به جمع مشترکان مگیران بپیوندید!

تنها با پرداخت 70 هزارتومان حق اشتراک سالانه به متن مقالات دسترسی داشته باشید و 100 مقاله را بدون هزینه دیگری دریافت کنید.

برای پرداخت حق اشتراک اگر عضو هستید وارد شوید در غیر این صورت حساب کاربری جدید ایجاد کنید

عضویت

جستجوی مقالات مرتبط با کلیدواژه « Chronic Obstructive Pulmonary Disease » در نشریات گروه « پزشکی »

  • Hossein Ali Khazaie, Nazar Ali Molaie, Forugh Forughi, Arewic Gowrkian, Javid Dehghan, Javad Mahmodi
    Background

    Cytokines are important in many pathobiological processes of chronic obstructive pulmonary disease (COPD). This study aimed to determine the relationship between serum levels of interleukin-33 (IL- 33) and the severity of COPD disease.

    Method

    In this cross-sectional research, the study population consisted of all COPD patients referring to the pulmonary clinic of Imam-Ali Hospital of Zahedan city. Sixty patients were selected using the available sampling method. Serum IL-33 levels were measured by the quantitative ELISA method.

    Results

    Of 60 patients, 23 (38.3%) and 37 (61.7%) subjects were male and female, respectively. Analysis shows a significant difference between serum IL-33 of the two groups with regard to the severity of COPD disease. There was a statistically significant negative relationship between the serum level of IL-33 and the severity (decrease of forced expiratory volume in one second (FEV1)) of COPD disease.

    Conclusion

    Our results indicate a systemic release of IL-33 correlated with the severity of COPD.

    Keywords: Cytokine, IL-33, Severity, Chronic Obstructive Pulmonary Disease, COPD}
  • Fatemeh Yassari, Seyed Mehran Marashian, Abolfazl Ghasemi Monfared, Somaieh Lookzadeh *
    Background
    The current study tried to assess the effects of CKD on the severity and outcome of COPD in a population of patients who referred to our tertiary center in Tehran through a 3-year time section.
    Materials and Methods
    Through a retrospective cross-sectional design, the current study tried to assess the effects of chronic kidney disease (CKD) on the health situation and some spirometric and para-clinical parameters as well as their outcomes in patients who had been hospitalized for COPD. The participants had already COPD and we separate them into two groups with or without CKD.
    Results
    Regarding the outcome of hospitalizations, 94% of the COPD and 77.9% of the COPD+CKD group were discharged in good health condition while 6% and 22.1% deceased, respectively. This shows significantly higher death rate in the latter group and the findings obtained the odds ratio of 4.5 for CKD to raise this rate.
    Conclusion
    The current study could suggest an absolute relationship between CKD and COPD in terms of respiratory and blood parameters as well as the mutual effects of the diseases on the outcome of each.
    Keywords: Chronic Obstructive Pulmonary Disease, Chronic Kidney Disease, Spirometry}
  • فاطمه کاظمی نسب*، نسیم بهزاد نژاد، موسی خلفی
    مقدمه

    بیماری مزمن انسداد ریوی (COPD) یکی از بیماری های تنفسی است که التهاب نقش مهمی در روند پیشرفت آن دارد. تمرینات ورزشی در بهبود التهاب مزمن موثر است؛ بااین حال، آثار تمرینات گوناگون ورزشی بر نشانگرهای التهابی در این بیماران واضح و روشن نیست؛ ازاین رو، هدف مطالعه حاضر بررسی تاثیر تمرینات ورزشی بر نشانگرهای التهابی IL-6، TNF-α و CRP در بیماران COPD است.

    مواد و روش ها

    پایگاه های اطلاعاتی PubMed، Web of Science، SID، Magiran و Google scholar برای مقالات منتشرشده تا جولای سال 2023 به صورت سیستماتیک جستجو شد و فراتحلیل برای تاثیر تمرینات ورزشی بر نشانگرهای التهابی در بیماران COPD انجام گرفت. تفاوت میانگین استاندارد (SMD) و فاصله اطمینان 95 درصد (CI) با استفاده از الگوی اثر تصادفی محاسبه گردید؛ همچنین برای تعیین ناهمگونی از آزمون I2 و برای بررسی سوگیری انتشار از آزمون فونل پلات و تست Egger استفاده شد.

    یافته های پژوهش:

     نتایج تجزیه وتحلیل داده های 11 مطالعه با 578 بیمار COPD نشان داد که تمرینات ورزشی به کاهش غیر معنادار مقادیر گردش خونی CRP (P=0.16، [175/0 الی 100/0-] SMD=-0.413) و IL-6 (P=0.54، [36/0 الی 69/0-] SMD=-0.164) و TNF-α (P=0.51، [44/1- الی 72/0] SMD=-0.358) در بیماران COPD منجر می شود؛ همچنین نتایج تحلیل زیرگروهی نشان داد که تمرین هوازی (P=0.1، SMD=-0.55) نسبت به تمرین مقاومتی (P=0.7، SMD=-0.09)، به کاهش CRP سرمی در بیماران COPD می انجامد؛ اما به هرحال، این تفاوت معنادار نیست.

    بحث و نتیجه گیری

    یافته های فراتحلیل حاضر نشان می دهد که احتمالا تمرینات هوازی یک مداخله ورزشی موثر برای کاهش CRP در بیماران COPD باشد.

    کلید واژگان: تمرین ورزشی, بیماری مزمن انسداد ریوی, اینترلوکین 6, فاکتور نکروز تومور آلفا, پروتئین واکنشی C}
    Fatemeh Kazeminasab*, Nasim Behzanejad, Mousa Khalafi
    Introduction

     Chronic obstructive pulmonary disease (COPD) is one of the respiratory diseases in which inflammation plays a key role in its development. Exercise training has acritical role in improving chronic inflammation. Nonetheless, the effects of various exercise training on inflammatory markers in these patients are not clear. Therefore, the present study aimed to assess the impact of exercise on the inflammatory markers, including IL-6, TNF-α, and c-reactive protein in patients with COPD.

    Material & Methods

    A systematic search was conducted on PubMed, Web of Science, SID, Magiran, and Google scholar databases for articles published until July 2023. A meta-analysis was performed for the impact of exercise on inflammatory markers in COPD patients. Effect size (SMD) and 95% confidence interval were calculated using random effect model. Moreover, I2 test was employed to determine heterogeneity, while Funnel plot test and Egger test were used to check publication bias.

    Results

    The results of the data analysis of 11 studies on 578 patients with COPD demonstrated that exercise led to a non-significant decrease in circulating CRP values [SMD=-0.413 (-0.100 to 0.175), P=0.16], IL-6 [SMD=-0.164 (-0.69 to 0.36], P=0.54], TNF-α [SMD=-0.358 (-1.44 to 0.72), P=0.51) in COPD patients. Furthermore, the results of the subgroup analysis pointed out that aerobic training [SMD=-0.55, P=0.1] compared to resistance training [SMD=-0.09, P=0.7] led to a decrease in CRP in patients with COPD. Nonetheless, this difference was not significant.

    Discussion & Conclusion

    The findings of the present meta-analysis illustrated that aerobic exercise is probably an effective exercise intervention to reduce CRP in patients with COPD.

