Exploration of the role of gastroesophageal reflux disease in chronic obstructive pulmonary disease Patients: A nationwide population-based cohort study

Session presented on Friday, July 25, 2014: Purpose: To investigate whether GERD is associated with an increased risk of severe acute exacerbation of COPD (AECOPD) by analyzing a nationwide health care database. Methods: This study employed a population-based retrospective cohort design. We conducted propensity score method with 1:2 matching. In this study we analyzed 1,976 COPD subjects with GERD and 3,943 COPD subjects as a comparison group. We individually tracked each subject in this study for 12 months and identified those subjects who experienced episodes of severe AECOPD required hospitalization or emergency department visit. The cumulative incidence of AECOPD was estimated using the Kaplan-Meier method to analyze the difference between two groups. Hazard ratios (HR) were calculated using Cox proportional hazards regression analysis. Results: The incidence of severe AECOPD was 3.40 and 2.34 per 1,000 person-months in individuals with and without GERD, respectively (P=0.0137). Following adjustment for sex, age, ischemic heart disease, heart failure, atrial fibrillation, hypertension, osteoporosis, anxiety, diabetes mellitus, angina, stroke, anemia, dementia, occupational category, monthly insurance premium, Cox regression analysis revealed that GERD was associated with severe AECOPD (HR=1.45, 95% CI=1.07 ~ 1.95). Conclusion: This study demonstrated that GERD is an independent risk factor for severe AECOPD. Caution should be exercised in COPD patients when assessing GERD symptoms in clinical practice

Snapping hip caused by a venous hemangioma of the gluteus maximus muscle: a case report

<p>Abstract</p> <p>Introduction</p> <p>Snapping hip, or coxa saltans, is defined as a clinical condition where a usually painful, audible snap occurs during hip flexion and extension. Its causes can be divided into external, internal or intra-articular origin. Accurate diagnosis is a prerequisite to successful treatment. We report a rare cause of snapping hip which is different from any previously reported cases.</p> <p>Case presentation</p> <p>A 23-year-old man presented to us with right hip pain of more than 10 years duration. Atrophy of the right gluteus maximus with snapping and tenderness were also noted. The imaging study revealed a focal intramuscular lesion in the lateral portion of the right gluteus maximus muscle. Surgery was performed and pathological examination concluded this mass to be a venous hemangioma.</p> <p>Conclusion</p> <p>Intramuscular hemangioma, though rare, should be considered in the differential diagnosis of a snapping hip even though muscle fibrosis is most frequently encountered.</p