scholarly journals A Self-Adaptive and Efficient Context-Aware Healthcare Model for COPD Diseases

Informatics ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 41
Author(s):  
Hamid Mcheick ◽  
John Sayegh
Keyword(s):  
Rule Base ◽  
Context Aware ◽  
Separation Of Concerns ◽  
Obstructive Pulmonary Disease ◽  
Architecture Model ◽  
Adaptive Architecture ◽  
Copd Patients ◽  
Software Modules ◽  
Healthcare Model ◽  
The Impact

The emergence of pervasive computing technology has revolutionized all aspects of life and facilitated many everyday tasks. As the world fights the coronavirus pandemic, it is necessary to find new ways to use technology to fight diseases and reduce their economic burden. Distributed systems have demonstrated efficiency in the healthcare domain, not only by organizing and managing patient data but also by helping doctors and other medical experts to diagnose diseases and take measures to prevent the development of serious conditions. In the case of chronic diseases, telemonitoring systems provide a way to monitor patients’ states and biomarkers in the course of their everyday routines. We developed a Chronical Obstructive Pulmonary Disease (COPD) healthcare system to protect patients against risk factors. However, each change in the patient context initiated the execution of the system’s entire rule base, which diminished performance. In this article, we use separation of concerns to reduce the impact of contextual changes by dividing the context, rules and services into software modules (units). We combine healthcare telemonitoring with context awareness and self-adaptation to create an adaptive architecture model for COPD patients. The model’s performance is validated using COPD data, demonstrating the efficiency of the separation of concerns and adaptation techniques in context-aware systems.

Oxidative stress and damage to erythrocytes in patients with chronic obstructive pulmonary disease — changes in ATPase and acetylcholinesterase activity

2015 ◽  
Vol 93 (6) ◽  
pp. 574-580 ◽  
Author(s):  
Bożena Bukowska ◽  
Paulina Sicińska ◽  
Aneta Pająk ◽  
Aneta Koceva-Chyla ◽  
Tadeusz Pietras ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Obstructive Pulmonary Disease ◽  
Red Blood Cells ◽  
Pulmonary Disease ◽  
Blood Cells ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Membrane Enzymes ◽  
Copd Patients ◽  
The Impact

The study indicates, for the first time, the changes in both ATPase and AChE activities in the membrane of red blood cells of patients diagnosed with COPD. Chronic obstructive pulmonary disease (COPD) is one of the most common and severe lung disorders. We examined the impact of COPD on redox balance and properties of the membrane of red blood cells. The study involved 30 patients with COPD and 18 healthy subjects. An increase in lipid peroxidation products and a decrease in the content of -SH groups in the membrane of red blood cells in patients with COPD were observed. Moreover, an increase in the activity of glutathione peroxidase and a decrease in superoxide dismutase, but not in catalase activity, were found as well. Significant changes in activities of erythrocyte membrane enzymes in COPD patients were also evident demonstrated by a considerably lowered ATPase activity and elevated AChE activity. Changes in the structure and function of red blood cells observed in COPD patients, together with changes in the activity of the key membrane enzymes (ATPases and AChE), can result from the imbalance of redox status of these cells due to extensive oxidative stress induced by COPD disease.

scholarly journals Exertional Desaturation Has Higher Mortality Than Non-Desaturation in COPD

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1110
Author(s):  
Shih-Feng Liu ◽  
Chien-Hung Chin ◽  
Ching-Wang Tseng ◽  
Yung-Che Chen ◽  
Ho-Chang Kuo
Keyword(s):  
Cox Regression ◽  
Univariate Analysis ◽  
Chronic Obstructive ◽  
Maximal Heart Rate ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis ◽  
Copd Patients ◽  
Average Survival ◽  
Hs Crp ◽  
The Impact

Background and objectives: Exertional desaturation (ED) is often overlooked in chronic obstructive pulmonary disease (COPD). We aim to investigate the impact of ED on mortality and the predictors of ED in COPD. Materials andmethods: A cohort of COPD patients with clinically stable, widely ranging severities were enrolled. ED is defined as oxyhemoglobin saturation by pulse oximetry (SpO2) < 90% or a drop of ΔSpO2 ≥ 4% during a six-minute walk test (6MWT). Cox regression analysis is used to estimate the hazard ratio (HR) for three-year mortality. Results: A total of 113 patients were studied, including ED (N = 34) and non-ED (N = 79) groups. FVC (% of predicted value), FEV1/FVC (%), FEV1 (% of predicted value), DLCO (%), maximal inspiratory pressure, SpO2 during the 6MWT, GOLD stage, and COPD severity were significantly different between the ED and non-ED groups in univariate analysis. Low minimal SpO2 (p < 0.001) and high maximal heart rate (p = 0.04) during the 6MWT were significantly related to ED in multivariate analysis. After adjusting for age, gender, body mass index, 6MWD, FEV1, mMRC, GOLD staging, exacerbation, hs-CRP, and fibrinogen, the mortality rate of the ED group was higher than that of the non-ED group (p = 0.012; HR = 4.12; 95% CI 1.37–12.39). For deaths, the average survival time of ED was shorter than that of the non-ED group (856.4 days vs. 933.8 days, p = 0.033). Conclusions: ED has higher mortality than non-ED in COPD. COPD should be assessed for ED, especially in patients with low minimal SpO2 and high maximal HR during the 6MWT.

