15 research outputs found
Registri bolesnika s hroniÄnim opstruktivnim bolestima pluÄa ā zaÅ”to su važni?
COPD is most probably not just a single disease, but a syndrome made up of numerous individual overlapping diseases. The concept of phenotyping COPD patients would not be feasible without major population-based studies and patient registries. The aim of setting up a COPD registry has been defined as the need to establish the disease prevalence, phenotype incidence, clinical features, co-morbidities, treatment specificities, together with monitoring of the diseaseās natural course and its outcome on a large sample of patients. In Serbia, an online registry of COPD patients has been operational since 2016, and the recent insight (before the manuscriptās submission) shows over 4,200 entries.
Analysis of the population of patients entered shows that an average patient is male (63%), smoker or ex-smoker (90.48%), over 60 years of age (82.01%). Pulmonary function analysis shows that the majority of enrolled patients (82%) have moderate to severe obstruction, with an average FEV1 of 52.82% of the predicted value, while 45% of patients have FEV1 value below 50% of the predicted value. The Charlson Comorbidity Index shows that half of the patients (49.97%) have one comorbidity. Most common comorbidities are arterial hypertension, diabetes mellitus, liver disease, congestive heart failure, and coronary ischemic disease. Comorbidities such as osteoporosis, depression, and anxiety have been reported very rarely. The phenotype analysis showed equal shares of two predominant groups: non-exacerbators (51.12%), and exacerbators (48.88%) within which there are groups of patients with pulmonary emphysema (34.35%) and patients with chronic bronchitis (14.53%). The data indicate that strategy for COPD treatment in our environment is changing towards adoption of modern recommendations and guidelines for treatment of this disease.
The data enable a comprehensive insight into the disease and drawing up of feasible treatment strategies that give us hope for success.HOBP verovatno nije samo jedna bolest veÄ sindrom saÄinjen od brojnih, pojedinaÄnih bolesti koje se preklapaju. Koncept fenotipizacije pacijenata sa HOBP-om ne bi bio moguÄ bez velikih, populacionih studija i registara pacijenata. Cilj kreiranja registara pacijenata sa HOBP-om je definisan potrebom da se na velikom uzorku utvrdi prevalenca bolesti, uÄestalost fenotipova, kliniÄke karakteristike, komorbiditeti, specifiÄnosti terapije, uz praÄenje prirodnog toka bolesti do njenog ishoda. U Srbiji od 2016. godine postoji elektronski (onlajn) registar pacijenata sa hroniÄnom opstruktivnom boleÅ”Äu pluÄa, koji je u momentu pisanja ovog teksta brojao viÅ”e od 4200 unosa. Analiza populacije pacijenta unetih u registar HOBP-a ukazuje na to da je proseÄan pacijent muÅ”karac (63% pacijenata), puÅ”aÄ ili bivÅ”i puÅ”aÄ (ukupno 90,48% pacijenata), stariji od 60 godina (82,01% pacijenata). Analiza pluÄne funkcije pokazuje da veÄina pacijenata (82%) ima umerenu i srednje teÅ”ku opstrukciju, sa proseÄnom vrednoÅ”Äu FEV1 od 52,82% predviÄene vrednosti, dok 45% pacijenata ima vrednost FEV1 nižu od 50% predviÄene vrednosti. Äarlsonov indeks komorbiditeta je pokazao da polovina pacijenata (49,97%) ima jedan komorbiditet. NajuÄestaliji komorbiditeti su: arterijska hipertenzija, dijabetes melitus, bolesti jetre, kongestivna srÄana slabost i koronarna ishemijska bolest. Komorbiditeti poput osteoporoze, depresije i anksioznosti su vrlo retko prijavljivani. U pogledu fenotipova zapaža se da je uÄestalost dve dominirajuÄe grupe bolesnika izjednaÄena: grupa neegzacerbatora (51,12%), zatim egzacerbatora (48,88%), u okviru kojih se nalaze grupe pacijenata sa emfizemom pluÄa sa 34,35% zastupljenosti i pacijenata sa hroniÄnim bronhitisom sa 14,53% zastupljenosti. Podaci ukazuju na to da se strategija leÄenja HOBP-a u naÅ”oj sredini ipak menja, uz usvajanje savremenih preporuka i smernica za leÄenje ove bolesti.
