APPROACHES TO COMBINED TREATMENT OF PATIENTS WITH CARDIOPULMONARY PATHOLOGY

2020 ◽  
pp. 11-15
Author(s):  
H. A. Tymchenko ◽  
Anton Viktorovych Rohozhyn
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Antihypertensive Drugs ◽  
Combined Treatment ◽  
Chronic Obstructive ◽  
Channel Blockers ◽  
Comorbid Conditions ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Obstructive Pulmonary Disease

Treatment and control of hypertension is an important clinical problem, especially in the case of concomitant risk factors and bronchoobstructive diseases. The use of antihypertensive drugs in the patients with bronchoobstructive pathology has certain features. The use of β−blockers for the treatment of hypertension in the patients with cardiopulmonary pathology helps to reduce mortality, the number of visits to the doctor, those to the emergency rooms and exacerbations of chronic obstructive pulmonary disease. Angiotensin II receptor antagonists are the preferred choice for the patients with chronic obstructive pulmonary disease, requiring the treatment with renin−angiotensin−aldosterone inhibitors compared with angiotensin−converting enzyme inhibitors. Statin therapy improves a shortness of breath, reduces exacerbations, hospitalizations and mortality in the patients with cardiopulmonary pathology. The use of anticoagulants and anti−platelet agents in this category of patients helps to reduce the future morbidity and mortality associated with thrombotic diseases. There are no safety concerns or contraindications to the use of calcium channel blockers or aldosterone receptor blockers (including spironolactone) in the patients with cardiopulmonary pathology, but high doses of diuretics should be used with caution. Pulmonary rehabilitation programs, which included either strength training or a combination of general exercise, were effective for both the patients with bronchoobstructive disease and comorbid conditions. However, the indications, components, regimen, and end goals of such programs for "complex patients" with several comorbid conditions that complicate each other are remained poorly understood. Key words: cardiopulmonary comorbidity, drug treatment, physical rehabilitation, hypertension, chronic obstructive pulmonary disease.

Comorbid conditions at chronic obstructive pulmonary disease: the questions under investigation and discussion

2021 ◽  
Author(s):  
O. I. Lemko ◽  
M. O. Haysak ◽  
D. V. Reshetar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Metabolic Syndrome ◽  
Pulmonary Disease ◽  
Metabolic Disorders ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

The second part of the review examines in detail the questions of diagnostics and peculiarities of the metabolic syndrome manifestations, which presents the link between most comorbid conditions at patients with chronic obstructive pulmonary disease. The metabolic syndrome is based on the insulin resistance and compensatory hyperinsulinemia, caused by both chronic low‑intensity inflammation and increased adipose tissue, often against the background of aggravated heredity at diabetes mellitus. The authors elucidate aspects of the effects of obesity, cachexia and some endocrine disorders on the disease course. The deficiency of researches on endocrine status, especially thyroid function and related metabolic disorders was emphasized. Possible pathogenetic mechanisms of osteoporosis development in this contingent of patients are considered. The need for further research of the pathogenetic role of vitamin D is discussed. Data on the role of the functional state of kidneys in the development of metabolic disorders in an organism have been presented, though kidney pathology in patients with chronic obstructive pulmonary disease is not currently considered as a comorbid condition. The contradictory literature data on the development of anemia in these patients were analysed. The authors presented data on the development of oncological processes as a systemic manifestation at COPD and performed analysis of common and mutually aggravating mechanisms of the development of these pathological conditions. Attention has been paid to the relationship between gastroesophageal reflux disease, bronchiectasis and obstructive sleep apnea with chronic obstructive pulmonary disease. The prospects of modern genetic research in chronic obstructive pulmonary disease and comorbid conditions have been determined.

scholarly journals Preliminary Study to Evaluate Three Different Treatments on Stable Chronic Obstructive Pulmonary Disease Patients Based on Markov Model

2019 ◽  
Vol 2019 ◽  
pp. 1-16
Author(s):  
Xue-qing Yu ◽  
Shu-guang Yang ◽  
Han Li ◽  
Yang Xie ◽  
Jian-sheng Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Markov Model ◽  
Pulmonary Disease ◽  
Western Medicine ◽  
Combined Treatment ◽  
Cost Utility ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Life Years

