Pub Date : 2022-12-01Epub Date: 2022-01-09DOI: 10.1080/15412555.2021.2020234
Diêgo Mendes Xavier, Endi Lanza Galvão, Alenice Aliane Fonseca, Glaciele Maria de Souza, Vanessa Pereira Lima
Conventional pulmonary rehabilitation programs are used as therapies for the treatment of chronic obstructive pulmonary disease (COPD). However, this modality presents barriers that make rehabilitation difficult. For this reason, home-based pulmonary rehabilitation (HBPR) has been used to overcome these barriers. The objective was to systematically compare a structured program with HBPR or a control group for participants with COPD. The primary outcome was an improvement in symptoms in the level of dyspnea and secondary outcomes were parameters in lung function, exercise capacity, health-related quality of life (HRQoL) and the impact of the disease on the individual. The Medline (via PubMed), Virtual Health Library and Cochrane Library databases were searched until May 10, 2021. Randomized controlled trials were included without restrictions on the year of publication or language. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB). Our results showed that there was a significant decrease in the level of dyspnea, (MD: 5.46; 95% CI: 1.97 to 8.96), increased distance covered (MD: 61.75; 95% CI: 42, 94 to 80.56, significant improvement in HRQoL (MD: -11.30; 95% CI: -19.81 to -2.79) and reduction in the impact of the disease (DM: -4.71; 95% CI: -7.95 to -1.47). All results found were comparing the intervention group versus the control group. To conclude we found a reduction in the levels of dyspnea, an increase in the distance covered on the six-minute walk test, improving HRQoL and decreasing the impact of the disease in COPD patients in home-based pulmonary rehabilitation.
{"title":"Effects of Home-Based Pulmonary Rehabilitation on Dyspnea, Exercise Capacity, Quality of Life and Impact of the Disease in COPD Patients: A Systematic Review.","authors":"Diêgo Mendes Xavier, Endi Lanza Galvão, Alenice Aliane Fonseca, Glaciele Maria de Souza, Vanessa Pereira Lima","doi":"10.1080/15412555.2021.2020234","DOIUrl":"https://doi.org/10.1080/15412555.2021.2020234","url":null,"abstract":"<p><p>Conventional pulmonary rehabilitation programs are used as therapies for the treatment of chronic obstructive pulmonary disease (COPD). However, this modality presents barriers that make rehabilitation difficult. For this reason, home-based pulmonary rehabilitation (HBPR) has been used to overcome these barriers. The objective was to systematically compare a structured program with HBPR or a control group for participants with COPD. The primary outcome was an improvement in symptoms in the level of dyspnea and secondary outcomes were parameters in lung function, exercise capacity, health-related quality of life (HRQoL) and the impact of the disease on the individual. The Medline (<i>via</i> PubMed), Virtual Health Library and Cochrane Library databases were searched until May 10, 2021. Randomized controlled trials were included without restrictions on the year of publication or language. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB). Our results showed that there was a significant decrease in the level of dyspnea, (MD: 5.46; 95% CI: 1.97 to 8.96), increased distance covered (MD: 61.75; 95% CI: 42, 94 to 80.56, significant improvement in HRQoL (MD: -11.30; 95% CI: -19.81 to -2.79) and reduction in the impact of the disease (DM: -4.71; 95% CI: -7.95 to -1.47). All results found were comparing the intervention group versus the control group. To conclude we found a reduction in the levels of dyspnea, an increase in the distance covered on the six-minute walk test, improving HRQoL and decreasing the impact of the disease in COPD patients in home-based pulmonary rehabilitation.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"18-46"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39797526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-14DOI: 10.1080/15412555.2022.2101992
Manuel Kuhn, Dario Kohlbrenner, Noriane A Sievi, Christian F Clarenbach
Approximately, half of COPD patients die from cardiovascular diseases. A prolongation of cardiac repolarization (measured as QTc interval) is associated with cardiovascular events or cardiovascular deaths in populations of older adults and COPD. One way to reduce the QTc could be to increase physical activity (PA). We investigated whether QTc can be reduced by an increase in PA in patients with severe COPD. This is a secondary outcome analysis from a randomized controlled trial investigating the effects of a 3 months pedometer based program to improve PA. 12-lead ECG was assessed at baseline and after 3 months. We measured PA using a validated triaxial accelerometer. Data were analyzed from 59 participants. Multiple regression modeling, including adjustment for baseline QTc, sex, QT prolonging medications, BMI, smoking status and FEV1%, showed no evidence for an association between an improvement of ≥15% PA and QTc reduction. A 15% improvement in PA according to step counts over 3 months seems not to reduce QTc interval by its MCID of 20 ms in patients with severe to very severe COPD.
