The influence of gender differences on the illness perception and women's point of view on COPD.

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is an irreversible disease and has influence on patients' quality of life. The aim is to investigate the influence of gender on the illness perception in COPD patients. MATERIALS AND METHODS: This prospective study enrolled 151 COPD patients. For the evaluation of illness perception, we used Brief Illness Perception Questionnaire (BIPQ). RESULTS: Average FEV1 values were significantly different (p = 0.007) in favor of woman compared to men. There was a higher proportion of GOLD stage 3 and less stage 4 in women. We found a significant difference in total BIPQ scores between female and male patients (p = 0.008). Women gave a significantly higher score on question 6 and 8 (p = 0.003). We found a significant difference in total BIPQ scores between female and male patients. Women perceive COPD as a significantly more threatening disease and accept chronic course and long-term treatment. CONCLUSION: COPD is no longer a disease that predominantly affects men. BIPQ is a convenient tool for fast assessment of illness perception for COPD. Patients' perceptions of COPD is in correlation with gender and GOLD stadium. The results of this study have potential benefits in terms of health promotion and improvement of the quality of life and outcome (Fig. 4, Ref. 21).

The usefulness of MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio for diagnosis and assessment of COPD severity.

BACKGROUND: Inflammation, oxidative stress and an imbalance between proteases and protease inhibitors are recognized pathophysiological features of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with COPD and to assess their relationship with lung function, symptom severity scores and recent acute exacerbations. METHODS: In this observational cohort study, serum levels of MMP-9 and TIMP-1 and the MMP-9/TIMP-1 ratio in the peripheral blood of COPD patients with stable disease and healthy controls were determined, and their association with lung function (postbronchodilator spirometry, body plethysmography, single breath diffusion capacity for carbon monoxide), symptom severity scores (mMRC and CAT) and exacerbation history were assessed. RESULTS: COPD patients (n = 98) had significantly higher levels of serum MMP-9 and TIMP-1 and a higher MMP-9/TIMP-1 ratio than healthy controls (n = 47) (p ≤ 0.001). The areas under the receiver operating characteristic curve for MMP-9, TIMP-1 and the MMP-9/TIMP-1 ratio for COPD diagnosis were 0.974, 0.961 and 0.910, respectively (all p < 0.05). MMP-9 and the MMP-9/TIMP-1 ratio were both negatively correlated with FVC, FEV1, FEV1/FVC, VC, and IC (all p < 0.05). For MMP-9, a positive correlation was found with RV/TLC% (p = 0.005), and a positive correlation was found for the MMP-9/TIMP-1 ratio with RV% and RV/TLC% (p = 0.013 and 0.002, respectively). Patients with COPD GOLD 3 and 4 presented greater MMP-9 levels and a greater MMP-9/TIMP-1 ratio compared to GOLD 1 and 2 patients (p ≤ 0.001). No correlation between diffusion capacity for carbon monoxide and number of acute exacerbations in the previous year was found. CONCLUSIONS: COPD patients have elevated serum levels of MMP-9 and TIMP-1 and MMP-9/TIMP-1 ratio. COPD patients have an imbalance between MMP-9 and TIMP-1 in favor of a pro-proteolytic environment, which overall indicates the importance of the MMP-9/TIMP-1 ratio as a potential biomarker for COPD diagnosis and severity.

Pneumonia caused by Sphingomonas paucimobilis infection after a dental intervention.

INTRODUCTION: Sphingomonas paucimobilis can be found in air, water systems, dialysis fluid, nebulizers and laboratory instruments in hospitals. Despite its low pathogenicity, it can cause severe infections. CASE REPORT: A 54-year-old man presented with fever, cough and pain in the right hemithorax. The laboratory results showed elevated inflammatory parameters. Chest radiography showed right upper lobe pneumonia. Empiric antibiotic therapy (cephalosporin) was prescribed. On control examination chest radiography showed incomplete regression. Chest computer tomography (CT) finding was bronchopneumonia in the right upper lobe. Bacteriological examination of fiberaspirate revealed Sphingomonas paucimobils. Trimethoprim-sulfamethoxazole was prescribed based on the antibiogram. After two weeks the control laboratory analysis was normal. The patient was fully recovered. CONCLUSIONS: Our patient had no comorbidities or malignancies, and no hospitalization in the recent past. He had a dental intervention 5 days prior to the onset of symptoms. We propose that it was an infection after the dental intervention.