scholarly journals Hemodiafiltration for Intoxication with Lithium Unmasking Its Anti-Parkinsonian Effect

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Josef Finsterer ◽  
◽  
Claudia Stöllberger ◽  
Rebekka Wlassits ◽  
◽  
...  
Keyword(s):  
Previous History ◽  
The Body ◽  
Lower Limbs ◽  
Chronic Obstructive ◽  
Psychiatric Medication ◽  
Retirement Home ◽  
Lithium Intoxication ◽  
Bundle Branch Block ◽  
Obstructive Pulmonary Disease ◽  
Resting Tremor

From lithium it is known that it exhibits an anti-Parkinson effect [1]. Accordingly, smokers develop less frequently Parkinson’s Disease (PD) than the non-smoking population [2]. This is because tobacco contains a significant amount of lithium [3]. The anti-PD effect of lithium is explained by increased autophagy and reduction of intracellular a-synuclein [3]. Lithium inhibits GSK-3ß and consequently increases the ß-catenine activity [4]. Development of a Parkinson crisis due to flushing out of lithium by Hemodiafiltration (HDF), as in the following case, has not been reported. The patient is a 63 years male (height 180cm, weight 75kg) who was living with his mother in a retirement home and developed fever since 4 days prior to admission. His previous history was positive for psychosis, bipolar disorder, arterial hypertension, chronic renal failure, chronic obstructive pulmonary disease, diabetes, bilateral hydrocele, prostate hypertrophy, polyneuropathy, lithium intoxication, and hyperlipidemia. He had the diagnosis of a questionable extra-pyramidal syndrome but no anti-Parkinson medication. His home medication included aripiprazole (400 mg/ once every 30 d), biperiden (8 mg/d), midazolam (0.25 mg/d), lithium (900 mg/d), quetiapine (50 mg/d), trazodone (75 mg/d), nebivolol (2.5 mg/d), metformin (850 mg/d), simvastatin (20 mg/d), tamsulosin (0.4 mg/d), fenoterol with ipratropium-bromid, and tiotropium plus olodaterol. On admission (hospital day-1 (hd1)) he was comatose, had spontaneous resting tremor, and arterial hypotension (80/40 mmHg). Blood tests revealed hypokaliemia, hypernatriemia, and renal insufficiency (Table 1). The swab test for SARS-CoV2 was negative. ECG showed AV-block-I, right bundle-branch-block, and QT-prolongation (501 ms). X-ray of the lung was normal. Clinical neurologic exam on hd2 revealed somnolence, pain upon maximal passive anteflexion of head, nuchal rigor, ptosis, ophthalmoparesis, spontaneous myocloni all over the body, mild rigor of all extremities, reduced tendon reflexes on the lower limbs, and clonus of the left lower leg (Table 1). Cerebral CT-scan was non-informative. He was treated with fluid substitution, cefuroxim, levetirazetam (LEV) (1000 mg/d), and discontinuation of all psychiatric medication.

scholarly journals EVALUATION OF THE QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN OVERWEIGHT PATIENTS

2020 ◽  
Vol 73 (8) ◽  
pp. 1668-1670
Author(s):  
Mykola M. Ostrovskyy ◽  
Nadiia V. Korzh
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Pathological Process ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). Patients’ quality of life was evaluated with the help of standardized St.George’s Respiratory Questionnaire (SGRQ). Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.

scholarly journals Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India

2021 ◽  
Author(s):  
Soibam Pahel Meitei ◽  
Sudheer Tale ◽  
Arjun Kumar Negi ◽  
Ruchi Dua ◽  
Rohit Walia ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Venous Thromboembolism ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Obstructive Pulmonary Disease ◽  
Test Probability ◽  
D Dimer

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA).  Results were analysed using SPSS version 23.  Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.

scholarly journals Influence of the phenotype of the disease on the parameters of the antioxidant defense system and the level of some interleukins in the blood of patients with chronic obstructive pulmonary disease

