Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients

\ua9 2024, European Respiratory Society. All rights reserved.Background Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods A systematic review was performed identifying studies that reported in-hospital mortality, postdischarge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisation

TECHNOLOGICAL PROCESSES OF PRODUCTION OF THE MASS FUNCTION CAST BARS

A number of scientifically grounded technical decisions, the whole set of which has enabled to create technological processes of production of high-quality cast bars of mass appointment is offered

Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis

Sarcopenia prevalence and its clinical impact are reportedly variable in chronic obstructive pulmonary disease (COPD) due partly to definition criteria. This review aimed to identify the criteria used to diagnose sarcopenia and the prevalence and impact of sarcopenia on health outcomes in people with COPD. This review was registered in PROSPERO (CRD42018092576). Five electronic databases were searched to August 2018 to identify studies related to sarcopenia and COPD. Study quality was assessed using validated instruments matched to study designs. Sarcopenia prevalence was determined using authors' definitions. Comparisons were made between people who did and did not have sarcopenia for pulmonary function, exercise capacity, quality of life, muscle strength, gait speed, physical activity levels, inflammation/oxidative stress, and mortality. Twenty-three studies (70% cross-sectional) from Europe (10), Asia (9), and North and South America (4) involving 9637 participants aged ≥40 years were included (69.5% men). Sarcopenia criteria were typically concordant with recommendations of hEuropean and Asian consensus bodies. Overall sarcopenia prevalence varied from 15.5% [95% confidence interval (CI) 11.8-19.1; combined muscle mass, strength, and/or physical performance criteria] to 34% (95%CI 20.6-47.3; muscle mass criteria alone) (P = 0.009 between subgroups) and was greater in people with more severe [37.6% (95%CI 24.8-50.4)] versus less severe [19.1% (95%CI 10.2-28.0)] lung disease (P = 0.020), but similar between men [41.0% (95%CI 26.2-55.9%)] and women [31.9% (95%CI 7.0-56.8%)] (P = 0.538). People with sarcopenia had lower predicted forced expiratory volume in the first second (mean difference -7.1%; 95%CI -9.0 to -5.1%) and poorer exercise tolerance (standardized mean difference -0.8; 95%CI -1.4 to -0.2) and quality of life (standardized mean difference 0.26; 95%CI 0.2-0.4) compared with those who did not (P < 0.001 for all). No clear relationship was observed between sarcopenia and inflammatory or oxidative stress biomarkers. Incident mortality was unreported in the literature. Sarcopenia is prevalent in a significant proportion of people with COPD and negatively impacts upon important clinical outcomes. Opportunities exist to optimize its early detection and management and to evaluate its impact on mortality in this patient group

