COPD (Pulmonary Research) Research Papers (original) (raw)

Background. Chronic obstructive pulmonary disease (COPD) is commonly managed in primary care but there is poor awareness of evidence-based guidelines and the quality and interpretation of spirometry is suboptimal. Objectives. The aims of this qualitative study were to explore how an intervention involving case finding and management of COPD was implemented, and the extent to which the GPs and practice nurses (PNs) worked in partnership to diagnose and manage COPD. Methods. Semi-structured interviews with PNs (n = 7), GPs (n = 4) and patients (n = 26) who had participated in the Primary care EarLy Intervention for Copd mANagement (PELICAN) study. The Theoretical Domains Framework was used to guide the coding and analysis of the interviews with PN and GPs. The patient interviews were analysed thematically. Results. PNs developed technical skills and understood the requirements for good-quality spirometry. However, many lacked confidence in its interpretation and felt this was not part of their professional role. This was reflected in responses from the GPs. Once COPD was diagnosed, the GPs tended to manage the patients with the PNs less involved. This was in contrast with PNs' active role in managing patients with other chronic diseases such as diabetes. The extent to which the GPs and PNs worked in partnership to manage COPD varied. Conclusions. PNs improved their skills and confidence in performing spirometry. Beliefs about their professional role, identity and confidence influenced the extent to which PNs were involved in interpretation of the spirometry results and managing the patient in partnership with the GP.

- by
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- Primary Health Care, Evidence Based Practice, Australia, Qualitative Research

Pulmonary rehabilitation (PR) improves functional exercise capacity and health status in people with COPD, although these outcomes are often not maintained following PR. Self-efficacy is a precursor to outcomes achievement, yet few studies have examined the importance of selfefficacy to outcome improvement during PR, or how it develops over time. Further, the contribution of exercise-specific self-efficacy to outcomes in PR is unknown. The aims of this study were to determine (i) whether baseline exercise self-efficacy predicts PR attendance; and change in functional exercise capacity and health status over PR; and (ii) determine if exercise self-efficacy changes with PR. Fifty-eight out of sixty-four patients with COPD completed PR and assessments of exercise self-efficacy (task, coping, scheduling), the 6-minute walk test (6MWT), and St. George's Respiratory Questionnaire (SGRQ) at the beginning and end of PR.

Varón de 58 anos, exfumador desde hacia 4 años de 60 paquetes-año. El paciente consultó a su médico de familia en 2012 por disnea como único síntoma respiratorio, con una puntuación de 2 en la escala modificada de la Medical Research... more

- by Epocsite Ferrer
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- COPD (Pulmonary Research), COPD, Medicina, Neumología

Varón de 65 años natural de Portugal. Alérgico a la penicilina y el metamizol (exantema cutáneo), ex fumador desde hace 19 años con un factor de expo- sición de 50 paquetes/año. Historia de paludismo a los 33 años y dermatitis... more

- by Epocsite Ferrer
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- Health Sciences, Health, Medicine, COPD (Pulmonary Research)

Paciente de 58 años, de profesión adminis- trativo, que acude por primera vez en los úl- timos 5 años al medico de familia consultan- do por dolor en el tobillo en la deambulación a raíz de una caída hace 1 semana. Bebedor... more

- by Epocsite Ferrer
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- Health Sciences, Health, Medicine, COPD (Pulmonary Research)

