1
|
Tang W, Rong Y, Zhang H, Lin W, Zeng W, Wu W. Screening and early diagnosis of chronic obstructive pulmonary disease: a population study. BMC Pulm Med 2023; 23:424. [PMID: 37924038 PMCID: PMC10623865 DOI: 10.1186/s12890-023-02728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Although chronic obstructive pulmonary disease (COPD) is a common disease leading to further morbidity and significant mortality, there is still limited data on screening for COPD. The purpose of this study was to establish an early chronic obstructive pulmonary disease (COPD) screening system for the community and hospitals in Nanshan District in Shenzhen City, to improve the rate of early diagnosis and treatment of patients with COPD. METHODS We identified individuals at high risk of COPD using a questionnaire survey and analyzed the relevant influencing factors in the early stages of COPD in high-risk groups. RESULTS We collected a total of 5,000 COPD screening questionnaires, and a total of 449 patients were diagnosed with COPD by pulmonary function examination. The prevalence of COPD in people aged 20 and above in Nanshan District of Shenzhen City was estimated to be 8.98%, with a base of 5000. The severity classification as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria was as follows: GOLD I accounted for 34.74%; GOLD II accounted for 37.64%; GOLD III accounted for 16.04%; and GOLD IV accounted for 11.58%. Common features of early COPD that we identified were: (1) patients were mainly males, accounting for 68.0%; (2) COPD was common among people aged 50-59 years, comprising 31%; (3) 96.0% of patients often had severe respiratory symptoms and had frequent coughs when they did not have a cold; (4) 57.2% of patients experienced shortness of breath when walking quickly on level ground or climbing gentle slopes; (5) 72.6% of patients had a family history of bronchial asthma and COPD. Multivariate ordinal multi-classification logistic regression showed that gender, age, shortness of breath, and the use of firewood, grass, and coal stoves were all influencing factors in pulmonary function grading. CONCLUSION A screening questionnaire combined with a pulmonary function test should be adopted as a COPD screening strategy to be implemented at the primary level as a public health priority in China to reduce the incidence, disability, and mortality from COPD.
Collapse
Affiliation(s)
- Wenhui Tang
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China.
| | - Yan Rong
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China
| | - Hongmei Zhang
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China
| | - Wenji Lin
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China
| | - Wenmei Zeng
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China
| | - Wenhong Wu
- Department of Respiratory & Critical Medicine, Shenzhen Municipal Qianhai Shekou Free Trade Zone Hospital, No. 36, Shekou Industrial seventh Road, Nanshan District, Shenzhen, 518067, China
| |
Collapse
|
2
|
Chen Y, Wang Y, Li Z, Jing J, Jiang D, Yuan X, Li F. Exploration of the Mechanism of Shengxian Decoction Against Chronic Obstructive Pulmonary Disease Based on Network Pharmacology and Experimental Verification. Assay Drug Dev Technol 2023; 21:258-272. [PMID: 37682969 DOI: 10.1089/adt.2023.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
Shengxian decoction (SXT) is clinically used in chronic obstructive pulmonary disease (COPD) treatment. This study aimed to explore the mechanism and target genes of SXT acting on COPD. Differentially expressed genes (DEGs) between COPD and controls were identified and then performed enrichment analysis. The effective active compounds and corresponding target genes were obtained from the traditional Chinese medicine systems pharmacology database. We also compiled COPD related genes from the GeneCards database. Through the protein-protein interaction (PPI) network and least absolute shrinkage and selection operator (LASSO) regression was performed to identify key genes. Molecular docking was used for docking of key genes and compounds. The expression of key genes was detected by quantitative real-time PCR in COPD patients and bronchial epithelial cells stimulated with cigarette stroke extract (CSE). We identified 1,458 intersected DEGs from GSE47460 and GSE57148 datasets. Compared with intersected DEGs, we obtained 33 SXT target COPD-related genes. PI3K-Akt signaling pathway, MAPK signaling pathway, and focal adhesion were enriched by these 33 genes, as well as intersected DEGs. According to LASSO regression, there were 12 genes considered as signature genes. Then we constructed active compounds and corresponding six target genes. Finally, HIF1A and IL1B were selected as key genes by combining PPI network. HIF1A and IL1B were all upregulated expression in COPD and CSE stimulated cells and recovered in SXT treated CSE stimulated cells. This study provides a scientific basis for the identification of active compounds and target genes of SXT in the treatment of COPD.
