scholarly journals Test with external peripheral vascular occlusion in evaluation of ergoreflex in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 27 (4) ◽  
pp. 451-457
Author(s):  
Aleksey V. Kosyakov ◽  
Vladimir N. Abrosimov

Aim. To evaluate changes in the cardiointervalogram (CIG) in the test with external peripheral vascular occlusion in patients with chronic obstructive pulmonary disease (COPD) and in individuals without diseases of the respiratory system. Materials and Methods. The study included 105 men, of them 64 patients with COPD (age 64.988.67) and 41 volunteers without diseases of the respiratory system (age 61.689.21). The autonomic status was examined and alterations in CIG in the test with occlusion were evaluated on Varicard hardware and software complex (OOO Ramena, Russia). Results. The obtained data showed the autonomic imbalance with predomination of the activity of sympathetic division of the autonomic nervous system (ANS) in patients with COPD as compared to the control group (p0.05). A study of ergoreflex by analysis of changes in CIG showed reduction of the activity of sympathetic division of the ANS in the test with external peripheral vascular occlusion in individuals without diseases of the respiratory system. In patients with COPD, changes in CIG in the test were less expressed and not always achieved statistically significant level (p0.05). Conclusions. Differences in the results of the test with external peripheral vascular occlusion in patients with COPD and volunteers without diseases of the respiratory system are attributed to hyperactivation of ergofeflex in patents with COPD.

2019 ◽  
Vol 27 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Vladimir N. Abrosimov ◽  
Aleksey V. Kosyakov ◽  
Maria N. Dmitrieva

Aim. To study the relationship between parameters of cardiointervalometry and ergoreflex, and 6-minute walk test data in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods. The study included 103 men, of them 63 patients with COPD, 40 patients of the control group. Functional assessment of external respiration and a 6-minute walk test were performed using Spiropalm 6MWT equipment (Cosmed, Italy). The autonomic status and the influence of the ergoreflex on it were assessed by the method of cardiointervalometry before, during and after the test with external peripheral vascular occlusion using Varicard hardware and software complex (LLC Ramena, Ryazan, Russia). Results. When performing a 6-minute walk test, significant differences were obtained between the groups of patients with COPD and of the control group in the majority of the studied parameters (p0.01). In 18 of 63 patients with COPD, the level of SpO2 in 6-minute walk test decreased by 4% (p0.01). The obtained result is of considerable importance for assessment of exercise tolerance in patients with COPD. In tests with external peripheral vascular occlusion in patients with COPD and of the control group, the index of activity of regulatory systems (IARS) increased in both groups. However, after completion of the test, the index in patients with COPD decreased below the initial values (p0.05), and in patients of the control group the changes were even more pronounced (p0.01). Patients with COPD were divided into groups depending on the distance covered in 6-minute walk test. Analysis of the data revealed a moderate positive correlation between the covered distance and the forced expiratory volume in the 1st second (FEV1, R=0.45, p0.01).The maximum level of the total effect of the autonomic regulation of blood circulation was recorded in patients who covered the minimum distance (227.7748.13 m) in 6-minute walk test. Besides, a moderate negative correlation between IARS and the results of 6-minute test was recorded (R=-0.34, p0.01). Conclusions. 1. For assessment of the functional status of patients in 6-minute walk test it is important to take measurement of saturation throughout the whole test. 2. The change in IARS values in the test with external peripheral vascular occlusion can be regarded as a reduction of the influence of reflex from the lower limb ergoreceptors on the functional condition of patients. 3. Patients with COPD showed a marked autonomic imbalance. IARS showed a moderate negative correlation with the distance covered in 6-minute walk test. 4. Maximum value of IARS was obtained in patients with the minimal distance covered in 6-minute walk test.


Author(s):  
Hossam Abd El Monem Ali ◽  
Ahmed Salama Al-Adl

Abstract Background Chronic obstructive pulmonary disease is associated with significant systemic abnormalities which includes systemic inflammation and neurohormonal activation that are considered the main mechanisms of the pathophysiology in systemic involvement. The aim of the present study was to detect the subclinical affection of the central nervous system in patients with stable chronic obstructive pulmonary disease. Results Forty patients with chronic obstructive pulmonary disease were enrolled in this study and 30 healthy subjects as a control group. All patients and healthy subjects were submitted to full history taking, clinical examination, arterial blood gases, spirometry, evoked potential, and electroencephalogram. Regarding to brain stem auditory evoked potentials, there was a statistically significant increase of latency of waves numbers I, III, and V, and a statistically significant increase of interpeak latencies I–III in the COPD group when compared to the control group. On the other hand, there was a statistically significant decrease of brain stem auditory evoked potential I and V amplitudes on both sides in the COPD group when compared to the control group. In visual evoked potential, there was a statistically significant increase of latency and decrease of amplitude of P100. In addition, there was a statistically significant increase of electroencephalogram changes in the COPD group when compared to the control group (20.0% vs. 3.3%, respectively). Conclusion In patients with chronic obstructive pulmonary disease, the central nervous system could be affected subclinically as the severity of chronic obstructive pulmonary disease increased, and the patient should be electrophysiologically monitored for early detection of nervous system affection.