Cardiovascular disease contributes a significant share to the all-cause mortality of COPD; therefore it is sensible to assume similar positive outcomes with its mortality benefiting measures in the COPD group as well. The study by Raymakers et al published in CHEST (September 2017) found a significant all-cause and COPD-related mortality benefit with the use of statin drugs. The inclusion of a vast number of participants from databases, with a follow-up of a reasonable duration and a focus on adherence to statin drug use are the strengths of this retrospective study. Although the results endorsed a clear benefit with statin drugs, the rationale for certain selection methods and their potential bias cannot be overlooked. Contrary to the authors’ quotation on the frequent existence of COPD among the population older than 30 years of age, they have included only individuals aged 50 years and older. A population with a mean age of 70 years might have a high prevalence of known or subclinical cardiovascular disease. Remarkably, documentation of this morbidity’s existence in the studied COPD population was not attempted. It could have been more interesting to observe the statin drug-related mortality benefit among the subgroup of patients with COPD without known cardiovascular disease. Most importantly, identifying patients with COPD based on anticholinergic or beta-agonist use without spirometric confirmation might have allowed diagnostic inaccuracies and also ignored the significance of disease severity. The occurrence of such misdiagnosis without the support of spirometry was recognized by a few earlier studies and for that reason the evidence-based guidelines strongly recommend the objective measurement of airflow limitation for confirmation.

- by Vijay Kumar Chattu MD, MPH
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- Mortality, COPD (Pulmonary Research), Statins, Cardiovascular Diseases

The story behind the Hay Fever tape. Its development, organzones and more.....

- by Esther de Ru
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- Physiotherapy, COPD (Pulmonary Research), Physical Therapy, Taping

Varón de 61 años, diagnosticado de EPOC. Ex fumador de 70 paquetes/año.
Antecedentes personales
• Hipertensión arterial y dislipemia.
• Cardiopatía isquémica (portador de triple
stent coronario).
• Aneurisma de aorta abdominal.
• Nefrectomía izquierda por hipernefroma.
Tratamiento actual
En el año 2009 se pautó tratamiento con la combinación fluticasona/salmeterol 50/ 500 μg y tiotropio.

- by Epocsite Ferrer
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- Health Sciences, Health, Medicine, COPD (Pulmonary Research)

Hombre de 64 años, sin aler- gias medicamentosas conocidas. No presenta hábi- to enólico y es exfumador desde hace 7 años con un índice tabáquico de 45 paquetes-año. Como antecedentes patológicos destacan: hipertensión esencial... more

- by Epocsite Ferrer
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- Health Sciences, Health, Medicine, COPD (Pulmonary Research)

A question was posed regarding the use and usefulness of taping the diaphragm. As it is one of our most important muscles, not only for breathing but also for posture and trunk stability I thought this would make a nice topic for this... more

- by Esther de Ru
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- Physiotherapy, COPD (Pulmonary Research), Physical Therapy, Kinesiotaping
- by Jay Muhammad
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- COPD (Pulmonary Research), DIAGNOSA PENYAKIT PARU, PPOK

Varón de 56 años, ex fumador desde hace 6 de 30 paquetes/año, con antecedentes laborales de haber trabajado en un bar durante 15 años. Antecedentes familiares de interés: madre que presenta asma desde hace unos 30 años. El paciente está diagnosticado de EPOC desde hace mucho tiempo y acude a la consulta cada 6 meses para control clínico y funcional.

- by Epocsite Ferrer
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- Medicine, COPD (Pulmonary Research), COPD, Medicina

asuhan keperawatan pada klien dengan penyakit paru obtruktif kronik

Varón de 67 años que acude a la consulta remitido por su médico de cabecera para es- tudio de disnea. Fumador de 30 cigarrillos/ día, con tabaquismo acumulado de 60 pa- quetes/año. Jubilado desde los 65 años, ha trabajado como... more

- by Epocsite Ferrer
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- Health Sciences, Health, Public Health, Medicine

The results of the study were plotted comparatively for all patients in the two study groups. The rendering of the results was done using sectorial graphics. Thus, information regarding the vulnerable gender to respiratory diseases was shown, regarding patients who have been diagnosed with cardiopulmonary disease. At the same time, data regarding age groups with known chronic cardiopulmonary pathology vulnerable to lung disease were plotted. The data presented in this study and the obtained results render information on respiratory pathology associated with cardiopulmonary disease in chronic patients with various cardiopulmonary disease.

