Life In Chronic Obstructive Pulmonary Disease Patients Research Articles

Periodontal status and chronic obstructive pulmonary disease (COPD)\xa0exacerbations: a systematic review

BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal status and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations.MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life (QoL) and hospitalisation. Quality and risk of bias assessment were carried out using the Newcastle Ottawa Scale for observational studies, Robins-1 tool for non-randomised intervention studies and Cochrane risk of bias assessment (RoB-2) tool for randomised clinical trials. Studies were assessed for eligibility and quality by two assessors independently.ResultsSearches identified 532 records and 8 met the inclusion criteria. Included studies were three clinical trials, one prospective cohort study, one case–control, and three cross-sectional studies. A narrative synthesis was performed. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores and fewer teeth with exacerbation, but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of a high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations, hospitalisation and quality of life in COPD patients. The evidence is of moderate to low certainty and is limited by high risk of bias suggesting the need for well-designed and adequately powered randomised controlled trials, to inform future research and clinical practice.The PROSPERO registration number CRD42020180328.

Impact of Lung Function and Exacerbations on Health-Related Quality of Life in COPD Patients Within One Year: Real-World Analysis Based on Claims Data.

PurposeReal-world evidence on the impact of forced expiratory volume in one second (FEV1) and exacerbations on health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) is sparse especially with regard to GOLD ABCD groups. This study investigates how changes in FEV1 and exacerbations affect generic and disease-specific HRQoL in COPD patients over one year.MethodsUsing German claims data and survey data, we classified 3016 COPD patients and analyzed their health status by GOLD groups AB and CD. HRQoL was measured with the disease-specific COPD assessment test (CAT) and the visual analog scale (VAS) from the generic Euro-Qol 5D-5L. We applied change score models to assess associations between changes in FEV1 (≥100 mL decrease/no change/≥100 mL increase) or the development of severe exacerbations with change in HRQoL.ResultsFEV1 decrease was associated with a significant but not minimal important difference (MID) deterioration in disease-specific HRQoL (mean change [95% CI]: CAT +0.74 [0.15 to 1.33]), while no significant change was observed in the generic VAS. Experiencing at least one severe exacerbation also had a significant impact on CAT deterioration (+1.58 [0.52 to 2.64]), but again not on VAS. Here, GOLD groups AB showed not only a statistically but also a clinically relevant MID deterioration in CAT (+2.1 [0.88 to 3.32]). These particular patient groups were further characterized by a higher probability of being male, having a higher mMRC and Charlson index, and a lower probability of having higher FEV1 or BMI values.ConclusionFEV1 decline and the occurrence of ≥1 severe exacerbation are significantly associated with overall deterioration in disease-specific HRQoL. Preventing severe exacerbations particularly in patients without previous severe exacerbations (ABCD groups A and B) may help to stabilize the key patient-reported outcome HRQoL.

Гипотиреоз и хроническая обструктивная болезнь легких

Риск хронической обструктивной болезни легких (ХОБЛ), а также заболеваний щитовидной железы увеличивается с возрастом. ХОБЛ — общее системное заболевание, связанное с хроническим воспалением. Много эндокринологических расстройств, включая заболевания щитовидной железы, связаны с системным воспалением. Эпидемиологические исследования показывают, что у пациентов с ХОБЛ повышенный риск расстройств щитовидной железы. Эти ассоциации недостаточно изучены, и тиреоидные заболевания не включены в общепризнанный список сопутствующих заболеваний ХОБЛ. В то же время они могут значительно ухудшить качество жизни больных ХОБЛ. К сожалению, диагностика довольно тяжелая, поскольку многие признаки маскируются симптомами основного заболевания. Выяснение корреляции между заболеваниями щитовидной железы и ХОБЛ будет способствовать лучшей помощи лицам с такой патологией. В этом обзоре проанализирована доступная литература, описывающая существующие связи между ХОБЛ и заболеваниями щитовидной железы. Признаки или симптомы пониженной функции щитовидной железы могут быть неспецифическими, особенно среди пожилых людей, поэтому дифференциальная диагностика между симптомами ХОБЛ и симптомами, связанными с заболеваниями щитовидной железы, может вызвать трудности. Многие данные свидетельствуют о более высоком риске изменения функционального состояния щитовидной железы у больных ХОБЛ. Гипотиреоз может влиять на дыхательную функцию разными механизмами, даже у лиц с интактной дыхательной системой. Поэтому трудно различить, являются гормональные изменения причиной или следствием различных признаков и симптомов нарушения дыхания. В некоторых случаях коррекция гормональных изменений может улучшить качество жизни больных ХОБЛ и другие последствия заболевания. Установление взаимосвязей между ХОБЛ, функцией щитовидной железы и тиреоидными расстройствами может предоставить важную информацию о системной природе ХОБЛ.

