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Serum Amyloid A in Stable Patients with Chronic Obstructive Pulmonary Disease Does Not Reflect the Clinical Course of the Disease. Int J Mol Sci 2023; 24:ijms24032478. [PMID: 36768801 PMCID: PMC9916457 DOI: 10.3390/ijms24032478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/09/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
Serum amyloid A (SAA) is a good systemic marker of the exacerbations of chronic obstructive pulmonary disease (COPD), but the significance of SAA in stable patients with COPD has not been widely investigated. We aimed to evaluate the SAA level in peripheral blood from stable patients with COPD and to search for correlations between SAA and other inflammatory markers and clinical characteristics of the disease. Serum SAA, IL-6, IL-8, TNF-alpha, basic blood investigations, pulmonary function testing and a 6-min walk test were performed. The correlations between SAA and other inflammatory markers, functional performance and the number of disease exacerbations were evaluated. A total of 100 consecutive patients with COPD were analyzed. No correlations between SAA and inflammatory markers as well as pulmonary function were found. Hierarchical clustering identified two clusters incorporating SAA: one comprised SAA, PaO2 and FEV1 and the second was formed of SAA and nine other disease markers. The SAA level was higher in patients with blood eosinophils < 2% when compared to those with blood eosinophils ≥ 2% (41.8 (19.5-69.7) ng/mL vs. 18.9 (1.0-54.5) ng/mL, respectively, p = 0.04). We conclude that, in combination with other important disease features, SAA may be useful for patient evaluation in stable COPD.
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Impact of anxiety and depression on the prognosis of copd exacerbations. BMC Pulm Med 2022; 22:169. [PMID: 35488330 PMCID: PMC9052487 DOI: 10.1186/s12890-022-01934-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/31/2022] [Indexed: 12/20/2022] Open
Abstract
Background Frequent and highly prevalent as comorbidities in Chronic Obstructive Pulmonary Disease (COPD) patients, both depression and anxiety seem to have an impact on COPD prognosis. However, they are underdiagnosed and rarely treated properly.
Aim To establish the prevalence of depression and anxiety in patients admitted for Acute Exacerbation of COPD (AECOPD) and determine their influence on COPD prognosis. Methods Prospective observational study conducted from October 1, 2016 to October 1, 2018 at the following centers in Galicia, Spain: Salnés County Hospital, Arquitecto Marcide, and Clinic Hospital Complex of Santiago de Compostela. Patients admitted for AECOPD who agreed to participate and completed the anxiety and depression scale (HADS) were included in the study. Results 288 patients (46.8%) were included, mean age was 73.7 years (SD 10.9), 84.7% were male. 67.7% patients were diagnosed with probable depression, and depression was established in 41.7%; anxiety was probable in 68.2% and established in 35.4%. 60.4% of all patients showed symptoms of both anxiety and depression. Multivariate analysis relates established depression with a higher risk of late readmission (OR 2.06, 95% CI 1.28; 3.31) and a lower risk of mortality at 18 months (OR 0.57, 95% CI 0.37; 0.90). Conclusion The prevalence of anxiety and depression in COPD patients is high. Depression seems to be an independent factor for AECOPD, so early detection and a multidisciplinary approach could improve the prognosis of both entities. The study was approved by the Ethical Committee of Galicia (code 2016/460).
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Baitha U, Ranjan P, Deb KS, Bauddh NK, Singh V, Kaloiya G, Kumar A, Sahu A. Association of Somatic Symptom Severity With Sociodemographic Parameters In Patients With Medically Unexplained Physical Symptoms: A Cross-Sectional Study From a Tertiary Care Center in India. Cureus 2020; 12:e9250. [PMID: 32821596 PMCID: PMC7430686 DOI: 10.7759/cureus.9250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background There is a paucity of studies assessing the severity of somatic symptoms in medically unexplained physical symptoms (MUPS) from Medicine outpatient department (OPD). Methodology This cross-sectional study was conducted in Medicine OPD of a tertiary care hospital in India, in which 245 MUPS-diagnosed patients out of 976 consecutive screened patients were evaluated for the severity of somatic symptoms (by administering the Patient Health Questionnaire-15) and its sociodemographic correlates. Results Out of 245 recruited patients, three-fourth had a significant severity level of somatic symptoms. High level of somatic symptom severity was more common in females (p ≤ 0.001), married patients (p = 0.011), rural dwellers (p = 0.035), less educated (p = 0.003), and those with lower socioeconomic status (p = 0.001). Conclusions Patients with MUPS have a high level of somatic symptom severity with certain sociodemographic correlates. Further research should be conducted to investigate the reasons for this and to formulate a cost-effective treatment strategy.