{"title":"Increasing Daily Physical Activity and Its Effects on QTc Time in Severe to Very Severe COPD: A Secondary Analysis of a Randomised Controlled Trial.","authors":"Manuel Kuhn, Dario Kohlbrenner, Noriane A Sievi, Christian F Clarenbach","doi":"10.1080/15412555.2022.2101992","DOIUrl":"https://doi.org/10.1080/15412555.2022.2101992","url":null,"abstract":"<p><p>Approximately, half of COPD patients die from cardiovascular diseases. A prolongation of cardiac repolarization (measured as QTc interval) is associated with cardiovascular events or cardiovascular deaths in populations of older adults and COPD. One way to reduce the QTc could be to increase physical activity (PA). We investigated whether QTc can be reduced by an increase in PA in patients with severe COPD. This is a secondary outcome analysis from a randomized controlled trial investigating the effects of a 3 months pedometer based program to improve PA. 12-lead ECG was assessed at baseline and after 3 months. We measured PA using a validated triaxial accelerometer. Data were analyzed from 59 participants. Multiple regression modeling, including adjustment for baseline QTc, sex, QT prolonging medications, BMI, smoking status and FEV1%, showed no evidence for an association between an improvement of ≥15% PA and QTc reduction. A 15% improvement in PA according to step counts over 3 months seems not to reduce QTc interval by its MCID of 20 ms in patients with severe to very severe COPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":" ","pages":"339-344"},"PeriodicalIF":2.2,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-06DOI: 10.1080/15412555.2022.2081540
Colin Bartz-Overman, A. Albanese, V. Fan, E. Locke, T. Parikh, S. Thielke
Abstract Previous research has identified unexpectedly strong associations between dyspnea and pain, but the reasons remain unclear. Ascertaining the underlying biological and psychological mechanisms might enhance the understanding of the experience of both conditions, and suggest novel treatments. We sought to elucidate whether demographic factors, disease severity, psychological symptoms and biomarkers might account for the association between pain and dyspnea in individuals with COPD. We analyzed data from 301 patients with COPD who were followed in a prospective longitudinal observational study over 2 years. Measures included self-reported dyspnea and pain, pulmonary function tests, serum levels of inflammatory cytokines, measures of physical deconditioning, and scales for depression and anxiety. Analyses involved cross-sectional and longitudinal linear regression models. Pain and dyspnea were strongly correlated cross-sectionally (r = 0.77, 95% CI 0.72–0.82) and simultaneously across time (r = 0.42, 95% CI 0.28–0.56). Accounting for any of the other health factors only slightly mitigated the associations. Symptoms of pain and dyspnea thus may be fundamentally linked in COPD, rather than being mediated by common biological, psychological, or functional factors. From the patient’s perspective, pain and dyspnea may be part of the same essential experience. It is possible that treatments for one condition would improve the other.
先前的研究已经发现了呼吸困难和疼痛之间出乎意料的强烈联系，但原因尚不清楚。确定潜在的生物学和心理学机制可能会增强对这两种情况的理解，并提出新的治疗方法。我们试图阐明人口统计学因素、疾病严重程度、心理症状和生物标志物是否可能解释慢性阻塞性肺病患者疼痛和呼吸困难之间的关联。我们分析了301名COPD患者的数据，这些患者在一项前瞻性纵向观察研究中随访了2年多。测量包括自我报告的呼吸困难和疼痛、肺功能测试、血清炎症细胞因子水平、身体降条件测量以及抑郁和焦虑量表。分析包括横截面和纵向线性回归模型。疼痛和呼吸困难在横断面上呈强相关(r = 0.77, 95% CI 0.72-0.82)，同时在时间上呈强相关(r = 0.42, 95% CI 0.28-0.56)。考虑到任何其他健康因素只能略微减轻这种关联。因此，疼痛和呼吸困难的症状可能与COPD有根本联系，而不是由常见的生物、心理或功能因素介导。从患者的角度来看，疼痛和呼吸困难可能是同一基本体验的一部分。对一种情况的治疗可能会改善另一种情况。
{"title":"Potential Explanatory Factors for the Concurrent Experience of Dyspnea and Pain in Patients with COPD","authors":"Colin Bartz-Overman, A. Albanese, V. Fan, E. Locke, T. Parikh, S. Thielke","doi":"10.1080/15412555.2022.2081540","DOIUrl":"https://doi.org/10.1080/15412555.2022.2081540","url":null,"abstract":"Abstract Previous research has identified unexpectedly strong associations between dyspnea and pain, but the reasons remain unclear. Ascertaining the underlying biological and psychological mechanisms might enhance the understanding of the experience of both conditions, and suggest novel treatments. We sought to elucidate whether demographic factors, disease severity, psychological symptoms and biomarkers might account for the association between pain and dyspnea in individuals with COPD. We analyzed data from 301 patients with COPD who were followed in a prospective longitudinal observational study over 2 years. Measures included self-reported dyspnea and pain, pulmonary function tests, serum levels of inflammatory cytokines, measures of physical deconditioning, and scales for depression and anxiety. Analyses involved cross-sectional and longitudinal linear regression models. Pain and dyspnea were strongly correlated cross-sectionally (r = 0.77, 95% CI 0.72–0.82) and simultaneously across time (r = 0.42, 95% CI 0.28–0.56). Accounting for any of the other health factors only slightly mitigated the associations. Symptoms of pain and dyspnea thus may be fundamentally linked in COPD, rather than being mediated by common biological, psychological, or functional factors. From the patient’s perspective, pain and dyspnea may be part of the same essential experience. It is possible that treatments for one condition would improve the other.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"33 1","pages":"282 - 289"},"PeriodicalIF":2.2,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80275688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1080/15412555.2022.2078695
