scholarly journals Gambaran Hitung Jenis Leukosit pada Pasien Penyakit Paru Obstruktif Kronik yang Dirawat di RSUP Dr. M. Djamil Padang

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Revi Sofiana Martantya ◽  
Ellyza Nasrul ◽  
Masrul Basyar

AbstrakPenyakit paru obstruktif kronik (PPOK) ditandai oleh adanya hambatan aliran udara yang irreversibel dan bersifat progresif. Asap rokok, polusi udara, dan infeksi berulang pada saluran napas akan mengaktivasi makrofag alveolus dan melepaskan mediator inflamasi yang merangsang progenitor granulositik dan monositik di sumsum tulang sehingga mempengaruhi hitung jenis leukosit pada darah tepi. Faktor lain yang dapat mempengaruhi hitung jenis leukosit pada pasien PPOK adalah adanya penyakit penyerta. Desain penelitian ini adalah retrospektif deskriptif terhadap data rekam medik 69 orang yang dirawat di bagian paru dan penyakit dalam RSUP dr. M. Djamil Padang. Hasil penelitian menunjukkan pasien PPOK tanpa penyakit penyerta (n=9) memiliki nilai rata-rata hitung jenis basofil 0±0%, eosinofil 1,22±1,2%, neutrofil batang 3,33±2,5%, neutrofil segmen 79,56±9,26%, limfosit 13,67±6,55%, dan monosit 2,22±2,44%. Pada pasien PPOK dengan penyakit penyerta infeksi (n=41) didapatkan nilai rata-rata hitung jenis basofil 0±0%, eosinofil 1,02±1,59%, neutrofil batang 1,98±2,63%, neutrofil segmen 81,07±8,44%, limfosit 12,83±6,68%, dan monosit 3,1±2,71%. Pada pasien PPOK dengan penyakit penyerta non infeksi (n=19) didapatkan nilai rata-rata hitung jenis basofil 0±0%, eosinofil 2,16±5,65%, neutrofil batang 2,16±1,77%, neutrofil segmen 79,0±10,44%, limfosit 14,16±8,03%, dan monosit 2,53±1,87%. Penelitian ini memperlihatkan pasien PPOK tanpa penyakit penyerta, dengan penyakit penyerta infeksi, dan dengan penyakit penyerta non infeksi mengalami neutrofilia dan limfositopenia.Kata kunci: PPOK, hitung jenis leukositAbstractChronic Obstructive Pulmonary Disease (COPD) characterized by airflow obstruction that is irreversible and progressive. Cigarette smoke, air pollution, and recurrent infections in the respiratory tract can activates alveolar macrophages to release inflammatory mediators that stimulate granulocytic and monocytic progenitors in the bone marrow that can affect leukocyte counts in peripheral blood. Other factors that can also affect leukocyte count in COPD patients is the presence of comorbidities. The design of this study was descriptive retrospective from medical record of 69 people with COPD who were treated at the lungs and internal medicine department of dr. M. Djamil Hospital Padang. The result of this study show in COPD patients without comorbidities (n=9) average value of basophil counts 0±0%, eosinophils 1.22±1.2%, neutrophils rod 3.33±2.5%, neutrophils segment 79.56±9.26%, lymphocytes 13.67±6.55%, and monocytes 2.22±2.44%. COPD patients with infectious comorbidities (n=41) obtained average value of basophil counts 0±0%, eosinophils 1.02±1.59%, neutrophils rod 1.98±2.63%, neutrophils segment 81.07±8.44%, lymphocytes 12.83±6.68%, and monocytes 3.1±2.71%. In COPD patients with non-infectious comorbidities (n=19) obtained average value of basophil counts 0±0%, eosinophils 2.16±5.65%, neutrophils rod 2.16±1.77%, neutrophils segment 79.0±10.44%, lymphocytes 14.16±8.03%, and monocytes 2.53±1.87%. This study shows that COPD patients without comorbidities, with infectious, and with non-infectious comorbidities obtained neutrophilia and lymphocytopenia.Keywords:COPD, differential leukocyte count

