scholarly journals Prevalence of psychiatric co morbidities in bronchial asthma and chronic obstructive pulmonary disease patients in North India population cohort

Author(s):  
Vineet Mahajan ◽  
Himanshu Sareen ◽  
Surya Kant ◽  
Jyoti Bajpai ◽  
Apoorva Narain ◽  
...  

Background: Psychiatric co morbidities tend to occur quite frequently in patients of chronic respiratory diseases mainly bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD) but still it is highly under diagnosed. Aim and objective of the study was to find out the prevalence of psychiatric co morbidities in asthma and COPD and to correlate them with disease severity according to Global Initiative against Obstructive Lung Disease (GOLD) and Global Initiative against Asthma (GINA) guidelines.Methods: Study was conducted in Department of TB and Chest in association with Department of Psychiatry of Punjab Institute of Medical Sciences, a secondary care medical college in north India. A total 204 patients, 68 of bronchial asthma, 68 0f COPD and 68 were controls included in the study. Diagnosis and severity of respiratory diseases was assessed by spirometry. Evaluation of psychiatric co morbidities was done using the MINI international neuropsychiatric interview questionnaire.Results: The frequency of psychiatric co morbidities in COPD patients was significantly higher (32.4%) compared to patients of bronchial asthma (20.6%). The most common co morbidity in both arms was generalized anxiety disorder (17.6% in COPD patients and 10.3% in patients of bronchial asthma.Conclusions: COPD patients have a higher frequency of psychiatric co morbidities compared to bronchial asthma patients and control population. These should be properly screened and treated. 

2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.


Author(s):  
Kaushlendra Pratap Narayan ◽  
S. K. Verma ◽  
Surya Kant ◽  
R. A. S. Kushwaha ◽  
Santosh Kumar ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Fabrizio Facchinetti ◽  
Maurizio Civelli ◽  
Dave Singh ◽  
Alberto Papi ◽  
Aida Emirova ◽  
...  

Chronic respiratory diseases are the third leading cause of death, behind cardiovascular diseases and cancer, affecting approximately 550 million of people all over the world. Most of the chronic respiratory diseases are attributable to asthma and chronic obstructive pulmonary disease (COPD) with this latter being the major cause of deaths. Despite differences in etiology and symptoms, a common feature of asthma and COPD is an underlying degree of airways inflammation. The nature and severity of this inflammation might differ between and within different respiratory conditions and pharmacological anti-inflammatory treatments are unlikely to be effective in all patients. A precision medicine approach is needed to selectively target patients to increase the chance of therapeutic success. Inhibitors of the phosphodiesterase 4 (PDE4) enzyme like the oral PDE4 inhibitor roflumilast have shown a potential to reduce inflammatory-mediated processes and the frequency of exacerbations in certain groups of COPD patients with a chronic bronchitis phenotype. However, roflumilast use is dampened by class related side effects as nausea, diarrhea, weight loss and abdominal pain, resulting in both substantial treatment discontinuation in clinical practice and withdrawal from clinical trials. This has prompted the search for PDE4 inhibitors to be given by inhalation to reduce the systemic exposure (and thus optimize the systemic safety) and maximize the therapeutic effect in the lung. Tanimilast (international non-proprietary name of CHF6001) is a novel highly potent and selective inhaled PDE4 inhibitor with proven anti-inflammatory properties in various inflammatory cells, including leukocytes derived from asthma and COPD patients, as well as in experimental rodent models of pulmonary inflammation. Inhaled tanimilast has reached phase III clinical development by showing promising pharmacodynamic results associated with a good tolerability and safety profile, with no evidence of PDE4 inhibitors class-related side effects. In this review we will discuss the main outcomes of preclinical and clinical studies conducted during tanimilast development, with particular emphasis on the characterization of the pharmacodynamic profile that led to the identification of target populations with increased therapeutic potential in inflammatory respiratory diseases.


2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Bo Zhou ◽  
Shufang Liu ◽  
Danni He ◽  
Kundi Wang ◽  
Yunfeng Wang ◽  
...  

