scholarly journals Office-Based Sedation/General Anesthesia for COPD Patients, Part I

2018 ◽  
Vol 65 (4) ◽  
pp. 261-268 ◽  
Author(s):  
Kristin Chino ◽  
Steven Ganzberg ◽  
Kristopher Mendoza
Keyword(s):  
General Anesthesia ◽  
Treatment Plan ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Anxiety Control ◽  
Copd Patients ◽  
Dental Office ◽  
Organ Systems

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office–based settings can be quite complex without a current understanding of the etiology, course, severity, and treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other comorbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article will cover the epidemiology, etiology, and pathophysiology of COPD. Patient evaluation in the preoperative period will also be reviewed. Part II will cover which patients are acceptable for sedation/general anesthesia in the dental office–based setting as well as sedation/general anesthesia techniques that may be considered.

scholarly journals Office-Based Sedation/General Anesthesia for COPD Patients, Part II

2019 ◽  
Vol 66 (1) ◽  
pp. 44-51
Author(s):  
Kristin Chino ◽  
Steven Ganzberg ◽  
Kristopher Mendoza
Keyword(s):  
General Anesthesia ◽  
Treatment Plan ◽  
Current Treatment ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Anxiety Control ◽  
Dental Office ◽  
Organ Systems

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article covered the epidemiology, etiology, and pathophysiology of COPD. Patient considerations in the preoperative period were also reviewed. Part II will cover which patients are acceptable for sedation/general anesthesia in the dental office-based setting as well as sedation/general anesthesia techniques that may be considered. Postoperative care will also be reviewed.

scholarly journals Somatotypes trajectories during adulthood and their association with COPD phenotypes

2020 ◽  
Vol 6 (3) ◽  
pp. 00122-2020
Author(s):  
Miguel J. Divo ◽  
Marta Marin Oto ◽  
Ciro Casanova Macario ◽  
Carlos Cabrera Lopez ◽  
Juan P. de-Torres ◽  
...  
Keyword(s):  
Early Adulthood ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Multiple Organ ◽  
Airflow Limitation ◽  
Initial Increase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Continuous Increase ◽  
Copd Patients

RationaleChronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation.ObjectivesWe hypothesised that somatotype changes – as a surrogate of adiposity – from early adulthood follow different trajectories to reach distinct phenotypes.MethodsUsing the validated Stunkard's Pictogram, 356 COPD patients chose the somatotype that best reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based trajectory modelling was used to determine somatotype trajectories. We then compared the current COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory.Measurements and main resultsAt 18 years of age, 88% of the participants described having a lean or medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m−2) while the other 12% a heavier somatotype (estimated BMI between 25 and 27 kg·m−2). From age 18 onwards, five distinct trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age 40. Patients with this trajectory were primarily females with low BMI and DLCO (diffusing capacity of the lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had significantly lower forced expiratory volume in 1 s (FEV1), DLCO, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype.ConclusionsCOPD patients have distinct somatotype trajectories throughout adulthood. Those with the MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in early adulthood deserve particular attention as they seem to develop more severe COPD.

scholarly journals Erectile dysfunction and sex hormone changes in chronic obstructive pulmonary disease patients

2013 ◽  
Vol 8 ◽  
Author(s):  
Hasan Kahraman ◽  
Bilal Sen ◽  
Nurhan Koksal ◽  
Metin Kilinç ◽  
Sefa Resim
Keyword(s):  
Erectile Dysfunction ◽  
Sexual Dysfunction ◽  
Treatment Plan ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Copd Patients ◽  
Group A

Background: The prevalence of sexual dysfunction in patients with COPD is high and its significance has not been sufficiently stressed. The aim of this study is to investigate the incidence of erectile dysfunction (ED) and the factors affecting its frequency in COPD patients. Methods: Seventy patients with COPD and 68 healthy volunteers were included in the study. The International Index of Erectile Function questionnaire was used to evaluate ED, and the Beck Depression Inventory was used to evaluate depression. Results: The smoking rate was higher and oxygen saturation (SaO2) and body mass index (BMI) were lower in the COPD group. Blood tests revealed higher levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol. Testosterone level was lower but it was not statistically significant. Various degrees of ED were detected in 78.6% of COPD patients and 55.8% of the controls. Depression was more common in the COPD group. There was a negative correlation between forced expiratory volume in 1 sec (FEV1) level and ED and between SaO2 and ED in the COPD group. A positive correlation was noted between age and ED in both groups. No significant correlation was found among hormonal status and FEV1, ED, depression, SaO2, or BMI. Conclusions: The present study provides further confirmation that COPD is a risk factor for erectile dysfunction. When establishing a treatment plan for improving the pulmonary function of COPD patients, sexual dysfunction and depression, which are usually neglected but diminish quality of life, should also be addressed.

