Société Tunisienne des Maladies Respiratoires et d'Allergologie STMRA

Physical inactivity in COPD and increased patient perception of dyspnea.

Physical inactivity in COPD and increased patient perception of dyspnea.

Int J Chron Obstruct Pulmon Dis. 2012;7:743-55

Authors: Katajisto M, Kupiainen H, Rantanen P, Lindqvist A, Kilpeläinen M, Tikkanen H, Laitinen T

Abstract
OBJECTIVE: To study patients' levels of exercise activity and the clinical characteristics that relate to physical activity and inactivity among patients with chronic obstructive pulmonary disease (COPD).
METHODS: A postal questionnaire was administered to 719 patients with COPD in 2010; patients were recruited from the Helsinki and Turku University Central Hospitals in Finland and have been followed since 2005. The questionnaire asked participants about their exercise routines and other daily activities, potential restrictions to exercise, health-related quality of life, and subjective sensations of dyspnea upon exertion.
RESULTS: A total of 50% of the participants reported exercising > 2 times a week throughout the year. The proportion of the exercise inactive patients increased in parallel with disease progression, but the participants exhibited great variation in the degree of activity as well as in sport choices. Year-round activity was better maintained among patients who exercised both indoors and outdoors. Training activity was significantly correlated with patients' reported subjective dyspnea (r = 0.32, P < 0.001), health-related quality of life (r = 0.25, P < 0.001), mobility score (r = 0.37, P < 0.001), and bronchial obstruction (r = 0.18, P < 0.001). Active patients did not differ from inactive patients in terms of sex, age, smoking status, somatic comorbidities, or body mass index. Irrespective of the level of severity of patients' COPD, the most significant barrier to exercising was the subjective sensation of dyspnea.
CONCLUSION: When a patient with COPD suffers from dyspnea and does not have regular exercise routines, the patient will most likely benefit from an exercise program tailored to his or her physical capabilities.

PMID: 23152679 [PubMed - in process]

Treating the small airways.

Treating the small airways.

Respiration. 2012;84(6):441-53

Authors: Usmani OS

Abstract
The final article in this series evaluates the approaches undertaken to treating the small-airway region of the lungs and the clinical implications of inhaled therapy targeting the periphery in patients with asthma and chronic obstructive pulmonary disease.

PMID: 23154684 [PubMed - in process]

Can spirometric norms be set using pre- or post- bronchodilator test results in older people?

Can spirometric norms be set using pre- or post- bronchodilator test results in older people?

Respir Res. 2012 Nov 16;13(1):102

Authors: Kato B, Gulsvik A, Vollmer W, Janson C, Studnika M, Buist S, Burney P

Abstract
ABSTRACT: BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is defined by post-bronchodilator spirometry. Data on "normal values" come predominantly from pre-bronchodilator spirometry. The effects of this on diagnosis are unknown. METHODS: Lower limits of normal (LLN) were estimated from "normal" participants in the Burden of Obstructive Lung Disease (BOLD) programme. Values separately derived using pre- and post-bronchodilator spirometry were compared. Sensitivity and specificity of criteria derived from pre-bronchodilator spirometry and pre-bronchodilator spirometry adjusted by a constant were assessed in the remaining population. The "gold standard" was the LLN for the post-bronchodilator spirometry in the "normal population". For FEV1/FVC, sensitivity and specificity of criteria were assessed when a fixed value of < 70% was used rather than LLN. RESULTS: Of 6,600 participants with full data, 1,354 were defined as "normal". Mean differences between pre- and post- bronchodilator measurements were small and the Bland-Altman plots showed no association between difference and mean value. Compared with using the gold standard, however, tests using pre-bronchodilator spirometry had a sensitivity and specificity of detecting a low FEV1 of 78.4% and 100%, a low FVC of 99.6% and 99.1% and a low FEV1/FVC ratio of 65% and 100%. Adjusting this by a constant improved the sensitivity without substantially altering the specificity for FEV1 (99%, 99.8%), FVC (97.4%, 99.9%) and FEV1/FVC (98.7%, 99.5%). CONCLUSIONS: Using pre-bronchodilator spirometry to derive norms for lung function reduces sensitivity compared to a post-bronchodilator gold standard. Adjustment of these values by a constant can improve validity of the test.

PMID: 23157675 [PubMed - as supplied by publisher]

Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

Med Intensiva. 2012 Nov 15;

Authors: Rialp Cervera G, Del Castillo Blanco A, Pérez Aizcorreta O, Parra Morais L, por el GT-IRA de la SEMICYUC

Abstract
Noninvasive ventilation (NIV) with conventional therapy improves the outcome of patients with acute respiratory failure due to hypercapnic decompensation of chronic obstructive pulmonary disease (COPD) or acute cardiogenic pulmonary edema (ACPE). This review summarizes the main effects of NIV in these pathologies. In COPD, NIV improves gas exchange and symptoms, reducing the need for endotracheal intubation, hospital mortality and hospital stay compared with conventional oxygen therapy. NIV may also avoid reintubation and may decrease the length of invasive mechanical ventilation. In ACPE, NIV accelerates the remission of symptoms and the normalization of blood gas parameters, reduces the need for endotracheal intubation, and is associated with a trend towards lesser mortality, without increasing the incidence of myocardial infarction. The ventilation modality used in ACPE does not affect the patient prognosis.

PMID: 23158869 [PubMed - as supplied by publisher]

Therapeutic Potential of Growth Factors in Pulmonary Emphysematous Condition.

Therapeutic Potential of Growth Factors in Pulmonary Emphysematous Condition.

Lung. 2012 Nov 17;

Authors: Muyal JP, Muyal V, Kotnala S, Kumar D, Bhardwaj H

Abstract
Pulmonary emphysema is a major manifestation of chronic obstructive pulmonary disease (COPD), which is characterized by progressive destruction of alveolar parenchyma with persistent inflammation of the small airways. Such destruction in the distal respiratory tract is irreversible and irreparable. All-trans-retinoic acid was suggested as a novel therapy for regeneration of lost alveoli in emphysema. However, profound discrepancies were evident between studies. At present, no effective therapeutic options are available that allow for the regeneration of lost alveoli in emphysematous human lungs. Recently, some reports on rodent's models have suggested the beneficial effects of various growth factors toward alveolar maintenance and repair processes.

PMID: 23161370 [PubMed - as supplied by publisher]

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Physical inactivity in COPD and increased patient perception of dyspnea.

Treating the small airways.

Can spirometric norms be set using pre- or post- bronchodilator test results in older people?

Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

Therapeutic Potential of Growth Factors in Pulmonary Emphysematous Condition.

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Blog With Right Sidebar

Physical inactivity in COPD and increased patient perception of dyspnea.

Treating the small airways.

Can spirometric norms be set using pre- or post- bronchodilator test results in older people?

Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

Therapeutic Potential of Growth Factors in Pulmonary Emphysematous Condition.

Search

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