- by Tim Sandle
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- Health, Medicine, COPD (Pulmonary Research), Hospital Management
- by Nam Nguyen
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- COPD (Pulmonary Research)

Paciente de 73 años, con enfermedad pulmonar obstructiva crónica y mala adherencia al tratamiento

Paciente de 61 años, con enfermedad pulmonar obstructiva crónica y mala adherencia al tratamiento

Background: The rising prevalence of chronic illnesses hinders the sustainability of the health care system because of the high cost of frequent hospitalizations of patients with complex chronic conditions. Clinical trials have demonstrated that telemonitoring can improve health outcomes, but they have generally been limited to single conditions such as diabetes, hypertension, or heart failure. Few studies have examined the impact of telemonitoring on complex patients with multiple chronic conditions, although these patients may benefit the most from this technology. OBJECTIVE: The aim of this study is to investigate the impact of a smartphone-based telemonitoring system on the clinical care and health outcomes of complex patients across several chronic conditions. METHODS: A mixed-methods, 6-month randomized controlled trial (RCT) of a smartphone-based telemonitoring system is being conducted in specialty clinics. The study will include patients who have been diagnosed with one or more of any of the following conditions: heart failure, chronic obstructive pulmonary disease, chronic kidney disease, uncontrolled hypertension, or insulin-requiring diabetes. The primary outcome will be the health status of patients as measured with SF-36. Patients will be randomly assigned to either the control group receiving usual care (n=73) or the group using the smartphone-based telemonitoring system in addition to usual care (n=73). RESULTS: Participants are currently being recruited for the trial. Data collection is anticipated to be completed by the fall of 2018. CONCLUSIONS: This RCT will be among the first trials to provide evidence of the impact of telemonitoring on costs and health outcomes of complex patients who may have multiple chronic conditions. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 41238563; http://www.isrctn.com/ISRCTN41238563 (Archived by WebCite at http://www.webcitation.org/6ug2Sk0af) and Clinicaltrials.gov NCT03127852; https://clinicaltrials.gov/ct2/show/NCT03127852 (Archived by WebCite at http://www.webcitation.org/6uvjNosBC).

Varón de 63 años de edad que acude a con- sultas externas de atención primaria por disnea de esfuerzo de, aproximadamente, 6 meses de duración. El paciente es agricultor de profesión, ex fumador desde hace 5 años (fumó 20... more

- by Epocsite Ferrer
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- Health Sciences, Health, Medicine, COPD (Pulmonary Research)
- by Dr Arnab Maji
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- COPD (Pulmonary Research)

Treatment of respiratory disorders using a metered-dose inhaler (MDI) with spacer becomes one of the important points. Pharmacists at pharmacies are the final key in therapy to ascertain how the use of inhalation tools is correct. This study aims to determine the completeness of each step of information on how to use MDI with spacer given by pharmacists at pharmacies in East Surabaya. The research design used is cross-sectional study with the subject of research is pharmacist in pharmacy. The research variable is the explanation of how to use MDI inhaler with spacer. An assessment method of 8 steps on how to use MDI with spacer and each number gets a value. Research subjects were 22 pharmacists. Most pharmacists describe each step orally by using the tool directly, ie at step: 1a (77.27%), 1b (77.27%), 2 (81.81%), 3 (31.81%) , 4a (59.09%), 4b (13.63%), 5a (100%), 5b (63.63%), 6a (90.90%), 6b (40.90%), 8a (9 , 09%), and 8b (9.09%). Most of the pharmacists explain verbally with a demonstration tool but only one pharmacist can explain all the steps completely. Therefore, pharmacists need to improve IEC services related to the use of MDI with a spacer for respiratory treatment.

