Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Objective: Although the importance of assessing inspiratory flow in the selection of treatments for chronic obstructive pulmonary disease (COPD) is understood, evaluation of this factor is not yet widespread or standardized. The objective of the present work was to evaluate the peak inspiratory flow (PIF) of patients with COPD and to explore the variables associated with a suboptimal PIF. Methods: An observational, cross-sectional study was carried out at specialized nursing consultations over a period of 6 months. We collected clinical data as well as data on symptoms, treatment adherence, and patient satisfaction with their inhalers via questionnaires. PIF was determined using the In-Check Dial G16® device (Clement Clarke International, Ltd., Harlow, UK). In each case, the PIF was considered suboptimal when it was off-target for any of the prescribed inhalers. The association with suboptimal PIF was evaluated using multivariate logistic regression and the results were expressed as the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 122 COPD patients were included in this study, of whom 34 (27.9%) had suboptimal PIF. A total of 229 inhalers were tested, of which 186 (81.2%) were dry powder devices. The multivariate analysis found an association between suboptimal PIF and age (OR = 1.072; 95% CI (1.019, 1.128); p = 0.007) and forced vital capacity (OR = 0.961; 95% CI (0.933, 0.989); p = 0.006). Conclusions: About a third of patients in complex specialized COPD care have suboptimal PIFs, which is related to age and forced vital capacity.

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ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

Journal of Biomedical and Pharmaceutical Research ◽

10.32553/jbpr.v8i2.586 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

Melvin K Mathews ◽

Abubaker Siddiq ◽

Bharathi D R

Keyword(s):

Illness Perceptions ◽

Pharmacist Intervention ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Post Test ◽

Knowledge Practice ◽

And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

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Study of red cell distribution width levels and its correlation with severity of disease in patient with chronic obstructive pulmonary disease

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212801 ◽

2021 ◽

Author(s):

Shashidhar Ramappa ◽

Aishhwarrya Umeshchandra G. ◽

Sheshan V. ◽

Manigandan .

Keyword(s):

Cross Sectional Study ◽

Red Cell Distribution Width ◽

Chronic Obstructive ◽

Red Cell ◽

Cell Distribution ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Distribution Width ◽

Severity Of Disease ◽

Copd Patients

Background:COPD has been accepted as component of systemic inflammatory syndrome. Red cell distribution width (RDW) is a measure of coefficient of variation of mean corpuscular volume which increases in chronic systemic inflammation. The aim of the study was to evaluate the RDW as a predictor of severity of COPD using BODE index.Methods:In this cross-sectional study 107 COPD patients were evaluated by measuring RDW and this was correlated with the severity of disease using GOLD staging.Results:RDW correlates well with COPD patients. Significant correlation of RDW with BODE index (r=0.650, p and It; 0.001), gold staging (r=0.459, p and It; 0.001), 6MWT (r=0.697, p and It; 0.001) were observed.Conclusions: RDW was found to increase in patients with increasing severity of COPD. Hence its potential role as a marker of severity of disease and in predicting risk of cardiovascular disease can be explored.

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The Prevalence of Diabetes Mellitus in Chronic Obstructive Pulmonary Disease Patients

Jurnal Respirologi Indonesia ◽

10.36497/jri.v40i1.97 ◽

2020 ◽

Vol 40 (1) ◽

pp. 48-57

Author(s):

Mariska Pangaribuan ◽

Faisal Yunus ◽

Triya Damayanti ◽

Rochsismandoko Rochsismandoko

Keyword(s):

Diabetes Mellitus ◽

Cross Sectional Study ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Inhaled Corticosteroid ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Number Of Patients

Backgrounds: Type 2 diabetes mellitus (DM) is a common comorbidity of COPD. COPD may be considered as a risk factor for new onset type 2 DM via multiple pathophysiological alterations such as systemic inflammation, smoking, oxidative stress, obesity and inhaled corticosteroid use. Exact prevalence of DM in COPD patients in Indonesia still unclear. Co-morbid conditions like DM have great impact on the outcome of COPD in the form of severity, morbidity and mortality. Methods: A cross sectional study was done in Asthma-COPD clinic Persahabatan Hospital from February to March 2017 to screen COPD patients for DM. Sixty-four subjects were recruited. Interview, physical examination and laboratory testing were performed in all subjects. Results: A total of 64 patients with COPD (Males=60, Female=4) with mean age 65±8.7 were screened for DM. Patients with known history of DM were 12 subjects (18.8%) and were enrolled as known DM cases. Remaining 52 subjects (81.3%) whose DM status was unclear were screened by random or fasting blood sugar and HbA1c. Two subjects (3.1%) were considered as newly diagnosed DM cases. Prevalence of DM in present study was 21.9%. Number of patients with pre-diabetes was 16 subjects (25%). There was no significant relationship between gender, age, smoking, nutritional status, airflow limitation and inhaled corticosteroid use in occurrence of DM among COPD patients. Conclusions: Prevalence of DM in COPD patients in the present study is 21.9%. It is important to screen all COPD patients for DM routinely. (J Respir Indo. 2020; 40(1): 48-57)