Benefits, for patients with late stage chronic obstructive pulmonary disease, of being cared for in specialized palliative care compared to hospital. A nationwide register study

BackgroundIn early stage chronic obstructive pulmonary disease (COPD), dyspnea has been reported as the main symptom; but at the end of life, patients dying from COPD have a heavy symptom burden. Still, specialist palliative care is seldom offered to patients with COPD; they more often receive end of life care in hospitals. Furthermore, symptoms, symptom relief and care activities in the last week of life for COPD patients are rarely studied. The aim of this study was to compare patient and care characteristics in late stage COPD patients treated in specialized palliative care (SPC) versus hospital.MethodsTwo nationwide registers were merged, the Swedish National Airway Register (SNAR) and the Swedish Register of Palliative Care (SRPC). Patients with COPD and < 50% of predicted forced expiratory volume in 1 s (FEV1), who had died in inpatient or outpatient SPC (n = 159) or in hospital (n = 439), were identified. Clinical COPD characteristics were extracted from the SNAR, and end of life (EOL) care characteristics from the SRPC. Descriptive statistics were used to describe the sample and the registered care and treatments. Independent samples t-test, Mantel–Haenszel chi-square test and Fisher’s exact test was used to compare variables. To examine predictors of place of death, bivariate and multivariate logistic regression analyses were performed with a dependent variable with demographic and clinical variables used as independent variables.ResultsThe patients in hospitals were older and more likely to have heart failure or hypertension. Pain was more frequently reported and relieved in SPC than in hospitals (p = 0.001). Rattle, anxiety, delirium and nausea were reported at similar frequencies between the settings; but rattle, anxiety, delirium, and dyspnea were more frequently relieved in SPC (all p < 0.001). Compared to hospital, SPC was more often the preferred place of care (p < 0.001). In SPC, EOL discussions with patients and families were more frequently held than in hospital (p < 0.001). Heart failure increased the probability of dying in hospital while lung cancer increased the probability of dying in SPC.ConclusionThis study provides evidence for referring more COPD patients to SPC, which is more focused on symptom management and psychosocial and existential support.

Self-Management and Integrated Pulmonary Care As an Essential Part of Treatment of Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common, chronic and progressive disease that is a major public health problem worldwide. Treatment for stable COPD relies on pharmacological and non-pharmacological procedures. Education, self-management interventions and personalized pulmonary rehabilitation should be part of chronic care for patients with COPD at all stages of their disease. The comprehensive care should be provided by integrated pulmonary care based on pulmonary centers and a multidisciplinary team to all patients with COPD. Holistic approach to the patient with COPD and his involvement in therapy and working closely with healthcare professionals will improve quality of life of COPD patients. It also modifies the course of the disease, prevents progression and may reduce the frequency of exacerbations. In this article, we present the proposed model of integrated pulmonary care, structures necessary for multidisciplinary treatment and self-management intervention as essential elements in the treatment of patients with COPD.

Effects of the Health Belief Model-Based Intervention on Anxiety, Depression, and Quality of Life in Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition. COPD causes a heavy burden on the patients through negative impacts on the quality of life and psychological health. The health belief model (HBM) is proposed and modified by several social psychologists and is confirmed to have benefits in the recovery of various diseases. This research aimed to explore the effects of the HBM-based intervention on anxiety, depression, and quality of life in COPD patients entering pulmonary rehabilitation (PR). Methods: This research was conducted at the Tianjin Rehabilitation Recuperate Center of Chinese PLA in 2019. A total of 136 COPD patients were randomized into the intervention group and the control group. In the control group, patients received the PR program. In the intervention group, patients received both PR program and the HBM-based intervention. Quality of life was measured by the COPD assessment test. The outcomes of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Results: The HBM-based intervention decreased both anxiety and depression scores among COPD patients. The COPD assessment test score was declined by the HBM-based intervention, which also decreased the serum levels of interleukin-6 and C-reactive protein in COPD patients entering PR. Conclusion: The HBM-based intervention alleviates anxiety and depression, enhances quality of life, and inhibits inflammation in COPD patients entering PR.

