Surfactant protein a polymorphism is associated with susceptibility to chronic obstructive pulmonary disease in Chinese Uighur population.

J Huazhong Univ Sci Technolog Med Sci. 2012 Apr;32(2):186-9

Authors: Guan J, Liu X, Xie J, Xu X, Luo S, Wang R, Xu Y

Abstract
This study investigated the correlation between surfactant protein-A (SP-A) polymorphism and the susceptibility of chronic obstructive pulmonary disease (COPD) in Xinjiang Uighurs. Genomic DNA was extracted from peripheral blood of 194 COPD smokers and 201 healthy smokers of Uighur who were hospitalized in or paid a visit to one of the four Xinjiang-based hospitals involved in the study, from March 2009 to December 2010. Single nucleotide polymorphisms (SNPs) were studied at aa62 (CCA/CCG rs1136451) and aa219 (CGG/TGG, rs4253527) in SP-A. Genotypes were determined by using the TaqMan polymerase chain reaction (PCR). Our results showed that genotype frequencies were different between the COPD and normal smokers in aa62 (x (2)=6.852, P=0.033). There were also significant differences in allele genotype frequencies between the COPD and the control and allele G might decrease the risk COPD (x (2)=6.545, P=0.011; OR=0.663; 95% CI: 0.484-0.909). The result suggested that polymorphism of aa62 (CCA/CCG, rs1136451) of SP-A may be associated with the susceptibility to COPD in Xinjiang Uighurs.

PMID: 22528218 [PubMed - in process]

Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease.

CMAJ. 2012 Apr 23;

Authors: Rocker G, Young J, Donahue M, Farquhar M, Simpson C

Abstract
BACKGROUND:A recent national practice guideline recommends the use of opioids for the treatment of refractory dyspnea in patients with advanced chronic obstructive pulmonary disease (COPD). We conducted two qualitative studies to explore the experiences of patients and family caregivers with opioids for refractoryCOPD-related dyspnea and the perspectives and attitudes of physicians toward opioids in this context. METHODS:Patients (n = 8; 5 men, 3 women), their caregivers (n = 12; 5 men, 7 women) and physicians (n = 28, 17 men, 11 women) in Nova Scotia participated in the studies. Semi-structured interviews were recorded, transcribed verbatim, coded conceptually and analyzed for emergent themes using interpretive description methodology. RESULTS:Patients reported that opioids provided a sense of calm and relief from severe dyspnea. Family caregivers felt that opioids helped patients to breathe more "normally," observed improvements in patients' symptoms of anxiety and depression, and experienced reductions in their own stress. Patients reported substantial improvements in their quality of life. All patients and family caregivers wanted opioid therapy to continue. Most physicians were reluctant to prescribe opioids for refractory dyspnea, describing a lack of related knowledge and experience, and fears related to the potential adverse effects and legal censure. INTERPRETATION:Discrepancies between the positive experiences of patients and family caregivers with opioids and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care. Bridging this gap will require initiatives to improve the uptake of practice guidelines and to increase confidence in prescribing opioids for dyspnea refractory to conventional treatment.

PMID: 22529167 [PubMed - as supplied by publisher]

Pain in people with chronic obstructive pulmonary disease (COPD).

Respir Med. 2012 Apr 22;

Authors: Hajghanbari B, Holsti L, Road JD, Darlene Reid W

Abstract
INTRODUCTION: The prevalence and characteristics of pain are not known in COPD patients. The purposes of this study were to determine if pain is more common in COPD patients than in healthy people and if it was related to self-reported physical activity, health related quality of life (HRQoL) and comorbidities. METHODS: Participants returned a mailed survey package that contained: 1) McGill Pain Questionnaire (MPQ) and Brief Pain Inventory (BPI) to evaluate pain severity and how pain interferes with activities; 2) Tampa Scale for Kinesiophobia (TSK) to evaluate fear of movement related to pain; 3) Short Form-36 (SF-36), to measure HRQoL; 4) Community Health Activities Model Program for Seniors (CHAMPS) to evaluate physical activity; 5) a form to list medications and comorbidities. RESULTS: Forty-seven COPD patients and 47 age- and gender-matched healthy people responded. People with COPD demonstrated more pain (MPQ and BPI, p = 0.000), a greater pain-related interference in their lives (BPI, p = 0.000), a higher pain-related fear of movement, and lower frequency and energy expenditure of physical activities (CHAMPS, p = 0.000) than healthy people (TSK, p < 0.001). Pain severity (MPQ and BPI) was indirectly correlated to the Physical Component Score of the SF-36. COPD patients identified pain in the neck and trunk 3.1 times more often than healthy people. The number of comorbidities was the most consistent independent correlate of pain in COPD patients. CONCLUSIONS: COPD patients demonstrate more pain which interferes with activities more so than healthy people of similar age. Pain is also negatively associated with HRQoL in COPD.

PMID: 22531146 [PubMed - as supplied by publisher]

Publication year: 2012
Source:Revue des Maladies Respiratoires, Volume 29, Issue 4

Y. Douadi, C. Dayen, S. Lachkar, C. Fournier, L. Thiberville, P. Ramon, G. François, V. Jounieaux

L’échoendoscopie endobronchique est une technique qui permet à un endoscopiste confirmé de ponctionner les adénopathies médiastinales et/ou hilaires afin de réaliser un diagnostic et/ou un staging complet sans recours à un acte chirurgical. Si elle a vu le jour dans le début des années 2000, ce n’est que depuis quelques années qu’elle s’est développée réellement en France. Il s’agit d’un matériel onéreux, fragile et d’une haute technicité. Il a donc fallu adapter cette technique aux spécificités et contraintes du système de santé français : anatomopathologie, accès à l’anesthésie, imagerie, formation, coût du matériel, cotation. Les premiers centres à avoir été dotés de cette technique ont dû s’adapter rapidement et se créer leur propre expérience sur la technique. Des séminaires de formation ont été réalisés afin de transmettre cette expérience. Après ces quelques années, il semblait logique de faire le point sur cette technique en tenant compte des spécificités françaises et de transmettre ainsi l’expérience accumulée. Dans cet article, les auteurs proposent une revue de la littérature en abordant tous les aspects essentiels pour pouvoir débuter cette technique dans les meilleures conditions dans une structure de santé française. Endobronchial ultrasound (EBUS) is a technique which allows the endoscopist to sample mediastinal and/or hilar lymph nodes for complete staging of thoracic malignancy without recourse to surgery. Originally developed at the beginning of the 21st century, EBUS has become a well developed practice within France in recent years. As the technique requires high tech, expensive and fragile equipment, it has been important to develop an approach that is appropriate for the specific features and constraints of the French health system, including access to anaesthesia, imaging modalities and costing. The first centers to adopt EBUS had to adapt quickly and develop their own practices for its use. Training seminars were carried out in order to pass on this experience. After the passage of several years, it seems helpful to give a progress report on this technique through the stages of its development, taking account of the specificities of the French system and thus to transmit this accumulated experience. In this article, the authors review the literature concerning all the essential aspects needed to apply this technique under the best conditions in the French health system.