2017 ◽  
Vol 8 (6) ◽  
pp. 38-41 ◽  
Author(s):  
Ivan I. Pavlyuchenko ◽  
Evgenii A. Kokov ◽  
Lyudmila N. Kokova ◽  
Olga S. Okhremenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Adaptive Systems ◽  
Complex Disease ◽  
Antioxidant Properties ◽  
The Body ◽  
Chronic Obstructive ◽  
Common Disease ◽  
Obstructive Pulmonary Disease ◽  
Active Forms Of Oxygen

Chronic obstructive pulmonary disease (COPD) is a common disease involving the pathological process, of bronchopulmonary and cardiovascular systems. This is a complex disease in which inflammation plays a leading role in the formation of the whole complex of pathological changes. COPD accompanies local deficit of antiproteases, excessive formation of active forms of oxygen, inducing uncontrolled lipid peroxidation and oxidative stress. An increase in the level of proinflammatory cytokines, such as IL-6, IL-8, TNF-α, is particularly significant in the combination of chronic obstructive disease with metabolic syndrome. Determination of a specific phenotype of COPD, and the degree of disruption of protective and adaptive systems in these forms of the disease course allows optimizing the treatment regimens for patients. The purpose of this work was to identify additional biochemical and biophysical markers of phenotyping and monitoring of therapy in patients with COPD of different phenotype and severity level in the acute stage on the basis of studying the main indicators of the system of antioxidant protection of blood and some cytokines. Significant differences in antioxidant system (AOS) indices in patients with COPD of different phenotype and severity were determined. The established differences in the activity of erythrocyte enzymes and the overall antioxidant activity of blood plasma can serve as an important additional link for the phenotyping of COPD. Complex treatment with the use of anticoagulants, normalizing the rheological properties of blood and mucolytics with pronounced antioxidant properties, reduces the level of prooxidant load on the body due to correction of metabolic processes and has the most pronounced effect on AOS blood parameters and cytokine profile.

scholarly journals Scoping Review: Pengaruh Paparan Asap Rokok Terhadap Kadar Kotinin Dalam Tubuh Perokok Pasif

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Madina Tul Munawaroh ◽  
Annisa Rahmah Furqaani ◽  
Lelly Resna Nugrahawati
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Trial ◽  
Coronary Heart Disease ◽  
Scoping Review ◽  
The Body ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Cytochrome P450 Family

Perokok pasif adalah orang tidak merokok, namun ikut menghirup asap rokok dari orang-orang merokok di sekitarnya. Produk yang dihirup dihasilkan dari asap utama yang dihembuskan dan asap dari ujung rokok yang masih membara. Perokok pasif memiliki kandungan nikotin yang akan dimetabolisme menjadi kotinin menggunakan enzim CYP2A6 Cytochrome P450, Family 2, Subfamily A, Polypeptide dan didistribusikan dalam tubuh perokok pasif seperti darah, saliva, dan urine. Hasil metabolisme mengakibatkan peningkatan kadar kotinin dalam tubuh perokok pasif. Dampak peningkatan kadar kotinin menyebabkan gangguan kesehatan seperti lung cancer, oral cancer, asthma, chronic obstructive pulmonary disease (COPD), dan coronary heart disease. Tujuan penelitian menganalisis pengaruh paparan asap rokok terhadap kadar kotinin dalam tubuh perokok pasif. Penelitian dilakukan dengan metode scoping review dengan subjek artikel ilmiah nasional dan internasional yang memenuhi kriteria kelayakan (eligible). Hasil pada penelitian ini diambil dari artikel yang akan dinilai secara PICOS, yaitu Population: anak-anak perokok pasif yang terdapat pada jurnal artikel, Intervention/Exposure: asap rokok sekunder, Comparison: anak-anak yang tidak tinggal dengan perokok, Outcome: kadar kotinin dalam tubuh perokok pasif, Studi: RCT, clinical trial, dan cross sectional. Artikel yang memenuhi kelayakan (eligible) ada 6 artikel. Simpulan penelitian ini menunjukkan bahwa pada perokok pasif menunjukan kadar kotinin yang meningkat.  Scope Review: The Effect of Cigarette Exposure to Cotinine Levels in The Body of Passive SmokersSecondhand smoke is a product produced from the main smoke that is exhaled and the smoke from the tip of the cigarette that is still burning. Passive smokers who contain nicotine which will be metabolized into cotinine use the enzymes CYP2A6 Cytochrome P450, Family 2, Subfamily A, Polypeptides and distros in the body of passive smokers such as blood, saliva and urine. From the measurement results the increase in cotinine levels in the body of passive smokers. The impact of increasing levels of cotinins causes health problems such as lung cancer, oral cancer, asthma, chronic obstructive pulmonary disease (COPD), and coronary heart disease. The research objective was to analyze the effect of cigarette smoke on cotinine levels in the body of passive smokers. The research was taken using the scoping review method with the subject of national and international scientific articles that meet the eligibility criteria (elegible). The results in this study were taken from articles to be taken using PICOS, namely Population: children of passive smoking found in journal articles, Intervention/Exposure:secondary cigarette smoke, Comparison: children who do not live with smokers, Results: body cotinine levels in passive smokers, Studies (RCT, clinical trial, and cross sectional). There are 6 articles that fulfill the eligibility (elegible). The conclusion of this study shows that exposure to passive smoking using cotinine concentrations taken in the body of passive smokers shows an increase in cotinine levels.