This study evaluates the costs and utilities of different treatment strategies for stable chronic obstructive pulmonary disease (COPD) patients based on Markov model and provides guidance for clinical decision and health policy making. Patients with stable COPD from four subcenters had been investigated. A Markov model with three states, namely, GOLD 1-2, GOLD 3-4, and death, was built using TreeAge Pro 2011 software. Cost-utility ratio (CUR) and incremental cost-utility ratio (ICUR) from forty Markov circles were applied to measuring the economics evaluation of three different treatments. A total of 236 stable COPD patients were randomly assigned into three groups, Western medicine group (79 cases), traditional Chinese medicine (TCM) group (79 cases), and combined group (78 cases). The results of Markov cohort simulation showed that the accumulative quality-adjusted life years (QALYs) of the three above groups per 100 000 people in 40 years were 1 702 773, 1 616 797, and 1 709 668 years, respectively, and the accumulative costs were 13 582 138 466, 1 207 904 113, and 14 656 607 371 Yuan, respectively. The CURs of the three groups were 87 235, 74 602, and 87 223 Yuan/QALY, respectively. ICURs of combined group were 8 707 and 41 705 Yuan as against Western medicine group and TCM group, respectively. Therefore, combined treatment has a lower cost, higher health output, and more socioeconomic benefits in the long run. Markov model is recommended to conduct health economics evaluation of different treatments for COPD.

scholarly journals Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Rationale and Methods for an Integrated Knowledge Translation Study

2013 ◽  
Vol 20 (4) ◽  
pp. 281-284 ◽  
Author(s):  
Pat G Camp ◽  
W Darlene Reid ◽  
Cristiane Yamabayashi ◽  
Dina Brooks ◽  
Donna Goodridge ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease

BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions.OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD.METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD.RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework.CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.

scholarly journals The influence of various regimens of treatment on the level of proinflammatory cytokine TNF-alpha in induced sputum in case of an exacerbation of chronic obstructive pulmonary disease (copd) in persons, who suffered from pulmonary tuberculosis

2013 ◽  
Vol 17 (1 (65)) ◽  
pp. 38-40
Author(s):  
Ya. V. Ivanova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Disease ◽  
Proinflammatory Cytokine ◽  
Combined Treatment ◽  
Induced Sputum ◽  
Tnf Alpha ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Tnf Α

The influence of various regimens of treatment of the regional (in induced sputum) level of proinflammatory cytokine TNF-α in patients with chronic obstructive pulmonary disease (COPD), who have suffered from pulmonary tuberculosis (PT), has been studied. An advantage of using a combined treatment of COPD exacerbation by means of β2agonist and an anticholinergic preparation (berodual), and also doxofillin (aerofillin) for the purpose of correcting regional (endobronchial) imbalance of cytokine homeostasis is proved.

Treatment Patterns in Asthma- Chronic Obstructive Pulmonary Disease Overlap Syndrome

2016 ◽  
Vol 51 (3) ◽  
pp. 232-238
Author(s):  
Maithili Deshpande ◽  
Jennifer Arnoldi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Rescue Medication ◽  
Treatment Patterns ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Disease Definition ◽  
Global Initiative

Background: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is a complex disease entity with limited guidance surrounding medication therapy. Objective: To evaluate a patient population with possible ACOS and their medication regimen based on the Global Initiative for Asthma and Global Initiative for COPD joint statement for ACOS. Methods: This was a retrospective study based at a large clinical practice within a school of medicine. The sample included adults 40 to 85 years old who had an active concurrent diagnosis of asthma and COPD. Patients were considered to have likely inconsistent therapy (only preventive, no rescue medication), inconsistent therapy (neither preventive nor rescue medication), and likely consistent therapy (both preventive and rescue medication or rescue medication alone). Results: A total of 513 patients were included the study. The majority of the sample were female (75%) and white (87.1%), with an average age of 61 years. About 7% of patients had likely inconsistent therapy, whereas 7.7% had inconsistent therapy to control their airway disease. Never smokers were more likely than former smokers to have inconsistent therapy (adjusted odds ratio [OR] = 4.54; CI = 1.86-11.04). Adults 65 years and older were more likely than those aged 40 to 49 years to be in the likely inconsistent therapy group (adjusted OR = 4.01; CI = 1.04-15.34). Patients without any comorbid conditions were more likely than those with 2 or more comorbid conditions to be in the likely inconsistent group (adjusted OR = 3.50; CI = 1.39-8.77). Conclusion: As the disease definition and treatment recommendations evolve, future studies should continue to monitor ACOS treatment patterns and outcomes.

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.

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