Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, with approximately 70% to 80% of adults with COPD being undiagnosed. Patients with undiagnosed COPD are at increased risk of poor outcomes and a worsened quality of life, making early detection a crucial strategy to mitigate the impact of COPD and reduce the burden on healthcare systems. In the past decade, increased interest has been focused on the development of effective strategies and instrument for COPD early detection. However, identifying undiagnosed cases of COPD is still challenging. Both screening and case-finding approaches have been adopted to identify undiagnosed COPD, with case-finding being recommended by the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline and the updated United States Preventive Services Task Force (USPTF) recommendation. Nonetheless, the approaches, criteria, and instruments used for early detection of COPD are varied. However, advances in the taxonomy and risk factors of COPD are continuously being investigated. It is important to continuously assess the current state of knowledge on COPD early detection, given the challenges associated with identifying undiagnosed COPD. This review aims to highlight recent advances in early detection of COPD. To discuss the current challenge and opportunity in COPD early detection, providing an overview of existing literature on COPD case-finding strategies, including the approaches, criteria for subjects, and instruments. The review also summarizes the current progress in COPD case-findings and proposes a COPD case-finding flowchart as an efficient method for identifying at risk COPD patients.

The multikinase inhibitor, sorafenib (Nexavar®, BAY43-9006), which inhibits both the Raf/MEK/ERK pathway and several receptor tyrosine kinases (RTKs), has shown significantly therapeutic benefits in advanced hepatocellular carcinoma (HCC). However, not all HCC patients respond to sorafenib well and new therapeutic strategies to optimize the efficacy of sorafenib are urgently required. Overexpression of breast cancer resistance protein (BCRP/ABCG2) mediates the drug-efflux of several tyrosine kinase inhibitors (TKIs) to attenuate their efficacy. This study aimed to investigate the role of BCRP/ABCG2 in the sensitivity of HCC to sorafenib. Our data showed that BCRP/ABCG2 mediated the efflux of sorafenib. Co-treatment with a BCRP/ABCG2 inhibitor greatly augmented the cytotoxicity of sorafenib in HCC cells. Similar results were also achieved by the competitive inhibitor of BCRP/ABCG2, gefitinib, in combination with sorafenib. These results suggest not only that BCRP/ABCG2 is a potential predictor for the sorafenib sensitivity in HCC, but also that blockage of BCRP/ABCG2 may be a potential strategy to increase the response of HCC cells to sorafenib.

Despite improvements in diagnosis and treatment, pyogenic liver abscess remains a life-threatening disease. This study evaluated clinical outcome and prognostic factors in patients with pyogenic liver abscess admitted to the intensive care unit. Retrospective study. Medical and surgical intensive care unit in a 1,700-bed university-based hospital. Four hundred and thirty-six adult patients (≥18 yrs) with a diagnosis of pyogenic liver abscess were reviewed, and 72 patients with pyogenic liver abscess who required intensive care were enrolled in the study. None. Twenty of 72 enrolled patients died, yielding an intensive care unit mortality rate of 28%. The most common underlying disease was diabetes mellitus (51%), and the most common microorganism was Klebsiella pneumoniae (74%). Compared with survivors, nonsurvivors had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (22.2 ± 9 vs. 13.7 ± 6, p < .001), higher serum creatinine levels (2.9 ± 2 vs. 1.9 ± 2 mg/dL, p = .02), and longer prothrombin times (21 ± 5 vs. 16 ± 5 s, p = .01) on the first day of intensive care unit admission. In addition, factors associated with mortality included inadequate antibiotic therapy (p = .026), septic shock (p = .002), acute respiratory failure (p < .001), and acute renal failure (p = .043) on the first day of intensive care unit admission. On multivariate logistic regression analysis, factors that independently correlated with mortality were the presence of acute respiratory failure (p = .003, relative risk = 18.7) and APACHE II score >16 (p = .026, relative risk = 7.43). In patients with pyogenic liver abscess requiring intensive care, variables including size of liver abscess, pathogens, comorbidity, and most laboratory data were not associated with mortality. Only the presence of acute respiratory failure and APACHE II score >16 on the first day of intensive care unit admission were significant prognostic factors.