scholarly journals Features of histological changes in the lungs of mature animals under conditions of hyperhomocysteinemia

2019 ◽  
pp. 32-37
Author(s):  
І. А. Samborska ◽  
O. Ye. Маievskyi ◽  
Z. M. Nebesna
Keyword(s):  
Ccd Camera ◽  
The Body ◽  
Male Rats ◽  
Experimental Simulation ◽  
Chronic Obstructive ◽  
Adult Rats ◽  
Histological Changes ◽  
Obstructive Pulmonary Disease ◽  
Vascular Walls ◽  
Inflammatory Infiltrates

Hyperhomocysteinemia is a well-known risk factor for atherosclerosis, coronary heart disease, stroke, and venous thrombosis. However, in recent decades, the range of diseases associated with elevated homocysteine levels has expanded significantly. The influence of this amino acid on the occurrence and development of pathologies of the respiratory system, in particular, chronic obstructive pulmonary disease, bronchial asthma, lung and pleural cancer, is currently being actively studied. The aim of the study is to find the features of histological changes in the lungs of adult rats under conditions of hyperhomocysteinemia. The experimental study was performed on 22 white nonlinear adult (6-8 months) male rats. During the experiment, the animals were divided into two groups – control and experimental. Simulation of the state of persistent hyperhomocysteinemia was achieved by administering to rats the experimental group of thiolactone homocysteine at a dose of 200 mg/kg body weight intragastrally for 60 days. Histological specimens were studied using an SEO CCAN light microscope and photo-documented using a Vision CCD Camera with an image output system from histological specimens. Histological examinations of the lungs of adult animals under conditions of hyperhomocysteinemia revealed adaptive-compensatory and destructive changes in the components of the organ. Discirculatory disorders, remodeling of the bronchial wall with the formation of inflammatory infiltrates in them were revealed. Significant areas of dys- and atelectasis and emphysematically altered areas of the parenchyma were found in the respiratory tract of the lungs. In the alveolar septa, peribronchially and paravasally, histo- and leukocyte infiltration, formation of inflammatory conglomerates were determined. Remodeling of vascular walls, especially the microcirculatory tract leads to disruption of blood supply to the body and hypoperfusion of lung tissue.

scholarly journals Medical image of the month: mucinous adenocarcinoma of the lung mimicking pneumonia

2021 ◽  
Vol 22 (1) ◽  
pp. 8-10
Author(s):  
Nicholas Blackstone ◽  
Tammer El-Aini
Keyword(s):  
Emergency Room ◽  
Medical Image ◽  
Previous History ◽  
Left Lung ◽  
Chronic Obstructive ◽  
Lung Mass ◽  
Obstructive Pulmonary Disease ◽  
Left Upper Lobectomy ◽  
History Of ◽  
Artery Disease

