Pathogenetic rationale for the use of intermittent normobaric hypoxytherapy in the rehabilitation of patients with chronic obstructive pulmonary disease

Pulmonary Disease ◽

Respiratory Function ◽

Clinical Symptoms ◽

Main Group ◽

Control Group ◽

Chronic Obstructive ◽

And Control ◽

Adaptive Reactions

Objective — to determine affects of the intermittent normobaric hypoxytherapy on the dynamics of general non‑specific adaptive reactions in the complex rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Materials and methods. The treatment and examinations involved 450 patients with COPD, including GOLD 2 in 55.56 % (250 people) and GOLD 3 in 44.44 % (200 patients). The mean age was (52.65 ± 14.80) years, proportion of female and male subjects was equal. All patients received basic drug therapy according to the Order of MoH of Ukraine. The disease duration was 10 to 30 years, the remission stage was established in all patients. Patients were randomized into two groups: main (400 people) and control (50 people) with the same COPD severity distribution. Patients of the main group received additional 30 minutes sessions of interval normobaric hypoxytherapy for 20 days. The examination were performed for the dynamics of clinical symptoms, respiratory function, nonspecific resistance of an organism. Results. Most patients had symptoms of the disease against the background of basic COPD medication even on the remission stage. Unfavorable and intense adaptive reactions were determined in 71.33 % of COPD patients, and eustress reactions only in 16.89 %. Sanogenetic types of adaptive reactions were found in 28.45 % of subjects, maladaptive types — in 21.78 % of persons, pathogenetic — in 63.33 % of patients. At GOLD 2, tense reactions were diagnosed in 69.6 % of subjects, and in GOLD 3 in 73.0 %. As the severity of the disease increased, there was an increase in the development of intense training and activation responses. Upon completion of the course of hypoxytherapy, the exercise tolerance increased, and shortness of breath appeared only after severe physical activity in 90.25 % of patients in the main group, whereas in the control group similar changes were observed only in 20.0 % of patients. The respiratory function indicators in patients of the main group increased on average by 17.52 %, while in the control group — by 3.3 %. In the main group, favorable adaptation reactions prevailed in 88.25 % of patients, while in the control group this indicator was 32.0 %. The percentage of adverse reactions in the main group decreased significantly and was 11.75 % after treatment, the proportion of stress reactions — 46.25 %. In GOLD 2, the proportion of pathogenetic reactions decreased to 17.33 % and 56.00 % of the main and control groups, and in GOLD 3 — in 20.44 % and 44.0 %, respectively (p < 0.05). Conclusions. The use of a course of normobaric hypoxytherapy promoted the reduction of the main clinical COPD symptoms, increase of the frequency of favorable adaptive reactions up to 88.25 %, it raised clinical effectiveness of the treatment, which allowed to avoid disease exacerbations during the year in 80.95 % of patients.

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

Journal of Iranian Medical Council ◽

10.18502/jimc.v4i3.7218 ◽

2021 ◽

Author(s):

Somayeh Ghadimi ◽

Atefeh Fakharian ◽

Mohsen Abedi ◽

Reyhaneh Zahiri ◽

Mahsan Norouz Afjeh ◽

...

Keyword(s):

Quality Of Life ◽

Pulmonary Disease ◽

Control Group ◽

Chronic Obstructive ◽

Copd Patients ◽

And Control

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.

Clinical-genealogical study of patients with chronic obstructive pulmonary disease

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2002-4-38-41 ◽

2002 ◽

Vol 1 (4) ◽

pp. 38-41

Author(s):

G. N. Seitova ◽

S. A. Bogushevich ◽

E. A. Dementjeva ◽

S. V. Nesterovich ◽

E. B. Bukreeva

Keyword(s):

Pulmonary Disease ◽

Control Group ◽

Chronic Obstructive ◽

Chronic Obstructive Bronchitis ◽

And Control

We present data of clinical-genealogical study of patients with chronic obstructive bronchitis (82 people) and control group (108 people). Study of frequency of lung’s disease in parents and relatives of seek patients and patients from control group revealed the prevalence of bronchopulmonary pathology in the first group in comparison with the second. Study of frequency morbidity depending on the gender of descendents determined the significant prevalence in girls than in boys. Study of type of family burdening in seek patients revealed the prevalence of the type «seek mother, healthy father».