Author(s):  
Hossam Abd El Monem Ali ◽  
Ahmed Salama Al-Adl

Abstract Background Chronic obstructive pulmonary disease (COPD) is accompanied by substantial systemic dysregulations that comprise systemic inflammation and neurohormonal activation in addition to many neurological involvements, such as cerebrovascular diseases, polyneuropathies, motor neuron diseases, and cognitive impairment has been described in COPD patients. The aim of the current work was to detect the subclinical affection of the peripheral nervous system in patients with stable COPD. Results Forty COPD patients and 30 subjects as healthy control were enrolled. All included subjects were submitted to complete medical history, clinical evaluations, investigations in the form of; arterial blood gases, spirometry, in addition to nerve conduction study. The patients with COPD were classified according to GOLD criteria for severity in grade I in 7.5% grade II in 62.5%, grade III in 20%, and grade IV in 10%. The results show a statistically significant increase in distal latency and a statistically significant decrease of amplitude and conduction velocity in patients with COPD when compared to the examined nerves of control group. The demyelinating nerve affection was the most common. Conclusion In COPD patients the peripheral nervous system could be affected subclinically once the severity of COPD increased and the patient should be neurophysiologically observed for early recognition of peripheral nervous system affection.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2019 ◽  
Vol 39 (2) ◽  
pp. 103-112
Author(s):  
Maratus Sholihah ◽  
Suradi Suradi ◽  
Jatu Aphridasari

Introduction: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Cigarette smoke and noxious agent result in oxidative stress and activate release of inflammatory mediators such as Interleukin-8 (IL-8). Quercetin is a flavonoid compound containing anti-inflammatory effects which can be used as an adjuvant therapy in stable COPD. Objective: To analyze the effect of quercetin on serum IL-8 levels, % VEP1, and CAT score of stable COPD patients. Methods: Experimental clinical trial with pre-test and pasca-test design was performed in 30 patients with stable COPD in Dr. Moewardi Surakarta between December 2017 and January 2018. The samples taken by using purposive sampling were divided into two groups treatment groups received standard therapy and quercetin 500mg/day for 28 days and control groups only received standard therapy. The decrease in inflammation was measured by serum IL-8 examination, improvement of obstruction measured by %FEV1 and clinical improvement measured by CAT score. Results: IL-8 serum level was significantly lower in treatment group than of in control group (p=0,001). The percentage of FEV1 was insignificant different between the two group (p=0,236). However CAT score was significantly lower in treatment group compared to that of in control group (p=0,001) Conclusions: Quercetin can decrease IL-8 serum level and decrease CAT score when given in combination with standard therapy for COPD patients. (J Respir Indo 2019; 39(2))


2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Lei Liu ◽  
Bin Liu

<p class="16"><em>Background and Objective: Pneumatic nebulizers (PN) are commonly used to treat COPD. We aimed to evaluate and compare two PNs with respect to effectiveness and delivery, and the effect of using a membrane filter to prevent drug wastage.</em><em></em></p><p><em>Methods: COPD patients (240) were divided into an experimental group (EG); treated with a YZB/GEM1058-2009 medical atomizer, and a control group (CG); treated with a DNA100 medical atomizer. A polypropylene membrane was then applied to each nebulizer.</em><em></em></p><p class="16"><em>Results: Wastage per inhalation was 79.56% in the EG, and 87% in the CG and reduced to 35.3% in the EG and 42.1% in the CG following application of a polypropylene membrane. </em><em>The  ratio of drug not atomised </em><em>per inhalation was 10.32% in the EG, and 24.52% in the CG and altered to 30.2% and 37.3% with the polypropylene membrane. </em><em> </em><em>The total effective rate, cure rate and weekly efficiency were 96.7%, 73.3% and 93.3%, respectively in the EG, and 93.3%, 60% and 83.3% respectively in the CG, and increased to 100%, 93.3% and 100%, respectively in the EG, and 100%, 83.3% and 93.3%, respectively, in the CG with the membrane application. The number of days required to be effective was 4±2.4 days in the EG, and 7±3.8 in the CG and decreased to 3±1.4 in the EG, and 5±3.1 in the CG with the membrane. </em><em></em></p><p class="16"><em>Conclusions</em><em>: There was a high percentage of drug wastage with both PNs. YZB/GEM1058-2009 was significantly more effective than DNA100 but a </em><em>polypropylene </em><em>microporous membrane significantly improved the effectiveness of both.</em><em></em></p><p class="16"><em>Keywords: Chronic Obstructive Pulmonary Disease; Pneumatic Nebulizer; </em><em>Drug waste; Polypropylene microporous membrane</em><em></em></p>


2019 ◽  
Author(s):  
Esther Helen Steveling-Klein ◽  
Claudia Gerhards ◽  
Caroline Zaehringer ◽  
Nebal Abu Hussein ◽  
Selina Dürr ◽  
...  

