Face-to-face Training as an Effective Approach for Instructing Rotahaler Technique in Newly Diagnosed Cases of Asthma and COPD: a Pilot Study

Introduction: This study aimed to evaluate the effectiveness of face-to-face training for instructing rotahaler technique in newly diagnosed cases of asthma and chronic obstructive pulmonary disease. Methods: A hospital-based study was conducted on twenty patients who were prescribed rotahaler for the first time. Patients received face-to-face training on rotahaler technique from pharmacist using GINA guidelines. The patients rotahaler technique was assessed after two weeks of training and scored one for correct and zero for incorrect steps. Descriptive statistics was performed. Results: The mean age of the study population was 48.85±20.49 years. Eleven (55%) patients were females and 13 (65%) were formally uneducated. Fourteen patients (70%) were able to perform all the steps correctly giving overall median score of 8 (7-8). Conclusions: Face-to-face training seems to be effective approach for instructing rotahaler technique in asthma and COPD patients. Keywords: asthma; COPD; face-to-face training; inhaler technique; pharmacist.

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Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

npj Primary Care Respiratory Medicine ◽

10.1038/s41533-021-00226-y ◽

2021 ◽

Vol 31 (1) ◽

Author(s):

Evdoxia Gogou ◽

Ourania S. Kotsiou ◽

Dimitra S. Siachpazidou ◽

Maria Pinaka ◽

Charalampos Varsamas ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Disease Diagnosis ◽

Chronic Obstructive ◽

Newly Diagnosed ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Significant Burden ◽

Study Population ◽

Primary Healthcare Centers

AbstractPrimary care centers are ideal positions to identify chronic obstructive pulmonary disease (COPD). We determined the COPD prevalence among ever-smokers aged 40–65 years attending a 2-year program conducted in 22 Greek primary healthcare centers and made comparisons between genders, patients less than or greater than 55 years, and newly or previously diagnosed COPD patients. A total of 117 persons, after studying 1100 people, were diagnosed with previously unknown or known COPD, providing a COPD prevalence of 10.6% among the study population. In all, 7.5% of the participants were newly diagnosed with COPD. Women with COPD reported smoking less but experienced worse respiratory and depressive symptoms than men. A total of 19% of the COPD population below 55 years experienced wheezing and exacerbations more frequently than older patients. Newly diagnosed COPD patients were significantly younger, reported a significant burden of symptoms without seeking medical help. Primary health care has a crucial role in the early detection of COPD among unsuspecting smokers.

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Characteristics and outcomes in acute patients receiving mechanical ventilation in a Coronary Care Unit (CCU)

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.165 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

M Rivadeneira Ruiz ◽

DF Arroyo Monino ◽

T Seoane Garcia ◽

MP Ruiz Garcia ◽

JC Garcia Rubira

Keyword(s):

Mechanical Ventilation ◽

Cardiac Arrest ◽

Hospital Mortality ◽

Coronary Care Unit ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Funding Sources ◽

Copd Patients ◽

The Mean ◽

Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Objectives Mechanical ventilation is the short-term technical support most widely used and cardiac arrest its main indication in a Coronary Care Unit (CCU). However, the knowledge about the specific moment and ventilator mode of onset to avoid the acute lung injury is still equivocal. Our objective is to determine the survival rate and the prognostic factors in patients supported by mechanical ventilation. Methods We conducted a retrospective cohort study of adult patients admitted to the CCU between January 2018 and November 2020 that received mechanical ventilation during the hospital stay. Results We collected 94 patients, 28% females with a median age of 68 ± 11,9. 43% were diabetics and almost one quarter of them had some degree of chronic obstructive pulmonary disease (COPD). Ischemic cardiopathy (33%) and heart failure (31%) were frequent pathologies as well as renal injury (29% patients a filtration rate below 45 mL/min/1,73m2). The reason for initiating mechanical ventilation was cardiac arrest in the half of the patients. Volume-controlled ventilation (73%) was the initial setting mode in most cases. The support with vasoactive drugs were highly necessary in these patients (Infection rate of 48%). In the subgroup analysis, we realized that the number of reintubations and the necessity of non-invasive ventilation were higher in the COPD group (p = 0,01), as well as tracheostomy (p = 0,03). COPD patients also needed higher maintaining PEEP, though this was not statistically significant. The mean length of stay in the intensive care unit of our cohort was 11 days (range: 1-78 days; median: 8 days) and the mean length of mechanical ventilation 6 days (range: 1-64 days; median: 3 days). The in-hospital mortality was 41,4%. Conclusions Cardiac arrest is the most common reason of mechanical ventilation support. Our study showed that COPD patients presented more complications during the weaning and the period after extubation. In-hospital mortality remains high in intubated patients.

