scholarly journals Flexible Piezoelectric Thin Films for Podiatric Sensors with Wireless Communication

2021 ◽  
Vol 6 (1) ◽  
pp. 48
Author(s):  
Samia Adrar ◽  
Mohammed El Gibari ◽  
Philippe Saillant ◽  
Arnaud Chambellan ◽  
Marc Jubeau ◽  
...  
Keyword(s):  
Thin Films ◽  
Wireless Communication ◽  
University Hospital ◽  
Piezoelectric Sensors ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Analog To Digital ◽  
Piezoelectric Thin Films ◽  
Wireless Communication Protocol

For reasons of availability and cost, patients are sent home increasingly early, with limited follow-up due to the complexity and size of medical devices. In this context, researchers from IETR and MIPS laboratories are working on a device which should monitor the progress of a patient, in order to detect early the aggravation of a disease such as Chronic Obstructive Pulmonary Disease (COPD) or diabetes with walking disorders. The device is based on flexible piezoelectric thin films (3 µm thick) that can be used as podiatric sensors and have been developed by the IETR laboratory. The originality of this work lies both in the approach to the design of the gait-monitoring device—because it was carried out directly in consultation with a doctor from the University Hospital of Nantes and a podiatrist—and in the portability of the device, which should eventually allow the follow-up of a patient at home. For this study, the flexible piezoelectric sensors have been elaborated using a Chemical Solution Deposition (CSD) process and a commercial aluminum (Al) foil as substrate. In order to increase the flexibility of sensors and to aid its insertion in a shoe, piezoelectric films have been encapsulated by lamination into polyethylene terephthalate (PET, 150 μm). In this paper, the elaboration and characterization of flexible piezoelectric sensors, analog-to-digital converter and wireless communication protocol used for data transmission are presented.

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

2019 ◽  
Vol 9 (6) ◽  
pp. 41
Author(s):  
Salwa A. Mohamed
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Assessment Scale ◽  
University Hospital ◽  
Control Group ◽  
Chronic Obstructive ◽  
Breathing Exercise ◽  
Obstructive Pulmonary Disease ◽  
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.

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

THE USE OF BIOCHEMICAL MARKERS IN THE FOLLOW UP OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2018 ◽  
Vol 42 (2) ◽  
pp. 33-57
Author(s):  
Fathy, Shadya, A. ◽  
Elattar, Mai. M. ◽  
Abdel Wahab, Hanan, M. F. ◽  
Fahmy, Fifi, A.
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Biochemical Markers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Screening Program ◽  
Tertiary Care ◽  
Airflow Obstruction ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Targeted Screening ◽  
History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

Patterns of use and trends in the use of medications for the control of COPD in a cohort of Colombian patients, 2017-2019 v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Population Database ◽  
Obstructive Pulmonary Disease ◽  
Prescription Patterns ◽  
Short Acting ◽  
Patterns Of Use ◽  
Long Acting

Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-acting β-agonists (2997, 31.6%) and inhaled corticosteroids (ICS) (2239, 23.6%), but 5083 (53.6%) patients received a long-acting bronchodilator. At the beginning of the follow-up, 645 (6.8%) patients were put on triple therapy with antimuscarinics, β-agonists, and ICS, and at 12 months, this rose to 1388 (20.6%). A total of 57.9% had comorbidities, most often hypertension (44.4%). Conclusions: This group of patients with COPD treated in Colombia frequently received short-acting bronchodilators and ICS, but a growing proportion are undergoing controlled therapy with long-acting bronchodilators, a situation that can improve the indicators of morbidity, exacerbations, and hospitalization.

Therapeutic innovation and sustainability in immune-mediated pathologies

2021 ◽  
Author(s):  
Miguel Ángel Calleja Hernández
Keyword(s):  
Patient Adherence ◽  
Serum Levels ◽  
Pharmacy Service ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Clinical Activity ◽  
Pharmacy Services ◽  
Biological Drugs ◽  
Obstructive Pulmonary Disease ◽  
Immune Mediated

