Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients

BACKGROUND AND AIMS: Recently a multidimensional grading system based on the body mass index (B), degree of airflow obstruction (O), dyspnea (D) and exercise capacity (E) - the BODE index - has begun to be used increasingly for the evaluation of chronic obstructive pulmonary disease (COPD) patients. The aim of our study was to investigate the relationship between the BODE index and disease duration, annual exacerbation and hospitalization rates, health related quality of life and systemic inflammatory markers like C-reactive protein (CRP), tumor necrosis factor (TNF)-α and interleukin (IL)-8. MATERIALS AND METHODS: In 88 stable COPD patients we evaluated the body-mass index, pulmonary function tests, Modified Medical Research Council dyspnea scale and six-minute walk test (6 MWT). BODE scores were determined. Disease duration, number of exacerbations and hospitalization in the previous year were recorded. We also performed arterial blood gases analysis, administered the St. George's Respiratory Questionnaire (SGRQ) and measured serum levels of CRP, TNF-α, IL-8. RESULTS: According to BODE score 52% of patients were BODE 1, 21% BODE 2, 15% BODE 3 and 12% were BODE 4. There was a significant relationship between BODE index and COPD stage as classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (p < 0.001). Correlations between BODE score and disease duration (p = 0.011), number of exacerbations (p < 0.001) and hospitalizations (p < 0.001) in the last year were also observed. SGRQ symptom, activity, emotion scores and total scores were found to be significantly correlated to BODE (p < 0.001). Serum CRP levels and BODE were also correlated (p = 0.014); however, no correlation was found between serum levels of TNF-α and IL-8 and BODE. CONCLUSIONS: As the BODE index shows a strong correlation with various prognostic and follow up parameters of COPD and systemic inflammation, its use should be considered for the evaluation of COPD patients

Multiple distant metastases in a case of malignant pleural mesothelioma

Introduction: Malignant pleural mesothelioma (MPM) is a malignant of mesodermal neoplasm and arises from multipotential mesothelial or subserosal cells of the pleura, pericardium and peritoneum. Case: A seventy five year-old male patient was admitted with chest and lower limb pain. He was a heavy smoker and exposed to environmental asbestos in his childhood. PET-CT scans showed multiple pathological FDG uptakes in lungs and other organs. Biopsies performed from lung and anterior thigh muscles were reported as epitheloid type malignant pleural mesothelioma. Discussion: We emphasize that unexpected distant metastases can be observed in MPM and occasionally primary diagnosis can be determined by the biopsy of the metastatic regions. This case also points out the role of PET-CT in the staging of malign mesothelioma by determining different metastatic sites

Exposure to Fumes of a Vegetable Margarine for Frying: Respiratory Effects in an Experimental Model

Deep frying is one of the strongest emission sources into indoor air. A vegetable margarine has recently been used in commercial kitchens. This study investigated the respiratory effects of exposure to its fumes in an experimental model. A setup with glass chambers was constructed. A chamber housed a fryer. The fumes were transported to the other chamber where 24 Wistar albino rats were placed in four randomized groups: acute, subacute, chronic, and control for the exposure durations. PM10 concentration in the exposure chamber was monitored to ensure occupational levels were obtained. Sacrification was performed 24 h after exposure. Lung, trachea, and nasal concha specimens were evaluated by two blinded histologists under a light microscope with hematoxylin-eosin. Mild mononuclear cell infiltration, alveolar capillary membrane thickening, alveolar edema, and diffuse alveolar damage, along with diffuse hemorrhage, edema, and vascular congestion in the interstitium were observed in the acute and subacute groups, and were overexpressed in the chronic group, whereas normal lung histology was observed in the control group. The results indicate that exposure to fumes of vegetable margarine for frying in commercial kitchens may cause pulmonary inflammation that becomes severe as the duration of the exposure increases

Radiologic features of COPD exacerbations: quantitative analysis of thorax computerised tomography

AbstractBackground-aim:&nbsp;Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a negative impact on the prognosis of the disease. Radiological findings might be a helpful assessment tool to predict future exacerbations. Here we identified quantitative computerized tomography (CT) findings in relation to AECOPD.Methods:&nbsp;Thorax CT features of COPD patients who applied to our clinic during the last 5 years were retrospectively evaluated and analyzed based on voxel attenuation. Subjects were divided into two groups according to the presence of acute severe exacerbation during the last 12 months after the date of the CT scan. Thus, groups are named GOLD A-B and GOLD E&nbsp;according to&nbsp;GOLD 2023. Quantitative voxel-based attenuation analysis was done by Myrian® Expert software (Intrasense SA-1231, Montpellier, France). Emphysema was defined as attenuation values&lt;-950 Hounsfield Unit (HU).Results:&nbsp;Of 106, 24 subjects had at least one severe AECOPD in the following year of CT. Emphysema percentage was significantly higher in GOLD E in the GOLD A-B group (3% vs 10%,&nbsp;p=0.001) (Table 1). However, both groups displayed similar values in lung volume and mean attenuation.Conclusion:&nbsp;Higher emphysema percentage might indicate increased AECOPD risk. Quantitative CT analysis could be a helpful assessment tool to evaluate exacerbation risk.</p

The comparison of quantitative CT features of COPD and pre-COPD: results from a real-life study

AbstractBackground:&nbsp;Although fixed airway obstruction on spirometry is crucial for COPD diagnosis, it might be insufficient to identify subjects with pre-COPD. Quantitative computerized tomography (CT) measurements might be helpful to distinguish the subjects with pre-COPD. Thus, we aimed to compare quantitative CT findings of subjects with pre-COPD and COPD.Methods:&nbsp;Subjects who were admitted to our clinic with chronic respiratory symptoms and were evaluated for COPD as a pre-diagnosis were included in the study. Subjects were categorized as COPD and pre-COPD groups according to the FEV1/FVC ratio. Thorax CT voxel-based attenuation analysis was performed by Myrian® Expert software(Intrasense SA-1231, Montpellier, France). Attenuation values lower than -950 Hounsfield Units (HU) were defined as emphysema.Results:&nbsp;Of 163, 106 COPD and 57 pre-COPD cases were included. COPD group had significantly higher lung volume (5683 ml vs 4921 ml,&nbsp;p=0.001) and lower mean attenuation value (-830.0 HU vs -808.2 HU,&nbsp;p&lt;0.001) than the pre-COPD group. Moreover, the COPD group had a higher emphysema percentage than the pre-COPD group (3.87% vs 0.28%,&nbsp;p&lt;0.001).Conclusion:&nbsp;Quantitative CT of pre-COPD demonstrated radiologic findings that might help to corroborate COPD diagnosis, which was also associated with the severity of the airflow obstruction and be an alternative method for COPD diagnosis when it is difficult to reach spirometry." data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);">" data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);">" data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);"></div

Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortality

Conclusion: Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission. (C) 2013 Elsevier Inc. All rights reserved