&lt;p&gt;Inflammation and infections in unreported chronic obstructive pulmonary disease exacerbations&lt;/p&gt;

Calderazzo, Maria Adelaide; Trujillo-Torralbo, Maria-Belen; Finney, Lydia J.; Singanayagam, Aran; Bakhsoliani, Eteri; Padmanaban, V; Kebadze, Tatiana; Aniscenko, Julia; Elkin, Sarah; Johnston, Sebastian L.; Mallia, Patrick

doi:10.2147/copd.s191946

Cited by 13 publications

(11 citation statements)

References 28 publications

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“…It has been observed in COPD patients, that failure to report exacerbations is related to higher risk of emergency department and hospital admission, greater lung function deterioration, and worse SGRQ scores than treated exacerbations and thus, may result in a poorer prognosis when compared to treated exacerbations [13][14][15][16]. Improved reporting and detection of exacerbations has been achieved in COPD through the use of patient completed diaries.…”

Section: Discussionmentioning

confidence: 99%

“…The mean score during this "pre-exacerbation" period was 11.3 points (SD 2.7) with a mean change of + 4 points (SD 1.8) (p < 0.0001 by paired t-test). The peak symptom score during exacerbation was a mean of 16.4 (3.1) (range [12][13][14][15][16][17][18][19][20][21][22]. The change from baseline was a mean of 9.1 points (SD 2.5) with a range of 5 to 14.…”

Section: Dynamic Changes In Symptoms Over Time and Detection Of Exacementioning

confidence: 99%

“…It has been suggested that 2/3 of COPD exacerbations are not reported to health care professionals [13,15]. These are important events to recognize using diaries because unreported exacerbations have been linked to a greater risk of hospitalization, lung function deterioration, particularly forced expiratory volume in 1 s (FEV 1 ), and worse St George's respiratory questionnaire (SGRQ) scores than treated exacerbations [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)

et al. 2020

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Background: Recurrent bronchiectasis exacerbations are related to deterioration of lung function, progression of the disease, impairment of quality of life, and to an increased mortality. Improved detection of exacerbations has been accomplished in chronic obstructive pulmonary disease through the use of patient completed diaries. These tools may enhance exacerbation reporting and identification. The aim of this study was to develop a novel symptom diary for bronchiectasis symptom burden and detection of exacerbations, named the BEST diary. Methods: Prospective observational study of patients with bronchiectasis conducted at Ninewells Hospital, Dundee. We included patients with confirmed bronchiectasis by computed tomography, who were symptomatic and had at least 1 documented exacerbation of bronchiectasis in the previous 12 months to participate. Symptoms were recorded daily in a diary incorporating cough, sputum volume, sputum colour, dyspnoea, fatigue and systemic disturbance scored from 0 to 26. Results: Twenty-one patients were included in the study. We identified 29 reported (treated exacerbations) and 23 unreported (untreated) exacerbations over 6-month follow-up. The BEST diary score showed a good correlation with the established and validated questionnaires and measures of health status (COPD Assessment Test, r = 0.61, p = 0.0037, Leicester Cough Questionnaire, r = − 0.52,p = 0.0015, St Georges Respiratory Questionnaire, r = 0.61,p < 0.0001 and 6 min walk test, r = − 0.46,p = 0.037). The mean BEST score at baseline was 7.1 points (SD 2.2). The peak symptom score during exacerbation was a mean of 16.4 (3.1), and the change from baseline to exacerbation was a mean of 9.1 points (SD 2.5). Mean duration of exacerbations based on time for a return to baseline symptoms was 15.3 days (SD 5.7). A minimum clinically important difference of 4 points is proposed. Conclusions: The BEST symptom diary has shown concurrent validity with current health questionnaires and is responsive at onset and recovery from exacerbation. The BEST diary may be useful to detect and characterise exacerbations in bronchiectasis clinical trials.