- by Amelia Lorensia
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- COPD (Pulmonary Research), Inhalers, Metered Dose Inhalers

BACKGROUND: Smoking and alcohol use have been associated with common genetic variants in multiple loci. Rare variants within these loci hold promise in the identification of biological mechanisms in substance use. Exome arrays and genotype imputation can now efficiently genotype rare nonsynonymous and loss of function variants. Such variants are expected to have deleterious functional consequences and to contribute to disease risk. METHODS: We analyzed w250,000 rare variants from 16 independent studies genotyped with exome arrays and augmented this dataset with imputed data from the UK Biobank. Associations were tested for five phenotypes: cigarettes per day, pack-years, smoking initiation, age of smoking initiation, and alcoholic drinks per week. We conducted stratified heritability analyses, single-variant tests, and gene-based burden tests of nonsynonymous/ loss-of-function coding variants. We performed a novel fine-mapping analysis to winnow the number of putative causal variants within associated loci. RESULTS: Meta-analytic sample sizes ranged from 152,348 to 433,216, depending on the phenotype. Rare coding variation explained 1.1% to 2.2% of phenotypic variance, reflecting 11% to 18% of the total single nucleotide polymorphism heritability of these phenotypes. We identified 171 genome-wide associated loci across all phenotypes. Fine mapping identified putative causal variants with double base-pair resolution at 24 of these loci, and between three and 10 variants for 65 loci. Twenty loci contained rare coding variants in the 95% credible intervals. CONCLUSIONS: Rare coding variation significantly contributes to the heritability of smoking and alcohol use. Finemapping genome-wide association study loci identifies specific variants contributing to the biological etiology of substance use behavior.

The clinical manifestations of chronic obstructive pulmonary disease symptoms variably affect the health of the patients, requiring them to visit specialized doctors in medical units. Diagnosis is by a specialized and complete medical examination accompanied by laboratory investigation. The interpretation of the results has the aim of establishing an appropriate therapeutic conduct according to the stage of the disease. The selected medical methods, aimed at improving the symptomatology of the disease, are undertake to ensure the life quality of patients diagnosed with chronic obstructive pulmonary disease. Among the laboratory tests that are required in order to evaluate the respiratory function of patients is spirometry. To consider this a study was performed in the second quarter of 2014 on a population segment, selected from the medical specialized service. The study collected statistical data on the testing of the respiratory function. This provided a comprehensive picture of patients investigated by this functional exploration method.

- by Tim Sandle
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- Pathology, Health Sciences, Medical Sciences, Medical Anthropology

Lately there is lot of increased concern about stress during undergraduate medical training. However, studies about the
same from Indian medical schools are limited. The objective of the study was to assess perceived stress. A cross-sectional,
questionnaire–based survey was carried out among 1st MBBS students of B J Govt. Medical College, Pune. A 14-item
questionnaire: perceived stress scale (PSS) was used to assess the stress perceived by the students. Mean PSS score in the study population (n=150) was 24.91(SD 7.31, that in female students (n=83) was 24.78 (SD 7.61) while the same for male students (n =67) was 25.07 (SD 6.97). Thus in the study, medical students reported a higher level of perceived stress. However, there is no significant difference found between sex nor among hostelers & day scholars groups and neither among the students from rural &
urban background for the perceived stress score. The students have shown a higher level of perceived stress by using the PSS-14 scale. This calls for further assessment of severity as well as depth of problem and intervention to take remedial measures to improve medical education.

- by Veena Shriram and +1
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- Oxidative Stress, COPD (Pulmonary Research), Antioxidants, COPD Biomarkers

A continuación presentamos 6 casos clínicos en situaciones de la práctica clínica habitual de pacientes diagnosticados con EPOC de fe- notipos distintos. Planteamos los casos con su metodología diagnóstica, su tratamiento y evolución clínica según las normativas de las guías, junto a comentarios y una discusión práctica. Estos casos pretenden ser procesos asistenciales clínicos de situaciones que nos encontramos con frecuencia, mostrándolo que un grupo de expertos hacen en el manejo de estos pacientes.

