scholarly journals Application of acetylcysteine in inhalation form in complex treatment of patients with bronchial asthma with neutrophilic type of inflammation

2020 ◽  
pp. 34-36
Author(s):  
V.I. Ignatieva ◽  
S.G. Opimakh ◽  
D.V. Dobrianskyi ◽  
G.L. Gumeniuk ◽  
R.I. Ilnytskyi ◽  
...  

Background. Bronchial asthma (BA) is a heterogeneous chronic inflammatory disease of the airways. On the base of this heterogeneity, among other factors, a significant role is played by the type of inflammation (eosinophilic, neutrophilic or malogranulocytic). In this regard it is offered to allocate separate endotypes of the disease. BA with a neutrophilic type of inflammation is characterized by more severe course with the presence of obstruction at the level of small bronchi and fixed bronchoobstruction. In the presence of disorders at the level of small bronchi, it is advisable to prescribe anti-inflammatory drugs in delivery devices that can create a high concentration of drugs in the peripheral departments (eg, Respimat, inhaled inhalers, fine aerosols). Mucolytics disrupt the structure of the mucus gel, thereby reducing its viscosity and elasticity and, thus, improving the viscoelastic properties of sputum, which facilitate airway clearance and promote the targeted delivery of bronchodilators and anti-inflammatory drugs to the small bronchi. Objective. To evaluate the effectiveness of the use of ultrafine-particle glucocorticoid tiotropium bromide through Respimat in standard therapeutic doses and inhalation of a10 % solution of acetylcysteine with a nebulizer once a day for 10 days as basic therapy. Materials and methods. The diagnosis of BA with the neutrophilic type of inflammation was established in patients, whose results of the blood analysis by microscopy showed the level of neutrophils ≥4000 in 1 μl. The effectiveness of treatment of patients having BA with neutrophilic type of inflammation was studied in 30 patients. First (control) group consisted of 15 patients (5 men and 10 women, mean age – 53.2±4.9 years, FEV1 after test with a bronchodilator – 50.6±16.3 %, FEV1/FVC – 66.4±17,8), who received as a standard therapy a combined drug – 320 mcg of budesonide and 9 mcg of formoterol – twice a day in complex treatment. Second (main) group consisted of 15 patients (9 men and 6 women, mean age – 53.6±3.8 years, FEV1 – 51.5±4.7 %, FEV1/FVC – 67,2±3,5), who were administered the inhalation of 250 μg of ultrafine-particle beclomethasone dipropionate and 12 μg of formoterol twice a day, 5 mcg tiotropium bromide as inhalations through the delivery device respimat once a day for 3 months. In the complex treatment, the inhalation of acetylcysteine (3 ml of 10 % solution) with a nebulizer once a day in the morning (duration of an inhalation session – 10 min) for 10 days was additionally prescribed. Results and discussion. After 3 months in patients of group 2, the effectiveness of treatment was 93.3 %. There was a statistically significant increase in the total score of the test for asthma control (ACT) from 14.3±1.3 to 20.3±0.8 points (p<0.05), a decrease in the total score evaluation of the questionnaire for the control of asthma symptoms (ACQ) from 2.3±0.2 to 1.1±0.1 points (p<0.05), which indicated an improvement in the control of asthma symptoms and a reduction in exacerbations; clinically significant decrease in the number of symptoms from 71.4±5.6 to 51.3±5.0 points (p<0.05) according to the results of the St. George’s Hospital quality of life questionnaire, which indicated an improvement in the quality of life of patients; an increase in MEF50 from 28.9±4.5 % to 41.6±4.2 %, MEF25 from 19.1±2.9 % to 27.6±2.6 % and FEV1/FVC from 67.2±3.5 % to 76.1±2.3 %, which indicated an improvement in bronchial patency at the level of small bronchi and a decrease in fixed bronchial obstruction; an increase in the number of passed meters 6MWT from 266.3±16.2 to 312.0±14.4 m, a decrease in shortness of breath on the Borg scale from 2.5±0.3 to 1.5±0.1 points before the test and from 4.1±0.3 to 3.1±0.3 points after the test, which testified to the increase of tolerance to physical activity. The complex therapy was well tolerated by patients and was not accompanied by the development of side effects. In patients of the control group, statistically significant dynamics of the studied indicators was not detected. Conclusions. Prescription to patients with BA with the neutrophilic type of inflammation according to the severity of the disease as a basic therapy of ultrafine-particle inhaled glucocorticoid tiotropium bromide through a modern technical device Respimat in a standard therapeutic dose, and formoterol 12 μg twice a day for 10 days led to a positive dynamics of clinical symptoms of asthma, improved respiratory function, increased tolerance to physical activity, and improved the quality of life, thus, resulted in the effectiveness of treatment of patients with BA with the neutrophilic type of inflammation being 93.3 %.

