scholarly journals Influence of Anxiety/Depression on the Subjective Evaluation of Cough in Patients with Chronic Obstructive Pulmonary Disease and Obesity

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 134
Author(s):  
Evgeniy Ovsyannikov ◽  
Sergey Avdeev ◽  
Andrey Budnevsky ◽  
Yanina Shkatova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Weight ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Monitoring Device ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Normal Body ◽  
Normal Body Weight ◽  
Anxiety Depression

Background and objectives: Obesity and anxiety and/or depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). For doctors treating COPD, cough has a certain importance as a symptom. The purpose of this study was to figure out how obesity and anxiety/depression may influence the subjective assessment of cough. Materials and Methods: 110 patients with COPD participated in the study. The patients were divided into two groups, one including obese patients, and the other including patients with normal body weight. All patients filled out the hospital anxiety and depression scale (HADS) questionnaire, evaluated the severity of their cough by using visual analogue scale (VAS) on the 1st and 10th day of treatment, and underwent a 12 h cough monitoring with a special cough monitoring device both on the 1st and the 10th day of treatment. Results: The severity of anxiety according to the HADS in patients with COPD and normal body weight was significantly higher than in patients with COPD and obesity, corresponding to 9.25 ± 1.37 and 8.20 ± 1.18 points, respectively (p = 0.0063). The patients with normal body weight and obesity, but without anxiety and depression, subjectively noted an improvement in their well-being on the 10th day of treatment (p = 0.0022, p = 0.0021, respectively). In subgroups with normal body weight and obesity with anxiety and/or depression, the mean values for VAS on day 10 did not change significantly (p = 0.1917, p = 0.1921, respectively). Also, patients from the subgroup with normal body weight and anxiety/depression had a significantly higher assessment of their cough on day 10 than obese patients with anxiety/depression (p = 0.0411). The VAS values correlated positively with the actual amount of cough (r = 0.42, p = 0.0122 and r = 0.44, p = 0.0054, respectively) in patients without anxiety and/or depression, while in patients with anxiety and/or depression, there was an inverse correlation between VAS values and cough (r = −0.38, p = 0.0034 and r = −0.40, p = 0.0231). Conclusions: It is important to diagnose and treat anxiety and depression in patients with COPD for a better prognosis and higher efficacy of medical treatments. While treating such patients, it is preferable to use a cough monitoring device for objective assessments, since the patients may exaggerate or underestimate their symptoms.

scholarly journals Systemic inflammation in patients with chronic obstructive pulmonary disease and obesity

2020 ◽  
Vol 92 (3) ◽  
pp. 13-18 ◽  
Author(s):  
E. S. Ovsyannikov ◽  
S. N. Avdeev ◽  
A. V. Budnevsky
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Weight ◽  
Tumor Necrosis Factor ◽  
Pulmonary Disease ◽  
Tumor Necrosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Normal Body ◽  
Normal Body Weight ◽  
Necrosis Factor

Chronic obstructive pulmonary disease (COPD) is an important public health problem. According to various studies, the prevalence of obesity in patients with COPD is as high as 50%. Aim. To evaluate pro- and anti-inflammatory cytokine profile, lung diseases biomarkers levels and adipokines levels in patients with COPD and obesity. Materials and methods. The study included 88 patients with COPD (GOLD 24, group D). Patients were divided into two groups. The first group consisted of 44 patients with COPD and normal body weight: 35 men and 9 women. The second group 44 patients with obesity and COPD: 34 men and 10 women. The levels of pro- and anti-inflammatory cytokines were determined interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor  (TNF-), interleukin-4 (IL-4), interleukin-10 (IL-10), as well as the concentration of highly sensitive C-reactive protein (CRP), surfactant protein D, elastase, leptin, adiponectin, 1-antitrypsin, receptors of tumor necrosis factor 1 and 2 (TNF-R1, TNF-R2). Results. In patients with COPD and obesity, compared with patients with COPD and normal body weight, the levels of CRP, interferon-, TNF-, TNF-R1, TNF-R2 were significantly higher. At the same time, the levels of IL-4, IL-6, IL-8, IL-10 did not differ significantly. The level of leptin in patients with COPD and obesity was significantly higher than in patients with COPD and normal body weight. Conclusion. In patients with COPD and obesity, in contrast to patients with COPD with normal body weight, the severity of systemic inflammation is significantly higher. However, further research is needed in this area.

scholarly journals EVALUATION OF PROTEOLYTIC AND FIBRINOLYTIC ACTIVITY OF BLOOD PLASMA IN COMORBID CHRONIC CORONARY SYNDROME, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND OBESE

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
I.L. Nemish ◽  
G.Ya. Stupnytska ◽  
O.I. Fediv
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Blood Plasma ◽  
Pulmonary Disease ◽  
Fibrinolytic Activity ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Normal Body ◽  
Coronary Syndrome