The Effects of the Home-based Self-care Program Follow-up on Re-hospitalization Frequency and Quality of Life in Patients With Chronic Obstructive Pulmonary Disease

Objectives: Chronic Obstructive Pulmonary Disease (COPD) impacts the quality of life of the affected patients. The present study aimed to determine the effects of home-based self-care program follow-up on re-hospitalization frequency and quality of life in COPD patients. Methods: This quasi-experimental study was performed on 44 COPD patients at Masih Daneshvari Hospital in Tehran City, Iran, in 2018. For collecting the necessary data, we used demographic data checklist, COPD Assessment Test, and the St. George’s Quality of Life questionnaire. We used SPSS v. 22 for analyzing the obtained data. Results: The present study revealed that the highest age frequency was in the 61-70 years age group. Moreover, the male gender had the highest frequency and most research participants had elementary school education; the highest frequency regarding the disease duration was &gt;5 years. Besides and the hospitalization frequency was once a year. The present study findings indicated that the provided self-care program follow-up reduced the re-hospitalization frequency and increased the quality of life of the explored COPD patients (P&lt;0.001). Discussion: The obtained results revealed that implementing a course of home-based follow-up self-care program could reduce re-hospitalization and increase the quality of life of COPD patients; thus, it is suggested that such follow-up programs be included in COPD treatment plans.

The Effect of Religious Coping on the Satisfaction with Life Among Turkish Patients with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) with life-threatening features due to uncomfortable symptoms such as dyspnea decreases satisfaction with life. This study aims to determine the effect of religious coping methods on satisfaction with life in patients with COPD in Turkey. This descriptive and cross-sectional study was conducted with patients who had COPD for at least a year (n = 149). The positive religious coping levels of the patients were high while their negative religious coping levels were low and their levels of satisfaction with life were below average. A positive correlation was found between the positive religious coping levels and satisfaction with life of the patients (p < 0.05). The patients' age, general health levels, economic status, state of meeting their daily needs and usage of positive religious coping were the factors that significantly affected their levels of satisfaction with life, and these factors explained 38% of the total variance in the patients' satisfaction with life. It is important to evaluate religious coping in increasing the satisfaction with life of COPD patients who receive treatment in health institutions.

The effect of Tai Chi on the pulmonary rehabilitation of chronic obstructive pulmonary disease: a systematic review and meta-analysis.

The effectiveness of Tai Chi for chronic obstructive pulmonary disease (COPD) so far is unclear. The present systematic review aimed to determine the influence of Tai Chi among people with COPD. We searched six electronic databases for relevant studies in September, 2019. The methods of standard meta-analysis were used for identifying relevant studies, quality appraisal, and synthesis. The primary outcomes were six-minute walking distance (6MWD), percentage predicted forced expiratory flow volume in the first second (%PredFEV1), and St. George's Respiratory Questionnaire (SGRQ) score. A total of 23 studies including 1663 participants were included in the meta-analysis. The pooled data showed that the Tai Chi group was associated with a significant improvement in 6MWD [mean difference (MD) 40.83 m, 95% CI: 32.47 to 49.19], %PredFEV1 (MD 1.67%, 95% CI: 0.41 to 2.93), SGRQ score (MD -6.57, 95% CI: -10.17 to -2.98), and Chronic Respiratory Disease Questionnaire (CRQ) (MD 1.60, 95% CI: 0.89 to 2.30) relative to the blank control population. When compared with breathing exercises, the 6MWD was significantly enhanced with Tai Chi (MD 14.15 m, 95% CI: 3.76 to 24.53). Finally, when compared with breathing and walking exercises, Tai Chi was associated with a significant improvement in 6MWD (MD 7.68 m, 95% CI: 2.28 to 13.09 m) and SGRQ score (MD -6.31, 95% CI: -9.13 to -1.48). Tai Chi may have the potential to reduce dyspnoea, enhance exercise capacity, and improve the quality of life in COPD patients. People with COPD may obtain benefit from practicing Tai Chi.

Musculoskeletal Disorders in Chronic Obstructive Airway Diseases: A Neglected Clinical Entity.

Chronic obstructive pulmonary disease (COPD) is a lung disease that can affect various extra-pulmonary organs; one being the musculoskeletal system. Skeletal muscle dysfunction and osteoporosis are two important musculoskeletal disorders that have an impact on the quality of life in COPD patients in terms of morbidity and mortality. Treatment related adverse effects of COPD such as steroid-induced myopathy and osteoporosis are well recognised. Other comorbidities like sarcopenia, cardiovascular disease, metabolic diseases (diabetes mellitus, obesity, and thyroid diseases), chronic kidney disease, sleep apnoea, anaemia, and depression are also noted, which can contribute to impaired health status, increased healthcare utilisation, and even mortality. As well, it has been shown that autoimmunity and autoimmune rheumatic diseases (AIRDs) are linked to COPD. In this mini-review, we intend to give an overview of different types of musculoskeletal disorders associated with COPD.