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 122
Author(s):  
Marta Pérez-Rodríguez ◽  
Saleky García-Gómez ◽  
Javier Coterón ◽  
Juan José García-Hernández ◽  
Javier Pérez-Tejero

Background and objectives: Acquired brain injury (ABI) is the first cause of disability and physical activity (PA) is a key element in functional recovery and health-related quality of life (HRQoL) during the subacute and chronic phases. However, it is necessary to develop PA programs that respond to the heterogeneity and needs of this population. The aim of this study was to assess the effectiveness of a PA program on the HRQoL in this population. Materials and Methods: With regard to recruitment, after baseline evaluations, participants were assigned to either the intervention group (IG, n = 38) or the control group (CG, n = 35). Functional capacity, mood, quality of life and depression were measured pre- and post-intervention. The IG underwent the “Physical Activity and Sport for Acquired Brain Injury” (PASABI) program, which was designed to improve HRQoL (1-h sessions, two to four sessions/week for 18 weeks). The CG underwent a standard rehabilitation program without PA. Results: Results for the IG indicated significant differences and large effect sizes for the physical and mental dimensions of quality of life, as well as mood and functional capacity, indicating an increase in HRQoL. No significant differences were found for the CG across any variables. Conclusions: The PASABI program was feasible and beneficial for improving physiological and functionality variables in the IG. The wide range of the activities of the PASABI program allow its application to a large number of people with ABI, promoting health through PA, especially in the chronic phase.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonessa Boing ◽  
Tatiana do Bem Fretta ◽  
Melissa de Carvalho Souza Vieira ◽  
Gustavo Soares Pereira ◽  
Jéssica Moratelli ◽  
...  

Abstract Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.


2021 ◽  
Author(s):  
Florie FILLOL ◽  
Ludivine PARIS ◽  
Sébastien PASCAL ◽  
Aurélien MULLIEZ ◽  
Christian-François ROQUES ◽  
...  

BACKGROUND Lack of physical activity (PA) and sedentary behaviors are leading risk factors for non-communicable diseases (NCD). Web-based interventions are effective in increasing PA in older adults and in NCD patients. In many countries a course of spa therapy is commonly prescribed to NCD patients and represents an ideal context to initiating lifestyle changes. OBJECTIVE The main objective of this study was to evaluate in NCD patients the effectiveness of an intervention combining an individual face-to-face coaching during spa therapy and, when returning home, a web- and smartphone-based PA program including a connected wrist pedometer and a connected weighing scale, on the achievement of physical activity guidelines (PAG) 12 months after the end of spa therapy. METHODS This was a 12-month, prospective, parallel-group, randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received usual advices about PA. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants in both groups, were assessed by phone every 2 months. Primary outcome was meeting PAG (PA≥600 METs) at 12 months after the end of spa therapy. Secondary outcomes were: meeting current PAG at 6 months of follow-up; sedentary time, weight and waist circumference, PA and quality of life, at 6 and 12 months. Objective use data of the web-and smartphone-based PA program were collected. Analytic methods include intention-to-treat and constrained longitudinal data analyses. RESULTS The study sample was 228 patients (female : 77.2% (176/228), mean age: 62.4 years (SD 6.7), retired: 53.9% (123/228), mean BMI = 28.2 kg.m-2 (SD 4.2)). No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group versus control group (81% vs 67% respectively, OR = 2.34 (95% CI 1.02- 5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight and waist circumference, at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in intervention group versus control group (mean difference: 4.1 (95% CI 1.9-6.3; P<.001). The mean duration use of the program was 7.1 months (SD 4.5). Attrition rate during the first 2 months of the program was 20.4% (23/113) whereas 39.8% (45/113) of the participants used the program for at least 10 months. CONCLUSIONS The results showed significantly more participants meeting PAG at one year in the intervention group compared to controls. A course of spa therapy offers the ideal time and setting to implement education in PA. Digital coaching seems to be more efficient than usual coaching for increasing the level of PA and decreasing sedentariness on the long term. CLINICALTRIAL ClinicalTrials.gov NCT02694796; https://clinicaltrials.gov/ct2/show/NCT02694796.