Protective coatings made of refractory metals by thermal spraying technique

W pracy zaprezentowano nowe warstwy stopowe na bazie molibdenu o wysokiej zawartości renu, przeznaczone do zwiększania odporności korozyjnej elementów ceramicznych/cermetalicznych na działanie ciekłego szkła, w szczególności szkła sodowo-wapniowego. Przeznaczeniem są szczególnie narażone na korozję i erozję elementy instalacji do topienia szkła takie, jak gardziele przelotowe, bubblery, rozdzielniki ciekłego szkła oraz oczka. Cermetalicznym podłożem, na powierzchni którego wytworzono techniką natryskiwania plazmowego warstwy, jest spiekany ogniotrwały materiał na bazie niestabilizowanego ZrO2 z dodatkiem Mo. Wytworzone materiały poddane zostały procesowi krzemowania celem wytworzenia powłoki chroniącej warstwę przed utlenieniem w początkowej fazie zanim nastąpi całkowite stopienie szkła. Wytworzenie warstw wymagało opracowania metody umożliwiającej wytwarzanie proszku stopowego o morfologii pozwalającej na stosowanie go w procesach natryskiwania cieplnego. W celu otrzymania proszku wykazującego dużą sypkość opracowano metodę polegającą na wprowadzaniu renu do molibdenu w procesie redukcji nadrenianu amonu. Badano wpływ zastosowania operacji wygrzewania proszku po procesie redukcji na skład fazowy i mikrostrukturę proszków oraz otrzymanych z nich warstw. Operacja wygrzewania wpływa na jakościowy i ilościowy skład fazowy proszków, natomiast nie ma istotnego wpływu na skład fazowy warstw. Wytworzone materiały poddano próbom odporności korozyjnej, na podstawie których można stwierdzić, że opracowane warstwy bardzo dobrze chronią wyrób ceramiczny/cermetaliczny od korozyjnego działania szkła sodowo-wapniowego. Nie zaobserwowano składników szkła w cermetalu. Istotne jest również to, że rozpuszczalność składników warstwy w szkle jest minimalna.The article presents novel molybdenum-based alloy coatings with a high rhenium content for improvement of corrosion resistance of ceramic/cermet elements towards molten glass, particularly soda-lime glass. The expected destination of the studied materials are elements especially exposed to corrosion such as passage throats, bubblers, separatory funnels for liquid glass. The substrate is a sintered refractory material made of unstabilized zirconia with Mo addition. Obtained materials were subjected to silicon in order to grow a cover layer to protect coating from oxidizing during the initial phase before glass is completely melted. For the purpose of deposition it was necessary to develop a method for preparation of alloy powder with a morphology applicable for thermal spraying. In order to obtain powder with high flowability a method of introduction of rhenium into molybdenum during ammonium perrhenate reduction was developed. The powders and coatings were investigated for phase composition and microstructure after annealing of reduced powder. The process of annealing was found to influence the phase composition of powders but not of the coatings. Tests of corrosion resistance carried out with the resulting materials indicate that the coatings protect well the underlaying ceramic/cermet core from the corrosive action of soda-lime glass. No glass element were found in the cermet material. It is also important that solubility of layer components in glass is minimal

Inspiring stories: the impact that being part of ERS activities can have on a professional career

Each year, the European Respiratory Society (ERS) offers many opportunities to support Early Career Members (ECMs) working in the respiratory field in advancing their careers, including fellowships, representation at ERS assemblies, and presentations at the ERS Congress. Through these opportunities, ECMs can meet other respiratory professionals, find synergies, work together and discover new ways to increase their visibility and advance their careers, as well as create new and lasting friendships. In this issue, we provide an overview of the impact that being part of the ERS activities can have on professional careers, through the voices of ECMs. We hope to inspire all ECMs to participate in future ERS opportunities!info:eu-repo/semantics/publishedVersio

Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies.

AIMS: We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. METHODS: The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006 and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS and obese patients with MetS. Differences in all-cause mortality was analyzed using Kaplan-Meier and Cox regression analyses. RESULTS: 45,615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14,202 (31%) by NCEP/ATP III criteria, and 17,216 (37.7%) by JIS criteria. Follow-up was available for 44,620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese (hazard ratio, HR: 1.88 [95% CI, 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively) and non-obese individuals (HR: 2.11 [95% CI 1.85-2.40] and 1.7 [95% CI, 1.56-1.85] according to NCEP/ATP III and JIS criteria respectively). Obese patients without MetS had a higher mortality risk than non-obese patients without MetS (HR: 1.16 [95% CI 1.10-1.23] and HR: 1.22 [95%CI 1.15-1.30], respectively in subgroups with NCEP/ATP III and JIS criteria applied). CONCLUSIONS: MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised

Benefits of non-invasive ventilation in acute hypercapnic respiratory failure

Non-invasive ventilation (NIV) with bilevel positive airway pressure is a non-invasive technique, which refers to the provision of ventilatory support through the patient's upper airway using a mask or similar device. This technique is successful in correcting hypoventilation. It has become widely accepted as the standard treatment for patients with hypercapnic respiratory failure (HRF). Since the 1980s, NIV has been used in intensive care units and, after initial anecdotal reports and larger series, a number of randomized trials have been conducted. Data from these trials have shown that NIV is a valuable treatment for HRF. This review aims to explore the principal areas in which NIV can be useful, focusing particularly on patients with acute HRF (AHRF). We will update the evidence base with the goal of supporting clinical practice. We provide a practical description of the main indications for NIV in AHRF and identify the group of patients with hypercapnic failure who will benefit most from the application of NIV