E. Derom, E. Meijer, J. V. van Enschot
Abstract Background: Hypoxemia is currently treated in hospital wards with oxygen, released continuously by “conventional” flow meters. A new type of hybrid flow meter allows to switch between on-demand and continuous mode. The aim of this observational study was to assess whether this new device reduces oxygen expenditure, is well accepted in a hospital setting and improves patient comfort during oxygen therapy. Methods: Oxygen was administered in hypoxemic patients with conventional or hybrid flow meters to maintain an oxygen saturation of ≥ 92% over a 12-week period. Every two weeks conventional and hybrid flow meters were switched. The overall oxygen delivery to the ward was continuously measured with a data logging device installed in the main oxygen pipeline and corrected for multiple confounding factors. Humidity measurements, for which a sensor placed in front of one of the nostrils, and patient questionnaires, were used to assess patient comfort during continuous and on-demand flow. Results: Overall oxygen delivery decreased by 39% when switching from continuous flow to on-demand therapy after correction for confounding factors. Continuous flows significantly decreased relative humidity more than equivalent on-demand settings and the latter tended to increase comfort. Conclusions: Hybrid flow meters cause a significant reduction in oxygen delivery in a hospital ward, which may lead to financial savings. Using the on-demand technology also lowers the dryness of the upper airways (and may increase patient comfort), while maintaining an adequate oxygenation.
{"title":"An On-Demand Oxygen Flow Meter for Enhanced Patient Comfort and Reduced Oxygen Cost in Hospitals","authors":"E. Derom, E. Meijer, J. V. van Enschot","doi":"10.1080/15412555.2022.2078695","DOIUrl":"https://doi.org/10.1080/15412555.2022.2078695","url":null,"abstract":"Abstract Background: Hypoxemia is currently treated in hospital wards with oxygen, released continuously by “conventional” flow meters. A new type of hybrid flow meter allows to switch between on-demand and continuous mode. The aim of this observational study was to assess whether this new device reduces oxygen expenditure, is well accepted in a hospital setting and improves patient comfort during oxygen therapy. Methods: Oxygen was administered in hypoxemic patients with conventional or hybrid flow meters to maintain an oxygen saturation of ≥ 92% over a 12-week period. Every two weeks conventional and hybrid flow meters were switched. The overall oxygen delivery to the ward was continuously measured with a data logging device installed in the main oxygen pipeline and corrected for multiple confounding factors. Humidity measurements, for which a sensor placed in front of one of the nostrils, and patient questionnaires, were used to assess patient comfort during continuous and on-demand flow. Results: Overall oxygen delivery decreased by 39% when switching from continuous flow to on-demand therapy after correction for confounding factors. Continuous flows significantly decreased relative humidity more than equivalent on-demand settings and the latter tended to increase comfort. Conclusions: Hybrid flow meters cause a significant reduction in oxygen delivery in a hospital ward, which may lead to financial savings. Using the on-demand technology also lowers the dryness of the upper airways (and may increase patient comfort), while maintaining an adequate oxygenation.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"30 1","pages":"274 - 281"},"PeriodicalIF":2.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88344010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-26DOI: 10.1080/15412555.2022.2070062
Niuniu Li, Jianling Ma, Kun Ji, Liyun Wang
Abstract This study aimed to conduct a meta-analysis to investigate whether short-term exposure to fine (PM2.5) and coarse (PM10) particulate matter was associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalization, emergency room visit, and outpatient visit at different lag values. PubMed, Embase, and the Cochrane Library were searched for relevant papers published up to March 2021. For studies reporting results per 1-µg/m3 increase in PM2.5, the results were recalculated as per 10-µg/m3 increase. We manually calculated the RRs for these two studies and transferred the RRs to estimate 10 µg/m3 increases in PM2.5. Automation tools were initially used to remove ineligible studies. Two reviewers independently screened the remaining records and retrieved reports. Twenty-six studies (28 datasets; 7,018,419 patients) were included. There was a significant association between PM2.5 and AECOPD events on lag0 (ES = 1.01, 95%CI: 1.01-1.02, p < 0.001; I2=88.6%, Pheterogeneity<0.001), lag1 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=82.5%, Pheterogeneity<0.001), lag2 (ES = 1.01, 95%CI: 1.01-1.01, p < 0.001; I2=90.6%, Pheterogeneity<0.001), lag3 (ES = 1.01, 95%CI: 1.00-1.01, p < 0.001; I2=88.9%, Pheterogeneity<0.001), lag4 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=83.7%, Pheterogeneity<0.001), and lag7 (ES = 1.00, 95%CI: 1.00-1.00, p < 0.001; I2=0.0%, Pheterogeneity=0.743). The subgroup analyses showed that PM2.5 influenced the rates of hospitalization, emergency room visits, and outpatient visits. Similar trends were observed with PM10. The risk of AECOPD events (hospitalization, emergency room visit, and outpatient visit) was significantly increased with a 10-µg/m3 increment in PM2.5 and PM10 from lag0 to lag7. List Of Abbreviations: particulate matter (PM2.5 and PM10); acute exacerbation of chronic obstructive pulmonary disease (AECOPD); Chronic obstructive pulmonary disease (COPD); Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); Effect sizes [48]; confidence intervals (CIs)
