scholarly journals Role of the Emphysema Index Combined with the Chronic Obstructive Pulmonary Disease Assessment Test Score in the Evaluation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qi Ding ◽  
Xia Wei ◽  
Jie Li ◽  
Yan-Zhong Gao ◽  
Shu-Di Xu ◽  
...  

Background. This study aimed to evaluate the efficacy of the emphysema index (EI) in distinguishing chronic bronchitis (CB) from chronic obstructive pulmonary disease (COPD) and its role, combined with the COPD Assessment Test (CAT) score, in the evaluation of COPD. Methods. A total of 92 patients with CB and 277 patients with COPD were enrolled in this study. Receiver operating characteristic (ROC) curves were analyzed to evaluate whether the EI can preliminarily distinguish chronic bronchitis from COPD. Considering the heterogeneity of COPD, there might be missed diagnosis of some patients with bronchitis type when differentiating COPD patients only by EI. Therefore, patients with COPD were classified according to the CAT score and EI into four groups: Group 1 (EI < 16%, CAT < 10), Group 2 (EI < 16%, CAT ≥ 10), Group 3 (EI ≥ 16%, CAT < 10), and Group 4 (EI ≥ 16%, CAT ≥ 10). The records of pulmonary function and quantitative computed tomography findings were retrospectively analyzed. Results. ROC curve analysis showed that EI = 16.2% was the cutoff value for distinguishing COPD from CB. Groups 1 and 2 exhibited significantly higher maximal voluntary ventilation (MVV) percent predicted (pred), forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), maximal midexpiratory flow of 25–75% pred, carbon monoxide-diffusing capacity (DLCO)/alveolar ventilation (VA), FEV1 % pred p ≤ 0.013 , and maximal expiratory flow 50% pred (all p < 0.05 ) than Group 4. FEV1/FVC and DLCO/VA were significantly lower in Group 3 than in Group 2 ( p = 0.002 and p < 0.001 , respectively). The residual volume/total lung capacity was higher in Group 3 than in Groups 1 and 2 p < 0.05 . Conclusions. The combination of EI and CAT was effective in the evaluation of COPD.

2019 ◽  
Vol 38 (4) ◽  
pp. 503-511 ◽  
Author(s):  
Füsun Şahin ◽  
Ayşe Filiz Koşar ◽  
Ayşe Feyza Aslan ◽  
Burcu Yiğitbaş ◽  
Berat Uslu

Summary Background Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have all been investigated as novel inflammatory markers of cardiac and oncological diseases, while there is only a limited number of studies investigating these markers in chronic obstructive pulmonary disease (COPD). In the present study we examine NLR, PLR; and other markers, such as eosinophil, MPV, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width (RDW), and C-reactive protein (CRP) in patients with stable and acute exacerbation of COPD. Methods Stable COPD (Group 1, n=140), COPD with acute exacerbation (Group 2, n=110), and healthy controls (Group 3, n=50) were included in the study. Leukocyte, CRP, hemoglobin (HB), RDW, platelet, MPV, PCT, PDW, neutrophil, lymphocyte, eosinophil, NLR, and PLR were analyzed in all groups. Results HB, leukocyte, platelet, neutrophil, eosinophil, MPV, PCT, CRP, NLR, and PLR were significantly higher, while the lymphocyte was lower in Group 1 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while lymphocyte was lower in Group 2 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while HB, platelet, MPV, PCT, and lymphocyte were significantly lower in Group 2 than in Group 1. NLR and PLR increased significantly in patients with bronchiectasis when compared to those without in Group 1. Conclusions Our study results suggest that NLR, PLR and RDW can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with COPD.


Author(s):  
Aswathy M ◽  
Radhakrishnan VN ◽  
Jithesh M

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing, which is progressive and is not fully reversible. COPD includes chronic bronchitis and emphysema. Symptoms of COPD are well explained in Ayurveda in the context of Kasa and Swasa among which chronic bronchitis can be better correlated to Vataja and Kaphaja kasa and emphysema to Tamaka swasa. COPD is characterized by mucous hyper secretion, airway narrowing, fibrosis and destruction of lung parenchyma. Even though the existing conventional management is excellent, Ayurveda provides additional benefits such as improvement in quality of life. The study drug Hareetakyadi yoga is mentioned in Prakarana of kasa in Chikitsa manjari. The objective of the study was to evaluate the Effect of Hareetakyadi yoga in Chronic Obstructive Pulmonary Disease. The Study includes 10 subjects of age group 40-70 years of both gender, diagnosed clinically and as per investigations satisfying COPD, stage 1 & 2 as per GOLD criteria of spirometry attending department of Kayachikitsa, Government Ayurveda College, Thiruvananthapuram. A protocol from Deepana to Virechana were done as preparatory phase before administering drug. Hareetakyadi yoga having the properties of Kapha vata hara, Agni deepana and Rasayana property seems to be effective in the management of this disease.


Author(s):  
Narachai Prasungriyo ◽  
Nungruthai Sooksai

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.


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