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Mazet-Carpentier A, Maoz Z, Sudres JL, Bouchard JP. [Chronic obstructive pulmonary disease: somato-psychological dimensions]. REVUE DE L'INFIRMIERE 2022; 71:46-48. [PMID: 36509483 DOI: 10.1016/j.revinf.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is a poorly understood lung disease. It is accompanied by significant psychological co-morbidities (anxiety, depression, identity and body image disorders) which are under-diagnosed and have an impact on quality of life and the frequency of re-hospitalization. The management of COPD is multidisciplinary and its role is to prevent complications, relieve symptoms and slow the progression of the disease. Therapeutic education of the patient brings a real added value in this multidisciplinary management.
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Affiliation(s)
| | - Zeev Maoz
- Clinique cardio-vasculaire et pulmonaire de Saint-Orens, 12 avenue de Revel, 31650 Saint-Orens-de-Gameville, France; Centre d'étude et de recherche en psychopathologie et psychologie de la santé (CERPPS, EA 7411), Maison de la recherche, Université Toulouse Jean-Jaurès, 5 allée Antonio-Machado, 31058 Toulouse cedex 9, France
| | - Jean-Luc Sudres
- Clinique cardio-vasculaire et pulmonaire de Saint-Orens, 12 avenue de Revel, 31650 Saint-Orens-de-Gameville, France
| | - Jean-Pierre Bouchard
- Department of Statistics and Population Studies, Faculty of Natural Sciences, University of the Western Cape, Robert-Sobukwe Road, Bellville, 7535 Cape-Town, South Africa; Institut psycho-judiciaire et de psychopathologie (IPJP), Institute of Forensic Psychology and Psychopathology, Centre hospitalier de Cadillac, 33410 Cadillac, France; Unité pour malades difficiles (UMD), Pôle de psychiatrie médico-légale (PPML), Centre hospitalier de Cadillac, 33410 Cadillac, France; Psychologie, Criminologie, Victimologie (PCV), Bordeaux, France.
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Peiffer G, Underner M, Perriot J, Fond G. [COPD, anxiety-depression and cognitive disorders: Does inflammation play a major role?]. Rev Mal Respir 2021; 38:357-371. [PMID: 33820658 DOI: 10.1016/j.rmr.2021.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/11/2021] [Indexed: 02/08/2023]
Abstract
COPD is a chronic respiratory disease, often associated with extrapulmonary manifestations. Co-morbidities, including anxiety, depression and cognitive impairment, worsen its progression and quality of life. The prevalence of these disorders is high, yet they are often poorly understood and inadequately managed. In the development of psychological disorders, there is accumulated evidence highlighting the major role of systemic inflammation, as well as chronic disease, genetics, the consequences of smoking, hypoxaemia, oxidative stress, and the gut microbiome In addition to traditional treatments such as bronchodilatator medications, respiratory rehabilitation and smoking cessation, systemic inflammation is an interesting therapeutic target, with the use of anti-inflammatory drugs, anti-cytokines, and nutritional interventions.
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Affiliation(s)
- G Peiffer
- Service de pneumologie - tabacologie, CHR Metz-Thionville, 57085 Metz cedex 3, France.
| | - M Underner
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri-Laborit, 86021 Poitiers, France
| | - J Perriot
- Dispensaire Émile-Roux, CLAT 63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Fond
- CEReSS, hôpital de la Conception, Marseille Université, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
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Péran L, Le Ber C, Pichon R, Cabillic M, Beaumont M. [Follow-up and evaluation of plans developed during pulmonary rehabilitation]. Rev Mal Respir 2018; 35:929-938. [PMID: 30201399 DOI: 10.1016/j.rmr.2018.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 05/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pulmonary rehabilitation inevitably contains two essential components: therapeutic education and exercise training. The principal aim of this study was to evaluate the evolution over a year of the realization of plans determined during a pulmonary rehabilitation program (PRP). METHODS At the end of a PRP the patient made plans in accordance with his health condition. A telephone enquiry was undertaken at 3, 7 and 12 months to evaluate the progress of the plans, the motivation to perform them, dyspnoea and quality of life. RESULTS The data of 65 patients were analyzed (87 inclusions). Fifty-seven percent of the plans continued for one year. Walking had an adherence rating of 71%. Loss of motivation appeared to be the main cause for stopping (20%). Quality of life remained stable (p=0.39) and an increase in dyspnoea, though statistically significant (p<0.01), was of no clinical relevance. CONCLUSION The majority of plans were maintained but without clinical effect on the quality of life or the level of dyspnoea. Decreased motivation was the major limitation to realization or continuation of the plans. New studies will have to be implemented to analyze the factors which lead to this decrease.
