scholarly journals Clinical efficacy of mechanical bacterial lysate in the prevention of infectious exacerbations of chronic obstructive pulmonary disease

2020 ◽  
Vol 92 (4) ◽  
pp. 57-63
Author(s):  
S. N. Avdeev ◽  
G. S. Nuralieva ◽  
V. V. Gainitdinova ◽  
G. E. Baimakanova ◽  
A. K. So ◽  
...  

Aim. To evaluate the efficacy of mechanical bacterial lysate on the prevention of infectious exacerbations of chronic obstructive pulmonary disease in patients with frequent exacerbations. Materials and methods. The study included patients (n=60) with frequent exacerbations of COPD (groups C and D according to the GOLD classification). All COPD patients were divided into two groups by blind method. The first group (n=30) received conventional therapy for COPD plus MBL (the course included 3 cycles of 10 days therapy with 20-day intervals between them). The second group of patients (control, n=30) received conventional therapy for COPD without MBL.We evaluated the severity of symptoms, frequency of recurrence of COPD exacerbations, readmissions, need for emergency care and changes in basic therapy of COPD. Evaluations were done on 10 days, 1, 3 and 6 months from the start of the study. Results. Adding of MBL to the therapy list of COPD resulted in a significant decrease of biomarkers of systemic inflammation and sputum purulence during compared to the control group. After 6 months of observation MBL group demonstrated statistically significant improvement of respiratory function, decrease in frequency of COPD exacerbations, needs for emergency medical service, reduced changes in basic therapy and hospitalization for exacerbation of COPD. Therapy with MBL showed a high degree of safety and low incidence of adverse events. Conclusion. The results of the study indicate that MBL may be used for the prevention of severe infectious exacerbations of COPD.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yusup Subagio Sutanto ◽  
Tutty Ariani

Background: Exacerbated chronic obstructive pulmonary disease is an acute condition, characterized by persistent air flow limitations, related to the excessive chronic inflammatory response in the airways and lung parenchyma caused by exposure to harmful gases or particles. Increased airway inflammation during exacerbations leads to increased levels of IL-8 and the risk of hospitalization. Lycopene is a carotenoid which has a positive effect on the respiratory system. The purpose of this study was to determine the effect of administration  lycopene to IL-8 levels and hospitalization time of patients with COPD disease exacerbations.Methods: The  experimental test with pretest and posttest  design for 30 patients with COPD exacerbations in Dr. Moewardi Surakarta Hospital and Dr. Soehadi Prijonegoro Sragen Hospital was conducted from February to March 2018. Samples were taken by consecutive sampling divided into two groups including the treatment group receiving standard therapy and lycopene 1x10 mg / day during treatment and the control group only receiving standard therapy. IL-8 levels  and hospitalization time of patients with COPD disease exacerbations  were measured.Results: There were significant differences between the treatment group compared to the control group for a decrease in IL-8 (p = 0.029) and a decrease in hospitalization time (p = 0,000).Conclusion: The administration of lycopene 1x10 mg / day significantly reduce IL-8 levels and hospitalization time of patient with COPD exacerbations. 


2020 ◽  
Vol 29 (6) ◽  
pp. 716-724
Author(s):  
D. G. Pavlush ◽  
V. A. Nevzorova ◽  
E. A. Gilifanov ◽  
V. B. Shumatov ◽  
I. M. Martynenko

Chronic obstructive pulmonary disease (COPD) is a disease holding a stable position in morbidity and mortality structure in patients aged over 40 years.The aim of the study was to evaluate the condition of otorhinolaryngological (ENT) organs in patients with the COPD at different disease periods with subsequent analysis of COPD exacerbation rate based on the results of therapy regimen change according to the established comorbidity.Materials and Methods. Examination of ENT organs was performed in patients with COPD (n = 99) Patients from group 1 (n = 50) were treated at Pulmonary Department of the Regional State Budgetary Health Institution "Vladivostok Clinical Hospital No.1" for disease exacerbation; outpatients from group 2 (n = 49) had stable COPD course. Control group (n = 50) included patients without history of smoking and without respiratory and hearing disorders. All patients were matched by age and sex. Repeated examination was conducted in patients (n = 72) with stable COPD after 6 months.Results. It was observed that patients from groups 1 and 2 had different severity of disease symptoms, but equally high (> 2) risk of COPD exacerbation within 1 year. 50.0 and 42.9% of patients actively complained about the ENT organ-related conditions during the periods of COPD exacerbation and stable course, respectively. Among ENT organ diseases the most frequent were laryngeal diseases reported in 84.0 and 73.5% of patients with COPD exacerbation and stable course, respectively. The chronic catarrhal rhinitis and pharyngitis were revealed in 26 and 30% of patients with COPD exacerbation (p < 0.01). According to the data of 6-month study, the number of COPD exacerbations in high-risk patients with COPD using personal treatment plan for ENT-organ diseases was reduced by half, which had a positive effect on the condition of ENT-organs.Conclusion. The study showed that patients with COPD often ENT-organ-related complaints – in the exacerbation period about 50% of patients, and at stable course – 43%. Patients most often complain on glottic incompetence with the most pronounced symptoms at COPD exacerbation. Decreased number of COPD exacerbations by 2 times in patients with high risk of their occurrence and improvement of ENT organ condition were noted if ENT diseases were timely treated. ENT specialist consultation should be provided at dispensary observation organization for patients with COPD in order to personalize the treatment plan depending on the clinical situation.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

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.


Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2019 ◽  
Vol 39 (2) ◽  
pp. 103-112
Author(s):  
Maratus Sholihah ◽  
Suradi Suradi ◽  
Jatu Aphridasari

Introduction: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Cigarette smoke and noxious agent result in oxidative stress and activate release of inflammatory mediators such as Interleukin-8 (IL-8). Quercetin is a flavonoid compound containing anti-inflammatory effects which can be used as an adjuvant therapy in stable COPD. Objective: To analyze the effect of quercetin on serum IL-8 levels, % VEP1, and CAT score of stable COPD patients. Methods: Experimental clinical trial with pre-test and pasca-test design was performed in 30 patients with stable COPD in Dr. Moewardi Surakarta between December 2017 and January 2018. The samples taken by using purposive sampling were divided into two groups treatment groups received standard therapy and quercetin 500mg/day for 28 days and control groups only received standard therapy. The decrease in inflammation was measured by serum IL-8 examination, improvement of obstruction measured by %FEV1 and clinical improvement measured by CAT score. Results: IL-8 serum level was significantly lower in treatment group than of in control group (p=0,001). The percentage of FEV1 was insignificant different between the two group (p=0,236). However CAT score was significantly lower in treatment group compared to that of in control group (p=0,001) Conclusions: Quercetin can decrease IL-8 serum level and decrease CAT score when given in combination with standard therapy for COPD patients. (J Respir Indo 2019; 39(2))


2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Lei Liu ◽  
Bin Liu

<p class="16"><em>Background and Objective: Pneumatic nebulizers (PN) are commonly used to treat COPD. We aimed to evaluate and compare two PNs with respect to effectiveness and delivery, and the effect of using a membrane filter to prevent drug wastage.</em><em></em></p><p><em>Methods: COPD patients (240) were divided into an experimental group (EG); treated with a YZB/GEM1058-2009 medical atomizer, and a control group (CG); treated with a DNA100 medical atomizer. A polypropylene membrane was then applied to each nebulizer.</em><em></em></p><p class="16"><em>Results: Wastage per inhalation was 79.56% in the EG, and 87% in the CG and reduced to 35.3% in the EG and 42.1% in the CG following application of a polypropylene membrane. </em><em>The  ratio of drug not atomised </em><em>per inhalation was 10.32% in the EG, and 24.52% in the CG and altered to 30.2% and 37.3% with the polypropylene membrane. </em><em> </em><em>The total effective rate, cure rate and weekly efficiency were 96.7%, 73.3% and 93.3%, respectively in the EG, and 93.3%, 60% and 83.3% respectively in the CG, and increased to 100%, 93.3% and 100%, respectively in the EG, and 100%, 83.3% and 93.3%, respectively, in the CG with the membrane application. The number of days required to be effective was 4±2.4 days in the EG, and 7±3.8 in the CG and decreased to 3±1.4 in the EG, and 5±3.1 in the CG with the membrane. </em><em></em></p><p class="16"><em>Conclusions</em><em>: There was a high percentage of drug wastage with both PNs. YZB/GEM1058-2009 was significantly more effective than DNA100 but a </em><em>polypropylene </em><em>microporous membrane significantly improved the effectiveness of both.</em><em></em></p><p class="16"><em>Keywords: Chronic Obstructive Pulmonary Disease; Pneumatic Nebulizer; </em><em>Drug waste; Polypropylene microporous membrane</em><em></em></p>


2015 ◽  
Vol 1 (1) ◽  
pp. 00011-2015 ◽  
Author(s):  
Jørgen Vestbo ◽  
Peter Lange

Exacerbations have significant impact on the morbidity and mortality of patients with chronic obstructive pulmonary disease. Most guidelines emphasise prevention of exacerbations by treatment with long-acting bronchodilators and/or anti-inflammatory drugs. Whereas most of this treatment is evidence-based, it is clear that patients differ regarding the nature of exacerbations and are likely to benefit differently from different types of treatment. In this short review, we wish to highlight this, suggest a first step in differentiating pharmacological exacerbation prevention and call for more studies in this area. Finally, we wish to highlight that there are perhaps easier ways of achieving similar success in exacerbation prevention using nonpharmacological tools.


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