scholarly journals Krónikus légzőszervi betegek tápláltsági állapotának vizsgálata – klinikai megfigyelések

2019 ◽  
Vol 160 (23) ◽  
pp. 908-913
Author(s):  
Mónika Fekete ◽  
Vince Pongor ◽  
Ágnes Fehér ◽  
Márta Veresné Bálint ◽  
János Tamás Varga ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pulmonary Function ◽  
Respiratory Muscles ◽  
Prognostic Indicator ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Record System ◽  
Severity Of Disease ◽  
Copd Patients ◽  
System Inclusion

Abstract: Introduction: The increased metabolism of nutrients and the low energy intake may lead to malnutrition among chronic obstructive pulmonary disease (COPD) patients. Aim: The goal of our study was to examine the nutritional status of our population aged over 40, and its relationship with the severity of the disease. Method: We conducted a retrospective study at the National Korányi Institute of Pulmonology in 2017. Pulmonary function and anthropometric data were obtained from the electronic health record system. Inclusion criteria were age over 40 and the diagnosis of COPD. Severity of disease was assessed by forced expiration volume and categorized according to GOLD stages. We used SPSS Statistics V22.0 for data analysis. Results: The mean age of participants was 66; 49.3% were men, 50.7% were women. Average BMI was 27.14 kg/m², with values comprising cachexia and severe obesity. According to the FEV1%pred results of the 3236 patients, 30% fell in the GOLD I, 40% in the GOLD II, 23% in the GOLD III, and 7% in the GOLD IV categories. Pearson coefficient found positive correlation between FEV1 and nutritional status (H = 0.2297, r = 0.1401), specifically between severity of cachexia and severity of disease. The analysis of variance showed significant correlation between severity of disease and nutritional status; patients with higher BMI had better pulmonary function. Conclusion: Malnutrition had an adverse effect on pulmonary functions and performance of respiratory muscles, whereas higher BMI had a positive effect on FEV1. Our results suggest that BMI could be used as a lung function prognostic indicator for COPD patients. Orv Hetil. 2019; 160(23): 908–913.

scholarly journals Increased circulating obestatin in patients with chronic obstructive pulmonary disease

2014 ◽  
Vol 9 ◽  
Author(s):  
Yi Lei ◽  
Yasha Liang ◽  
Xiaojing Liu ◽  
Xiaoyang Liao ◽  
Fengming Luo
Keyword(s):  
Nutritional Status ◽  
Pulmonary Function ◽  
Normal Control ◽  
Systemic Inflammation ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Copd Patients ◽  
Tnf Α

Background: Some peptides, which regulate the metabolic balance, are thought to play important roles in nutritional disorders and systemic inflammation in COPD. Treatment of rats with obestatin decreased body-weight gain. Obestatin was also found to be correlated with inflammation in rheumatoid arthritis. The aims of this study were to investigate the level of circulating obestatin in COPD and to analyze the relationship among obestatin and nutritional status, and systemic inflammation. Methods: 32 COPD patients with BMI less than 20 kg/m2 and 22 normal controls were included. Body composition was estimated using “foot-to-foot” BIA technology. Circulating obestatin was determined with enzyme-linked immunosorbent assay. Pulmonary function, TNF-α and C reactive protein were also measured. Results: The level of circulating obestatin was higher in COPD with underweight than that in normal control (5562.75 ± 3435.43 pg/ml in COPD, 3663.90 ± 2313.95 pg/ml in controls, p = 0.028). BMI, Waist circumference, hip circumference, bodyFAT and FAT% in COPD group were lower than those in normal control. Positive correlation was found among circulating C reactive protein, TNF-α and obestatin. There was no significant correlation among BMI, pulmonary function and obestatin. Conclusions: This study shows that circulating obestatin is higher in underweight COPD patients, and positively correlated to systemic inflammation, but not to nutritional status.

