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      Comparison of clinical baseline characteristics between Asian and Western COPD patients in a prospective, international, multicenter study

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          Abstract

          We aimed to compare clinical characteristics between Asian and Western chronic obstructive pulmonary disease (COPD) patients. This was a sub-analysis of an international, multicenter, prospective cohort study. Asian patients were enrolled in Singapore and South Korea. Western patients were enrolled in Spain, Poland, Ireland, the United Kingdom, and Malta. A total of 349 patients were analyzed. Among them, 110 (32%) patients were Asian and 239 (68%) Western. Male sex was more predominant in Asian than in Western (95% versus 63%, respectively; P<0.01). Body mass index was significantly lower in Asian (23.5 versus 27.1; P<0.01). The proportion of patients with a history of exacerbation was lower in Asian (12% versus 64%; P<0.01). Although patients were enrolled by same inclusion criteria, there were several differences between Asian and Western COPD patients. Our study has shown unbiased real-world differences between Asian and Western COPD patients. Since prospective follow-up study is currently ongoing, the result of this study can be fundamental base of future analysis.

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          Most cited references 16

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          Respiratory risks from household air pollution in low and middle income countries.

          A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.
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            Clinical characteristics of patients with tuberculosis-destroyed lung.

             C Rhee,  K H Yoo,  J. Lee (2013)
            Multicentre study.
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              COPD in Asia

               Wan C Tan,  Tze P. Ng (2008)
              COPD is a global health concern, and is a major cause of chronic morbidity and mortality worldwide. According to the World Health Organization, it is currently the sixth leading cause of death in the world, and further increases in the prevalence and mortality of the disease is predicted for the coming decades. These increases are mainly linked to the epidemic of tobacco exposure and indoor and outdoor air pollution in Asian countries. The burden of COPD in Asia is currently greater than that in developed Western countries, both in terms of the total number of deaths and the burden of disease, as measured in years of life lost and years spent living with disability. The types of health-care policies and the practice of medicine vary considerably among the regions of Asia and have an impact on the burden of disease. Treatment aims in Asian countries are based on evidence-based management guidelines. Barriers to the implementation of disease management guidelines are related to issues of resource conflict and lack of organizational support rather than cultural differences in medical practice. To reduce this burden of COPD in Asian countries, there is a need for a multifaceted approach in improving awareness of prevalence and disease burden, in facilitating accurate diagnosis of COPD among chronic respiratory diseases, in championing health policies that reduce the burden of the main risk factors for COPD and in the wider use of evidence-based management for COPD.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                COPD
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                25 July 2019
                2019
                : 14
                : 1595-1601
                Affiliations
                [1 ]Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
                [2 ]Pneumology Department, University Hospital Vall d’Hebron/Vall d’Hebron Research Institute (VHIR) , Barcelona, Spain
                [3 ]CIBER de Enfermedades Respiratorias (CIBERES) , Madrid, Spain
                [4 ]2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases , Warsaw, Poland
                [5 ]Department of Respiratory Medicine, Royal College of Surgeons , Dublin, Ireland
                [6 ]Optimum Patient Care , Cambridge, UK
                [7 ]Centre of Academic Primary Care, University of Aberdeen , Aberdeen, UK
                [8 ]Department of Respiratory Medicine, Bispebjerg Hospital , Copenhagen, Denmark
                [9 ]Singhealth Duke-NUS Medical Academic Clinical Programme, Duke-NUS Medical School , Singapore
                [10 ]Respiratory Department, Hospital de Alta Resolución de Loja , Madrid, Spain
                [11 ]Department of Respiratory Medicine, Mater Dei Hospital , L-Imsida, Malta
                [12 ]Public Health, Mental, Maternal and Child Health Nursing Department, Faculty of Medicine and Health Sciences, University of Barcelona , Barcelona, Spain
                [13 ]Hospital Comarcal de Laredo , Cantabria, Spain
                [14 ]Department of Respiratory and Critical Care Medicine, Changi General Hospital , Singapore
                [15 ]Primary Health-care Center Son Pisà, IB-Salut , Palma, Spain
                [16 ]Pneumology Department, Hospital Arnau de Vilanova , Valencia, Spain
                [17 ]Observational and Pragmatic Research Institute , Singapore
                Author notes
                Correspondence: Chin Kook RheeDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St Mary’s Hospital, The Catholic University of Korea , 222 Banpo-daero, Seocho-gu, Seoul06591, Republic of KoreaTel +82 22 258 6067Fax +82 2 599 3589Email chinkook77@ 123456gmail.com
                Article
                208245
                10.2147/COPD.S208245
                6664421
                © 2019 Kim et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Tables: 1, References: 18, Pages: 7
                Categories
                Short Report

                Respiratory medicine

                asian, copd, western

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