Browsing by Subject "COPD"
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Item Chronic Obstructive Pulmonary Disease and You(2008-04-07) Williams, JonathanChronic Obstructive Pulmonary Disease (COPD) is a common disease amongst smokers with a 60 or more pack-year history of smoking. This document was created to help patients understand some basic information about the disease and the basics of medical treatment for this disease.Item COPD (Chronic Obstructive Pulmonary Disease) - what is it and what can I do about it?(2012-07-23) Fier, RyanItem Extreme weather and mortality among a nationwide cohort of Veterans with COPD(2023) Rau, AustinClimate change is increasing the frequency, severity and duration of extreme weather events. Individuals with climate sensitive diseases such as chronic respiratory diseases are at an enhanced risk of health challenges due to climate change. However, there is a lack of individual level studies examining how extreme weather events such as heat and cold waves may increase the risk of mortality among individuals with chronic obstructive pulmonary disease (COPD), a climate sensitive respiratory disease. Using nationwide individual level health data from the Veterans Health Administration, three studies were designed to estimate heat and cold wave associated mortality risk among this susceptible population.The first study evaluated heat and cold wave mortality risk among the entire population of patients with COPD and examined health disparities by individual characteristics including gender, age, race and ethnicity. Results indicated cisgender females had an increased heatwave associated mortality risk. While some racial disparities in mortality risk were detected, the evidence was weak. The second study further examined disparities in heat and cold wave associated mortality via less commonly studied effect measure modifiers including comorbidities, smoking status and urbanicity. Patients with concurrent COPD and asthma had a greater risk of heatwave related mortality whereas patients with COPD alone had the greatest cold wave associated mortality risk. Smokers and patients living in urban settings had enhanced risk of both heat and cold wave related mortality. The third study assessed the added mortality risk incurred during compound climate hazards (droughts and heatwaves) among this susceptible population. Results indicated heatwaves that occurred during droughts had larger mortality risks compared to heatwaves during non-drought conditions. These three studies provide evidence that individuals with COPD are at risk of adverse health events from heat and cold waves and identified heterogeneities in risk based on characteristics including social, biological and geographical constructs. There is an apparent need in climate and health epidemiology for more large-scale individual level assessments of people with climate sensitive diseases. As contemporary impacts of climate change are realized, it is imperative to devote resources and energy into elucidating health risks associated with extreme weather events to identify and protect at-risk segments of the population.Item Flu shots prevent COPD related illness(2012-04-10) Beckman, JoanItem Healthy Lung Evaluation Prior to Surgery(2012-03-06) Abcejo, ArneyItem Microfabrication Approaches for Understanding the Role of Laminin Output in Extracellular Matrix Composition in Chronic Obstructive Pulmonary Disease(2019-07) Boysen, MichaelChronic obstructive pulmonary disease (COPD) is an umbrella term used to indicate chronic bronchitis, emphysema, or a mixture of the two. Affecting over 10 million people and currently the 4th leading cause of death in the United States, COPD is prevalent amongst many aging individuals, with the severity of symptoms worsening over time1. To date, there is very little knowledge of COPD mechanisms and treatment methods. A decrease in laminin production, a key component of extra cellular matrices (ECMs), has been correlated with a decrease in lung function. We aimed to study the potential of lung ECMs modified to output increased laminin, namely lama3 and lama4, to reset older lung ECM to a younger state. To achieve this, we utilized modified muscular thin films (MTFs) with human lung fibroblasts (HLFs) that we called pulmonary thin films (PTFs). Stress in the cell monolayer of the PTF due to contraction, one key measure of pulmonary tissue function, causes the construct to bend. From this, the resulting contractile force can be derived due to known mechanical properties of PDMS, thickness of PTFs, and the radius of the curved beam upon contraction. First, we used microcontact printing of the modified ECMs on the PTFs. Then, after experiencing difficulty seeding on the substrate using microcontact printing, we employed a microfluidic deposition method with genipin to increase ECM adherence to the polydimethylsiloxane (PDMS) substrate. While we were able to successfully