scholarly journals A Pulmonary Rehabilitation Decisional Score to Define Priority Access for COPD Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Michele Vitacca ◽  
Laura Comini ◽  
Marilena Barbisoni ◽  
Gloria Francolini ◽  
Mara Paneroni ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Health System ◽  
Outpatient Clinic ◽  
Pulmonary Rehabilitation ◽  
Ad Hoc ◽  
Allocation Decision ◽  
Copd Patients ◽  
Very High

This retrospective study aimed to evaluate, through an ad hoc 17-item tool, the Pulmonary Rehabilitation Decisional Score (PRDS), the priority access to PR prescription by respiratory specialists. The PRDS, scoring functional, clinical, disability, frailty, and participation parameters from 0 = low priority to 34 = very high priority for PR access, was retrospectively calculated on 124 specialist reports sent to the GP of subjects (aged 71±11 years, FEV1%  51±17) consecutively admitted to our respiratory outpatient clinic. From the specialist’s report the final subject’s allocation could be low priority (LP) (>60 days), high priority (HP) (30–60 days), or very high priority (VHP) (<30 days) to rehabilitation. The PRDS calculation showed scores significantly higher in VHP versus LP (p<0.001) and significantly different between HP and VHP (p<0.001). Comparing the specialist’s allocation decision and priority choice based on PRDS cut-offs, PR prescription was significantly more appropriate in VHP than in HP (p=0.016). Specialists underprescribed PR in 49% of LP cases and overprescribed it in 46% and 30% of the HP and VHP prescriptions, respectively. A multicomprehensive score is feasible being useful for staging the clinical priorities for PR prescription and facilitating sustainability of the health system.

scholarly journals Six-Minute Walking Distance Improvement after Pulmonary Rehabilitation Is Associated with Baseline Lung Function in Complex COPD Patients: A Retrospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Andrea Zanini ◽  
Alfredo Chetta ◽  
Federico Gumiero ◽  
Sabrina Della Patrona ◽  
Silvia Casale ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Lung Function ◽  
Pulmonary Rehabilitation ◽  
Walking Distance ◽  
Copd Patients

scholarly journals Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

2021 ◽  
Vol 18 (8) ◽  
pp. 4207
Author(s):  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Jesus G. Ponce-Gonzalez ◽  
Alberto Marin-Galindo ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Rehabilitation Programme ◽  
Group Differences ◽  
Control Group ◽  
Chronic Obstructive ◽  
Maximum Value ◽  
Copd Patients ◽  
Significant Difference ◽  
Pulmonary Rehabilitation Programme ◽  
Positive Increment

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = −435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, −8.5 L/min, BF10 = 25), respiratory rate (RR, −3.3 breaths/min, BF10 = 2), heart rate (HR, −13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, −183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, −3.8 L/min, BF10 = 1.1) and compared to CG in VE (−8.3 L/min, BF10 = 3.6), VCO2 (−215.9 L/min, BF10 = 3.0), EqCO2 (−3.7 L/min, BF10 = 1.1) and HR (−12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (−4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.

scholarly journals Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications

2021 ◽  
pp. 019459982098745
Author(s):  
Mirko Aldè ◽  
Federica Di Berardino ◽  
Paola Marchisio ◽  
Giovanna Cantarella ◽  
Umberto Ambrosetti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Outpatient Clinic ◽  
Otitis Media With Effusion ◽  
Tertiary Level ◽  
Vestibular Disorders ◽  
Therapeutic Implications ◽  
History Of ◽  
Clinic Population

Objective To evaluate the role of social isolation during the lockdown due to the SARS-CoV-2 outbreak (severe acute respiratory syndrome coronavirus 2) in modifying the prevalence of otitis media with effusion (OME) and the natural history of chronic OME. Study Design Retrospective study. Setting Tertiary level referral audiologic center. Methods We assessed the prevalence of OME among children aged 6 months to 12 years who attended the outpatient clinic for hearing or vestibular disorders during 2 periods before the lockdown, May-June 2019 (n = 350) and January-February 2020 (n = 366), and the period immediately after the lockdown, May-June 2020 (n = 216). We also compared the disease resolution rates between a subgroup of children with chronic OME (n = 30) who were diagnosed in summer 2019 and reevaluated in May-June 2020 and a similar subgroup (n = 29) assessed in 2018-2019. Results The prevalence of OME in this clinic population was 40.6% in May-June 2019, 52.2% in January-February 2020, and 2.3% in May-June 2020. Children with chronic OME had a higher rate of disease resolution in May-June 2020 (93.3%) than those examined in May-June 2019 (20.7%, P < .001). Conclusion Closure of schools and the physical distancing rules were correlated with a reduction in the prevalence of OME and favored the resolution of its chronic forms among children who attended the outpatient clinic. These data could suggest that in the presence of chronic OME, keeping young children out of group care settings for a period might be beneficial to allow for OME resolution.

Pulmonary Rehabilitation in COPD Patients with Elevated PCO2

1988 ◽  
Vol 138 (6) ◽  
pp. 1519-1523 ◽  
Author(s):  
Steven Foster ◽  
Deborah Lopez ◽  
Henry M. Thomas
Keyword(s):  
Pulmonary Rehabilitation ◽  
Elevated Pco2 ◽  
Copd Patients

scholarly journals P149 Piloting and evaluating post-pulmonary rehabilitation (PR) long-term exercise (LTE) for COPD patients

Thorax ◽  
2011 ◽  
Vol 66 (Suppl 4) ◽  
pp. A127-A128
Author(s):  
S. E. Roberts ◽  
G. Kettle ◽  
S. Rogers ◽  
A. Segal ◽  
S. Purcell ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Copd Patients

Utilization Patterns and Trends in The Use of Medications for Asthma Control in a Cohort of Colombian Patients, 2017-2019. v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Retrospective Study ◽  
General Practitioner ◽  
Health System ◽  
Triple Therapy ◽  
Inhaled Corticosteroids ◽  
Prescription Patterns ◽  
Utilization Patterns ◽  
Control Therapy ◽  
Long Acting

Objective:To determine the trend in the use of medications used to treat asthma in a group of patients affiliated to the Colombian health system. Methods:A retrospective study on prescription patterns of medications used to treat asthma in patients over 5 years of age between 2017 and 2019. Sociodemographic variables, medications used and combinations, persistence of use and prescribing physician were considered. Results:10,706 people with a diagnosis of asthma were identified, with predominance in female sex (56.8 %), median age 32.2 ± 26.1 years. At the start of follow-up, 53.2% of patients aged 5-11 years were receiving monotherapy, mean 1.5 ± 0.6 drugs/patient, especially inhaled corticosteroids (ICS; 55.9%) and short-acting β-agonists (SABA; 55.6%). Moreover, in patients older than 12 years, 53.5% were treated in monotherapy, mean 1.6 ± 0.7 drugs/patient, of which 45.9% were on SABA, and 37.1 % on ICS.Between 63.0% and 83.6% of patients were treated by a general practitioner. The proportion of patients on the ICS/ long-acting β-agonists (LABA) combination grew at 24 months follow-up by 411% and 177%, respectively. 12.5% of patients (495) received triple therapy (ICS/LABA+LAMA [long-acting anticholinergics]), particularly with fluticasone/salmeterol+tiotropium. Conclusions:Patients with a diagnosis of asthma older than 5 years in Colombia are mainly receiving control therapy with ICS, alone or combined with SAMA and, to a lesser extent, with LABA.

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