scholarly journals Cognitive dysfunction in severe chronic obstructive pulmonary disease (COPD) with or without Long-Term Oxygen Therapy (LTOT)

2015 ◽  
Vol 10 ◽  
Author(s):  
Roberto W. Dal Negro ◽  
Luca Bonadiman ◽  
Fernanda P. Bricolo ◽  
Silvia Tognella ◽  
Paola Turco
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cognitive Dysfunction ◽  
Reference Values ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Normal Reference ◽  
Copd Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition which can lead to comorbidities of variable severity, cognitive dysfunction included. The role of supplemental oxygen in preventing COPD-induced cognitive deterioration is still debated, but only episodically investigated. The aim of this study was to compare the cognitive pattern of hypoxemic COPD subjects treated with long-term oxygen (LTOT) to that of patients of comparable severity assuming oxygen on irregular basis, and to normal reference values. Methods: Lung function, arterial blood gases, health status, and cognitive function measured by means of four psychometric tests focusing different domains of cognition (such as: MMSE, Clock test; TMT-A; TMT-B) were assessed in 146 well matched hypoxemic COPD patients (males n = 96, 66%; mean age = 70.5 ± 12.9). Seventy-three patients were assuming long-term oxygen (LTOT), while the remaining seventy-three were only using oxygen as needed (AN). Regarding statistics, t test and ANOVA (Duncan test) were used to analyze data, assuming a p < 0.05 as the lowest limit of significance. Results: Even though all COPD patients showed a poorer psychometric profile vs corresponding normal reference values, LTOT patients showed a lower prevalence of severe deterioration in cognition. Also the extent of impairment was significantly lower in these patients when assessed by TMT-A and TMT-B (p < 0.012 and 0.001, respectively), but not when measured by MMSE and Clock test (both p = ns). Several domains of cognition are variably affected by persistent hypoxemia in COPD patients. A panel of psychometric tools is needed for identifying the pattern of cognitive dysfunctions in these patients. Memory and attention (functions assessed by MMSE and Clock test) are only mildly-moderately affected, while visual processing, reproduction of numeric sequences, cognition flexibility, and shifting capacity (functions assessed by TMT-A and TMT-B) are much more deteriorated (p < 0.012 and p < 0.001, respectively). Conclusions: Only LTOT allows to preserve significantly (p < 0.022) cognitive functions from the COPD-induced deterioration. This assumption is of strategic value for COPD patients who are prescribed long-term oxygen because they frequently are not aware of the cognitive risks related to their condition.

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

2021 ◽  
Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.

scholarly journals Impact of chronic obstructive pulmonary disease and dyspnoea on clinical outcomes in ticagrelor treated patients undergoing percutaneous coronary intervention in the randomized GLOBAL LEADERS trial

2019 ◽  
Vol 6 (4) ◽  
pp. 222-230
Author(s):  
Mariusz Tomaniak ◽  
Ply Chichareon ◽  
Kuniaki Takahashi ◽  
Norihiro Kogame ◽  
Rodrigo Modolo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Abstract Aims To evaluate long-term safety and efficacy of ticagrelor monotherapy in patients undergoing percutaneous coronary interventions (PCIs) in relation to chronic obstructive pulmonary disease (COPD) at baseline and the occurrence of dyspnoea reported as adverse event (AE) that may lead to treatment non-adherence. Methods and results This is a non-prespecified, post hoc analysis of the randomized GLOBAL LEADERS trial (n = 15 991), comparing the experimental strategy of 23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT) after PCI with the reference strategy of 12-month DAPT followed by 12-month aspirin monotherapy. Impact of COPD and dyspnoea AE (as a time-dependent covariate) on clinical outcomes was evaluated up to 2 years. The primary endpoint was a 2-year all-cause mortality or non-fatal, centrally adjudicated, new Q-wave myocardial infarction. The presence of COPD (n = 832) was the strongest clinical predictor of 2-year all-cause mortality after PCI [hazard ratio (HR) 2.84; 95% confidence interval (CI) 2.21–3.66; P adjusted = 0.001] in this cohort (n = 15 991). No differential treatment effects on 2-year clinical outcomes were found in patients with and without COPD (primary endpoint: HR 0.88; 95% CI 0.58–1.35; P = 0.562; P int = 0.952). Overall, at 2 years dyspnoea was reported as an AE in 2101 patients, more frequently among COPD patients, irrespective of treatment allocation (27.2% in experimental arm vs. 14.5% in reference arm, P = 0.001). Its occurrence was not associated with a higher rate of the primary endpoint (P adjusted = 0.640) in the experimental vs. the reference arm. Conclusion In this exploratory analysis, COPD negatively impacted long-term prognosis after PCI. Despite higher incidence of dyspnoea in the experimental arm, in particular among COPD patients, the safety of the experimental treatment strategy appeared not to be affected. Clinical trial registration unique identifier NCT01813435.

Long-term Prognosis of Chronic Obstructive Pulmonary Disease (COPD) Patients on Home Oxygenotherapy

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 383A
Author(s):  
María del Carmen García García ◽  
Jacinto Hernández Borge ◽  
Pedro Pires Goncalves ◽  
Carlos Antonio Aranda López ◽  
Lourdes Cañón Barroso ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Term Prognosis

Long-Term Auscultation in Chronic Obstructive Pulmonary Disease: Renaissance of an Ideograph of Medical Care

Respiration ◽  
2021 ◽  
pp. 1-8
Author(s):  
Sarah Bettina Schwarz ◽  
Wolfram Windisch ◽  
Daniel Sebastian Majorski ◽  
Jens Callegari ◽  
Marilena Pläcking ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prospective Trial ◽  
Respiratory Sounds ◽  
Chronic Obstructive ◽  
Inpatient Setting ◽  
Obstructive Pulmonary Disease ◽  
Additional Information ◽  
Copd Patients

<b><i>Background:</i></b> Electronic auscultation technology has advanced dramatically in the last few years. Therefore, long-term pulmonary auscultation could provide additional information about respiratory system by monitoring acute chronic obstructive pulmonary disease (AECOPD) exacerbations or by identifying wheezing phenotypes amongst stable COPD patients. <b><i>Objectives:</i></b> Comparison of respiratory sounds in stable versus AECOPD patients recorded with a portable respiratory sound monitor over a period of 24 h. <b><i>Methods:</i></b> This prospective trial evaluated cough and wheezing events using an auscultation monitor specially developed for this purpose with 4 integrated highly sensitive microphones, in stable and severely AECOPD patients for a period of 24 h in an inpatient setting. <b><i>Results:</i></b> Twenty stable COPD patients (12 male, 60%) and 20 severely exacerbated COPD patients (14 male, 70%) were analyzed. In AECOPD patients, long-term auscultation revealed a significantly higher number of wheezing epochs than stable COPD patients (591 [IQR: 145–1,645] vs. 152 [IQR: 90–400]; <i>p</i> = 0.021). Conversely, cough epochs did not differ between AECOPD and stable COPD patients (213 [IQR: 140–327] vs. 162 [IQR: 123–243]; <i>p</i> = 0.256). The Borg-dyspnea scale, CAT score, and total CCQ score each showed no correlation with wheezing frequency, while CAT and CCQ scores did correlate with coughing frequency. <b><i>Conclusion:</i></b> Wheezing, but not coughing, occurs more frequently in AECOPD patients than in stable COPD patients, indicating that severe wheezing is an important clinical sign of exacerbation, while coughing is not. Therefore, the patterns of wheezing and coughing, as assessed by long-term auscultation, differ in stable versus exacerbated COPD patients.

The Clinical Implications of Carbon Dioxide Increased Level in Arterial Blood Related to Severe Exacerbations of Chronic Obstructive Pulmonary Disease

2018 ◽  
Vol 69 (8) ◽  
pp. 2050-2053 ◽  
Author(s):  
Gabriela Jimborean ◽  
Oana Cristina Arghir ◽  
Simona Claudia Cambrea ◽  
Elena Dantes ◽  
Adriana Socaci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Arterial Blood ◽  
Copd Patients ◽  
Hypercapnic Encephalopathy

In the evolution of patients with chronic obstructive pulmonary disease (COPD), exacerbations occur, especially, in severe stages, determining aggravated respiratory failure and decreased survival. In order to evaluate the implications of COPD exacerbations in patients with second type of chronic respiratory failure and hypercapnic encephalopathy, a prospective observational study was done among 195 COPD in patients of Targu Mures Clinical County Hospital, Romania. Inclusion criteria consisted in severe exacerbations of COPD, complicated by hypercapnia, defined by an increased level of arterial blood gas carbon dioxide (PaCO2) �45 mmHg, suggestive for the second type of respiratory failure. The increased values of PaCO2 ranged between 45 and 112 mmHg among 95 patients. The prevalence of hypercapnia in COPD patients, admitted in hospital for severe exacerbations, was high (n=91/195; 46.66%). The majority of COPD patients (93.4%) were initially hospitalized in the intensive care unit (ICU) department because of hypercapnic encephalopathy. The mortality rate was higher among patients with endotracheal tube insertion than in patients treated by noninvasive mechanical ventilation. High levels of hypercapnia, conscience disorders and respiratory acidosis may be considered factors of severity in COPD exacerbation.

scholarly journals Chronic Obstructive Pulmonary Disease and Hepatitis C

Folia Medica ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 132-138
Author(s):  
Evgeni V. Mekov ◽  
Rosen E. Petkov ◽  
Dimitar T. Kostadinov ◽  
Krasimir A. Antonov ◽  
Deian T. Jelev
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hepatitis C ◽  
Pulmonary Disease ◽  
Hcv Infection ◽  
Chronic Obstructive ◽  
Additional Risk Factor ◽  
Long Term Effects ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

