Predictive factors for exacerbation and re-exacerbation in chronic obstructive pulmonary disease: an extension of the Cox model to analyze data from the Swiss COPD cohort

The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation.MethodsIn order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed.ResultsData of 1,247 patients (60.4% males, 46.6% current smokers) were analyzed, 268 (21.5%) did not fulfill spirometric diagnostic criteria for COPD. Data of 748 patients (63% males, 44.1% current smokers) were available for model analysis. In order to predict exacerbation an extended Cox Model was performed. Mean FEV1/FVC-ratio was 53.1% ( ±11.5), with a majority of patients in COPD GOLD classes 2 or 3. Hospitalization for any reason (HR1.7;P = 0.04) and pronounced dyspnea (HR for mMRC grade four 3.0;P 
Source: Multidisciplinary Respiratory Medicine - Category: Respiratory Medicine Source Type: research

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Conclusions: DM programs implemented to control diabetes, CHD/HTN, CHF/CKD, and asthma/COPD are cost-effective and show some evidence of improved clinical outcomes. PMID: 31990232 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Publication date: Available online 27 January 2020Source: The Lancet NeurologyAuthor(s): Franziska Hopfner, Günter U Höglinger, Gregor Kuhlenbäumer, Anton Pottegård, Mette Wod, Kaare Christensen, Caroline M Tanner, Günther DeuschlSummaryBackgroundβ-adrenoceptors are widely expressed in different human organs, mediate important body functions and are targeted by medications for various diseases (such as coronary heart disease and heart attack) and many β-adrenoceptor acting drugs are listed on the WHO Model List of Essential Medicines. β-adrenoceptor antagonists are used by billions ...
Source: The Lancet Neurology - Category: Neurology Source Type: research
Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population. In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1 ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung structure and function Original Articles: Lung structure and function Source Type: research
In this study, we estimated the short-term effects of PM on cause-specific hospitalization in Yichang, China. Daily data for PM level, meteorological factors, and hospital admissions (total hospitalization counts = 391,960) in Yichang between 2015 and 2017 were collected. We conducted a time-series study and applied a generalized additive model to evaluate the association between every 10 μg/m3 increment of PM and percent increase of hospitalization. We found positive and statistically significant associations between PM and hospital admissions for multiple outcomes, including all-cause, total respiratory, t...
Source: Environmental Science and Pollution Research International - Category: Environmental Health Authors: Tags: Environ Sci Pollut Res Int Source Type: research
Background: COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes most prone to CHD is poorly understood. We aimed to examine COPD characteristics as CHD risk factors.Methods: 251 COPD patients and 370 non-COPD controls from Norway, aged 48-90, took coronary CT angiography (CCTA) and pulmonary CT in 2013-2015. Arterial blood gasses, bioelectrical impedance and lung function was measured, and a detailed medical history taken. CCTA were evaluated as either wall changes+stenosis (possible coronary disease) or stenosis only (certain coronary disease), and emphysema defined as>10% of total area
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
Astudy published this week in theMorbidity and Mortality Weekly Report adds to the growing body of evidence indicating that experiencing adverse events in childhood such as abuse or witnessing intimate partner violence increases the risk of numerous negative health and socioeconomic outcomes in adulthood.Researchers from the Centers for Disease Control and Prevention used data from more than 144,000 respondents who participated in the Behavioral Risk Factor Surveillance System (BRFSS) from 2015 to 2017. The BRFSS is an annual state-based telephone survey of adults in which participants report on their health behaviors and ...
Source: Psychiatr News - Category: Psychiatry Tags: abuse Adverse Childhood Experiences Behavioral Risk Factor Surveillance System depression drinking intimate partner violence Morbidity and Mortality Weekly Report smoking substance misuse Source Type: research
CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences. PMID: 316...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
ConclusionAlthough the investigated co-morbidities are capable or inducing pathophysiological changes that are predisposing factors for tumor progression, none is an independent prognostic factor in patients with RCC.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Authors: Jany B, Bals R, Dreher M, Held M, Jany L, Rembert Koczulla A, Pfeifer M, Randerath W, Watz H, Wilkens H, Steinkamp G Abstract When caring for patients with respiratory diseases, always think of the heart! This is especially important for COPD patients, but also for a variety of other disorders of the respiratory system. At the workshop "Luftschlösser", held once more at Wiesbaden, Germany in February 2019 the many and important interactions of the lungs and the heart as well as the therapeutic implications were discussed. Based on pathophysiology, the psycho-social consequences of dyspnea, t...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
The objectives of the review are to assess the factor associated with increasing use of hookah, its health effects, options for hookah smoking cessation and public health policy initiatives to mitigate waterpipe use. PMID: 31483237 [PubMed - as supplied by publisher]
Source: Cardiovascular and Hematological Agents in Medicinal Chemistry - Category: Cardiology Tags: Cardiovasc Hematol Agents Med Chem Source Type: research
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