Evaluatıon of The Relatıonshıp Between The Levels and Perceptıons of Dyspnea and The Levels of Anxiety and Depressıon in Chronıc Obstructıve Pulmonary Dısease (COPD) Patıents

Psychological morbidity is common in chronic respiratory diseases. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) and risk factors for comorbid depression in chronic obstructive pulmonary disease (COPD) are addressed. Consecutive COPD patients (GOLD stage I–IV, 40–75 years old) were enrolled in a multicentre, cross-sectional cohort study. Diagnosis of depression was ascertained through clinical records. Lung function, HADS score, 6-minute walking test (6-MWT), MRC dyspnoea score, and COPD Assessment Test (CAT) were evaluated. Two hundred fifty-nine COPD patients (mean age 62.5 years; 32% female; mean FEV1 48% predicted) were included. Patients diagnosed with depression (29/259; 11.2%) had significantly higher HADS-D and HADS-Total scores than nondepressed patients (median (quartiles) HADS-D 6 [4; 9] versus 4 [2; 7], median HADS-Total 14 [10; 20] versus 8 [5; 14]). Receiver-operating characteristic plots showed moderate accuracy for HADS-D, AUC 0.662 (95%CI 0.601–0.719), and HADS-Total, AUC 0.681 (95%CI 0.620–0.737), with optimal cut-off scores of >5 and >9, respectively. Sensitivity and specificity were 62.1% and 62.6% for HADS-D compared to 75.9% and 55.2% for HADS-Total. Age, comorbidities, sex, and lower airflow limitation predicted depression. The HADS exhibits low diagnostic accuracy for depression in COPD patients. Younger men with comorbidities are at increased risk for depression.

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Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Journal of Clinical Medicine ◽

10.3390/jcm9082670 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2670

Author(s):

Keiji Oishi ◽

Kazuto Matsunaga ◽

Toshihiro Shirai ◽

Keita Hirai ◽

Yasuhiro Gon

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Stable State ◽

Epidemiologic Studies ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Blood Eosinophils ◽

The Relationship

Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.

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Relationship between Vitamin D Level and Serum TNF-α Concentration on the Severity of Chronic Obstructive Pulmonary Disease

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.663 ◽

2019 ◽

Vol 7 (14) ◽

pp. 2298-2304

Author(s):

Muhammad Ilyas ◽

Agussalim Agussalim ◽

Megawati Megawati ◽

Nasrum Massi ◽

Irawaty Djaharuddin ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Vitamin D ◽

Airway Obstruction ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Vitamin D Levels ◽

Tnf Α ◽

The Relationship

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing proinflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralization of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD. Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. For that reason, this study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. Methods This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr.Wahidin Sudirohusodo General hospital Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometric measurement. Assessment of airway obstruction levels referred to the GOLD spirometric criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. Results The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. In view of the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. In view of the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value<0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. Conclusions: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.

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Chronic obstructive pulmonary disease and cardiovascular comorbidity

Kardiologiia ◽

10.18087/cardio.2572 ◽

2019 ◽

Vol 59 (8S) ◽

pp. 24-36 ◽

Cited By ~ 3

Author(s):

Z. R. Aisanov ◽

A. G. Chuchalin ◽

E. N. Kalmanova

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

General Population ◽

Pulmonary Disease ◽

Point Of View ◽

Chronic Obstructive ◽

Bronchial Obstruction ◽

Obstructive Pulmonary Disease ◽

Cardiovascular Comorbidity ◽

Copd Patients ◽

The Relationship

In recent years, a greater understanding of the heterogeneity and complexity of chronic obstructive pulmonary disease (COPD) has come from the point of view of an integrated clinical assessment of severity, pathophysiology, and the relationship with other pathologies. A typical COPD patient suffers on average 4 or more concomitant diseases and every day about a third of patients take from 5 to 10 different drugs. The mechanisms of the interaction of COPD and cardiovascular disease (CVD) include the effects of systemic inflammation, hyperinflation (hyperinflation) of the lungs and bronchial obstruction. The risk of developing CVD in patients with COPD is on average 2–3 times higher than in people of a comparable age in the general population, even taking into account the risk of smoking. The prevalence of coronary heart disease, heart failure, and rhythm disturbances among COPD patients is significantly higher than in the general population. The article discusses in detail the safety of prescribing various groups of drugs for the treatment of CVD in patients with COPD. Achieving success in understanding and managing patients with COPD and CVD is possible using an integrated multidisciplinary approach.