Abstract Background: Prevalence and impact of chronic rhinosinusitis (CRS) in chronic obstructive pulmonary disease (COPD) remain unclear. We hypothesized that CRS is more frequent in patients with COPD compared to controls and we aimed to evaluate the odds of CRS in both groups. Methods: We recruited patients with COPD and a healthy control group in a tertiary referral hospital in Switzerland. Diagnosis of CRS was defined according to published guidelines and supported by computed tomography (CT) findings. Sino-nasal-outcome-test-20 (SNOT-20) and sino-nasal-outcome-test-primary-nasal-symptom-score (SNOT-PNS-score) were self-assessed with a cut-off for abnormality of >12. Results: Data from 83 COPD patients (35 females, age: 67 years ± 10) and 34 controls (18 females, age: 67 years ± 12) were analyzed. In the COPD group 14 out of 83 (20.3%) fulfilled the diagnosis of CRS compared to only 1 out of 34 (3%) in the control group (OR 6.7; 95% CI 0.84-53.10; p = 0.064). Forty-eight COPD patients (59%) and 14 controls (41%) had an abnormal SNOT-20 score (OR 1.96; 95% CI 0.87-4.40; p=0.10), with a median score of 16.0 (ICR 21) in COPD patients compared to a median score of 8.0 (ICR 13) in controls (p=0.001). The SNOT-PNS-score was abnormal in 49 COPD patients (59%) and in 9 controls (26%) (OR 4.00; 95% CI 1.66-9.64; p=0.001). Abnormal findings of the upper airways did not correlate with COPD severity or smoking status. Conclusions: CRS was a frequent diagnosis in patients with COPD. CRS reduces quality of life in this patient group.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Rifat Saba ◽  
Nadeem Hafeez ◽  
Muhammad Zain-ul-Abideen ◽  
Muhammad Abdullah Nabeel

Objective: To investigate the impact of self-management intervention on the effectiveness of emotional regulation in patients suffering from chronic obstructive pulmonary disease (COPD). Materials and Methods: This study was conducted in the Pulmonology Department of Jinnah hospital Lahore in Collaboration with community medicine department for Six months duration from March 2018 to August 2018. 86 consecutive chronic COPD patients were diagnosed in the stable phase. 43 patients in each group were divided into a control group and a randomized observation group. In the control group, the continuous feeding mode outside of a conventional hospital and an enhanced guide to self-care programs in the observation group (information about the disease, breathing exercises, emotions, home oxygen therapy, medication technique, healthy life behaviors and deteriorating action plans) were used to compare differences in results. Results: For six-month follow-up visits, personal hygiene behavior, physical education, cognitive symptoms and management of medical care results, and observation groups in both groups were more visible and the differences were statistically significant (p <0.05); Self-regulation of emotions regulation in two groups was increased, including positive effect, deterrence / anguish, anger / irritation and total results. In addition, the extent of growth in the observation group was clearer and the differences were statistically significant (p <0.05). Conclusion: intervention of the self-monitoring program can improve the self-control behavior of patients with COPD and is important for improving the effectiveness of regulation and prediction of emotions.


2019 ◽  
Vol 4 (6) ◽  
pp. e001921
Author(s):  
Max Oscar Bachmann ◽  
Eric D Bateman ◽  
Rafael Stelmach ◽  
Alvaro A Cruz ◽  
Matheus Pacheco de Andrade ◽  
...  

IntroductionThe Practical Approach to Care Kit (PACK) guide was localised for Brazil, where primary care doctors and nurses were trained to use it.MethodsTwenty-four municipal clinics in Florianópolis were randomly allocated to receive outreach training and the guide, and 24 were allocated to receive only the guide. 6666 adult patients with asthma or chronic obstructive pulmonary disease (COPD) were enrolled, and trial outcomes were measured over 12 months, using electronic medical records. The primary outcomes were composite scores of treatment changes and spirometry, and new asthma and COPD diagnosis rates.ResultsAsthma scores in 2437 intervention group participants were higher (74.8%, 20.4% and 4.8% with scores of 0, 1 and 2, respectively) than in 2633 control group participants (80.0%, 16.8% and 3.2%) (OR for higher score 1.32, 95% CI 1.08 to 1.61, p=0.006). Adjusted for asthma scores recorded in each clinic before training started, the OR was 1.24 (95% CI 1.03 to 1.50, p=0.022). COPD scores in 1371 intervention group participants (77.7%, 17.9% and 4.3% with scores of 0, 1 and 2) did not differ from those in 1181 control group participants (80.5%, 15.8% and 3.7%) (OR 1.21, 95% CI 0.94 to 1.55, p=0.142). Rates of new asthma and COPD diagnoses, and hospital admission, and indicators of investigation, diagnosis and treatment of comorbid cardiovascular disease, diabetes and depression, and tobacco cessation did not differ between trial arms.ConclusionPACK training increased guideline-based treatment and spirometry for asthma but did not affect COPD or comorbid conditions, or diagnosis rates.Trial registrationNCT02786030 (https://clinicaltrials.gov/).


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