AbstractChronic obstructive pulmonary disease (COPD) is a preventable, treatable disease with significant extrapulmonary manifestations that could affect negatively its course in some patients. Hepatitis C virus infection (HCV), on the other hand, is associated with a number of extrahepatic manifestations. COPD patients have increased prevalence of HCV and patients with HCV, especially older ones, have increased prevalence and faster progression of COPD. HCV infection exerts long-term effects on lung tissue and is an additional risk factor for the development of COPD. The presence of HCV is associated with an accelerated loss of lung function in COPD patients, especially in current smokers. COPD could represent extrahepatic manifestation associated with HCV infection. The aim of this article was to review the literature on prevalence of HCV in COPD and vice versa, pathogenetic link and the consequences of their mutual existence.

Study of Pulmonary Hypertension and Its Predictors in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Sally youssef Hamada ◽  
Mohamed Saeed El Hoshy ◽  
Mona Saeed El Hoshy ◽  
Heba Ahmed Eshmawey ◽  
Heba Said Gharraf
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Pulmonary Disease ◽  
Right Atrial ◽  
Chronic Obstructive ◽  
Systolic Pulmonary Artery Pressure ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Copd Patients ◽  
History Of

Abstract Background Pulmonary hypertension (PH) is one of the most common complications of chronic obstructive pulmonary disease (COPD). PH in COPD is caused by many factors mainly hypoxia. Aim The aim was to assess prevalence and predictors of PH in COPD patients. Patients and methods A prospective, observational study was carried out on 100 patients diagnosed with COPD admitted at chest department of Alexandria university hospitals and Al. Mamoura chest hospital. All patients were subjected to complete medical history taking (Age, sex, smoking index, history of previous hospital admission for COPD exacerbation and history of previous ICU admission for the same reason), routine laboratory investigations including complete blood count (CBC), arterial blood gases (ABG), pulmonary function test (FEV1, FVC, FEV1/FVC ratio), Body mass index(BMI), six minute walk test, COPD assessment test (CAT) score, dyspnea assessment by modified Medical Research Council(m MRC) and Echocardiography relevant data (right atrial area, left atrial size, ejection fraction, valvular heart disease, PH, right ventricular function TAPSE (Tricuspid annular plane systolic excursion), systolic pulmonary artery pressure (SPAP) and tricuspid regurge velocity if present. Results A total of 100 COPD patients were included in the study 88 (88%) were males and 12 (12%) were females. Among patients with pulmonary hypertension 32 (94.1%) were males and 2 (5.9%) were females. On the other hand, 84.8%(n = 56) of patients without PH were males and 15.2%(n = 10) were females. Mean ± SD age of the patients was 60.12 ± 8.59 years. Mean ±SD age of the patients with pulmonary hypertension was 61.26±7.97 years, and for patients without PH mean± SD was 59.53 ± 8.88 years. With no statistically significant difference between the two groups. PH was diagnosed in 34 (34%) of patients, m PAP ≥25mmHg, of whom11 (32.4%) showed severe PH m PAP ≥40mmHg, 23 (67.6%) mild, moderate PH. Conclusion Although, the most important factors predicting PH in COPD patients were FEV1 and EF, respectively, but in COPD patients with severe PH was FEV1.

scholarly journals A Different Aproach of Chronic Obstructive Pulmonary Disease Severity and Plastic Medical Devices Used for Oxygenotherapy

2019 ◽  
Vol 56 (2) ◽  
pp. 295-300 ◽  
Author(s):  
Doina Ecaterina Tofolean ◽  
Gilda Popescu ◽  
Ioan Anton Arghir ◽  
Mirela Frandes ◽  
Ariadna Petronela Fildan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Depression Scale ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Scale Scores ◽  
At Home

A very common questionnaire, used to evaluate the health status of Chronic Obstructive Pulmonary Disease (COPD) patients, COPD assessment test (CAT), was applied to finding correlations between the items of CAT and other tests used in the same category of COPD patients. A sample of 56 male COPD patients, aged between 51 and 74 years, mean 63.86 (�5.55), half of them receiving long-term oxygen therapy, using transparent, hypoallergenic plastic masks or nasal cannulas, answered to CAT mostly choosing single items, statistically significant correlated with the Hospital Anxiety and Depression Scale scores (HADs), like walking up hills and stairs (r = 0.412, p[ 0.01), doing activities at home (r = 0.329, p[ 0.01), confidence leaving my home (r = 0.409, p[ 0.001), sleep (r = 0.277, p[ 0.01), and energy (r = 0.387, p[ 0.01), but CAT item walking up hills and stairs correlated better to 6 min walking distance (6MWD) (r = -0.581, p[ 0.01). The most significant correlations were found between 3 items of CAT as walking up hills and stairs, limitations doing activities at home and confidence leaving home in a most powerful and depression scores and 6MWD.

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