The importance of movement for people living with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that gives rise to symptoms of breathlessness, chronic fatigue, and cough. The impact of COPD on people's activity has been widely acknowledged, yet it appears that we know little about how individuals experience activity. We employed a grounded theory study with 18 participants with COPD to explore their dimensions of activity. We identified two core concepts that captured participants' experience of activity; these were stagnation and movement. We found fresh air to be the single most important aspect affecting participants' experience of stagnation and movement; this was linked to a changed perception of symptoms. We identified the environment as an important context influencing the experience of COPD and activity. Our stagnation-movement theory explains the experience of activity within its environmental context, and how this experience might be affected on physical, social, and psychological levels.     

矽肺合并慢性阻塞性肺疾病

矽肺合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)加重了肺组织结构的破坏,造成肺功能迅速下降。随着疾病的进展,后期易出现肺源性心脏病、呼吸衰竭等严重并发症,增加患者死亡风险。本文从矽肺合并COPD的致病危险因素和临床治疗两个方面进行简要综述。     

Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home

AIM: The aim of the study was to assess total daily energy expenditure (TDE), as measured by doubly labelled water (DLW), and describe its components in home-living underweight patients with severe chronic obstructive pulmonary disease (COPD). METHODS: Basal metabolic rate (BMR) was measured prior to the study. Ten patients received DLW, followed by urine analysis by isotope ratio mass spectrometry from 10 standardised occasions during 15 days. Dietary intake was registered by each patient the first 7 days of the study. The patients were also interviewed about their physical activity pattern. RESULTS: Measured BMR was higher than predicted in five of the 10 patients using equations from WHO. Using disease-specific equations, estimated BMR was higher for male, but not for female COPD patients. The best estimation of BMR resulted from prediction including fat-free mass. TDE varied considerably between 5200 and 11,100 kJ. Physical activity level (PAL) ranged from 1.15 to 1.80. Energy intake varied between 4500 and 9100 kJ. In underweight patients with severe COPD, TDE is highly variable, ranging from 110 to 200 kJ/kg body weight. CONCLUSIONS: This is the first study assessing and describing total energy expenditure in underweight patients with severe COPD living at home. Energy requirement in the patient group cannot solely be calculated from prediction equations. BMR should be measured and physical activity level assessed.     

基于Android的慢阻肺管理系统的研发

目的:设计一款基于Android的慢阻肺管理系统,为患者提供诊断、自我管理及远程监护等功能.方法:该系统由便携式多参数肺功能仪、医生Android端、患者Android端及服务器组成.其中Android端采用Android Studio开发平台,通过Java语言编程搭建,整个系统采用MVP(Model-View-Pre...     

宁夏居民慢性阻塞性肺疾病认知行为的现况调查

目的了解宁夏居民慢性阻塞性肺疾病（COPD）认知行为的现状,探讨影响居民认知水平的相关因素,为制定COPD干预措施提供依据。方法采用多阶段分层整群随机抽样方法,在宁夏回族自治区4个地级市抽取12个调查点,对40岁以上居民4268例进行COPD问卷调查。整理数据资料,采用多因素线性回归方法分析COPD认知水平的影响因素。结果实际调查4200例,有效问卷4056份,有效应答率96．57％。其中,仅6．51％（264／4056）听说过COPD,13．88％（563／4056）认为吸烟是慢支、肺气肿的危险因素,6．39％（259／4056）知晓肺功能检测。影响认知的主要因素是收入水平、城乡、文化程度、民族。宁夏40岁以上人群的吸烟率为28．80％（1168／4056）,回族低于汉族（20．40％VS34．63％,P〈0．05）。回汉吸烟人群中,吸烟指数及重度吸烟者所占比例无明显差异（P〉0．05）。结论宁夏居民对COPD缺乏认识,防治意识差,推行健康教育工作刻不容缓。回族人群吸烟率虽然低于汉族,但对COPD缺乏认识仍是不可忽视的问题。     

Pathophysiology of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a disease state characterised by airflow obstruction that is not fully reversible and progressive. Symptoms, as cough, sputum production and dyspnoea, functional impairment and complications of COPD can all be explained on the basis of the underlying lung inflammation and the resulting pathology. The chronic airflow obstruction is caused by a mixture of small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema). On one hand, chronic inflammation causes remodelling and narrowing of the small airways. On the other hand, destruction of the lung parenchyma, also by an inflammatory process, leads to the loss of alveolar attachments to the small airways and decreases lung elastic recoil. In turn, these changes reduce the ability of the airways to remain open during expiration.     

Exacerbations of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is characterised by a progressive decline in lung function, reduced exercise performance, and worsening of health status. Exacerbations are important clinical events in chronic obstructive pulmonary disease and are defined as sudden worsening of respiratory symptoms and function requiring medical intervention. The most common causes of chronic obstructive pulmonary disease exacerbations are bacterial or viral infections, but comorbidity may be important. A major issue is the decision regarding home management or hospital management of exacerbations. Because of exacerbations, a frequent assessment of severity of chronic obstructive pulmonary disease is required for targeting pharmacological therapy.     

Epidemiology of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality, all over the world. COPD, which was the sixth leading cause of death worldwide in 1990, will become the third one in 2020. COPD is a complex disease, influenced by genetic, behavioral, and environmental factors. The most important factor for developing COPD is tobacco smoke. Also environmental conditions represents risk for developing COPD. Furthermore, diet and a low socioeconomic status are correlated to the disease. Genetic factors, familial history, and childhood lower respiratory tract infections play an important role in the etiology of COPD. Burden of COPD is very high for community. Furthermore, the disease often is under-diagnosed and treated only at advanced stages, whilst it is a substantial health problem even among young adults. This needs to be taken into account by health personnel and decision-makers.     