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Affiliation(s)
- L Péran
- Service de réhabilitation respiratoire, centre hospitalier des Pays de Morlaix, 29672 Morlaix, France.
| | - C Le Ber
- Service de réhabilitation respiratoire, centre hospitalier des Pays de Morlaix, 29672 Morlaix, France
| | - R Pichon
- Service de réhabilitation respiratoire, centre hospitalier des Pays de Morlaix, 29672 Morlaix, France
| | | | - M Beaumont
- Service de réhabilitation respiratoire, centre hospitalier des Pays de Morlaix, 29672 Morlaix, France; EA3878 (GETBO), CHU Brest, 29200 Brest, France
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Tailoring Treatment in Obstructive Lung Disease: Asthma, COPD, Asthma/COPD Overlap and Eosinophilic COPD. CURRENT GERIATRICS REPORTS 2018. [DOI: 10.1007/s13670-018-0253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Underner M, Cuvelier A, Peiffer G, Perriot J, Jaafari N. Influence de l’anxiété et de la dépression sur les exacerbations au cours de la BPCO. Rev Mal Respir 2018; 35:604-625. [PMID: 29937312 DOI: 10.1016/j.rmr.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/13/2018] [Indexed: 02/05/2023]
Affiliation(s)
- M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur CS 10587, 86021 Poitiers cedex, France.
| | - A Cuvelier
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, centre hospitalier universitaire de Rouen, 76031 Rouen, France; Université de Rouen-Normandie, UPRES EA3830 groupe de recherche sur le handicap ventilatoire (GRHV), Institut de recherche et d'innovation biomédicale (IRIB), 76000 Rouen, France
| | - G Peiffer
- Service de pneumologie, centre hospitalier régional Metz-Thionville, 57038 Metz, France
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur CS 10587, 86021 Poitiers cedex, France
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Perriot J, Underner M, Peiffer G, Dautzenberg B. [Helping smoking cessation in COPD, asthma, lung cancer, operated smokers]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:170-180. [PMID: 29748064 DOI: 10.1016/j.pneumo.2018.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 02/05/2023]
Abstract
Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality.
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Affiliation(s)
- J Perriot
- Dispensaire Emile-Roux, CLAT63, centre de tabacologie, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
| | - M Underner
- Centre hospitalier Henri-Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - B Dautzenberg
- Groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Soler J, Guillaumot A, Moreau L, Manzoni D, Chaouat A, Chabot F. Impact du réentraînement à l’effort sur la dépression et la qualité de vie dans la BPCO : expérience du réseau RIR Lorraine. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE Balance impairment in chronic obstructive pulmonary disease (COPD) is associated with a worsening of quality of life (QOL) as related with fatigue perception, depression, and anxiety. The aim of this study was to examine the effect of balance training included in pulmonary rehabilitation (PR) on QOL, fatigue perception, depression, and anxiety in patients with COPD. METHODS Patients were assigned randomly to an intervention or PR-only group. The intervention group underwent balance training 3 times a week for 6 months concurrently with PR. The PR-only group received 6 months of the standard PR program. Quality of life was assessed at the beginning and at the end of the program using the St. George's Respiratory Questionnaire, fatigue using the Multidimensional Fatigue Inventory, and anxiety and depression using the Hospital Anxiety and Depression Scale. Exercise tolerance was determined from the 6-minute walk test. RESULTS After the 6 months of the intervention or PR-only, both the intervention (n = 32) and PR-only (n = 30) groups improved their QOL (activity, impact, and total) with a significant intergroup difference (P < .05) after PR. General fatigue, physical fatigue, and reduced activity decreased in both groups with an intergroup difference (P < .05). Anxiety decreased significantly in both groups with a greater change in the intervention group (P < .01). Only the intervention group had an improved depression score at the end of 6 months. CONCLUSIONS Balance training added to PR improved health-related QOL, fatigue, and mental health in patients with COPD.