Periodontal Status, Its Treatment Needs, and Its Relationship with Airflow Limitation and Quality of Life in COPD Patients.

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent respiratory diseases in the world. There is an impressive relationship between periodontal status and airflow limitation in patients with COPD. Therefore, in this study, we aimed to investigate the periodontal status, its treatment needs, and its relationship with the severity of airway obstruction and quality of life in patients with COPD. In this case-control study, 36 healthy men (control group) and 35 men afflicted with COPD (case group) were investigated. On the basis of spirometry results and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, patients with COPD were further divided into 4 groups. The participants' quality of life was evaluated using COPD Assessment Test (CAT) questionnaire. Thereafter, both groups of participants were referred to a dentistry clinic so that the related specialist could investigate their periodontal health status. The relationship between the periodontal indices and the variables under study including GOLD stage, CAT score, Forced Expiratory Volume in first second and Forced Vital Capacity (FEV1/FVC) ratio, Forced Expiratory Volume in first second (FEV1), and the exacerbation rate were statistically analyzed using independent t-test, one-way analysis of variance, Tukey's test, and Pearson correlation coefficient. The results revealed that probing pocket depth (PDD), bleeding on probing (BOP), and loss of attachment (LOA) are negatively correlated with FEV1% (r=-0.53, p=0.001), (r=-0.62, p=0.001), and (r=-0.72, p=0.001) as well as FEV1/FVC ratio (r=-0.45, p=0.007), (r=-0.47, p=0.004), and (r=-0.61, p=0.001), respectively. The results showed that PDD, BOP, and LOA are positively correlated with CAT score (r=0.51, p=0.002), (r=0.47, p=0.004), and (r=0.71, p=0.001), respectively. Periodontal problems are positively associated with COPD severity as determined by GOLD criteria and negatively associated with quality of life of patients with COPD.

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia \u2013 a cross-sectional study

BackgroundThe Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients’ health-related quality of life (HRQoL) according to their COPD phenotypes.MethodsThis was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c).ResultsOf 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers.The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p < 0.001). There were significantly more patients with mMRC 2–4 among AE (68.6%) (p < 0.001), compared to those with ACO (38.5%) and NON-AE (16.7%). AE patients had significantly higher total CAT (p = 0.003; p < 0.001) and SGRQ-c (both p < 0.001) scores than those with ACO and NON-AE. Patients with ACO had significantly higher total CAT and SGRQ-c (both p < 0.001) scores than those with NON-AE.AE patients had significantly higher score in each item of CAT and component of SGRQ-c compared to those with NON-AE (all p < 0.001), and ACO [(p = 0.003–0.016; p = < 0.001–0.005) except CAT 1, 2 and 7. ACO patients had significantly higher score in each item of CAT and component of SGRQ-c (p = < 0.001–0.040; p < 0.001) except CAT 2 and activity components of SGRQ-c.ConclusionsThe HRQoL of COPD patients was significantly different across different COPD phenotypes. HRQoL was worst in AE, followed by ACO and NON-AE. This study supports phenotyping COPD patients based on their exacerbation frequency and COPD subtypes. The treatment of COPD should be personalised according to these two factors.

THE ROLE OF PULMONARY REHABILITATION IN ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective: Chronic obstructive pulmonary disease (COPD) reduces lung function and generates systemic effects that decrease the quality of life. COPD is a major cause of chronic morbidity and mortality worldwide. Pulmonary rehabilitation can reduce symptoms of dyspnea and improve exercise capacity and quality of life in COPD patients.&#x0D; Methods: We report a case of a 60 y old male with an acute exacerbation (AE) of COPD and pneumonia. The inpatient pulmonary rehabilitation program was 5 consecutive days of 3 repetitions of cough control, 2 sets of 6 repetitions of pursed-lip breathing, 2 sets of 6 repetitions of deep breathing exercises, postural drainage, and manual clapping twice daily. Postural drainage in the lateral basal segment and manual clapping in the right lower lobe was chosen according to the chest x-ray (CXR).&#x0D; Results: At the initial visit, the following information was noted: inspiration capacity with incentive spirometry, 600 cc/s; chest expansion, 1.5 cm; and single-breath counting (SBC), 11. The activities of daily living (ADL) score according to the Barthel Index was 70, and CXR results showed COPD and pneumonia in the right lower lobe. After 5 d of pulmonary rehabilitation, there was a clear airway and improvement in shortness of breath (SOB), and the following was noted: incentive spirometry, 900 cc/s; chest expansion, 2 cm; SBC, 20; and Barthel Index score, 100.&#x0D; Conclusion: Early inpatient pulmonary rehabilitation in COPD AEs is clinically effective and safe, controls breathing and coughing, strengthens the respiratory muscles, and improves the clearing of the airway, which improves the patient’s pulmonary function capacity and quality of life.