Clinical efficacy of hepatoprotector in the complex therapy of non-alcoholic steatohepatitis against the background of obesity for comorbidity with chronic obstructive pulmonary disease

Modern Gastroenterology ◽

10.30978/mg-2021-1-17 ◽

2021 ◽

Author(s):

O. S. Khukhlina ◽

O. Ye. Hryniuk

Keyword(s):

Pulmonary Disease ◽

Liver Steatosis ◽

Subjective Assessment ◽

Main Group ◽

Control Group ◽

Chronic Obstructive ◽

Alcoholic Steatohepatitis ◽

Complex Therapy

Objective — to establish the Antral efficacy in terms its effects on the intensity of clinical and biochemical syndromes of non‑alcoholic steatohepatitis (NASH) against the background of obesity at comorbidity with chronic obstructive pulmonary disease (COPD). Materials and methods. The examinations involved 65 NASH patients with I degree obesity and COPD 2 — 3 D. The patients were divided into two groups: 32 patients control groups received NASH therapy (Essentiale forte N (Sanofi Avensis/Nutterman and Cie GmbH) 300 mg, 2 caps., 3 times per day) for 30 days and basic COPD therapy. The second, main group consisted of 33 NASH patients with I degree obesity and COPD 2 — 3 D, who along with the basic therapy for COPD received hepatoprotector Antral (Farmak, Ukraine) 200 mg, 3 times daily for 30 days. The mean age of the patients was 56.3 ± 3.21 years. The comparison group consisted of 30 apparently healthy people (AHP). The values of 30 practically healthy individuals were used as reference. Results. According to the scale of subjective assessment of the intensity of asthenia after treatment in patients of the main group, the effectiveness of its elimination was 3.9 times higher than that of patients in the control group (relative risk 3.87; 95 % CI [1.16 — 12.91], p < 0.05). The manifestations of dyspepsia disappeared faster in the patients of the main group. The use of antral 3.7 times more influenced the manifestations of cholestasis (p < 0.05). Body mass index (BMI) > 32 kg/m2 after treatment, which included a hypocaloric diet and Antral, remained in 13 patients in the main group (39.4 %) versus 29 patients in control group (90.6 %) (p < 0.05). During one month after the treatment, markers of cytolysis remained in 9 patients in control group (28.1 %), and in 1 patient of the main group (3.0 %) (OR 9.28; 95 % CI [1.11 — 77, 52], p < 0.05). The increased activity of cholestasis markers after treatment remained only in 5 patients in the main group (15.2 %) in comparison with 22 (68.8 %) controls. In the dynamics of treatment of patients in the main group, significant increase in the protein‑synthesizing function of the liver was revealed (albumin levels increased by 30.56 % (p < 0.05) relative to the indicator in the control group). Conclusions. The use of Antral in the complex therapy of NASH of patients with the concomitant obesity and COPD was more effective than standard therapy in terms of removal of clinical NASH syndromes: asthenic‑vegetative, dyspepsia, abdominal discomfort, cholestasis, hepatomegaly, degree of liver steatosis; biochemical syndromes: cytolysis, cholestasis, mesenchymal inflammation, hepatocellular failure.

Clinical Effectiveness of a Combination of Black Elder Berries, Violet Herb, and Calendula Flowers in Chronic Obstructive Pulmonary Disease: The Results of a Double-Blinded Placebo-Controlled Study

Biology ◽

10.3390/biology9040083 ◽

2020 ◽

Vol 9 (4) ◽

pp. 83

Author(s):

Tatiana V. Kirichenko ◽

Igor A. Sobenin ◽

Yuliya V. Markina ◽

Elena V. Gerasimova ◽

Andrey V. Grechko ◽

...

