COPD
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The aim of this study was to assess the changes in muscle fiber conduction velocity (CV), as a sign of fatigue during knee extensor contraction in patients with chronic obstructive pulmonary disease (COPD) as compared with healthy controls. Eleven male patients (5 with severe and 6 with moderate COPD; age 67 ± 5 years) and 11 age-matched healthy male controls (age 65 ± 4 years) volunteered for the study. CV was obtained by multichannel surface electromyography (EMG) from the vastus lateralis (VL) and medialis (VM) of the quadriceps muscle during isometric, 30-second duration knee extension at 70% of maximal voluntary contraction. ⋯ No difference in CV decline was found between the moderate COPD patients and the healthy controls. These findings suggest that severe COPD may impair muscle functions, leading to greater muscular fatigue, as expressed by CV changes. The results may be due to a greater involvement of anaerobic metabolism and a shift towards fatigable type II fibers in the muscle composition of the severe COPD patients.
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Multicenter Study
End-of-Life Discussion, Patient Understanding and Determinants of Preferences in Very Severe COPD Patients: A Multicentric Study.
Discussion about patients' end-of-life (E-o-L) preferences should be part of the routine practice. Using a semi-structured interview with a scenario-based decision, we performed a prospective multicentre study to elicit the patients' E-o-L preferences in very severe chronic obstructive pulmonary disease (COPD). We also checked their ability to retain this information and the respect of their decisions when they die. ⋯ Less than 50% of the patients retained a full comprehension of the options at 24 hours. About half of the patients who died in the follow-up period were not treated according to their wishes. In conclusion, in end-stage COPD more efforts are needed to improve communication, patients' knowledge of the disease and E-o-L practice.
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The smoking habit is accompanied by an acute inflammatory response which follows tissue injury. It would be desirable to find a non-invasive inflammatory marker that would simplify the task of studying and monitoring smokers more simply and allow us to identify populations at risk of contracting Chronic Obstructive Pulmonary Disease (COPD). Today's expectations regarding research focus on issues ranging from inflammatory markers to those of exhaled breath temperature (EBT) are considerable. ⋯ They repeated EBC measurement after 1 week (T3) and then after 3 months (T4) from smoking cessation. EBT is higher in smokers compared to controls. EBT increases after cigarette smoking and progressively decreases with the increase of time from when the last cigarette was smoked. Thus, we can conclude that EBT is increased in smokers and also sensitive to the acute effect of cigarette smoke.