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Introduction: Currently, strategies for improving alpha1 antitrypsin deficiency (AATD) diagnosis are needed. Here we report the performance of a multinational multiplex-based genotyping test on dried blood spots and buccal swabs sent by post or courier and with web registration for subjects with suspected AATD in Argentina, Brazil, Chile, Colombia, Spain, and Turkey., Methods: This was an observational, cross-sectional analysis of samples from patients with suspected AATD from March 2018 to January 2022. Samples were coded on a web platform and sent by post or courier to the central laboratory in Northern Spain. Allele-specific genotyping for the 14 most common mutations was carried out with the A1AT Genotyping Test (Progenika-Grifols, Spain). SERPINA1 gene sequencing was performed if none of the mutations were found or one variant was detected in heterozygous status and the AAT serum level was < 60 mg/dl, or if requested by the clinician in charge., Results: The study included 30,827 samples: 30,458 (94.7%) with final results after direct genotyping and 369 (1.1%) with additional gene sequencing. Only 0.3% of the samples were not processed due to their poor quality. The prevalence of the most frequent allele combinations was MS 14.7%, MZ 8.6%, SS 1.9%, SZ 1.9%, and ZZ 0.9%. Additionally, 70 cases with new mutations were identified. Family screening was conducted in 2.5% of the samples. Samples from patients with respiratory diseases other than COPD, including poorly controlled asthma or bronchiectasis, also presented AATD mutations., Conclusions: Our results confirm the viability of this diagnostic system for genotyping AATD conducted simultaneously in different countries. The system has proved satisfactory and can improve the timely diagnosis of AATD., (© 2022. The Author(s).)

Objective: The aim of the study was to determine the nutritional status and anthropometric values in a group of patients with COPD and to examine the relationship between these factors and disease severity., Methods: A total of 105 COPD patients were included in this cross-sectional study. The patients underwent spirometric exmination. Mini nutritional assessment form was applied, and the anthropometric values of the patients were measured by bioelectrical impedance method. Nutrient registration forms were given using a 3-day, 24-hour recall method to assess the nutrient uptake. COPD severity was determined using the Global Initiative for Chronic Obstructive Lung Disease criteria, and the correlations between nutritional status and disease severity parameters were measured., Results: The prevalence of malnutrition in our patients with COPD was found to be 17%. Spirometric parameters were found to be significantly lower in patients with low body mass index (BMI) and malnutrition. As the modified Medical Research Council dyspnea scale score increased, the frequency of malnutrition increased ( P =0.002). Positive significant correlation was found between spirometric variables and muscle mass and fat external tissue volume of the patients. Patients receiving higher protein content in diet showed a better muscle mass amount ( P <0.001)., Conclusion: Our study results confirmed that malnutrition is an important and frequently encountered problem in COPD patients, and spirometric values of the patients with malnourishment and with low BMI are significantly lower. We think that nutritional status should be evaluated in every COPD patient, and nutritional intake should be tailored individually., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Introduction: Despite the presentation of similar symptoms, the airway diseases have different underlying pathophysiological processes and must be distinguished to enable the administration of appropriate treatment. In several studies the clinician- and patient-related causes of poor compliance to treatment in asthma/chronic obstructive pulmonary disease (COPD) patients have been evaluated. This study aimed to determine the clinical and sociodemographic characteristics of newly diagnosed treatment-naïve asthma and COPD patients in Turkey., Materials and Methods: This national, multicentre, prospective, observational study was conducted in 122 centres. A questionnaire including items related to demographic, clinical, laboratory parameters was applied. All patients were intended to be followed-up for 12 months., Result: 1892 adult patients (1116 asthma and 776 COPD) from 122 centres were enrolled. Overall 95%, 86% and 65% of intermittent, mild persistent and moderate persistent asthma patients were over-treated. Among COPD patients, the percentages of over-treated patients were 66%, 79% and 82% for those with GOLD stage A, B and C. Physicians' adherence to guidelines was appropriate in 93% of severe persistent asthma patients and 89% of GOLD stage D COPD patients. Among patients with high compliance to treatment, proportion of asthma patients with total control was 44% and that of COPD patients at GOLD stage A was 41%. In consecutive two visits, this figure increased to 52% and 63% in asthma patients and 54% and 50% in COPD patients., Conclusions: The main findings are: (a) patients are frequently over-treated and (b) patients do not adhere to visits as expected, in both asthma and COPD.

Chronic obstructive pulmonary disease (COPD) and asthma are airway diseases with acute exacerbations. Natural course of both disease are affected by exacerbations. COPD exacerbations may be caused by infections and other causes; indoor and outdoor pollution, cardiovascular diseases, asthma-COPD overlap syndrome, COPD- obstructive sleep apnea syndrome, pulmonary embolism, gastro-oesophageal reflux, anxiety-depression, pulmonary hypertension. Exposure to triggering factors, viral infections, treatment insufficiency may cause asthma exacerbations. Smoking cessations, prevention of infections, long-acting anticholinergics, long-acting 2 agonists, inhaled corticosteroids, phosphodiesterase-4 inhibitors, mucolytics, prophilactic antibiotics can be effective on the prevention of COPD exacerbations. Asthma exacerbations may be decreased by the avoidance of allergens, viral infections, occupational exposures, airpollution, treatment of comorbid diseases. Effective treatment of asthma is required to prevent asthma exacerbations. Inhaled steroids and combined treatments are the most effective preventive therapy for exacerbations. Patient education and cooperation is an element of the preventive measures for asthma attacks. Compliance to therapy, inhalation techniques, written asthma plans are required. The essential of COPD and asthma exacerbation treatment is bronchodilator therapy. Steroids are also implemented to the therapy, targeting the inflammation. Specific treatments of the cause (infection, airpollution, pulmonary embolism etc.) should be administered.

Asthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named "Asthma-COPD Overlap Syndrome" (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV1/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV1 pred or increase of FEV1 > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines.

Objectives: Chronic obstructive pulmonary disease (COPD) is an increasingly important cause of morbidity and mortality worldwide. Pericardial effusion (PE) is a current issue proven to be a mortality predictor, especially in pulmonary arterial hypertension. In this study, we aimed to evaluate the prognostic value of PE in COPD., Study Design: The study cohort consisted of 488 COPD patients and a control group of 50 healthy patients. At the start of the study, 37 patients (7.5%) had PE. Mean follow-up time was 12 months (range; 1-16 months). Clinical spirometric and echocardiographic data were compared between patients with PE(+) group (n=37), patients without PE(-) group (n=451) and the healthy control group., Results: Right ventricular functions were more depressed and pulmonary arterial pressure was more elevated in the PE(+) group. Also, Kaplan-Meier survival curve analysis showed that at one-year follow- up, mortality was higher in the PE(+) group: PE(-) group 139 (30.8%), PE(+) group 21 (56.8%) log-Rank p value: 0.009). Age, presence of PE, and oxygen usage were independent predictors of mortality in Cox regression analysis., Conclusion: Presence of PE predicts mortality in COPD patients at one-year follow-up.

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease characterized with progressive air flow limitation, and is expected to be the third leading cause of death until 2030 worldwide. The clinical trials in the last 10 years revealed that fix combinations (inhaled corticosteroids/long-acting beta-2 agonist; ICS/LABA) improve lung functions and quality of life, and reduced symptoms and exacerbation rates in patients with severe and very severe COPD.