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Assessment of Depression and Anxiety in Chronic Obstructive Pulmonary Disease Patients attending Pulmonary Medicine Department of Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India

International Journal of Advanced and Integrated Medical Sciences ◽

10.5005/jp-journals-10050-10092 ◽

2017 ◽

Vol 2 (3) ◽

pp. 137-139

Author(s):

Preeti Sharma ◽

Abhishek Kumar ◽

Arpit Jaiswal ◽

Chandra S Sharma ◽

Harsh Rathi ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Uttar Pradesh ◽

Anxiety And Depression ◽

Chronic Obstructive ◽

Pulmonary Medicine ◽

Depression And Anxiety ◽

Obstructive Pulmonary Disease ◽

Medical College ◽

Copd Patients

ABSTRACT Introduction Chronic disease like chronic obstructive pulmonary disease (COPD) is associated with various comorbidities. Anxiety and depression are among the common comorbidities and have significant impact on socioeconomic status of the person as well as the course of disease. In our study, we screened COPD patients attending the outpatient department (OPD) of pulmonary medicine for anxiety and depression, using different scales that include questionnaires. About 46.2 and 34.6% cases were found to have depression and anxiety respectively, among all COPD patients (n = 156). Incidence of anxiety and depression was directly proportional to severity of disease. Age, gender, locality, educational, marital, and socioeconomic statuses are some factors that play important roles in the development of these psychiatric comorbidities. Hence, mental assessment of COPD patients should be mandatory with every visit to the OPD. How to cite this article Jaiswal A, Kumar A, Rathi H, Sharma CS, Sharma P, Arya V. Assessment of Depression and Anxiety in Chronic Obstructive Pulmonary Disease Patients attending Pulmonary Medicine Department of Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(3):137-139.

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The Cost of Chronic Obstructive Pulmonary Disease (COPD) in Compliant Versus Non-Compliant Patients

Journal of Student Research ◽

10.47611/jsr.v10i1.797 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Kimberly Stephens Rudd ◽

Tiffany Jackman

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

The United States ◽

Chronic Obstructive ◽

Healthcare Outcomes ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Additional Costs ◽

The Cost ◽

The Relationship

A literature review conducted, on the cost of Chronic Obstructive Pulmonary Disease (COPD) between patients who are compliant versus non-compliant, reflects on the data for the United States with an emphasis on the areas within the Florida Panhandle. An overview of costs associated with noncompliant COPD patients and strategies for encouraging patients to adhere to treatment and improve healthcare outcomes is provided. A review of recent peer-reviewed articles was performed to determine the additional costs associated with non-compliance. The direct cost of COPD was estimated at $6,246 per patient annually. Nationally projected expenditures for COPD were $49.9 billion in 2010, while costs in Florida were $2.5 billion. Florida’s costs for COPD management ranks much higher than the national average. Potential causes for the differentiation are associated with newer medications and devices that contribute to a higher out-of-pocket expense for patients, patient denial about the seriousness of their illness, and/or inability to understand compliance with treatment. The relationship between the primary care provider and COPD patient is critical for adherence to therapy.

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Anxiety and depression in patients with occupational chronic obstructive pulmonary disease comorbid with biventricular heart failure

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2019-59-9-816-817 ◽

2020 ◽

pp. 816-816

Author(s):

L. A. Shpagina ◽

O. S. Kotova ◽

N. V. Kamneva

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Anxiety And Depression ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Comparison Groups

Occupational chronic obstructive pulmonary disease (COPD) patients with (n=44) or without (n=52) biventricular heart failure (HF) were investigated. Comparison groups were COPD in tobacco smokers with (n=38) or without (n=65) HF. Comorbid pathology was characterized by the highest levels of anxiety and depression (HADS-A score was 7.4+0.86, HADS-D score was 7.9+0.75) associated with serum S100В.

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Sarcopenia and Sarcopenic Obesity in Chronic Obstructive Pulmonary Disease Patients with Different Levels of Severity

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i4.109 ◽

2018 ◽

Vol 3 (1) ◽

pp. 17

Author(s):

Katayoun Samadi ◽

Shahram Kharabian ◽

Atefeh Abedini ◽

Foroogh Mohammadi ◽

Azam Adeli ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Muscle Strength ◽

Pulmonary Disease ◽

Muscle Mass ◽

Physical Performance ◽

Sarcopenic Obesity ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Relationship