Keyword(s):

Pulmonary Disease ◽

Respiratory Function ◽

Clinical Symptoms ◽

Experimental Studies ◽

Controlled Study ◽

Chronic Obstructive ◽

Moderate Severity ◽

Double Blinded

Chronic obstructive pulmonary disease (COPD) is a multifactorial disease, in which systemic inflammation plays a key role. This 6-month randomized double-blinded placebo-controlled study evaluates the possible effect of natural preparation Inflaminat on clinical symptoms of COPD, indicators of respiratory function, and exacerbation frequency in 60 patients with moderate severity of COPD. Inflaminat is a combination of natural ingredients black elder (Sambucus nigra L.) berries, violet (Viola tricolor L.) herb, and calendula (Calendula officinalis L.) flowers. The preparation has been previously demonstrated to possess anticytokine and anti-inflammatory effects in experimental studies. In present study, COPD dynamics were evaluated by means of BCSS (Breathlessness, Cough, and Sputum Scale) and spirometry tests. It was shown that 6-months Inflaminat administration led to significant decrease of BCSS points from 3.0 ± 0.6 to 1.9 ± 0.7, (p = 0.002) as well as significant increase of FEV1 from 66 ± 18% to 73 ± 17%, (p = 0.042); there were no beneficial dynamics in placebo group. Side effects associated with preparation administration were not identified. The results of the study suggest that Inflaminat may be employed in treatment of patients with moderate severity of COPD, since it has a positive effect on COPD symptoms according BCSS and indicators of respiratory function FEV1.

The effects of positioning and pursed-lip breathing exercise on dyspnea and anxiety status in patients with chronic obstructive pulmonary disease

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n6p41 ◽

2019 ◽

Vol 9 (6) ◽

pp. 41

Author(s):

Salwa A. Mohamed

Keyword(s):

Pulmonary Disease ◽

Assessment Scale ◽

University Hospital ◽

Control Group ◽

Chronic Obstructive ◽

Breathing Exercise ◽

And Control

Background and objective: Chronic obstructive pulmonary disease (COPD) remains a significant burden for health. It is one of the most common respiratory disease and leads to limitation of airflow as well as deteriorating health status. The aim of the study was to determine the effects of positioning and pursed lip breathing exercise on dyspnea and anxiety status in patients with chronic obstructive pulmonary disease.Methods: The study was carried in the outpatient clinics in Mansoura University Hospital & Chest Hospital at Mansoura region, utilizing a quasi-experimental study design on sixty patients diagnosed COPD. Participation was randomized into both groups (study group and control group). Pretest, posttest and follow-up evaluation was done using Dyspnea Assessment Scale, Anxiety Assessment Scale and Demographic and Medical History Questionnaires (MHQ). The researcher established exercise program aimed at effecting dyspnea and anxiety in chronic obstructive pulmonary disease patients to help improve breathing and control anxiety. The research was accomplished over four steps namely assessment, planning, implementation and evaluation. Each patient was evaluated at baseline, immediately and three months after implementation of program.Results: There were statistically significant improvements after intervention of program on dyspnea symptoms and anxiety status at post and follow-up test (p < .05). There was a statistically significant improvement in temperature (T), heart rate (HR), blood pressure (BP) and respiratory rate (RR) throughout study (p < .05) after intervention. Also there are positive relation between anxiety and dyspnea after intervention.Conclusions: Developing breathing technique and forward leaning position in COPD patients help to improve physiological outcomes, dyspnea symptoms and anxiety status after implementing of program. It is recommended to implement exercise training program as a part of treatment by health professionals in the clinical setting.

