Selected clinical highlights from the 2010 ERS Congress in Barcelona

Cordeiro, Carlos Robalo; Singh, SimerPreet; Herth, Felix J.F.; Ley, Sebastian; Chavannes, Niels H.; Clini, Enrico; Cottin, Vincent

doi:10.1183/09031936.00039011

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…It seems that primary screening for airflow obstruction with a handheld spirometer prior to full spirometry testing, which is easy to carry-out in all settings, could be considered as an efficient way to screen or find new COPD cases. [ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Burden of obstructive lung disease study in Tehran: Prevalence and risk factors of chronic obstructive pulmonary disease

et al. 2015

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Background:Chronic obstructive pulmonary disease (COPD) was ranked the sixth-most common cause of death worldwide in 1990, but now it is the third-most common cause. The goal of the present study was to assess the prevalence and determine the causes and risk factors of COPD in Tehran.Materials and Methods:This study followed a stratified cluster sampling strategy with proportional allocation within strata. The target population was all non-institutionalized inhabitants, aged 18 to 40 in one group and over 40 in another who resided in Tehran in 2013. The core questionnaire was developed from pre-existing validated questionnaires that had already been used in multi-national studies. The single most important outcome measure obtained as part of this protocol was spirometry before and after the administration of 200 mg (two puffs) of salbutamol.Results:The most commonly reported respiratory symptoms were: sputum production in 291 patients (16.2%) [95% confidence interval (CI): 14.5-17.9%], chronic cough in 171 (9.5%) (95% CI: 8.2-10.9%), wheezing in 377 (21.0%) (95%CI: 19.1-22.9%) and dyspnea in 388 patients (21.6%) (95% CI: 19.7-23.5%). The overall COPD prevalence defined by the post-bronchodilator spirometric functional criteria was 9.2%. This value in men (10.1%) was higher than in women (8.5%); the prevalence was significantly higher in subjects aged over 55 years (P ≤ 0.002). The prevalence of COPD was strongly dependent on smoking status, especially in ex-smokers, and increased considerably with age. 69% of patients with COPD were non-smoker.Conclusion:The high prevalence of verified COPD, a great deal of which was undiagnosed before by a physician, highlights the necessity of raising awareness of this disease among health professionals, and use of spirometry in the primary care setting. A future cross-sectional and prospective cohort study should be performed to explore all risk factors and their impact on decline in lung function and worsening of respiratory symptoms especially in non-smokers.

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Section: Discussionmentioning

confidence: 99%

Burden of obstructive lung disease study in Tehran: Prevalence and risk factors of chronic obstructive pulmonary disease

et al. 2015

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“…Statistical analysis showed that assessing three simple variables (age, smoking intensity and smoking status) among patients with any kinds of acute respiratory infections attending urgent primary care could be a feasible and effective way to short-list those who need spirometry testing to confirm the presence of underlying COPD. Moreover, preliminary screening for airflow obstruction using a handheld spirometer prior to full spirometry testing may be an efficient way of finding new COPD cases [29]. …”

Section: Discussionmentioning

confidence: 99%

The prevalence of undiagnosed chronic obstructive pulmonary disease in a primary care population with respiratory tract infections - a case finding study

et al. 2011

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BackgroundChronic obstructive pulmonary disease (COPD) is an underdiagnosed cause of morbidity and mortality worldwide. Prevalence of COPD has been shown to be highly associated with positive smoking history and increasing age. Spirometry is the method used for diagnosing COPD. However, identifying patients at risk of COPD to undergo spirometry tests has been challenging. Therefore, there is a need for new cost-effective and feasible diagnostic screening procedures for use in primary care centers. Our aim was to describe the prevalence and severity of undiagnosed COPD in a group of patients with respiratory infections attending urgent primary care, and to identify those variables in patients' history that could be used to detect the disease.MethodsPatients of 40-75 years (n = 138) attending urgent primary care center with acute respiratory tract infection, positive smoking history and no previously known pulmonary disease underwent pre- and post bronchodilator spirometry testing four to five weeks after the acute infection. Prevalence and severity of COPD were estimated following the Global Initiative for COPD (GOLD) criteria. Variables such as sex, age, current smoking status, smoking intensity (pack years) and type of infection diagnosis were assessed for possible associations with COPD.ResultsThe prevalence of previously undiagnosed COPD in our study group was 27%, of which 45% were in stage 1 (FEV1 ≥ 80% of predicted), 53% in stage 2 (50 ≤ FEV1 < 80% of predicted), 3% in stage 3 (30 ≤ FEV1 < 50% of predicted) and 0% in stage 4 (FEV1 < 30% of predicted). We found a significant association between COPD and age ≥ 55 (OR = 10.9 [95% CI 3.8-30.1]) and between COPD and smoking intensity (pack years > 20) (OR = 3.2 [95% CI 1.2-8.5]). Sex, current smoking status and type of infection diagnosis were not shown to be significantly associated with COPD.ConclusionA middle-aged or older patient with any type of common respiratory tract infection, positive smoking history and no previously known pulmonary disease has an increased likelihood of having underlying COPD. These patients should be offered spirometry testing for diagnosis of COPD.

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Exercise-based rehabilitation programmes for pulmonary hypertension

Morris

Kermeen

Holland

2017

Cochrane Database of Systematic Reviews

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In people with PH, exercise-based rehabilitation results in clinically relevant improvements in exercise capacity. Exercise training was not associated with any serious adverse events. Whilst most studies reported improvements in HRQoL, these may not be clinically important. Overall, we assessed the quality of the evidence to be low. The small number of studies and lack of information on participant selection makes it difficult to generalise these results across the spectrum of people with PH.

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Selected clinical highlights from the 2010 ERS Congress in Barcelona

Cited by 4 publications

References 40 publications

Burden of obstructive lung disease study in Tehran: Prevalence and risk factors of chronic obstructive pulmonary disease

Burden of obstructive lung disease study in Tehran: Prevalence and risk factors of chronic obstructive pulmonary disease

The prevalence of undiagnosed chronic obstructive pulmonary disease in a primary care population with respiratory tract infections - a case finding study

Exercise-based rehabilitation programmes for pulmonary hypertension

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