Factors Associated With Pulmonary Hypertension And Long-Term Survival In Bronchiectasis Subjects

Background: The development of pulmonary hypertension (PH) and its effect on long-term survival in bronchiectasis subjects has not been explored. The present study aims to analyze the factors associated with PH and its effect on long-term survival in bronchiectasis subjects. Methods: We prospectively evaluated 23 bronchiectasis subjects without PH and 16 with PH, as well as 20 healthy volunteers. Results: Bronchiectasis subjects with PH were more hypoxemic and had a greater number of involved lobes in high resolution computed tomography (HRCT) than did the bronchiectasis subjects without PH (P < 0.001 and P < 0.001, respectively). At three years, the survival rate was 95.7% for bronchiectasis subjects without PH and 56.3% for bronchiectasis with PH, and at 5 years, these rates were 95.7% and 62.5%, respectively (P = 0.002). Multivariate Cox regression analysis revealed that only the Medical Research Council (MRC) dyspnea score was independently related to poor survival in all bronchiectasis subjects (hazard ratio: 6.98; 95% CI: 2.41-20.23; P < 0.00001). Conclusions: Subjects with PH are more hypoxemic and have a greater number of involvements in the lobes of the lungs. Bronchiectasis subjects with PH have worse survival than do bronchiectasis subjects without PH. MRC dyspnea score is an independent predictor of long-term survival. (C) 2016 Elsevier Ltd. All rights reserved.WoSScopu

Functional Capacity, Physical Activity, And Quality Of Life In Hypoxemic Patients With Chronic Obstructive Pulmonary Disease

Background The risk of hypoxemia increases with the progression of chronic obstructive pulmonary disease (COPD) and the deterioration of pulmonary function. The aim of this study was to compare functional capacity, physical activity, and quality of life in hypoxemic and non-hypoxemic patients with COPD. Methods Thirty-nine COPD patients (mean age: 62.0±7.03 years) were included in this study. Arterial blood gas tensions were measured, and patients were divided into two groups according to oxygen partial pressure (PaO2), the hypoxemic COPD (PaO2 <60 mmHg) (n=18), and the control (PaO2 ≥60 mmHg) (n=21) groups. Functional exercise capacity was evaluated using the 6-minute walk test (6MWT). Oxygen saturation, dyspnea, and fatigue perception were measured before and after the 6MWT. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) and an accelerometer. Quality of life was assessed using the St George’s Respiratory Questionnaire (SGRQ). Results The number of emergency visits and hospitalizations were higher in hypoxemic patients (P<0.05). Lung function parameters, 6MWT distance, exercise oxygen saturation, IPAQ total score, and energy expenditure during daily life were significantly lower, but percentage of maximum heart rate reached during the 6MWT was significantly higher, in hypoxemic COPD patients than in controls (P<0.05). Conclusion Hypoxemia has a profound effect on functional capacity and physical activity in patients with COPD.PubMedWoSScopu

The Relationship Between Cough-Specific Quality Of Life And Abdominal Muscle Endurance, Fatigue, And Depression In Patients With Copd

PubMedWoSScopu

Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

Abstract Background and aims Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results Thirteen patients (59%) had severe fatigue, and their St George's Respiratory Questionnaire scores were significantly higher (p Conclusions Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.</p

Fatigue And Multidimensional Disease Severity In Chronic Obstructive Pulmonary Disease

Background and aims Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results Thirteen patients (59%) had severe fatigue, and their St George's Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was significantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Conclusions Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.PubMedWoSScopu

Predictors of Physical Inactivity in Elderly Patients with Chronic Obstructive Pulmonary Disease