2021 ◽  
Vol 7 (3C) ◽  
pp. 607-612
Author(s):  
Sergey Kokhan ◽  
Elena Romanova ◽  
Vladislav Dychko ◽  
Elena Dychko ◽  
Danil Dychko ◽  
...  

The article shows the results of physical therapy of those who have had coronavirus infection COVID-19 and who have completed a month's course of physical rehabilitation as a part of rehabilitation measures in the conditions of the innovative clinic "Academy of Health". The aim of the research is to study the impact of pulmonary rehabilitation programs for patients with moderate to severe COVID-19. The implementation of special breathing exercises made it possible to improve the oxygen saturation in the blood, to reduce shortness of breath and indicators of respiratory symptoms.  The tolerance to exercise has increased; physical activity and the quality of life of patients with pneumonia associated with COVID-19 have improved. The best results of the EQ-5D quality of life assessment were recorded in the experimental group compared to the control group.


2017 ◽  
Vol 11 (6) ◽  
pp. 701-710 ◽  
Author(s):  
Nobuaki Moriyama ◽  
Yukio Urabe ◽  
Shuichi Onoda ◽  
Noriaki Maeda ◽  
Tomoyoshi Oikawa

AbstractObjectiveThis study aimed to compare the physical activity level and health-related quality of life (HRQOL) between older survivors residing in temporary housing after the Great East Japan Earthquake (GEJE; temporary housing group) and older individuals residing in their own homes (control group) and to clarify whether mobility function and muscle strength were correlated with physical activity among older temporary housing residents.MethodsSubjects were recruited to the temporary housing group (n=64, 19 men and 45 women) or control group (n=64, 33 men and 31 women) according to their residence. Physical activity was assessed by the number of walking steps determined by using a triaxial accelerometer, mobility function by the Timed Up and Go test, muscle strength by the grasping power test, and HRQOL by the Medical Outcome Study 36-Item Short Form Survey v2.ResultsIn the temporary housing group, reduced physical activity and correlation between physical activity and mobility function in men, and muscle strength in both men and women, were observed. There was no significant difference in HRQOL between groups except for bodily pain in women.ConclusionSupport for older evacuees should focus on maintaining their physical activity level as well as on HRQOL to avoid deterioration of health in these survivors. (Disaster Med Public Health Preparedness. 2017;11:701–710)


2016 ◽  
Vol 33 (S1) ◽  
pp. S559-S559
Author(s):  
V. Korostiy ◽  
S. Hmain

IntroductionAccording to studies done in recent years regarding the treatment of patients with recurrent depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. According to the literature, complete remission occurs in only 40–50% of patients, in other cases there is residual symptoms.AimsEvaluating the effectiveness of art therapy in treatment in patients with recurrent depressive disorder on the quality of remission.MethodsThe study involved 135 patients: 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy. We used clinical, psychopathological, psychodiagnostic and statistical methods.ResultsThe results of the effectiveness of art therapy in complex treatment in patients with recurrent depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment, as well as in reducing of the severity of anhedonia and improving the quality of life in remission period.ConclusionThese results support the use of art therapy in treatment in patients with recurrent depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. s777-s777 ◽  
Author(s):  
H. Kozhyna ◽  
V. Korostiy ◽  
S. Hmain ◽  
V. Mykhaylov

IntroductionAccording to studies done in recent years regarding the treatment of patients with melancholy in major depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. Despite significant progress in the development of pharmacotherapy of depressive disorders, difficulty in achieving rapid reduction in depressive symptoms and stable remission in patients with melancholic depression necessitated the search for new approaches to the treatment of this pathology.AimsEvaluating the effectiveness of art therapy in treatment in patients with melancholy in major depressive disorder on the quality of remission.MethodsThe study involved 135 patients – 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy.ResultsThe results of the use of art therapy in complex treatment in patients with major depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment (60% of patients have noticed decreasing of melancholic state), as well as improving the quality of life in remission period.ConclusionThese results support the use of art therapy in treatment in patients with melancholy in major depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Author(s):  
Adeleh Khodabakhshi ◽  
Mohammad Esmaeil Akbari ◽  
Thomas N. Seyfried ◽  
Maryam Mahmoudi ◽  
Miriam Kalamian ◽  
...  

