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Pulmonary fibrosis and emphysema: Is the emphysema type associated with the pattern of fibrosis?

World Journal of Radiology 2015年第9期7卷 294-305页

作者： Anastasia Oikonomou Paraskevi Mintzopoulou argyris tzouvelekis Petros Zezos George Zacharis Anastasios Koutsopoulos Demosthenes Bouros Panos Prassopoulos Department of Radiology Democritus University of Thrace Department of Medical Imaging Sunnybrook Health Sciences Centre Department of Pneumonology Democritus University of Thrace Yale School of Medicine Department of Internal Medicine Section of Pulmonary Critical Care and Sleep Medicine Department of Endoscopic Unit Democritus University of Thrace Department of Internal Medicine Division of Gastroenterology Sunnybrook Health Sciences Centre Department of Pathology Democritus University of Thrace Department of Pathology University of Herakleion

AIM: To investigate whether the predominant emphysema type is associated with the high resolution computed tomography(HRCT) pattern of fibrosis in combined pulmonary fibrosis and emphysema(CPFE).METHODS: Fifty-three smokers with upper lobe emphysema and lower lobe pulmonary fibrosis on- HRCT-were retrospectively evaluated. Patients were stratified into 3 groups according to the predominant type of emphysema: Centrilobular(CLE), paraseptal(PSE), CLE = PSE. Patients were also stratified into 3 other groups according to the predominant type of fibrosis on HRCT: Typical usual interstitial pneumonia(UIP), probable UIP and nonspecific interstitial pneumonia(NSIP). HRCTs were scored at 5 predetermined levels for the coarseness of fibrosis(Coarseness), extent of emphysema(emphysema), extent of interstitial lung disease(Tot Ext ILD), extent of reticular pattern not otherwise specified(Ret NOS), extent of ground glass opacity with traction bronchiectasis(extG GOBx), extent of pure ground glass opacity and extent of honeycombing. HRCT mean scores, pulmonary function tests, diffusion capacity(DLCO) and systolic pulmonary arterial pressure were compared among the groups.RESULTS: The predominant type of emphysema was strongly correlated with the predominant type of fibrosis. The centrilobular emphysema group exhibited a significantly higher extent of emphysema(P < 0.001) and a lower extent of interstitial lung disease(P < 0.002), reticular pattern not otherwise specified(P < 0.023), extent of ground glass opacity with traction bronchiectasis(P < 0.002), extent of honeycombing(P < 0.001) and coarseness of fibrosis(P < 0.001) than the paraseptal group. The NSIP group exhibited a significantly higher extent of emphysema(P < 0.05), total lung capacity(P < 0.01) and diffusion capacity(DLCO)(P < 0.05) than the typical UIP group. The typical UIP group exhibited a significantly higher extent of interstitial lung disease, extent of reticular pattern not otherwise specified, extent of ground glass opacity with traction bronchiectasis, e

关键词： Emphysema Pulmonary fibrosis High resolution compu

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Rationale,design and baseline patient characteristics of the optimal type 2 diabetes management including benchmarking and standard treatment study in Greece

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World Journal of Diabetes 2014年第1期5卷 76-83页

作者： Michael S Kostapanos Vasilis Tsimihodimos Moses S Elisaf Emmanouil tzouvelekis Nikos Nikas Department of Internal Medicine School of MedicineUniversity of Ioannina Medical Department

AIM:To describe baseline data of the optimal type2 diabetes management including benchmarking and standard treatment(OPTIMISE)study in Greece.METHODS:"Benchmarking"is the process of receiving feedback comparing one’s performance with that of others.The OPTIMISE(NCT00681850)study is a multinational,multicenter study assessing,at a primary care level,whether using"benchmarking"can help to improve the quality of patient care,compared with a set of guideline-based reference values("non-benchmarking").In the Greek region,797 outpatients(457men,mean age 63.8 years)with type 2 diabetes were enrolled by 84 office-based physicians.Baseline characteristics of this population are presented.RESULTS:Hypertension was the most prevalent concomitant disorder(77.3%)and coronary heart disease was the most frequent macrovascular complication of diabetes(23.8%).Most patients were overweight or obese(body mass index 29.6±5 kg/m2),exhibiting mostly abdominal obesity(waist circumference102.6±13.6 cm).Biguanides were the most prevalent prescribed drugs for the management of diabetes(70.1%of all prescriptions),whereas statins(93.5%of all prescriptions)and angiotensin receptor blockers(55.8%of all prescriptions)were the most prevalent prescribed drugs for hyperlipidemia and hypertension,respectively.Only 37.4%of patients were on aspirin.Despite treatment,pre-defined targets for fasting plasma glucose(<110 mg/dL),glycated hemoglobin(<7%),systolic blood pressure(<130 mmHg and<125mmHg for patients with proteinuria)and low density lipoprotein cholesterol levels(<100 mg/dL and<70mg/dL for patients with coronary heart disease)were reached in a relatively small proportion of patients(29%,53%,27%and 31%,respectively).In a Greek population with type 2 diabetes,the control of glycemia or concomitant disorders which increase cardiovascular risk remains poor.CONCLUSION:Despite relevant treatment,there is a poor control of diabetes,hypertension and hyperlipidemia in Greek outpatients with type 2 diabetes.

关键词： Diabetes Benchmarking Treatment tar-get Glycemic control Dyslipidemia Blood pressure

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