2020 ◽  
Vol 7 (12) ◽  
pp. 1777
Author(s):  
C. Sri Krishna Appaji ◽  
P. Ravinder

Background: Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterised by persistent respiratory symptom and airflow limitation which is not fully reversible. It has been reported that patient with COPD has higher mortality due to cardiac disorder. We have designed this study with an aim to evaluate electrocardiography and echocardiography changes in COPD patients and correlate this finding with severity of disease.Method: In present study 60 randomly selected COPD patients were evaluated clinically, echocardiographically, electrocardiographically and pulmonary function test was performed. A careful history of patient was taken regarding demography, symptoms and aggravation factors. Detailed clinical examination of patient was done to know the sign symptom of cardiological and respiratory involvement.Result: In patients with severe COPD 4 (20%) patients have normal ECG, 12 (60%) have P pulmonale, 14 (70%) patients have right ventricular hypertrophy, low voltage complex was found in 6 (30%), RBBB was present in 4 (20%) patients, 12 (60%) have r wave in their electrocardiograph (ECG) and 2 (10%) patients presented with arrhythmia.Conclusions: From our study we can conclude that most of the patients with COPD were in 5th and 6th decade of life with male predominance. Patients with moderate airflow obstruction were common than severe obstruction. Cardiovascular changes depend upon the severity of disease.


Sensors ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 217 ◽  
Author(s):  
Wen-Yen Lin ◽  
Vijay Kumar Verma ◽  
Ming-Yih Lee ◽  
Horng-Chyuan Lin ◽  
Chao-Sung Lai

Chronic obstructive pulmonary disease (COPD) claimed 3.0 million lives in 2016 and ranked 3rd among the top 10 global causes of death. Moreover, once diagnosed and discharged from the hospital, the 30-day readmission risk in COPD patients is found to be the highest among all chronic diseases. The existing diagnosis methods, such as Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019, Body-mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index, modified Medical Research Council (mMRC), COPD assessment test (CAT), 6-minute walking distance, which are adopted currently by physicians cannot predict the potential readmission of COPD patients, especially within the 30 days after discharge from the hospital. In this paper, a statistical model was proposed to predict the readmission risk of COPD patients within 30-days by monitoring their physical activity (PA) in daily living with accelerometer-based wrist-worn wearable devices. This proposed model was based on our previously reported PA models for activity index (AI) and regularity index (RI) and it introduced a new parameter, quality of activity (QoA), which incorporates previously proposed parameters, such as AI and RI, with other activity-based indices to predict the readmission risk. Data were collected from continuous PA monitoring of 16 COPD patients after hospital discharge as test subjects and readmission prediction criteria were proposed, with a 63% sensitivity and a 37.78% positive prediction rate. Compared to other clinical assessment, diagnosis, and prevention methods, the proposed model showed significant improvement in predicting the 30-day readmission risk.


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 ◽  
...  

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.


2020 ◽  
Vol 9 (10) ◽  
pp. 3097 ◽  
Author(s):  
Iva Hlapčić ◽  
Andrea Hulina-Tomašković ◽  
Marija Grdić Rajković ◽  
Sanja Popović-Grle ◽  
Andrea Vukić Dugac ◽  
...  

