Abstract:
:The purpose of this article is to provide an overview of the epidemiology of COPD in India which is one of the most affected countries in the world and contributes significantly to the mortality and morbidity of this disease; to provide insights into the etiological determinants of COPD in India; comment on treatment aspects including drug treatment, adherence to guidelines, treatment of exacerbations and to try to comment on whether it differs significantly from rest of the world. The article reviews published literature on COPD in India; provides insight into comparative methodologies involved; comments on gaps in knowledge and suggests areas of further research such as Prescription Audit. India contributes very significantly to mortality from COPD 102.3/100,000 and 6,740,000 DALYs out of world total of 27,756,000 DALYs; thus significantly affecting health related Quality of Life in the country. COPD is surpassing Malaria, TB even today and the gap would get wider with time in near future. The lack of robust real time nation-wide data does plague India as well, however multiple studies from 1994 to 2010 show increasing trends of COPD morbidity and mortality. Since most inhalational drugs are available in the country there is no reason why mortality should not be comparable to rest of the world but there is poor adherence to treatment guidelines, both national and international. Urban centers in India are comparable to their global counterparts in terms of service quality and facilities and this is also work in progress. However, the rural hinterland is poorly serviced; national GDP spending on health is remarkably low. Some innovation is emerging and that could be the harbinger of a new future if properly nurtured. The article is an overview of COPD in India with emphasis on understanding the multi-dimensional nature of the problem and an attempt of providing insight into possible de-bottlenecking to reduce the pain and suffering of millions of COPD patients in India in future.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Bhome ABdoi
10.3978/j.issn.2072-1439.2012.03.15subject
Has Abstractpub_date
2012-06-01 00:00:00pages
298-309issue
3eissn
2072-1439issn
2077-6624pii
jtd-04-03-298journal_volume
4pub_type
杂志文章abstract:Background:Diabetes mellitus is a recognized risk factor for esophageal squamous cell carcinomas (ESCC), and metformin is a recognized protective factor for some gastrointestinal tumors. But knowledge is limited regarding the effect of metformin on survival outcome of ESCC patients with type 2 diabetes mellitus (T2DM)....
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.98
更新日期:2020-03-01 00:00:00
abstract::Video-assisted thoracoscopic surgery (VATS) has without doubt been the most important advance in thoracic surgery. The general anesthesia before the tracheal intubation for VATS was often accompanied with tracheal mucosa and lung injuries, which were typically manifested as painful throat, nausea, vomiting, and other ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.06.35
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:To explore the incidences of chronic obstructive pulmonary disease (COPD), obstructive ventilatory dysfunction, and obstructive small airway disease and their risk factors in a health check-up population, with an attempt to inform the early diagnosis and treatment of COPD. METHODS:Subjects who aged 20 years...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.09.35
更新日期:2015-09-01 00:00:00
abstract:Background:Bivalirudin has been shown to be associated with less major bleeding than heparin in patients undergoing percutaneous coronary intervention (PCI); but the confounding effect of concomitant glycoprotein IIb/IIIa inhibitors (GPI) limits meaningful comparison. We performed a systematic review and meta-analysis ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.76
更新日期:2018-06-01 00:00:00
abstract:Background:Trans-bronchoscope treatment for early stage small peripheral lung cancer, such as photodynamic therapy (PDT), has been investigated. However, despite the efficacy of PDT, light delivery issues limit its application. A method of administering mineral oil with a high refractive index (RI) was previously propo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-19-3887
更新日期:2020-07-01 00:00:00
abstract::Spontaneous pneumothorax during pregnancy is a rare pathological condition. Few cases have been reported previously in the literature. There is no universal guideline for the management of this condition yet. We report a case of recurrent spontaneous pneumothorax during twin pregnancy in a 30-year-old woman. Surgical ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2010.02.03.10
更新日期:2010-09-01 00:00:00
abstract::The development of advanced radiation technologies, including intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT) and proton therapy, has resulted in increasingly conformal radiation treatments. Recent evidence for the importance of minimizing dose to normal critical structures inc...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.01.155
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:There is increasing evidence that a considerable proportion of patients with diabetes remain undiagnosed and untreated, however, it is unclear whether this is associated with more severe coronary artery disease (CAD) and microvasculature changes compared with diagnosed patients. We assessed CAD extent and se...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.05.61
更新日期:2016-07-01 00:00:00
abstract:Background:Pulmonary complications (PCs) may influence long-term survivor. We sought to determine the long-term impacts of major pulmonary complications (MPCs) and identify the independent risk factors in non-small cell lung cancer (NSCLC) patients. Methods:A retrospective study was conducted to analyze the PCs of 828...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.10.144
更新日期:2017-12-01 00:00:00
abstract::Sleeve resection, a mainstay for centrally-located lung cancer, is a challenging procedure when the preserved lung is impaired. We herein reported a 61-year-old male who underwent right upper sleeve lobectomy for squamous cell carcinoma located at the orifice of the upper bronchus. The tumor invaded the main bronchus....