The aim - to assess the proteolytic and fibrinolytic activity of blood plasma in comorbidchronic coronary syndrome (CCS), chronic obstructive pulmonary disease (COPD), andobese.Material and methods. The study involved 110 patients, who were divided into 5 clinicalgroups: G1 – 22 CCS and obese patients, G2 – 22 COPD and normal body weightpatients, G3 – 22 CCS, COPD and normal body mass index (BMI) subjects, G4 – 22CCS, COPD and overweight patients and G5 – 22 CCS, COPD and obese I, II degreepatients. The control group consisted of 20 healthy individuals. Proteolytic activityof blood plasma was assessed by the lysis of azoalbumin, azocasein, and azocol, andfibrinolytic – by the lysis of azofibrin.Results. There was a significant increase 50,5%, 43,3%, 43,8% (p<0,05) azoalbuminlysis in the fifth participant’s group compared with the 1st, 2nd, and 4th groups. An increasein azocasein lysis 38,08% was observed (p<0,05) in CCS, COPD, and obese patientscompared with CCS, and obese patients. Azocol lysis was significantly higher 41,7%,13,8%, and 22,06% (p<0,05) in CCS, COP, and obese patients compared with the first,second, and fourth groups. Total fibrinolytic activity (TFA) of blood plasma was 17,7%,14,89%, 21,27% (p<0,05) lower in the 3rd, 4th, and 5th patients’ groups compared withthe 1st one. Enzymatic fibrinolytic activity (EFA) of blood plasma was 28,29%, 22,19%,35,85% (p<0,05) lower in the 3rd, 4th, and 5th patients groups compared with the 1st one.EFA level decrease 23,77% (p<0,05) was observed in the fifth group compared with thesecond one.Conclusions. The most pronounced changes in proteolytic (increased azoalbumin,azocasein, and azocol lysis) and fibrinolytic (decreased total and enzymatic) activitiesof the blood plasma in comorbid chronic сoronary syndrome, chronic obstructivepulmonary disease, and obese patients.

scholarly journals POS0358 EVALUATION OF THE EFFECT OF mTOR EXPRESSION ON THE CLINICAL MANIFESTATIONS OF KNEE OSTEOARTHRITIS IN OBESE AND NORMAL WEIGHT PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva
Keyword(s):  
Body Weight ◽  
Knee Pain ◽  
Mammalian Target Of Rapamycin ◽  
Clinical Manifestations ◽  
Normal Weight ◽  
Womac Pain ◽  
Obese Patients ◽  
Normal Body ◽  
Knee Oa ◽  
Normal Body Weight

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared

scholarly journals Prevalence of obstructive sleep apnea among patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Osama Ibrahim Mohammad ◽  
Ahmed Gouda Elgazzar ◽  
Shymaa Mohammad Mahfouz ◽  
Marwa Elsayed Elnaggar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Severe Copd

Abstract Background The conjunction of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The coexistence of these diseases has cardiovascular morbidity and mortality. The aim of this study is to assess the prevalence of OSA in COPD patients. One hundred COPD patients (obese and non-obese) performed sleep questionnaires and polysomnograms. Results OSA prevalence in COPD was 50% and it increases with increasing disease severity (P < 0.001). The highest prevalence of OSA was found in obese patients with severe COPD; 90.5% of these patients have OSA. In the OSA group, obese patients were found to have significantly higher STOP-Bang Questionnaire (SBQ), Epworth Sleep Scale (ESS), modified medical research council (mMRC) dyspnea scale, apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxygen desaturation index (ODI). Both obese and non-obese COPD patients showed significant positive correlations between AHI and smoking index (SI), SBQ, ESS, mMRC, ODI, and neck circumference (NC). Conclusions From this study, it can be concluded that moderate and severe COPD patients had a higher diagnosis of sleep-disordered breathing. Also, obese-COPD patients are more susceptible to develop OSA. Trial registration Name of the registry: Benha University Protocol Record Benha U123, Obstructive Sleep Apnea Prevalence in Patients With Chronic Obstructive Pulmonary Diseases. Trial registration number: NCT04903639. Date of registry: 5/22/2021 (retrospective study).

scholarly journals Accuracy of the Hospital Anxiety and Depression Scale for Identifying Depression in Chronic Obstructive Pulmonary Disease Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Christoph Nowak ◽  
Noriane A. Sievi ◽  
Christian F. Clarenbach ◽  
Esther Irene Schwarz ◽  
Christian Schlatzer ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Diagnostic Accuracy ◽  
Pulmonary Disease ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Hospital Anxiety ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Clinical Records

Psychological morbidity is common in chronic respiratory diseases. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) and risk factors for comorbid depression in chronic obstructive pulmonary disease (COPD) are addressed. Consecutive COPD patients (GOLD stage I–IV, 40–75 years old) were enrolled in a multicentre, cross-sectional cohort study. Diagnosis of depression was ascertained through clinical records. Lung function, HADS score, 6-minute walking test (6-MWT), MRC dyspnoea score, and COPD Assessment Test (CAT) were evaluated. Two hundred fifty-nine COPD patients (mean age 62.5 years; 32% female; mean FEV1 48% predicted) were included. Patients diagnosed with depression (29/259; 11.2%) had significantly higher HADS-D and HADS-Total scores than nondepressed patients (median (quartiles) HADS-D 6 [4; 9] versus 4 [2; 7], median HADS-Total 14 [10; 20] versus 8 [5; 14]). Receiver-operating characteristic plots showed moderate accuracy for HADS-D, AUC 0.662 (95%CI 0.601–0.719), and HADS-Total, AUC 0.681 (95%CI 0.620–0.737), with optimal cut-off scores of >5 and >9, respectively. Sensitivity and specificity were 62.1% and 62.6% for HADS-D compared to 75.9% and 55.2% for HADS-Total. Age, comorbidities, sex, and lower airflow limitation predicted depression. The HADS exhibits low diagnostic accuracy for depression in COPD patients. Younger men with comorbidities are at increased risk for depression.

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