Extracellular heat shock protein 70 (eHsp70) might modulate immune responses in chronic obstructive pulmonary disease (COPD). The aim of the study was to explore eHsp70 concentration in stable COPD, its association with disease severity and smoking status as well as its diagnostic performance in COPD assessment. Plasma samples were collected from 137 COPD patients and 95 healthy individuals, and concentration of eHsp70 was assessed by commercially available enzyme-linked immunosorbent assay (ELISA) kit (Enzo Life Science, Farmingdale, NY, USA). COPD patients were subdivided regarding airflow obstruction severity and symptoms severity according to the Global Initiative for COPD (GOLD) guidelines. eHsp70 concentration increased in COPD patients when compared to controls and increased with the severity of airflow limitation as well as symptoms burden and exacerbation history. eHsp70 concentration did not differ among COPD patients based on smoking status, yet it increased in healthy smokers compared to healthy nonsmokers. In addition, eHsp70 negatively correlated with lung function parameters forced expiratory volume in one second (FEV1) and FEV1/ forced vital capacity (FVC), and positively with COPD multicomponent indices BODCAT (BMI, airflow obstruction, dyspnea, CAT score), BODEx (BMI, airflow obstruction, dyspnea, previous exacerbations), CODEx (Charlson’s comorbidity index, airflow obstruction, dyspnea, previous exacerbations) and DOSE (dyspnea, airflow obstruction, smoking status, previous exacerbations) With great predictive value (OR = 7.63) obtained from univariate logistic regression, eHsp70 correctly classified 76% of cases. eHsp70 is associated with COPD prediction and disease severity and might have the potential for becoming an additional biomarker in COPD assessment.


Author(s):  
Thitta Mohanty ◽  
Mahismita Patro ◽  
Jyotirmaya Sahoo ◽  
Bijaya Kumar Meher ◽  
Manoranjan Pattnaik ◽  
...  

Background: Pneumococcal infections are frequent cause chronic obstructive pulmonary disease (COPD) exacerbations and though various guidelines recommend the use of pneumococcal vaccines routinely to COPD patients to prevent exacerbations, the data regarding the effectiveness of this vaccine is limited and contradictory. Aims and objectives was to compare the frequency of exacerbations in patients of COPD before and after administration of pneumococcal vaccine and to find out the frequency of exacerbations in patients of COPD who are vaccinated against those who are not vaccinated as well as to study the effectiveness of pneumococcal vaccine will be analysed in respect to age, sex, Body mass index (BMI), severity of disease and other co-morbidity.Methods: This was a randomized non-placebo controlled trial, conducted from September 2013 to August 2015 including total of 150 patients divided into two groups: cases and controls. The cases were administered PPV23 along with specific medication and were followed up at intervals of 3months. Exacerbations were identified based on ANTHONISEN’S criteria. Number of exacerbations in each follow-up was recorded. The data from both the groups were analysed statistically.Results: After 1 year of follow up, there was significant reduction in mean number of exacerbations (p value <0.0001) in patients with COPD in vaccinated group. PPV23 was more effective in patients with COPD of less than 65 years of age and with severe and/or very severe airflow obstruction and also in patients with lower BMI (≤21kg/m2), females and with co-morbidities.Conclusions: This is an important strategy to prevent the repeated exacerbations in COPD patients particularly in severe and very severe disease groups and we support the recommendation that pneumococcal vaccine should be administered to these patients.


Author(s):  
Dominika Mekal ◽  
Aleksandra Czerw ◽  
Andrzej Deptala

Background: It is the first study in Poland and one of the first in the world to assess the nutrition of patients with chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT). Methods: The study group consisted of 110 COPD patients treated with LTOT. Anthropometric measurements and spirometry were performed. The diet of patients was assessed using a 3-day nutrition diary. Results: When assessing the degree of airflow obstruction (FEV1% N) depending on the BMI in patients treated with LTOT, a statistically significant correlation was demonstrated between the BMI and the value of the FEV% N parameter (p = 0.0093). Patients with COPD with a BMI >30 had statistically significantly higher values of FEV1% N than patients with a BMI in the range of 20–24.9 (p = 0.0278). Intake of calcium, vitamins A, C, D, E and folates was lower than the recommended daily intake in more than 95% of COPD patients. Conclusions: The diet of COPD patients treated with long-term oxygen therapy was improperly balanced, with deficiencies of important nutrients. Airflow obstruction in the respiratory tract was significantly smaller in obese patients, and greater in patients with diagnosed malnutrition.


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nguefeu Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nguefeu Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco. Results The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


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