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CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.09.1701 ◽

2016 ◽

Vol 23 (09) ◽

pp. 1073-1078

Author(s):

Atif Sitwat Hayat ◽

Abdul Haque Khan ◽

Ghulam Nabi Pathan ◽

Mohammad Zubair Mushtaque

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

C Reactive Protein ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Reactive Protein ◽

Copd Patients ◽

Study Results

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).

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Activities of daily living in patients with chronic obstructive pulmonary disease with depressive symptoms

Fisioterapia e Pesquisa ◽

10.1590/1809-2950/19018827022020 ◽

2020 ◽

Vol 27 (2) ◽

pp. 194-201

Author(s):

Rilda Carla Alves de Souza ◽

Fabíola Cássia de Oliveira Silva Vieira ◽

Graziella Monicky Oliveira Costa ◽

Kamila Roberta Perpétua de Souza ◽

Laura Maria Gomes de Siqueira ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Pulmonary Disease ◽

Daily Living ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients

ABSTRACT This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.

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The Relationship Between Peak Inspiratory Flow and Hand Grip Strength Measurement in Men with Mild Chronic Obstructive Pulmonary Disease

10.21203/rs.3.rs-719942/v1 ◽

2021 ◽

Author(s):

Takahiro Tsuburai ◽

Yuko Komase ◽

Hajime Tsuruoka ◽

Baku Oyama ◽

Hiromi Muraoka ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Grip Strength ◽

Pulmonary Disease ◽

Hand Grip Strength ◽

Inspiratory Flow ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Peak Inspiratory Flow ◽

Hand Grip ◽

Copd Patients

Abstract Backgrounds: Chronic obstructive pulmonary disease (COPD) decreases quality of life and muscular strength. Inspiratory flow is important for inhalants in the bronchi but is complicated to measure in routine practice. We hypothesized that hand grip strength (HGS) would correlate with inhalation rate in patients with mild COPD.Methods: The COPD patients were recruited at the St. Marianna University School of Medicine, Yokohama Seibu Hospital, from 2015 to 2018. We measured peak inspiratory flow (PIF) through an In-Check flow meter attached with Diskus [PIF(D)] and Turbuhaler [PIF(T)] inhalers. The 6-minute walking test (6MWT), and the fraction of exhaled nitric oxide (FENO), spirometry, HGS, or forced oscillation technique (FOT) parameters were measured.Results: Forty-four subjects were enrolled. All were men, with a mean age (± SD) of 77.8 ± 9.36 years. Thirty-nine patients had mild COPD. PIF(D) was 110 (80, 140) L/min (median, interquartile range), PIF(T) was 80 (70, 90) L/min, and HGS was 28.7 (13.8, 43.6) kgf. PIF(D) and PIF(T) were significantly correlated (r = 0.443, p = 0.003). PIF(D) was significantly correlated with age (r = − 0.327, p = 0.030) and HGS (r = 0.326, p = 0.031). PIF(T) was significantly correlated with age (r = − 0.328, p = 0.030), FVC (r = 0.351, p = 0.019), 6MWT distance (r = 0.392, p = 0.011), and HGS (r = 0.328, p = 0.030).Conclusion: HGS might be more useful for predicting PIF than other parameters. Also, elderly COPD patients need to be taught inhaled methods carefully.

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Correlation of serum uric acid with severity of airflow limitation in the patients of chronic obstructive pulmonary disease

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20201114 ◽

2020 ◽

Vol 7 (4) ◽

pp. 634

Author(s):

Sujit Kumar ◽

Vimal Kumar Nishad ◽

Amitabh Das Shukla ◽

Santosh Kumar Chaudhary

Keyword(s):

Uric Acid ◽

Serum Uric Acid ◽

Cross Sectional Study ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Healthy Controls ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Exacerbation Risk

Background: Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA in COPD patients and to evaluate whether sUA level can be used as predictors of exacerbation risk and disease severity.Methods: This cross-sectional study included COPD patients and healthy controls. The sUA levels in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk were reported.Results: The study included 106 COPD patients and 110 healthy controls. The mean sUA levels were significantly higher in patients with COPD compared to healthy controls (p<0.05). Mean sUA levels were compared with different stages of COPD according to GOLD criteria. Stage 4 COPD subjects had highest sUA levels compared to other stages. Statistically significant trend was observed for GOLD staging of disease (p<0.05). Surprisingly non-smokers were having higher uric acid level than smokers (p<0.05). The ROC analyses indicated that sUA levels can be useful in predicting exacerbation risk (AUC, 0.412) especially at higher cut-off values, but with low specificity.Conclusions: Study suggested that sUA levels increased in patients with COPD compared to healthy controls. At higher cut-off values sUA levels might be useful in predicting COPD exacerbation risk and disease severity. However, more prospective cohort studies with large number of participants are needed to further analyse the possible different prognostic roles of hyperuricemia.