Abstract Introduction: Despite the potential benefits of ketogenic diets (KDs) for cancer, evidence of its effects on quality of life is lacking. This study has aimed to find out whether KD has adverse effects on quality of life, physical activity, and biomarkers in patients with breast cancer.Method: A total of 80 patients with locally advanced or metastatic breast cancer were randomly assigned to either a KD or a control group for this 12-week trial. Concurrent with the first, third, and fifth chemotherapy sessions (12-week), the quality of life, physical activity, and biomarkers (thyroid function tests, electrolytes, albumin, ammonia, ALP, lactate and serum ketones) were assessed. Dietary intake was also recorded on admission and the end of the treatment.Results: No significant differences were seen in the quality of life or physical activity between the two groups after 12 weeks; however, the KD group showed a better global quality of life compared to the control group at 6 weeks (P=0.02). Also, serum lactate and ALP levels decreased significantly in KD group compared to the control group after intervention (10.7±3 vs 13.3±4, 149±71 vs 240±164, P=0.02 and P=0.007, respectively). KD did not have any negative impact on thyroid hormones, electrolytes, or physical activity. Compliance among KD subjects ranged from 66.7% to 79.2% as assessed by dietary intake and serum ketones levels of >0.5.Conclusion: According to our results, chemotherapy combined with KD does not negatively impact the quality of life, physical activity, or biomarkers tracked during our study. Ketosis may improve the effectiveness of chemotherapy in patients with breast cancer in part by decreasing lactate and ALP.


2018 ◽  
Author(s):  
Julián Olalla ◽  
Jose María García de Lomas ◽  
Efrén Márquez ◽  
Francisco Jesús González ◽  
Alfonso Del Arco ◽  
...  

BACKGROUND New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. OBJECTIVE The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. METHODS A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. RESULTS The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. CONCLUSIONS Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.


2019 ◽  
Author(s):  
Leonessa Boing ◽  
Tatiana do Bem Fretta ◽  
Melissa de Carvalho Souza Vieira ◽  
Gustavo Soares Pereira ◽  
Jéssica Moratelli ◽  
...  

Abstract Background: Breast cancer is a global public health issue and the side effects of the clinical treatment can decline the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for breast cancer women and Pilates solo and belly dance can be an enjoyable type of physical activity for breast cancer women undergoing clinical treatment. The purpose of the study will be to provide a Pilates solo and a belly dance protocol (3x/16 weeks) for women undergoing breast cancer treatment and compare its effects with the control group. Methods: The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes 3x/week for 16 weeks) or a control group (receipt of a booklet on physical activity for breast cancer patients and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warm-up and stretching; the main stage and relaxation. Measurements of study outcomes will take place at baseline, post-intervention, 6-, 12- and 24-months (maintenance period). The data collection for both groups will occur with a questionnaire application and tests, covering general and clinical information, primary outcome will be quality of life (EORT QLQ C30 and BR23), secondary outcomes will be physical aspects as cardiorespiratory fitness (6-minute walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), strength (dynamometer test) and flexibility (sit and reach test) and psychological aspects as depressive symptoms (BECK Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI) and sleep quality (Pittsburgh Sleep Quality Index). Discussion: In view of the high prevalence of breast cancer among women, the implementation a specific protocol of Pilates solo and belly dance for patients with breast cancer is important considering the needs to improve the quality of life, physical and psychological aspects of their life. Pilates solo and belly dance are two kinds of physical activity that involves mental and body concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer a choice of supportive care to breast cancer women undergoing treatment to improve quality of life, physical and psychological aspects. Trial registration: ClinicalTrials.gov Identifier: NCT03194997 (registration date: 12 August 2017). Universal Trial Number (World Health Organization): U1111-1195-1623. https://clinicaltrials.gov/ct2/show/NCT03194997


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