Prognostic factors in the management of exacerbation of chronic obstructive pulmonary disease in Kuwait

To evaluate the clinical presentation and the factors of prognostic importance in the management of exacerbation of chronic obstructive pulmonary disease [COPD]. Subjects and One hundred and four patients who were hospitalized because of exacerbation of COPD between 1996 and 2000 were selected for further evaluation. Only patients who fulfilled the American Thoracic Society criteria for diagnosis of COPD were included. The factors examined included age, clinical features, duration of symptoms of exacerbation, severity of underlying disease, comorbid diseases, level of consciousness, previous hospitalization, intubation and assisted ventilation, hypercapnia, degree of acidemia and complications. Seventy-four of 104 [71%] hospitalized patients reviewed met the inclusion criteria for COPD. The mean age was 63.68 ' 12.6 years. There was a male:female ratio of 3:1. Fifty-eight patients [78%] had a baseline FEV1 <50% before hospitalization and 45 [64%] had previous hospitalization. Comorbid disease was found in 50% of the cases, while 78% had acidemia and 70% hypercapnia. Fourteen [19%] died on admission. Risk factors identified included severity of disease [p < 0.05]; presence of comorbid disease [p < 0.01]; acidemia [p < 0.0001]; hypercapnia [p < 0.0001]; previous hospitalization [p < 0.01], and assisted ventilation [p < 0.001]. This study revealed that the presence of comorbid disease, acidemia, previous hospitalization and assisted ventilation significantly contributed to mortality in patients with exacerbation of COPD.

Dietary factors and physical activity of obese and non-obese adolescent girls

Two groups of High Nursing School Girls, 40 obese, and 34 non-obese controls of matched age, height, grade, and socio-economic status, were compared with regard to dietary intake and physical activity. The anthropometric measurements showed a highly significant mean body weight, body mass index [BMI] and relative body weight. The skinfold thickness of the obese group in the following sites: biceps, triceps, sub scapular, and abdominal were significantly higher than that of non-obese girls. The most clear cut finding in the present study is that the obese group consumed significantly more calories, protein, fat and carbohydrate than their non-obese peers. Also the results showed that the majority of the obese girls categorized as less active compared to the non-obese controls. It appears that overeating and physical inactivity are important factors in the occurrence of obesity among the girls of this community