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.02.17
更新日期:2016-03-01 00:00:00
abstract:Background:CirRNA Circ_0058063 has been proven as an oncogene in bladder cancer, while its involvement in esophageal squamous-cell carcinomas (ESCC) is unknown. This study aimed to investigate the role of Circ_0058063 in ESCC. Methods:Paired ESCC and non-tumor tissues were collected from ESCC patients and gene express...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.57
更新日期:2020-03-01 00:00:00
abstract::Thanks to the recent improvements in thoracoscopy, a great deal of complex lung resections can be performed without performing thoracotomies. During the last years, experience gained through video-assisted thoracoscopic techniques, enhancement of the surgical instruments and improvement of high definition cameras have...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.09.17
更新日期:2014-10-01 00:00:00
abstract::Recent studies have demonstrated that there are differences among races in efficacy, tolerance and other outcomes in oncologic care. Some of these differences may be explained by different pharmacogenetics; however, social and environmental factors that can affect oncology practice are relatively underestimated. In th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.07.70
更新日期:2020-07-01 00:00:00
abstract::Mitral valve prolapse (MVP) is a common valve abnormality in general population. Despite the general belief of a benign disorder, several articles since the 1980s report sudden cardiac death (SCD) in MVP patients, with a substantial percentage of asymptomatic young individuals. The problem is to detect those patients ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.11.14
更新日期:2017-12-01 00:00:00
abstract::Malignant pleural mesothelioma (MPM) is a rare neoplasm that typically arises from mesothelial surfaces of the pleural cavity. Despite treatment improvements, it carries a dismal prognosis. The majority of patients either have unresectable disease or are not candidates for surgery due to medical comorbidities or old a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.10.19
更新日期:2018-01-01 00:00:00
abstract::Transbronchial lung biopsy with a cryoprobe, or cryobiopsy, is a promising new bronchoscopic biopsy technique capable of obtaining larger and better-preserved samples than previously possible using traditional biopsy forceps. Over two dozen case series and several small randomized trials are now available describing e...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.06.96
更新日期:2017-07-01 00:00:00
abstract::Acute respiratory distress syndrome (ARDS) remains associated with a poor outcome despite recent major therapeutic advances. Forecasting the outcome of patients suffering from such a syndrome is of a crucial interest and many scores have been proposed, all suffering from limits responsible for important discrepancies....
