The relationship between echocardiographic pulmonary steam velocity, respiratory functional tests and nocturnal oxygen desaturation in COPD patients

The aim of the study is to investigate the relationships between nocturnal oxygen desaturation levels and echocardiographic findings to diagnose earlier the pulmonary arterial hypertension (PH) in chronic obstructive pulmonary disease (COPD) and without daytime hypoxemia. We studied 55 consecutive patients with COPD (62.67 ± 8.20 years, 5 females) admitting our outpatient clinic and having consented to participate. All patients underwent routine biochemical, hematologic, thyroid function tests and chest x-ray. Spirometric tests, carbonmomoxide diffusion capacities, nocturnal sleep oxygen saturation level measures and 6 minute walking tests were performed to all patients. Systolic pulmonary steam velocity with pulsed-waved doppler and pulmonary artery pressures (PAP) of the patients were measured by transthoracic echocardiography. Thirty of the patients were found to have a normal PAP and 25 of them were found to have a high levels. A significant difference was determined between two groups in the terms of Pa02 (p=0.030), DLCO (p=0.009), percent sleep time spent with SaO2 <90% (TST90), (p<0.0001), the thickness of right ventricle (p<0.0001), minimum Sa02 levels in sleep (p=0.0009), mean Sa02 levels (p<0.0001) and the frequencies of nocturnal desaturations (p=0.030). PH was detected more frequently (11/12,:92%) among COPD patients with longer TST90 levels than 20% of total sleep time. As a conclusion, PH is a common clinical entity particularly among the patients having more frequent and longer nocturnal desaturation episodes. Observations of nocturnal oxygen desaturation on COPD patients may be a diagnostic tool to anticipate PH and to influence survivals

Prevalence of occupational asthma and respiratory symptoms in foundry workers

This cross-sectional study was conducted in a foundry factory to assess the prevalence of respiratory symptoms and occupational asthma in foundry workers. Physical examination, spirometric evaluation, chest radiograph, and a questionnaire related to respiratory symptoms were performed. Monitoring of peak expiratory flow rates, spirometric reversibility test, and high-resolution computed tomographies were performed for the participants having respiratory symptoms and/or impaired respiratory function test. A total of 347 participants including 286 workers from production department and 61 subjects who worked in nonproduction departments were enrolled in this study. It is found that phlegm (n: 71, 20.46%) and cough (n: 52, 14.98%) were the most frequent symptoms. The other symptoms were breathlessness (n: 28, 8.06%), chest tightness (n: 14, 4.03%), and wheezing (n: 7, 2.01%). The prevalence of occupational asthma was found to be more frequent among the subjects who worked in the production department (n: 48, 16.78%) than the other persons who worked in the nonproduction department (n: 3, 4.91%) by chi-square test (P: 0.001). To prevent hazardous respiratory effects of the foundry production, an early diagnosis of occupational asthma is very important. Cessation of cigarette smoking and using of protective masks during the working time should be encouraged. © 2013 Servet Kayhan et al

Soluble urokinase-type plasminogen activator receptor is a novel biomarker predicting acute exacerbation in COPD

Aziz Gumus,1 Nejat Altintas,2 Halit Cinarka,1 Aynur Kirbas,3 Muge Haziroglu,1 Mevlut Karatas,1 Unal Sahin1 1Department of Pulmonary Medicine, School of Medicine, Recep&nbsp;Tayyip Erdogan University, Rize, Turkey; 2Department of Pulmonary Medicine, School of Medicine, Namik Kemal University, Tekirdag, Turkey; 3Department of Clinical Biochemistry, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey Background: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory condition, and progresses with acute exacerbations. (AE). During AE, levels of acute phase reactants such as C-reactive protein (CRP) and inflammatory cells in the circulation increase. Soluble urokinase-type plasminogen activator receptor (suPAR) levels increase in acute viral and bacterial infections and in diseases involving chronic inflammation. The purpose of this study was to investigate the effectiveness of suPAR in predicting diagnosis of AE of COPD (AE-COPD) and response to treatment. Methods: The study population consisted of 43 patients diagnosed with AE-COPD and 30 healthy controls. suPAR, CRP, and fibrinogen levels were measured on the first day of hospitalization and on the seventh day of treatment. Results: We found that fibrinogen (P&lt;0.001), CRP (P&lt;0.001), and suPAR (P&lt;0.001) were significantly higher in patients with AE-COPD than in healthy controls. Fibrinogen (P&lt;0.001), CRP (P=0.001), and suPAR (P&lt;0.001) were significantly decreased by the seventh day of treatment. However, the area under receiver operator characteristic curve showed that suPAR is superior to CRP and fibrinogen in distinguishing AE-COPD. There was a correlation between fibrinogen, CRP, and suPAR. However, only fibrinogen was a powerful predictor of suPAR in multiple linear regression. In multiple logistic regression, only suPAR and fibrinogen were strong predictors of AE-COPD (P=0.002 and P=0.014, respectively). Serum suPAR was negatively correlated with forced expiratory volume in 1 second (r=-478, P=0.001). Conclusion: suPAR is a marker of acute inflammation. It is well correlated with such inflammation markers as CRP and fibrinogen. suPAR can be used as a predictor of AE-COPD and in monitoring response to treatment. Keywords: biomarker, chronic obstructive pulmonary disease, inflammation, suPA