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 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.

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.

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

scholarly journals Results of long-term treatment with short-acting bronchodilators of patients with chronic obstructive pulmonary disease (COPD) and COPD combined with asthma

2005 ◽  
pp. 101-106
Author(s):  
E. I. Shmelev ◽  
M. A. Khmelkova ◽  
Z. O. Grineva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Term Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short Acting ◽  
Copd Patients ◽  
Long Term Treatment

This study was designed to investigate long term treatment effects of short acting bronchodilators on respiratory symptoms, lung function, and the mean pulmonary artery pressure (mPAP) in patients with chronic obstructive pulmonary disease (COPD) and COPD combined with asthma (COPD + BA). The study involved 14 COPD patients and 16 COPD+BA patients, males and females (the average age, 60 yrs) with moderate to severe disease and the mPAP higher than 20 mm Hg. Clinical examination with scoring of cough, sputum, dyspnea, and lung auscultation signs; spirometry, ECG, echocardiography, chest X ray, and blood analysis were used. Clinical status and lung function were evaluated primarily and in 4, 12, and 24 wks; the mPAP was measured initially and in 12 and 24 wks. Before the study no one patient received persistent supporting therapy with bronchodilators, 15 COPD + BA patients and 7 COPD patients were given inhaled steroids. Persistent therapy of all the patients with Berodual 2 doses 4 times daily for 24 wks resulted in improvement in the clinical symptoms and lung function parameters, reduction in mPAP in both the groups but the results were better and they were reached faster in the patients with combined pathology. Thus, the regularly combined therapy with short acting β2 agonists and anticholinergics (Berodual) can be included in the algorithm of therapy of pulmonary hypertension in patients with COPD and COPD + BA.

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.

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.

scholarly journals Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>

2019 ◽  
Vol 16 (18) ◽  
pp. 3320 ◽  
Author(s):  
Charlotte Simonÿ ◽  
Claus Riber ◽  
Uffe Bodtger ◽  
Regner Birkelund
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Health Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Useful Knowledge ◽  
Copd Patients ◽  
Study Intervention ◽  
Intervention Description

Background: More feasible rehabilitation programmes for patients with chronic obstructive pulmonary disease (COPD) are warranted. Even so, still in its infancy, telerehabilitation to COPD patients reveals promising results, wherefore it is anticipated to contribute significant value to the current challenges of rehabilitation to these patients. To expand useful knowledge in the field, more sophisticated telerehabilitation interventions must be developed and appraised, but first and foremost, thoroughly described. Aims and methods: The aim of this article is to give a detailed description of the rationale and content of the >C☺PD-Life>> programme, within the bounds of the checklist of Template for Intervention Description and Replication (TIDieR). Approach: >C☺PD-Life>> is a telerehabilitation programme for COPD patients delivered as a study intervention by an interprofessional team of clinicians collaborating from both the hospital and the municipal healthcare system. Making use of two-way audio and visual communication software, 15 patients participated in the intervention via a tablet computer from their private setting. The programme was a six-month-long empowerment-based rehabilitation that aimed to support COPD patients in leading a satisfactory and confident life with appropriate physical activity and high disease management. Conclusions: A long-term interprofessional cross-sectoral telerehabilitation programme has been justified and described. The intervention was tested in 2017–2018 and the qualitative appraisal, along with an analysis of case-based measurements of development in physical capacity, COPD Assesment Test, and health management, is currently under production.

scholarly journals Safety and efficacy of Azithromycin in prevention of chronic obstructive pulmonary disease exacerbation: systematic review and meta-analysis

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 253
Author(s):  
Almegdad Ahmed ◽  
Abubaker Koko ◽  
Ahmed Abdelsalam ◽  
Awab Hilali ◽  
Mohamed Elsheikh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Safety And Efficacy ◽  
Copd Patients ◽  
Acute Exacerbations

Background: Chronic obstructive pulmonary disease (COPD) causes a major burden in terms of deaths and hospitalizations worldwide; it is associated with progressive lung function loss, and frequent exacerbations. Administration of macrolides has been considered beneficial in reducing the frequency of COPD exacerbations. The aim of this study is to assess the safety and efficacy of long-term administration of Azithromycin for patients with chronic obstructive pulmonary disease. Methods: An extensive search was conducted on SCOPUS, and PubMed databases, CENTRAL, and ClinicalTrials.gov clinical trial registers for randomized clinical trials conducted on COPD patients and administered Azithromycin for more than two weeks. The selected studies underwent assessment for the risk of bias. We conducted random-effect model meta-analysis for the frequency of acute exacerbations during follow-up as a primary outcome. Results: Out of 1021 screened records, 3 RCTs (Randomized controlled trials) involving 1264 patients were included in the final analysis. The pooled data of all 3 trials showed that administration of Azithromycin reduced the frequency of acute exacerbation of COPD [risk ratio (RR) = 0.69; 95% CI 0.53, 0.91, p = 0.01]. Subgroup analysis indicated that 500 mg Azithromycin [risk ratio (RR) =0.65; 95% CI 0.53-0.79, p=0.01] was found to be more beneficial than 250 mg Azithromycin [risk ratio (RR) = 0.60; 95% CI 0.27-1.33, p=0.21] in reducing acute exacerbation rate, however due to many limitations the analysis of the dosage was not conclusive. Conclusion: Long-term Azithromycin administration for COPD patients is statistically not associated with increased risk of developing adverse events; in addition, it might be effective in reducing the frequency of acute exacerbations of COPD. However, dosage and duration of Azithromycin administration analysis was not conclusive and thus more RCTs are needed in these areas.

scholarly journals Impact of bronchiectasis on long-term survival in patients with acute exacerbation of chronic obstructive pulmonary disease

2019 ◽  
Author(s):  
Ying Zhang ◽  
Shu Zhang ◽  
Yan-Li Gao ◽  
Zhen Wang ◽  
Xiao-Ning Bu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Medical Record ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Term Survival ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Background Only few studies have reported the association between bronchiectasis and mortality in patients with Chronic Obstructive Pulmonary Disease (COPD) and the results were controversial. This study aimed at assessing the prognostic influence of bronchiectasis on COPD patients and comparing differences of prognostic influence of different types of bronchiectasis on COPD patients. Patients and methods This study enrolled patients hospitalized for COPD exacerbation between 2013 and 2014. Bronchiectasis was identified on high-resolution computed tomography (HRCT) within 2 years prior to this hospitalization due to COPD exacerbation and Smith score was used to determine the extent of bronchiectasis. Clinical data were obtained from electronic inpatient medical record. The survival data were obtained through telephone follow-up or electronic medical record. Cox regression analysis was used to assess the prognostic influence of bronchiectasis on COPD patients. Results 748 COPD patients were included in this study. 318 patients were identified to have bronchiectasis. During a median follow-up time of 46 months, 624 COPD patients completed follow-up. There were 210 deaths, 112 of whom were comorbid bronchiectasis patients. Comorbid bronchiectasis patients revealed higher mortality than without bronchiectasis patients in 3 years and the whole follow-up, other than in hospital, 1 year and 2 years. The presence of bronchiectasis and its severity were independently associated with increased mortality of COPD patients. The presence of cystic/varicose bronchiectasis revealed higher mortality than cylindrical bronchiectasis and was independently associated with increased mortality of comorbid bronchiectasis patients. Conclusions The presence of bronchiectasis and its severity were independently associated with increased risk of all-cause mortality and mainly affected the long-term mortality of COPD patients. The presence of cystic/varicose bronchiectasis predicted higher death risk of COPD patients.

Sign in / Sign up

Export Citation Format

Share Document