摘要本研究旨在通过荟萃分析，探讨不同滞后值下短期暴露细颗粒物(PM2.5)和粗颗粒物(PM10)与慢性阻塞性肺疾病(AECOPD)急性加重期住院、急诊和门诊就诊是否相关。检索PubMed、Embase和Cochrane图书馆，检索截止到2021年3月发表的相关论文。对于报告PM2.5每增加1µg/m3结果的研究，结果按每增加10µg/m3重新计算。我们手动计算了这两项研究的相对危险度，并将相对危险度转移到PM2.5增加10微克/立方米的估计上。自动化工具最初用于删除不合格的研究。两个审阅者独立地筛选剩余的记录并检索报告。26项研究(28个数据集;包括7,018,419例患者)。PM2.5与lag0 AECOPD事件有显著相关性(ES = 1.01, 95%CI: 1.01 ~ 1.02, p < 0.001;I2=88.6%，异质性<0.001)，lag1 (ES = 1.00, 95%CI: 1.00-1.01, p <0.001;I2=82.5%，异质性<0.001)，lag2 (ES = 1.01, 95%CI: 1.01 ~ 1.01, p <0.001;I2=90.6%，异质性<0.001)，lag3 (ES = 1.01, 95%CI: 1.00-1.01, p <0.001;I2=88.9%，异质性<0.001)，lag4 (ES = 1.00, 95%CI: 1.00-1.01, p <0.001;I2=83.7%，异质性<0.001)，lag7 (ES = 1.00, 95%CI: 1.00-1.00, p <0.001;I2 = 0.0%, Pheterogeneity = 0.743)。亚组分析显示，PM2.5影响了住院率、急诊室就诊率和门诊就诊率。PM10也出现了类似的趋势。从lag0到lag7, PM2.5和PM10每增加10µg/m3, AECOPD事件(住院、急诊和门诊)的风险显著增加。缩写词列表:颗粒物(PM2.5、PM10);慢性阻塞性肺疾病急性加重(AECOPD);慢性阻塞性肺病(COPD);系统评价和荟萃分析(PRISMA)首选报告项目;效应量[48];置信区间(ci)
{"title":"Association of PM2.5 and PM10 with Acute Exacerbation of Chronic Obstructive Pulmonary Disease at lag0 to lag7: A Systematic Review and Meta-Analysis","authors":"Niuniu Li, Jianling Ma, Kun Ji, Liyun Wang","doi":"10.1080/15412555.2022.2070062","DOIUrl":"https://doi.org/10.1080/15412555.2022.2070062","url":null,"abstract":"Abstract This study aimed to conduct a meta-analysis to investigate whether short-term exposure to fine (PM2.5) and coarse (PM10) particulate matter was associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalization, emergency room visit, and outpatient visit at different lag values. PubMed, Embase, and the Cochrane Library were searched for relevant papers published up to March 2021. For studies reporting results per 1-µg/m3 increase in PM2.5, the results were recalculated as per 10-µg/m3 increase. We manually calculated the RRs for these two studies and transferred the RRs to estimate 10 µg/m3 increases in PM2.5. Automation tools were initially used to remove ineligible studies. Two reviewers independently screened the remaining records and retrieved reports. Twenty-six studies (28 datasets; 7,018,419 patients) were included. There was a significant association between PM2.5 and AECOPD events on lag0 (ES = 1.01, 95%CI: 1.01-1.02, p < 0.001; I2=88.6%, Pheterogeneity<0.001), lag1 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=82.5%, Pheterogeneity<0.001), lag2 (ES = 1.01, 95%CI: 1.01-1.01, p < 0.001; I2=90.6%, Pheterogeneity<0.001), lag3 (ES = 1.01, 95%CI: 1.00-1.01, p < 0.001; I2=88.9%, Pheterogeneity<0.001), lag4 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=83.7%, Pheterogeneity<0.001), and lag7 (ES = 1.00, 95%CI: 1.00-1.00, p < 0.001; I2=0.0%, Pheterogeneity=0.743). The subgroup analyses showed that PM2.5 influenced the rates of hospitalization, emergency room visits, and outpatient visits. Similar trends were observed with PM10. The risk of AECOPD events (hospitalization, emergency room visit, and outpatient visit) was significantly increased with a 10-µg/m3 increment in PM2.5 and PM10 from lag0 to lag7. List Of Abbreviations: particulate matter (PM2.5 and PM10); acute exacerbation of chronic obstructive pulmonary disease (AECOPD); Chronic obstructive pulmonary disease (COPD); Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); Effect sizes [48]; confidence intervals (CIs)","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"4 1 1","pages":"243 - 254"},"PeriodicalIF":2.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83712189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-23DOI: 10.1080/15412555.2022.2070465
C. Lavie, F. Sanchis-Gomar, I. Neeland
aJohn Ochsner heart and vascular institute, Ochsner Clinical school, the university of Queensland school of medicine, new Orleans, la, usa; bDepartment of Physiology, faculty of medicine, university of valencia and inCliva biomedical research institute, valencia, spain; cuh Center for Cardiovascular Prevention and Center for integrated and novel approaches in vascular-metabolic Disease (Cinema), harrington heart and vascular institute. university hospitals Cleveland medical Center. Case Western reserve university school of medicine, Cleveland, Oh, usa
{"title":"Body Composition and Pulmonary Diseases","authors":"C. Lavie, F. Sanchis-Gomar, I. Neeland","doi":"10.1080/15412555.2022.2070465","DOIUrl":"https://doi.org/10.1080/15412555.2022.2070465","url":null,"abstract":"aJohn Ochsner heart and vascular institute, Ochsner Clinical school, the university of Queensland school of medicine, new Orleans, la, usa; bDepartment of Physiology, faculty of medicine, university of valencia and inCliva biomedical research institute, valencia, spain; cuh Center for Cardiovascular Prevention and Center for integrated and novel approaches in vascular-metabolic Disease (Cinema), harrington heart and vascular institute. university hospitals Cleveland medical Center. Case Western reserve university school of medicine, Cleveland, Oh, usa","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"51 1","pages":"262 - 264"},"PeriodicalIF":2.2,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88222095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-20DOI: 10.1080/15412555.2022.2079485
