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1. COPD: Should Diagnosis Match Physiology?

Author

Studnicka, M, Horner, A, Sator, L, Buist, AS, Lamprecht, B, Zhong, NS, Liu, S, Lu, J, Ran, P, Wang, D, Zheng, J, Zhou, Y, Kocabaş, A, Hancioglu, A, Hanta, I, Kuleci, S, Turkyilmaz, AS, Umut, S, Unalan, T, Dawes, T, Bateman, E, Jithoo, A, Adams, D, Barnes, E, Freeman, J, Hayes, A, Hlengwa, S, Johannisen, C, Koopman, M, Louw, I, Ludick, I, Olckers, A, Ryck, J, Storbeck, J, Gislason, T, Benedikdtsdottir, B, Jörundsdottir, K, Gudmundsdottir, L, Gudmundsdottir, S, Gundmundsson, G, Nizankowska-Mogilnicka, E, Frey, J, Harat, R, Mejza, F, Nastalek, P, Pajak, A, Skucha, W, Szczeklik, A, Twardowska, M, Welte, T, Bodemann, I, Geldmacher, H, Schweda-Linow, A, Gulsvik, A, Endresen, T, Svendsen, L, Tan, WC, Wang, W, Mannino, DM, Cain, J, Copeland, R, Hazen, D, Methvin, J, Dantes, RB, Amarillo, L, Berratio, LU, Fernandez, LC, Francisco, NA, Garcia, GS, de Guia, TS, Idolor, LF, Naval, SS, Reyes, T, Roa, CC, Sanchez, MF, Simpao, LP, Jenkins, C, Marks, G, Bird, T, Espinel, P, Hardaker, K, Toelle, B, Burney, PGJ, Amor, C, Potts, J, Tumilty, M, McLean, F, Wouters, EFM, Wesseling, GJ, Bárbara, C, Rodrigues, F, Dias, H, Cardoso, J, Almeida, J, Matos, MJ, Simão, P, Santos, M, Ferreira, R, Janson, C, Olafsdottir, IS, Studnicka, M, Horner, A, Sator, L, Buist, AS, Lamprecht, B, Zhong, NS, Liu, S, Lu, J, Ran, P, Wang, D, Zheng, J, Zhou, Y, Kocabaş, A, Hancioglu, A, Hanta, I, Kuleci, S, Turkyilmaz, AS, Umut, S, Unalan, T, Dawes, T, Bateman, E, Jithoo, A, Adams, D, Barnes, E, Freeman, J, Hayes, A, Hlengwa, S, Johannisen, C, Koopman, M, Louw, I, Ludick, I, Olckers, A, Ryck, J, Storbeck, J, Gislason, T, Benedikdtsdottir, B, Jörundsdottir, K, Gudmundsdottir, L, Gudmundsdottir, S, Gundmundsson, G, Nizankowska-Mogilnicka, E, Frey, J, Harat, R, Mejza, F, Nastalek, P, Pajak, A, Skucha, W, Szczeklik, A, Twardowska, M, Welte, T, Bodemann, I, Geldmacher, H, Schweda-Linow, A, Gulsvik, A, Endresen, T, Svendsen, L, Tan, WC, Wang, W, Mannino, DM, Cain, J, Copeland, R, Hazen, D, Methvin, J, Dantes, RB, Amarillo, L, Berratio, LU, Fernandez, LC, Francisco, NA, Garcia, GS, de Guia, TS, Idolor, LF, Naval, SS, Reyes, T, Roa, CC, Sanchez, MF, Simpao, LP, Jenkins, C, Marks, G, Bird, T, Espinel, P, Hardaker, K, Toelle, B, Burney, PGJ, Amor, C, Potts, J, Tumilty, M, McLean, F, Wouters, EFM, Wesseling, GJ, Bárbara, C, Rodrigues, F, Dias, H, Cardoso, J, Almeida, J, Matos, MJ, Simão, P, Santos, M, Ferreira, R, Janson, C, and Olafsdottir, IS