Collapse
Affiliation(s)
- Yifei Chen
- Basic Teaching and Research Office of Traditional Chinese Medicine, College of Traditional Chinese Medicine, Xinjiang Medical University, Shuimogou, Urumqi, China
| | - Yiming Wang
- Department of Acupuncture, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Shaybagh, Urumqi, China
| | - Zheng Li
- Department of Respiration, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Shaybagh, Urumqi, China
- Department of Respiration, National Clinical Research Base of Traditional Chinese Medicine in Xinjiang, Shaybagh, Urumqi, China
| | - Jing Jing
- Department of Respiration, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Shaybagh, Urumqi, China
- Department of Respiration, National Clinical Research Base of Traditional Chinese Medicine in Xinjiang, Shaybagh, Urumqi, China
| | - De Jiang
- Basic Teaching and Research Office of Traditional Chinese Medicine, College of Traditional Chinese Medicine, Xinjiang Medical University, Shuimogou, Urumqi, China
| | - Xiaoxia Yuan
- Basic Teaching and Research Office of Traditional Chinese Medicine, College of Traditional Chinese Medicine, Xinjiang Medical University, Shuimogou, Urumqi, China
| | - Fengsen Li
- Department of Respiration, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Shaybagh, Urumqi, China
| |
Collapse
|
3
|
Fradelos EC, Lampropoulos IC, Raptis DG, Mantzaris D, Papathanasiou IV, Daniil Z, Gourgoulianis KI, Malli F. Efficiency of an Online Intervention in the Knowledge Concerning COPD in Nursing Students. TANAFFOS 2023; 22:290-297. [PMID: 38638391 PMCID: PMC11022201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 01/20/2023] [Indexed: 04/20/2024]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory disorder. Nurses play a major role in managing the disease. This study aimed to test the effect of a brief online intervention in increasing the knowledge of COPD in a sample of nursing students in Greece. Materials and Methods The intervention entailed a combination of two ½ hour lectures focusing on the treatment and care of patients with COPD according to existing guidelines. Data were collected with a structured questionnaire specially designed for this study including questions regarding information on sociodemographic characteristics of the participants, and the Bristol COPD Knowledge Questionnaire (BCKQ) which is designed to assess the knowledge of 13 COPD-specific topics. The questionnaire was distributed three times and the one-way ANOVA test of repeated measures was applied to investigate the effect of the educational intervention by examining the periods before, immediately after, and one month after the intervention. Results 125 nursing students participated in this study of which 13.6% were men (n=17) and 86.4% were women. According to the results of the repeated measures ANOVA test, there was a statistically significant improvement in gained knowledge about COPD. Conclusions Short educational interventions can be effective in acquiring and cultivating nursing students concerning COPD. These short online tutorials seem to be cost-effective as they can be organized easily and with minimal financial resources.
Collapse
Affiliation(s)
| | - Ioannis C. Lampropoulos
- Department of Respiratory Medicine, University of Thessaly, School of Medicine, Larissa, Greece
| | - Dimitrios G. Raptis
- Department of Respiratory Medicine, University of Thessaly, School of Medicine, Larissa, Greece
| | | | | | - Zoe Daniil
- Department of Respiratory Medicine, University of Thessaly, School of Medicine, Larissa, Greece
| | | | - Foteini Malli
- Department of Respiratory Medicine, University of Thessaly, School of Medicine, Larissa, Greece
- Respiratory disorders Lab, Faculty of Nursing, University of Thessaly, Greece
| |
Collapse
|
4
|
Wodwaski N, Webber E. Assessment and Management of COPD. Home Healthc Now 2023; 41:6-13. [PMID: 36607204 DOI: 10.1097/nhh.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction, worsening exercise performance and deteriorating health. It is associated with significant morbidity, mortality, and costs to healthcare systems. Although no cure exists for COPD, there are treatments, medications, and lifestyle changes patients can adopt to feel better and prevent further damage to their lungs. This article discusses the assessment and treatment strategies, medication administration, oxygen management, and education for patients with COPD. Home care strategies may alleviate readmissions or the need for emergent care, thus reducing the impact of COPD on patients.