V. Iamonti, Gerson F Souza, A. Castro, E. Porto, Lais G B Cruz, E. Colucci, M. Colucci, A. Sarmento, O. Nascimento, J. Jardim
Abstract Limited information is available regarding the role of anaerobic metabolism capacity on GOLD 1 and 2 COPD patients during upper limb exercise. We aimed to compare the upper limb anaerobic power capacity, blood lactate concentration, cardiovascular and respiratory responses, in male COPD patients versus healthy subjects during the 30-s Wingate anaerobic test (WAnT). The rate of fatigue and time constant of the power output decay (τ, tau) were also calculated and a regression analysis model was built to assess the predictors of τ in these patients. Twenty-four male COPD patients (post-bronchodilator FEV1 73.2 ± 15.3% of predicted) and 17 healthy subjects (FEV1 103.5 ± 10.1% of predicted) underwent the WAnT. Measurements were performed at rest, at the end of the WAnT, and during 3′ and 5′ of recovery time. Peak power (p = 0.04), low power (p = 0.002), and mean power output (p = 0.008) were significantly lower in COPD patients than in healthy subjects. Power output decreased exponentially in both groups, but at a significantly faster rate (p = 0.007) in COPD patients. The time constant of power decay was associated with resistance (in ohms) and fat-free mass (r 2 = 0.604, adjusted r 2 = 0.555, and p = 0.002). Blood lactate concentration was significantly higher in healthy subjects at the end of the test, as well as during 3′ and 5′ of recovery time (p < 0.01). Compared with healthy subjects, COPD patients with GOLD 1 and 2 presented lower upper limb anaerobic capacity and a faster rate of power output decrease during a maximal intensity exercise. Also, the WAnT proved to be a valid tool to measure the upper limb anaerobic capacity in these patients.
{"title":"Upper Limb Anaerobic Metabolism Capacity is Reduced in Mild and Moderate COPD Patients","authors":"V. Iamonti, Gerson F Souza, A. Castro, E. Porto, Lais G B Cruz, E. Colucci, M. Colucci, A. Sarmento, O. Nascimento, J. Jardim","doi":"10.1080/15412555.2022.2079485","DOIUrl":"https://doi.org/10.1080/15412555.2022.2079485","url":null,"abstract":"Abstract Limited information is available regarding the role of anaerobic metabolism capacity on GOLD 1 and 2 COPD patients during upper limb exercise. We aimed to compare the upper limb anaerobic power capacity, blood lactate concentration, cardiovascular and respiratory responses, in male COPD patients versus healthy subjects during the 30-s Wingate anaerobic test (WAnT). The rate of fatigue and time constant of the power output decay (τ, tau) were also calculated and a regression analysis model was built to assess the predictors of τ in these patients. Twenty-four male COPD patients (post-bronchodilator FEV1 73.2 ± 15.3% of predicted) and 17 healthy subjects (FEV1 103.5 ± 10.1% of predicted) underwent the WAnT. Measurements were performed at rest, at the end of the WAnT, and during 3′ and 5′ of recovery time. Peak power (p = 0.04), low power (p = 0.002), and mean power output (p = 0.008) were significantly lower in COPD patients than in healthy subjects. Power output decreased exponentially in both groups, but at a significantly faster rate (p = 0.007) in COPD patients. The time constant of power decay was associated with resistance (in ohms) and fat-free mass (r 2 = 0.604, adjusted r 2 = 0.555, and p = 0.002). Blood lactate concentration was significantly higher in healthy subjects at the end of the test, as well as during 3′ and 5′ of recovery time (p < 0.01). Compared with healthy subjects, COPD patients with GOLD 1 and 2 presented lower upper limb anaerobic capacity and a faster rate of power output decrease during a maximal intensity exercise. Also, the WAnT proved to be a valid tool to measure the upper limb anaerobic capacity in these patients.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"15 1","pages":"265 - 273"},"PeriodicalIF":2.2,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75647015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/15412555.2022.2072720
Jia-Jia Liu, Lin Liu, Hong-Hong Mu, Jia-yi Li, Lin Xu, Yaozong Wu, Benben Li, Ye Zhang, Xiang‐yan Zhang, Xian-wei Ye, Cheng Zhang
Abstract Our previous study suggested that hypomethylation of perforin promoter of CD4 + T cells might be involved in the pathogenesis of autoimmune emphysema of rats. Whether transfer of this kind of cells hypomethylated in vitro into naive immunocompetent rats also results in emphysema is unknown yet. To test the hypothesis above, thirty Sprague Dawley (SD) rats were randomly divided into three groups: a model group (n = 10), a normal control group (n = 10) and a sham operation group (n = 10). In the model group, spleen-derived CD4 + T cells of normal rats were treated with 5-azacytidine (5-Aza), complete Freund’s adjuvant and Phosphate Buffered Saline (PBS), then transferred into naive immunocompetent rats. The normal control group was injected with CD4 + T lymphocytes from spleens of normal rats and the same amount of adjuvant