THE INFLUENCE OF TREATMENT WITH INACTIVE VITAMIN ON INTRARENAL BLOOD FLOW IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Успехи геронтологии ◽

10.34922/ae.2020.33.2.020 ◽

2020 ◽

pp. 360-366

Author(s):

Е. В. Болотова ◽

В. В. Трембач ◽

А. В. Дудникова

Keyword(s):

Vitamin D ◽

Blood Flow ◽

Pulmonary Disease ◽

Resistance Index ◽

Main Group ◽

Control Group ◽

Chronic Obstructive ◽

Ckd Stage

Целью работы стала оценка динамики ультразвуковых параметров почечного кровотока у больных ХОБЛ, имеющих начальные стадии хронической болезни почек (ХБП), на фоне лечения препаратами неактивного витамина D . В исследование включены 264 пациента с ХОБЛ II-IV степени тяжести в сочетании с ХБП I-II стадии: 135 пациентов основной группы и 129 - контрольной. Каждая группа была разделена на четыре подгруппы по величине объема форсированного выдоха (ОФВ) и уровню витамина D . В основной группе был назначен препарат нативного витамина D по схеме, обеспечивающей поддержание уровня >34,3 нг/мл в течение года, в контрольной - согласно рекомендациям Российской ассоциации эндокринологов. Всем пациентам на этапе включения в исследование и после его окончания проводили УЗИ почек с расчетом индекса резистентности Пурсилота ( RI ), исследование уровня альбуминурии. У 16 (24,1%) пациентов основной группы выявлено уменьшение тяжести альбуминурии с А3 до А2, ау 58 (42,9%) - повышение СКФ. Статистически значимое снижение значения индекса резистентности почечных артерий зафиксировано у пациентов основной группы со среднетяжелым течением ХОБЛ ( GOLD 2) и дефицитом витамина D ( р <0,05). Поддержание уровня витамина D более 34,3 нг/мл в течение 12 мес у пациентов с ХОБЛ в сочетании с ХБП I-II стадии ассоциировано с уменьшением тяжести альбуминурии, повышением СКФ, статистически значимым снижение индекса резистентности почечных артерий у пациентов основной группы со среднетяжелым течением ХОБЛ ( GOLD 2) и дефицитом витамина D . The aim of the work was to assess the dynamics of ultrasound parameters of renal blood ﬂow in patients with chronic obstructive pulmonary disease (COPD)and initial stages of chronic kidney disease (CKD) during treatment with inactive vitamin D . The study included 264 patients with COPD of 2-4 degrees of severity in combination with CKD of 1-2 stages: 135 patients of the main group and 129 patients of the control group. Each group was divided into 4 subgroups according to the value of FEVand vitamin D level. In the main group, the native vitamin D was prescribed according to the scheme providing maintenance of vitamin D level >34,3 ng/ml during the year, in the control group - according to the recommendations of the Russian Association of Endocrinologists. An ultrasound of the kidneys with the calculation of the resistance index ( RI ) and albuminuria level were carried out in all patients at inclusion into the study and after its completion. A decrease in the severity of albuminuria from A3 to A2 was revealed in 24,1 % (16), and an increase in GFR - in 42,9 % (58) patients of all patients in the main group. A statistically signiﬁcant decrease in the renal artery resistance index was recorded in the group of patients with moderate COPD ( GOLD 2) and vitamin D deﬁciency in the main group ( p <0,05). The maintaining of vitamin D levels more than 34,3 ng/ ml over 12 months in patients with COPD in combination with CKD stage 1-2 was associated with a decrease in the severity of albuminuria, with an increase in GFR, and statistically signiﬁcant decrease of resistance index in renal arteries of patients with moderate clinical course of COPD ( GOLD 2) and lack of vitamin D .