fabricate, seed HLFs, and experiment on PTFs using fibronectin with both microcontact printing and the deposition method, we were unable to seed cells with the correct line pattern using either method. These results pushed us to try a different method to evaluate the force output of HLFs on our modified ECMs – Traction force microscopy (TFM). TFM utilizes experimentally observed ECM displacements via a fluorescent microbead laden substrate to calculate traction force vectors generated at the surface of a cell. Furthermore, force production is a key measure not only of HLF function, but pulmonary tissue function as well. We found that the HLF came in two different morphology categories – spindle and non-spindle. When analyzing data of both morphologies collectively, little was found with regards to the ECMs influence on cell force output. However, when analyzing the morphologies separately, the spindle morphology followed the trend hypothesized – the increased laminin output in older ECMs increased the traction force output of HLFs causing them to be statistically different from their nonmodified, old control comparison. To this end, our data suggested that increased laminin output displayed the potential to return normal, young function to old lung ECM and may be key in future therapy methods for combatting ailments suffered by patients with COPD.Item The Relationship Between Oral Health and Chronic Obstructive Pulmonary Disease Exacerbations(2019-05) Baldomero, ArianneIntroduction: Poor oral health has been implicated as an independent risk factor for the development of chronic obstructive pulmonary disease (COPD), but few studies have evaluated the association between oral health and COPD exacerbations. We aimed to determine if poor oral health is associated with COPD exacerbations and/or worse respiratory health. Methods: We performed a case-control study of oral health among COPD exacerbators and non-exacerbators. Cases (exacerbators) had experienced ≥1 exacerbation in the previous 12 months, while controls (non-exacerbators) had no exacerbations in the previous 24 months. We excluded those with <4 teeth. We evaluated the global oral health assessment, Oral Health Impact Profile (OHIP-5), dental symptoms/habits, and St. George’s Respiratory Questionnaire (SGRQ). In a subset, we performed blinded dental exams to measure bleeding on probing, probing depth, clinical attachment loss, periodontitis severity, plaque index, gingival index, and carries risk. We evaluated associations between oral health and COPD exacerbations using logistic regression. Linear regression was used to assess relationships between oral health and SGRQ scores. Results: Screened non-exacerbators (n=118) were significantly more likely to have <4 teeth, compared to screened exacerbators (n=100) (44% vs. 30% respectively; p=0.046). After excluding those with <4 teeth there were 70 cases and 66 controls. Self-reported oral health and objective dental exam measures did not vary significantly between cases vs. controls. However, the odds of severe COPD exacerbations requiring hospitalizations and/or emergency department visits trended higher in those with worse dental exam compared to those with better dental exam. Worse OHIP-5 was strongly associated with worse SGRQ scores. Conclusions: Oral health status was not related to COPD exacerbations, but was associated with self-reported respiratory health. Larger studies are needed to address oral health as a potential method to improve respiratory health in patients with COPD.Item Vitamin D status and longitudinal lung function decline in the Lung Health Study(2014-01) Kunisaki, KenLow vitamin D blood levels are postulated to be a risk factor for worse lung function, largely based on cross-sectional data. We sought to use longitudinal data to test the hypothesis that baseline plasma 25-hydroxyvitamin D [25(OH)D] is lower in subjects with more rapid lung function decline, compared to those with slow lung function decline. We conducted a nested, matched case-control study in the Lung Health Study 3 cohort. Cases and controls were continuous smokers with rapid and slow lung function decline, respectively, over approximately 6 years of follow-up. We compared baseline 25(OH)D levels between cases and controls, matching on date of blood draw and clinical center. Among 196 subjects, despite rapid and slow decliners experiencing strikingly and significantly different rates of decline of forced expiratory volume in one second (-152 vs. -0.3 mL/year; p<0.001), there was no significant difference in baseline 25(OH)D levels (25.0 vs. 25.9 ng/mL; p=0.54). There was a high prevalence of vitamin D insufficiency (35%) and deficiency (31%); only 4% had a normal 25(OH)D level in the winter. Although vitamin D insufficiency and deficiency are common among continuous smokers with established mild to moderate COPD, baseline 25(OH)D levels are not predictive of subsequent lung function decline.