Patients with ACOS show more severe clinical manifestations and a substantial increase in functional residual capacity and intrathoracic volume throughout the follow-up period, suggesting that the distal bronchi are impaired and pulmonary hyperinflation develops.
Background Osteoarthritis is an important social and medical problem. Obesity is an main modifiable risk factor for the development and progression of knee osteoarthritis. Objectives The aim of the study is to evaluate the influence of weight reduction on clinical symptoms and quality of life of patients with knee osteoarthritis. Methods The study included 50 women, aged 45-65 years with knee osteoarthritis stage II-III Kellgren-Lawrence and obesity (body mass index (BMI) >30kg/cm2). Control group consisted of 23 women aged 48 to 65 years with knee osteoarthritis and BMI<30kg/cm2. Obese patients were randomized into 2 groups. 1st group (25 patients) took orlistat a dose of 120 mg (1 tablet) 3 times daily for 6 months in combination with a low-calorie diet and physical activity. 2 group (25 patients) - non-pharmacological therapy of obesity (hypocaloric diet and physical activity). Patients in both groups received standard treatment regimen osteoarthritis. Functional index WOMAC, quality of life according to VAS were evaluated. Results Comparison of osteoarthritis patients with obesity (BMI>30kg/cm2) and without (BMI<30kg/cm2) revealed that although patients with overweight were slightly younger (mean age 55,6±5,3 and 58,7±5,4 years) and had a shorter duration of the disease (7±3,7 years and 9,3±4,1 years, respectively), but they had more severe osteoarthritis: in obesity knee osteoarthritis stage III was more frequently detected (11.4% vs4,3%), a significantly higher index WOMAC (p<0,05). Weight reduction was more signified in the group of patients on orlistat therapy by 9,05% (average 9,5 kg), compared with patients who were only on a hypocaloric diet where the weight has decreased by 2,54% (average 2,66 kg). WOMAC pain for patients who are on orlistat therapy decreased by 48.7% and was significantly lower (p=0,012) than in the 2 group, where the rate declined by only 32,2%. Similar changes were observed in functional failure: the dynamics of this index in the 1st group was significantly lower than in the 2 group (p=0,004) (a decrease of 49,75% and 32,77%, respectively). After 6 months against the background of the weight reduction the total index WOMAC decreased in both groups (at 49,31% and 32,9% respectively), but was significantly lower in the group treated with orlistat (p=0,006). Moreover, in this group revealed a significant improvement of life quality compared with those with a smaller weight loss (p<0,001). Tolerability of orlistat was good, only two patients reported adverse reactions like liquid stool against the background of errors in the diet (fatty meal). Conclusions Our study demonstrated that weight loss, especially while taking drugs that reduce weight by obese patients with knee osteoarthritis leads to a reduction in the clinical developments of knee osteoarthritis: relieve pain and improve the functional state of the knee. In this connection, drugs that affect the weight loss should be included in the treatment regimen of patients with osteoarthritis and obesity. Disclosure of Inte...
РезюмеЦель исследования. Изучить цитокиновый статус и выявить возможную взаимосвязь клинико-функциональных показателей и системного воспаления у больных бронхиальной астмой (БА) тяжелого течения в зависимости от курения. Материалы и методы. Обследовали 139 больных БА тяжелого течения в период обострения и вне его через 12 мес. В 1-ю группу вошли 98 некурящих больных с БА тяжелого течения, во 2-й группе наблюдался 41 курящий больной БА тяжелого течения. Группу контроля составили 40 относительно здоровых добровольцев. Изучали функцию внешнего дыхания, уровни α-ФНО, ИФН-γ, ИЛ-2, ИЛ-4, ИЛ-6, ИЛ-8, ИЛ-10, С-реактивного белка, нейтрофильной эластазы в плазме крови и интегральный цитокиновый индекс. Результаты. При БА тяжелого течения выявлено системное воспаление, более выраженное в период обострения заболевания и опосредованное повышенным уровнем ФНО-α, ИЛ-2, С-реактивного белка в обеих группах. В группе курящих пациентов отмечено статистически значимое повышение уровня ИЛ-8 и нейтрофильной эластазы, что может косвенно свидетельствовать об активном участии нейтрофилов в формировании хронического персистирующего воспаления. Заключение. Курение является клинически значимым фактором риска, отягощающим как течение БА, так выраженность воспаления в период обострения заболевания. Ключевые слова: бронхиальная астма, цитокины, курение, системное воспаление.Aim. To study cytokine status and to reveal a possible relationship of clinical and functional indicators and systemic inflammation in patients with severe asthma to tobacco smoking. Subjects and methods. Examinations were made in 139 patients with severe asthma during its exacerbation and without the latter after 12 months. Groups 1 and 2 included 98 nonsmoking and 41 smoking patients with severe asthma, respectively. A control group consisted of 40 apparently healthy volunteers. External respiratory function, plasma TNF-α, IFN-γ, IL-2, IL-4, IL-6, IL-8, IL-10, C-reactive protein, and neutrophil elastase levels, and integral cytokine index were studied. Results. Systemic inflammation that was more marked on a disease exacerbation and mediated by elevated TNF-α, IL-2, and C-reactive protein levels was detected in severe asthma in both groups. The smoking patient group showed a statistically significant increase in IL-8 and neutrophil elastase levels, which may be indirectly indicative of the active participation of neutrophils in the development of chronic persistent inflammation. Conclusion. Tobacco smoking is a clinically significant risk factor that aggravates both the course of asthma and the magnitude of inflammation during a disease exacerbation.
Chronic obstructive pulmonary disease is today one of the socially significant diseases, and its treatment remains a major medical problem.Currently, the main goals of treating patients with COPD are: eliminating symptoms and improving the quality of life, preventing exacerbations and reducing future risks, slowing the progression of the disease and reducing mortality.The article presents a clinical case from the practice of a patient with COPD who received tiotropium bromidi as monotherapy. The patient had significant impaired airway patency during spirometry, a decrease in exercise tolerance. The patient was assigned a new representative of combination preparations with a 24-hour action – Anoro Ellipta® (Vilanterol + Umeklidiniy) 22/55 mcg, with a new drug delivery vehicle. After 6 months of therapy with Anoro Ellipt®, the patient has increased exercise tolerance, improved pulmonary function, as well as quality of life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.