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Change in smoking behaviour of people who suffer from respiratory disease

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.19.0691 ◽

2020 ◽

Vol 24 (9) ◽

pp. 941-947

Author(s):

Y. C. Fan ◽

Y. Zhao ◽

Q. Xiang ◽

J. Hu ◽

M. Sharma ◽

...

Keyword(s):

Smoking Cessation ◽

Smoking Behaviour ◽

Control Group ◽

Chronic Obstructive ◽

Healthy Individuals ◽

Obstructive Pulmonary Disease ◽

Face To Face ◽

Cessation Rate ◽

Study Population ◽

Medical University

OBJECTIVE: To analyse smoking behaviour in patients suffering from non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) and pulmonary TB (PTB).METHODS: The study population comprised 421 inpatients newly diagnosed with NSCLC, COPD and PTB at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China, and 362 healthy individuals (controls) recruited from September 2016 to March 2017. All participants were current smokers. After enrolment, the subjects were invited to participate in face-to-face interviews to complete the self-designed questionnaire. A follow-up survey was performed 2 years later.RESULTS: Two years after being diagnosed, patients with NSCLC, COPD and PTB had smoking cessation rates of respectively 76.8%, 62.8% and 63.7%. The cessation rate was only 10.2% in the control group (P < 0.01). The difficulty of smoking cessation after diagnosis in patients with the three diseases was significantly decreased (P < 0.01).CONCLUSION: The smoking cessation rate among participants suffering from NSCLC, COPD and PTB increased after diagnosis compared with that before diagnosis, and was significantly higher than the control group of healthy individuals.

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Health-Related Quality Of Life, Uncertainty, ‎and Anxiety among Patients with Chronic Obstructive Pulmonary Disease

F1000Research ◽

10.12688/f1000research.51936.1 ◽

2021 ◽

Vol 10 ◽

pp. 420

Author(s):

Nazih Abu Tabar ◽

Mohammad Al Qadire ◽

Imad Thultheen ◽

Jafar Alshraideh

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Chronic Obstructive ◽

Health Related Quality ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Related Quality ◽

Health Related ◽

The Mean

Patients’ with Chronic Obstructive Pulmonary Disease suffer from serious respiratory symptoms that increase anxiety, stress, and uncertainty, and affect quality of life. The aim of this study was to assess level of anxiety, uncertainty, and health related quality of life (HRQoL) among COPD patients in Jordan. Correlational cross-sectional survey design was used to collect data from 153 COPD patients. ‎The study was conducted at pulmonary clinics in three major referral hospitals in Jordan that provide care for COPD patients from different parts of the country. To assess HRQoL, St. George ‎Respiratory Questionnaire‎ was completed. Uncertainty and anxiety level was measured by Mishel's uncertainty of illness scale and state anxiety inventory respectively. The mean age of participants was 66.8 (SD= 10.3) and most participants were males (94.1%) with. The mean score of HRQoL was 57.9 (SD = 20.5). The mean score of participants’ level of anxiety was 38.1 (SD = 11.1). The mean score of uncertainty was 66.1 (SD= 11.1). There is a statistically significant positive relationship between HRQoL and anxiety (r =.433, p< .01), and uncertainty (r=.483, p<.01). Increased anxiety and uncertainty among COPD patients was associated with low HRQoL. Health care providers need to pay attention the effect of anxiety and uncertainty on COPD patients’ quality of life and institute appropriate management.