scholarly journals Effect of Methylation Status of lncRNA-MALAT1 and MicroRNA-146a on Pulmonary Function and Expression Level of COX2 in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Li Sun ◽  
Aiqun Xu ◽  
Min Li ◽  
Xingyuan Xia ◽  
Pulin Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Methylation Status ◽  
Chronic Obstructive ◽  
Prostaglandin E ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Signaling Axis

This study aimed to investigate the role of methylation of MALAT1 and miR-146a in the pathogenesis of chronic obstructive pulmonary disease (COPD). COPD patients were grouped according to their methylation status of MALAT1 and miR-146a promoters, and we found that forced vital capacity, volume that has been exhaled at the end of the first second of forced expiration, and diffusion capacity for carbon monoxide were the highest in the MALAT1 HYPO + miR-146a HYPER group and lowest in the MALAT1 HYPER + miR-146a HYPO group, and COPD patients with hypermethylated MALAT1 showed lower expression of MALAT1 than that in the COPD patients with hypomethylated MALAT1. Meanwhile, miR-146a was the most significantly upregulated in the MALAT1 HYPER + miR-146a HYPO group and the most significantly downregulated in the MALAT1 HYPO + miR-146a HYPER group. Both prostaglandin E1 and cyclooxygenase 2 (COX2) expression were the highest in the MALAT1 HYPO + miR-146a HYPER group and the lowest in the MALAT1 HYPER + miR-146a HYPO group. In conclusion, our results established a MALAT1/miR-146a/COX2 signaling axis. The overexpression of MALAT1 could increase the expression of COX2 by inhibiting the expression of miR-146a, thus affecting the pulmonary function of COPD patients.

Metabolic derangements in COPD muscle dysfunction

2013 ◽  
Vol 114 (9) ◽  
pp. 1282-1290 ◽  
Author(s):  
Luis Puente-Maestu ◽  
Alberto Lázaro ◽  
Blanca Humanes
Keyword(s):  
Lactate Production ◽  
Respiratory Muscles ◽  
Oxidative Capacity ◽  
Chronic Obstructive ◽  
Diabetic Patients ◽  
Peroxisome Proliferator ◽  
Type I ◽  
Oxidase Gene ◽  
Altered Expression ◽  
Copd Patients

Mitochondrial muscle alterations are common in patients with chronic obstructive pulmonary disease (COPD) and manifest mainly as decreased oxidative capacity and excessive production of reactive oxygen species (ROS). The significant loss of oxidative capacity observed in the quadriceps of COPD patients is mainly due to reduced mitochondrial content in the fibers, a finding consistent with the characteristic loss of type I fibers observed in that muscle. Decreased oxidative capacity does not directly limit maximum performance; however, it is associated with increased lactate production at lower exercise intensity and reduced endurance. Since type I fiber atrophy does not occur in respiratory muscles, the loss of such fibers in the quadriceps could be to the result of disuse. In contrast, excessive production of ROS and oxidative stress are observed in both the respiratory muscles and the quadriceps of COPD patients. The causes of increased ROS production are not clear, and a number of different mechanisms can play a role. Several mitochondrial alterations in the quadriceps of COPD patients are similar to those observed in diabetic patients, thus suggesting a role for muscle alterations in this comorbidity. Amino acid metabolism is also altered. Expression of peroxisome proliferator-activated receptor-γ coactivator-1α mRNA is low in the quadriceps of COPD patients, which could also be a consequence of type I fiber loss; nevertheless, its response to exercise is not altered. Patterns of muscle cytochrome oxidase gene activation after training differ between COPD patients and healthy subjects, and the profile is consistent with hypoxic stress, even in nonhypoxic patients.

scholarly journals Comprehensive exercise training improves ventilatory muscle function and reduces dyspnea perception in patients with COPD

