Objective: To analyze the case characteristics of Chronic obstructive pulmonary disease caused by occupational irritant chemicals (OI-COPD). To provide basis for revising its diagnostic criteria. Methods: From June to December 2021, we investigated the information of OI-COPD patients confirmed by Shandong Institute of Occupational Health and Prevention of Occupational Diseases, Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Control, Qingdao Central Hospital affiliated to Qingdao University and other diagnostic institutions in the past five years, a total of 41 cases. The basic information of OI-COPD cases, occupational risk factors exposure information, medical history, smoking history and clinical symptoms were analyzed retrospectively. The measurement data were tested for normal distribution, which was described by x±s, and compared between groups by t test; Those who do not conform to the normal distribution are described by the median [M (Q(1), Q(3)) ] and analyzed by nonparametric test; The counting data were expressed in frequency and rate (% ), and the comparison between groups was tested. Results: Of the 41 cases, 33 were male and 8 were female. The age of the patient diagnosed with OI-COPD was (49.5±10.3) years old, and the minimum age was 30 years old; Among them, 8 patients had a definite long-term smoking history (more than 5 years) ; The exposure duration of occupational risk factors was (18.6±10.3) years, of which 3 patients had exposure duration of less than 5 years; The occupational risk factors leading to OI-COPD include acids and acid-forming compounds, bases, aldehydes, nitrogen oxides, chlorine and its compounds, etc. The exposure level of occupational risk factors is related to the degree of COPD airflow restriction (χ(2)=6.17, P <0.05). 18 patients with diagnosis age <50 years old were diagnosed as early-onset COPD. The incidence of respiratory symptoms in the early diagnosis COPD group was lower than that in the non-early diagnosis COPD group, and the FEV1% pred was significantly higher than that in the non-early diagnosis COPD group. The difference was statistically significant (P<0.01 ) . Conclusion: The exposure level of occupational risk factors may be the risk factor affecting the degree of COPD airflow restriction. With the increase of the exposure level of COPD patients, the proportion of respiratory symptoms will also increase accordingly.
Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; China/epidemiology* ; Pulmonary Disease, Chronic Obstructive/diagnosis* ; Lung ; Risk Factors ; Occupational Diseases/diagnosis* ; Occupational Exposure/adverse effects*

Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable chronic airway disease characterized by persistent airflow restriction and associated respiratory symptoms. COPD is the main cause of morbidity and mortality of chronic diseases and one of the top three causes of death in the world. The prevalence of COPD among provinces in China are at a high levels for years. The prevalence of COPD varies from country to country, region to region, and population to population, and the incidence and development of COPD are influenced by multi risk factors, including individual genetic factors, age, sex, body mass index, abdominal obesity and physical activity and environment factors, such as smoking, indoor and outdoor air pollution, and occupational exposure.
Air Pollution/adverse effects* ; Asthma/epidemiology* ; Humans ; Prevalence ; Pulmonary Disease, Chronic Obstructive/diagnosis* ; Risk Factors

Artificial Intelligence ; Humans ; Pulmonary Disease, Chronic Obstructive/diagnosis*

This study was to design a chronic obstructive pulmonary disease (COPD) screening equipment, based on the dual-differential pressure throttling technique. The technique combined a wide range, but low-resolution ratio sensor and a narrow range, but high-resolution ratio one. It can accurately detect the indexes of forced vital capacity (FVC), forced expiratory volume in one second (FEV), one second rate(FEV/FVC (%)), and achieve them in a low-cost way. The new designed machine will be compared with a British machine, named ML-3500. The correlations of FVC and FEV between new machine and ML-3500 were 0.998 and 0.999, respectively. The P values of paired test of these two indexes were over 0.05. Bland-Altman analysis of FVC, FEV and FEV/FVC (%) showed that more than 90% of the scatter points of the three parameters fell within the consistency interval. This machine can be used to accurately screen COPD and its low-cost would be advantage to promote in large population.
Forced Expiratory Volume ; Humans ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; Reproducibility of Results ; Respiratory Function Tests ; economics ; instrumentation ; Tidal Volume ; Vital Capacity

BACKGROUND: Although routine screening of carcinoembryonic antigen (CEA) is not recommended for the early diagnosis of colorectal cancers, CEA levels are frequently measured in practice and during opportunistic health screening programs. We evaluated the frequency of false-positive results according to CEA level at a health screening center. METHODS: The medical records of 25,786 participants who underwent a general health check-up and CEA testing at the Seoul National University Hospital Healthcare System Gangnam Center from March 2015 to February 2016 were reviewed. CEA levels were measured using the Architect i2000sr (Abbott Laboratories, USA). The cut-off level for elevated CEA was 5.0 ng/mL. RESULTS: Among 25,786 participants who underwent CEA screening, 597 (2.3%) had CEA levels >5.0 ng/mL. Among 597 participants with elevated CEA levels, 12 (2.0%) had actual malignancies with CEA levels of 8.3–155.3 ng/mL. Diabetes, smoking, chronic obstructive pulmonary disease, and colonic polyps were considered as causes of false elevation. The false-positive rates of CEA according to level were as follows: 5.1–10.0 ng/mL, 99.5%; 10.1–15.0 ng/mL, 87.2%; 15.1–20.0 ng/mL, 100.0%; >20.0 ng/mL, 33.3%. A subsequent decrease in the CEA level after a 1-month follow-up was observed in 47.6% of all cases with elevated CEA levels. CONCLUSIONS: False elevation in CEA levels in the range of 5.0–20.0 ng/mL is common in patients who underwent testing at a health screening center. False-positive results above 20.0 ng/mL are less common. These data could provide a guide for the interpretation of elevated CEA level at a health screening center.
Biomarkers ; Carcinoembryonic Antigen ; Colonic Polyps ; Colorectal Neoplasms ; Delivery of Health Care ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mass Screening ; Medical Records ; Pulmonary Disease, Chronic Obstructive ; Seoul ; Smoke ; Smoking