- by Epocsite Ferrer
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- COPD (Pulmonary Research), COPD, Medicina, Neumología

Background and Objectives: Previous studies have suggested that yoga positively impacts lung function and quality of life (QoL). The present prospective two-arm, single-blinded and controlled study evaluated the effect of adjuvant yoga therapy on pulmonary function and QoL in patients of Chronic Obstructive Pulmonary Disease (COPD). Material and Methods: Seventy two COPD patients were recruited and randomized to yoga group who received adjuvant yoga therapy in addition to standard medical management and control group who received only medical management. Yoga therapy protocol included loosening exercises, postures, breathing techniques and relaxation. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1) and FEV1/FVC were measured using computerized pulmonary function test 'Trueflow (ndd)'. Saint George Respiratory Questionnaire (SGRQ) was used to asses QoL. Changes in parameters were correlated with symptoms, activity, impacts and quality scores. Intra-group comparisons were done using Student's paired 't' test and intergroup comparisons using unpaired 't' test. Results: There was significant improvement (p < 0.001) in FVC and FEV1 after four weeks of adjuvant yoga therapy while controls showed decline in all parameters. QoL scores, namely: symptoms , activity , impacts and quality improved significantly in yoga group with no significant changes in controls. Significant correlation was found between pulmonary function and QoL in Yoga group. Conclusion: Significant improvements of lung function with adjuvant yoga therapy can be attributed to comprehensive yoga therapy package administered to participants resulting in decreased airway resistance and better lung compliance attributed to nonspecific broncho-protective / broncho-relaxing effect. Significant improvement in QoL scores can be attributed to improved vital capacity as well as enhanced self-confidence /self-reliance. We conclude that there is a positive and additive role of adjuvant therapy with standard medical management of COPD.

- by Ananda B Bhavanani
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- Pharmacology, Health Sciences, Pharmacy, Yoga Meditation

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease. It is among the fastest growing chronic diseases diagnosed in the world today. COPD is the third most common cause of death in the United States. It is characterized by the development of an inflammatory response of the lungs to noxious substances such as tobacco or air pollution. If the exposure becomes recurrent or persistent, the lungs develop chronic inflammatory response leading to lung parenchymal damage, air trapping and progressive airflow limitation. The Diagnosis of COPD is usually made in the context of symptoms and spirometry evidence of airway obstruction with post bronchodilator spirometry FEV1/FVC < 0.70. Most patients with COPD first seek medical attention when they develop dyspnea. Once the diagnosis of COPD is confirmed, the treatment is geared mainly towards preventing exacerbations and eliminating risk factors and exposures. Several treatment combinations can be used in patients with stable COPD to prevent exacerbations and to improve their quality of life. Patients with COPD exacerbations have to be appropriately diagnosed and promptly treated to prevent complications. Patient's symptoms, the degree of airflow limitation, risk of exacerbations and the presence of comorbidities have to be assessed. Both pharmacological and non-pharmacological interventions have been used in the management of COPD. Appropriate pharmacologic therapy can reduce COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance. None of the existing medications for COPD have been shown conclusively to modify the long-term decline in lung function.

Background: Nighttime symptoms can negatively impact the quality of life of patients with chronic obstructive pulmonary disease (COPD). Read this original research and sign up to receive International Journal of Chronic Obstructive... more

- by Dove Medical Press
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- COPD (Pulmonary Research)

El tratamiento del paciente con enfermedad pul- monar obstructiva crónica (EPOC) en fase estable está sufriendo un cambio de paradigma en los últi- mos tiempos. Las nuevas evidencias demostradas respecto a la superioridad de la broncodilatación dual en combinación fija (LABA: long acting beta2 agonist/LAMA: long acting muscarinic antagonist) comparada con la de LABA/CI en determinados grupos de pacientes ha desplazado el uso de corti- coides inhalados (CI) a fenotipos concretos.