2016 ◽  
Vol 71 (3) ◽  
Author(s):  
F. Cortopassi ◽  
A.A.M. Castro ◽  
E.F. Porto ◽  
M. Colucci ◽  
G. Fonseca ◽  
...  
Keyword(s):  
Exercise Training ◽  
Respiratory Muscles ◽  
Exercise Programme ◽  
Lower Limbs ◽  
Test Time ◽  
Chronic Obstructive ◽  
Endurance Test ◽  
Incremental Test ◽  
Copd Patients ◽  
Before And After

Background. Comprehensive exercise training (CET) is an efficient strategy to decrease dyspnea perception in chronic obstructive pulmonary disease (COPD) and may result in significant improvement in ventilatory muscles function. Our aim was to evaluate the effects of general exercise training on dyspnea perception and on respiratory muscles strength in COPD patients. Methods. Consecutive COPD patients were enrolled to complete a CET programme. The patients underwent a routine that included a global warm up, upper and lower limbs endurance exercise as well as stretching and relaxation. Before and after the CET programme, patients completed maximal inspiratory (PImax) and expiratory (PEmax) pressures measurements, maximal incremental test, endurance test, and 6-min walk distance (6MWD). Results. 71 patients (52 male). Mean age 67.6±8.6 years, FEV1 (%) 44.2±16.2 and Mahler dyspnea scale 6.4±1.8. The results before and after the exercise programme were: PImax 64.7±22.9 vs. 75.5±23.7 cmH2O (p=0.001), PEmax 110.8±28.1 vs. 120.4±28.1 cmH2O (p=0.004), 6MWD 510.6±90.3 vs. 528.2±99.7 metres (p=0.88), time of incremental test 672±135 vs. 856±226 sec (p<0.0001). Compared with the pre exercise programme, we observed a significant reduction on Borg dyspnea scale (6.1±2.8 to 3.6±2.3, p<0.0001) as well as a longer test time (504±218 to 1.038±841, p<0.0001) at the end of the endurance test after CET programme. Improvement of PImax correlated negatively with dyspnea perception at iso-time during the endurance test (r= -0.33, p=0.03). Conclusions. Our results confirm that CET is associated with significant improvement in PImax, PEmax and provide evidence demonstrating that CET reduces dyspnea perception in patients with COPD.

scholarly journals Exercise tolerance and dyspnea in patients with chronic obstructive pulmonary disease

2010 ◽  
Vol 67 (1) ◽  
pp. 36-41
Author(s):  
Ivan Cekerevac ◽  
Zorica Lazic ◽  
Ljiljana Novkovic ◽  
Marina Petrovic ◽  
Vojislav Cupurdija ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Exercise Tolerance ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Tolerance Level ◽  
Lung Hyperinflation ◽  
Copd Patients

Background/Aim. Peripheral muscle weakness and nutritional disorders, firstly loss of body weight, are common findings in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the impact of pulmonary function parameters, nutritional status and state of peripheral skeletal muscles on exercise tolerance and development of dyspnea in COPD patients. Methods. Thirty COPD patients in stable state of disease were analyzed. Standard pulmonary function tests, including spirometry, body pletysmography, and measurements of diffusion capacity were performed. The 6-minute walking distance test (6MWD) was done in order to assess exercise tolerance. Level of dyspnea was measured with Borg scale. In all patients midthigh muscle cross-sectional area (MTCSA) was measured by computerized tomography scan. Nutritional status of patients was estimated according to body mass index (BMI). Results. Statistically significant correlations were found between parameters of pulmonary function and exercise tolerance. Level of airflow limitation and lung hyperinflation had significant impact on development of dyspnea at rest and especially after exercise. Significant positive correlation was found between MTCSA and exercise tolerance. Patients with more severe airflow limitation, lung hyperinflation and reduced diffusion capacity had significantly lower MTCSA. Conclusion. Exercise tolerance in COPD patients depends on severity of bronchoobstruction, lung hyperinflation and MTCSA. Severity of bronchoobstruction and lung hyperinflation have significant impact on dyspnea level.