“Double-Dipping”

2013 ◽  
Vol 18 (4) ◽  
pp. 6-7
Author(s):  
Stephen L. Demeter
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Multiple Organ ◽  
Organ System ◽  
The Other ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Sixth Edition ◽  
Organ Systems ◽  
Artery Disease ◽  
Single Organ

Abstract The goal of impairment assessment is to accurately estimate the loss of structure and/or function due to an injury or illness. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) sometimes provides two or more methods for rating a given condition, or, in the case of two or more impairing conditions, it may be inappropriate to rate less significant conditions if the rating for the primary impairment already takes into account the deficit(s). Either scenario offers opportunities for “double-dipping” or rating the same impairment more than once. Duplicative ratings commonly occur when two or more impairing conditions are present in a single organ system and even more often if multiple organ systems are involved. Because of methodological changes, ratings using the AMA Guides, Sixth Edition, are less susceptible to double-dipping than those from earlier editions, especially musculoskeletal ratings. To avoid duplication, the rater must look closely at all elements included in the impairment classes and determine if any similarity exists in the other organ systems or conditions rated (eg, is the patient's coronary artery disease responsible for the diminished exercise capacity, or is it the cardiomyopathy, or is it chronic obstructive pulmonary disease). When two or more conditions are present, evaluators should rate the higher or highest impairment and then eliminate, as much as possible, the influence of similar symptoms, signs, or diagnostic test abnormalities when rating the lower impairments.

Inhaled therapies for asthma and chronic obstructive pulmonary disease

2020 ◽  
Vol 26 ◽  
Author(s):  
Yingmin Liang ◽  
Judith C.W. Mak
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cause Of Death ◽  
Lung Diseases ◽  
Treatment Plan ◽  
Inhalation Technique ◽  
Chronic Obstructive ◽  
Mucus Production ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

: Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases which are characterized by chronic inflammation and an increase in mucus production, and are highly prevalent conditions. Despite recent advances and multiple available therapies, there remains a significant unmet medical need. Over the past 40 years, the introduction of new classes of safe and effective therapy is scanty. In spite of the high burden of asthma and COPD among patients, there are fewer new approved therapies in comparison to cardiovascular, metabolic and neurological diseases due to few drug candidates and a higher failure rate in the development of respiratory medicine. Lung diseases are amongst the leading causes of death globally with asthma being one of the most prevalent respiratory diseases, which affects people of all ages but, despite effective therapies available, many patients are poorly controlled and have a low quality of life. COPD is currently ranked the fourth cause of death worldwide and predicted to become the third leading cause of death in 2030. The development of more effective treatments is urgently needed in order to reduce the high mortality rate and the enormous suffering from asthma and COPD. Various inhalation devices with different classes of medications are the foundation as therapies in both asthma and COPD. This article gives a comprehensive review of the promising inhaled therapies in the treatment of asthma and COPD. However, the lack of disease control in asthma and COPD patients may be due to numerous reasons. The association between non-adherence to guidelines on the part of the health care provider and poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patients is common. It is therefore essential to discuss the different delivery systems and the methods used in asthma and COPD patients.

scholarly journals Clinical characteristics and risk factors for mortality in patients with COVID-19 and chronic obstructive pulmonary disease in Wuhan, China

2020 ◽  
Author(s):  
Hao Zeng ◽  
Weiwei Huang ◽  
Yujie Liu ◽  
Lan Dong ◽  
Qifan Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Multiple Organ ◽  
Chronic Obstructive ◽  
Close Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis ◽  
Copd Patients ◽  
Discharged Patients

Abstract Patients with COVID-19 and COPD are at high risks. However, the risk factors for mortality in COPD patients infected COVID-19 are limited. In this retrospective study, consecutive COPD cases infected COVID-19 in East District of People's Hospital of Wuhan University from Jan 11th 2020 to Mar 28th 2020 were included. Different outcomes were compared between dead and discharged patients. Cox regression analysis was performed to explore the risk factors for death. Totally, 52 cases were included (aged 64.0-79.0 years, 39 [75.0%] males). Common symptoms on admission were cough (43, 82.6%), fever (41, 78.8%) and expectoration (21, 40.3%). Thirty-eight (73.1%) patients were discharged, and 14 (26.9%) cases were dead which mainly caused by multiple organ failure (7, 50.0%) and respiratory failure (6, 42.9%). Multivariate analysis indicated that age > 70 years (HR, 7.859, 95% CI: 1.376, 44.875; P = 0.020) and count of lymphocyte ≤ 0.8×109/L (HR, 27.429, 95% CI: 3.336, 225.530; P = 0.002) were risk factors for death. The study showed that close monitoring of the risk indexes is important for early supportive care during the management of patients with COVID-19 and COPD.

The Pharmacological Treatment of Ambulatory Chronic Obstructive Pulmonary Disease Patients

1992 ◽  
Vol 5 (4) ◽  
pp. 204-216
Author(s):  
G. Robert DeYoung ◽  
Patricia L. Vetter ◽  
Wayne A. Kradjan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Pharmacological Management ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Because of the widespread prevalence of chronic obstructive pulmonary disease (COPD) and the important role of drug therapy in its management, there is significant opportunity for the pharmacist to interact with COPD patients. Whether educating patients or other health care providers about COPD, a knowledge of the treatment options and their correct application in these patients is essential for pharmacists today. This article reviews the pharmacological management of ambulatory COPD patients, including the roles of β-agonists, anticholinergics, theophylline, steroids, oxygen, and other treatment modalities. Copyright © 1992 by W.B. Saunders Company

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

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.

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

Sign in / Sign up

Export Citation Format

Share Document