and PBS as above. In sham operation group, normal rats were injected intraperitoneally with complete Freund’s adjuvant and PBS. Histopathological evaluations (mean linear Intercept (MLI) and mean alveolar numbers (MAN)), anti-endothelial cell antibodies (AECA) in serum and bronchoalveolar lavage fluid (BALF), lung vascular endothelial growth factor (VEGF)), the apoptotic index (AI) of alveolar septal cells and the methylation levels of perforin promoter of CD4 + T cells were investigated. The levels of the methylation above and MAN were lower in the model group than in the control and the sham operation group, while the AECA in serum and BALF, VEGF, MLI and the AI were greater (all p < 0.05). The methylation levels of perforin promoter were positively correlated with the MAN (r = 0.747, p < 0.05) and negatively correlated with AI, AECA, MLI, and VEGF (r was −0.789, −0.746, −0.743, −0.660, respectively, all p < 0.05). This study suggests that transfer of invitro CD4 + T cells with hypomethylation of perforin promoter into rats causes autoimmune emphysema, possibly by increasing expression of VEGF and promoting alveolar septal cell apoptosis.
{"title":"Transfer of Invitro CD4 + T Cells with Hypomethylation of Perforin Promoter into Rats’ Abdomens Causes Autoimmune Emphysema","authors":"Jia-Jia Liu, Lin Liu, Hong-Hong Mu, Jia-yi Li, Lin Xu, Yaozong Wu, Benben Li, Ye Zhang, Xiang‐yan Zhang, Xian-wei Ye, Cheng Zhang","doi":"10.1080/15412555.2022.2072720","DOIUrl":"https://doi.org/10.1080/15412555.2022.2072720","url":null,"abstract":"Abstract Our previous study suggested that hypomethylation of perforin promoter of CD4 + T cells might be involved in the pathogenesis of autoimmune emphysema of rats. Whether transfer of this kind of cells hypomethylated in vitro into naive immunocompetent rats also results in emphysema is unknown yet. To test the hypothesis above, thirty Sprague Dawley (SD) rats were randomly divided into three groups: a model group (n = 10), a normal control group (n = 10) and a sham operation group (n = 10). In the model group, spleen-derived CD4 + T cells of normal rats were treated with 5-azacytidine (5-Aza), complete Freund’s adjuvant and Phosphate Buffered Saline (PBS), then transferred into naive immunocompetent rats. The normal control group was injected with CD4 + T lymphocytes from spleens of normal rats and the same amount of adjuvant and PBS as above. In sham operation group, normal rats were injected intraperitoneally with complete Freund’s adjuvant and PBS. Histopathological evaluations (mean linear Intercept (MLI) and mean alveolar numbers (MAN)), anti-endothelial cell antibodies (AECA) in serum and bronchoalveolar lavage fluid (BALF), lung vascular endothelial growth factor (VEGF)), the apoptotic index (AI) of alveolar septal cells and the methylation levels of perforin promoter of CD4 + T cells were investigated. The levels of the methylation above and MAN were lower in the model group than in the control and the sham operation group, while the AECA in serum and BALF, VEGF, MLI and the AI were greater (all p < 0.05). The methylation levels of perforin promoter were positively correlated with the MAN (r = 0.747, p < 0.05) and negatively correlated with AI, AECA, MLI, and VEGF (r was −0.789, −0.746, −0.743, −0.660, respectively, all p < 0.05). This study suggests that transfer of invitro CD4 + T cells with hypomethylation of perforin promoter into rats causes autoimmune emphysema, possibly by increasing expression of VEGF and promoting alveolar septal cell apoptosis.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"35 1","pages":"255 - 261"},"PeriodicalIF":2.2,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79718092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.1080/15412555.2022.2069554
Jaimy Klijnhout, D. Mannée, M. M. van den Heuvel, B. van den Borst, H. van Helvoort
Abstract Home-based lung function measurements can be used to capture day-to-day variations in symptoms in patients with chronic obstructive pulmonary disease (COPD). Although dynamic hyperinflation (DH) is clinically relevant, existing home-based measurements do not include its assessment. DH can be measured through inspiratory capacity (IC) measurements before and after metronome-paced tachypnea test (MPT). The goal of this study is to determine the accuracy of unsupervised home-based IC and DH measurements in COPD. Sixteen COPD patients performed IC and DH measurements during 4 home visits. Visit 1 was considered a training session. During all visits supervised and unsupervised IC at rest (ICREST) and after MPT (ICMPT) were measured. DH was calculated as the difference between ICREST and ICMPT, and as a percentage of ICREST. Bland-Altman analyses and ANOVA tests were performed to determine the effect of supervision and repeated measures over time. The biases between supervised and unsupervised ICREST, ICMPT, ΔIC and ΔIC% were 0.007 L, 0.007 L, 0 mL and −0.09% in the last visit, respectively. Limits of agreement of ICREST and ΔIC% decreased from ±0.261 mL to ±0.201 mL, and from ±13.84% to ±10.81% between visit 1 and 4, respectively. No significant effect of supervision or over time was found. After a robust training and a learning phase, COPD patients are able to perform IC measurements in an accurate manner in both rest and after MPT. This yield accurate assessment of DH, in an unsupervised home-based setting.