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Section: Discussionmentioning

confidence: 99%

Section: Dynamic Changes In Symptoms Over Time and Detection Of Exacementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)

et al. 2020

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“…Historically, the importance of viral and bacterial infections in precipitating COPD exacerbations has been underestimated [31]. More recently, it was found that bacterial infections, and possibly more importantly, viral infections (detected in 52% of patients with acute exacerbations) are associated with exacerbations and that viral infections can potentially trigger secondary bacterial infections [32][33][34]. Sebastian Johnston suggested that increased airway glucose levels detected in COPD patients, which were further increased during acute exacerbations, may be a mechanism through which rhinoviruses enhance bacterial growth [33].…”

Section: Scientific Year In Review: Respiratory Infectionsmentioning

confidence: 99%

ERS International Congress, Madrid, 2019: highlights from the Basic and Translational Science Assembly

et al. 2020

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In this review, the Basic and Translational Sciences Assembly of the European Respiratory Society (ERS) provides an overview of the 2019 ERS International Congress highlights. In particular, we discuss how the novel and very promising technology of single cell sequencing has led to the development of a comprehensive map of the human lung, the lung cell atlas, including the discovery of novel cell types and new insights into cellular trajectories in lung health and disease. Further, we summarise recent insights in the field of respiratory infections, which can aid in a better understanding of the molecular mechanisms underlying these infections in order to develop novel vaccines and improved treatment options. Novel concepts delineating the early origins of lung disease are focused on the effects of pre- and post-natal exposures on neonatal lung development and long-term lung health. Moreover, we discuss how these early life exposures can affect the lung microbiome and respiratory infections. In addition, the importance of metabolomics and mitochondrial function analysis to subphenotype chronic lung disease patients according to their metabolic program is described. Finally, basic and translational respiratory science is rapidly moving forward and this will be beneficial for an advanced molecular understanding of the mechanisms underlying a variety of lung diseases. In the long-term this will aid in the development of novel therapeutic targeting strategies in the field of respiratory medicine.

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“…Cigarette smoking is the most common cause of COPD that accounts for about 85 to 90% of cases. The other causes for COPD include exposure to environmental smoke, passive smoke, occupational exposure, and genetic predisposition [9][10][11]. The common symptoms of COPD are shortness of breath, cough (with or without expectoration), fever, chest tightness, and hemoptysis [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

A prospective observational study on acute exacerbation of chronic obstructive pulmonary disease in pulmonology department of tertiary care hospital

Thalla¹,

Yerubandi²,

Hafeezunnisa³

et al. 2020

Egypt J Bronchol

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Background Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gasses. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. Acute exacerbation in COPD (AECOPD) is frequent in the course of the illness and is the most common reason for medical visits, hospital admissions, and mortality among these patients. Exacerbations of COPD are associated with increased morbidity and mortality. To assess the exposure and severity of acute exacerbations of COPD with COPD Assessment Test (CAT Scale) and mMRC (modified Medical Research Council) Dyspnea scale. Study design was a hospital-based prospective observational study. Study site was conducted at Pulmonology Department of Government General Hospital, Vijayawada. Results The total patients were 197. Out of which, 119 were from In-patient Department (IPD) and 78 were from Out-patient Department (OPD). In this study, males were 167 (85%), among which, IPD were 97 (49%), OPD were 70 (36%), and females were 30 (15%), among which, IPD were 22 (11%), OPD were 8 (4%). Conclusion The morbidity and mortality of COPD have been increased in recent years. This study concludes that there is a relation between risk of acute exacerbations in COPD with habitual history and occupational history. Increase in exposure to occupational hazards, smoking habit leads to an increase in risk of acute exacerbations in COPD patients. The level of severity was more in smokers and the patients who had biomass, organic dust, and mineral exposure. When severity was observed, group D severity is more observed in population according to CAT scale and mMRC dyspnea scale.

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<p>Inflammation and infections in unreported chronic obstructive pulmonary disease exacerbations</p>

Cited by 13 publications

References 28 publications

Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)

Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)

ERS International Congress, Madrid, 2019: highlights from the Basic and Translational Science Assembly

A prospective observational study on acute exacerbation of chronic obstructive pulmonary disease in pulmonology department of tertiary care hospital

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