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Affiliation(s)
- Upendra Baitha
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | | | | | - Vishwajeet Singh
- Biostatistics, All India Institute of Medical Sciences, Delhi, IND
| | | | - Arvind Kumar
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | - Anamika Sahu
- Psychiatry, All India Institute of Medical Sciences, Delhi, IND
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Beutel TF, Zwerenz R, Michal M. Psychosocial stress impairs health behavior in patients with mental disorders. BMC Psychiatry 2018; 18:375. [PMID: 30509234 PMCID: PMC6278074 DOI: 10.1186/s12888-018-1956-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/16/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It has been shown, that in the general population psychosocial stress affects health behaviors. However similar studies of high risk populations are sparse. Therefore, the aim of this cross-sectional study is to analyze the association between common psychosocial stressors and health behavior in a sample of patients with mental disorders. METHODS We analyzed data of n = 2326 outpatients from a mental health care department. Severity of psychosocial stress was assessed by the PHQ-stress module of the Patient Health Questionnaire (PHQ). Health behaviors included obesity, uncontrolled eating, smoking and physical inactivity. Multiple binary regression models were conducted for the PHQ-stress score and for each of the ten PHQ-stress items as independent variables. RESULTS 'Financial stress' and 'having no one to turn to with problems' were mainly associated with adverse health behaviors after adjustment for multivariate effects. The most affected health behaviors were uncontrolled eating in both sexes and obesity in women. CONCLUSION Our findings indicate specific influences of psychosocial stressors on unhealthy behaviors in a clinical sample. Patients with financial strain and lack of social support might need specific support for improving their health behavior.
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Affiliation(s)
- Till Fabian Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. .,Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131, Mainz, Germany.
| | - Rüdiger Zwerenz
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Matthias Michal
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
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Niyonsenga T, Coffee NT, Del Fante P, Høj SB, Daniel M. Practical utility of general practice data capture and spatial analysis for understanding COPD and asthma. BMC Health Serv Res 2018; 18:897. [PMID: 30477507 PMCID: PMC6260571 DOI: 10.1186/s12913-018-3714-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/14/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND General practice-based (GP) healthcare data have promise, when systematically collected, to support estimating local rates of chronic obstructive pulmonary disease (COPD) and asthma, variations in burden of disease, risk factors and comorbid conditions, and disease management and quality of care. The use of GP information systems for health improvement has been limited, however, in the scope and quality of data. This study assessed the practical utility of de-identified clinical databases for estimating local rates of COPD and asthma. We compared COPD and asthma rates to national benchmarks, examined health related risk factors and co-morbidities as correlates of COPD and asthma, and assessed spatial patterns in prevalence estimates at the small-area level. METHODS Data were extracted from five GP databases in western Adelaide, South Australia, for active patients residing in the region between 2012 and 2014. Prevalence estimates were computed at the statistical area 1 (SA1) spatial unit level using the empirical Bayes estimation approach. Descriptive analyses included summary statistics, spatial indices and mapping of geographic patterns. Bivariate associations were assessed, and disease profiles investigated to ascertain multi-morbidities. Multilevel logistic regression models were fitted, accounting for individual covariates including the number of comorbid conditions to assess the influence of area-level socio-economic status (SES). RESULTS For 33,725 active patients, prevalence estimates were 3.4% for COPD and 10.3% for asthma, 0.8% higher and 0.5% lower for COPD and asthma, respectively, against 2014-15 National Health Survey (NHS) benchmarks. Age-specific comparisons showed discrepancies for COPD in the '64 years or less' and 'age 65 and up' age groups, and for asthma in the '15-25 years' and '75 years and up' age groups. Analyses confirmed associations with individual-level factors, co-morbid conditions, and area-level SES. Geographic aggregation was seen for COPD and asthma, with clustering around GP clinics and health care centres. Spatial patterns were inversely related to area-level SES. CONCLUSION GP-based data capture and analysis has a clear potential to support research for improved patient outcomes for COPD and asthma via knowledge of geographic variability and its correlates, and how local prevalence estimates differ from NHS benchmarks for vulnerable age-groups.
