Chronic Obstructive Pulmonary Disease Stage and Health-Related Quality of Life

Ferrer, Montse; Alonso, Jordi; Morera, Josep; Marrades, Ramón; Khalaf, Ahmad Taha; Aguar, María Carmen; Plaza, Vicente; Prieto, Luís; Antó, Josep M.

doi:10.7326/0003-4819-127-12-199712150-00003

Cited by 365 publications

(161 citation statements)

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“…KEYWORDS: Chronic obstructive pulmonary disease, muscle compartments, oxidised proteins, respiratory muscles, superoxide anion C hronic obstructive pulmonary disease (COPD) is a highly prevalent condition that imposes a substantial burden in terms of disability and impairment of quality of life [1]. COPD is also a leading cause of death worldwide and is projected to increase within the next decade, since the prevalence of cigarette smoking continues to rise and the population ages [2,3].…”

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confidence: 99%

Oxidised proteins and superoxide anion production in the diaphragm of severe COPD patients

Minguella²,

et al. 2009

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In the diaphragms of chronic obstructive pulmonary disease (COPD) patients, the nature of oxidatively modified proteins and superoxide anion production were explored.Diaphragm specimens were obtained through thoracotomy because of localised lung lesions in COPD patients (16 severe and eight moderate) and 10 control subjects. Lung and respiratory muscle functions were evaluated. Oxidised proteins were identified using immunoblotting and mass spectrometry. Protein and activity levels of the identified proteins were determined using immunoblotting and activity assays. Lucigenin-derived chemiluminescence signals in a luminometer were used to determine superoxide anion levels in muscle compartments (mitochondria, membrane and cytosol) using selective inhibitors.In severe COPD patients compared with controls, respiratory muscle function was impaired; creatine kinase, carbonic anhydrase III, actin and myosin were oxidised; myosin carbonylation levels were increased five-fold; creatine kinase content and activity and myosin protein were reduced; superoxide anion levels were increased in both mitochondria and membrane compartments; and the percentage of superoxide anion inhibition achieved by rotenone was significantly greater.In severe COPD patients, oxidation of diaphragm proteins involved in energy production and contractile performance is likely to partially contribute to the documented respiratory muscle dysfunction. Furthermore, generation of the superoxide anion was increased in the diaphragms of these patients.

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Oxidised proteins and superoxide anion production in the diaphragm of severe COPD patients

Minguella²,

et al. 2009

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“…COPD progresses through different stages, and has a major impact on functional abilities and quality of life [3][4][5]. The disease is also characterised by episodes of acute exacerbations that contribute to the deterioration of patients' health status [4,5].…”

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Self-management reduces both short- and long-term hospitalisation in COPD

Ma¹,

Schwartzman²,

Rouleau³

et al. 2005

Eur Respir J

171

103

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The aim of the present study was to assess the long-term impact on hospitalisation of a self-management programme for chronic obstructive pulmonary disease (COPD) patients.A multicentre, randomised clinical trial was carried out involving 191 COPD patients from seven hospitals. Patients who had one or more hospitalisations in the year preceding study enrolment were assigned to a self-management programme ''Living Well with COPD TM '' or to standard care. Hospitalisations from all causes were the primary outcome and were documented from the provincial hospitalisation database; emergency visits were recorded from the provincial health insurance database.Most patients were elderly, not highly educated, had advanced COPD (reflected by a mean forced expiratory volume in one second of 1 L), and almost half reported a dyspnoea score of 5/5 (modified Medical Research Council). At 2 years, there was a statistically significant and clinically relevant reduction in all-cause hospitalisations of 26.9% and in all-cause emergency visits of 21.1% in the intervention group as compared to the standard-care group. After adjustment for the self-management intervention effect, the predictive factors for reduced hospitalisations included younger age, sex (female), higher education, increased health status and exercise capacity.In conclusion, in this study, patients with chronic obstructive pulmonary disease who received educational intervention with supervision and support based on disease-specific self-management maintained a significant reduction in hospitalisations after a 2-year period.

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“…Por su parte, la espirometría es un examen de función pulmonar del cual no se describen fuertes correlaciones con medidas subjetivas como el bienestar, la satisfacción o la calidad de vida 5,21 . Es necesario comentar que la disnea es la única dimensión del cuestionario que no se asocia con la prueba de caminata por 6 min y, por el contrario, es la única que se asocia con el VEF 1 , lo que sumado a la baja consistencia interna de esta dimensión y a la forma de hacer las preguntas, sugiere la necesidad de una evaluación específica de si este único aspecto debe ser incluido en el instrumento o puede ser evaluado de mejor manera con otros medios disponibles.…”

Section: Discussionunclassified

“…Además de las alteraciones físicas, una proporción importante de los pacientes portadores de LCFA son incapaces de disfrutar la vida en toda su magnitud debido a la dificultad respiratoria, la inactividad impuesta por los síntomas, además de las desventajas mecánicas de su sistema respiratorio [2][3][4][5] . Por tanto, uno de los principales objetivos del manejo en estos pacientes, es mejorar su calidad de vida 4,6 .…”

Section: N V E S T I G a C I ó Nunclassified