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Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study

International Journal of Current Research in Physiology and Pharmacology (IJCRPP) ◽

10.31878/ijcrpp.2019.34.1 ◽

2019 ◽

pp. 1-4

Author(s):

Karthika M ◽

Prakash Chandra Bhardwaj ◽

Laimayum Amarnath Sharma ◽

W Kanan ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

C Reactive Protein ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Reactive Protein ◽

Copd Patients ◽

Serum Crp

Abstract Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004). Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD. Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal.

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Prevalence of Metabolic Syndrome in Chronic Obstructive Pulmonary Disease in Rural Population of Developing Country-A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47594.14663 ◽

2021 ◽

Author(s):

Atul Tiwari ◽

SK Piruwa ◽

SK Agrawaal ◽

GN Srivastava ◽

Deepak Shah

Keyword(s):

Cross Sectional Study ◽

Airflow Limitation ◽

Chronic Obstructive ◽

P Value ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Healthy Control

Introduction: Metabolic Syndrome (MetS) is characterised by the clustering of central obesity, hypertension, dyslipidemia, and hyperglycemia that predisposes patients to Cardiovascular Disease (CVD). It is a representative group of conditions with systemic inflammation, which is a potential mechanism responsible for both Chronic Obstructive Pulmonary Disease (COPD) and MetS. Aim: To detect incidence of MetS in COPD patients and its correlation with severity of COPD. Materials and Methods: The present study was an observational cross-sectional study which was conducted on 62 COPD patients in SS Hospital, BHU, Varanasi, Uttar Pradesh, India, from June 2015 to June 2017, diagnosed on basis of Global initiative for Lung Disease (GOLD) guidelines. 62 age and sex matched control having no cardio-respiratory history were included. All relevant investigations were done for all selected subjects and modified Medical Research Council (mMRC) dyspnoea grading was done in all the subjects. Standardised treatment modules were followed and spirometry and post-bronchodialater spirometry was performed 15-30 mins after inhalation of 400 mcg Salbutamol. Patients obstruction was classified according to the severity of airflow limitation based on post-bronchodilator Forced Expiratory Volume in one second (FEV1) as follows: mild (≥80% predicted); moderate (80>FEV1 ≥50% predicted); severe (50%> FEV1 ≥30% predicted); very severe (<30% predicted). Complete work-up and data collection were analysed by using Statistical Package for the Social Sciences (SPSS) version 23.0 software, descriptive cross tables, univariate and multivariate analysis. Independent Student’s t-test was used to compare the means of cases and controls. The p-value <0.05 was considered statistically significant. Results: Total 62 patients along with age and sex matched 62 healthy control in 1:1 ratio have been taken in the study, majority were in age group of 50-70 years. On comparing the mean values of different parametres of MetS in COPD cases and controls, significantly raised triglyceride level and fasting blood sugar in COPD cases (p-value <0.001 and 0.005 respectively) were observed. MetS was present in 29 cases (46.8%) of COPD whereas in healthy control population only 19 people (30.6%) were positive for MetS. Total of 55.2% cases of COPD with MetS was in group D whereas 84.8% cases of COPD without MetS were in group B of GOLD staging. Statistically significant (p<0.001) higher incidence of acute exacerbation was observed in cases of COPD with MetS. Conclusion: MetS was more prevalent among the COPD patient in 50-70 years age group with mild to moderate airflow limitation. More waist circumference i.e., central obesity, impaired fasting glucose, dyslipidemia, increases the risk of cardiovascular complication in these patients. MetS is an important co-morbidity in patients of COPD which fasten the natural course of disease by increasing the frequency of acute exacerbation.

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The characteristics of the frequent exacerbator with chronic bronchitis phenotype and non-exacerbator phenotype in patients with chronic obstructive pulmonary disease: a meta-analysis and system review

10.21203/rs.2.11323/v3 ◽

2020 ◽

Author(s):

Jianjun Wu ◽

Hong-ri Xu ◽

Ying-xue Zhang ◽

Yi-xuan Li ◽

Hui-yong Yu ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Chronic Bronchitis ◽

Pulmonary Disease ◽

Forced Vital Capacity ◽

Vital Capacity ◽

Meta Analysis ◽

Forced Expiratory Volume ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Abstract Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD). Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis. Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%). Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.

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