For a few years now, we have been experiencing a disruptive therapeutic innovation in immune-mediated pathologies with the incorporation of biological and targeted therapies that have significantly improved efficacy, safety and convenience for patients. The objective of the Pharmacy Services is to achieve the best health results with the rational use of the drug, that is, it is effective, safe and efficient. Pharmacy Services behave as a strategic element in hospitals and have four main axes: technology, logistics, scientific advice and direct clinical activity. In clinical activity, from the Pharmacy Services we promote greater patient adherence to their treatments, information about them to patients, review of drug interactions and effective monitoring to achieve the best health results. We use the CMO model (Capacity / Motivation / Opportunity), and we have implemented telepharmacy programs to facilitate collaborative dispensing with the community pharmacy. Thus, we gain comfort for patients and improvement of the comprehensive approach to patient needs. The levels of adherence are lower in chronic diseases as time passes from the start of treatment and with the disease controlled; pathologies such as chronic obstructive pulmonary disease, diabetes, or depression have mean adherence values of less than 50%. In the case of immune-mediated diseases the values are 70-90%, but we still need to improve them to achieve maximum effectiveness. From the Pharmacy Service we promote the maximum individualization of therapy, and we believe that no two patients are the same, not even the same patient is the same after the diagnosis and when he has been treatment for several years. For this reason, we have incorporated the determination of levels of biological drugs in the blood to be able to adjust the dosage to the individual needs of the patient. This allows us to optimize the dose when the pathology is controlled, maintaining the target serum levels, or to intensify the dose when control of the disease is not achieved, due to low levels of the drug or high levels of the antibodies that the patient may have generated. Currently, in the Pharmacy Service of University Hospital Virgen Macarena we monitor the levels of Infliximab, Adalimumab, Vedolizumab and Ustekinumab, with optimal results for the patients. It is vital to implement these strategies in a multidisciplinary way with the services involved, in this case mainly Digestive, Rheumatology and Dermatology. We have a pharmacist who is an expert in these pathologies who streamlines and catalyzes all activities in this area.

scholarly journals Functionality of patients with Chronic Obstructive Pulmonary Disease at 3 months follow-up after elastic resistance training: a randomized clinical trial

Pulmonology ◽  
2018 ◽  
Vol 24 (6) ◽  
pp. 354-357
Author(s):  
Isis Grigoletto Silva ◽  
Bruna Spolador de Alencar Silva ◽  
Ana Paula Coelho Figueira Freire ◽  
Ana Paula Soares dos Santos ◽  
Fabiano Francisco de Lima ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Resistance Training ◽  
Randomized Clinical Trial ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Elastic Resistance

scholarly journals β2-Adrenergic genotypes and risk of severe exacerbations in COPD: a prospective cohort study

Thorax ◽  
2019 ◽  
Vol 74 (10) ◽  
pp. 934-940 ◽  
Author(s):  
Truls Sylvan Ingebrigtsen ◽  
Jørgen Vestbo ◽  
Line Rode ◽  
Jacob Louis Marott ◽  
Peter Lange ◽  
...  
Keyword(s):  
Adrenergic Receptor ◽  
Vital Capacity ◽  
Genetic Factors ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
General Population Study ◽  
Heart Study ◽  
Acute Admissions

BackgroundIndividual susceptibility to exacerbations in chronic obstructive pulmonary disease (COPD) is likely influenced by genetic factors; however, most such variance is unexplained. We hypothesised that β2-adrenergic receptor genotypes, Gly16Arg (rs1042713, c.46G>A) and Gln27Glu (rs1042714, c.79C>G) influence risk of severe exacerbations in COPD.MethodsAmong 96 762 individuals in the Copenhagen General Population Study, we identified 5262 with COPD (forced expiratory volume in one second divided by forced vital capacity, FEV1/FVC, below 0.7, FEV1 less than 80% of predicted value, age above 40 years and no asthma) who had genotyping performed. Severe exacerbations were defined as acute admissions due to COPD during 5 years of follow-up (mean 3.4 years). 923 individuals with COPD diagnosed similarly in the Copenhagen City Heart Study (CCHS) were used for replication analyses.ResultsWe recorded 461 severe exacerbations in 5262 subjects. The HRs for severe exacerbations were 1.62 (95% CI 1.30 to 2.03, p=0.00002) for 16Gly/Arg heterozygotes and 1.41 (1.04 to 1.91, p=0.03) for 16Arg homozygotes, compared with 16Gly homozygotes. HRs were 1.35 (1.03 to 1.76, p=0.03) for 27Gln/Glu heterozygotes and 1.49 (1.12 to 1.98, p=0.006) for 27Gln homozygotes, compared with 27Glu homozygotes. Similar trends were observed in the CCHS. Among 27Gln homozygotes only, HRs were 5.20 (1.81 to 14.9, p=0.002) for 16Gly/Arg heterozygotes and 4.03 (1.40 to 11.6, p=0.01) for 16Arg homozygotes, compared with 16Gly homozygotes.ConclusionCommon β2-adrenergic receptor genotypes influence risk of severe exacerbations in COPD, potentially mainly by genetic influence of the 16Arg allele in rs1042713.

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