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The undrafted rookie out of Division II West Georgia likely won't play much on offense once he's healthy, but he could vie for a spot on special teams. John Hurst, 40. Global Initiative for Chronic Obstructive Lung Disease. At his pro day, he recorded a bench press of 15 repetitions of 225 pounds. In the group of patients with moderate disease in our study, exacerbations were more common among women than among men, and there were other factors that varied according to sex. A range of variables have inconsistently been associated with exacerbation frequency in previous studies.8-10 We have provided robust data from a single study showing that exacerbations requiring treatment become more frequent as the severity of COPD increases. Drs. Information and tools for librarians about site license offerings. Green did a good job to improve his 40 times, which was 4.62 at the combine. All reported P values are nominal and two-sided and were not adjusted for multiple comparisons. ); Cardiology and Respiratory Medicine, Hvidovre Hospital and University of Copenhagen, Copenhagen (J.V. RAS is a composite metric on a 0 to 10 scale based on the average of all of the percentile for each of the metrics the player completed either at the Combine or pro day. Dr. Vestbo reports receiving consulting fees from GlaxoSmithKline, Boehringer Ingelheim, Nycomed, Novartis, and AstraZeneca, receiving speaking fees from GlaxoSmithKline, AstraZeneca, Boehringer Ingelheim, Chiesi, Nycomed, and Talecris, and serving as chairman of the GOLD Scientific Committee; Dr. Hurst, receiving consulting fees from AstraZeneca, speaking fees from AstraZeneca, Chiesi, and Pfizer, and travel support from GlaxoSmithKline and AstraZeneca; Dr. Anzueto, consulting fees, speaking fees, and grants from GlaxoSmithKline and consulting fees and speaking fees from Dey Pharma, Pfizer, Boehringer Ingelheim, Bayer Schering Pharma, and Schering-Plough; Dr. Agusti, consulting fees from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Nycomed, and Roche, speaking fees from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Esteve, GlaxoSmithKline, Novartis, and Nycomed, grants from Almirall, GlaxoSmithKline, and Nycomed, and travel support from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Nycomed; Dr. MacNee, consulting fees from Boehringer Ingelheim, SMB, GlaxoSmithKline, Pfizer, and AstraZeneca and speaking fees from GlaxoSmithKline and AstraZeneca; Dr. Calverley, receiving consulting fees from GlaxoSmithKline, AstraZeneca, Nycomed, and Boehringer Ingelheim, speaking fees from GlaxoSmithKline and Nycomed, and travel support from Boehringer Ingelheim and providing expert testimony for Forest and Nycomed; Dr. Rennard, receiving grants from AstraZeneca, Biomarck, Centocor, Mpex, Nabi, Novartis, and Otsuka, consulting or speaking fees from Able Associates, Adelphi Research, APT Pharma and Britnall, Aradign, AstraZeneca, Boehringer Ingelheim, Chiesi, CommonHealth, Consult Complete, COPD Forum, Data Monitor, Decision Resource, Defined Health, Dey, Dunn Group, Easton Associates, Equinox, Gerson, GlaxoSmithKline, Infomed, KOL Connection, M. Pankove, MedaCorp, MDRx Financial, Mpex, Oriel Therapeutics, Otsuka, Pennside, PharmaVentures, Pharmaxis, PriceWaterhouse, Propagate, Pulmatrix, Reckner Associates, Recruiting Resources, Roche, Schlesinger Medical, Scimed, Sudler and Hennessey, TargeGen, Theravance, UBC, Uptake Medical, and VantagePoint Management; Dr. Wouters, consulting fees from GlaxoSmithKline and Nycomed, speaking fees from GlaxoSmithKline, Nycomed, and AstraZeneca, and grants from GlaxoSmithKline and AstraZeneca; and Dr. Wedzicha, speaking fees from GlaxoSmithKline, AstraZeneca, Novartis, Bayer, Boehringer Ingelheim, Chiesi, and Respifor, grants from GlaxoSmithKline, AstraZeneca, Chiesi, and Novartis, and travel reimbursements from Boehringer Ingelheim. The main strength of this analysis is the use of a large cohort of patients with COPD and a range of disease severity. (The characteristics of patients with moderate COPD are listed according to exacerbation frequency in Table 1 in the Supplementary Appendix.) There is currently much interest in defining specific phenotypes in COPD that may have different prognoses or treatment requirements.19 Our data suggest that the frequent-exacerbation phenotype can be identified on the basis of a history of exacerbations, potentially allowing for appropriate targeting of patients for interventions and making it possible to selectively recruit patients for clinical trials. Using data from the large observational ECLIPSE cohort, we examined the frequency of exacerbations among patients with moderate, severe, or very severe COPD. We can calculate the speed traveled over the second ten yards of the 40 yard dash