Background: Sarcopenia is defined as loss of muscle mass with attendant loss of muscle strength and physical function and is associated with advancing age. Inflammatory condition of chronic disease leads to more rapid progression of this syndrome, which may adversely affect quality of life. The aim of this study was to determine the relationship between chronic obstructive pulmonary disease (COPD) and sarcopenia.Methods: This study included 108 COPD patients who were treated in the pulmonary clinic at Masih Daneshvari Hospital. Patients were categorized into three groups based on Global Initiative for Obstructive Lung Disease criteria. Sarcopenic parameters including muscle mass, muscle strength, and physical performance were measured by Bioimpedance Analysis, hand grip dynamometer, and the Short Physical Performance Battery test, respectively. According to the European Working Group on Sarcopenia in Older People cutoff points and the definition of sarcopenic obesity, sarcopenic patients were diagnosed and categorized based on different COPD severity scores.Results: The relationship between sarcopenia and COPD grading, which was assessed using multiple regression models with adjustment of confounding factors, including age, chronic diseases, and smoking, was statistically insignificant. However, by using forced expiratory volume in 1 second (FEV1) or ratio of FEV1 to forced vital capacity in this model, the results were significant (P = 0.026). A positive linear correlation was observed between skeletal muscle index (SMI) and spirometric data, which was assessed by Spearman’s correlation test. By exploring the association between sarcopenia and obesity with the one-way analysis of variance test, sarcopenic patients represented to have the minimal spirometric measures. However, this difference was only significant for actual measurements.Conclusion: This study showed that sarcopenic COPD patients had smaller spirometric measurements and that sarcopenia and magnitude of SMI were positively correlated with obstruction severity.

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Evaluation of the relationship between the parameters of peripheral skeletal and respiratory muscles in patients with chronic obstructive pulmonary disease

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.03.000448 ◽

2020 ◽

Vol 92 (3) ◽

pp. 36-41

Author(s):

A. K. Suleymanova ◽

I. A. Baranova

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Respiratory Muscle ◽

Respiratory Muscles ◽

Chronic Obstructive ◽

Muscle Dysfunction ◽

Limb Muscle ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Relationship

Chronic obstructive pulmonary disease (COPD) is a group of diseases with high levels of comorbidity. Pathological changes of peripheral skeletal and respiratory muscles in COPD patients, which are often underestimated, occupy a special place. Aim. To study the relationship between functional and quantitative parameters of the peripheral (limb muscle) and respiratory muscles in COPD patients. Materials and methods. 127 patients (98 men/29 women, mean age 67.68.2 years) were under observation without acute COPD. All COPD patients were classified according to GOLD (2019) into groups A, B, C, D. The algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) was used to diagnose sarcopenia. The muscle mass was measured using dual energy X-ray absorptiometry (DXA) and the appendicular lean mass index (ASM) was estimated. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured by body plethysmograph MasterScreen Body. Quantitative assessment of thoracic muscle cross-sectional areas were performed using the CT scan using Vidar Dicom Viewer software. Results. Sarcopenia was diagnosed in 43.3% of COPD patients. Respiratory muscle dysfunction was determined in 66.1% of patients with COPD, its probability increased in groups C and D in comparison with groups A and B [chance ratio 6.6 (95% confidence interval 2.915.0); p0.0001]. Correlations between the functional parameters of sarcopenia and respiratory muscle strength as well as between the mass of peripheral skeletal muscles and respiratory muscle area have been established according to the data of computerized tomography (р0.01). Sarcopenia as well as respiratory muscle dysfunction was observed more frequently in persons with severe and extremely severe airway obstruction and in patients with predominantly emphysematic COPD phenotype (p0.01). Conclusion. Sarcopenia is a frequent comorbidity in COPD and its development is connected with the severity of the course of the main disease. Correlation between parameters of peripheral (limb muscle) and respiratory muscles in patients with COPD has been determined.

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Prevalence of Anxiety and Depression in Patient with Chronic Obstructive Pulmonary Disease

Nepal Medical College Journal ◽

10.3126/nmcj.v20i4.25139 ◽

2018 ◽

Vol 20 (4) ◽

pp. 155-162

Author(s):

Sita Sharma ◽

U. Shakya ◽

B. Gorkhali ◽

S. Neupane

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Psychiatric Symptoms ◽

Depression Scale ◽

University Teaching ◽

Anxiety And Depression ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Impact

Anxiety and depression are very common comorbidities in patients with chronic obstructive pulmonary disease (COPD). This study was aimed at documenting the prevalence anxiety and depression in COPD patient attending tertiary level hospital. A quantitative cross sectional analytical study was carried out in 221 patients with previously diagnosed COPD. Participants were recruited from respiratory OPD at Tribhuvan University Teaching Hospital, Nepal. Anxiety and depression were screened using previously validated Nepalese version of Hospital Anxiety and Depression Scale (HADS) and dyspnea was assessed using the modified Medical Research Council Dyspnea Scale (mMRC). COPD Assessment Test (CAT) was used to measure the impact of COPD on daily life. Data was analyzed using SPSS version 16. Out of 221, 140 patients (63.3%) had anxiety and 153 patients (69.2%) had depression and 133 (60.2%) had both psychiatric symptoms. Factors associated with anxiety and depression in COPD patients were age, ethnicity, educational status, marital status, current working status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, domiciliary oxygen therapy comorbidities along with dyspnea, CAT score. In conclusion, the study findings suggest that anxiety and depression are highly prevalent in COPD patients.

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