    Keywords: Chronic Obstructive Pulmonary Disease, C-Reactive Protein Exercise, Interleukin 6, Tumor Necrosis Factor-Alpha}
  • جواد حسینی، ناهید حسین زاده، فرشته عیدی، محبوبه فیروز، سمانه دامغانی، اسحق ایلدرآبادی*
    زمینه و هدف

    بیماری مزمن انسدادی ریه (COPD)[1] سومین عامل مرگ بیماران در جهان است. بستری بیماران در بیمارستان فرصت مناسبی برای درگیر نمودن مراقبین در مراقبت از بیماران است. مطالعه حاضر با هدف  تعیین و مقایسه تاثیر آموزش چهره به چهره به سالمندان و مراقبین بر شدت بیماری COPD انجام گرفت.

    روش ها

    این مطالعه به روش کار آزمایی بالینی دو گروهه، بیماران مبتلا به COPD مراجعه کننده به بخش داخلی بیمارستان امام خمینی (ره) در شهر اسفراین انجام شد. در گروه آموزش به سالمند و آموزش به مراقب هر کدام 29 سالمند حضور داشتند.. آموزش هر دو گروه به صورت انفرادی و چهره به چهره در چهار جلسه ی 20-30 دقیقه ای بود. پرسشنامه شدت بیماری (CAT) COPD Assessment Test قبل مداخله، حین ترخیص و یک ماه بعد از اتمام مداخله توسط بیماران تکمیل شد. تحلیل داده ها با استفاده از آزمون های آماری کای دو، دقیق فیشر، من ویتنی و فریدمن و با استفاده از نرم افزار SPSS24  انجام شد.

    نتایج

    شدت بیماری در گروه آموزش به سالمند و در گروه آموزش به مراقب در  قبل از مداخله، حین ترخیص و یک ماه بعد، باهم تفاوت معناداری داشتند (p< 0/001) . همچنین بین دو گروه  از نظر  تاثیر آموزش بر شدت بیماری تفاوت معنی داری وجود نداشت (P>0/05).

    نتیجه گیری

    هر دو روش آموزش چهره به چهره به سالمندان و مراقبین موجب کاهش شدت بیماری COPD شد. از آنجایی که اکثر سالمندان توسط مراقبین و به صورت رایگان مراقبت می شوند. آموزش به مراقبین روشی کم هزینه است. بنابراین پرستاران می توانند با آموزش به آنان، زمینه ارتقاء سلامت سالمندان  را فراهم نمایند.

    کلید واژگان: بیماری مزمن انسدادی ریه, COPD, شدت بیماری, سالمند, مراقبین, آموزش چهره به چهره}
    Seyed Javad Hosseini, Nahid Hossinzadeh, Fereshteh Eidy, Mahbobeh Firooz, Samaneh Dameghani, Es-hagh Ildarabadi *
    Background & Aim

    Chronic obstructive pulmonary disease (COPD) ranks as the third leading cause of global patient mortality. Patient hospitalization presents an opportune moment to engage caregivers in patient care. This study aims to assess and compare the impact of face-to-face education for the elderly and their caregivers on COPD severity.

    Methods

    This two-group clinical trial included COPD patients from the internal department of Imam Khomeini Esfarayen Hospital. Each group, one for elderly training and one for caregiver training, comprised 29 seniors and underwent four 20-30 minute face-to-face sessions. The COPD Assessment Test (CAT) was administered before intervention, during discharge, and one month post-intervention. Statistical tests, including Chi-square, Fisher's exact, Mann-Whitney, and Friedman, were employed for data analysis by SPSS24 .

    Results

    Significant differences in disease severity were observed in both the elderly training group and the caregiver training group before the intervention, during discharge, and one month later (p<0.001). However, there was no notable distinction between the two groups regarding the effectiveness of education on disease severity (P>0.05).

    Conclusion

    Face-to-face education for both the elderly and caregivers yielded reductions in COPD severity. Considering the cost-effectiveness of training caregivers, who often provide unpaid care for the elderly, nurses can contribute to improving elderly health through caregiver education.

    Keywords: chronic obstructive pulmonary disease, COPD, disease severity, elderly, caregivers, face-to-face education}
  • Mohammad Kazem Momeni, Omolbanin Afroshte *, Mohammad Ali Mashhadi, Abolfazl Payandeh, Mahmoud Amirian, Mohadeseh Chahkandi
    Background

    Inhaled corticosteroids (ICSs) have been widely used in the maintenance therapy of chronic obstructive pulmonary disease (COPD). Eosinophilic airway inflammation is a recognized inflammatory endotype in COPD. Nevertheless, the benefits and risks of ICS treatment remain controversial.

    Objectives

    Therefore, in this study, we determine the frequency of eosinophilia in COPD patients and compare the effects of ICSs in patients with and without eosinophilia referring to the lung clinics of Zahedan University of Medical Sciences.

    Methods

    In this study, 58 COPD patients were examined. Peripheral blood smears (PBS) were collected from all patients, and they were randomly divided into 2 groups. First, a 6-minute walking test (6MWT) was performed on all patients. Thereafter, two groups of patients received standard treatment with the Symbicort spray for 3 months. They were followed for this period, and the 6MWT was performed again at the end of the 3 months.

    Results

    The mean results of the 6MWT test before and after intervention in the eosinophilia-positive group were 164.02 meters and 192.11 meters, respectively. Therefore, there was a significant difference in patient activity levels before and after ICSs (P = 0.017). In the eosinophilia-negative group, there was a significant difference in patient activity levels based on the 6MWT test before and after taking ICSs (P < 0.001). However, there was no difference in activity levels between the two groups before and after the intervention (P = 0.68 and P = 0.36).

    Conclusions

    Our finding showed that treatment with inhaled β2-agonists plus corticosteroids did not affect the response to this treatment in subjects' groups with and without eosinophilia compared to the pre-treatment conditions.

    Keywords: Chronic Obstructive Pulmonary Disease, Inhaled Corticosteroid, Eosinophilia}
  • سکینه غفاری، فاطمه سلمانی*، مهرداد آذربرزین
    زمینه و هدف

    بیماری مزمن انسدادی ریه یک بیماری تنفسی ناتوان کننده است و از علل عمده مرگ ومیر و ناتوانی در دنیا محسوب می شود. درمان های حمایتی تنفسی جزء درمان های تجویزی جهت بهبود این بیماران می باشد. پژوهش حاضر با هدف تعیین تاثیر تمرینات تنفسی و فیزیوتراپی قفسه سینه بر خستگی بیماران مزمن انسدادی ریه طراحی شد. 

    روش بررسی

    مطالعه حاضر از نوع نیمه آزمایشی بر روی 45 بیمار مزمن انسدادی ریه که به روش نمونه گیری در دسترس انتخاب شدند انجام شد و توسط تخصیص تصادفی به دو گروه 15 نفره تمرینات تنفسی و فیزیوتراپی قفسه سینه و یک گروه 15 نفره کنترل تقسیم شدند. قبل و 6 هفته بعد از انجام مداخله پرسش نامه شدت خستگی کراپ توسط بیمار تکمیل شد. تحلیل داده ها با استفاده از آزمون تی زوجی، تحلیل واریانس یک طرفه و کای اسکوئر با نرم افزار SPSS نسخه 26 انجام شد.