BACKGROUND: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. METHODS: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). RESULTS: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6–13] days vs. 8 [6–12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. CONCLUSION: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.
Diagnosis ; Diagnosis, Differential ; Disease Progression ; Hospitalization ; Humans ; Insurance, Health ; Intensive Care Units ; Length of Stay ; Propensity Score ; Pulmonary Disease, Chronic Obstructive ; Tomography, X-Ray Computed

OBJECTIVE: Few studies have prospectively evaluated the diagnostic accuracy and temporal impact of ultrasound in the emergency department (ED) in a randomized manner. In this study, we aimed to perform a randomized, standard therapy controlled evaluation of the diagnostic accuracy and temporal impact of a standardized ultrasound strategy, versus standard care, in patients presenting to the ED with acute dyspnea.METHODS: The patients underwent a standardized ultrasound examination that was blinded to the team caring for the patient. Ultrasound results remained blinded in patients randomized to the treating team but were unblinded in the interventional cohort. Scans were performed by trained emergency physicians. The gold standard diagnosis (GSDx) was determined by two physicians blinded to the ultrasound results. The same two physicians reviewed all data >30 days after the index visit.RESULTS: Fifty-nine randomized patients were enrolled. The mean±standard deviation age was 54.4±11 years, and 37 (62%) were male. The most common GSDx was acute heart failure with reduced ejection fraction in 13 (28.3%) patients and airway diseases such as acute exacerbation of asthma or chronic obstructive pulmonary disease in 10 (21.7%). ED diagnostic accuracy, as compared to the GSDx, was 76% in the ultrasound cohort and 79% in the standard care cohort (P=0.796). Compared with the standard care cohort, the final diagnosis was obtained much faster in the ultrasound cohort (mean±standard deviation: 12±3.2 minutes vs. 270 minutes, P<0.001).CONCLUSION: A standardized ultrasound approach is equally accurate, but enables faster ED diagnosis of acute dyspnea than standard care.
Asthma ; Cohort Studies ; Diagnosis ; Diagnostic Imaging ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Heart Failure ; Humans ; Male ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Ultrasonography

BACKGROUND: Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS. METHODS: This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted. RESULTS: A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p < 0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD. CONCLUSION: Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.
Asthma ; Body Mass Index ; Bone Density ; Cross-Sectional Studies ; Diagnosis ; Female ; Humans ; Lung Diseases, Obstructive ; Osteoporosis ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking

PURPOSE: The purpose of the present study is to examine risk factors for unawareness of obstructive airflow limitation among adults with chronic obstructive pulmonary disease. METHODS: Secondary data analysis was performed with the data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES; 2013–2014). The data were analyzed with the IBM SPSS 22.0 version using frequency, percentage, odds ratio, and logistic regression. RESULTS: Ninety-eight percent of subject with a pulmonary function test score of FEV1/FVC < 0.7 (N=833) did not recognize that their lung function was impaired. The heavy drink, absence of tuberculosis or asthma diagnosis, and no symptom of expelling phlegm were identified as major risk factors for unawareness of airflow limitation. CONCLUSION: In order to increase awareness of airflow limitation and to prevent the worsening of the condition, the pulmonary function screening test should be provided to community residents including those who do not show symptoms of respiratory illness.
Adult ; Asthma ; Diagnosis ; Humans ; Korea ; Logistic Models ; Lung ; Lung Diseases ; Mass Screening ; Nutrition Surveys ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Statistics as Topic ; Tuberculosis

Sarcopenia was listed in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) as M62.84, on October 1, 2016. Sarcopenia is primarily associated with metabolic diseases, such as diabetes, obesity, and cachexia, as well as chronic renal failure, congestive heart failure, and chronic obstructive pulmonary disease. Sarcopenia is also significantly associated with osteoporosis in elderly populations and the combined disease is defined as osteosarcopenia. Several studies have confirmed that sarcopenia and osteoporosis (osteosarcopenia) share common risk factors and biological pathways. Osteosarcopenia is associated with significant physical disability, representing a significant threat to the loss of independence in later life. However, the pathophysiology and diagnosis of osteosarcopenia are not fully defined. Additionally, pharmacologic and hormonal treatments for sarcopenia are undergoing clinical trials. This review summarizes the epidemiology, pathophysiology, diagnosis, and treatment of osteosarcopenia, and includes Korean data.
Aged ; Cachexia ; Diagnosis ; Epidemiology ; Heart Failure ; Humans ; International Classification of Diseases ; Kidney Failure, Chronic ; Korea ; Metabolic Diseases ; Obesity ; Osteoporosis ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Sarcopenia