Browsing by Author "Perovic, Aleksandra (56921797700)"

Introduction: Chronic obstructive pulmonary disease (COPD) and asthma are chronic inflammatory respiratory disorders characterized by airflow limitation. Their main clinical characteristics are shortness of breath and chest tightness which are not always in correlation to airflow limitation, but in some cases are due to chronic hyperinflation. Chronic hyperinflation in some patients leads to impairment of respiratory muscle function. We aimed to compare maximal occlusive inspiratory and expiratory pressures (PImax and PEmax) between patients with stable asthma and COPD, determining their correlation with lung volumes in order to evaluate respiratory muscles function in stable forms of obstructive lung diseases. Materials and methods: Spirometry and body plethysmography were compared to respiratory muscle strength (PImax and PEmax) values after application of bronchodilator in 63 patients with stable COPD (31 individuals) and asthma (32 individuals), who did not have exacerbation in the 6 months prior to study. Results: A persistent hyperinflation was found in all patients with COPD and in 30 (93.8%) patients with asthma. Significantly lower values of forced expiratory volume percentage of predicted (FVC%), forced expiratory volume in first second percentage of predicted (FEV1%), and FEV1/FVC ratio were found in COPD group (105.15±18.89%/91.90±16.74%, p<0.01; 82.82±24.23%/57.40±18.93%, p<0.01; 64.32±12.83/49.21±10.27, p<0.01; for FVC%, FEV1% and FEV1/FVC ratio, respectively). Significantly higher values of residual volume percentage of predicted (RV%), total lung capacity (TLC%), and residual volume/total lung capacity ratio percentage of predicted (RV/TLC%) were found in COPD group when compared to the group of patients with asthma (124.28±22.02%/153.10±25.36%, p<0.01; 146.53±36.59%/187.42±39.77%, p<0.01; 136.03±30.19%/163.13±27.85%, p<0.01; for RV%, TLC% and RV/TLC%, respectively). Significantly lower values of PImax and PImax% were found in COPD group (6.89±2.31kPa/8.66±2.60kPa, p<0.01; 65.89±21.94%/81.07±25.18%, p<0.01). Significant correlation in both groups was established between PImax% values and RV%, TLC% and RV/TLC% (R =-0.672, p<0.01; R = -0.544, p<0.01 and R =-0.594, p<0.01; respectively). Conclusion: In both stable asthma and COPD the strength of expiratory muscles is completely preserved, while the strength of inspiratory muscles is impaired in both diseases. The magnitude of persistent hyperinflation could be responsible for the respiratory muscle weakness. We suggested that additional training of inspiratory muscles could be of benefit in these patients.

AlMS: The aim of our study was to evaluate the influence of early pulmonary rehabilitation treatment on values of oxygen saturation and transcutaneous pC02 in lung cancer patients after surgery. MATERIAL AND METHODS: The observational pilot study included 41 patients (25 males and 16 females) who underwent lung resection for lung cancer. Further parameters were continuously measured for 12 hours over 7 days period: oxygen saturation (Sp02), transcutaneous pC02 (TpC02), desaturation time (DT) and hypercapnia time (HT). RESULTS: Significantly lower values of Sp02 were found at day 3 compared to days 1 and 2 (p < 0.05 on both occasions), at day 4 compared to days 1 and 2 (p < 0.01 and p < 0.05 respectively), at day 6 compared to day 2 (p < 0.05), and at day 7 compared to day 2 (p < 0.05). There are, significant negative correlations between mean values of Sp02 and TpC02 on days 1, 3, 4 and 5 (R* -0.535, p < 0.01 on day 1; R=-0.477, R= -0.365, and R= -327 on days 3, 4, and 5, respectively all p < 0.05). CONCLUSION: Pulmonary rehabilitation administered to the lung cancer patients in early postoperative stage significant lowered Sp02 values in study group. Our preliminary findings stressed out importance and positive effects of early pulmonary rehabilitation on oxygen saturation values in lung cancer patients after surgery.

Background: The aim of this study was to establish whether non-atopic patients with cough variant asthma (CVA) have different pattern of response to direct bronchoconstrictors than non-atopic patients with classic asthma (CA). Method: A total of 170 patients of both sexes with stable CVA and CA were screened for the study and 153 were included. Patients with proven atopy were not included and 17 patients with worsening of their condition or with verified bronchial obstruction during screening were excluded. All included patients performed spirometry and underwent a bronchial challenge with histamine according to long-standing protocol in our laboratory. Results: Significantly higher frequency of bronchial hyper-responsiveness (BHR) was found in patients with CA than in patients with CVA (63.9% vs. 44.9%, respectively; p < 0.05). Sensitivity was significantly lower in patients with CVA (p < 0.05), while no significant difference was found in maximal response and responsiveness. Only patients with positive challenge tests were included in the analysis. Conclusion: Adult non-atopic patients with CVA and CA have a pattern of response to non-specific bronchial stimuli similar to atopic patients with same conditions, with the exception of similar maximal response, which may reflect the efficacy of previous treatment. We believe that further studies are needed to clarify the mechanisms involved in airway response to non-specific stimuli in CVA and CA, especially in non-atopic patients. Further studies should also clarify whether this response pattern has any implications on clinical presentation or on treatment options. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.