    یافته ها

    نتایج یافته ها نشان داد میانگین شدت خستگی بیماران قبل و بعد از مداخله در گروه آزمایش تمرینات تنفسی، فیزیوتراپی تنفسی و گروه کنترل تفاوت معنادار آماری داشت (0/001>P). این معناداری در گروه کنترل در جهت افزایش نمره شدت خستگی بوده است. همچنین میانگین شدت خستگی بین 3 گروه قبل از مداخله تفاوت معناداری نداشت، درحالی که بعد از مداخله تفاوت معنادار بود (0/001>P).

    نتیجه گیری

    باتوجه به تغییرات مشاهده شده میزان شدت خستگی بعد از درمان های حمایتی، پیشنهاد می شود از این درمان ها به صورت تکمیلی در کنار سایر درمان های دارویی برای بیماران استفاده شود تا باعث بهبود وضعیت تنفسی بیماران گردد.

    کلید واژگان: فیزیوتراپی قفسه سینه, تمرینات تنفسی, بیماری مزمن انسدادی ریه, خستگی}
    Sakineh Ghafari, Fatemeh Salmani*, Mehrdad Azarbarzin
    Background & Aims

    Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory disease and one of the main causes of death and disability in the world. Respiratory support treatments are among the methods for the recovery of these patients. The present study aims to assess the effect of breathing exercises and chest physiotherapy on the fatigue of patients with COPD.

    Materials & Methods

    This is a quasi-experimental study on 45 patients COPD who were selected by convenience sampling method and randomly assigned to two experimental groups of breathing exercises (n=15) and chest physiotherapy (n=15) and one control group (n=15). Before and 6 weeks after the intervention, Krupp’s Fatigue Severity Scale was completed by the patient. Data analysis was done using paired t-test, one-way analysis of variance and chi-square in SPSS software, version 26. 

    Results

    The mean scores of fatigue severity were significantly different in all groups between pretest and post-test phases (P<0.001). The fatigue severity in the intervention groups was reduced, while it increased in the control group, after intervention. There was no significant difference in fatigue severity among the three groups at baseline, but the difference was significant after the intervention (P<0.001). 

    Conclusion

    Considering the reduction in fatigue severity after two supportive treatments, it is recommended that breathing exercises and chest physiotherapy should be used along with drug treatments for patients with COPD to improve their respiratory conditions.

    Keywords: Chest Physiotherapy, Breathing Exercises, Chronic Obstructive Pulmonary Disease, Fatigue}
  • Maryam Edalatifard, Esmaeil Mortaz, Fariba Ghorbani, Besharat Rahimi, Seyed Mehran Marashian, Roshan Dinparastisaleh, Alireza Eslaminejad *
    Background
    Chronic Obstructive Pulmonary Disease (COPD) exacerbation is characterized by both airway and systemic inflammation. The present study aimed to investigate the relationship between serum levels of some inflammatory biomarkers and the phenotypes of COPD exacerbation.
    Materials and Methods
    This study includes known COPD patients, presenting to a hospital with acute exacerbation of COPD. Serum levels of CRP, ESR, CBC, TNF-α, IL-8, and IL-6 were measured at the time of admission. According to the previously done HRCT, the patients were divided into two groups including emphysema and chronic bronchitis. Levels of serum biomarkers were compared in the two groups. The relationships between biomarkers and duration of hospitalization were assessed too.
     
    Results
    Comparison of quantitative CRP levels, WBC, and platelet counts did not show a statistically significant difference between emphysema and chronic bronchitis but it was significantly higher than control subjects. Although not statistically significant, ESR level was higher in emphysema. TNF-alpha was 6.0±1.5 ng / ml and 1.5 ng / ml in the emphysema and chronic bronchitis groups, respectively. TNF-α had no significant difference compared to the groups. Although higher than the control group, IL-6 and IL-8 did not show significant differences between emphysema and chronic bronchitis. The two groups did not statistically differ in terms of hospital stay but patients with higher serum TNF-α tended to have longer hospitalization and ICU admission.
    Conclusion
    The present study showed predictably higher inflammatory biomarkers in COPD exacerbation but no significant difference between the two phenotypes of COPD and these two entities could not be discriminated based on inflammatory bio-factors.
    Keywords: Chronic Obstructive Pulmonary Disease, Emphysema, Chronic bronchitis, Tumor necrosis factor- α (TNF-α)}
  • Roya Baniamerian, Hanieh Tahermohammadi, Babak Daneshfard, Khosrow Agin, Saeed Sadr, Shahpar Kaveh, Nezhat Shakeri, Reza Ilkhani *
    Background

    Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases. The current therapeutic outcomes are not satisfactory and may cause adverse events such as cardiovascular complications. In this study, we aimed to discuss some effective medicinal herbs for the management of COPD.

    Materials and Methods

    In this review, we looked for effective medicinal herbs for productive cough with thick and sticky mucus in Persian medicine sources such as Qanoon fi al-Teb, Exir Azam, and Zakhire Kharazmshahi. Then, to find relevant evidence about them, the data sources (PubMed and Google Scholar) were searched in the English language without time restriction from inception up to March 2022.

    Results

    We found that Zataria multiflora, Thymus vulgaris L, Glycyrrhiza glabra L., Crocus sativus L., Nepeta bracteata Benth., and Hyssopus officinalis have beneficial effects on COPD due to their properties including anti-inflammatory and antioxidant activity. In addition, considering asthma COPD overlap (ACO), medicinal herbs including Cordia myxa, Adiantum capillus-veneris, Cinnamomum verum, Viola odorata, Borago officinalis, Linum usitatissimum and Vitis viniferia L. were found to have useful effects on asthma.

    Conclusion

    Considering the mentioned beneficial mechanisms of action of these medicinal herbs, they could be used as a complementary therapy in COPD and asthma. However, more experimental and clinical research should be done to confirm their clinical effects.

    Keywords: Asthma, Chronic Obstructive Pulmonary Disease, Lung diseases, Persian medicine, Medicinal Herb}
  • سحر رضایی نژاد*، حمید بخشی علی آباد، حسین بصیرت، هانیه ملکی، فاطمه امین، مهدی کریمی
    زمینه و هدف

    بیماری مزمن انسدادی ریه (Chronic Obstructive Pulmonary Disease ,COPD) با علایمی چون تنگی نفس و سرفه همراه است و به عنوان چهارمین علت مرگ ومیر در سطح جهان شناخته می شود. مطالعات محدودی نشان داده اند که ویتامین D3 می تواند در کاهش شدت بیماری و پیشگیری از تشدید حملات بیماران COPD تاثیر مثبتی داشته باشد. لذا در این مطالعه به بررسی همبستگی سطح سرمی ویتامین D3 و شدت بیماری در بیماران مزمن انسدادی ریه مراجعه کننده به کلینیک بیمارستان علی ابن ابیطالب (ع) رفسنجان در سال 95-1396 پرداخته شده است.

    مواد و روش ها

    این مطالعه، یک مطالعه توصیفی-همبستگی بود و 70 بیمار مبتلا به COPD پس از انجام اسپیرومتری و تایید COPD وارد مطالعه شدند. در آغاز پژوهش سطح سرمی ویتامین D3 در همه بیماران اندازه گیری شد. سپس متغیرهایی چون شدت بیماری با استفاده از نمره اسپیرومتری بر اساس معیار GOLD، شدت تنگی نفس بر اساس معیار MRC و تعداد حملات سنجیده شد. داده ها با استفاده از نرم افزار 20 SPSS و آزمون ضریب همبستگی اسپیرمن مورد تجزیه وتحلیل قرار گرفت.

    یافته ها

    از 70 بیمار مبتلا به COPD، 17 نفر (24٫2%) کمبود شدید ویتامین D3 و 21 نفر (30%) در سطح ناکافی ویتامین D3 بودند. همبستگی متوسط معنی داری بین سطح سرمی ویتامین D3 و شدت بیماری بر اساس داده های اسپیرومتری وجود داشت (0٫587= r و 0٫000=P). همچنین ارتباط معکوس معنی داری بین سطح سرمی ویتامین D3 با تعداد حملات (0٫000 =P) و شدت تنگی نفس (0٫05=P) مشاهده شد.

    نتیجه گیری

    نتایج مطالعه حاضر نشان داد که کمبود ویتامین D3 در افراد مبتلا به COPD شایع بوده. علاوه بر این با کمبود ویتامین D3 شدت بیماری در بیماران افزایش می یابد؛ بنابراین درمان سطح ناکافی از ویتامین D3 می تواند به طور بالقوه از شدت و تعداد حملات در این بیماران جلوگیری کند.

    کلید واژگان: بیماری مزمن انسدادی ریه, ویتامین D3, شدت بیماری, تعداد حملات}
    Sahar Rezaei Nejad*, Hamid Bakhshi Aliabad, Hosein Basirat, Haniye Maleki, Fatemeh Amin, Mahdi Karimi
    Background and Aim

    Chronic obstructive pulmonary disease (COPD) which is characterized by symptoms such as dyspnea and cough is the fourth leading cause of death worldwide. Limited studies have shown that vitamin D3 can have a positive impact on reducing the disease severity and preventing exacerbations in the patients with COPD. Therefore, in this study we evaluated the correlation of the serum vitamin D3 level with the severity of disease in COPD patients referring to the clinic of Ali-Ibn Abi Talib Hospital in Rafsanjan in 2015-2016.

    Materials and Methods

    This descriptive-correlational study included 70 patients with COPD. Diagnosis of COPD was confirmed by spirometry. In all patients, serum vitamin D3 level was measured then variables such as the severity of the disease (from spirometry score in GOLD criteria), the severity of dyspnea according to MRC dyspnea scale and the number of exacerbations were measured. Using software SPSS 20, data were analyzed by Spearman correlation.

    Results

    Among 70 COPD patients, 17 (24.2%) had severe vitamin D3 deficiency and 21 (30%) had insufficient vitamin D3 level. Significant moderate correlation was observed between the serum vitamin D3 level and severity of the disease based on the results of spirometry (r=0.587 and p=0.000). Also, vitamin D3 level showed significant inverse relationships with the frequency of exacerbations (p = 0.000) and the severity of dyspnea (p = 0.05).

    Conclusion

    The study findings indicated that vitamin D3 deficiency among COPD patients was prevalent. Moreover, there was a clear association between vitamin D3 deficiency and the severity of COPD. Therefore, treatment of vitamin D3 deficiency can potentially prevent the severity and frequency of exacerbations in these patients.

    Keywords: Chronic obstructive pulmonary disease, Vitamin D3, Severity of disease, Number of attacks}
  • فاطمه مرادی*، قاسم عسکری زاده، مسعود باقری
    اهداف 

    یکی از شایع ترین بیماری ها به موازات افزایش سن و سالمندی جمعیت، انسداد مزمن ریوی است که پیامدهای نامطلوبی بر عملکردهای شناختی به جای می گذارد. پژوهش حاضر با هدف بررسی اثرات تعاملی سن و ذخیره شناختی بر سرعت پردازش اطلاعات، حافظه فعال دیداری فضایی و نارسایی های شناختی در بیماران میانسال و سالمند مبتلا به انسداد مزمن ریوی انجام شد. 

    مواد و روش ها 

    در مطالعه مقطعی حاضر نمونه ای متشکل از 208 بیمار میانسال و سالمند مبتلا به انسداد مزمن ریوی بر اساس معیارهای ورود به مطالعه انتخاب شدند. داده ها با استفاده از شاخص ذخیره شناختی، پرسش نامه نارسایی های شناختی، تکلیف بلوک های کرسی و آزمون نماد ارقام گردآوری شدند. برای تجزیه و تحلیل داده ها از آزمون تحلیل واریانس چندمتغیره دوراهه با کمک نرم افزار SPSS نسخه 27 استفاده شد.

    یافته ها

    یافته های مطالعه حاضر حاکی از آن بود که 1. افزایش سن سرعت پردازش اطلاعات، حافظه فعال دیداری فضایی و نارسایی های شناختی را به طور معناداری در بیماران انسداد مزمن ریوی تحت تاثیر قرار می دهد، 2. ذخیره شناختی بر سرعت پردازش اطلاعات و نارسایی های شناختی بیماران انسداد مزمن ریوی تاثیر معناداری دارد، اما تاثیر ذخیره شناختی بر حافظه فعال دیداری فضایی مشاهده نشد و 3. اثر تعاملی سن و ذخیره شناختی صرفا بر نارسایی های شناختی مشاهده شد، در حالی که تعامل سن و ذخیره شناختی تاثیر معناداری بر سرعت پردازش و حافظه فعال دیداری فضایی نداشت.

    نتیجه گیری 

    نتایج پژوهش حاضر نشان داد سن و ذخیره شناختی ممکن است اثرات افتراقی بر حوزه های شناختی گوناگون در میانسالان و سالمندان مبتلا به انسداد مزمن ریوی داشته باشند.

    کلید واژگان: سالمندی, ذخیره شناختی, سرعت پردازش, نارسایی های شناختی مرتبط با سن, بیماری انسداد مزمن ریوی}
    Fateme Moradi*, Ghasem Askarizadeh, Masoud Bagheri
    Objectives 

    Chronic obstructive pulmonary disease (COPD) is one of the most common age-related diseases, which has adverse effects on cognitive functions. This study aims to investigate the interaction effects of age and cognitive reserve on information processing speed, visuospatial working memory, and cognitive failures in middle-aged and older adults with COPD.

    Methods & Materials 

    This cross-sectional study was conducted in 2023 on a 208 middle-aged and older patients with COPD who met the study criteria. Data were collected using the cognitive reserve index, cognitive failures questionnaire, the Corsi block-tapping test, and the symbol digit modalities test. The data were analyzed using multivariate analysis of variance in SPSS software, version 27.

    Results

    Aging significantly affected information processing speed, visuospatial working memory, and cognitive failures in COPD patients. Cognitive reserve had a significant effect on information processing speed and cognitive failures in COPD patients, but had no effect on visuospatial working memory. The interaction effect of age and cognitive reserve was significant only on the cognitive failures; the interaction effect had no significant effect on the information processing speed and visuospatial working memory. 

    Conclusion

    Age and cognitive reserve may have differential effects on various cognitive domains in middle-aged and older adults with COPD.

    Keywords: Aging, Cognitive reserve, Information processing speed, Age-related cognitive failures, Chronic obstructive pulmonary disease}
  • Changping Yun, Yuguang Wang, Dongxu Wang, Jialin Zang, Zhen Lv, Ruinan Liu, Houyi Cong
    Background

    Chronic obstructive pulmonary disease (COPD) has become a global public health problem due to its high mortality. So there is an urgent need to find an effective treatment

    Methods

    The targeting relationship among circABCB10, miR-130a and PTEN was predicted by  the targetscan database. The lung condition was detected by CT(Computed Tomograph). The expression levels of circABCB10, miR-130a and PTEN in lung tissues were determined by qRT-PCR. The COPD model was established by stimulating normal and silenced 16HBE cells in circABCB10 genes with cigarette smoke extract (CSE) at different concentrations. qRT-PCR was conducted for the expression levels of circABCB10, miR-130a and PTEN, WB for the expression levels of apoptotic proteins,ELISA for the content of inflammatory factors,and CCK8 for the effect of CSE on the proliferation of cells.

    Results

    CircABCB10 expression increased in lung tissues from patients with COPD and in 16HBE cells treated with CSE. The stimulation on cells with CSE increased the expression of inflammatory factors, while knocking down circABCB10 could reverse this response. The inflammatory response to the knockdown of circABCB10 was reversed by miR-130a inhibitor, which increased the expression of c-caspase 3. The targetscan database predicted the target factor downstream miR-130a was PTEN. Transfecting OE-PTEN reversed the inflammation of knocking down circABCB10, and increased the apoptosis and inflammation.

    Conclusion

    CircABCB10 can cause the inflammatory response by targeting miR-130a/PTEN axis, which is a mechanism that may lead to the occurrence and development of COPD.

    Keywords: Apoptosis, Immunology, Cells, Chronic obstructive pulmonary disease}
  • Armin Kheirypour, Arezoo Moini Jazani, MohammadHashem Hashempur, Hassan Ghobadi-Marallu, Ramin Nasimi Doost Azgomi

    Asthma and chronic obstructive pulmonary disease (COPD) are the most common chronic diseases with a high global burden of disease. Today, the use of complementary and alternative medicine (CAM) has become more popular. In general, in developing countries, easy access and low cost of traditional medicine, and in developed countries, more access to health information, the prevalence of old age and the increase in chronic diseases are the reasons for this increasing use of traditional medicine. This study aimed to determine the rate and pattern of CAM used and their relationships with demographic characteristics among asthmatic and COPD patients. This research was a cross-sectional study performed on asthma and COPD patients (n=357) referring to the Pulmonary Diseases affiliated with Ardabil University of Medical Sciences, Ardabil, Iran from 2019 to 2020. Data were collected by using semi-structured questionnaires including open and closed questions and face-to-face interviews. Three hundred and thirty-nine patients (95%) used at least one type of CAM in the last year of study. About half of the patients (49.9%) used more than two types of CAM during the last 12 months. Three hundred and four patients (85.2%) used medicinal plants. Few patients reported with the use of CAM to their physician or health care providers (16.1%, 12.5%, and 16.7% of the users of medicinal plants, bloodletting, and dry cupping respectively). Relatives and friends (77.9%) were with the most common sources of recommendation of CAM to the patients. The present study showed the high prevalence of using different types of CAM, especially herbal medicines in Iranian asthmatic and COPD patients. The main incentive for using CAM was for friends and family members, not health care providers. The use of CAM is associated with age patients age, family size, habitat, education, and occupation.

    Keywords: Asthma, Chronic obstructive pulmonary disease, Complementary, therapy, plant, Persian medicine}
  • Yousef Nikmanesh, Kourosh Zarea, Naser Hatamzadeh, Marya Cheraghi, Masoume Taherian, Saeid Jalali, Nourolla Tahery, Habib Allah Shahriyari, Akram Zhiani Fard, Mohammad Javad Mohammadi *

    Context: 

    A wide range of complications, including chronic respiratory diseases, asthma attacks, cardiovascular diseases (CDs), various cancers (blood, lung, and brain), and even death, can result from air pollution. It is essential to assess the health effects on humans caused by environmental air pollutants and non-communicable diseases (NCDs), including coronavirus disease 2019 (COVID-19). The purpose of this review study was to investigate the synergistic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and air pollutants on the risk factors for chronic obstructive pulmonary disease (COPD), CDs, and respiratory diseases (RDs).

    Evidence Acquisition: 

    An extensive literature review was conducted. A total of 1 005 articles were retrieved from sources, including Google Scholar, Springer, PubMed, Web of Science, and Springer databases. In the final stage of the literature review, a significant association between mortality related to COVID-19 and air pollution emissions was identified, contributing to the risk factors associated with CDs and RDs.

    Results

    The result showed that air pollution can have synergistic effects on the transmission of SARS-CoV-2 viruses and has an increasing effect on the incidence of RDs [such as SARS and Middle East respiratory syndrome (MERS)] and CDs. According to the findings, exposure to toxic air pollutants, whether chronic or acute, can have severe effects, including a decrease in airway ciliary function, damage to the mucous membrane, reduced air sac elasticity, decreased lung capacity, and an increased risk of CDs.

    Conclusions

    COVID-19 and air pollutants pose a serious threat to human and animal health. Epidemiological studies have shown that in addition to environmental conditions, individual sensitivity plays a key role in the development of conditions such as COPD, CDs, RDs, cancer, and mortality.

    Keywords: COVID-19, Air Pollution, Risk Factors, Chronic Obstructive Pulmonary Disease, Cardiovascular Diseases, Respiratory Diseases}
  • Fateme Monjazebi, Vahid Zamanzadeh, Fereshteh Najafi *
    Background

     Limitations of activities of daily living (ADLs) are well-known in chronic obstructive pulmonary disease (COPD) patients. However, a lack of consensus regarding the concept of ADL in COPD patients causes problems in their measurement. This study was conducted to clarify and conceptualize the concept of ADLs in COPD.

    Methods

     The hybrid model of concept analysis consisting of a literature review phase, a fieldwork phase, and an analytical phase was applied. In the first phase, an extensive literature review was performed by searching the accredited databases for relevant articles published within 2000-2022. In the second phase, 18 in-depth interviews with COPD patients were carried out in Tehran, Iran. Field observational notes were transcribed verbatim, and qualitative content analysis was performed. In the analytical phase, attributes of ADLs were derived from the previous two phases.

    Results

     Based on the attributes derived from the final analytical phase, ADLs in COPD patients are complex and multifactorial and are affected by dyspnea and factors influencing it. The pattern of daily activities, communication, and self-care in COPD patients changes toward living normally and independently.

    Conclusions

     The concept analysis of ADLs in COPD patients revealed some key attributes. The results might be useful for designing nursing models, developing theories and measurement tools, and increasing the capacity to perform ADLs in COPD patients.

    Keywords: Activities of daily living, Chronic obstructive pulmonary disease, Qualitative research, Hybrid concept analysis}
  • ویدا شیخ، فاطمه کارگر، عباس مرادی، سعید خاکی زاده، ابراهیم نادی*
    سابقه و هدف

     بیماری انسدادی مزمن ریه Chronic Obstructive Pulmonary Disease (COPD) مشکلی مرتبط با سلامت در سراسر جهان و چهارمین علت مرگ ومیر در دنیا است. هدف از مطالعه ی حاضر تعیین نسبت آلبومین/کراتینین ادراری و سطح اسیداوریک سرمی به عنوان پیش بین های شدت بیماری در مبتلایان به بیماری انسدادی مزمن ریه است.

    مواد و روش ها

     این مطالعه ی مقطعی درباره ی 67 بیمار مبتلا به COPD بر اساس معیار تشخیصی GOLD مراجعه کننده به درمانگاه فوق تخصصی ریه و بخش اسپیرومتری و بیماران بستری در بخش ریه ی بیمارستان شهید بهشتی همدان انجام گرفت. از بیماران COPD آزمایش خون و ادرار گرفته شد و سطح اسیداوریک سرمی، آلبومین وکراتینین ادراری در چک لیست ثبت شد.

    یافته ها

     65/7 درصد بیماران COPD را مردان و 34/3 درصد را زنان تشکیل دادند. میانگین سن بیماران 61/77 سال بود. شدت بیماری در 20/89 درصد از بیماران بسیار شدید، 22/38 درصد شدید، 5/73 درصد متوسط و 2/98 درصد خفیف بود. نتایج تحلیل رگرسیونی نشان داد که سطح اسیداوریک سرمی، FEV1 را در بیماران مبتلا به COPD به طور معنی داری، پیش بینی می کند. همچنین، سطح اسیداوریک سرمی بین بیماران مبتلا به COPD در سطوح شدت بیماری دارای تفاوت معنی دار بود.

    نتیجه گیری

    بر اساس یافته های پژوهش حاضر می توان نمره ی FEV1 بیماران مبتلا به COPD و در نتیجه، شدت بیماری را بر اساس سطح اسیداوریک سرمی بیماران پیش بینی کرد و بر این اساس، پیشنهاد می شود که کنترل و بررسی فاکتورهای غیرریوی، به ویژه اسیداوریک سرمی در افراد مبتلا به COPD در فرایند درمان این بیماران مدنظر قرار گیرد.

    کلید واژگان: آلبومین, اسیداوریک, بیماری انسدادی مزمن ریه, کراتینین}
    Vida Sheikh, Fatemeh Kargar, Abbas Moradi, Saeed Khaki Zadeh, Ebrahim Nadi*
    Background and Objective

    As a global healthcare issue, Chronic Obstructive Pulmonary Disease (COPD) is mainly associated with smoking. Nonetheless, environmental and occupational issues are also linked to its development. The present study aimed to assess the urine albumin-to-creatinine ratio (ACR) and serum uric acid (SUA) levels as predictors of disease severity in COPD patients.

    Materials and Methods

    This cross-sectional study was conducted on 67 patients diagnosed with COPD using the Global Initiative for Obstructive Lung Disease diagnostic criteria. The participants were patients who were either referred to the subspecialty clinic of the pulmonology and spirometry unit of Hamadan Shahid Beheshti Hospital or were hospitalized in the pulmonology ward. Blood and urine samples were taken from the COPD patients, and the serum uric acid, urine albumin, and urine creatinine levels were assessed and recorded in a checklist. The data were analyzed in SPSS software (version 23) at a significance level of 0.05.

    Results

    In terms of gender, 5.7% of the participants were male and 34.3% were female. The mean age of patients was 61.77 years. The stages of disease severity in the patients were as follows: 20.89%, 22.38%, 5.73%, and 2.98% of cases had very severe, severe, moderate, and mild COPD, respectively. The regression analysis results demonstrated that SUA levels could significantly predict the FEV1 in COPD patients; nonetheless, urine ACR could not predict the FEV1 scores.

    Conclusion

    As evidenced by the result of the present study, the FEV1 in COPD patients and disease severity could be predicted by the SUA levels. Therefore, it is recommended to consider monitoring and assessing non-pulmonary factors, especially SUA levels, in the treatment of COPD patients.

    Keywords: Albumins, Chronic Obstructive Pulmonary Disease, Creatinine, Uric Acid}
  • Fariba Rezaeetalab, Sedigheh Noori, Ali Shamshirian, Amirali Moodi Ghalibaf, Farid Poursadegh, Mahnaz Mozdourian *
    Introduction
    Gamma-glutamyl transferase (GGT) is a liver enzyme that is involved in inflammation and oxidative stress. It has been hypothesized that elevated GGT may occur secondary to oxidative stress in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and can be used as an indicator of inflammation in these patients. The present study aimed to determine the relationship between serum GGT and arterial blood gas (ABGs) on the one hand and COPD severity in AECOPD patients on the other hand.
    Methods
    Patients with AECOPD were evaluated for disease severity based on the global initiative for chronic obstructive lung disease (GOLD), Modified British Medical Research Council (mMRC), COPD Assessment Test (CAT), and spirometry assessment upon admission at the hospital. Moreover, the GGT level in patients was analyzed based on the severity of the disease. The data were analyzed using SPSS software (version 25.0) by proper statistical tests. The significance level was P˂0.05.
    Results
    The mean±SD of the CAT score in the patients was obtained at 19.6± 4.6. According to the mMRC scale, most patients were grade 2 (n=29, 52.7%) and grade 1 (n=17, 30.9%), respectively. In addition, according to GOLD criteria, most patients (n=34, 61.8%) had moderate and severe (n=16, 29.1%) disease, respectively. The median (IQR) GGT levels in patients with mMRC 0-1 were 28.7 (12.98) IU/L, and those with mMRC 2-4 were 21 (33) IU/L (P=0.770). Additionally, the median (IQR) of GGT levels in patients in GOLD A-B were obtained at 26(18) IU/L, and in patients in GOLD C-D were reported as 18 (23.80) IU/L (P=0.222). The results showed a significant positive relationship between GGT level and AECOPD severity (r=+0.277, P=0.04). Moreover, a significant negative relationship was observed between GGT level and forced vital capacity (FVC) (r=-0.268, P=0.04). According to the Pearson correlation test, There was no significant correlation between GGT level with arterial HCO3 (P=0.123), PCO2 (P=0.511), PO2 (P=0.888), FEV1 (P=0.356), and FEV1/FVC (P=0.975).
    Conclusion
    In conclusion, while a significant positive relationship was found between GGT levels and AECOPD severity, the study suggests that serum GGT levels may not have clinical efficacy in differentiating between patients with varying intensities of AECOPD periods. Further research with larger sample sizes and consideration of additional factors is warranted to confirm these findings.
    Keywords: Acute exacerbation, Chronic Obstructive Pulmonary Disease, Gamma-glutamyl transferase, AECOPD}
  • Aishee Bhattacharyya, Avas Chandra Roy, Subrata Basu, Krishanko Das*
    Background & Aims

    COPD and metabolic syndrome are highly prevalent and contribute significantly to morbidity and mortality worldwide. Limited evidence suggests a higher prevalence of metabolic syndrome in COPD patients, indicating a potential link between metabolic syndrome and impaired lung function. We aimed to study the correlation between COPD severity and metabolic syndrome components, and between CRP and COPD severity.

    Materials & Methods

    This cross-sectional observational study involved 100 COPD outpatients. Metabolic syndrome parameters were assessed using NCEP criteria. Patients were categorized per GOLD classification using MMRC grading and spirometry. We compared blood pressure, blood glucose, cholesterol, triglycerides, and waist circumference across GOLD stages, and clinical, metabolic, and spirometry parameters between those with and without metabolic syndrome. Analysis was performed using GraphPad Prism 9 and SPSS 26.0.

    Results

    48% of COPD patients had metabolic syndrome. SBP, blood glucose and triglycerides were significantly higher in severe COPD compared to stages I and II. Among metabolic parameters, blood glucose and SBP were significant negative predictors of FEV1/FVC adjusted for age, smoking and BMI. CRP level, diabetes, hypertension, and abdominal adiposity were associated with airflow limitation severity. FEV1/FVC was significantly lower in extreme BMI groups. Those with metabolic syndrome had higher MMRC grade, exacerbation rate, and CRP, but lower FEV1/FVC and smoking history than those without.

    Conclusion

    This study emphasizes assessing and managing metabolic syndrome in COPD patients, and suggests links between inflammation, metabolic syndrome, and impaired lung function.

    Keywords: Chronic Obstructive Pulmonary Disease, Systolic Blood Pressure, Fasting Blood Glucose, Waist Circumference, Metabolic Syndrome, Forced Expiratory Volume}
  • Iman Reiszadeh, Shahla Abolhassani *, Reza Masoudi, Soleiman Kheiri

    Context:

     Fatigue and the reduced quality of life are among the most common problems of patients with chronic obstructive pulmonary disease (COPD), affecting all aspects of life in these patients.

    Aims

     This study aimed to evaluate the effects of self‑care program based on the Orem self‑care model on fatigue and quality of life in patients with COPD.

    Setting and Design: 

    This was a randomized controlled trial conducted on 66 patients with COPD who were admitted to hospitals of Shahrekord University of Medical Sciences, Iran.

    Materials and Methods

     The patients were randomized either to the intervention group or control group using random numbers by random allocation software. The intervention group received self‑care program based on the Orem’s self‑care theory, including four educational sessions as well as a 2‑month follow‑up. The control group received only usual care. The needed data were collected using the Fatigue Severity Scale and 12‑item Short‑Form Health Survey questionnaire once before and once after the interventions and then analyzed using descriptive and analytic statistics.

    Statistical Analysis Used: 

    These data were analyzed by SPSS software using descriptive and analytic statistics.

    Results

     In the intervention group, the mean score of fatigue reduced and the mean score of quality of life significantly increased after performing the interventions (P < 0.05). Moreover, the mean scores of fatigue and quality of life were significantly different between the groups (P < 0.05). The mean changes in terms of fatigue and quality of life scores were significantly greater in the intervention group compared to the control group (P < 0.05).

    Conclusion

     Orem’s self‑care theory is an effective nursing theoretical framework used to reduce fatigue and improve quality of life, thus it can be used for other chronic diseases and conditions as well.

    Keywords: Chronic obstructive pulmonary disease, Fatigue, Orem self‑care mode, Quality of life, Self‑care}
  • مهرناز اسدی قراباغی*، مرسا غلامزاده
    زمینه و هدف

    بیماری انسدادی مزمن ریوی که با محدودیت جریان هوای دمی و بازدمی تعریف می شود، از بیماری های شایع و مهم تنفسی است. تنگی نفس فعالیتی از شکایت های اصلی این بیماران است که با محدودیت توان فیزیکی و جسمی این افراد به ویژه در هنگام انجام فعالیت های روزانه همراه است. بازتوانی ریه و ورزش های تنفسی همراه با دارودرمانی از اصلی ترین برنامه های درمانی در این بیماران است .یکی از موانع برنامه های بازتوانی، ناهماهنگی و عدم تطابق بین روش های درمانی و شاخص های فرهنگی، اعتقادی و اجتماعی بیماران است که موجب شکست درمان در دراز مدت می شود. لذا این مطالعه با هدف بررسی تلاوت آیات قرآن به روش ترتیل به عنوان یک ورزش تنفسی فرهنگ مدار بر ظرفیت عملکردی بیماران مبتلا به بیماری انسدادی مزمن ریوی به انجام رسید.

    روش ها

    مطالعه حاضر یک مطالعه نیمه تجربی مقدماتی است که به صورت آینده نگر در بیماران سرپایی انسدادی مزمن ریوی که کاهش ظرفیت های تنفسی و کم توانی در انجام کارهای روزانه مانند راه رفتن داشتند و به کلینیک ریه مراجعه کرده بودند، انجام شد. تعداد هشت بیمار در مطالعه به صورت داوطلبانه و با مراعات کدهای اخلاقی شرکت کردند. زمان شروع مطالعه 25 فروردین 1400 بود و به مدت 6 هفته ادامه یافت. بیماران به مدت چهل روز هر تعدادی از آیات سوره مبارکه یاسین که برای آنها مقدور بود را به روش ترتیل تلاوت می کردند. پیامدهای مورد بررسی برای مقایسه نتایج پیش و پس آزمون، اندازه گیری حجم های تنفسی و آزمون شش دقیقه ای پیاده روی بود.

    یافته ها

    هشت بیمار داوطلب وارد مطالعه شدند. متوسط سن شرکت کنندگان (66/38 ± 12/00) سال بود. گستره سنی بین 42 تا 83 سال بود. سه بیمار زن و پنج نفر مرد بودند. متوسطFEV1 بعد از شرکت در مطالعه افزایش معنادار داشت (P-value = 0.0002) متوسط مسافت طی شده در تست پیاده روی شش دقیقه بعد از شرکت در مطالعه نیز به طور معنادار افزایش پیدا کرد و از (71/43 ± 310/66) متر به (25/365 ± 85/72) متر رسید (P-value = 0.0002). میزان تنگی نفس ادراک شده در حین تست پیاده روی شش دقیقه بعد از شرکت در مطالعه کاهش معنادار داشت (P-value = 0.0007).

    نتیجه گیری

    نتایج مطالعه نشان می دهد که تلاوت قرآن به روش ترتیل که بیماران کهنسال به آن گرایش دارند و با فرهنگ اعتقادی آنها نیز هم خوانی دارد؛ از طریق تنظیم ارادی سرعت جریان هوای بازدمی و طولانی کردن زمان بازدم در زمان تولید آواهای قرآنی، باعث کاهش احتباس هوا در ریه ها و افزایش ظرفیت عملکردی و میزان مسافت طی شده در تست شش دقیقه پیاده روی می شود. از آنجایی که این روش بازتوانی به دلیل تولید آواهای های مطلوب مورد علاقه افراد است، بیماران تمایل بیشتری برای ادامه این روش بازتوانی به طور مستمر در دراز مدت خواهند داشت.

    کلید واژگان: بیماری انسدادی مزمن ریه, تست پیاده روی شش دقیقه ای, ورزش های تنفسی}
    Mehrnaz Asadi Gharabaghi*, Marsa Gholamzadeh
    Background & aim

    Chronic Obstructive Pulmonary Disease (COPD) is one of the most common respiratory diseases. Due to limitation of breathing; especially on exhalation, shortness of breath, mostly on exertion is the main complaint of these patients, which in turn leads to a decrease in functional capacity and physical activity during daily life activities. Breathing exercises, pulmonary rehabilitation along with drug therapy, are foundation treatments. However, one of the obstacles of rehabilitation programs is the discrepancy between therapeutic measures and social-cultural aspects of patients’ personal lives that decrease the success rate of programs in long term. The aim of the present study was to investigate the effect of reciting the Quran by tartil as a culture- based breathing exercise on functional capacity of patients with COPD.

    Methods

    The study was a prospective case series study done on a group of COPD patients referring to an outpatient respiratory clinic. They were enrolled in the study voluntarily with consideration of ethical codes. They were stable but had imitation in daily activities due to exertional dyspnea. The study was commenced on 2021/04/14 and terminated after six weeks. The subjects recited as much as Ayat of Yassin every day by tartil. Forced Expiratory lung Volume in first second (FEV1) and 6-minute walk distance test were measured before and after the study.

    Result

    In order to carry out this study, eight COPD patients participated. The mean age was 66.38 ± 12.00 years, ranging from 42 to 83. Participants included three women and five men. Mean FEV1 increased at the end of study from 1.58 ± 0.76 to 1.36 ± 0.46. (P value = 0.002). The distance on six-minute walk distance test (6 MWT) increased from 310.60 ± 71.43 meters to 356.25 ± 85.72 meters significantly (P value = 0.002). The subjects perceived their shortness of breath decreased during 6 MWT at the end of study. The score decreased from 5.5 ± 1.5 to 4.5 ± 1.5 (P value=0.007).

    Discussion

    Our preliminary results showed that reciting the Quran by tartil, which is compatible with religious culture, can increase the functional capacity of COPD patients. In reciting, the expiratory time and flow are adjusted to produce Quranic sounds. This might in turn reduce lung hyperinflation and air trapping. These changes cause an increase in the functional capacity of patients in terms of six-minute walk distance. In addition, a higher motivation of patients to perform such practical and functional exercises guaranties efficiency of such pulmonary rehabilitation in long term.

    Keywords: Chronic Obstructive Pulmonary Disease, Six-minute Walk Test, Breathing Exercises}
  • مرجان قاضی سعیدی، محمدامین عباسی اسلاملو، کبری دارابیان*، الهام عطایی
    زمینه و هدف

    با وجود پیشرفت مداوم در پزشکی، Chronic Obstructive Pulmonary Disease (انسداد مزمن ریوی (COPD)) همچنان یک بیماری تنفسی پیشرو، غیرقابل درمان و مزمن است که عملکرد بیماران را از ابعاد مختلف محدود کرده و کیفیت زندگی آن ها را  به میزان قابل توجهی کاهش می دهد. در این مسیر  خودمراقبتی بیماران و به کارگیری ابزارهای مرتبط با آن  در کنترل و درمان بیماری اثر قابل توجهی دارد. هدف این پژوهش ، طراحی و ایجاد برنامه ی کاربردی جهت خودمراقبتی انسداد مزمن ریوی مبتنی بر اندروید بود.

    روش بررسی

    این پژوهش از نوع توصیفی-توسعه ای با رویکرد کاربردی بود. در گام اول بر اساس مطالعه ی منابع کتابخانه ای و گایدلاین ها و بررسی پرونده های بیماران بستری مبتلا به COPD در بیمارستان فیروزآبادی، پرسش نامه ای با هدف نیازسنجی اطلاعاتی و تعیین اقلام داده ای و قابلیت های موردنیاز در برنامه ی کاربردی طراحی گردید. آن گاه بر اساس نمونه ای 10 نفره (به روش تصادفی و در دسترس) از پزشکان متخصص داخلی و فوق تخصص ریه در بیمارستان های فیروزآبادی و حضرت رسول، وابسته به دانشگاه علوم پزشکی ایران، بررسی و تکمیل گردید. داده ها با استفاده از آمار توصیفی، تحلیل و سپس جداول سناریو و نمودارهای موردکاربرد جهت نمایش جریان کلی برنامه کاربردی ترسیم شد. برنامه کاربردی با استفاده از زبان برنامه نویسی جاوا در محیط نرم افزار اندروید استودیو 2021 طراحی و ایجاد گردید. پس از نصب برنامه ی کاربردی بر روی تلفن همراه ده نفر از بیماران مبتلا به COPD مراجعه کننده به درمانگاه تخصصی داخلی و ریه بیمارستان فیروزآبادی شهرری و استفاده از آن به مدت یک هفته ، نظرات بیماران درمورد کاربردپذیری برنامه کاربردی از طریق پرسش نامه QUIS جمع آوری و تحلیل شد. 

    یافته ها

    بخش های برنامه کاربردی، متعاقب نظرسنجی متخصصان، موارد اطلاعات فردی ، اطلاعات بالینی ، مدیریت بیماری ، گزارش گیری و نکات آموزشی تعیین شد. که پس از طراحی جهت استفاده و ارزیابی در اختیار بیماران قرارگرفت. درپایان پژوهش، نتایج حاصل از ارزیابی قابلیت استفاده و میزان رضایت مندی از برنامه کاربردی نشان داد که از دیدگاه بیماران، برنامه کاربردی با میانگین امتیاز 8/1(از 10 امتیاز) در سطح خوب قرار گرفته است.

    نتیجه گیری

    از برنامه ی کاربردی خودمراقبتی طراحی شده می توان در جهت افزایش آگاهی بخشی، کمک به مدیریت بیماری ، افزایش سطج کیفیت زندگی و کاهش عوارض بیماری و کاهش بار بیماری  برای بیماران مبتلا به انسداد مزمن ریوی استفاده نمود.

    کلید واژگان: برنامه کاربردی, خودمراقبتی, انسداد مزمن ریوی, ارزیابی کاربرد پذیری}
    Marjan Ghazi Saeedi, Mohammad Amin Abbasi Eslamloo, Kobra Darabiyan*, Elham Ataei
    Background and Aim

    Despite the continuous progress in medicine, COPD (Chronic Obstructive Pulmonary Disease) is still a progressive, incurable and chronic respiratory condition that limits the patients’ functions in various dimensions, and significantly reduce their quality of life. In this way, self-care of patients and the use of related tools have a significant effect in disease control and treatment. The purpose of this research was design and development of an android-based application for COPD.

    Materials and Methods

    This research was a descriptive developmental type with a practical approach. Initially, based on the study of library resources, guidelines, and the examination of the medical records of COPD inpatients in Firouzabadi Hospital, a questionnaire was designed to identify the information requirements, data items and features of the application. Then it was reviewed and finalized by a sample of 10 (randomized and convenience sampling) internal and lung specialist doctors in Firouzabadi and Hazrat Rasool hospitals affiliated to Iran University of Medical Sciences. The data was analyzed using descriptive statistics, and then scenario tables and UML diagrams were illustrated to show the overall flow of the application. The application was designed and developed using the Java programming language in the Android Studio 2021 platform. After installing the application on the mobile phones of ten COPD patients of the internal and pulmonary clinic of Firouzabadi Shahre Rey Hospital, and using it for a week, the opinions of the patients about the usability of the application were collected through the QUIS questionnaire, and analyzed. 

    Results

    Application sections were determined following experts’ survey, personal information items, clinical information, disease management, reporting, and training points, which were provided to patients after design for use and evaluation. At the end of the research, the results of the evaluation of the usability and satisfaction level of the application showed that from the patients’ point of view, the application is at a good level with an average score of 1.8 (out of 10 points).

    Conclusion

    The developed self-care application can be used to increase awareness, help to manage the disease, increase the level of quality of life, and reduce the complications and disease burden for patients with COPD.

    Keywords: Application, Self-Care, Chronic Obstructive Pulmonary Disease, Usability Evaluation}
نکته
  • نتایج بر اساس تاریخ انتشار مرتب شده‌اند.
  • کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شده‌است. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
  • در صورتی که می‌خواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.
درخواست پشتیبانی - گزارش اشکال