{"title":"Patients with Chronic Obstructive Pulmonary Disease Can Accurately Perform Home-Based Measurements of Inspiratory Capacity and Dynamic Hyperinflation","authors":"Jaimy Klijnhout, D. Mannée, M. M. van den Heuvel, B. van den Borst, H. van Helvoort","doi":"10.1080/15412555.2022.2069554","DOIUrl":"https://doi.org/10.1080/15412555.2022.2069554","url":null,"abstract":"Abstract Home-based lung function measurements can be used to capture day-to-day variations in symptoms in patients with chronic obstructive pulmonary disease (COPD). Although dynamic hyperinflation (DH) is clinically relevant, existing home-based measurements do not include its assessment. DH can be measured through inspiratory capacity (IC) measurements before and after metronome-paced tachypnea test (MPT). The goal of this study is to determine the accuracy of unsupervised home-based IC and DH measurements in COPD. Sixteen COPD patients performed IC and DH measurements during 4 home visits. Visit 1 was considered a training session. During all visits supervised and unsupervised IC at rest (ICREST) and after MPT (ICMPT) were measured. DH was calculated as the difference between ICREST and ICMPT, and as a percentage of ICREST. Bland-Altman analyses and ANOVA tests were performed to determine the effect of supervision and repeated measures over time. The biases between supervised and unsupervised ICREST, ICMPT, ΔIC and ΔIC% were 0.007 L, 0.007 L, 0 mL and −0.09% in the last visit, respectively. Limits of agreement of ICREST and ΔIC% decreased from ±0.261 mL to ±0.201 mL, and from ±13.84% to ±10.81% between visit 1 and 4, respectively. No significant effect of supervision or over time was found. After a robust training and a learning phase, COPD patients are able to perform IC measurements in an accurate manner in both rest and after MPT. This yield accurate assessment of DH, in an unsupervised home-based setting.","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"25 1","pages":"236 - 242"},"PeriodicalIF":2.2,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72784738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-26DOI: 10.1080/15412555.2022.2061935
J. Jalasto, P. Kauppi, R. Luukkonen, A. Lindqvist, A. Langhammer, H. Kankaanranta, H. Backman, E. Rönmark, A. Sovijärvi, P. Piirilä
Abstract Asthma and COPD are common chronic obstructive respiratory diseases. COPD is associated with increased mortality, but for asthma the results are varying. Their combination has been less investigated, and the results are contradictory. The aim of this prospective study was to observe the overall mortality in obstructive pulmonary diseases and how mortality was related to specific causes using postal questionnaire data. This study included data from 6,062 participants in the FinEsS Helsinki Study (1996) linked to mortality data during a 24-year follow-up. According to self-reported physician diagnosed asthma, COPD, or smoking status, the population was divided into five categories: combined asthma and COPD, COPD alone and asthma alone, ever-smokers without asthma or COPD and never-smokers without asthma or COPD (reference group). For the specific causes of death both the underlying and contributing causes of death were used. Participants with asthma and COPD had the highest hazard of mortality 2.4 (95% CI 1.7–3.5). Ever-smokers without asthma or COPD had a 9.5 (3.7–24.2) subhazard ratio (sHR) related to lower respiratory tract disease specific causes. For asthma, COPD and combined, the corresponding figures were 10.8 (3.4–34.1), 25.0 (8.1–77.4), and 56.1 (19.6–160), respectively. Ever-smokers without asthma or COPD sHR 1.7 (95% CI 1.3–2.5), and participants with combined asthma and COPD 3.5 (1.9–6.3) also featured mortality in association with coronary artery disease. Subjects with combined diseases had the highest hazard of overall mortality and combined diseases also showed the highest hazard of mortality associated with lower respiratory tract causes or coronary artery causes. Abbreviations: Cig Cigarette COPD Chronic obstructive pulmonary disease CVD Cardiovascular disease FEV1 Forced Expiratory Volume in one second FVC Forced Vital Capacity FinEsS Finland, Estonia, and Sweden study on chronic obstructive pulmonary diseases HR Hazard Ratio sHR Subhazard Ratio ICD-10 International Statistical Classifications of Diseases and Related Health Problems (Version 10)