- by Epocsite Ferrer
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- Health Sciences, Health, COPD (Pulmonary Research), COPD
- by Eduardo Matias
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- Physiotherapy, COPD (Pulmonary Research), Pulmonary Rehabilitation

Purpose: Oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) has been validated as a surrogate marker for partial pressure of oxygen to fraction of inspired oxygen ratio among mechanically ventilated patients with acute respiratory distress syndrome (ARDS). The validity of SpO2/FiO2 measurements in predicting ARDS has not been studied. Recently, a Lung Injury Prediction Score (LIPS) has been developed to help identify patients at risk of developing ARDS.
Methods: This was a secondary analysis of the LIPS-1 cohort. A multivariate logistic regression included all established variables for LIPS, Acute Physiology and Chronic Health Evaluation 2, age, and comorbid conditions that could affect SpO2/FiO2. The primary outcome was development of ARDS in the hospital. The secondary outcomes included hospital mortality, hospital day of ARDS development, and hospital day of death.
Results: Of the 5584 patients, we evaluated all 4646 with recorded SpO2/FiO2 values. Median SpO2/FiO2 in those who did and did not develop ARDS was 254 (100, 438) and 452 (329, 467), respectively. There was a significant association between SpO2/FiO2 and ARDS (P ≤ .001). The SpO2/FiO2 was found to be an independent predictor of ARDS in a “dose-dependent” manner; for SpO2/FiO2 < 100—odds ratios (OR) 2.49 (1.69-3.64, P < .001), for SpO2/FiO2 100 < 200—OR 1.75 (1.16-2.58, P = .007), and for SpO2/FiO2 200 < 300—OR 1.62 (1.06-2.42, P = .025). The discriminatory characteristics of the multivariable model and SpO2/FiO2 as a single variable demonstrated area under the curve (AUC) of 0.81 and AUC of 0.74, respectively.
Conclusions: The SpO2/FiO2, measured within the first 6 hours after hospital admission, is an independent indicator of ARDS development among patients at risk.

- by VIKAS BANSAL
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- Pulmonary Research, Research, COPD (Pulmonary Research), Critical Care Medicine

A qualitative report of users' experiences of home telemonitoring in COPD (Chronic Obstructive Lung Disorder) in Lothian Region. This research, with patients, carers, nurses, physiotherapists and GPs provided an early insight into the experience of the players in a new approach to managing chronic disease, and was designed to inform the design and development of a larger study of the techical, clinical, social, organisational, and usability issues.

- by Dr. Jenny Ure
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- Telehealth, Qualitative Research, Chronic illness, COPD (Pulmonary Research)

The purpose of this study here is to explain the dynamics and characteristics of research fields in the presence of crisis. This paper focuses on effects of global pandemic crisis of COVID-19 (Coronavirus Disease 2019) in science dynamics. Results suggest that crisis-driven research field is characterized by an unparalleled velocity of scientific production that supports scientific and technological advances, open access and document type with short notes and papers. Understanding the dynamics of science and its consequences during the crisis is of critical importance for planning and allocating resources toward positive societal impact.

- by Mario Coccia
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- Open Access, Sociology of Knowledge, Crisis Management, Scientometrics

Background:
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically
spread all over the world in the early part of 2020. No studies have yet summarised the
potential severity and mortality risks caused by COVID-19 in patients with chronic
obstructive pulmonary disease (COPD), and we update information in smokers.
Methods:
We systematically searched electronic databases from inception to March 24, 2020. Data
were extracted by two independent authors in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a
modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible
studies and conducted a meta-analysis using a random-effects model to calculate pooled
prevalence rates and 95% confidence intervals (95%CI).
Results:
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of
15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19
patients. All studies were included in the meta-analysis. The crude case fatality rate of
COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in
COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively.
COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35)
compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4–
2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139)
of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated
RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have
severe complications compared to former and never smokers. Current smokers also had a
higher mortality rate of 38.5%.
Conclusion:
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19
infection was associated with substantial severity and mortality rates in COPD. Compared to
former and never smokers, current smokers were at greater risk of severe complications and
higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in
COPD patients and current smokers.

- by Jaber S. Alqahtani
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- COPD (Pulmonary Research), Smoking Cessation, Smoking