Published
2020

2. Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis

Author

Sator, L, Horner, A, Studnicka, M, Lamprecht, B, Kaiser, B, McBurnie, M, Buist, A, Gnatiuc, L, Mannino, D, Janson, C, Bateman, E, Burney, P, Zhong, N, Liu, S, Lu, J, Ran, P, Wang, D, Zheng, J, Zhou, Y, Kocabaş, A, Hancioglu, A, Hanta, I, Kuleci, S, Turkyilmaz, A, Umut, S, Unalan, T, Dawes, T, Jithoo, A, Adams, D, Barnes, E, Freeman, J, Hayes, A, Hlengwa, S, Johannisen, C, Koopman, M, Louw, I, Ludick, I, Olckers, A, Ryck, J, Storbeck, J, Gislason, T, Benedikdtsdottir, B, Jörundsdottir, K, Gudmundsdottir, L, Gudmundsdottir, S, Gundmundsson, G, Nizankowska-Mogilnicka, E, Frey, J, Harat, R, Mejza, F, Nastalek, P, Pajak, A, Skucha, W, Szczeklik, A, Twardowska, M, Welte, T, Bodemann, I, Geldmacher, H, Schweda-Linow, A, Gulsvik, A, Endresen, T, Svendsen, L, Tan, W, Wang, W, Cain, J, Copeland, R, Hazen, D, Methvin, J, Dantes, R, Amarillo, L, Berratio, L, Fernandez, L, Francisco, N, Garcia, G, De Guia, T, Idolor, L, Naval, S, Reyes, T, Roa, C, Sanchez, M, Simpao, L, Jenkins, C, Marks, G, Bird, T, Espinel, P, Hardaker, K, Toelle, B, Amor, C, Potts, J, Tumilty, M, McLean, F, Wouters, E, Wesseling, G, Bárbara, C, Rodrigues, F, Dias, H, Cardoso, J, Almeida, J, Matos, M, Simão, P, Santos, M, Ferreira, R, Olafsdottir, I, Nisser, K, Spetz-Nyström, U, Hägg, G, Lund, G, Jõgi, R, Laja, H, Ulst, K, Zobel, V, Lill, T, Koul, P, Malik, S, Hakim, N, Khan, U, Chowgule, R, Shetye, V, Raphael, J, Almeda, R, Tawde, M, Tadvi, R, Katkar, S, Kadam, M, Dhanawade, R, Ghurup, U, Harrabi, I, Denguezli, M, Tabka, Z, Daldoul, H, Boukheroufa, Z, Chouikha, F, Khalifa, W, Ayuyao, F, Tady, C, Tan, D, Banal-Yang, S, Balanag, V, Reyes, M, Juvekar, S, Hirve, S, Sambhudas, S, Chaidhary, B, Tambe, M, Pingale, S, Umap, A, Shelar, N, Devchakke, S, Chaudhary, S, Bondre, S, Walke, S, Gawhane, A, Sapkal, A, Argade, R, Gaikwad, V, Salvi, S, Brashier, B, Londhe, J, Madas, S, Obaseki, D, Erhabor, G, Awopeju, O, and Adewole, O

Subjects
respiratory tract diseases
Abstract

Background There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. Methods A false positive diagnosis of COPD was considered when participants reported a doctor’s diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7). Results Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of “chronic bronchitis” or “emphysema” (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. Conclusions False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.

Published
2019

3. Gaps in using bronchodilators, inhaled corticosteroids and influenza vaccine among 23 high- and low-income sites

Author

Gnatiuc, L, Buist, AS, Kato, BS, Janson, C, Aït-Khaled, N, Nielsen, R, Koul, PA, Nizankowska-Mogilnicka, E, Obaseki, D, Idolor, LF, Harrabi, I, Burney, PGJ, Vollmer, W, Gillespie, S, McBurnie, M, Jithoo, A, Coton, S, Azhar, H, Zhong, NS, Liu, SM, Lu, JC, Ran, PX, Wang, DL, Zheng, JP, Zhou, YM, Kocabas, A, Hancioglu, A, Hanta, I, Kuleci, S, Turkyilmaz, AS, Umut, S, Unalan, T, Studnicka, M, Dawes, T, Lamprecht, B, Schirhofer, L, Bateman, E, Adams, D, Barnes, E, Freeman, J, Hayes, A, Hlengwa, S, Johannisen, C, Koopman, M, Louw, I, Ludick, I, Olckers, A, Ryck, J, Storbeck, J, Gislason, T, Benedikdtsdottir, B, Jorundsdottir, K, Gudmundsdottir, L, Gudmundsdottir, S, Gundmundsson, G, Frey, J, Harat, R, Mejza, F, Nastalek, P, Pajak, A, Skucha, W, Szczeklik, A, Twardowska, M, Welte, T, Bodemann, I, Geldmacher, H, Schweda-Linow, A, Gulsvik, A, Endresen, T, Svendsen, L, Tan, WC, Wang, W, Mannino, DM, Cain, J, Copeland, R, Hazen, D, Methvin, J, Dantes, RB, Amarillo, L, Berratio, LU, Fernandez, LC, Francisco, NA, Garcia, GS, De Guia, TS, Naval, SS, BOLD Collaboration, and Çukurova Üniversitesi

Subjects
Pulmonary and Respiratory Medicine, Low income, Influenza vaccine, business.industry, Cross-sectional study, Determinants for use, Inhaled corticosteroids, medicine.disease, Prevention of exacerbations, Vaccination, Copd and asthma treatments, Infectious Diseases, Multicenter study, Low and middle income countries, Environmental health, Immunology, medicine, business, Essential respiratory medications, Asthma
Abstract

Background Increasing access to essential respiratory medicines and influenza vaccination has been a priority for over three decades. Their use remains low in low- and middle-income countries (LMICs), where little is known about factors influencing use, or about the use of influenza vaccination for preventing respiratory exacerbations. Methods We estimated rates of regular use of bronchodilators, inhaled corticosteroids and influenza vaccine, and predictors for use among 19 000 adults in 23 high-income countries (HICs) and LMIC sites. Results Bronchodilators, inhaled corticosteroids and influenza vaccine were used significantly more in HICs than in LMICs, after adjusting for similar clinical needs. Although they are used more commonly by people with symptomatic or severe respiratory disease, the gap between HICs and LMICs is not explained by the prevalence of chronic obstructive pulmonary disease or doctor-diagnosed asthma. Site-specific factors are likely to influence use differently. The gross national income per capita for the country is a strong predictor for use of these treatments, suggesting that economics influence under-treatment. Conclusion We still need a better understanding of determinants for the low use of essential respiratory medicines and influenza vaccine in low-income settings. Identifying and addressing these more systematically could improve the access and use of effective treatments.