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Lipid Profile Status of Chronic Obstructive Pulmonary Disease in Hospitalized Patients

Bangladesh Journal of Medical Biochemistry ◽

10.3329/bjmb.v3i2.13810 ◽

2013 ◽

Vol 3 (2) ◽

pp. 42-45 ◽

Cited By ~ 1

Author(s):

K Begum ◽

MK Begum ◽

ZH Sarker ◽

MRK Dewan ◽

MJH Siddique

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Total Cholesterol ◽

Pulmonary Disease ◽

Mean Value ◽

High Density Lipoproteins ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Healthy Control ◽

The Mean

The aim of this study was to evaluate the serum level of total cholesterol, triglycerides (TG), low density lipoproteins (LDL) and high density lipoproteins, (HDL) in chronic obstructive pulmonary disease (COPD) patients admitted in National Institute of Disease of Chest and Hospital, Mohakhali, Dhaka during. January 2009 to January 2010. Twenty two patients with COPD and 22 healthy controls were included in this study. Total cholesterol, HDL and TG levels were determined with ILAB 1800 Chemistry Analyzer using ILAB test Reagents. LDL concentration was calculated using the Friedewald Equation. The mean level of TG was 150.04±29.66 mg/dl and 126.14±13.28 in COPD patients and healthy control, respectively. A statistically significant difference was found between the two groups (p<0.001). The mean level of TC was 181.83±20.11 mg/dl and 176.28±15.35 mg/dl in COPD patients and healthy control respectively (p<0.001). LDL level mean value was 116.12±14.26 mg/dl and 108.95±10.39 in COPD patients and control respectively (p<0.001). The mean value of HDL showed 38.79±2.4 in COPD patients and 39.014±1.56 in control. A statistically significance was also found between the two groups (p<0.001). Our results showed that the values of TC, TG, LDL were higher than healthy control that is highly significant statistically. On the other hand, the was significantly decreased HDL level compared with controls. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13810 Bangladesh J Med Biochem 2010; 3(2): 42-45

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Accuracy of tidal volume, lung volume, and flow measurements by inductance vest in COPD patients

Journal of Applied Physiology ◽

10.1152/jappl.1984.56.6.1659 ◽

1984 ◽

Vol 56 (6) ◽

pp. 1659-1665 ◽

Cited By ~ 19

Author(s):

D. W. Hudgel ◽

M. Capehart ◽

B. Johnson ◽

P. Hill ◽

D. Robertson

Keyword(s):

Tidal Volume ◽

Lung Volume ◽

Chronic Obstructive ◽

Flow Measurements ◽

Obstructive Pulmonary Disease ◽

Mean Error ◽

Copd Patients ◽

Residual Capacity ◽

The Mean ◽

Thoracic And Abdominal

We analyzed the accuracy of the inductance vest in measuring several ventilatory parameters in five patients with chronic obstructive pulmonary disease (COPD). We assessed tidal volume (VT) accuracy at different respiratory frequencies in different lying body positions with different thoracic and abdominal contributions to breathing and the accuracy over a 4-h time span. Mean percent error was calculated without regard to direction of error. The mean error of vest VT estimation was 7.6% for all body positions studied and 5.6% for right and left lateral positions combined. Vest VT accuracy was unchanged after 4 h and with changes in thoracic and abdominal contributions to VT. The mean errors for inspiratory and expiratory times were 3.3 and 2.0%, respectively. Volume was differentiated to flow. For respiratory rates ranging from 12 to 30 breaths/min, the mean error of the vest and our differentiation circuit in duplicating peak flows measured at the mouth was 3.5%. The ability of the vest to estimate changes in end-expiratory position or functional residual capacity was not as good as with VT; the mean error was 30.7%. For estimation of VT, ventilatory timing, and airflow in COPD patients, the inductance vest performs well. For measurement of changes in lung volume, improvements in vest design need to be made.