scholarly journals Immediate effect of Chest Proprioceptive Neuromuscular Facilitation on Respiratory Rate, Chest Expansion and Peak Expiratory Flow Rate in patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 9 (1) ◽  
pp. 3724-3729
Author(s):  
Hetal M Mistry ◽  
◽  
Rutuja V Kamble ◽  
Keyword(s):  
Respiratory Rate ◽  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Respiratory Muscles ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chest Expansion ◽  
Copd Patients ◽  
Expiratory Flow

Background: In Chronic Obstructive Pulmonary Disease (COPD), as result of dynamic hyperinflation, primary respiratory muscles go into weakness and length tension relationship of muscles is altered. This leads to decreased ability of primary respiratory muscles to generate muscle tension. COPD patients mostly use accessory muscle for breathing and there is lack of facilitation of intercostal muscle and weakness of diaphragm. Few studies are conducted to assess the immediate effect of Chest Proprioceptive Neuromuscular Facilitation (PNF) i.e. intercostal stretch among COPD patients. Therefore, there is need to find out immediate effect of chest PNF- intercostal stretch on respiratory rate (RR), chest expansion, peak expiratory flow rate (PEFR) among patient with COPD. Objective: To find out immediate effect chest PNF on respiratory rate, chest expansion and peak expiratory flow rate. Methodology: Ethical clearance and participant consent was taken. Study design was Qausi experimental study. The 65 subjects were taken by convenient sampling. Intercostal stretch was applied over 2nd and 3rd rib bilaterally for 10 breaths with 1 minute rest with a 10 repetitions and Outcome measures were assessed before and immediately after giving chest PNF. SPSS 16 software was used to analyse the data. The normality of the data was assessed using parametric paired t test. Significance level was set at 0.05 and 95% Confidence Interval. Outcome Measures: Respiratory rate, Chest expansion, Peak expiratory flow rate. Result: Immediate effect of chest PNF showed that there was statistically significant increase in PEFR and chest expansion at three level (P=0.000) and there was statistically significant decrease in RR (P=0.000). Conclusion: There is immediate effect of Chest PNF- intercostal stretch on, Respiratory rate, Chest expansion at three level that is axillary, nipple and xiphisternal and Peak expiratory flow rate. It is an easy to use, less time consuming, easy to understand and cost effective technique. KEY WORDS: Chest PNF, intercostal stretch, COPD.

Enteral Nutrition in the Chronic Obstructive Pulmonary Disease (COPD) Patient

2012 ◽  
Vol 25 (6) ◽  
pp. 583-585 ◽  
Author(s):  
Heather F. DeBellis ◽  
James W. Fetterman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Pulmonary Disease ◽  
Dietary Habits ◽  
Physiological Stress ◽  
Nutritional Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient’s nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient’s dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

scholarly journals Study of red cell distribution width levels and its correlation with severity of disease in patient with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
Shashidhar Ramappa ◽  
Aishhwarrya Umeshchandra G. ◽  
Sheshan V. ◽  
Manigandan .
Keyword(s):  
Cross Sectional Study ◽  
Red Cell Distribution Width ◽  
Chronic Obstructive ◽  
Red Cell ◽  
Cell Distribution ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Severity Of Disease ◽  
Copd Patients

Background:COPD has been accepted as component of systemic inflammatory syndrome. Red cell distribution width (RDW) is a measure of coefficient of variation of mean corpuscular volume which increases in chronic systemic inflammation. The aim of the study was to evaluate the RDW as a predictor of severity of COPD using BODE index.Methods:In this cross-sectional study 107 COPD patients were evaluated by measuring RDW and this was correlated with the severity of disease using GOLD staging.Results:RDW correlates well with COPD patients. Significant correlation of RDW with BODE index (r=0.650, p and It; 0.001), gold staging (r=0.459, p and It; 0.001), 6MWT (r=0.697, p and It; 0.001) were observed.Conclusions: RDW was found to increase in patients with increasing severity of COPD. Hence its potential role as a marker of severity of disease and in predicting risk of cardiovascular disease can be explored.

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