Published
2015

4. Serious Asthma Events with Fluticasone plus Salmeterol versus Fluticasone Alone

Author

Stempel, Da, Raphiou, Ih, Kral, Km, Yeakey, Am, Emmett, Ah, Prazma, Cm, Buaron, Ks, Pascoe, Sj, Austri, Investigators, Altieri, Hh, Antuni, Jd, Bergna, Ma, Cuadrado, Ja, De Gennaro MS, Fazio Lizandrelo CL, Gattolin, G, Gosn, Am, Larrateguy, Ld, Marcipar, Am, Maspero, Jf, Medina, Iv, Perez Chada RD, Silva, D, Victorio, Cf, Bardin, Pg, Carroll, Pa, Clements, Bs, Dore, Nd, Robinson, Pd, Fitzgerald, Da, Robinson, Pj, Russo, Ma, Sajkov, D, Thomas, Ps, Upham, Jw, Forstner, B, Kaik, G, Koeberl, Gh, Studnicka, M, Wallner, G, Balthazar, Y, Bauler, A, Dupont, Lj, Martinot, Jb, Ninane, V, Peché, R, Pilette, C, Dimitrova, R, Dimova, D, Kissyova Ibrishimova, G, Loboshka Becheva, M, Machkovska, M, Madjarov, S, Mandazhieva Pepelanova, M, Naidenova, I, Noleva, K, Takovska, N, Terziev, C, Aggarwal, Nk, Chapman, Kr, Csanadi, Ma, Dhillon, R, Henein, S, Kelly, Aj, Lam, As, Liem, Jj, Lougheed, Md, Lowe, Dw, Rizvi, Q, van den Berg, L, Zidel, B, Barros Monge MJ, Calvo Gil MA, Castillo Hofer CR, Diaz Amor PV, Lezana Soya, V, Quilodran Silva CN, Bolivar Grimaldos, F, Solarte-Rodriguez, I, Butkovic-Tomljanovic, R, Hegedus-Jungvirth, M, Ivkovic-Jurekovic, I, Simunov-Karuza, G, Buresova, M, Bursova, J, Fratrik, J, Guttlerova, E, Hartman, P, Jirmanova, I, Kalina, P, Kolman, P, Kucera, M, Povysilova, L, Pravda, P, Svabkova, A, Zakova, L, Backer, V, Maltbaek, N, Johnsen, Cr, Aries, Sp, Babyesiza, A, Barth, D, Benedix, A, Berg, P, Bergtholdt, B, Bettig, U, Bindig, Hw, Botzen, U, Brehler, R, Breyer, Go, Bruckhaus-Walter, M, Dapper, T, Eckhard, Jg, Engelhard, R, Feldmeyer, F, Fissan, H, Franz, Kh, Frick, Bs, Funck, J, Gessner, Cm, Ginko, T, Grigat, Ce, Grimm-Sachs, V, Groth, G, Hampf, J, Hanf, G, Havasi-Jost, G, Heinz, Gu, Helm, K, Hoeltz, S, Hofmann, S, Jander, R, Jandl, M, Jasch-Hoppe, B, Jung, T, Junggeburth, Jj, Kardos, P, Knueppel, W, Koch, T, Kolorz, C, Korduan, M, Korth-Wiemann, B, Krezdorn, Hg, Kroker, A, Kruell, M, Kuehne, P, Lenk, U, Liefring, E, Merke, J, Micke, L, Mitlehner, W, Mueller, H, Naudts, If, Neumann, G, Oldenburg, W, Overlack, A, Panzer, F, Reinholz, N, Remppis, R, Riegel, P, Rueckert, P, Schaetzl, Rj, Schauer, U, Hamelmann, E, Schenkenberger, I, Schlegel, V, Scholz, G, Schroers, M, Schwittay, A, Sebert, M, Tyler, K, Soemantri, Pa, Stock, P, Stuchlik, G, Unland, M, von Mallinckrodt, C, Wachter, J, Weber, U, Weberling, F, Wehgartner-Winkler, S, Weimer, J, Wiemer, S, Winkelmann, Ej, Zeisler, Kh, Ziegner, A, Zimny, Hh, Andrasofszky, Z, Bartha, A, Farkas, M, Gömöri, K, Kis, S, Major, K, Mészáros, I, Mezei, M, Rakvacs, M, Szalai, Z, Szántó, J, Szentesi, M, Szolnoki, E, Valyon, E, Zibotics, H, Anwar, J, Arimah, C, Djajalaksana, S, Rai, Ib, Setijadi, Ar, Setyanto, Db, Susanti, F, Syafiuddin, T, Syamsi, Ln, Wijanarko, P, Yunus, F, Bonavia, M, Braga, M, Chetta, Aa, Cerveri, I, Luisetti, M, Crimi, N, Cutrera, R, De Rosa, M, Esposito, S, Foresi, A, Gammeri, E, Iemoli, E, Legnani, Dl, Michetti, G, Pastorello, Ea, Pesci, A, Pistolesi, M, Riva, E, Romano, A, Scichilone, N, Terracciano, L, Tripodi, S, Choi, I, Kim, C, Kim, Js, Kim, Wj, Koh, Yy, Kwon, Ss, Lee, Sh, Lee, S, Lee, Sk, Park, Cs, Cirule, I, Eglite, R, Petrova, I, Poga, M, Smiltena, I, Chomiciene, A, Davoliene, I, Griskeviciene, V, Naudziunas, A, Naudziunas, S, Rudzeviciene, O, Sitkauskiene, B, Urbonas, G, Vaicius, D, Valavicius, A, Valiulis, A, Vebriene, J, bin Abdul Aziz FA, Daud, M, Ismail, Ai, Tengku Saifudin TI, Md Kassim RM, Mohd Fadzli FB, Wan Mohamad WH, Aguilar Dominguez PE, Aguilar-Orozco, Ra, Garza-Salinas, S, Ramirez-Diaz, Sp, Sánchez Llamas, F, Soto-Ramos, M, Velarde-Mora, Hj, Aguirre Sosa, I, Cisneros, Am, Estrella Viladegut RA, Matsuno Fuchigami, A, Adiaz-Baui, Tt, Bernan, Ap, Onia, Af, Sandagon, Mj, S-Naval, S, Yu, Cy, Bartuzi, Z, Bielous-Wilk, A, Błażowski, Ł, Bożek, A, Brzostek, J, Chorostowska-Wynimko, J, Ciekalska, K, Ziora, D, Cieslicki, J, Emeryk, A, Folcik, K, Gałuszka-Bilińska, A, Gawlik, R, Giejlo, M, Harat, R, Hofman, T, Jahnz-Różyk, K, Jedrzejczak, M, Kachel, T, Kamiński, D, Kelm Warchol, A, Konieczny, Z, Kwasniewski, A, Leszczyński, W, Mincewicz, G, Niezgoda, K, Olszewska-Ziąber, A, Onasz-Manitius, M, Pawlukiewicz, M, Piotrowicz, P, Piotrowski, W, Pisarczyk-Bogacka, E, Piskorz, P, Prokop-Staszecka, A, Roslan, A, Słomka, A, Smalera, E, Stelmach, I, Swierczynska-Krepa, M, Szmidt, M, Tarnowska-Matusiak, M, Tłuczykont, B, Tyminska, K, Waszkuc-Golonko, J, Wojciechowska, I, Alexandrescu, Ds, Neamtu, Ml, Todea, D, Alekseeva, E, Aleksandrova, E, Asherova, I, Barbarash, Ol, Bugrova, O, Bukreeva, Eb, Chermenskiy, A, Chizhova, O, Demko, I, Evdokimova, A, Giorgadze, Ml, Grigoryev, S, Irkhina, I, Khurkhurova, Nv, Kondyurina, Eg, Kostin, Vi, Kudelya, L, Laleko, Sl, Lenskaya, L, Levashov, S, Logvinenko, N, Martynov, A, Mizernitski, Y, Nemtsov, B, Novozhenov, Vg, Pavlishchuk, S, Popova, Vv, Reshetko, Ov, Sherenkov, A, Shirinsky, Vs, Shpagina, L, Soloviev, Ki, Tkachev, A, Trofimov, Vi, Vertkin, Al, Vorobeva, E, Idrisova, E, Yakushin, S, Zadionchenko, V, Zhiglinskaya, O, Zykov, K, Dopudja Pantic, V, Nadaskic, R, Nestorovic, B, Skodric Trifunovic, V, Stojanovic, A, Vukcevic, M, Vujic, T, Mitic Milikic, M, Banovcin, P, Horvathova, H, Karako, P Sr, Plutinsky, J, Pribulova, E, Szarazova, M, Zlatos, A, Adams, L, Badat, A, Bassa, A, Breedt, J, Bruning, A, Ellis, Gc, Emanuel, S, Fouche, Lf, Fulat, Ma, Gani, M, Ismail, Ms, Jurgens, Jc, Nell, H, Nieuwoudt, G, Noor, F, Bolliger, Ct, Puterman, As, Siddique, N, Trokis, Js, Vahed, Ya, Van Der Berg BJ, Van der Linden, M, Van Zyl, L, Visser, Ss, Antépara Ercoreca, I, Arnedillo Muñoz, A, Barbe Illa, F, Barreiro López, B, Blanco Aparicio, M, Boada Valmaseda, A, Bosque García, M, Bustamante Ruiz, A, Carretero Anibarro, P, Del Campo Matias, F, Echave-Sustaet, Jm, Espinosa de los Monteros Garde MJ, Garcia Hernandez GM, López Viña, A, Lores Obradors, L, Luengo Planas MT, Monsó Molas, E, Navarro