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Affiliation(s)
- T Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia. .,Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - N T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - P Del Fante
- Healthfirst Network, Adelaide, South Australia, Australia.,Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - S B Høj
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.,Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - M Daniel
- Centre for Research and Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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Doppler C, Arnhard K, Dumfarth J, Heinz K, Messner B, Stern C, Koal T, Klavins K, Danzl K, Pitterl F, Grimm M, Oberacher H, Bernhard D. Metabolomic profiling of ascending thoracic aortic aneurysms and dissections - Implications for pathophysiology and biomarker discovery. PLoS One 2017; 12:e0176727. [PMID: 28467501 PMCID: PMC5415060 DOI: 10.1371/journal.pone.0176727] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/14/2017] [Indexed: 02/04/2023] Open
Abstract
Objective Our basic understanding of ascending thoracic aortic aneurysm (ATAA) pathogenesis is still very limited, hampering early diagnosis, risk prediction, and development of treatment options. “Omics”-technologies, ideal to reveal tissue alterations from the normal physiological state due to disease have hardly been applied in the field. Using a metabolomic approach, with this study the authors seek to define tissue differences between controls and various forms of ATAAs. Methods Using a targeted FIA-MS/MS metabolomics approach, we analysed and compared the metabolic profiles of ascending thoracic aortic wall tissue of age-matched controls (n = 8), bicuspid aortic valve-associated aneurysms (BAV-A; n = 9), tricuspid aortic valve-associated aneurysms (TAV-A; n = 14), and tricuspid aortic valve-associated aortic dissections (TAV-Diss; n = 6). Results With sphingomyelin (SM) (OH) C22:2, SM C18:1, SM C22:1, and SM C24:1 only 4 out of 92 detectable metabolites differed significantly between controls and BAV-A samples. Between controls and TAV-Diss samples only phosphatidylcholine (PC) ae C32:1 differed. Importantly, our analyses revealed a general increase in the amount of total sphingomyelin levels in BAV-A and TAV-Diss samples compared to controls. Conclusions Significantly increased levels of sphingomyelins in BAV-A and TAV-Diss samples compared to controls may argue for a repression of sphingomyelinase activity and the sphingomyelinase-ceramide pathway, which may result in an inhibition of tissue regeneration; a potential basis for disease initiation and progression.
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Affiliation(s)
- Christian Doppler
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
- Cardiac, Vascular, and Thoracic Surgery, Medical Faculty, Johannes-Kepler University, Linz, Austria
| | - Kathrin Arnhard
- Institute of Legal Medicine and Core Facility Metabolomics, Innsbruck Medical University, Innsbruck, Austria
| | - Julia Dumfarth
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Katharina Heinz
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Barbara Messner
- Department of Cardiac Surgery, Vienna Medical University, Vienna, Austria
| | - Christian Stern
- Department of Cardiac Surgery, Vienna Medical University, Vienna, Austria
| | | | | | - Katarina Danzl
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Florian Pitterl
- Institute of Legal Medicine and Core Facility Metabolomics, Innsbruck Medical University, Innsbruck, Austria
| | - Michael Grimm
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Herbert Oberacher
- Institute of Legal Medicine and Core Facility Metabolomics, Innsbruck Medical University, Innsbruck, Austria
| | - David Bernhard
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
- Cardiac, Vascular, and Thoracic Surgery, Medical Faculty, Johannes-Kepler University, Linz, Austria
- * E-mail:
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Xiong W, Xu M, Zhao Y, Wu X, Pudasaini B, Liu JM. Can we predict the prognosis of COPD with a routine blood test? Int J Chron Obstruct Pulmon Dis 2017; 12:615-625. [PMID: 28243079 PMCID: PMC5315204 DOI: 10.2147/copd.s124041] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The major characteristic of COPD is systemic inflammation. The parameters such as neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-basophil ratio (EBR) in routine blood test (RBT) are considered to be the underlying biomarkers of inflammation. We hypothesized that the prognosis of patients with COPD can be predicted with RBT. METHODS Patients with COPD in stable stage were enrolled. The RBT, pulmonary function testing (PFT), BODE index, C-reactive protein (CRP), procalcitonin, and erythrocyte sedimentation rate (ESR) were performed at enrollment and every follow-up once in every 3 months during the 24-month follow-up period. Meanwhile, exacerbation count and mortality incidence were recorded. The correlation between the prognostic biomarkers and the prognosis of patients was analyzed. RESULTS The NLR and EBR in RBT have a significant correlation with the severity of patients with COPD. The NLR is an independent predictor for mortality and the EBR is an independent predictor for exacerbation. CONCLUSION As an inexpensive, accessible, and convenient assay, RBT may be used as a practical means in the prediction of prognosis of patients with COPD in future clinical settings.
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Affiliation(s)
- Wei Xiong
- Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine
| | - Mei Xu
- Department of Pediatrics, Gongli Hospital, Second Military Medical University
| | - Yunfeng Zhao
- Department of Respiratory Medicine, Punan Hospital
| | - Xueling Wu
- Department of Respiratory Medicine, Renji Hospital, Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Bigyan Pudasaini
- Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine
| | - Jin-ming Liu
- Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine
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Zhao W, Wu Z, Chen J, Jia H, Huang Z, Chen M, Gu X, Liu M, Zhang Z, Wang H, Wang P, Cheng W. Survival prediction of anxious emotion in advanced cancer patients receiving palliative care. Psychooncology 2016; 26:1463-1469. [DOI: 10.1002/pon.4314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/11/2016] [Accepted: 11/11/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Weiwei Zhao
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety; Ministry of Education; Fudan University; Shanghai China
| | - Jianhua Chen
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Huixun Jia
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
| | - Zhe Huang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Menglei Chen
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Xiaoli Gu
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Minghui Liu
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Zhe Zhang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Huaping Wang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Peng Wang
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
- Department of Integrative Oncology; Fudan University Shanghai Cancer Center; Shanghai China
| | - Wenwu Cheng
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
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