Abstract Backgrounds: Some studies have reported association of circulating fibrinogen with the risk of chronic obstructive pulmonary disease (COPD), and the results are conflicting. To yield more information, we aimed to test the hypothesis that circulating fibrinogen is a promising biomarker for COPD by a meta-analysis. Methods: Data extraction and quality assessment were independently completed by two authors. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (95% CI). Results: Forty-five articles involving 5586/18604 COPD patients/controls were incorporated. Overall analyses revealed significantly higher concentrations of circulating fibrinogen in COPD patients than in controls (WMD: 84.67 mg/dl; 95% CI: 64.24–105.10). Subgroup analyses by COPD course showed that the degree of increased circulating fibrinogen in patients with acute exacerbations of COPD (AECOPD) relative to controls (WMD: 182.59 mg/dl; 95% CI: 115.93–249.25) tripled when compared in patients with stable COPD (WMD: 56.12 mg/dl; 95% CI: 34.56–77.67). By COPD severity, there was a graded increase in fibrinogen with the increased severity of COPD relative to controls (Global Initiative for Obstructive Lung Disease (GOLD) I, II, III, and IV: WMD: 13.91, 29.19, 56.81, and 197.42 mg/dl; 95% CI: 7.70–20.11, 17.43–40.94, 39.20–74.41, and −7.88 to 402.73, respectively). There was a low probability of publication bias. Conclusion: Our findings indicate a graded, concentration-dependent, significant relation between higher circulating fibrinogen and more severity of COPD.


Author(s):  
Dushyant Lal ◽  
Sachin Manocha ◽  
Arunabha Ray ◽  
V.K. Vijayan ◽  
Raj Kumar

AbstractBronchial asthma and chronic obstructive pulmonary disease (COPD) are the major obstructive disorders that may contribute to the severity in individual patients. The present study was designed to compare the efficacy and safety of theophylline and doxofylline in patients with bronchial asthma and COPD.A total of 60 patients, 30 each with bronchial asthma and COPD, were enrolled for the study. Each group of 30 patients received standard treatment for asthma and COPD. Each group was again subdivided into two with 15 patients each, who received theophylline or doxofylline in addition to standard therapy, for a period of 2 months. Each patient was followed up fortnightly for the assessment of efficacy parameters using a pulmonary function test (PFT), clinical symptoms and emergency drug use, and safety was assessed by recording adverse drug reactions.Both theophylline and doxofylline produced enhancements in PFT at different time intervals in both asthma and COPD patients. The maximum beneficial effects were seen at 6 weeks for asthma patients and at 8 weeks for COPD patients for both theophylline and doxofylline.The comparative study showed that doxofylline was more effective as evidenced by improvement in PFT as well as clinical symptoms, and reduced incidence of adverse effects and emergency bronchodilator use.


Folia Medica ◽  
2019 ◽  
Vol 61 (4) ◽  
pp. 512-521
Author(s):  
Yanitsa A. Zhelyazkova ◽  
Tanya T. Tacheva ◽  
Dimo M. Dimov ◽  
Denitsa G. Vlaykova ◽  
Aneliya V. Bivolarska ◽  
...  

Leptin is one of the adipokines shown to exert a significant effect in respiratory diseases, including chronic obstructive pulmonary disease (COPD).The aim of the present study was to evaluate the possible role of serum leptin as biomarker in COPD.The serum leptin levels were assessed in 58 patents with stable COPD and 21 controls applying ELISA method.The leptin levels were higher, although not significantly, in COPD patients than in controls (221.52&plusmn;24.28(SE) vs. 165.04&plusmn;26.01 pg/ml, p=0.197). This tendency turned out significant when only females were compared (414.60&plusmn;60.63 vs. 219.40&plusmn;44.15 pg/ml, p=0.038). The levels of leptin were highly dependent on the BMI both in COPD patients (p<0.001) and in controls (p=0.024): they were the highest in obese individuals and decreased with reducing the BMI.In the COPD group, women had significantly higher leptin levels than men (p<0.0001) independent of the BMI. The non-smoking patients had significantly higher leptin levels than ex-smokers (p=0.007) and current smokers (p=0.007). In patients with BMI above 25, several associations were observed: patients with mild COPD had higher serum leptin level than those with severe or very severe COPD (p=0.038); the leptin levels correlated positively with FEV1% (r= 0.304, p=0.045) and FEV1/FVC ratio (I= 0.348, p=0.021), and tended to correlate negatively with ABCD GOLD groups (Rho=-0.300, p=0.043) and with the CAT points (Rho=-0.258, p=0.091); the leptin levels below 300 ng/ml determined 4.08-fold higher risk for more severe COPD.The results of our study confirm that the serum leptin levels depend significantly on the BMI and are interfered by gender and smoking habits. However, this adipokine cannot be used as a serum biomarker for distinguishing COPD patients, but its decrease might be associated with aggravation of the disease.