Dourdil, A, Nieto García AJ, Perpina Tordera, M, Picado Valles, C, Rodriguez Alvarez Mdel, M, Saura Vinuesa, A, Serra Batlles, J, Soler Sempere MJ, Toran Montserrat, P, Valdés Cuadrado LG, Villasante Fernandez-Montes, C, Cheng, Sl, Chern, Jh, Chiu, Mh, Chung, Cl, Lai, Rs, Lin, Ck, Liu, Yc, Wang, Cc, Wei, Yf, Amer, L, Berenfus, Vi, Besh, L, Duka, Kd, Fushtey, Im, Garmash, N, Dudnyk, O, Godlevska, O, Vlasenko, Ma, Hospodarskyy, I, Iashyna, L, Kaladze, M, Khvelos, Si, Kostromina, Vp, Krakhmalova, O, Kryuchko, T, Kulynych, Ov, Krasko, Mp, Levchenko, O, Litvinova, T, Panina, Ss, Pasiyeshvili, Lm, Prystupa, Ln, Romaniuk, Li, Sirenko, I, Synenko, Vi, Vynnychenko, Lb, Yatsyshyn, Ri, Zaitsev, I, Zhebel, V, Zubarenko, O, Arthur, Cp, Brown, V, Burhan, H, Chaudhuri, R, Collier, D, Barnes, Nc, Davies, Ej, Ellery, A, Kwok, S, Lenney, W, Nordstrom, M, Pandya, Hc, Parker, Iw, Rajakulasingam, K, Seddon, P, Sharma, R, Thomas, Ec, Wakeling, Ja, Abalos-Galito, M, Abboy, C, Abreu, E, Ackerman, If, Acosta, Ia, Adaoag, Aa, Ahmed, M, Ali, Mi, Allen, Dr, Allen GG Jr, Diogo, Jj, Allison, Dc, Alwine, Lk, Apaliski, Sj, Arastu, Rs, Arora, Cm, Auerbach, D, Azzam, Sj, Badar FL 3rd, Baker, Jw, Barasch, Jp, Barber, Ma, Bardinas-Rodriguez, R, Barreiro, Tj, Baumbach, Rr, Baur, Ce, Baxter, Bs, Beach, Jl, Beasley, Rl, Beavins, Je, Beliveau, Wj, Benbow, Mj, Bennett, Nl, Bennett, Rl, Bernal, H, Bernstein, Di, Blaiss, Ms, Blumenthal, Kw, Boas, Sr, Borders, Jl, Boscia, Ja, Boulware, Wn, Bowling, Bt, Brabec, Ba, Bramlet, Dg, Figueroa, Dp, Brautigam, Df, Brownell, Jm, Bruce, Tr, Call, Rs, Campbell, Ca, Canaan, Ya, Cannon, Df, Carpio, Jm, Cathcart, Ws, Cevallos, Jp, Chauhan, Av, Chuang, Rb, Chevalier, D, Christensen, J, Christensen, Ta, Christina, Mo, Chrzanowski, Rr, Civitarese, Fa, Clark, Jp, Clifford, Dp, Lapidus, Rj, Coggi, Ja, Lenz, Jj, Cohen, Kr, Collins, Bg, Collins, H, Comellas, A, Condit, J, Cordasco EM Jr, Corder, Cn, Covar, Ra, Coverston, Kd, Croce, Sa, Cruz, H, Curtis, Ct, Daftary, Pk, Dalan, D, Dalawari, Sp, Daly, Wc, Davis, Kc, Dawes, Kw, Decotiis, Ba, Deluca, Rf, Desantis, Dm, De Valle OL, Diaz, Jl, Diaz, Jd, Dice, Jp, Elizalde, A, Hosler, Mr, Dixon, C, Dobkin, La, Dobrusin, Rs, Dransfield, Mt, Ebbeling, Wl, Edwards, Jd, Elacion, Jm, Elkayam, D, Ellison, Wt, Elsen, Jr, Engel, Lr, Ensz, Dj, Ericksen, Cl, Ervin, Je, Fang, C, Abrahamian, F, Farrah, Vb, Field, Jd, Fishman, Hj, Florea, R, Nayyar, S, Focil, A, Focauld, F, Franco MA Jr, Frandsen, Br, Ganti, K, Garcia, Fl, Lee, Wm, Garscadden, Ag, Gatti, Ea, Gellady, Am, George, Ar, Gibbon, Gw, Gleason, Gp, Goldberg, P, Goldstein, Mf, Gonzalez, Ge, Gower, Rg, Grande, Ja, Gregory, D, Grubb, Sd, Guthrie, Rp, Haas, Ta, Haft, Ks, Hajal, R, Hammond, Gd, Hansel, Nn, Hansen, Vr, Harris, Af, Hartman, An, Harvey, Rr, Hazan-Steinberg, S, Headley, Dm, Heigerick, Gc, Heller, Bn, Hendrix, El, Herrod, Jn, Hewitt, Mj, Hines, Rl, Hirdt, Ap, Hirschfield, Ja, Hoffman, Ks, Hogan, Ad, Howland, Wc, Hsu, Cc, Hsu, Fj, Hubbard, Wm, Hudson, Jd, Huffman, C, Hussain, M, Ioachimescu, Oc, Ismail, Ym, Jaffrani, Na, Jiang, N, Jones, Sw, Jordan, Rs, Joshi, Ke, Kaashmiri, Mw, Kalafer, M, Kamdar, Ba, Kanuga, Jg, Kao, Nl, Karetzky, M, Katsetos, Jc, Kay, Js, Kimmel, Ma, Kimura, Sh, Kingsley, Jk, Mahmood, Sm, Subich, Dc, Kirstein, Jl, Kleerup, Ec, Klein, Rm, Koh, Dw, Kohli, N, Koura, Fa, Kovacs, Sp, Kratzer, J, Kreit, Ci, Kreutter, Fm, Kubicki, Tm, Labuda, Jm, Latorre, Aj, Lara, Mm, Lechin, Ae, Lee, Jj, Lee, Md, Lentnek, Al, Lesh, Kw, Levins, Pf, Anspach, Rb, Levinsky, Dm, Lillestol, Mj, Lim, H, Livezey, Md, Lloyd-Turney, Cw, Lockey, Rf, Long, Ra, Lynch, Mj, Macgillivray, Bk, Mahadevan, Kp, Makam, Sk, Maloney, Mj, Mapel, D, Margolis, Bd, Margulies, J, Martin, Ef, Martin, Ee, Mascolo, M, Mataria, H, Sunbuli, M, Mathur, Rn, Mattar, Pn, Maynard, Km, Maynard, N, Mccormick, B, Mcelya, M, Mcevoy, Ce, Mckenzie, Wc, Medwedeff, Le, Mehta, Kd, Melamed, Ir, Meli, Jv, Merrick, Bh, Meyers, Pj, Miller, Bt, Minton, Sm, Miranda, Fg, Mohar, De, Montenegro, Ch, Morris, Fa, Morrison, Bs, Moss, Mh, Munoz, F, Naini, Gr, Nakamura, Ct, Naseeruddin, S, Nassim, C, Navazo, Lj, Nissim, Je, Norman, D, Oberoi, Ms, O'Connor, Tm, Offenberger, J, Orr, Rr, Osea, Ea, Paine, Wj, Rasmussen, Nl, Palatnik, M, Pangtay, D, Panuto, Ja, Patel, M, Perera, Ms, Perez, A, Peters PH Jr, Pimentel SM Jr, Pluto, Tm, Pollock, Mt, Posner, Ls, Pritchard, Jc, Pudi, Kk, Puig, Cm, Qaqundah, Py, Radbill, Mk, Rahman, St, Raikhel, M, Raissy, Hh, Ramstad, Ds, Ranasinghe, Es, Rangel, Os, Rapo, Se, Raschal, Sp, Reddy, Dg, Rehman, Sm, Reyes, Sr, Rhodes, Rb, Riffer, E, Rihal, Ps, Riley ED 4th, Rodriguez, Dh, Rogers, Cm, Rohlf, Jl, Romeu, H, Roney, Cw, Ronsick, So, Rosen, Jb, Rowe, Ms, Ruoff, Ge, Ryan, Eh, Saff, Rh, Saini, N, Anand, S, Balakrishnan, K, Samuels, Bs, Samuelson, Rj, Saniuk, Rj, Sargeant, Wo, Saunders, Mk, Saway, W, Scarupa, Md, White, Mv, Schear, Mj, Schwarz, Cm, Scott, Rb, Segall, N, Seibert, Af, Seidmeyer, V, Seidner, Mr, Seifer, Fd, Serje, J, Shah, Ms, Shah, Sb, Shapero, Pa, Shearer, Sd, Sheikh, Sq, Shepherd, Ts, Sher, Er, Sher, Ld, Short, Bh, Silas, Pe, Alvey, Jc, Silverfield, Jc, Simon, Sj, Sitar, S, Skoner, Dp, Smallow, Sa, Smart, Ba, Smith, Ca, Smith, Ke, Smith, Sk, Snyders, Gc, Soong, W, Soufer, J, Spangenthal, S, Stahlman, Je, Steele, Lg, Stegemoller, Rk, Stocks, J, Storms, Ww, Suen, J, Surowitz, Rz, Swauger, Jr, Taber, La, Tan, Ae, Pratt, Se, Tanus, T, Tarpay, Mm, Tarshis, Ga, Tenney, Jw, Tilghman, Kg, Trevino, Me, Troyan, Be, Twiddy, Sk, Updegrove, Jd, Urval, Kr, Uusinarkaus, Kt, Vaela, R, Van Cleeff, M, Varano, S, Vo, Qd, Wainz, Rj, Wald, Ja, Wall, Sj, Wasserman, Rl, Weinstein, Dl, Welker, Ja, Wellmon, B 2nd, Wells, T, Wenocur, Hs, Williams, Dl, Williams, Sl, Win, Ph, Wingo, Td, Wisman PP Jr, Wyszomierski, Da, Yamada, Hm, Yarows, S, Yunger TM Jr, Ziering, Rw., the AUSTRI Investigators, Stempel, D., Raphiou, I., Kral, K., Yeakey, A., Emmett, A., Prazma, C., Buaron, K., and Pascoe, S. Scichilone N tra i collaboratori