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Chen R, Chen R, Chen X, Chen L. Effect of endurance training on expiratory flow limitation and dynamic hyperinflation in patients with stable chronic obstructive pulmonary disease. Intern Med J 2015; 44:791-800. [PMID: 24860934 DOI: 10.1111/imj.12483] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Expiratory flow limitation (EFL) is the primary pathophysiological hallmark of chronic obstructive pulmonary disease (COPD). However, the effect of lower-extremity endurance training alone on EFL in patients with COPD remains largely unknown. AIM This study aims to determine the effects of endurance training on EFL and dynamic hyperinflation in patients with stable COPD. METHODS This was a prospective, single-blinded, non-randomised controlled 12-week study recruiting Chinese patients with stable COPD in an endurance training group (n = 15) or a control group (n = 13). Before and at the end of the study, we measured the EFL, pulmonary function, peak inspiratory flow (PIF) and maximum inspiratory pressure (MIP); moreover, the patients underwent a constant work rate exercise test in which Borg dyspnoea scale, tidal breathing flow volume curves and inspiratory capacity (IC) were determined every other minute. RESULTS Exercise training significantly improved the exercise endurance time (7.00 ± 3.05 vs 18.13 ± 6.44 min, P < 0.001), MIP (69.49 ± 16.03 vs 80.18 ± 15.97 cmH2 O, P < 0.001) and PIF (3.96 ± 1.01 vs 4.51 ± 1.13 L/s, P = 0.014), but not EFL (3.33 ± 0.49 vs 3.40 ± 0.51, P = 0.334). Subjects on training had decreased breathing frequency (26.26 ± 7.13 vs 23.15 ± 5.34 breaths/min, P = 0.002), minute ventilation (30.28 ± 7.52 vs 26.85 ± 4.17 L, P = 0.013), tidal peak expiratory flow (1.53 ± 0.22 vs 1.32 ± 0.20 L/s, P = 0.006), mean expiratory flow (0.87 ± 0.19 vs 0.68 ± 0.15 L/s, P = 0.011) and Borg dyspnoea score (7.20 ± 1.15 vs 3.93 ± 1.39, P < 0.001), as well as increased IC (1.50 ± 0.34 vs 1.67 ± 0.45 L, P = 0.002), expiratory time (1.47 ± 0.62 vs 1.72 ± 0.62 s, P = 0.004) and inspiratory flow reserve (2.05 ± 1.10 vs 2.95 ± 1.19 L/s, P = 0.002) at isotime. These changes were not observed in the control group. CONCLUSION Endurance training may benefit stable COPD patients in improving exercise endurance, inspiratory muscle strength, ventilatory requirements, exercise-induced hyperinflation and exertional dyspnoea.
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Affiliation(s)
- R Chen
- Department of Respiratory diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou, China
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Escamilla R. La BPCO au-delà de l’appareil respiratoire. Presse Med 2014; 43:1381-6. [DOI: 10.1016/j.lpm.2014.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/21/2014] [Accepted: 05/05/2014] [Indexed: 01/12/2023] Open
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Strid JMC, Christiansen CF, Olsen M, Qin P. Hospitalisation for chronic obstructive pulmonary disease and risk of suicide: a population-based case-control study. BMJ Open 2014; 4:e006363. [PMID: 25421339 PMCID: PMC4244413 DOI: 10.1136/bmjopen-2014-006363] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To examine risk of suicide among individuals with hospitalised chronic obstructive pulmonary disease (COPD) and to profile differences according to sex, age, psychiatric history, and recency and frequency of COPD hospitalisations. DESIGN Nested case-control study. SETTING Data were retrieved from Danish national registries. PARTICIPANTS All suicide cases aged 40-95 years deceased between 1981 and 2006 in Denmark (n=19,869) and up to 20 live population controls per case matched on sex and date of birth (n=321,867 controls). MAIN OUTCOME MEASURES The relative risk of suicide associated with COPD was computed using conditional logistic regression and adjusted for effects of psychiatric history and important sociodemographic factors. RESULTS In our study population, 3% of suicide cases had been hospitalised for COPD compared with 1% of matched population controls. Thus, a hospitalised COPD was associated with a significantly increased risk for suicide (OR 2.6; 95% CI 2.3 to 2.8). The increased risk remained significant after adjustment for psychiatric history and sociodemographic variables (OR 2.0; 95% CI 1.8 to 2.2), and increased progressively with frequency and recency of COPD hospitalisation. At the same time, suicide risk associated with COPD differed significantly by sex, age and psychiatric status. The relative risk was more pronounced in women, in individuals older than 60 years and in persons with no history of psychiatric illness. CONCLUSIONS COPD confers an important risk factor for suicide completion. Risk assessment and prevention efforts should take patients' sex, age and psychiatric history into consideration.