Pathology of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lung characterized by poorly reversible airflow limitation. It is not a unique disease entity but rather a complex of conditions which include emphysema, chronic bronchitis and, sometimes, asthma. Moreover, COPD is a progressive disease often associated with exacerbations. Cigarette smoking, which is the most important risk factor for the development of COPD, induces pathological changes involving lung parenchyma, peripheral airways and central airways. Since lung parenchyma and peripheral airways are the sites responsible for airflow limitation and central airways are the main site of mucus hypersecretion, pathological changes in these compartments may be relevant in the development of COPD.     

维生素D与慢性阻塞性肺病

摘要:迄今为止,尚无一种治疗慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease,COPD）的药物能延缓肺功能的长期下降。近期对维生素D的研究,给COPD的治疗带来了新的希望。研究表明维生素D缺乏可加剧COPD的进展,而充足的维生素D对COPD有一定保护作用。本文通过总结近期国内外相关研究,对维生素D作用于COPD的可能机制进行了概括;进一步探究了维生素D的作用,尤其是对COPD患者的作用。     

Dietary evaluation of outpatients with chronic obstructive pulmonary disease

Protein-calorie malnutrition is prevalent among individuals with chronic obstructive pulmonary disease (COPD), and suboptimal body weight has been associated with increased morbidity and mortality. Pulmonary function, anthropometric measurements, and dietary intake were evaluated in 64 outpatients with stable COPD to assess interrelationships of those parameters. Those individuals with body weights less than 75% of standard for height, age, and sex had the greatest degree of airway obstruction, poorest lung diffusing capacity, and greatest loss of body fat and muscle mass. Contrary to what had been anticipated, calorie and protein intake levels were highest in the less than 75% of standard body weight group, decreased as relative body weight increased, and were lowest in the greater than 105% of standard body weight group. Those results indicate that caloric needs increase as COPD progresses. Intake levels of calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C were adequate in terms of the RDAs and were not related to relative body weight.     

Asthma and chronic obstructive pulmonary disease overlap

Asthma bronchiale and chronic obstructive pulmonary disease are the most prevalent lung diseases characterized by inflammation of the airways. International and Hungarian guidelines provide proper definitions for clinical symptoms, diagnostics and therapy of both diseases. However, in everyday clinical practice, overlap of asthma and chronic obstructive pulmonary disease has become more frequent. As guidelines are mainly based on large, multicenter, randomized, controlled trials that exclude overlap patients, there is a lack of diagnostic and especially therapeutic strategies for these patients. This review summarizes clinical characteristics of asthma and chronic obstructive pulmonary disease overlap, and provides daily practical examples for its management.     

慢性阻塞性肺疾病住院患者特征分析

目的 分析呼伦贝尔地区慢性阻塞性肺疾病COPD）住院患者的临床特征,为进一步评价COPD住院患者临床用药的合理性提供参考依据。方法 采用随机抽样的方法选取呼伦贝尔市某三级医院3所,分别抽取2012年1月1日-2015年12月31日COPD住院患者800例,合计2 400例,提取病历中临床特征的相应信息。结果 COPD住院患者中,男性患者占57.79%,女性患者占42.21%;年龄为（71.4±19.1）岁,71~80岁的患者构成比最高（占37.79%）;GOLDⅠ级患者占8.71%,GOLDⅡ级患者占28.42%,GOLDⅢ级患者占36.38%,GOLDⅣ级患者占26.50%;吸烟患者占61.50%,非吸烟患者占38.50%（924/2 400）;伴发疾病14种,合计伴发3 279例次,人均伴发疾病1.4种,COPD伴急性加重占55.05%（1 805/3 279）,COPD伴肺部感染性疾病占49.71%（1 630/3 279）。结论 呼伦贝尔地区COPD住院患者生存质量的提高有赖于对老年COPD患者的健康教育、早期治疗、防治伴发疾病。     

Minimizing the impact of chronic obstructive pulmonary disease

COPD, a common disease with potentially devastating consequences, is both preventable and treatable. The key to successful disease management is differential diagnosis, and the most important intervention is smoking cessation. Medications can be used to reduce symptoms, vaccines to prevent life-threatening exacerbations, and oxygen to treat hypoxemia. Diet and exercise also may help improve outcomes.     

Circulating ghrelin in patients with chronic obstructive pulmonary disease

OBJECTIVE: Unexplained weight loss is common in patients with chronic obstructive pulmonary disease (COPD). Because ghrelin plays an important role in energy homeostasis, this study investigated the plasma level of ghrelin in COPD. METHODS: Plasma ghrelin levels and levels of leptin, tumor necrosis factor-alpha, and C-reactive protein were measured in 29 patients with COPD and 17 healthy controls. Body composition was assessed with bioelectrical impedance analysis. RESULTS: Body mass index and percentage of body fat were lower in patients who had COPD than in healthy controls. Plasma ghrelin and leptin concentrations were significantly lower in patients who had COPD than in healthy controls (ghrelin: 0.25+/-0.22 ng/mL versus 0.43+/-0.24 ng/mL, P=0.013; leptin: 1.77+/-0.70 ng/mL versus 2.85+/-0.96 ng/mL, P=0.000). In contrast, tumor necrosis factor-alpha and C-reactive protein were significantly higher in those with COPD than in controls. Plasma ghrelin (log transformed) was positively correlated with body mass index and percentage of body fat in patients with COPD but negatively correlated in control subjects. Plasma ghrelin was negatively correlated with tumor necrosis factor-alpha and C-reactive protein in COPD. CONCLUSION: Plasma ghrelin level was decreased in COPD and this is different from other weight-loss diseases. These data suggest that decreased ghrelin and other factors may contribute to alterations in metabolic status during inflammatory stress in this disease.