Underdiagnosis, false diagnosis and treatment of COPD in a selected population in Northern Greece.

Background: In the primary care setting, diagnosis and treatment of COPD is not always consistent with GOLD guidelines.

Objectives: To calculate the prevalence of COPD underdiagnosis, false diagnosis and treatment in the general population of northern Greece.

Methods: Observational study in the context of an early COPD detection and smoking cessation project.

Comparison of Three Screening Questionnaires for Chronic Obstructive Pulmonary Disease in the Primary Care.

Background: Even though the diagnosis of chronic obstructive pulmonary disease (COPD) is easy and based mainly on spirometry and symptoms, the prevalence of underdiagnosis is extremely high. The use of simple screening tools (e.g.

Estimating the extent and economic impact of under and overdiagnosis of chronic obstructive pulmonary disease in primary care.

The aim of the present study was to estimate the frequency of under- and over-diagnosis as well as overtreatment and their impact on the financial burden of inhaled drugs for stable chronic obstructive pulmonary disease (COPD). We examined 3200 subjects (65.5% males) of the general population (>40 year old, current or former smokers, and asthma patients were excluded) during a 3-year period.

Evaluation of a Decision Support System for Obstructive Sleep Apnea with Nonlinear Analysis of Respiratory Signals.

Introduction: Obstructive Sleep Apnea (OSA) is a common sleep disorder requiring the time/money consuming polysomnography for diagnosis. Alternative methods for initial evaluation are sought. Our aim was the prediction of Apnea-Hypopnea Index (AHI) in patients potentially suffering from OSA based on nonlinear analysis of respiratory biosignals during sleep, a method that is related to the pathophysiology of the disorder.

Umeclidinium bromide/vilanterol combination in the treatment of chronic obstructive pulmonary disease: a review.

Chronic obstructive pulmonary disease (COPD) is a common disease among the elderly that could be prevented by smoking cessation. As it is characterized by airflow limitation that is not fully reversible, bronchodilator therapy is the first choice of treatment. Symptomatic COPD patients with or without risk for future exacerbations have a strong indication for the permanent use of long- and ultralong-acting β2-agonists and/or long-acting muscarinic antagonists.

Reference Equations for Static Lung Volumes and TL from a Population Sample in Northern Greece.

Background: The most commonly used reference equations for the measurement of static lung volumes/capacities and transfer factor of the lung for CO (TL) are based on studies around 30-40 years old with significant limitations. Objectives: Our aim was to (1) develop reference equations for static lung volumes and TL using the current American Thoracic Society/European Respiratory Society guidelines, and (2) compare the equations derived with those most commonly used. Methods: Healthy Caucasian subjects (234 males and 233 females) aged 18-91 years were recruited.

Exposure to PM10 as a risk factor for the development of nasal obstruction and chronic obstructive pulmonary disease.

Objectives: To investigate whether air pollution is a potential risk factor for airways obstruction.

Methods: A prospective cohort study (11.3 +/- 2.

COPD assessment test: a simple tool to evaluate disease severity and response to treatment.

The COPD assessment test (CAT) is a short questionnaire designed to assess the impairment in health status of COPD patients. We aimed to determine the change of the CAT in COPD patients after 1 year of treatment and test the association between the score and clinical and lung function variables. Methods A cohort of 111 newly diagnosed COPD patients in primary care was evaluated at baseline and one year after the implementation of the recommended treatment according to the Global Initiative for the management of COPD (GOLD).

Smoking among adolescents in Northern Greece: a large cross-sectional study about risk and preventive factors.

Background: The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents.

Methods: We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one.

Chest imaging and lung function impairment after long-term occupational exposure to low concentrations of chrysotile.

The aim of the present study was the investigation of radiographic findings in relation to lung function after occupational exposure to permissible levels of relatively pure chrysotile (0.5-3% amphiboles). We studied 266 out of the total 317 employees who have worked in an asbestos cement factory during the period 1968-2004 with chest x-ray, high-resolution computed tomography (HRCT) and lung function tests.

Diagnosis of chronic obstructive pulmonary disease in the primary care setting.

Chronic obstructive pulmonary disease (COPD) remains a major cause of morbidity and mortality with increasing rates during the last decades. Due to the progressive nature of the disease, underestimation of symptoms by the patients, lack of knowledge and underuse of spirometry by the Primary Care providers the disease remains under-diagnosed in about half of the cases. Patients with a smoking history of ≥20 pack-years and relevant symptoms (e.

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting.

Aims: To investigate the validity of the International Primary Care Airways Guidelines (IPAG) questionnaire and PiKo-6® (Ferraris Respiratory Europe Ltd.) flow meter as screening tools for diagnosing chronic obstructive pulmonary disease (COPD) in the primary care setting.

Methods: The first 50 patients in 25 general practice offices completed the IPAG questionnaire and underwent spirometry with the handheld PiKo-6® flow meter.