Subjects
Male, asthma, serious events, fluticasone, salmeterol, AUSTRI, Exacerbation, Intention to Treat Analysi, INHALED CORTICOSTEROIDS, Severity of Illness Index, law.invention, 0302 clinical medicine, Randomized controlled trial, law, immune system diseases, Ús terapèutic, Broncodilatadors, 030212 general & internal medicine, Child, Fluticasone, RISK, ACTING BETA-AGONISTS, EXACERBATIONS, METAANALYSIS, MORTALITY, SAFETY, DEATH, FDA, Medicine (all), Hazard ratio, General Medicine, Bronchodilator agents, Middle Aged, Fluticasone-Salmeterol Drug Combination, Bronchodilator Agents, Intention to Treat Analysis, Anesthesia, Female, Salmeterol, medicine.drug, Human, Adult, medicine.medical_specialty, Adolescent, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Fluticasone propionate, 03 medical and health sciences, Double-Blind Method, Internal medicine, Administration, Inhalation, medicine, Humans, Asma, Bronchodilator Agent, Asthma, Aged, Proportional Hazards Models, business.industry, Therapeutic use, medicine.disease, respiratory tract diseases, 030228 respiratory system, Fluticasone Propionate, Salmeterol Xinafoate Drug Combination, Proportional Hazards Model, business
Abstract

