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Respiratory morbidity of preterm infants of less than 33 weeks gestation without bronchopulmonary dysplasia: a 12-month follow-up of the CASTOR study cohort.

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Respiratory morbidity of preterm infants of less than 33 weeks gestation without bronchopulmonary dysplasia: a 12-month follow-up of the CASTOR study cohort.

Epidemiol Infect. 2013 Sep 13;:1-13

Authors: Fauroux B, Gouyon JB, Roze JC, Guillermet-Fromentin C, Glorieux I, Adamon L, DI Maio M, Anghelescu D, Miloradovich T, Escande B, Elleau C, Pinquier D

Abstract
SUMMARY The aim of this study was to describe the incidence and risk factors for respiratory morbidity during the 12-month period following the first respiratory syncytial virus (RSV) season in 242 preterm infants [<33 weeks gestational age (GA)] without bronchopulmonary dysplasia and 201 full-term infants (39-41 weeks GA) from the French CASTOR study cohort. Preterm infants had increased respiratory morbidity during the follow-up period compared to full-terms; they were more likely to have wheezing (21% vs. 11%, P = 0·007) and recurrent wheezing episodes (4% vs. 1%, P = 0·049). The 17 infants (14 preterms, three full-terms) who had been hospitalized for RSV-confirmed bronchiolitis during their first RSV season had significantly more wheezing episodes during the follow-up period than subjects who had not been hospitalized for RSV-confirmed bronchiolitis (odds ratio 4·72, 95% confidence interval 1·71-13·08, P = 0·003). Male gender, birth weight <3330 g and hospitalization for RSV bronchiolitis during the infant's first RSV season were independent risk factors for the development of wheezing episodes during the subsequent 12-month follow-up period.

PMID: 24029023 [PubMed - as supplied by publisher]

Chronic obstructive pulmonary disease: a risk factor for type 2 diabetes: a nationwide population-based study.

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Chronic obstructive pulmonary disease: a risk factor for type 2 diabetes: a nationwide population-based study.

Eur J Clin Invest. 2013 Aug 8;

Authors: Lee CT, Mao IC, Lin CH, Lin SH, Hsieh MC

Abstract
BACKGROUND: Type 2 diabetes mellitus (DM) is a common medical disorder and a leading cause of morbidity and mortality worldwide. We investigated whether chronic obstructive pulmonary disease (COPD) was the risk factor for type 2 diabetes in an Asian population.
MATERIALS AND METHODS: From Taiwan's National Health Insurance Research Database, we collected data from 16 088 patients, including 8044 COPD patients and 8044 age- and gender- matched control subjects. Cox proportional hazard regression was performed to evaluate independent risk factors for type 2 diabetes in all patients and identify risk factors in patients with COPD.
RESULTS: During the 5·5-year follow-up, patients with COPD were found to have a significantly higher rate of incident type 2 diabetes than the control group (P < 0·001). COPD was significantly associated with type 2 diabetes hazard ratio (HR : 1·41, 1·23-1·63, P < 0·001) after adjusting sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, coronary artery disease (CAD) and cerebrovascular disease. Cox regression analysis showed that hypertension (HR : 1·55, 1·33-1·80, P < 0·001) and hypertriglycemia (HR : 1·48, 1·15-1·90, P = 0·002) were important risk factors for type 2 diabetes in patients with COPD.
CONCLUSIONS: Patients with COPD have a higher risk of type 2 diabetes compared with control subjects after adjusting for confounding factors such as sex, age, residential area, insurance premium, steroid use, hypertriglycemia, hypertension, CAD and cerebrovascular disease. Continuous surveillance of signals of dysglycemia may be incorporated into care programmes for patients with COPD.

PMID: 24028296 [PubMed - as supplied by publisher]

Longitudinal Changes in Clinical Outcomes in Older Patients with Asthma, COPD and Asthma-COPD Overlap Syndrome.

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Longitudinal Changes in Clinical Outcomes in Older Patients with Asthma, COPD and Asthma-COPD Overlap Syndrome.

Respiration. 2013 Sep 11;

Authors: Fu JJ, Gibson PG, Simpson JL, McDonald VM

Abstract
Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults is not well understood. Objective: To examine the prognosis of OADs and to identify potential determinants for longitudinal changes in clinical outcomes. Methods: We consecutively recruited 99 older adults (>55 years) with OADs who underwent a multidimensional assessment at baseline and 4 years which involved spirometry, 6-min walk distance (6MWD), assessments of health status (Saint George's Respiratory Questionnaire, SGRQ), comorbidity, and serum and sputum biomarkers. All-cause mortality and respiratory hospitalisation during the follow-up period were recorded. Clinical outcomes were compared between basal and final visits, and changes in clinical outcomes were compared among asthma, COPD and asthma-COPD overlap groups. Associations between clinical parameters, biomarkers and prognosis were examined. Results: After a median follow-up of 4.2 years, outcome data were available for 75 (75.8%) patients. There were 16 (16.2%) deaths. The BODE index predicted all-cause mortality in older people with OADs. While spirometry, 6MWD and SGRQ deteriorated significantly over the 4 years, there was significant heterogeneity in the longitudinal changes in these clinical outcomes. Participants with COPD had a significant decline in FEV1 (p = 0.003), SGRQ (p = 0.030) and 6MWD [decline of 75.5 (93.4) m, p = 0.024]. The change in 6MWD was lower in the asthma-COPD overlap group. Airflow reversibility was associated with a reduced decline in 6MWD. Conclusion: COPD patients had a poor prognosis compared with asthma and asthma-COPD overlap patients. The BODE index is a useful prognostic indicator in older adults with OADs. Both airway disease diagnosis and BODE index warrant specific attention in clinical practice. © 2013 S. Karger AG, Basel.

PMID: 24029561 [PubMed - as supplied by publisher]

The GOLD Rush

The Gold Rush, a 1925 classic silent movie by Chaplin, depicted him in his trademark little tramp character as a lone prospector searching for the precious metal somewhere in Alaska. On 16 November 2011, the release of the current revision of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Executive Summary in Shanghai, China, just recently published elsewhere,3 gave way to a new rush, the GOLD rush.

Clinical guidelines need to be updated regularly to implement some of the vast knowledge about chronic obstructive pulmonary disease (COPD) accumulated over the last years, and to assess implementation and adherence.

This second 5-year revision of the GOLD strategic document has somewhat shaken the COPD world for good. The GOLD authors presented a new classification ...

Pulmonary rehabilitation; what's in a name?

The therapeutic efficacy of pulmonary rehabilitation is now well established and supported by a substantial body of clinical trial evidence.1 2 The place of pulmonary rehabilitation in the management of chronic obstructive pulmonary disease (COPD) and other chronic respiratory diseases has been enshrined in national and international guidelines including those recently produced by the British Thoracic Society.3 In recent years, attention has shifted from questions regarding the effectiveness of the intervention for those who successfully attend and complete a programme, to meeting challenges for the delivery of pulmonary rehabilitation to the wider population with disabling lung disease. A key driver of this focus is the perception in many quarters that uptake and adherence to rehabilitati...

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