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A CLINICAL STUDY ON SAFETY AND EFFICACY OF FORMOTEROL AND TIOTROPIUM COMBINATION COMPARED TO FORMOTEROL AND TIOTROPIUM WITH ROFLUMILAST COMBINATION IN TREATMENT OF MODERATE TO SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i3.21871 ◽

2018 ◽

Vol 11 (3) ◽

pp. 184 ◽

Cited By ~ 1

Author(s):

Kavitha Devi M ◽

Sarumathy S ◽

Sarath Lal Sasidharan ◽

Sarumathy S ◽

Mehanaz Shaik ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Comorbid Condition ◽

Obstructive Pulmonary Disease ◽

Safety And Efficacy ◽

Copd Patients ◽

Before And After ◽

Study Population ◽

Group B

Objectives: The objective of this study is to assess the safety and efficacy of formoterol and tiotropium combination compared to formoterol and tiotropium with roflumilast combination in treatment of moderate-to-severe chronic obstructive pulmonary disease (COPD) patients on inhaled combination therapy. Methods: A comparative prospective interventional study was carried out in 61 COPD patients who were visiting the pulmonary medicine ward during 6 months (October 2016 to March 2017). The patients were randomized into two groups. Group A patients received a combination of formoterol and tiotropium, whereas Group B patients received roflumilast along with formoterol and tiotropium combination. Spirometry tests were done to both the study population. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were noted at the initial visit and after the treatment. All the statistical analyses such as mean and p values were calculated using SPSS 14.0 version software. Results: The average age group of the study population was 57.63±8.3 years. Comorbid condition such as diabetes mellitus was higher in the study groups. Comparison of spirometry reports before and after drug administration in both groups was done. FEV1 and FVC were found to be statistically significant between the study group (0.001, p<0.05).The average mean change of FEV1 before and after treatment in Group B was found to be improved as compared to Group B (0.66). Conclusion: Tiotropium and formoterol with roflumilast combination were found to be safe and effective in moderate-to-severe COPD patients.

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SP-D Polymorphisms and the Risk of COPD

Disease Markers ◽

10.1155/2012/802145 ◽

2012 ◽

Vol 33 (2) ◽

pp. 91-100 ◽

Cited By ~ 4

Author(s):

Tania A. Shakoori ◽

Don D. Sin ◽

S. Nazim Hussain Bokhari ◽

Farkhanda Ghafoor ◽

A. R. Shakoori

Keyword(s):

Restriction Analysis ◽

Serum Levels ◽

Surfactant Protein ◽

Surfactant Protein D ◽

Chronic Obstructive ◽

Nucleotide Polymorphisms ◽

Limited Data ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

First Time

Introduction: There are limited data linking serum levels of surfactant protein D, its genetic polymorphisms to the risk of Chronic Obstructive Pulmonary Disease (COPD).Objectives: We sought to investigate these relationships using a case control study design.Methods: Post bronchodilator values of FEV1/FVC <0.7 were used to diagnose COPD patients (n= 115). Controls were healthy subjects with normal spirometry (n= 106) Single nucleotide polymorphisms (rs721917, rs2243639, rs3088308) were genotyped using polymerase chain reaction (PCR) and restriction analysis. Serum SP-D levels were measured using a specific immunoassay.Results:Allele ‘A’ at rs3088308 (p< 0.00,B= −0.41) and ‘C’ allele at rs721917 (p= 0.03; B = −0.30) were associated with reduced serum SP-D levels. Genotype ‘T/T’ at rs721917 was significantly associated with risk of COPD (p= 0.01). Patients with repeat exacerbations had significantly higher serum SP-D even after adjusting for genetic factors.Conclusions:We report for the first time that rs3088308 is an important factor influencing systemic SP-D levels and confirm the previous association of rs721917 to the risk of COPD and serum SP-D levels.

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Precipitating causes and outcomes of chronic obstructive pulmonary disease exacerbation at a tertiary care center in northeast Thailand

Asian Biomedicine ◽

10.5372/1905-7415.0802.283 ◽

2014 ◽

Vol 8 (2) ◽

pp. 229-236 ◽

Cited By ~ 1

Author(s):