2020 ◽  
Vol 7 (4) ◽  
pp. 656
Author(s):  
Noklangkumla Sangtam ◽  
Sunanda Haorongbam ◽  
Kshetrimayum Silpa ◽  
Yumnam Priyabarta Singh

Background: Bronchiectasis is common in patients with Chronic Obstructive Pulmonary Disease (COPD). COPD with bronchiectasis has been considered a phenotype with worse lung function and more severe exacerbations. There is scarce literature on the characteristics and optimal management of such patients.Methods:Patients with COPD reporting within the one-year study period were subjected to High Resolution Computed Tomography (HRCT) scan of the thorax. Sputum was sent for Gram-stain and culture/sensitivity for patients found to have bronchiectasis. Bronchiectasis Severity Index (BSI) was calculated using the online BSI calculator. Association between presence of bronchiectasis and gender, lung function and frequency of exacerbations was statistically analysed.Results: Total 62 patients with COPD were enrolled. Bronchiectasis was present in 11 (17.7%) patients. The most common bacterial isolate from sputum of patients with bronchiectasis was Haemophilus influenza (54.54%). The prevalence of bronchiectasis was more in females (19.45% compared to 15.4% in males), but this association was not found to be statistically significant(p=0.748). Forced Expiratory volume in 1st second (FEV1) was found to be significantly lower in patients with bronchiectasis (p<0.05). There was increased frequency of exacerbations among patients with bronchiectasis. This association was however not found to be statistically significant (p=0.765), 1 (9.1%) patient had low BSI score (0-4), 3 (27.3%) patients had intermediate BSI score (5-8) and 7 (63.3%) patients had high BSI score (≥9).Conclusions:The presence of bronchiectasis in COPD is a phenotype associated with a poor clinical course. The characteristics of this co-existence are largely unknown. More studies are required to properly characterize and manage patients with this coexistence. 1.         Global Initiative for Chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2014. Available at: http://wwwgoldcopdorg/. Accessed 1 February, 20182.         Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2019 report. Available at: https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf. Accessed 24 January 2019.3.         Martínez-García MA, de la Rosa Carrillo D, Soler-Cataluña JJ, Donat-Sanz Y, Serra PC, Lerma MA, et al. Prognostic value of bronchiectasis in patients with moderate-to-severe chronic obstructive pulmonary disease. Am J Respirat Crit Care Med. 2013 Apr 15;187(8):823-31.4.         Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CFbronchiectasis. Thorax. 2010 Jul 1;65(Suppl 1):i1-58.5.         Mao B, Lu HW, Li MH, Fan LC, Yang JW, Miao XY, et al. The existence of bronchiectasis predicts worse prognosis in patients with COPD. Scientific reports. 2015 Jun 16;5:10961.6.         Jin J, Yu W, Li S, Lu L, Liu X, Sun Y. Factors associated with bronchiectasis in patients with moderate-severe chronic obstructive pulmonary disease. Med (Baltimore) 2016;95(29):e4219.7.         Du Q, Jin J, Liu X, Sun Y. Bronchiectasis as a co morbidity of chronic obstructive pulmonary disease: a systematic review and meta-analysis. PLoS One. 2016;11(3):e0150532.8.         Ni Y, Shi G, Yu Y, Hao J, Chen T, Song H. Clinical characteristics of patients with chronic obstructive pulmonary disease with co morbid bronchiectasis: a systemic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2015;10:1465-75.9.         Loebinger MR, Wells AU, Hansell DM, Chinyanganya N, Devaraj A, Meister M, et al. Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur Respir J. 2009;34(4):843-9.10.      Rakhimova E, Wiehlmann L, Brauer AL, Sethi S, Murphy TF, Tummler B. Pseudomonas aeruginosa population biology in chronic obstructive pulmonary disease. J Infect Dis. 2009;200(12):1928-35.11.      Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med. 2014;189(5):576-85.12.      Dou S, Zheng C, Cui L, Xie M, Wang W, Tian H, et al. High prevalence of bronchiectasis in emphysema-predominant COPD patients. Int J Chron Obstruct Pulmon Dis. 2018;13:2041-7.13.      Ramakrishna R, Ambica A. Association of Bronchiectasis in Moderate to Severe COPD patients attending Katuri Medical College Hospital, Guntur from 2011-2013. J Evidence Based Med Healthcare 2015;2(13):2062-76.14.      Martinez-Garcia MA, Soler-Cataluna JJ, Donat Sanz Y, Catalan Sera P, Agramunt Lerma M, Ballestin Vicente J, et al. Factors associated with bronchiectasis in patients with COPD. Chest 2011;140(5):1130-7.15.      Kumar S, Singh GV, Gupta RK, Singh H, Prakash G. To estimate the prevalence of bronchiectasis in COPD patients. IOSR JDMS. 2018;17(3):82-90.16.      Woodhead M, Blasi F, Ewig S. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J. 2005;26:1138-80.17.      Patel IS, Vlahos I, Wilkinson TM, Lloyd-Owen SJ, Donaldson GC, Walks M, et al. Bronchiectasis, Exacerbation indices and Inflammation in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2004;170(4):400-7.18.      Chen YH, Sun YC. Bronchiectasis as a co morbidity of chronic obstructive pulmonary disease: implications and future research. Chin Med J (Engl). 2016;129(17):2017-9.19.      Gatheral T, Kumar N, Sansom B. COPD-related bronchiectasis; independent impact on disease course and outcomes. COPD. 2014;11(6):605-14.20.      Goeminne PC, Nawrot TS, Ruttens D, Seys S, Dupont LJ. Mortality in non-cystic fibrosis bronchiectasis: a prospective cohort analysis. Respir Med. 2014 Feb 1;108(2):287-96.21.      Hurst JR, Elborn JS, De Soyza A. COPD–bronchiectasis overlap syndrome. Eur Respir J. 2015;45:310-3.