scholarly journals Impact of tobacco-related chronic obstructive pulmonary disease on developmental trajectories of comorbidities in the Taiwan population

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Te-Wei Ho ◽  
Yi-Ju Tsai ◽  
Chun-Ta Huang ◽  
Angela Shin-Yu Lien ◽  
Feipei Lai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Developmental Trajectories ◽  
Chronic Obstructive ◽  
Control Groups ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control ◽  
The Impact

AbstractComorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017–2.198], malignancy (IRR 2.397; 95% CI 1.408–4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612–5.318), heart failure (IRR 2.531; 95% CI 1.502–4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176–3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.

scholarly journals The impact of the involvement of a healthcare professional on the usage of an eHealth platform: a retrospective observational COPD study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Cathelijne M. van Zelst ◽  
Marise J. Kasteleyn ◽  
Esther M. J. van Noort ◽  
Maureen P. M. H. Rutten - van Molken ◽  
Gert-Jan Braunstahl ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Professional ◽  
Self Management ◽  
Care Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Observational Cohort ◽  
Blended Care ◽  
The Impact

Abstract Background Ehealth platforms, since the outbreak of COVID-19 more important than ever, can support self-management in patients with Chronic Obstructive Pulmonary Disease (COPD). The aim of this observational study is to explore the impact of healthcare professional involvement on the adherence of patients to an eHealth platform. We evaluated the usage of an eHealth platform by patients who used the platform individually compared with patients in a blended setting, where healthcare professionals were involved. Methods In this observational cohort study, log data from September 2011 until January 2018 were extracted from the eHealth platform Curavista. Patients with COPD who completed at least one Clinical COPD Questionnaire (CCQ) were included for analyses (n = 299). In 57% (n = 171) of the patients, the eHealth platform was used in a blended setting, either in hospital (n = 128) or primary care (n = 29). To compare usage of the platform between patients who used the platform independently or with a healthcare professional, we applied propensity score matching and performed adjusted Poisson regression analysis on CCQ-submission rate. Results Using the eHealth platform in a blended setting was associated with a 3.25 higher CCQ-submission rate compared to patients using the eHealth platform independently. Within the blended setting, the CCQ-submission rate was 1.83 higher in the hospital care group than in the primary care group. Conclusion It is shown that COPD patients used the platform more frequently in a blended care setting compared to patients who used the eHealth platform independently, adjusted for age, sex and disease burden. Blended care seems essential for adherence to eHealth programs in COPD, which in turn may improve self-management.

scholarly journals The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

scholarly journals Effect of Antioxidants in the Treatment of COPD Patients: Scoping Review

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Mauricio Orozco-Levi ◽  
Claudia Colmenares-Mejía ◽  
Jessica Ruíz ◽  
Yurley Dayanna Valencia-Barón ◽  
Alba Ramírez-Sarmiento ◽  
...  
Keyword(s):  
Scoping Review ◽  
Respiratory Symptoms ◽  
Hospital Readmissions ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Negative Effects ◽  
Obstructive Pulmonary Disease ◽  
Nutritional Interventions ◽  
Copd Patients ◽  
The Impact

Chronic obstructive pulmonary disease (COPD) is a common, preventable, treatable lung disease characterized by persistent respiratory symptoms and airflow limitation and multiorgan impact. This affects the nutritional status of patients and requires multidimensional interventions including nutritional interventions according to individual metabolic needs. Our scoping review determined the effects of antioxidants in the treatment of COPD patients and their role in the decrease in the probability of exacerbations, hospital readmissions, and changes in lung function. The sources MEDLINE, LILACS, and Google Scholar were consulted and 19 studies were selected. The most indicated antioxidants are N-Acetylcysteine, vitamins E and D, and Zinc. Other antioxidants from plants or fruits extracts are also being investigated. The beneficial effect of antioxidants in stable or exacerbated patients is not clear, but theoretical and biological arguments of benefit justify lines of research that specify the impact on reducing oxidative stress and negative effects in COPD.

scholarly journals Influence of Particulate Matter during Seasonal Smog on Quality of Life and Lung Function in Patients with Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 16 (1) ◽  
pp. 106 ◽  
Author(s):  
Chaicharn Pothirat ◽  
Warawut Chaiwong ◽  
Chalerm Liwsrisakun ◽  
Chaiwat Bumroongkit ◽  
Athavudh Deesomchok ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Particulate Matter ◽  
Lung Function ◽  
Chronic Obstructive ◽  
Short Term ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Impact

