EFFICACY OF THIOTROPY BROMIDE IN THE OUTPATIENT TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
pp. 42-45
Author(s):  
А. М. ЖУКЕМБАЕВА ◽  
К.С. ЛАТКИНА ◽  
Д.Д. ШЕКТИБАЙ ◽  
Т. Н. КЕМЕРХАН ◽  
А. Б. КУАНЫШ ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Outpatient Treatment ◽  
Clinical Symptoms ◽  
Pathological Process ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference

Проведен сравнительный анализ динамики клинической симптоматики, явлений бронхиальной обструкции и проходимости бронхов при проведении лечения тиотропия бромидом у 26 больных хронической обструктивной болезнью легких II стадии. Из них было 15 (57,7%) мужчин и 11 (42,3%) женщин. Средний возраст пациентов составил 51,4±2,6 года. Средний стаж курения у мужчин был равен 27,6±2,4 лет, у женщин - 22,5±3,6 лет, при этом достоверных различий между мужчинами и женщинами не было выявлено (P>0,05). Установлено, что на фоне лечения ХОБЛ тиотропия бромидом отмечалась достоверная положительная динамика и регрессия клинической симптоматики ХОБЛ, снижение обструкции и увеличение проходимости бронхов. Полученные результаты свидетельствовали об эффективности и целесообразности применения тиотропия бромида при лечении ХОБЛ на ранних этапах развития патологического процесса в амбулаторных условиях. A comparative analysis of the dynamics of clinical symptoms, the phenomenon of bronchial obstruction and bronchial permeability during treatment with thiotropy bromide was performed in 26 patients with chronic obstructive pulmonary disease of stage II, including 15 (57.7%) men and 11 (42.3%). . The average age of patients was 51.4 ± 2.6 years. The average experience of smoking was 27.6 ± 2.4 years for men, 22.5 ± 3.6 years for women, and there was no significant difference between men and women (P> 0.05). In the treatment of chronic obstructive pulmonary disease with thiotropy bromide revealed a significant positive dynamics and regression of clinical symptoms of COPD, decreased obstruction and increased bronchial permeability. The obtained results showed the effectiveness and feasibility of the use of thiotropy bromide in the treatment of COPD in the early stages of the pathological process on an outpatient basis

scholarly journals THE IMPLICATION OF SOLUBLE MOLECULES OF CELLULAR ADHESION IN THE PROGRESSION OF COPD IN OVERWEIGHT PATIENTS

2021 ◽  
pp. 27-32
Author(s):  
N. V. Korzh ◽  
M. M. Ostrovskyy
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Blood Serum ◽  
Pulmonary Disease ◽  
Pathological Process ◽  
Stable Phase ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Subgroup Ii ◽  
Complex Therapy

Abstract. Due to the high prevalence rates, severity, high risk of disability and death, chronic obstructive pulmonary disease (COPD) still remains an extremely important medical and economic problem not only in Ukraine but also worldwide. According to the WHO estimates, at least 65 million people on our planet suffer from moderate or severe COPD. The severity of the disease and its prognosis are often determined by the influence of concomitant pathology on the frequency of exacerbations, so the problem of comorbidity is becoming increasingly important. Recently, the number of patients with a combination of COPD and overweight is increasing, which is considered as a mutual aggravating factor and negatively affects the prognosis of the disease in such patients. The basis of treatment of patients with COPD is to reduce symptoms, prevent and treat exacerbations, improve exercise tolerance and prevent the progression of the pathology. The objective of the research: to assess the value of sICAM-1 in blood serum as a marker of inflammation and criterion for the treatment of the destabilization phase in COPD III degree of bronchial obstruction in overweight patients. 112 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The main treatment group involved 45 patients suffering from COPD ІІІ degree of bronchial obstruction (subgroup I included 18 patients (40%) with stable phase of pathological process, subgroup II involved 27 patients (60%) at exacerbation phase), and the experimental group consisted of 67 COPD patients with ІІІ degree of bronchial obstruction (subgroup I included 25 patients (37.3%) with stable phase of pathological process; subgroup II involved 42 patients (62.7%) at exacerbation phase).  The control group involved 23 apparently healthy individuals (AHI).  The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). The levels of systemic inflammatory markers were determined by quantitative methods in blood serum: levels of sICAM-1 were identified using ELISA kits (Dialcone, France). While evaluating these indices in the complex therapy of COPD of III degree of bronchial obstruction in patients with overweight, a positive dynamics of its levels was observed on the 10th day. But more significant changes were observed three months after the treatment in those patients who agreed to modify their lifestyle as part of the comprehensive treatment of COPD III degree of bronchial obstruction. According to the research, we found an increase in sICAM-1, more significant in overweight patients, which is one of the manifestations of systemic inflammation in COPD III degree of bronchial obstruction, and complex therapy of this pathology is more effective when modifying the lifestyle of patients.