2008 ◽  
pp. 60-65
Author(s):  
E. A. Titova ◽  
A. I. Algazin ◽  
T. A. Kornilova ◽  
I. P. Sokol ◽  
E. M. Reutskaya ◽  
...  

Fifty-two patients with chronic obstructive pulmonary disease (COPD) aged 44 to 71 yrs were examined. Of them, 26 ones suffered from type 2 diabetes mellitus (DM). We established that in patients with concomitant DM, COPD has more severe course with more advanced respiratory failure and chronic cor pulmonale and more frequent exacerbations. COPD patients with concomitant DM more often have co-morbidity, such as obesity, ischemic heart disease, chronic heart failure. Co-morbidity of COLD and DM requires more extensive pharmacotherapy.


Author(s):  
Anand Kumar ◽  
Sachin Gupta ◽  
Sudhir Chaudhri ◽  
Sanjay Kumar Verma ◽  
Avdhesh Kumar ◽  
...  

Background: Worldwide, Chronic obstructive pulmonary disease (COPD) is the one of the leading cause of chronic morbidity and mortality. COPD is one of the diseases in which smoking is the common and important risk factor when it is associated with Metabolic syndrome (MetS). The individual components of MetS, i.e., obesity, dyslipidemia, fasting hyperglycaemia, and hypertension were independently associated with impairment of lung function too. The objective of this study is to find out the prevalence of metabolic syndrome among COPD patients.Methods: This was a cross-sectional study conducted in department of Respiratory Diseases and a total of 70 COPD patients were included in the study, which were enrolled for treatment from July 2016 to July 2017. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), 2015 guideline. International Diabetes Federation (IDF) guideline; (2005) was used in diagnosis of metabolic syndrome.Results: Seventy patients with COPD were enrolled during the study period. There were 45 males (64.2%) and 25(35.7%) females. Mean age of male patients was 58.67±9.87 years, while mean age of female patients was 57.23±10.4 years (35-87 years). Mean BMI of male was 24.33±6.64 kg/m2, while in case of female it was 30.07±6.95 kg/m2 and overall mean BMI of study population was 26.22±7.22 kg/m2. The mean   waist circumference of male was 86.91±13.31 cm while in female it was 87.18±14.51 cm. The Overall prevalence of metabolic syndrome was 31.34% and most common in GOLD stage-3 (47.06%), followed by stage-2 (40%), followed by stage-4 (25.71%) and 7.4 % in GOLD stage -1.Conclusions: The presence of metabolic syndrome is common in patients with COPD and, all COPD patients should be considered for screening for it.


2018 ◽  
Vol 96 (6) ◽  
pp. 527-536
Author(s):  
N. A. Karoli ◽  
A. P. Rebrov

Chronic obstructive pulmonary disease (COPD) creates conditions for endothelial damage with the development of endothelial dysfunction: hypoxia, an increase in biologically active substances, including cytokines, leukotrienes, etc. Previous studies have been conducted in COPD patients with a combination of arterial hypertension and coronary heart disease. The aim of the study was to evaluate the endothelial damage and the vasoregulatory function of the vascular wall in patients with COPD of varying severity. Material and methods. The study included 76patients with COPD (men, mean age 51.14 ± 0.97years). COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (2013) guidelines. The patients were divided into two groups according to COPD severity: the 1st group (GOLD I-II) included 27 patients, the 2nd group (GOLD III-IV) included 49 patients. Antithrombogenic, vasoregulatory function of the endothelium, synthesis of nitric oxide (NO) in blood plasma by the level of stable NO metabolites (nitrates and nitrites) was studied. The number of desquamated endotheliocytes, von Willebrand factors in the blood was determined. As a result of the study, a significant damage to the endothelium, an increase in the thickness of the wall of the brachial artery, a decrease in the total plasma concentration of stable NO metabolites, a violation of the antithrombogenic and vasoregulatory activity of the vascular wall in COPD patients compared with healthy people. The most significant changes were found in patients with severe COPD.


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