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The prevalence of chronic obstructive pulmonary disease (COPD) in females has increased, changing the concept of COPD as a disease mostly limited to males. In this study, the clinical characteristics of COPD in females were investigated.
The study was based on a multicenter cohort of COPD patients recruited from 54 medical centers in South Korea. Sex-based differences in general characteristics, exposure risk factors, depression scores, results of pulmonary function tests, COPD exacerbation, symptom scores, and radiologic findings were evaluated. Sex-related differences in the annual FEV
change over 5 years were analyzed in a linear mixed model.
Of the 2515 patients enrolled in this study, 8.1% were female. Female patients who had a higher BMI and a lower level of education were less likely to be smokers, were more exposed to passive smoking/biomass, and were more depressed compared to males. The rates of bronchiectasis, previous childhood respiratory infection, and asthma were higher in females. Female patients also had more symptoms and a poorer exercise capacity than males, but no significant differences were observed in terms of exacerbations. Radiologic findings revealed that male patients had worse emphysema, and female patients had worse bronchiectasis, as determined based on chest X-ray and computed tomography findings. Neuronal Signaling agonist On pulmonary function tests, female patients had less obstruction and less annual FEV
loss over 5 years.
This study revealed differences in the clinical parameters between male and female patients with COPD, including general characteristics, disease characteristics, and clinical outcomes.
This study revealed differences in the clinical parameters between male and female patients with COPD, including general characteristics, disease characteristics, and clinical outcomes.
COPD exacerbations occur more frequently with disease progression and are associated with worse prognosis and higher healthcare expenditure.
To utilize a networked system, optimized with statistical process control (SPC), for remote patient monitoring (RPM) and to identify potential predictors of COPD exacerbations.
Seventeen subjects, mean (SD) age of 69.7 (7.2) years, with moderate to severe COPD received RPM. Over 2618 patient-days (7.17 patient-years) of monitoring, we obtained daily symptom scores, treatment adherence, self-reported activity levels, daily spirometry (SVC, FEV
, FVC, PEF), inspiratory capacity (IC), and oxygenation (SpO
). These data were used to identify predictors of exacerbations defined using Anthonisen and other criteria.
After implementation of SPC, concordance analysis showed substantial agreement between FVC (decrease below the 7-day rolling average minus 1.645 SD) and self-reported healthcare utilization events (κ=0.747, P<0.001) as well as between increased use of ironchodilators and fall in oxygen saturation. An RPM program that captures these parameters may be used to guide appropriate interventions aimed at reducing healthcare utilization in COPD patients.
The associations of high-density lipoprotein cholesterol (HDL-C) with mortality are still unclear. We explored the associations of HDL-C with all-cause and cause-specific mortality in an adult population.
Deaths were classified into all-cause, cardiovascular, and cancer mortality. Survival curve, multivariate Cox regression, and subgroup analyses were conducted, and hazard ratio (HR) and 95% confidence interval (CI) were performed. We fitted Cox regression models for all-cause, cardiovascular, and cancer mortality to evaluate their associations with categories of HDL-C (≤30, 31-40, 41-50, 51-60 [reference], 61-70, >70 mg/dL).
A total of 42,145 (20,415 (48.44%) males, mean age 47.12±19.40 years) subjects were enrolled. At an average follow-up of 97.52±54.03 months, all-cause, cardiovascular, and cancer mortality numbers were 5,061 (12.01), 1,081 (2.56%), and 1,061 (2.52%), respectively. When compared with the reference group (HDL-C 51-60 mg/dL), a U-shaped association was apparent for all-cause mortality, with elevated risk in participants with the lowest (≤30 mg/dL) (HR=1.33; 95% CI=1.14- 1.56) and highest (>70 mg/dL) (HR=1.14; 95% CI=1.02-1.27) HDL-C concentration. Associations for cardiovascular and cancer mortality were non-linear. An elevated risk for cancer mortality was observed in those with the highest HDL-C concentration (HR=1.06; 95% CI-0.84-1.34) compared with the reference group, although it was not statistically significant. The effect of HDL-C on mortality was adjusted by some traditional risk factors including age, gender, race, or comorbidities.
A U-shaped association was observed between HDL-C and all-cause mortality among an adult population.
A U-shaped association was observed between HDL-C and all-cause mortality among an adult population.
Older adults experience challenges employing technology in their health-care management due to changes in cognitive and physical functions. This study aimed to investigate the acceptance of technology among older Korean adults with multiple chronic health conditions and examine factors associated with technology acceptance, adopting the senior technology acceptance model (STAM).
In total, 226 community-dwelling older adults with more than two chronic conditions participated in this study. We conducted a survey that covered demographics, gerontechnology self-efficacy, gerontechnology anxiety, facilitating conditions, self-reported health conditions, cognitive ability, social relationships, attitude toward life and satisfaction, physical functioning, and technology acceptance.
Older Korean adults with multiple chronic health conditions scored moderately high for technology acceptance (25.36±5.28). There were significant differences in technology acceptance according to age (r=-0.241), cognitive ability (r=0.225), gerontechnology self-efficacy (r=0.323), and facilitating conditions (r=0.288). Only age and education were significant factors predicting technology acceptance (Adjusted R
=0.151, p<0.001).
Although older Korean adults with multiple chronic conditions displayed good technology acceptance, their age and education level predicted the level of acceptance. Given that some components of the STAM model have social and cultural relevance, it is necessary to conduct research across various cultures to better understand technology acceptance by older adults.
Although older Korean adults with multiple chronic conditions displayed good technology acceptance, their age and education level predicted the level of acceptance. Given that some components of the STAM model have social and cultural relevance, it is necessary to conduct research across various cultures to better understand technology acceptance by older adults.