Which bronchodilator to choose if a patient with chronic obstructive pulmonary disease continues to smoke?

2021 ◽  
Vol 31 (4) ◽  
pp. 469-476
Author(s):  
V. I. Kupaev ◽  
D. A. Osipov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Fixed Dose ◽  
Combination Group ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Quit Smoking ◽  
Significant Difference ◽  
Long Acting

From 30 to 43% of smoking patients with chronic obstructive pulmonary disease (COPD) cannot give up nicotine despite the diagnosis and deterioration of health. Most of the publications related to the treatment of COPD do not distinguish smoking patients into a separate group. The aim of this study is a comparative analysis of the effectiveness of long-acting muscarinic antagonists (LAMA), LAMA/long-acting β2 -agonists (LABA) in smoking patients.Methods. The study involved 121 patients with a high degree of nicotine addiction and irreversible bronchial obstruction. All the patients continued to receive bronchodilator therapy. The respondents were divided into two groups: patients who quit smoking and patients who continued to smoke. In turn, each group was divided into two subgroups depending on the treatment – LAMA (Tiotropium 5 μg and Glycopyrronium 50 μg) and LAMA/LABA (tiotropium/olodaterol 5/5 μg and glycopyrronium/idacaterol 50/110 μg). We used the changes of FEV1 and the dynamics of CAT (COPD Assessment Test) as the comparison criteria.Results. The results of the CAT and spirometry showed a tendency to improve in both groups, regardless of the treatment regimen. However, the improvement in symptoms and spirometry parameters were more pronounced in the group of patients who quit smoking: –1 and –11 points, respectively (p < 0.05) and 12 and 23%, respectively (p < 0.05). Comparison of the efficacy of various treatment regimens in the group of smoking patients showed there was no statistically significant difference between LAMA and LAMA/LABA neither in spirometry parameters (11.45 and 13.1%; p < 0.05), nor in the CAT scores (–1.5 and –1.67; p < 0.05). However, combination therapy (LAMA/LABA) was more effective than monotherapy (LAMA) in the group of patients who quit smoking both according to spirometry (25.5 and 13%, respectively; p < 0.05) and CAT (–12.3 and –5.9, respectively; p < 0.05). There was no statistically significant difference between the active substances both in the monotherapy group (tiotropium/glycopyrronium) and in the combination group (tiotropium/olodaterol and glycopyrronium/indacaterol).Conclusion. According to CAT and spirometry, there was no difference between tiotropium and glycopyrronium, nor was there a difference between fixed-dose combinations of tiotropium/olodaterol and glycopyrronium/ indacaterol (both in the group of smokers and in the group of non-smokers). Smoking cessation is key to improving both spirometry and CAT results.

RESPIRATORY TUBERCULOSIS AND CHRONIC OBSTRUCTIVE LUNG DISEASE - FEATURES OF THE COMORBIDE STATE

2019 ◽  
Author(s):  
Anna Viktorovna Katicheva ◽  
Nikolai Andreyevich Brazhenko ◽  
Olga Nikolaevna Brazhenko ◽  
Anna Georgievna Chuikova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Rapid Development ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Cardiovascular Pathology ◽  
Systemic Arterial Hypertension

In modern conditions, chronic tobacco intoxication and chronic obstructive pulmonary disease are widespread and affect the health and life expectancy of patients. Among patients with tuberculosis, chronic tobacco intoxication and COPD are also widespread. Against the background of smoking and chronic obstructive pulmonary disease in patients with tuberculosis of the respiratory system, bronchial obstruction, hypoxemia, impaired capillary pulmonary blood flow, and a decrease in the diffusion capacity of the lungs are determined. A comorbid state is accompanied by the development of oxidative stress, systemic inflammation, endothelial dysfunction. Such changes in combination with dyslipidemia contribute to the development of multifocal atherogenesis, systemic arterial hypertension and the rapid development of cardiovascular pathology