BACKGROUND The safe and appropriate use of long-acting beta-agonists (LABAs) for the treatment of asthma has been widely debated. In two large clinical trials, investigators found a potential risk of serious asthma-related events associated with LABAs. This study was designed to evaluate the risk of administering the LABA salmeterol in combination with an inhaled glucocorticoid, fluticasone propionate. METHODS In this multicenter, randomized, double-blind trial, adolescent and adult patients (age, ≥12 years) with persistent asthma were assigned to receive either fluticasone with salmeterol or fluticasone alone for 26 weeks. All the patients had a history of a severe asthma exacerbation in the year before randomization but not during the previous month. Patients were excluded from the trial if they had a history of lifethreatening or unstable asthma. The primary safety end point was the first serious asthma-related event (death, endotracheal intubation, or hospitalization). Noninferiority of fluticasone–salmeterol to fluticasone alone was defined as an upper boundary of the 95% confidence interval for the risk of the primary safety end point of less than 2.0. The efficacy end point was the first severe asthma exacerbation. RESULTS Of 11,679 patients who were enrolled, 67 had 74 serious asthma-related events, with 36 events in 34 patients in the fluticasone–salmeterol group and 38 events in 33 patients in the fluticasone-only group. The hazard ratio for a serious asthmarelated event in the fluticasone–salmeterol group was 1.03 (95% confidence interval [CI], 0.64 to 1.66), and noninferiority was achieved (P = 0.003). There were no asthma-related deaths; 2 patients in the fluticasone-only group underwent asthmarelated intubation. The risk of a severe asthma exacerbation was 21% lower in the fluticasone–salmeterol group than in the fluticasone-only group (hazard ratio, 0.79; 95% CI, 0.70 to 0.89), with at least one severe asthma exacerbation occurring in 480 of 5834 patients (8%) in the fluticasone–salmeterol group, as compared with 597 of 5845 patients (10%) in the fluticasone-only group (P

