Personalised Medicine for Asthma and Chronic Obstructive Pulmonary Disease

Heaney, Liam G.; McGarvey, Lorcan

doi:10.1159/000455395

Cited by 27 publications

(16 citation statements)

References 57 publications

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“…PFTs alone cannot differentiate to diagnose the right condition [5,6] . CT, however, can provide imaging-based characteristics about the lungs including measurements on lung parenchyma for detailed analyses of individual bronchi, such as small airways.…”

mentioning

confidence: 99%

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

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Background: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinics; therefore, for diagnostic purposes, imaging-based measurements could be beneficial to differentiate between the two diseases. Objectives: We aim to analyze quantitative measurements of the lung and bronchial parameters that are provided by low-dose computed tomography (CT) to differentiate COPD and asthma from an imaging perspective. Materials and Methods: 69 COPD patients, 52 asthma patients, and 20 healthy subjects were recruited to participate in CT imaging and pulmonary function tests (PFTs). Comparative analysis was performed to identify differences between COPD and asthma in CT measurements. PFT measurements enabled validation of the differentiation between COPD and asthma patients. Results: There were significant differences among the COPD, asthma, and healthy control groups. The differences were more significant among the following: inspiratory emphysema index (EI)_-950 (%), expiratory lung volume, expiratory mean lung density (MLD), and expiratory EI_-950 (%) and EI_-850 (%). The COPD group had a significantly higher EI_-950 (%) than the asthma group (p = 0.008). There were significant differences among the three groups in lumen area (LA), wall area (WA), total area, and Pi10WA. The asthma group had significantly higher WA%/WV% than both the COPD (p = 0.002) and the control group (p = 0.012). There was high sensitivity in EI_-950 (%), EI_-850 (%) and expiratory MLD in the parenchyma and high sensitivity in LA and Pi10WA in small airways in the differential diagnosis of COPD and asthma. Conclusion: To aid the diagnosis, CT can provide quantitative measurements to differentiate between COPD and asthma patients.

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confidence: 99%

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

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“…The role of nebulized MgSO 4 is remains to be clarified in chronic asthma [1,[24][25][26]. As a result, clinical observations suggest heterogeneity in response, most likely related to treatment intensity, the medication used, and the severity of asthma [27,28]. In one study, oral Mg 2+ was supplemented for 16 weeks, yet no differences were found in PFT, symptoms, and use of bronchodilator.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Hypomagnesemia and Pulmonary Function Tests in Patients with Chronic Asthma

et al. 2018

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Objective: To investigate the relationship between serum values of magnesium and the parameters of the pulmonary function tests (PFT) in patients with chronic asthma. Subjects and Methods: This study recruited 50 patients with chronic stable asthma and 40 healthy individuals as a control group. Data on age, sex, severity of asthma, PFT, and details of drug therapy were obtained from each group. Serum magnesium, potassium, phosphorus, calcium, and sodium levels were also measured. To evaluate differences between groups, the Student t test or Mann-Whitney U test was performed for continuous variables, and the χ² test for categorical variables. Results: In the asthma group, 10% (n = 9) of the patients had hypomagnesemia and 5.5% (n = 5) had hypophosphatemia. Patients with asthma were divided into two groups: the hypomagnesemic group (n = 9) and the normomagnesemic group (n = 41). Forced expiratory volume in 1 s (FEV₁), FEV₁%, peak expiratory flow (PEF), and PEF% were lower in the hypomagnesemic group than in the normomagnesemic group (p = 0.02). Multiple logistic regression analysis revealed a statistically significant association between hypomagnesemia and PFT in the hypomagnesemic asthmatic group. The correlations of age with FEV₁, FEV₁%, PEF, and PEF% were as follows: p = 0.00, r = 0.29; p = 0.00, r = 0.43; p = 0.03, r = 0.22; p = 0.00, r = 0.38; and p = 0.03, r = 0.22, respectively. The correlation of serum magnesium levels with PFT (FEV₁, FEV₁%, PEF, PEF%) were as follows: p = 0.001, r = 0.29; p = 0.001, r = 0.43; p = 0.03, r = 0.22; and p = 0.001, r = 0.38, respectively. The other electrolytes were within the normal range in both groups. Conclusion: In this study, hypomagnesemia and hypophosphatemia were found to be the most common electrolyte abnormalities in patients with chronic stable asthma. FEV₁, FEV₁%, PEF, and PEF% were significantly lower in asthmatic patients with hypomagnesemia compared to asthmatic patients with normomagnesemia.

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“…Az interjúk szerint a COPD-s betegek oktatására nagy szükség van. Érdemes ezt strukturáltan, a szakorvosok tapasztalatát felhasználva, a beteg nyelvezetének és tudásszintjének megfelelően megtenni [29]. A fentiekben bemutattuk a COPD diagnosztizáltságával, az orvos betegképével, a beteg adherenciájával és az inhalátorral kapcsolatos attitűdöket.…”

Section: Következtetésekunclassified

Egy oktatóprogram fejlesztésének lehetőségei tüdőgyógyász szakorvosok krónikus obstruktív tüdőbetegséggel kapcsolatos megítélése alapján

Olah

Kresznerits

Kun

et al. 2020

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Absztrakt: Bevezetés: A krónikus obstruktív tüdőbetegség jelentős egészségügyi teher mind a beteg, mind a társadalom részére. Betegoktatással ez a teher csökkenthető, így magyar környezetben kerestük az optimális tartalmat ehhez. Célkitűzés: 1) A tüdőgyógyászok véleményére épülő betegoktatási tartalom tervezése; 2) a tüdőgyógyászok magatartásának és percepcióinak megismerése; 3) a beteg adherenciája (együttműködése) javítási lehetőségeinek felmérése. Módszer: Országszerte 20 gondozóban, kórházban és rehabilitációs központban dolgozó tüdőgyógyásszal készítettünk interjút. A struktúrát úgy alakítottuk ki, hogy egy betegoktató program kulcselemeit definiáljuk, valamint hogy teret engedjünk a percepciók, terápiás attitűdök felfedésének. Eredmények: Az átlagos krónikus obstruktív tüdőbeteg dohányos, férfi, alulszocializált, köhög, fullad, és 40 évnél idősebb. Betegségét nem veszi komolyan, csak súlyosabb esetben fordul orvoshoz, adherenciája is csak ekkor nő meg. Ez a hatás gyakran átmeneti, csak a rosszullétre korlátozódik. Az adherencia szerint három csoport különíthető el: marginális jó adherencia (kb. 10%) mellett az átlag 30–40% között van, és a betegek jelentős része (60%) minimális adherenciával bír. Az inhalátor használata ideális esetben maximum 3 lépésből áll, könnyen reprodukálható és elmagyarázható. Következtetés: Az oktatóprogram keretét meghatározó szempontok a megfelelő betegkép (személyre szabás), a tüdőgyógyászati, helyszíni oktatás, az orvos–beteg kapcsolat, a betegek hozzáállása és az életmódbeli változtatások (leszokás a dohányzásról), valamint a megfelelő inhalátor kiválasztása. Orv Hetil. 2020; 161(3): 95–102.

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Personalised Medicine for Asthma and Chronic Obstructive Pulmonary Disease

Cited by 27 publications

References 57 publications

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

The Relationship between Hypomagnesemia and Pulmonary Function Tests in Patients with Chronic Asthma

Egy oktatóprogram fejlesztésének lehetőségei tüdőgyógyász szakorvosok krónikus obstruktív tüdőbetegséggel kapcsolatos megítélése alapján

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