Anemia of chronic disease in chronic obstructive pulmonary disease: a case-control study of cardiopulmonary exercise responses.

Background: Anemia may be present in patients with chronic obstructive pulmonary disease (COPD) and further impair their functional capacity.

Objectives: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET).

Methods: ACD prevalence was assessed in 283 consecutive patients with stable COPD (263 males, 60 females; age 60.

Pulmonary rehabilitation in non-small cell lung cancer patients after completion of treatment.

Objectives: The functional status of patients with non-small cell lung cancer (NSCLC) is often limited not only by cancer itself, but also by the different types of treatment and by comorbidities [eg, chronic obstructive pulmonary disease (COPD), congestive heart failure]. The aim of this study was to investigate the utility of an inpatient multidisciplinary pulmonary rehabilitation (PR) program on pulmonary function and exercise capacity of patients with NSCLC after completion of their treatment.

Methods: Forty-seven patients with NSCLC underwent a PR program after completing cancer treatment.

Therapeutic pneumoperitoneum in a patient with pulmonary tuberculosis and persistent fever.

Artificial pneumoperitoneum represents a therapeutic technique first applied in the treatment of pulmonary tuberculosis (TB) in prechemotherapy antimycobacterial era. A 25-year-old patient presented with pulmonary TB diagnosed during the 8th month of her pregnancy. She was febrile and in severe clinical condition.

Interferon α-induced sarcoidosis to a patient with polycythemia vera.

Treatment with interferon (IFN) can precipitate a variety of inflammatory conditions, including sarcoidosis. Although many other systems can be affected, the clinical picture in this case mostly includes cutaneous and pulmonary symptoms. The prognosis is better than the idiopathic form of the disease, and the most effective treatment is considered the discontinuation of antivirus therapy alone or in combination with corticosteroid administration.

An unusual cause of spontaneous pneumothorax.

Bronchopulmonary sequestration is a congenital pulmonary malformation consisting of a non-functioning region of lung parenchyma that receives systemic arterial blood supply. The authors present the case of a 31-year-old male who presented with spontaneous pneumothorax as the initial clinical manifestation of an intralobar bronchopulmonary sequestration. There was a persistent air leak through the chest tube which remained in the pleural cavity for 12 days.

Iliopsoas tuberculous abscess associated with cervical and axillary tuberculous lymphadenopathy.

The authors report a case of iliopsoas tuberculous abscess without obvious spinal column involvement. Cervical and axillary tuberculous lymphadenopathy were also presented. Despite appropriate antituberculous treatment, patient required percutaneous drainage with CT-guided catheter insertion.

Assessment of respiratory mechanics by impulse oscillometry in orthopneic patients with acute left ventricular failure.

Background: This study investigated the respiratory function and mechanics of patients with orthopnea caused by acute left ventricular failure (ALVF).

Methods: The study comprised 40 patients with ALVF and 15 control subjects. All patients underwent lung function tests and impulse oscillometry in both sitting and supine positions.

Screening of patients with Obstructive Sleep Apnea Syndrome using C4.5 algorithm based on non linear analysis of respiratory signals during sleep.

Aim: To classify patients with possible diagnosis of Obstructive Sleep Apnea Syndrome (OSAS) into groups according to the severity of the disease using a decision tree producing algorithm based on nonlinear analysis of 3 respiratory signals instead of the use of full polysomnography.

Patients-methods: Eighty-six consecutive patients referred to the Sleep Unit of a Pulmonology Department underwent full polysomnography and their tests were manually scored. Three nonlinear indices (Largest Lyapunov Exponent-LLE, Detrended Fluctuation Analysis-DFA and Approximate Entropy-APEN) were extracted from two respiratory signals (nasal cannula flow-F and thoracic belt-T).

Pleural plaques in dentists from occupational asbestos exposure: a report of three cases.

Background: White asbestos (chrysotile) has been used in dentistry since 1930 when it was introduced as a lining material for casting rings.

Methods: All three patients presented with pleural plaques on chest X-rays as well as on CT-scans. They were working as dentists for 35-45 years.

Ameloblastoma of the mandible with pulmonary metastases 45 years after initial diagnosis.

Ameloblastoma of the mandible is a rare odontogenic tumour that rarely metastasizes. We report a patient with a slowly progressing ameloblastoma of the mandible diagnosed at the age of seven and resected multiple times due to tumour recurrence. Multiple pulmonary metastatic nodules were resected at thoracotomy 27 years after the initial diagnosis; however, further pulmonary disease was discovered.

Long-term prognosis of asthma is good--a 12-year follow-up study. Influence of treatment.

The number of studies on the prognosis of bronchial asthma (BA) is rather limited. The aim of the study was to determine the evolution of BA in a long-term 12-year follow-up and to investigate possible contributing factors. One hundred and sixty-three patients who visited the Out-patient Clinic for BA from 1989 to 1993 (Visit 1) were included in the study.