Possibilities of cardiovascular events in patients with chronic obstructive pulmonary disease and newly diagnosed tuberculosis, including those associated with HIV infection, when prescribing long-acting β2-agonists

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 32-39
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Tb Treatment ◽  
Long Acting ◽  
Β2 Agonists

Chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis (TB) are a common pathology among respiratory diseases. Both conditions may have common risk factors, aggravating each other, accom-panied by the development of bronchial obstructive syndrome, requiring mandatory medical correction to increase the effectiveness of therapy for both the main and concomitant pathologies. The aim of the study was to study the effectiveness of treatment of TB in patients with COPD first diagnosed with tuberculosis, including those associated with HIV when prescribing long-acting β2-agonists. Materials and methods. A simple com-parative study included 60 patients of a TB dispensary aged 30–65 years. Patients were divided into 2 groups of 30 people (TB+COPD and TB+COPD+HIV), each of whom for 2 months received a long-acting β-agonist (indacaterol) as an accompanying therapy for the cor-rection of bronchial obstructive syndrome (BOS), with subsequent assessment of the effectiveness of therapy. Results. Subjectively, patients of both groups noted the rapid development of positive dynamics (short-ness of breath decreased from 1–3 days of taking the drug, coughing — within a week, tolerance to physical exertion improved), which was confirmed by indica-tors of the function of external respiration (FEV1). The state of the cardiovascular system was assessed by the results of daily monitoring of blood pressure (BPM). In the COPD+TB group, there is a certain average daily systolic blood pressure (SBP) with a tendency to nor-malize indicators, which is possibly associated with a decrease in the severity of hypoxia during bronchodi-lator therapy. In the COPD+TB+HIV group, the average daily level of SBP increased by 1 mm Hg, but given the very low starting rates, the increase in blood pressure had a positive effect on the patients' condition. The average heart rate (HR) during bronchodilator thera-py did not tend to increase. The best TB treatment re-sults were obtained in the TB+COPD group. In terms of the closure rate of TB+COPD decay cavities — 26.6%, TB+COPD+HIV — 20.0%), the TB+COPD+HIV group had longer periods of abacillation and closure of decay cav-ities, which is associa ted with the severity of the under-lying and associated diseases. The drug was well toler-ated in both groups. Conclusion. The use of 300 mcg long-acting β-adrenomimetics in the complex therapy of β2-adrenergic agonists for patients with TB+COPD and TB+ COPD+HIV can reduce the severity of bronchial obstruction syndrome, improve quality of life, increase adherence to TB treatment, thereby shortening hospi-talization and reduce the likelihood of disability of pa-tients, without the development of side effects from other organs and systems.

scholarly journals EVALUATION OF THE QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN OVERWEIGHT PATIENTS

2020 ◽  
Vol 73 (8) ◽  
pp. 1668-1670
Author(s):  
Mykola M. Ostrovskyy ◽  
Nadiia V. Korzh
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Pathological Process ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). Patients’ quality of life was evaluated with the help of standardized St.George’s Respiratory Questionnaire (SGRQ). Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.

scholarly journals Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) Comorbidities in Lithuanian National Database: A Cluster Analysis

2022 ◽  
Vol 19 (2) ◽  
pp. 970
Author(s):  
Elena Jurevičienė ◽  
Greta Burneikaitė ◽  
Laimis Dambrauskas ◽  
Vytautas Kasiulevičius ◽  
Edita Kazėnaitė ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Kidney Diseases ◽  
Screening Tools ◽  
National Database ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
The Impact

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.

scholarly journals Effect of Pharmacy Counseling on Readmissions in Patients with Acute Exacerbations of COPD: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Narachai Prasungriyo ◽  
Nungruthai Sooksai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Direct Costs ◽  
Disease Assessment ◽  
Chronic Obstructive ◽  
P Value ◽  
Intervention Period ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Acute Exacerbations

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.

scholarly journals Morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease

2008 ◽  
pp. 48-52
Author(s):  
E. V. Privalova ◽  
T. V. Vavilova ◽  
N. A. Kuzubova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Compensatory Reaction ◽  
Copd Patients

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.

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