哮喘和COPD是常见的慢性阻塞性呼吸系统疾病。慢性阻塞性肺病与死亡率增加有关，但对于哮喘，结果是不同的。他们的结合很少被调查，结果是矛盾的。本前瞻性研究的目的是观察阻塞性肺疾病的总体死亡率，以及死亡率与特定原因的关系。这项研究包括了FinEsS赫尔辛基研究(1996)中6062名参与者的数据，这些数据与24年随访期间的死亡率数据有关。根据自我报告的医生诊断的哮喘、COPD或吸烟状况，将人群分为五类:合并哮喘和COPD、单独COPD和单独哮喘、不患有哮喘或COPD的吸烟者和不患有哮喘或COPD的不吸烟者(参照组)。对于具体死亡原因，既使用了根本死亡原因，也使用了促成死亡原因。哮喘和COPD患者的死亡率最高，为2.4 (95% CI 1.7-3.5)。没有哮喘或COPD的吸烟者与下呼吸道疾病特定原因相关的亚危险比(sHR)为9.5(3.7-24.2)。哮喘、慢性阻塞性肺病及合并哮喘的相应数字分别为10.8(3.4-34.1)、25.0(8.1-77.4)、56.1(19.6-160)。无哮喘或COPD的吸烟者的sHR为1.7 (95% CI 1.3-2.5)，合并哮喘和COPD的参与者的sHR为3.5(1.9-6.3)，其死亡率也与冠状动脉疾病相关。合并疾病的受试者总体死亡率最高，合并疾病也显示出与下呼吸道原因或冠状动脉原因相关的死亡率最高。简写:香烟COPD慢性阻塞性肺疾病CVD心血管疾病FEV1用力呼气一秒容积FVC用力肺活量FinEsS芬兰、爱沙尼亚、瑞典慢性阻塞性肺疾病研究HR危险比sHR亚危险比国际疾病及相关健康问题统计分类(第10版)
{"title":"Self-Reported Physician Diagnosed Asthma with COPD is Associated with Higher Mortality than Self-Reported Asthma or COPD Alone – A Prospective 24-Year Study in the Population of Helsinki, Finland","authors":"J. Jalasto, P. Kauppi, R. Luukkonen, A. Lindqvist, A. Langhammer, H. Kankaanranta, H. Backman, E. Rönmark, A. Sovijärvi, P. Piirilä","doi":"10.1080/15412555.2022.2061935","DOIUrl":"https://doi.org/10.1080/15412555.2022.2061935","url":null,"abstract":"Abstract Asthma and COPD are common chronic obstructive respiratory diseases. COPD is associated with increased mortality, but for asthma the results are varying. Their combination has been less investigated, and the results are contradictory. The aim of this prospective study was to observe the overall mortality in obstructive pulmonary diseases and how mortality was related to specific causes using postal questionnaire data. This study included data from 6,062 participants in the FinEsS Helsinki Study (1996) linked to mortality data during a 24-year follow-up. According to self-reported physician diagnosed asthma, COPD, or smoking status, the population was divided into five categories: combined asthma and COPD, COPD alone and asthma alone, ever-smokers without asthma or COPD and never-smokers without asthma or COPD (reference group). For the specific causes of death both the underlying and contributing causes of death were used. Participants with asthma and COPD had the highest hazard of mortality 2.4 (95% CI 1.7–3.5). Ever-smokers without asthma or COPD had a 9.5 (3.7–24.2) subhazard ratio (sHR) related to lower respiratory tract disease specific causes. For asthma, COPD and combined, the corresponding figures were 10.8 (3.4–34.1), 25.0 (8.1–77.4), and 56.1 (19.6–160), respectively. Ever-smokers without asthma or COPD sHR 1.7 (95% CI 1.3–2.5), and participants with combined asthma and COPD 3.5 (1.9–6.3) also featured mortality in association with coronary artery disease. Subjects with combined diseases had the highest hazard of overall mortality and combined diseases also showed the highest hazard of mortality associated with lower respiratory tract causes or coronary artery causes. Abbreviations: Cig Cigarette COPD Chronic obstructive pulmonary disease CVD Cardiovascular disease FEV1 Forced Expiratory Volume in one second FVC Forced Vital Capacity FinEsS Finland, Estonia, and Sweden study on chronic obstructive pulmonary diseases HR Hazard Ratio sHR Subhazard Ratio ICD-10 International Statistical Classifications of Diseases and Related Health Problems (Version 10)","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"226 - 235"},"PeriodicalIF":2.2,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83215292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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