No abstract available. Article truncated after 150 words. Clinical Scenario: A 60-year-old man with a history of chronic obstructive pulmonary disease presented to the hospital with worsening shortness of breath over a period of 3 days. He had a 50-pack-year history of smoking, coronary artery disease, and a previous history of a left lung mass of unknown pathology status post left upper lobectomy. He was bought to the emergency room via ambulance after being found at home with oxygen saturations in the 60s. Upon arrival to the emergency room, he required continuous oxygen at 15 L/min to maintain his oxygen saturations above 88%. He had a progressive, markedly productive cough over the last few weeks prior to presentation. He had been treated for pneumonia with multiple courses of antibiotics over the last two months without any significant improvement. His blood work was significant for a leukocytosis with neutrophilia and an elevated D-dimer. He underwent a CTA of the …

scholarly journals Efficacy Of Unsupervised Home-Based Pulmonary Rehabilitation For Patients With Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Jang Ho Lee ◽  
Hyang Yi Lee ◽  
Youngwon Jang ◽  
Jae Seung Lee ◽  
Yeon-Mok Oh ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Home Based ◽  
Hospital Visits

Abstract Background: Pulmonary rehabilitation (PR) is a well-established treatment for chronic obstructive pulmonary disease (COPD). The standard protocol for PR requires frequent hospital visits, which can be difficult for patients. We performed this study to assess whether unsupervised home-based PR (HBPR) is effective for patients with COPD.Methods: This investigation was a prospective cohort study. After assessing the outcome data, including the results of a COPD assessment test (CAT); the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; a pulmonary function test; the modified Medical Research Council (mMRC) dyspnea scale; and the 6-min walking test (6MWT), specialists imparted education to patients about unsupervised HBPR. Patients who exercised more than three times per week were classified as the compliant group, and the others were categorized as the noncompliant group. Changes in the outcomes were compared between the compliant and noncompliant groups.Results: 41 patients were enrolled in this study. After 8 weeks of unsupervised HBPR, there were significant improvements in CAT scores, BODE index, and forced expiratory volume in 1 s among patients in the compliant group compared with those in the noncompliant group. Moreover, their CAT and mMRC scores improved significantly after 8 weeks compared with those at baseline. On the other hand, patients in the noncompliant group showed no significant improvement in any of the outcomes.Conclusions: Unsupervised HBPR can be effective for compliant patients with COPD. We recommend unsupervised HBPR for patients with COPD even when regular hospital visits for PR are not possible.Trial registration: NCT03754881

scholarly journals Exact Solution of Two-Dimensional Unsteady Airflow in an Inclined Trachea

2016 ◽  
Vol 10 (1) ◽  
pp. 191 ◽  
Author(s):  
Esam. A. Ahmed Alnussairy ◽  
Ahmed Bakheet ◽  
Norsarahaida Amin
Keyword(s):  
Exact Solution ◽  
Gravitational Force ◽  
Slope Angle ◽  
The Body ◽  
Chronic Obstructive ◽  
Two Dimensional ◽  
Negative Effects ◽  
Obstructive Pulmonary Disease ◽  
Continuity Equations ◽  
Bromwich Integral

<p>The exact solution of the two-dimensional momentum and continuity equations governing the unsteady airflow in an inclined trachea was carried out. The oscillating airflow was described by setting one side of the boundaries be a periodic pressure function. The solution was obtained using Bromwich integral. The present results show that the inclination angle θ and gravitational force g reduces the pressure drop and has a greater effect on the velocity profile of airflow from the trachea to the lungs. Therefore, sleeping in a horizontal position may lead to negative effects for many patients. However, the inclined position is better, and it is dependent on the slope angle position taking, the benefits of gravitational force and utilizing it to improve the breathing of the body. These results are of help in breathing problems, mild sleep apnea, snoring, asthma and chronic obstructive pulmonary disease.</p>

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