Assessment of effectiveness of training of respiratory musculature in patients with chronic obstructive pulmonary disease and obesity

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj2019273367-374 ◽

2019 ◽

Vol 27 (3) ◽

pp. 367-374

Author(s):

Evgeniy S. Ovsyannikov ◽

Andrey V. Budnevsky ◽

Yanina S. Shkatova

Keyword(s):

Quality Of Life ◽

Pulmonary Disease ◽

Main Group ◽

Control Group ◽

Chronic Obstructive ◽

Clinical Group ◽

Forced Expiration ◽

Obstructive Pulmonary Disease

Aim. To assess the influence of training of respiratory musculature on the expressiveness of symptoms, tolerance to physical loads, spirometric parameters and quality of life of patients with chronic obstructive pulmonary disease (COPD) and obesity. Materials and Methods. The study included 52 patients with COPD (clinical group D) and obesity, of them 42 men and 10 women with the mean age 65.4±6.8 years and body mass index 33.6±2.9 kg/m2. The patients were divided to 2 groups: the main group with training of respiratory musculature (TRM) within 12 months using a respiratory exerciser, and the control group with simulation of TRM using the same exerciser, but with minimal load. Results. In 12 months the patients of the main group showed a reliable reduction of dyspnea on mMRC scale (Modified Medical Research Council), improvement of health related quality of life on St. George’s Respiratory Questionnaire (SGRQ), increase in forced expiration volume in 1 second and in forced vital capacity of lungs, increase in the covered distance in 6-minute walk test, reduction of the average duration of hospitalization for exacerbation of COPD. Conclusion. Taking into account the obtained data, TRM can be considered as an effective component of the lung rehabilitation program in patients with COPD.

Clinical and functional features of the nasal cavity, paranasal sinuses and pharynx in patients with chronic obstructive pulmonary disease in remission

Kazan medical journal ◽

10.17816/kmj1512 ◽

2014 ◽

Vol 95 (3) ◽

pp. 352-356

Author(s):

E A Gilifanov ◽

V A Nevzorova ◽

S A Artyushkin ◽

D G Pavlush ◽

L B Ardeeva

Keyword(s):

Nasal Cavity ◽

Pulmonary Disease ◽

Paranasal Sinuses ◽

Functional Condition ◽

Main Group ◽

Control Group ◽

Chronic Obstructive ◽

Functional Features

Aim. To assess functional condition of the nasal cavity, paranasal sinuses, pharynx in patients with remission of chronic obstructive pulmonary disease. Methods. Patients were distributed to 2 groups. The main group included 49 patients with stages II and III of chronic obstructive pulmonary disease in remission, control group included 50 healthy non-smoking volunteers without any known respiratory diseases. Patients underwent general examination, completed by rigid endoscopic examination, examination of ciliary clearance, anterior active rhinomanometry, olfactometry, nasal cavity and paranasal sinuses computed tomography. Pharynx examination included nasal cavity posterior endoscopy, mesopharyngoscopy, lower part of the parynx was examined by rigid endoscope with viewing angle of 70°. Results. Ciliary clearance was 26.7±3.06 minutes in patients of the main group, compared to 16.4±1.11 minutes in patients of the control group. Smell acuity was 1.86±0.11 units in patients of the main group, compared to 2.3±0.15 units in patients of the control group. Signs of nasal and pharyngeal diseases, including signs of chronic inflammation of nasal mucosa and chronic catarrhal pharyngitis was found in 30 patients. Conclusion. Patients with chronic obstructive pulmonary disease had higher prevalence of chronic rhinitis and pharyngitis, worse smell acuity and impaired ciliary clearance compared to healthy controls.

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

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00095 ◽

2020 ◽

Vol 29 (2) ◽

pp. 864-872

Author(s):

Fernanda Borowsky da Rosa ◽

Adriane Schmidt Pasqualoto ◽

Catriona M. Steele ◽

Renata Mancopes

Keyword(s):

Oral Cavity ◽

Pulmonary Disease ◽

Thermal Sensation ◽

Sensory Function ◽

Control Group ◽

Chronic Obstructive ◽

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.