Collapse
|
5
|
Cazzola M, Ora J, Calzetta L, Rogliani P, Matera MG. Advances in inhaled corticosteroids for the treatment of chronic obstructive pulmonary disease: what is their value today? Expert Opin Pharmacother 2022; 23:917-927. [PMID: 35575510 DOI: 10.1080/14656566.2022.2076592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION As of today, there is still a need to determine which COPD patients may benefit from ICS therapy, whether ICSs are useful in COPD patients without chronic bronchitis, and whether long-acting bronchodilators can reduce the risk of exacerbations in frequent exacerbators even if ICSs are not used, and whether combination therapy including ICSs is helpful in infrequent exacerbators to optimise the use of ICSs in COPD. Nevertheless, in recent years, a fair amount of evidence has been produced that, at least in part, can help define the role of ICSs in COPD better. AREAS COVERED Herein, the authors provide an overview of current use of ICS in COPD and discuss their value to the current treatment armamentarium. The article includes discussion of which patients will benefit best from the use of ICSs, their potential uses and adverse effects. EXPERT OPINION There is growing agreement on why, in whom, and when ICS therapy can be used in COPD, although the consensus is still lacking because of the heterogeneity of COPD. The use of blood eosinophil counts (BECs) is only helpful in T2 inflammation, while there is a lack of biomarkers indicating the presence of T1 and T17 immunity, which is poorly responsive to ICS. Identifying ICS-sensitive endotypes using specific biomarkers that have yet to be identified and validated is likely to demonstrate that ICSs can influence the natural course of COPD in at least a subset of patients.
Collapse
Affiliation(s)
- Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Josuel Ora
- Unit of Respiratory Medicine, "Tor Vergata" Hospital Foundation, Rome, Italy
| | - Luigino Calzetta
- Unit of Respiratory Diseases and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.,Unit of Respiratory Medicine, "Tor Vergata" Hospital Foundation, Rome, Italy
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
6
|
Yang W, Li F, Li C, Meng J, Wang Y. Focus on Early COPD: Definition and Early Lung Development. Int J Chron Obstruct Pulmon Dis 2021; 16:3217-3228. [PMID: 34858022 PMCID: PMC8629909 DOI: 10.2147/copd.s338359] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a disease with high incidence rate and mortality rates worldwide. It is the third leading cause of death in the world. Nevertheless, little progress has been made in treating and preventing the disease. Under these circumstances, the concept of “early COPD” was proposed. Although this concept is not new, most health-care workers do not fully understand early COPD and tend to confuse it with mild COPD. In this review, we mainly discuss the definition of early COPD and the developmental trajectory of lung function. Although patients with early COPD have no symptoms, their lung function is already lower than that of normal people. A relatively complete definition is needed to identify this group of people. Reduced lung function is the diagnostic criterion for COPD, but lung development is a long-term dynamic process. In addition to smoking and air pollution, we should pay more attention to prenatal and childhood risk factors, for example, parents smoking, birth weight, preterm birth, mode of delivery, childhood respiratory infections and childhood asthma. Health-care workers need to be fully aware of early COPD, to reduce the morbidity of COPD and take effective measures to prevent these risk factors.
Collapse
Affiliation(s)
- Weichang Yang
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Fengyuan Li
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Can Li
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Jiaqi Meng
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Ying Wang
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| |
Collapse
|