Published
2016

5. Efficacy of oral amantadine among patients hospitalised with COVID-19: A randomised, double-blind, placebo-controlled, multicentre study.

Author

Barczyk A, Czajkowska-Malinowska M, Farnik M, Barczyk M, Boda Ł, Cofta S, Duława J, Dyrbuś M, Harat R, Huk M, Kotecka S, Nahorecki A, Nasiłowski J, Naumnik W, Przybylski G, Słaboń-Willand M, Skoczyński S, Wita K, Zioło G, and Kuna P

Subjects
Humans, Male, Middle Aged, Female, SARS-CoV-2, Double-Blind Method, Patients, Amantadine therapeutic use, Treatment Outcome, COVID-19
Abstract

Background: Amantadine has been proposed as a treatment for COVID-19 because it shows anti-SARS-CoV-2 activity in vitro. However, to date, no controlled study has assessed the safety and efficacy of amantadine in COVID-19., Research Question: Whether amantadine is effective and safe among patients with different COVID-19 severity classifications., Study Design: and Methods: This was multi-centre, randomised, placebo-controlled study.Patients with oxygen saturation ≤94% and no need for high-flow oxygen or ventilatory support were randomly allocated to receive oral amantadine or placebo (1:1) for 10 days in addition to standard care. The primary endpoint was time to recovery assessed over 28 days since randomisation, defined as discharge from hospital or no need for supplemental oxygen., Results: The study was terminated early due to a lack of efficacy after an interim analysis. Final data from 95 patients who received amantadine (mean age, 60.2 years; 65% male; 66% with comorbidities) and 91 patients who received placebo (mean age, 55.8 years; 60% male; 68% with comorbidities) were obtained. The median (95% CI) time to recovery was 10 days both in the amantadine (9-11) and placebo arms (8-11; subhazard ratio = 0.94 [95%CI 0.7-1.3]). The percentage of deaths and percentage of patients who required intensive care at 14 and 28 days did not significantly differ between the amantadine and placebo groups., Interpretation: Adding amantadine to standard care in patients hospitalised with COVID-19 did not increase the likelihood of recovery., Clinical Trial Registration: ClinicalTrials.gov; No.: NCT04952519; www., Clinicaltrials: gov., (Copyright © 2023. Published by Elsevier Ltd.)

Published
2023
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6. Prospective, population-based surveillance of the burden of Streptococcus pneumoniae in community-acquired pneumonia in older adults, Chrzanów County, Poland, 2010 to 2012.

Author

Harat R, Alexander R, Gray S, Gutterman EM, Pluta J, Pride M, Shite S, Fijolek J, and Kozub J

Subjects
Aged, Aged, 80 and over, Community-Acquired Infections diagnosis, Community-Acquired Infections microbiology, Female, Humans, Incidence, Lung diagnostic imaging, Male, Middle Aged, Pneumonia, Pneumococcal diagnosis, Pneumonia, Pneumococcal microbiology, Poland epidemiology, Prospective Studies, Radiography, Serogroup, Sputum microbiology, Streptococcus pneumoniae isolation & purification, Urine microbiology, Community-Acquired Infections epidemiology, Cost of Illness, Pneumonia, Pneumococcal epidemiology, Population Surveillance
Abstract

Introduction: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest x-ray-confirmed CAP (CXR+CAP), S pneumonia- positive CAP, S pneumonia-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland., Material and Methods: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest x-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumonia-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures., Results: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumonia-positive CAP, and S. pneumonia-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6)., Conclusions: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines.

Published
2016
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7. A retrospective study of hospitalized pneumonia in two Polish counties (2006-2008).