Predicting Quality of Life in Chronic Obstructive Pulmonary Disease Patients Living in the Rural Area of Chiang Mai Province, Thailand

Background: Chronic Obstructive Pulmonary Disease (COPD) becomes burdensome and reduces the quality of life in COPD patients and their families. Understanding the factors affecting the quality of life could improve the process of care and treatment of these patients. Therefore, this study aimed to investigate the factors that influence and can predict the quality of life in COPD patients. Methods: A total of 281 COPD patients were included and analyzed by spirometry measurement, BODE index and its components (body mass index; BMI, forced expiratory volume in one second % predicted; FEV1%predicted, dyspnea score of the modified Medical Research Council; mMRC, and distance in the six-minute walking test; 6MWT).Quality of life was assessed by the St. George’s Respiratory Questionnaire (SGRQ). Results: The total SGRQ score was 42.1±17.4. The mMRC dyspnea score, ABCD group classification of COPD and BODE index moderately correlated with the total SGRQ score. Weak correlations were found between BMI, FEV1%predicted and 6MWT. Multiple regression analysis showed that the mMRC dyspnea score, BODE index, age, and COPD group D were important predictors of quality of life in COPD patients with R2 of 0.467. Conclusion: The mMRC dyspnea score, BODE index, age, and COPD group D could predict the quality of life in the COPD patients in this study.

Effects of neuromuscular electrical stimulation on exercise capacity and quality of life in COPD patients: a systematic review and meta-analysis.

Neuromuscular electrical stimulation (NMES) has been shown to produce benefits in the muscle function of chronic obstructive pulmonary disease (COPD) patients. The definite effectiveness of NMES, applied in isolation or concurrently with conventional pulmonary rehabilitation (PR) or exercise training, remains unclear. This review was to determine the effects of NMES on exercise capacity, functional performance, symptoms, and health-related quality of life (HRQoL) in COPD patients. Electronic databases (PubMed, Embase, Web of Science, the Cochrane Library) were searched for relevant randomized controlled trials (RCTs). Two investigators independently screened the eligible studies up to February 2020 that used NMES as the intervention group. The outcome measures were 6-min walking distance (6MWD), peak rate of oxygen uptake (VO2 peak), St George’s Respiratory Questionnaire (SGRQ), and symptoms of dyspnoea and fatigue. Data were extracted using a predefined table and papers were appraised using Downs and Black tool. We analyzed 13 RCTs with 447 COPD patients. In the analysis of 6MWD, pooled estimates showed a significant increase in the NMES group, compared with the control group (mean difference (MD) = 27.05, 95% confidence interval (CI): 8.46–45.63, P<0.001). There were also improvements in symptoms of dyspnea or leg fatigue, and reduction in London Chest Activity of Daily Living (LCADL) scores. No statistically significant difference was observed in VO2 peak, peak power, and SGRQ. NMES could improve exercise capacity and reduce perceived sensation of dyspnea during exercise in patients with COPD, but not to be recommended as an effective alternative training modality in the rehabilitation of stable COPD patients.

KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA DOSE İNDEKSİ KAS FONKSİYON BOZUKLUĞU, GÜNLÜK YAŞAM AKTİVİTELERİ VE YAŞAM KALİTESİ İLE İLİŞKİLİDİR

