Factors associated with BMI in greek adults with asthma

Background. The association between asthma and obesity remains controversial and limited to a few studies. Objective. The present study was designed to examine the association between body mass index (BMI) and clinical measures of asthma morbidity in Greek asthma patients. Study Design. A cross-sectional study in 100 outpatients at the asthma department of the 'Amalia Fleming' General Hospital in Athens, Greece, was conducted. Asthma diagnosis was confirmed by a specialist, according to Global Initiative for Asthma (GINA) guidelines. Participants were classified, with respect to BMI (kg/m 2), in three groups: normal: <25.0, overweight: 25.0-29.9.0 and obese: ≥30.0. Data were modeled through multiple logistic regression analysis for the association of overweight/obesity with the study variables: demographics, asthma severity, smoking, pulmonary function (forced expiratory volume in one second; FEV1), asthma control (Asthma Control Test; ACT), disability associated with dyspnea (Medical Research Council MRC breathlessness scale), and physical activity in leisure time. Results. Overweight/obesity was detected in 56 participants (56%). Multivariate regression analysis resulted in an excess risk of overweight/obesity for older participants (odds ratio OR: 1.71, 95% confidence interval CI: 1.10-2.64 for a 10-year increase in age). Conclusion. Age seems to be highly associated with overweight/obesity in Greek adults with asthma who tend to maintain a similar body weight compared to the general population. Copyright © 2010 Informa Healthcare USA, Inc

The effect of a holistic self-management plan on asthma control

The holistic self-management plan includes lifelong actions that enable patients to cope with their disease. The present study was designed to evaluate the effect of a holistic self-management plan on asthma control. A 12-month controlled study was conducted. Adult patients with mild-to-moderate asthma (n = 24) who attended the emergency asthma department were randomized to two groups: One group followed four educational sessions and three personal home sessions (n = 12), while a second group received a short manual with asthma information (n = 12). The main measure was the asthma control test (ACT), while secondary outcomes were self-efficacy (general self-efficacy scale, GSE), end-tidal carbon dioxide (ETCO2), respiratory rate (RR), breathing hold time (BHT), the Nijmegen Questionnaire (NQ), and spirometry (FEV1% predicted (forced expiratory volume in 1 second % predicted)) scores. The 2 × 4 ANOVA showed a significant interaction effect between intervention and time in ACT (p = 0.001), GSE (p < 0.001), ETCO2 (p < 0.001), RR (p < 0.001), BHT (p < 0.001), NQ (p = 0.05), and FEV1% predicted (p < 0.001). Predictors of asthma control were self-efficacy and ETCO2. In conclusion, this exploratory study provided support for the effectiveness of holistic self-management in asthma control. Behavioral changes, as indicated by the development of self-efficacy and the reduction of hyperventilation, contributed to the effectiveness of the intervention. © 2017 Taylor & Francis

Serum uric acid and arterial lactate levels in patients with obstructive sleep apnea syndrome: the effect of CPAP treatment

Objectives: Serum uric acid (UA) and arterial lactate acid (LA) are markers of oxidative stress and tissue hypoxia that are present in patients with obstructive sleep apnea syndrome (OSAS). The aim of the study was to evaluate the associations between UA and LA levels and OSAS characteristics as well as the effect of their levels after continuous positive airway pressure (CPAP) treatment. Methods: This is a retrospective of newly diagnosed patients with OSAS. UA and LA levels were measured the night before the diagnostic sleep study, and 6 months after CPAP therapy. Results: We evaluated 604 individuals with OSAS and 98 controls (i.e. individuals without sleep-related breathing disorders). Baseline median (IQR) serum UA levels were higher in OSAS patients compared to controls; 7.0 (6.4, 8.1) mg/dL vs 6.3 (6.1, 6.4) mg/dL, respectively (p < 0.001). This difference remained significant, after adjustment of serum UA to creatinine ratio (UA/Cr) (p < 0.001). Patients with OSAS had higher LA levels at baseline compared to controls; 2.26 (2.25, 2.31) mmol/L vs 1.90 (1.87, 1.97) mmol/L, respectively (p < 0.001). Both UA and LA levels decreased significantly after CPAP treatment [median (IQR): 7.0 (6.4, 8.1) mg/dL vs 6.4 (6.2, 6.8) mg/dL, p < 0.001 and 2.26 (2.25, 2.31) mmol/L vs 2.08 (2.07, 2.31) mmol/L, p < 0.001]. Several sleep parameters were independent predictors of UA and LA levels. Conclusion: In OSAS patients increased serum UA and arterial LA levels are found. CPAP therapy resulted in significant reductions in levels of both biomarkers. © 2021 Informa UK Limited, trading as Taylor & Francis Group