The impact of outdoor air pollution on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients, as measured by the COPD assessment test (CAT) questionnaire, is limited. The aim of this study was to determine the impact of a short-term increase in outdoor particulate matter in which the particles are less than 10 microns in diameter (PM10) during a seasonal smog period on QoL, symptoms, and lung function in COPD patients. This prospective observational study was conducted at Chiang Dao Hospital, Chiang Mai, Thailand between March and August 2016. Measurement of QoL, severity of dyspnea, forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1) were performed at both high and low PM10 periods. Fifty-nine patients met the inclusion criteria for enrollment into the study, with the mean age being 71.5 ± 8.0 years. Total CAT score, but not mMRC score, was statistically higher during the high PM10 period. The two lung function parameters, FVC and FEV1, were significantly lower at the high PM10 compared to the low PM10 period. We concluded that exposure to PM10 during the seasonal smog period resulted in short-term negative impact on the quality of life and lung function in COPD patients.

scholarly journals Comorbid Conditions in Chronic Obstructive Pulmonary Disease: Potential Therapeutic Targets for Unmet Needs

2020 ◽  
Vol 9 (10) ◽  
pp. 3078 ◽  
Author(s):  
Kazuto Matsunaga ◽  
Misa Harada ◽  
Junki Suizu ◽  
Keiji Oishi ◽  
Maki Asami-Noyama ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Characteristics ◽  
Unmet Needs ◽  
Therapeutic Targets ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Impact

The management of chronic obstructive pulmonary disease (COPD) has improved significantly due to advances in therapeutic agents, but it has also become apparent that there are issues that remain difficult to solve with the current treatment algorithm. COPD patients face a number of unmet needs concerning symptoms, exacerbations, and physical inactivity. There are various risk factors and triggers for these unmet needs, which can be roughly divided into two categories. One is the usual clinical characteristics for COPD patients, and the other is specific clinical characteristics in patients with comorbid conditions, such as asthma, cardiovascular disease, and bronchiectasis. These comorbidities, which are also associated with the diversity of COPD, can cause unmet needs resistance to usual care. However, treatable conditions that are not recognized as therapeutic targets may be latent in patients with COPD. We again realized that treatable traits should be assessed and treated as early as possible. In this article, we categorize potential therapeutic targets from the viewpoint of pulmonary and systemic comorbid conditions, and address recent data concerning the pathophysiological link with COPD and the impact of intervention on comorbid conditions in order to obtain evidence that could enable us to provide personalized COPD management.

scholarly journals Respiratory rehabilitation techniques used for the treatment of COPD patients

2020 ◽  
Vol 11 (Vol.11, no.3) ◽  
pp. 269-273
Author(s):  
Georgeta PATRASCA ◽  
Gilda POPESCU ◽  
Doina Ecaterina TOFOLEAN ◽  
Anca MAIEREAN ◽  
Gabriela DOGARU ◽  
...  
Keyword(s):  
Exercise Tolerance ◽  
Demographic Data ◽  
Rehabilitation Program ◽  
Pharmacological Therapy ◽  
Chronic Obstructive ◽  
Borg Scale ◽  
Lung Function Decline ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Impact

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world. At present, the pharmacological therapy is not enough for a patient with COPD in regard to heath status and exercise tolerance. It requires additional therapies aimed to improve the quality of life, delay the lung function decline, increase exercise capacity, and reduce the respiratory symptoms and the number of exacerbations. Pulmonary rehabilitation program (PRP) has been shown to improve respiratory muscle, to optimize functional, psychosocial, behavioral and nutritional status. The aim of the present study was to asses the impact of PRP on COPD patients, focusing on the clinical benefits of PRP, which may further provide to the patients a good support for change. Material and method. Sixty-seven patients with clinically stable COPD were enrolled in this prospective study, consisting in a 6-weeks of PRP. There were recorded demographic data, smoking and medical history, and abnormal findings at the physical examination. All patients completed CAT (COPD Assessment Test) questionnaire and dyspnea on Borg scale, they performed spirometry, and six minutes walking test (6MWT), before and after the completion of the rehabilitation program. Results and Discussions. After the 6-week period of PRP, a large proportion of patients presented higher values of spirometric parameters, although the change was no statistically significant. The impact of COPD on the patient’s health was significantly improved, 58.2% of patients registered < 10 points of CAT questionnaire after PRP (p<0.05). 75% of patients reported a 0-5 points of dyspnea on Borg scale comparing with 29% before the PRP (p=0.0147), and 56% a 0-5 points of fatigue while only 25% of patients had the same score before the rehabilitation programme (p=0,022). Only 8 patients (11.94% vs 31.34%, p<0.05) reported a SaO2 lower than 90% after the PRP. The 6MWD was longer than 250m at the end of the 6-weeks of PRP for 38 patients (56.7% vs 22.38%, p<0.05). Conclusions. The present study showed that a PRP added to pharmacological treatment had a beneficial role of increasing the patient’ health status and exercise tolerance for COPD patients.

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