Wipa Reechaipichitkul

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Respiratory Failure ◽

Tract Infection ◽

Respiratory Tract ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

Copd Exacerbation ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Mean

Abstract Background: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a leading cause of hospitalization and economic burden. Frequent exacerbations impair quality of life and effect decline of lung function. Objective: We evaluated characteristics of COPD patients with frequent exacerbations. The precipitating causes, outcomes, hospital stay, and cost of admission were also determined. Methods: The study population included COPD patients admitted because of acute COPD exacerbation at Srinagarind Hospital between 1 January 2006 and 31 December 2010. Results: Over the 5-year period, 183 patients were admitted. Their mean age was 74.9 (SD 9.28) years and the male to female ratio was 170:13. Most patients (144; 79%) had one exacerbation per year and 39 (21%) had more than one per year. The group with more exacerbations, had a higher stage of the disease than those with only one exacerbation (p = 0.023), but there was no significant difference in the mortality rate (18% vs 14%, p = 0.53). A total of 245 episodes of acute exacerbation of COPD occurred in 183 patients. The mean duration of symptoms was 4.1 (SD 3.46) days. Forty-seven percent presented with Anthonisen type III, 42.4% with Anthonisen type II, and 10.6% with Anthonisen type I exacerbations. For 44 exacerbations (18%), the precipitating causes were not determined. The most common precipitating cause was pneumonia, which occurred in 90 episodes (36.7%). The second common was bronchitis (27.8%); followed by heart failure (8.2%), infected bronchiectasis (5.3%), diarrhea (1.2%), acute urinary retention (0.8%), unstable angina (0.4%), pneumothorax (0.4%), urinary tract infection (0.4%), atrial fibrillation (0.4%) and drug induced cough (0.4%). The organisms responsible for respiratory tract infection were identified in 31% cases of pneumonia and 18% of bronchitis cases. The top three common pathogens for pneumonia were Pseudomonas aeruginosa (9%), Acinetobacter baumannii (8%), and Klebsiella pneumoniae (8%). The top three common pathogens for bronchitis were P aeruginosa (7%), Haemophilus influenza (6%), and K pneumoniae (4%). About one quarter (25.3%) of acute exacerbations were complicated by respiratory failure. The mean duration of admission was 17.3 days (range 1-682 days). The mean cost of admission per exacerbation was 80,010 Thai baht (US $2,666) (range, 2,779-3,433,108 baht). The total cost for 245 exacerbations was 19.6 million baht ($653,000). Conclusion: Respiratory tract infections were common causes of COPD exacerbation and one quarter of which developed respiratory failure. Preventive measures such as vaccination, smoking cessation, lung rehabilitation, and appropriate drug use are helpful.

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Correlation between sestrin2 expression and airway remodeling in COPD

10.21203/rs.3.rs-54810/v2 ◽

2020 ◽

Author(s):

Da-Wei Zhang ◽

Yuan-Yuan Wei ◽

Shuang Ji ◽

Guang-He Fei

Keyword(s):

Airway Remodeling ◽

Chest Ct ◽

Chronic Obstructive ◽

Pathological Changes ◽

Obstructive Pulmonary Disease ◽

Control Subjects ◽

Imaging Characteristics ◽

Copd Patients ◽

Staining Methods ◽

First Time

Abstract Background. Airway remodeling is a major pathological characteristic of chronic obstructive pulmonary disease (COPD), and has been shown to be associated with oxidative stress. Sestrin2 has recently drawn attention as an important antioxidant protein. However, the underlying correlation between sestrin2 and airway remodeling in COPD has yet to be clarified.Methods. A total of 124 subjects were enrolled in this study, including 62 control subjects and 62 COPD patients. The pathological changes in airway tissues were assessed by different staining methods. The expression of sestrin2 and matrix metalloproteinase 9 (MMP9) in airway tissues was monitored by immunohistochemistry. Enzyme-linked immunosorbent assays (ELISAs) were used to detect the serum concentrations of sestrin2 and MMP9. The airway parameters on computed tomography (CT) from all participants were measured for evaluating airway remodeling. The relationship between serum sestrin2 and MMP9 concentration and airway parameters in chest CT was also analyzed. Results. In patients with COPD, staining of airway structures showed distinct pathological changes of remodeling, including cilia cluttered, subepithelial fibrosis, and reticular basement membrane (Rbm) fragmentation. Compared with control subjects, the expression of sestrin2 and MMP9 was significantly increased in both human airway tissues and serum. Typical imaging characteristics of airway remodeling and increased airway parameters were also found by chest CT. Additionally, serum sestrin2 concentration was positively correlated with serum MMP9 concentration and airway parameters in chest CT.Conclusion. Increased expression of sestrin2 is related to airway remodeling in COPD. We demonstrated for the first time that sestrin2 may be a novel biomarker for airway remodeling in patients with COPD.

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