Hyperventilation in asthma: A validation study of the Nijmegen Questionnaire-NQ

Introduction: The Nijmegen questionnaire (NQ) has previously been used for screening the hyperventilation syndrome (HVS) in asthmatics. However, no validity study has been reported so far. Objective: To examine the validity and reliability of the NQ in asthma patients and identify the prevalence of HVS. Methods: The NQ (n=162) was examined for translation, construct, cross-sectional and discriminant validity as well as for internal consistency and test-retest reliability. Results: Principal component analysis and exploratory factor analysis revealed a single factor solution with 11 items and 58.6% of explained variability. These 11 NQ items showed high internal consistency (Cronbach's alpha=0.92) and test-retest reliability (IR=0.98). Higher NQ scores were found in the following subgroups: women versus men (p<0.01); participants with moderate versus mild asthma (p<0.001) or uncontrolled versus controlled asthma (p<0.001), and participants with breath-hold time (BHT)<30 versus≥30s (p<0.01) or end-tidal CO2 (ETCO2) ≤35 versus >35mmHg (p<0.001). A cut-off score of >17 discriminated the participants with regard to the presence of HVS. The NQ showed 92.73% sensitivity and 91.59% specificity. The total NQ score was found significantly correlated with ETCO2 (r=-0.68), RR (r=0.66) and BHT (r=-0.65). The prevalence of HVS was found 34%. Conclusion: The NQ is a valid and reliable questionnaire for screening HVS in patients with stable mild-to-moderate asthma. © 2014 Informa Healthcare USA, Inc

Statins and outcome after hospitalization for COPD exacerbation: A prospective study

Background: Retrospective studies have shown that the use of statins is associated with reduced mortality and decreased hospitalizations from COPD, but data from prospective studies are lacking. Methods: We followed-up prospectively 245 patients admitted to hospital for exacerbations of COPD (ECOPD) with monthly evaluations for one year. The role of statins on outcomes was evaluated by Cox regression analysis after proper adjustments for age, gender, BMI, current smoking status, Charlson comorbidity index and COPD stage. Health-related quality of life (HRQoL) was evaluated by Saint George's Respiratory Questionnaire. Results: There was no effect of statins on either 30-day or 1-year mortality. Patients receiving statins presented a lower total number of ECOPD during the 1-year follow up (2.1 +/- 2.7 vs. 2.8 +/- 3.2 ECOPD/patient respectively, p = 0.037). After proper adjustments, the use of statins was associated with a lower risk for ECOPD [HR: 0.656 (95% CI: 0.454-0.946)] and severe ECOPD [HR: 0.608 (95%CI: 0.381-0.972)]. The group of statins presented better improvement in HRQoL at 2, 6 and 12 months (p < 0.001). Conclusions: The use of statins in patients hospitalized for ECOPD was associated with a lower risk for subsequent ECOPD and severe ECOPD and improved HRQoL These data support a possible beneficial role for these agents in COPD. (C) 2011 Elsevier Ltd. All rights reserved

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

The impact of depressive symptoms on outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been thoroughly evaluated in prospective studies. We prospectively enrolled 230 consecutive patients hospitalised for AECOPD, without previous diagnosis of depression. Depressive symptoms were evaluated with Beck&apos;s depression inventory. Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and on days 3, 10 and 40. Patients were evaluated monthly for 1 year. Patients with depressive symptoms required longer hospitalisation (mean±SD 11.6±3.7 versus 5.6&lt;4.1 days, p,0.001). Clinical variables improved during the course of AECOPD, but depressive symptoms on admission had a significant impact on dyspnoea (p&lt;0.001) and CAT score (p50.012) improvement. Patients with depressive symptoms presented more AECOPD (p&lt;0.001) and more hospitalisations for AECOPD (p&lt;0.001) in 1 year. In multivariate analysis, depressive symptoms were an independent predictor of mortality (hazard ratio 3.568, 95% CI 1.302-9.780) and risk for AECOPD (incidence rate ratio (IRR) 2.221, 95% CI 1.573-3.135) and AECOPD hospitalisations (IRR 3.589, 95% CI 2.319-5.556) in 1 year. The presence of depressive symptoms in patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalisations in 1 year. © ERS 2013