easily, as the distance and time are both known. New Zealand: D. Quinn, Wellington. Make, Denver; S. Rennard, Omaha, NE; C. Rochester, New Haven, CT; P. Scanlon, Rochester, MN; D. Schuller, Omaha, NE; F. Sciurba, Pittsburgh; A. Sharafkhaneh, Houston; T. Siler, St. Charles, MO; E. Silverman, Boston; A. Wanner, Miami; R. Wise, Baltimore; R. ZuWallack, Hartford, CT. 1. Chest 2009;135:975-982, 26. This correlates to a 6.9 score out of 10.0. Our data also support the view that the consequences of exacerbation become more severe with increasing disease severity. Among the 945 patients with moderate COPD, 208 (22%) had frequent exacerbations (two or more during the first year of the study). Czech Republic: J. Krepelka, Prague. Biomarker data were log10-transformed before all regression analyses. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005;171:446-452, 4. The recruitment criteria included an age of 40 to 75 ... Hurst JR, Perera WR, Wedzicha JA. Eur Respir J 2007;30:1124-1130, 25. Factors Associated with Increased Exacerbation Frequency in the Stepwise Multivariate Model. In the first year of follow-up, the exacerbation rates were 0.85 per person for patients with moderate disease (GOLD stage 2), 1.34 for those with severe disease (GOLD stage 3), and 2.00 for those with very severe disease (GOLD stage 4). Exacerbations were significantly associated with worsening lung function (according to post-bronchodilator FEV. Meguro M, Barley EA, Spencer S, Jones PW. Shahab L, Jarvis MJ, Britton J, West R. Prevalence, diagnosis and relation to tobacco dependence of chronic obstructive pulmonary disease in a nationally representative population sample. Among the patients in the study who had very severe COPD, 29% appeared to have had resistance to exacerbations, although some of these patients may have been unable to recognize an exacerbation (which may therefore not have been reported to their physician for treatment).4,27 This finding also has potential implications for therapy, in that it may not be necessary to take aggressive approaches to the prevention of exacerbations in patients with very severe COPD if they do not have a history of such events. Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group information and services. AKA: john wendell hurst. The condition of the patients was graded according to the stages of disease defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD).12 After the baseline visit, patients were followed for a total of seven visits: at 3 months, at 6 months, and every 6 months thereafter for 3 years. Computed tomographic (CT) scanning of the chest was performed to evaluate the severity and distribution of emphysema (for details, see the Supplementary Appendix, available with the full text of this article at NEJM.org). Vestbo J, Anderson W, Coxson HO, et al. The time traveled between the 20 and 40 yard lines is known as the Flying Twenty. Bhowmik A, Seemungal TA, Sapsford RJ, Wedzicha JA. (The characteristics of patients with very severe COPD, categorized according to exacerbation frequency, are listed in Table 2 in the Supplementary Appendix.) 20--26.5. Steering Committee: H. Coxson, L. Edwards, R. Tal-Singer, D. Lomas, W. MacNee, E. Silverman, C. Crim, J. Vestbo, J. Yates. Our conservative definition of exacerbation probably underestimates the frequency of symptom-defined events.8 Nevertheless, the proportion of patients with GOLD stage 4 disease who had frequent exacerbations (two or more annually) was more than twice the proportion of patients with GOLD stage 2 disease who had frequent exacerbations. Chest 2007;132:456-463, 17. Norway: P. Bakke, Bergen. This finding supports the hypothesis that patients who are more subject to frequent exacerbations, some of whom have milder disease, have a distinct susceptibility phenotype that is relatively stable over time and can be identified on the basis of the patient's recall of previously treated events. The economic burden of COPD. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. Covering the impact of coronavirus on the sports world. The time he traveled the second ten yards at his pro day was 0.97 seconds. We thank all the study participants for their willingness to advance medical science in the field of COPD, Gardiner-Caldwell Communications for technical assistance in the initial preparation of a figure, Drs. A greater impairment in health status (quality of life) was associated with exacerbations in the overall cohort of patients with moderate COPD, but the association was not observed in the models in which each sex was analyzed separately. This correlates to a 6.31 score out of 10.0. Hurst can return to the lineup as early as Sunday's home game versus the Packers depending on how he responds to a week of practice.

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