Purpose: Composite measures have potential to account for many of the facets of disease in chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the relationship between the DOSE (Dyspnea, Obstruction, Smoking, Exacerbation) Index which is a multi-component assessment tool and handgrip and respiratory muscle strength, activities of daily living (ADL) and health-related quality of life in patients COPD. Methods: Forty-five patients with COPD (30 males, 15 females, mean FEV1 =50.60±16.00%) were included. The DOSE Index was calculated using the modified Medical Research Council dyspnea scale, obstruction level, smoking status, and exacerbation rate. Inspiratory and expiratory muscle strength (MIP and MEP) was measured using a mouth-pressure device. Handgrip strength was determined using hand dynamometer. Activities of daily living were evaluated using the London Chest Activity of Daily Living Scale (LCADL), and quality of life was assessed using the diseasespecific COPD Assessment Test (CAT). Results: The DOSE Index score was related with handgrip strength (r=-0.388, p=0.009), MIP (r=- 0.323, p=0.033), LCADL-physical activity score (r=0.314, p=0.038), LCADL-leisure activities score (r=0.397, p=0.008), and CAT score (r=0.435, p=0.003). Conclusion: Increased multi-component disease severity is related to decreased handgrip and respiratory muscle strength, physical activity and leisure time activities of daily living, and worse health-related quality of life in COPD patients. The DOSE Index, a simple disease severity assessment tool, is a convenient and practical tool for assessment in pulmonary rehabilitation programs.

Effect of average volume-assured pressure support treatment on health-related quality of life in COPD patients with chronic hypercapnic respiratory failure: a randomized trial

The long-term effect of average volume-assured pressure support (AVAPS) on health-related quality of life (HRQOL) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure (CHRF) remains unclear.The objective of this study is to identify the long-term effect of AVAPS in COPD patients with CHRF through assessment of HRQOL, exercise tolerance after six months duration.MethodsIn this randomized, controlled, parallel-group study, 40 stable hypercapnic COPD patients were randomized in a 1:1 ratio to receive either spontaneous timed AVAPS (ST/AVAPS) (intervention) or Bilevel positive airway pressure (ST/BiPAP) (control). HRQL was measured with the Short Form 12 Health Survey Questionnaire (SF-12). Exercise tolerance assessed by 6 min walking distance. Analyses were done between groups from baseline to the average of six months measurements.ResultsAVAPS led to significant 6 months improvements in several domains of (SF-12) compared to the control group, with the greatest improvement seen in general health [treatment effect of 8.2 points (95% confidence interval [95% CI 3.2 to 11.7; p = 0.001)], vitality (treatment effect 5.4 points [95% CI 1.4 to 9.3]; p = 0.001), physical functioning 5.5 points [95% CI 1.1 to 9.8]; p = 0.001) and bodily pain 5.1 points [95% CI 3.4 to 8.8]; p = 0.002). The physical health summary score improved by 3.7 points (95% CI 1.2 to 5.8; p = 0.001), but no significant improvement in the emotional or social role functioning, mental health subscale was noted.AVAPS also resulted in improvement 6 min walking distance 9.2 points (95% CI − 1 to − 15];p = 0.001). A significant reduction in the daytime (PaCO2) was observed after 6 months in those treated with AVAPS.ConclusionsIn COPD patients with hypercapnic respiratory failure, AVAPS improved exercise tolerance and multiple domains of HRQOL over six months of follow-up, with the significant improvement observed in general health.

Pharmacological Management of Chronic Obstructive Pulmonary Disease by Low-Dose Theophylline: A Prospective Hospital-based Study in East Godavari of Andhra Pradesh

Background: High therapeutic dose of theophylline is not tolerated well by some patients. As it is an effective and affordable drug, the effectiveness of low-dose theophylline in pharmacological management of chronic obstructive pulmonary disease (COPD) was assessed. Aim: The aim of this study was to detect the efficacy of low-dose theophylline in COPD patients. Patients and Methods: Patients with stable COPD were enrolled. The complete blood picture (CBP), pulmonary function tests (PFTs), and St. George's Respiratory Questionnaire (SGRQ) were performed at enrolment. Patients were categorized into two groups: subjects and controls. All the participants were given medication for COPD as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. However, subjects were kept on low-dose sustained-release oral drug theophylline (150 mg twice daily) as an add-on. At every follow-up, once every 10 days up to 30 days, their parameters were recorded. The difference between the prognostic biomarkers was analyzed using the Student's “t”-test. Results: The CBP, SGRQ, and PFTs showed improvement in COPD patients treated with low-dose theophylline, i.e., subject group. Even though the PFTs improved in subjects, evidence of COPD remained. Low-dose theophylline may help to improve the quality of life in COPD patients. Conclusion: As a Cost-effective medication, low-dose theophylline can be used as an add-on drug to GOLD guidelines for the treatment of COPD. The subjects may feel better and can lead their normal life even with COPD.

Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.

Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.