Introduction. There is a paucity of population-based data on chronic obstructive pulmonary disease (COPD) prevalence in Poland. To address this problem we participated in the Burden of Obstructive Lung Disease (BOLD) Initiative which was developed to provide standardized methods for estimating the prevalence of COPD and its risk factors. Objectives. The study aimed to assess the prevalence of COPD and some of its risk factors in adults aged 40 years and older in the Malopolska region in southern Poland. Patients and methods. Region-representative sample was drawn, basing on the current census data. Detailed BOLD questionnaires as well as pre-and post-bronchodilatator spirometry were applied to eligible individuals. Results. Six hundred and three subjects provided questionnaire and spirometry data; of those 526 provided spirometry data of appropriate quality and were included in the final analysis. Estimated population prevalence of COPD was 22.1%, whereas 10.9% had COPD in GOLD Stage ≥2. COPD was far more common in men and its prevalence increased with age and exposure to tobacco smoke, and was inversely related to education level. The prevalence of current tobacco smoking was 28% (34% and 22% in men and women, respectively). Seventy-nine percent of men and 42% of women were ever-smokers. Twenty-nine percent of never smoking individuals were passively exposed to tobacco smoke in their households. Conclusions. Our results confirm the high prevalence of COPD in the studied region of Poland and emphasize the need to increase efforts to improve COPD awareness and limit tobacco smoking habit.
Increased risk of thrombotic events occurs in chronic obstructive pulmonary disease (COPD). Elevated fibrinogen and C-reactive protein (CRP), being common in COPD, are associated with formation of dense fibrin clots resistant to lysis. Statins have been found to display anti-inflammatory and antithrombotic effects. We investigated fibrin clot properties in COPD patients prior to and following statin therapy. Ex vivo plasma fibrin clot permeability, compaction, and fibrinolysis were assessed in 56 patients with stable COPD, aged 64.9 +/- 9.2 years (mean FEV(1), 54.7 +/- 15.9% predicted), versus 56 controls matched for age, sex and cardiovascular risk factors. Patients were then randomly assigned to receive simvastatin 40 mg/day (n = 28) or to remain without statins for three months (n = 28). Patients with COPD had lower clot permeability (6.1+/- 1.07 versus 9.2 +/- 0.9 10(-9) cm(2), p < 0.0001), decreased compaction (44.9 +/- 4.5 versus 63.9 +/- 6.1%, p < 0.0001), higher maximum D-dimer levels released from clots (4.23 +/- 0.55 versus 3.53 +/- 0.31 mg/l, p < 0.0001) with a decreased rate of this release (75.0 +/- 8.3 versus 80.9 +/- 8.0 microg/l/min, p = 0.03) and prolonged lysis time (9.84 +/- 1.33 versus 8.02 +/- 0.84 min, p < 0.0001) compared with controls. Scanning electron microscopy confirmed denser clot structure in COPD. Multiple linear regression analysis after adjustment for age and fibrinogen showed that in the COPD patients, CRP was the only independent predictor of permeability (R(2) = 0.47, p < 0.001) and lysis time (R(2) = 0.43, p < 0.001). Simvastatin improved clot properties (p < 0.05) despite unaltered CRP and irrespective of cholesterol reduction. Our study shows that fibrin clots in COPD patients are composed of much denser networks that are more resistant to lysis, and these properties can be improved by statin administration.
Introduction: In the Proszowice county, both lung cancer and chronic obstructive pulmonary disease (COPD) are more common in comparison with other regions of Poland. The purpose of this paper was to provide a report on a prevention program carried out in the area to reduce the burden of COPD and lung cancer in the region. Material and methods:The program consisted of the following: active prevention -questionnaire survey offered to every county inhabitant aged at least 40 and chest X-ray and spirometry performed in selected subjects; and passive preventioncovering multiple educational activities promoting healthy lifestyle. Data obtained from questionnaire survey and spirometry were further analyzed. Results: Education program covered all local children aged 13-15, a majority of adolescents and a significant proportion of adult inhabitants of the county. Questionnaire data were obtained from 14,455 subjects (about 70% of county inhabitants). On the basis of the questionnaire results, the participants were selected to undergo spirometry (5,816 subjects) and chest X-ray (5,514 subjects). Current smokers constituted 24.2% of the total number of participants (33.3% of men and 16.8% of women). Electronic cigarettes were currently used by 0.65% of the subjects. Negative impact of occupational exposures (including farming) on lung function and the presence of respiratory symptoms was observed. Basing on post-bronchodilator spirometry, COPD was diagnosed in 13.2% of the subjects. Physician's diagnosis of asthma was reported by 7.2%. Conclusion: Educational activities and questionnaire-based study were targeted at and reached the majority of the county inhabitants. The study provided data on the prevalence and risk factors of COPD, asthma and respiratory symptoms in the Proszowice region.
INTRODUCTION Chronic cough and sputum production are among the most commonly reported medical symptoms. 1 Cough and sputum expectoration for most days for at least 3 months during at least 2 consecutive years are considered the epidemiological criteria of chronic bronchitis (CB). 2 Clinical diagnosis requires exclusion of common diseases causing CB symptoms, especially asthma and heart failure. CB was originally recognized as a stand-alone condition, 3 but since the term chronic obstructive pulmonary disease
Introduction: The aim of the study was to evaluate the concentration of 9a11b prostaglandin F2, a stable metabolite of prostaglandin D2 (PGD2) and leukotriene E4 (LTE4), in patients with stable and exacerbated chronic obstructive pulmonary disease (COPD). Material and methods: The study included 29 COPD patients aged 73 ± 8.34 years, with mean FEV1 = 48.64 ± 15.75% of predicted normal value, and 29 healthy controls aged 57.48 ± 10.86 years, with mean FEV1 = 97.17 ± 13.81% of predicted normal value. Urine and blood samples were taken from COPD patients during exacerbation and in the stable phase of the disease; LTE4 was measured in urine using commercial enzyme immunoassay (EIA), and 9a11b prostaglandin F2 (9a11bPGF2), a stable metabolite of PGD2, was measured in blood and urine using GC/MS. Results: Urine concentrations of LTE4 in urine (677.15 vs. 436.4 pg/mg of creatinine; p = 0.035) and serum levels of 9a11bPGF2 (5.35 vs. 3.07 pg/mL; p = 0.007) were significantly higher in patients with exacerbated COPD than in the control group. There was no difference in LTE4 levels in urine and 9a11bPGF2 in serum between exacerbated and stable COPD. The urinary 9a11bPGF2 concentration did not differ between the studied groups. We found a positive correlation between smoking history and urine LTE4 level (r = 0.395; p = 0.002) as well as blood 9a11bPGF2 concentration (r = 0.603; p = 0.001) in COPD patients. Conclusions: Urine levels of 9a11bPGF2 and LTE4 did not differ between the stable COPD group and the control group. There were no differences between urine LTE4 levels and blood and urine 9a11bPGF2 levels between exacerbated and stable COPD. Finally, LTE4 concentration in urine and 9a11bPGF2 in blood were significantly higher in exacerbated COPD patients than in the control group.
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