journal_title:Journal of thoracic disease
pub_type: 评论,杂志文章
doi:10.21037/jtd.2016.07.54
更新日期:2016-08-01 00:00:00
abstract:Background:Atherosclerosis in diabetic patients progresses fast. Evidence on how to choose target vessels of percutaneous coronary interventions (PCIs) in diabetic patients post-coronary artery bypass graft (post-CABG) is insufficient. Methods:One hundred and fifty-seven patients with diabetes and previous CABG, who u...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.10.33
更新日期:2019-11-01 00:00:00
abstract::A 56-year-old male patient was admitted due to one small pulmonary nodule in the apicoposterior segment of the right upper lobe, which was found on his health screening one month ago. Preoperative examinations showed no distant metastasis, and his heart and lung functions could tolerate the lobectomy. Chest computed t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.12.15
更新日期:2014-12-01 00:00:00
abstract::With accumulation of experiences in video-assisted thoracic surgery (VATS) lobectomy, complete VATS sleeve lobectomy (SL) has been carried out in more and more medical centers. We here presented a procedure of sleeve right upper lobectomy by complete VATS for a 62-year-old male patient with central squamous cell carci...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.112
更新日期:2018-07-01 00:00:00
abstract::More than half of primary lung cancers are not resectable at diagnosis and 40% of deaths may be secondary to loco-regional disease. Many of these patients suffer from symptoms related to airways obstruction. Indications for therapeutic endoscopic treatment are palliation of dyspnea and other obstructive symptoms in ad...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.07.68
更新日期:2017-08-01 00:00:00
abstract::During recent years, continuous technological innovation has provoked an increase of extracorporeal life support (ECLS) use for perioperative cardiopulmonary support in lung transplantation. Initial results were disappointing, due to ECLS-specific complications and high surgical risk of the supported patients. However...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.43
更新日期:2018-08-01 00:00:00
abstract:Background:Although emphysema and small cell lung cancer (SCLC) are prevalent in smokers, no previous study has investigated the prognostic impact of computed tomography (CT)-determined emphysema in SCLC. This study was undertaken to analyze the prognostic value of emphysema scores as determined by baseline CT scans in...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.97
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:For patients diagnosed with locally advanced esophageal cancer, neoadjuvant therapy followed by surgery is the most common approach. However, randomized trials resulted in inconsistent conclusions. We conducted this retrospective study to evaluate the influence of neoadjuvant therapy on postoperative events ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.02.19
更新日期:2017-02-01 00:00:00
abstract:Background:After lung transplantation (LT), between 2% and 25% of bronchial anastomoses develop complications requiring therapeutic intervention. The status of healing of both bronchial anastomoses and downhill airways are well described by the French consensual MDS standardized grading system (Macroscopic, Diameter, S...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.03.21
更新日期:2020-05-01 00:00:00
abstract:Background:The purpose of our study was to investigate the correlation between tumor volume (TV) and each subtype of thymic epithelial tumors (TETs) based on the World Health Organization (WHO) classification and Masaoka staging. Methods:Sixty-one consecutive patients (45 thymomas and 16 thymic carcinomas) were studie...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.09.133
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to reveal the short-term outcomes of video-assisted thoracoscopic surgery (VATS) segmentectomy without tracheal intubation compared with intubated general anesthesia with one-lung ventilation (OLV). METHODS:We performed a retrospective review of our institutional database of consec...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.02.50
更新日期:2016-03-01 00:00:00
abstract:Background:Pleural fluid pH and glucose levels are both recommended in the workup of pleural effusions. Whether their levels correlate and predict each other or contribute independent knowledge is unclear. We aimed to investigate the pH/glucose relationship, assess their concordance and ascertain whether performing bot...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.12.101
更新日期:2019-01-01 00:00:00
abstract:Background:Surgery plays an important role in the management of complex thoracic infections (CTIs). We aimed to describe the contemporary surgical outcomes of CTIs. Methods:The 2014-2017 National Surgical Quality Improvement Program (NSQIP) database was queried for patients with the following procedures: bilobectomy, ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.08.43
更新日期:2018-09-01 00:00:00
abstract::Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, which is time-dependent and associated with unacceptably high mortality. Thus, when treating suspicious or confirmed cases of sepsis, clinicians must initiate broad-spectrum antimicrobials within the first ho...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.01.47
更新日期:2020-03-01 00:00:00