Author

Harat R, Górny G, Jorgensen L, Pluta J, Gray S, Dartois N, Ye J, and Gutterman EM

Subjects
Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Causality, Child, Child, Preschool, Comorbidity, Diagnosis-Related Groups statistics & numerical data, Female, Hospital Mortality, Humans, Incidence, Infant, Infant, Newborn, Male, Middle Aged, Odds Ratio, Pneumonia mortality, Poland, Respiratory Insufficiency epidemiology, Respiratory Insufficiency therapy, Retrospective Studies, Hospitalization statistics & numerical data, Pneumonia epidemiology, Pneumonia therapy
Abstract

Introduction: In Poland, multi-cause pneumonia is not well characterized, and there is limited pneumococcal vaccination in the youngest and oldest age groups. The goal of this study was to assess hospitalized pneumonia across all age groups in two Polish counties., Material and Methods: Using electronic administrative databases, cases were identified as county residents hospitalized at Chrzanów and Inowrocław County Hospitals from 2006-2008, assigned a diagnosis of pneumonia. Calculations by admission year, sex, and age category were: hospitalization rates per 1000 persons; in-hospital mortality rates per 100 persons; and median length of stay (LOS)., Results: There were 1444 and 2956 hospitalizations for new episodes of pneumonia with rates of 3.76 (95% confidence interval [CI] 3.57-3.96) and 5.99 (95% CI 5.77-6.21) per 1000 persons in Chrzanów and Inowrocław counties, respectively. In combined data, the highest hospitalization rate was among patients aged 0-4 years (30.77; 95% CI 29.06-32.55) followed by those aged ≥ 75 years (25.39; 95% CI 24.01-26.83). In-hospital mortality rates increased with age at both sites. The median LOS was 8 days., Conclusions: Pneumonia hospitalizations were substantial, especially for the youngest and oldest age groups. Future public health interventions aimed at these age groups might improve disease outlook.

Published
2013

8. [Effects of biomass combustion and occupational exposures on lung function in random population sample of Malopolska inhabitants].

Author

Mejza F, Nastałek P, Skucha W, Harat R, and Niżankowska-Mogilnicka E

Subjects
Adult, Air Pollutants, Occupational adverse effects, Biomass, Coal, Environmental Monitoring, Female, Humans, Male, Poland epidemiology, Pulmonary Disease, Chronic Obstructive epidemiology, Respiratory Function Tests statistics & numerical data, Spirometry statistics & numerical data, Wood, Air Pollutants adverse effects, Air Pollution, Indoor adverse effects, Inhalation Exposure adverse effects, Occupational Exposure adverse effects, Pulmonary Disease, Chronic Obstructive etiology, Smoke adverse effects
Abstract

Introduction: Risk factors other than tobacco smoking contribute to about 20% of chronic obstructive pulmonary disease cases. Exposure to these risk factors and their influence on lung function has not been adequately studied in the population of Malopolska., Material and Methods: In random population sample of adults at least forty years old, residents of 2 districts of Malopolska, data on exposure to known and probable respiratory risk factors were collected using questionnaire. All subjects without contraindications performed pre- and post-bronchodilatator spirometry., Results: We analyzed data from 618 subjects; 94,8% subjects lived for longer than 6 months in a dwelling where stove using coal or wood has been used for cooking and/or heating. At the time of study as many as 32.5% subjects were still using coal or wood for cooking or heating. Coal or wood were used as fuel on average for more than 30 years; 67% of subjects have ever worked in professions carrying a risk of exposure to potential respiratory risk factors. We have identified an independent relationship of farming with lower FEV1/FVC values as well as increased chronic obstructive pulmonary disease risk., Conclusions: Significant proportion of Malopolska inhabitants has been exposed to risks associated with cooking or heating with coal or wood. In the studied population farming was related to increased risk of chronic obstructive respiratory disease.

Published
2012

9. Prevalence of COPD and tobacco smoking in Malopolska region--results from the BOLD study in Poland.

Author

Nizankowska-Mogilnicka E, Mejza F, Buist AS, Vollmer WM, Skucha W, Harat R, Pajak A, Gasowski J, Frey J, Nastalek P, Twardowska M, Janicka J, and Szczeklik A

Subjects
Adult, Aged, Bronchodilator Agents, Female, Humans, Male, Middle Aged, Poland epidemiology, Prevalence, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive etiology, Risk Factors, Sampling Studies, Smoking adverse effects, Spirometry, Surveys and Questionnaires, Pulmonary Disease, Chronic Obstructive epidemiology, Smoking epidemiology
Abstract

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-bronchodilator 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 > or = 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.

Published
2007

10. [Transthoracic fine-needle lung biopsy with linear transducer and bioptic channel monitored ultrasonographically].

Author

Kowalski J, Harat R, Pawlicki L, Irzmański R, and Cegliński T

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Transducers, Ultrasonography, Biopsy, Fine-Needle instrumentation, Biopsy, Fine-Needle methods, Lung diagnostic imaging, Lung pathology
Abstract

From 1999 to 2002 81 transthoracic fine-needle lung biopsies (TFNB) were performed with use of linear transducer (3.5 MHz) and bioptic channel, monitored ultrasonographically. The procedure was applied in 70 patients with peripheral lesions on chest X-ray or CT, which needed histopathological examination. Our study showed that linear transducer with bioptic channel is useful in monitoring needle path and material aspiration during transthoracic fine-needle biopsy. Application of this equipment makes the procedure safe for patients and the percentage of observed complications is low. Specificity and sensitivity of the procedure is comparable to other imaging techniques.

Published
2004

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