Ovakvi podaci nam omoguÄavaju da sagledamo bolest iz svih uglova i kreiramo realno izvodljive strategije leÄenja koje daju nadu za postizanje uspeha
Silent sinus syndrome: One more reason for an ophthalmologist to have a rhinologist as a good friend
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Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD
Objective: The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD), using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. Material and Methods: The study included 80 participants aging between 18 and 65 years. The experimental group (EG) was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG), comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index). Quantity and pH value of saliva were determined in the laboratory. Results: In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001). Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199). Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001). Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001). Conclusion: It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice
Chilaiditi's sign and syndrome: Theoretical facts and a case report
Introduction. Chilaiditi's syndrome is a rare condition manifested by
gastrointestinal symptoms, and radiologically verified by transposition of
the large intestine loop. This radiological finding with no manifested
symptoms is termed the Chilaiditi's sign. The aim of this case report was to
remind the clinicians of the possibility of this rare syndrome, whose
symptoms and signs may be misinterpreted and inadequately treated, with
consequent diverse complications. Case report. We presented the theoretical
facts and a patient in whom the diagnosis of Chilaiditi's syndrome was
established incidentally, when hospitalized for an exacerbation of his
chronic obstructive pulmonary disease. The Chilaiditi's sign was verified as
an incidental finding on chest X-ray performed to evaluate the primary
disease. Conclusion. Chilaiditi's syndrome is a benign condition which rarely
requires surgery. Its clinical importance lies in adequate differential
diagnostic approach and timely management of potentially serious
complications
Intrathoracic malignant peripheral nerve sheath tumor with poor outcome: a case report
We report a case of intrathoracic malignant peripheral nerve sheath tumor in a 65-year old woman revealed after a few-month history of progressive dyspnea, appetite and body mass loss. The chest magnetic resonance (MR) examination revealed the presence of a large tumor occupying the mediastinum and a major portion of the right hemithorax. The diagnostic tumor sample was obtained by parasternal biopsy in local anesthesia. The surgical resection of the tumor could not be performed due to its excessive size, intrathoracic involvement and bad respiratory reserves of a patient. The chemotherapy and irradiation were performed as palliative measures. The lethal outcome appeared 10 months after the diagnosis was established
Patient-related independent clinical risk factors for early complications following Nd: YAG laser resection of lung cancer
Introduction: Neodymium:yttrium aluminum garnet (Nd:YAG) laser resection is one of the most established interventional pulmonology techniques for immediate debulking of malignant central airway obstruction (CAO). The major aim of this study was to investigate the complication rate and identify clinical risk factors for complications in patients with advanced lung cancer.
Methods: In the period from January 2006 to January 2011, data sufficient for analysis were identified in 464 patients. Nd:YAG laser resection due to malignant CAO was performed in all patients. The procedure was carried out in general anesthesia. Complications after laser resection were defined as severe hypoxemia, global respiratory failure, arrhythmia requiring treatment, hemoptysis, pneumothorax, pneumomediastinum, pulmonary edema, tracheoesophageal fistulae, and death. Risk factors were defined as acute myocardial infarction within 6 months before treatment, hypertension, chronic arrhythmia, chronic obstructive pulmonary disease (COPD), stabilized cardiomyopathy, previous external beam radiotherapy, previous chemotherapy, and previous interventional pulmonology treatment.
Results : There was 76.1% male and 23.9% female patients in the study, 76.5% were current smokers, 17.2% former smokers, and 6.3% of nonsmokers. The majority of patients had squamous cell lung cancer (70%), small cell lung cancer was identified in 18.3%, adenocarcinoma in 3.4%, and metastases from lung primary in 8.2%. The overall complication rate was 8.4%. Statistically significant risk factors were age (P = 0.001), current smoking status (P = 0.012), arterial hypertension (P < 0.0001), chronic arrhythmia (P = 0.034), COPD (P < 0.0001), and stabilized cardiomyopathy (P < 0.0001). Independent clinical risk factors were age over 60 years (P = 0.026), arterial hypertension (P < 0.0001), and COPD (P < 0.0001).
Conclusion : Closer monitoring of patients with identified risk factors is advisable prior and immediately after laser resection. In order to avoid or minimize complications, special attention should be directed toward patients who are current smokers, over 60 years of age, with arterial hypertension or COPD
Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD
Abstract Objective: The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD), using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. Material and Methods: The study included 80 participants aging between 18 and 65 years. The experimental group (EG) was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG), comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index). Quantity and pH value of saliva were determined in the laboratory. Results: In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001). Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199). Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001). Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001). Conclusion: It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice