Day 1 :
Keynote Forum
Yong Xiao Wang
Albany Medical College, USA
Keynote: Promising molecular mechanisms and therapeutic options for chronic obstructive pulmonary disease (COPD)
Time : 09:30-10:10
Biography:
Dr. Yong-Xiao Wang has been a Full Professor in Albany Medical College (USA) since 2006. Dr. Wang has had extensive research experience in basic, translational and drug research concerning pulmonary hypertension, asthma, chronic obstructive pulmonary disease, diabetes, and cardiac arrhythmia for over 30 years. As the Principal Investigator, he has/had numerous NIH R01 research awards, AHA Established Investigator Award, and various other grants, for which he often holds/held NIH R01 grants with other awards each year. As the corresponding author, first author and key contributor, he has had numerous publications in highly peer-reviewed journals including Antioxid Redox Signal (impact factor: 8.209), Proc Natl Acad Sci USA (9.432), Nature (34.480), Circ Res (9.214), etc. Dr. Wang has been the editor of academic books in the field including one entitled by “Redox Signaling in Health and Disease Pulmonary Vasculature” that was published by Springer (New York) last fall. Dr. Wang has also served as the editorial board member and/or section editor for the Clinical and Translational Medicine, Pulmonary Circulation and several other journals.
Abstract:
COPD is the third leading cause of mortality in the world and will be the second leading cause of death by 2020. However, the molecular mechanisms for this devastating disease remain largely unknown; currently, the clinical therapeutic options are neither specific and nor always effective. A major characteristic of COPD is expiratory airflow limitation, which can be attributed to airway hyperresponsiveness. A very important player (VIP) in airway hyperresponsiveness is the increased contraction of airway smooth muscle cells (ASMCs). An increase in intracellular calcium ([Ca2+]i) is a key factor in the increased contraction in AMCs. Consistent with this view, bronchodilators including muscarinic receptor antagonists, β-adrenergic receptor agonists and corticosteroids are used as the first-line drugs in the clinical treatment of COPD, and the functional role of all these forefront drugs are associated with their inhibition of the increased [Ca2+]i and contraction in ASMCs. Multiple ion channels such as inositol trisphosphate receptor (IP3R)/Ca2+ release channel, ryanodine receptor (RyR)/Ca2+ release channel and canonical transient receptor potential-3 (TRPC3) channel, play a major role in initiation and maintenance of [Ca2+]i. Recent studies suggest that these channels are essential for airway hyperresponsiveness in COPD and other pulmonary diseases. Equally interestingly, IP3R, RyR and TRPC3 channels are highly sensitive to reactive oxygen species (ROS), and ROS are well known to mediate airway hyperresponsiveness and other unleashed cellular responses in COPD. ROS are primarily produced by mitochondria and NADPH oxidase (NOX). A number of antioxidants targeted at mitochondria and/or NOX are currently used in clinical trials and show potential effectiveness in the treatment of COPD. ROS may implement their role in COPD by causing of oxidation of IP3R, RyR and TRPC3 channels, leading to their hyperfunctions. Thus, it is reasonably believed that genetic and pharmacological inhibition of these channels, like antioxidants, may also be effective for therapies of COPD. In support, studies using animals have revealed their therapeutic for airway hyperresponsiveness and COPD.
Keynote Forum
Kun Qing
University of Virginia
Keynote: A New COPD Phenotype Characterized by Hyperpolarized Xenon-129 MRI
Time : 10:10-10:50
Biography:
Kun Qing is an MR scientist with more than nine years of experience working in the medical imaging research field. Currently, I am serving as an Assistant Professor of Radiology & Medical Imaging at University of Virginia (UVa). My research has primarily focused on development and optimization of MR and image processing techniques to provide better depiction of lung structure and function. Also I served as PI or Co-Investigator on multiple research projects and performed MR imaging studies to investigate patients with pulmonary diseases and their responses to treatments. The hyperpolarized xenon-129 dissolved-phase MRI [ref 1] that I developed is the first non-invasive imaging technique to measure regional gas exchange in the human lung. It showed its unique abilities to characterize lung disease and detect early changes of lung function in many primary lung diseases.
Abstract:
Purpose: Airway-predominant chronic bronchitis (CB) and alveolar-predominant emphysema (EM) were regarded as major phenotypes of smoke-induced COPD. Routine clinical tools, including pulmonary function tests (PFTs) and computed tomography (CT), have their limitations to characterize COPD. This study will characterize COPD phenotypes using a new imaging tool - hyperpolarized xenon-129 (Xe129) MRI [1].
Methods: Thirteen healthy and thirty-three COPD subjects were recruited and underwent PFT, CT. COPD patients were phenotyped into three groups by PFT percent diffusion capacity (%DLCO) and CT percent of EM lung tissue (%EM): 1) EM: low %DLCO and high %EM; 2) CB: high %DLCO and low %EM; and 3) mixed indeterminate (IND) phenotype: low %DLCO but low %EM. Xe129 MRI was subsequently administered to determine airflow limitation by measuring percent of ventilation dead space (%VD) and alveolar gas uptake by measuring Xe129 diffused into interstitial tissue [tissue/gas ratio, reflecting lung tissue integrity] or into red blood cells (RBCs) [RBC/tissue ratio, reflecting gas exchange and pulmonary perfusion].
Results and Discussion: Using the criteria described above, 18% of patients (6/33) were EM predominant; 21% (7/33) were CB phenotype; and surprisingly, 61% (20/33) were IND phenotype. The IND group had %FEV1 substantially overlapped the CB group (p>0.05, Figure 1a), and did not show significantly higher %VD than the control group (p>0.05, Figure 1b). Also, no statistical differences were found in Xe129 tissue/gas ratios among the control, CB and the IND groups (p>0.05). However, the RBC/tissue ratios, measuring gas transfer from the interstitium further to the blood stream, were much lower in the mixed group as compared to all other groups (p<0.05) (Figure 1d).
Conclusion: There seemed to be a new mixed phenotype of COPD identified in a majority of COPD patients, which had minimal emphysematous tissue destruction, but impaired gas exchange to the blood as indicated by Xe129 MRI.
Keynote Forum
Shigeo Takizawa
Biophilia Institute, Japan
Keynote: Proposition of Restructuring of the Rehabilitation Medicine on Japanese
Time : 11:10-11:50
Biography:
Taki Takizawa is neither a doctor nor an engineer but served as the Fujisawa city councilor after graduating Keio University, and has been striving to socialize the Rehabilitation Method, which he recognized and organized. He got the 24 patent in Japan, the United States, and Australia. In order to sustain a super-aged society as one of the baby boomers, he organized the study group and promoted the research. At last, the Biophilia Academy was authorized the non-profit registered academic organization officially.
He has gained the 18 research grants from the Japanese government and else for doing those since 1995. The Japanese Biophilia Rehabilitation Journal No.2017 volume 1 was published as a memorial edition this time for his 26 pieces of papers that summarized their history. He finished the course of the master's degree for the kind of social technology at the University of the Air at the age of 60.
Abstract:
The society that an age pyramid reverses is unprecedented for the human beings in the modern world. Aging progresses quickly with baby boomers' aging, and it is expected that the severe society "one young man supports one elderly” visits soon as well as the disabled elderly increase in Japan. And these are global subjects that the World Health Organization makes targets to solve. All Japanese are covering the whole nation medical insurance. And all cerebrovascular disease and bone fracture patients have received rehabilitation medical treatment as much as they need but the increase of requiring-care elderly is remarkable.
In such a situation, the human change in connection with the rehabilitation medicine in Japan doubled to 1787 from 810 medical specialists in about ten years by 2012, and the physiotherapist increased 470% to over 100,000 people from 20,000 people and up. Reduction of those who need requiring care was expected by those increase. However, they doubled 5,540,000 people in 2012 from 2,180,000 in 2000. And five academic societies and the Japanese Ministry of Health, Labour and Welfare published the Stroke treatment guidelines in 2004. They examined the effect on comparing the results of the typical technique of neuromuscular facilitation technique (FT) and the traditional technique (TT) (muscular power reinforcement, the range of motion (ROM) ex. and Motion Training). They reported very few effective results deriving from FT than TT in it. These aspects have suggested that the restructuring of the rehabilitation medicine is required. We have proposed the effective intervention method, which was patented by US and AU patent office. The patients who treated by the method exceeds 30% has re-acquired walking from bedridden. In a lecture, the author introduces the Takizawa method based on the motivative exercise, devices to use and the result of our research from 1989.
- CO-Morbidities in COPD | COPD Theraupetics | COPD Exacerbations
Chair
Yong Xiao Wang,
Albany Medical College, USA
Co-Chair
Vasileios Andrianopoulos
Schoen Klinik Berchtesgadener Land, Germany
Session Introduction
Vasileios Andrianopoulos
Schoen Klinik Berchtesgadener Land , Germany
Title: Changes in cognitive function of cognitively impaired patients with COPD after Pulmonary Rehabilitation and 1-year follow-up: Preliminary data
Time : 11:50-12:20
Biography:
Vasileios Andrianopoulos is a clinical exercise physiologist / researcher working as postdoctoral research fellow at Schoen Klinik Berchtesgadener Land in Germany. He has his expertise in COPD pathophysiology, COPD-related cognitive impairment, clinical exercise assessment and Pulmonary Rehabilitation programs for COPD patients. Devoting himself to research, he acquired experience in designing research protocols, analyzing data and writing manuscripts as well as in operating several clinical devices. He has numerous scientific publications in healthy individuals and COPD patients. Since 2014, he is an active member of the European Respiratory Society (ERS) College of Experts and recently, in 2016, he has been awarded with a prestigious Marie Skłodowska-Curie fellowship co-funded by the European Union (EU) and the European Respiratory Society (ERS) for his project about cognitive dysfunction in patients with COPD
Abstract:
The beneficial effects of Pulmonary Rehabilitation (PR) are well established in COPD. However, data for the effectiveness of PR in patients with COPD and co-existing cognitive impairment are limited. We wish to compare the effect of a Pulmonary Rehabilitation program on cognitive function, health status, and exercise outcomes in cognitively normal (CN) and cognitively impaired (CI) patients with COPD. Methodology & Theoretical Orientation: Sixty COPD patients (FEV1: 47±15%; 42%women) referred to 3-week in-patient PR and classified as “CN” or “CI” according to the Montreal Cognitive Assessment (MoCA) cutoff-score (≤25points). Domain-specific cognitive function (MoCA, SMMSE, ACER, T-ICS), health status (CAT), health-related quality of life (SF-36), the six-minute walk test (6MWT) and cerebral oxygen availability during cycle endurance test (CET) at 75% of peak Work Rate, were assessed on admission and discharge of PR program. Findings: Twenty-five patients (42%) presented evidences of CI and low performance in cognitive tests. Compared to CN, CI patients improved visuospatial skills and fluency (Effect Size; ES: 0.44; 0.48), whilst similar improvements in memory (ES: 0.75), physical and social function (ES: 0.45; 0.47), vitality (ES: 0.56), general and mental health (ES: 0.47; 0.67) were observed, respectively. CI patients did not improve body pain and limitations from emotional problems as assessed by SF-36 but increased 6MWD (from 378 to 403m, p=0.052), CET (from 10.0 to 12.3min, p<0.001) and SpO2 nadir ([Δ]: +1.1%, p=0.047) in cycling, whilst CET cerebral oxygen availability remained unchanged. The proportion of CI and CN with clinically relevant improvements in 6MWT, CET and CAT was similar. Conclusion & Significance: CI patients gain significant benefits in cognitive function from PR but are not responsive to improvements in body pain and emotional limitations compared to CN. Persistent body pain may have limited the effectiveness of PR and improvements in the 6MWT in cognitively impaired patients with COPD.
Uma Hariharan
Ram Manohar Lohia Hospital, India
Title: Acute downhill course of emergency presentation of undiagnosed mediastinal masses: Flow charts and critical care management
Time : 12:20-12:50
Biography:
Uma Hariharan is a teaching faculty at the Ram Manohar Lohia Hospital, India. She has extensive experience in safe anesthesia for cancer surgeries and robotic surgeries. She is also trained in ultrasound-guided regional anesthesia and Palliative Medicine. She has more than 75 publications to her credit, including several book chapters. She is also on the Editorial Board of several reputed national and international journals. She is also an expert at Trauma care and is an instructor for Advanced Trauma Life Support (ATLS). She is also an expert at Hospital Management (PGDHM). She also has keen interest in Transplant anesthesia and Critical Care.
Abstract:
Mediastinal masses can be a great mimic. Their acute presentation can be mistaken for bronchial asthma, COPD exacerbation or subglottic stenosis. A high index of suspicion, eternal vigilance and prompt action can be rewarding in the emergency scenario. Mediastinal masses can have varied presentations or may even remain silent till very late. There have been numerous articles on anaesthetic management of patients with mediastinal masses. There is paucity of literature on acute presentation and course of events following airway interventions in patients with unrecognized mediastinal masses in the emergency or critical care set up. In the event of their presentation as reactive airway disease or acute airway obstruction, the possibility of a mediastinal mass must be kept in mind, when standard medical management fails to improve the condition or when definitive airway management worsens the condition further. Positive pressure ventilation can be disastrous as it leads to further increases in intra-thoracic pressures. A cardiothoracic surgeon opinion should be sought early and femoral vessels may be cannulated prophylactically. Facilities for institution of life support or ECMO (extra-corporeal membrane oxygenation) is desirable in intensive care units caring for patients with mediastinal masses.
Rajathilakam
GMC kollam, India
Title: Predicting a clinical outcome in COPD patients applying the gold 2013 staging criteria
Biography:
Rajathilakam has pursued MBBS and working as a faculty in Department of Pulmonary Medicine, GMC Kollam, India
Abstract:
Background: Chronic obstructive pulmonary disease (COPD) is a common disease, associated with high morbidity and mortality and is a leading cause of hospitalization and death in the elderly. Acute exacerbations contribute considerably to the diminished quality of life (QOL) in patients with COPD. Several etiologic factors alone or in combination cause acute exacerbation of COPD (AECOPD). Prediction of outcome of chronic obstructive pulmonary disease (COPD) is a major concern for long-term management of this disease. No consistent Indian studies are available using the new GOLD update (2013 staging criteria) and for COPD outcome based on composite scores like DOSE, ADO and BODE index.
Aim: The purpose of this study was to classify patients into different severity groups as per GOLD 2013 criteria, to describe the outcomes of patients with COPD in terms of exacerbation or death, to evaluate factors associated with recurrent exacerbations and to determine which of three multidimensional assessment systems (the body mass index, obstruction, dyspnea and exercise capacity (BODE) index, dyspnea, obstruction, smoking, exacerbations (DOSE) index or age, dyspnea, obstruction (ADO) index) is superior for predicting exacerbations. The earlier guidelines determined the severity of disease primarily based on spirometric staging and this study based on the new GOLD updates includes airflow limitation, history of COPD exacerbation and symptoms to classify and grade COPD severity.
Methods: This was a prospective cohort study of COPD patients conducted in the OPD or immediately prior to hospital discharge and followed up monthly for 1 year in a tertiary care centre of North Kerala from January 2014 to June 2015. Data on the outcome measures and associated factors were collected in a stable state. Pulmonary function tests, the 6-minute walk distance (6MWD), modified medical respiratory council (MMRC) dyspnea scores, oxygen saturation levels, body composition, comorbidities, smoking status, age and GOLD staging were analyzed and predictions of exacerbation by the three assessment systems were compared. Statistical analysis was done using SPSS version 18.
Results: Out of 300 patients 12 (4%) patients lost follow up 24 (8%) died during the study period. 62 (20.7%) in group B and 238 (79.3%) in group D of 2013 GOLD staging criteria. The mean annual exacerbation rate was 2.42 events per patients per year. Death and rate of exacerbation correlated significantly with lower predicted forced expiratory volume in 1 second (FEV1) (p value<0.001), lesser 6 MWD (p value<0.001), higher MMRC dyspnea score (p value<0.001), GOLD stage D (p value <0.001) higher DOSE index (p value <0.001), higher BODE index (p value <0.001) and higher ADO index (p value<0.001). For prediction of exacerbation the area under curve were larger for BODE index than for DOSE and ADO index (p value <0.001). Adjusted multiple logistic regression identified the BODE index as a significant predictor of risk of COPD exacerbation.
Conclusion: These composite scores DOSE, ADO and BODE index can be used to assess outcome in COPD in Indian patients. BODE index was a better predictor of COPD exacerbation when compared with DOSE and ADO index.
Serap Duru
Diskapi Education and Research Hospital, Turkey
Title: A rare complication related with oral anticoagulant Use: Diffuse Alveolar Hemorrhage
Time : 13:50-14:20
Biography:
Serap Duru is particularly specialized on chest diseases, has received her MD degree from Çukurova Medical Faculty in 2002. She has worked on chest diseases department in Dıskapı Education and Research Hospital from 2005. She has published numerous scientific papers, as well as presentations and posters. She has worked on asthma, chronic obstructive pulmonary disease, lung cancer, pulmonary embolism, interstitial lung diseases and endobronchial USG. She is a member of Turkish Thoracic Society and European Respiratory Society (ERS).
Abstract:
Diffuse alveolar hemorrhage (DAH) caused by immune and non-immune etiological factors, characterized by diffuse alveolar consolidation often presents with the clinical trial of dyspnea, hemoptysis, anemia, as a result of the disruption of the alveolocapillary membrane of the lung. Oral anticoagulants are the most commonly used drugs in order to prevent thromboembolic complications. Various bleeding complications may occur during treatment with oral anticoagulants but the development of DAH is quite rare. We present four cases, when the patients are over 65 years of age, followed up at our clinic with diffuse alveolar hemorrhage as a rare complication of the uncontrolled use of anticoagulant (Warfarin) therapy. In the thorax CT, patchy ground glass infiltration areas accompanied by scattered alveolar filling defects were seen in the lung. Although normal bronchial systems were observed in the fiberoptic bronchoscopy, hemorrhagic foci were observed on mucosa and transbronchial biopsy was not carried out. In the obtained hemorrhagic lavage fluid, hemosiderin laden macrophages were observed in addition to erythrocytes. Following supportive treatment including oxygen administration, vitamin K replacement and erythrocyte suspension and discontinuation of warfarin, clinical and radiological findings rapidly improved and our cases were discharged uneventfully. Diffuse alveolar hemorrhage is a life threatening complication, which may develop due to many etiologic factors and it is a catastrophic complication of the uncontrolled use of warfarin, a requiring early diagnosis and investigations before respiratory failure develops. In warfarin associated DAH, especially elderly patients that regularly use the drug, they should be warned against the risk of hemorrhage and should be monitored by clinicians.
Vasileios Andrianopoulos
Schoen Klinik Berchtesgadener Land, Germany
Title: Effect of Pulmonary Rehabilitation on physical and mental status in cognitively impaired patients with COPD: Preliminary data
Time : 15:20-15:50
Biography:
Vasileios Andrianopoulos is a clinical exercise physiologist / researcher working as postdoctoral research fellow at Schoen Klinik Berchtesgadener Land in Germany. He has his expertise in COPD pathophysiology, COPD-related cognitive impairment, clinical exercise assessment and Pulmonary Rehabilitation programs for COPD patients. Devoting himself to research, he acquired experience in designing research protocols, analyzing data and writing manuscripts as well as in operating several clinical devices. He has numerous scientific publications in healthy individuals and COPD patients. Since 2014, he is an active member of the European Respiratory Society (ERS) College of Experts and recently, in 2016, he has been awarded with a prestigious Marie Skłodowska-Curie fellowship co-funded by the European Union (EU) and the European Respiratory Society (ERS) for his project about cognitive dysfunction in patients with COPD.
Abstract:
Pulmonary Rehabilitation (PR) is widely recognized as an important therapeutic intervention that improves health status in patients with COPD. However, the extent of the improvements in cognitive function after PR in COPD patients with co-existing cognitive impairment has not yet been adequately investigated. We wish to compare changes in cognitive function after 3-week PR program and at 1-year follow-up in cognitive normal (CN) and cognitive impaired (CI) patients with COPD. Methodology & Theoretical Orientation: Thirty-two COPD patients (FEV1: 43±14%; 44% women) referred to 3-week in-patient PR and classified as “CN” or “CI” according to the Montreal Cognitive Assessment (MoCA) cutoff-score (≤25points). Face-to-face and telephone-based cognitive assessment was performed at admission and discharge of PR, and at 1-year follow-up, respectively. Overall cognitive performance was assessed by the “Telephone (T-) Interview for Cognitive Status” (T-ICS), whilst domain-specific cognitive evaluation also included T-MoCA and T-SMMSE. Changes in cognitive performance from admission to discharge and at follow-up were compared in CN and CI COPD. Findings: Thirteen patients (41%) showed evidences of CI and low performance in cognitive tests. From admission to discharge, CI patients had comparable increase on overall cognitive performance (Effect Size; ES: 0.53) compared to CN (ES: 0.65) improving memory (ES: 0.55), whilst had positive changes on attention (ES: 0.44), language/ executive (ES: 0.36), and fluency (ES: 0.32). From discharge to follow-up, CI patients had comparable deterioration on overall cognitive performance (ES: -1.26) compared to CN (ES: -1.59) decreasing attention (ES: -1.42), whilst had negative changes on memory (ES: -0.86), language/executive (ES: -0.34), fluency (ES: -0.10). Conclusion & Significance: Cognitively impaired patients with COPD improve to similar extent cognitive function after a 3-week PR program compared to CN and have comparable cognitive deterioration after 1-year. These changes in cognitive function may be dependent on the baseline levels of cognitive performance in COPD.
Ginika Egesimba
Institute of Tropical Medicine, Nigeria
Title: TB infection among HIV positive adolescent and related complexities in health settings in Northern Nigeria
Biography:
Ginika Egesimba A dynamic individual with abstract thinking skill ever willing to address challenges of the medical world in a fast moving globe through evidence informed medicine. A challenging field remains the focus of my dream and passion of pursuit. I have a mix of clinical practice experience, programming for public health, including evaluation of HIV/AIDS, TB, & Malaria programs, grant proposal writing skills, training and capacity building and knowledge transfer skills, good knowledge of country Monitoring and Evaluation ( M&E) processes and data collection tools, information and data management practices , good clinical practice (GCP), solid grasp of conduct of clinical, health services, and outcome research including process and impact evaluation with experience in research protocol development and data collection tool. Presently working at Institute of Tropical Medicine Antwerp, Belgium
Abstract:
Background: Adolescent age presents transition across biological, psychosocial, educational, disease affectation and other life experiences. Infection with HIV leaves them significantly vulnerable to Tuberculosis infection. This age of transition across a range of life circumstances is associated with complexities of diseases healing particularly TB co-infected with HIV. The paper examined the significance of TB Prevalence among PLHIV Adolescents between the ages of 10-19 and related complexities.
Method: A cross-sectional retrospective review of data collected over a period 15 months from October 1, 2014 to December 31, 2015 using the Pro-ACT MSH Database was analyzed with Excel. Data analyzed were routine monthly data collected from 41 supported comprehensive health facilities.
Result: 787 (M-357; F-430) Adolescent PLHIV were screened for TB out of which 32(M-16; F-16) presumptive TB cases were further evaluated for TB. 20 (M-8; F-12) of them were diagnosed with TB while 15 (M-6; F-9) were commenced on treatment accounting for a 2.5% TB prevalence over the period. In categorizing these adolescents into 10-14 and 15-19 age group, the 10-14 years age group had the highest number of HIV infection and invariable presented more number of adolescents to be screened for TB (416 vs 371). TB preponderance was reported within 15-19 years, females carried more of the burden and more of missed treatment is reported in older adolescent. (4 TB cases for the ages of 15-19 as against 1 for age 10-14).
Conclusions: The highly mobile nature of older adolescent (15-19) may account for preponderance of TB cases in the group. With more presumptive TB cases identified among younger adolescent (10-14), active follow up is required as they transition to the mobile age which are more prone to TB This finding provides opportunity to explore further why older adolescent both carry TB burden among PLHIV as well as missed treatment opportunities.
D.V. Krasnov
FSBI Novosibirsk Tuberculosis Research Institute, Russia
Title: Effect of endobronchial valve application on the respiratory function in patients with pulmonary tuberculosis and concomitant chronic nonspecific lung diseases.
Biography:
Krasnov D.V. - Chief Researcher in the Novosibirsk Tuberculosis Research Institute, head of the surgical department for tuberculosis patients and he is the scientific leader of a number of research works on phthisiology and thoracic surgery.
Krasnov D.V. is a recognized expert in the field of tuberculosis surgery, has a degree of Doctor of Medicine. He is a high professional in all methods of surgical treatment in patients with pulmonary tuberculosis. In 2013, he participated in the development and drafting of international recommendations for the surgical treatment of multidrug-resistant tuberculosis for the WHO European Region.
Krasnov D.V. carried out a large amount of research work in the field of surgical treatment of patients with pulmonary tuberculosis and especially drug resistant tuberculosis. Results of his research work were repeatedly reported at international scientific and practical conferences, congresses and symposia.
Abstract:
The article presents a retrospective analysis of treatment results in patients with destructive pulmonary tuberculosis and concomitant chronic nonspecific lung diseases.
The aim of the study was to evaluate the effect of endobronchial valve (EBV) application on the respiratory function.
Materials and methods: 102 patients were included in an open comparative retrospective study. In 49 patients (main group), the EBV was used in the treatment, and 53 patients (comparison group) received standard anti-tuberculous chemotherapy. The parameters of the respiratory function (RF) were measured at three critical points during hospital stage of treatment and in the long-term period.
Results: the installation of EBV led to a slight decrease in the level of vital lungs capacity (VLC) and the forced expiration volume. After removal of the valve, these RF values came to the initial level. Standard anti-TB therapy of patients in the comparison group contributed to a 6% decrease in the VLC values below the baseline, while the level of bronchial patency was preserved. At the final measurement in the main group, the proportion of patients with normal volumetric RF values increased with a simultaneous decrease in the proportion of patients with moderate and significantly reduced rates. Also in the main group, there was an increase in the proportion of patients with normal indices of bronchial patency, and in the comparison group the proportion of patients with normal indices remained at the same level.
Conclusion: EBV application leads to a non-significant (less than 10% decrease in relation to the initial indices) and reversible disruption of both volume and bronchial patency of respiratory function. There is a significant irreversible decrease in the parameters of the respiratory function during the long treatment of patients with infiltrative pulmonary tuberculosis.