RESUMEN
OBJECTIVE: To determine distribution of COPD assessment categories and physicians' adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 strategy in Turkish COPD patients. METHODS: A total of 1,610 COPD patients (mean [standard deviation] age: 62.6 [9.9] years, 85.7% were males) were included in this multicenter, non-interventional, cross-sectional study. Patients were categorized via GOLD 2013 strategy document. Consistency between reported and re-classified GOLD categories, and measures used for symptom evaluation and exacerbation was analyzed. RESULTS: Overall, 41.1% of patients were assigned to GOLD A, while 13.2% were assigned to GOLD C categories. Long-acting beta-2 agonist + long-acting muscarinic antagonist + inhaled corticosteroid regimen was the most common treatment (62.0%). Over-treatment was noted in >70% of GOLD A, B, and C patients. A high consistency between measures of symptom evaluation (Kappa coefficient =0.993, P<0.0001) and a low-moderate consistency between exacerbation risk measures (Kappa coefficient =0.237, P<0.0001) were noted. CONCLUSION: Our findings revealed GOLD A as the most prevalent category in Turkish cohort of COPD patients. Group assignment was altered depending on the chosen measure for symptom and risk assessment. Physician non-adherence to treatment recommendations in GOLD 2013 document leading to over-treatment in patients assigned to GOLD A, B, and C categories was also detected.
Asunto(s)
Pulmón/fisiopatología , Pautas de la Práctica en Medicina , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Administración por Inhalación , Corticoesteroides/administración & dosificación , Agonistas de Receptores Adrenérgicos beta 2/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Broncodilatadores/administración & dosificación , Estudios Transversales , Progresión de la Enfermedad , Quimioterapia Combinada , Femenino , Adhesión a Directriz , Humanos , Pulmón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Antagonistas Muscarínicos/administración & dosificación , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Valor Predictivo de las Pruebas , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/clasificación , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Recuperación de la Función , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Turquía/epidemiologíaRESUMEN
Tracheobronchopathia osteochondroplastica (TO) is a rare and benign disorder of unknown cause affecting the large airways. It is characterized by the presence of multiple osseous and cartilaginous nodules in the submucosa of the trachea and main bronchi that is characterized by the progression of submucosal bone and/or cartilage including nodules through the lumen of trachea and bronchus. We present four cases that were diagnosed TO while investigating for the causes of hemoptysis and chronic cough. We plan to emphasize TO in differential diagnosis in proper patients.