Background: Aging may contribute to decreased physical activity in chronic obstructive pulmonary disease (COPD). We explored the predictors of physical inactivity in older patients with COPD. Methods: Thirty male patients with clinically stable COPD participated in the study (age 66.9 +/- 4.3 years, forced expiratory volume in 1 second [FEV1, % of predicted] 52.6 +/- 24.6%). Patient characteristics were recorded. Pulmonary function testing was performed and disease stage was determined using the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) classification system. Maximal inspiratory and expiratory muscle strength and quadriceps muscle strength were determined using a hand-held device. Dyspnea perception was assessed using the modified Medical Research Council (MMRC) scale. Functional capacity was evaluated using a 6-minute walk test (6MWT). Heart rate and oxygen saturation were recorded before and after 6MWT. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Results: In elderly COPD patients, the IPAQ sitting score was significantly related to 6MWT distance (r = -0.51), GOLD stage (r = 0.52), paroxysmal nocturnal dyspnea (r = -0.42) and orthopnea (r = -0.50), MMRC score (r = 0.40), FEV1 (r = -0.48). FEV1/forced vital capacity (FVC) (r = -0.47), forced expiratory flow between 25% and 75% of FVC (r = -0.43), peak expiratory flow (r = -0.43), baseline heart rate (r = 0.40), change in heart rate (r = -0.46), and baseline oxygen saturation (r = -0.43, p < 0.05). GOLD stage, change in heart rate, and orthopnea independently predicted the IPAQ sitting score (R = 0.732, R-2 = 0.536, F-(1.24) = 4.769, p = 0.039). Conclusion: Disease severity, heart rate response to exercise, and orthopnea are determinants of physical inactivity in elderly COPD. Copyright (C) 2013, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.WoSScopu

Extrapulmonary Features Of Bronchiectasis: Muscle Function, Exercise Capacity, Fatigue, And Health Status

Background There are limited number of studies investigating extrapulmonary manifestations of bronchiectasis. The purpose of this study was to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis. Methods Twenty patients with bronchiectasis (43.5 ± 14.1 years) and 20 healthy subjects (43.0 ± 10.9 years) participated in the study. Pulmonary function, respiratory muscle strength (maximal expiratory pressure – MIP - and maximal expiratory pressure - MEP), and dyspnea perception using the Modified Medical Research Council Dyspnea Scale (MMRC) were determined. A six-minute walk test (6MWT) was performed. Quadriceps muscle, shoulder abductor, and hand grip strength (QMS, SAS, and HGS, respectively) using a hand held dynamometer and peripheral muscle endurance by a squat test were measured. Fatigue perception and health status were determined using the Fatigue Severity Scale (FSS) and the Leicester Cough Questionnaire (LCQ), respectively. Results Number of squats, 6MWT distance, and LCQ scores as well as lung function testing values and respiratory muscle strength were significantly lower and MMRC and FSS scores were significantly higher in patients with bronchiectasis than those of healthy subjects (p < 0.05). In bronchiectasis patients, QMS was significantly associated with HGS, MIP and MEP (p < 0.05). The 6MWT distance was significantly correlated to LCQ psychological score (p < 0.05). The FSS score was significantly associated with LCQ physical and total and MMRC scores (p < 0.05). The LCQ psychological score was significantly associated with MEP and 6MWT distance (p < 0.05). Conclusions Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis. Fatigue was associated with dyspnea and health status. Respiratory muscle strength was related to peripheral muscle strength and health status, but not to fatigue, peripheral muscle endurance or exercise capacity. These findings may provide insight for outcome measures for pulmonary rehabilitation programs for patients with bronchiectasis.PubMedWoSScopu

Updates in Chronic Obstructive Pulmonary Disease for the Year 2014

WOS: 000370844800007PubMed ID: 29404083Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Research conducted over the past decade has contributed much to our current knowledge of the pathogenesis and treatment of COPD. Additionally, an evolving literature has recently accumulated information about the management of COPD and also about exacerbations. This article reviews a concise summary on the updates in COPD including 1) new pathogenic mechanisms and therapeutic targets, 2) management of patients in Group B, C and D according to GOLD 2014 report; 3) prevention and management of exacerbation; 4) monitoring of natural history; and 5) essential but usually forgotten parts of the management

sj-docx-1-imj-10.1177_10815589241232366 – Supplemental material for Compliance with guideline recommendations in the management of patients with hospitalized community-acquired pneumonia

Supplemental material, sj-docx-1-imj-10.1177_10815589241232366 for Compliance with guideline recommendations in the management of patients with hospitalized community-acquired pneumonia by Pinar Bakir Ekinci, Emre Kara, Gulcin Telli Dizman, Sefa Metin, Ahmet Cagkan Inkaya, Kutay Demirkan, Lutfi Coplu and Serhat Unal in Journal of Investigative Medicine</p