From the scoping review when measuring FeNO, the evidence is still lacking preventing us from recommending the general use of FeNO in clinical practice for COPD patients. Although FeNO level is higher in ACO(S) patients than COPD-only, it is still unclear if there is a FeNO cut-off that can be used to make the diagnosis of ACO(S) and/or to guide therapy with inhaled corticosteroids/glucocorticoids in COPD patients. After studying FeNO in a population-based sample of COPD, we were not able to show that FeNO levels could be used as a biomarker for differentiating ACO from COPD-only, and it is still too soon to be able to make a recommendation of using it in clinical practice. " --
Models Of Exacerbations In Asthma And Copd
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Author : Ulf Sjöbring
language : en
Publisher: Karger Medical and Scientific Publishers
Release Date : 2007-01-01
Models Of Exacerbations In Asthma And Copd written by Ulf Sjöbring and has been published by Karger Medical and Scientific Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007-01-01 with Medical categories.
This volume provides an overview of exacerbation models of asthma and chronic obstructive pulmonary disease (COPD). Within this wide field the book focuses on experimental systems that mimic pathobiological processes likely to be critical in exacerbations of these conditions. To generate insight into the mechanisms of exacerbation of pulmonary disease and to promote the discovery of future treatments, both animal models and human experimental models are described. For this update some of the most eminent scientists within the area of pulmonology could be recruited to share their knowledge of this evolving field of human medicine. Models of Exacerbations in Asthma and COPD will be of great interest to pulmonologists, allergologists, specialists in internal medicine and critical care, as well as to microbiologists, infectiologists and pharmacologists studying the response to respiratory infections.
Translating The Impacts Of Chronic Obstructive Pulmonary Disease Exacerbations
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Author : Laura Labonté
language : en
Publisher:
Release Date : 2016
Translating The Impacts Of Chronic Obstructive Pulmonary Disease Exacerbations written by Laura Labonté and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with categories.
"Chronic obstructive pulmonary disease (COPD) is one of the most under-diagnosed chronic diseases. Its burden is mostly attributable to exacerbations, acute events of worsened symptoms that lead to disease progression as well as significant morbidity and mortality. As many individuals remain undiagnosed, exacerbations are simply treated as acute events by healthcare providers. Through lack of proper disease management, these individuals will continue to experience exacerbations, and as disease progresses, will become susceptible to many comorbid conditions. Cardiovascular (CV) comorbidity is the second cause of death among COPD patients. However, some determinants of increased CV risk could be mediated using specific interventions. An important common link between CV disease and COPD is enhanced inflammation. As such, inflammatory mediators are attractive targets for modulating CV risk in COPD. The purpose of this thesis was to evaluate the wide range of impacts of COPD exacerbations, from population burdens, to CV risk, to inflammation in subjects representing different stages of disease using a translational research approach. Two research projects were carried out to address this objective. The first consisted of an analysis of exacerbation-like respiratory events among subjects with undiagnosed and previously diagnosed COPD, embedded within an existing population based cohort study called Canadian Cohort Obstructive Lung Disease (CanCOLD). Exacerbation-like respiratory events were measured in these subjects using a questionnaire administered every three months. Differences in the characteristics of subjects with undiagnosed and diagnosed COPD were assessed, as well as those associated with reporting exacerbation-like respiratory events. The proportion of subjects reporting events and odds of using health services were also compared. The second was a local study of diagnosed COPD patients hospitalized for exacerbations, who have advanced disease and elevated CV risk. A measure of arterial stiffness, carotid-femoral pulse wave velocity (cf-PWV), and powerful predictor of CV events, was measured sequentially in these patients, as well as several inflammatory mediators and other clinical variables. The associations between these were determined over time. In the CanCOLD cohort, subjects with undiagnosed COPD had milder symptoms, better lung function and less functional impairment compared to diagnosed subjects. However, lower health-related quality of life was associated with reporting exacerbation-like respiratory events in both groups of subjects. Although the proportion of subjects reporting these events was lower among undiagnosed subjects, health service utilization was similar to that of diagnosed subjects. Within the local study, several important predictors of increased cf-PWV over time were identified, including decline in lung function and subsequent exacerbations. Additionally, club cell (CC)-16, a lung-specific inflammatory mediator was identified as a determinant of changes in cf-PWV and exacerbation frequency over time. Moreover, RelB, a nuclear factor (NF)-[kappa]B family member and mediator of pulmonary inflammation, was identified as a potential novel mediator of CV function in COPD patients.This thesis demonstrates that, at the populational level, many subjects are not diagnosed for their COPD, but experience exacerbation-like respiratory events that result in a much greater utilization of health services than previously thought. With regards to CV morbidity, several novel predictors of arterial stiffening were identified; some of these representing potentially modifiable targets. CC-16 was identified as an important novel inflammatory link between pulmonary function and CV function in COPD patients. Consequently, the results of this thesis describe the wide range of impacts of exacerbations from populational burdens to inflammation." --