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Affiliation(s)
- Jennie Maria Christin Strid
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | | | - Morten Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Ping Qin
- National Centre for Register-based Research, Aarhus University, Aarhus C, Denmark
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Nonadherence in chronic obstructive pulmonary disease patients: what do we know and what should we do next? Curr Opin Pulm Med 2014; 20:132-7. [PMID: 24452102 DOI: 10.1097/mcp.0000000000000027] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF REVIEW Although nonadherence research in patients with chronic obstructive pulmonary disease (COPD) lags well behind other diseases, new evidence helps inform understanding about the degree and underlying causes of patient nonadherence, interventions that can improve adherence, and areas of research needed to further progress in improving this problem in patients with COPD. RECENT FINDINGS Fewer than half of treatments for COPD, including oxygen supplementation, physical rehabilitation, and medication, are taken as prescribed. Most patients abandon their treatment after an initial start. Nonadherence in turn contributes to rising rates of hospitalization, death, and healthcare costs. The reasons why patients choose not to use their COPD treatments are not fully understood, although depression is clearly a contributing factor. Although a substantial number of studies have tested adherence interventions, few have included COPD patients or addressed polypharmacy in patients with multiple comorbidities. SUMMARY The paucity of research does not reflect the inadequacy of available treatments. Lessons learned from the research outside of COPD and a small number of COPD studies suggest that a collaborative care approach will likely provide the most potential for improving overall care, including management of depression and enhancement of adherence. Exploitation of mobile telephone technology to engage patients in a discussion of their self-care should not be ignored as a potential intervention for COPD patients. VIDEO ABSTRACT
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Enhanced non-eupneic breathing following hypoxic, hypercapnic or hypoxic-hypercapnic gas challenges in conscious mice. Respir Physiol Neurobiol 2014; 204:147-59. [PMID: 25242462 DOI: 10.1016/j.resp.2014.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 09/10/2014] [Accepted: 09/12/2014] [Indexed: 01/26/2023]
Abstract
C57BL6 mice display non-eupneic breathing and spontaneous apneas during wakefulness and sleep as well as markedly disordered breathing following cessation of a hypoxic challenge. We examined whether (1) C57BL6 mice display marked non-eupneic breathing following hypercapnic or hypoxic-hypercapnic challenges, and (2) compared the post-hypoxia changes in non-eupneic breathing of C57BL6 mice to those of B6AF1 (57BL6 dam × A/J sire) and Swiss-Webster mice, which display different ventilatory responses than C57BL6 mice. C57BL6 mice displayed marked increases in respiratory frequency and non-eupneic breathing upon return to room-air after hypoxic (10% O2, 90% N2), hypercapnic (5% CO2, 21% O2 and 74% N2) and hypoxic-hypercapnic (10% O2, 5% CO2 and 85% N2) challenges. B6AF1 mice displayed less tachypnea and reduced non-eupneic breathing post-hypoxia, whereas Swiss-Webster mice displayed robust tachypnea with minimal increases in non-eupneic breathing post-hypoxia. These studies demonstrate that non-eupneic breathing increases after physiologically-relevant hypoxic-hypercapnic challenge in C57BL6 mice and suggest that further studies with these and B6AF1 and Swiss-Webster mice will help define the genetics of non-eupneic breathing.
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Underner M, Perriot J, Peiffer G. [Smoking cessation in smokers with chronic obstructive pulmonary disease]. Rev Mal Respir 2014; 31:937-60. [PMID: 25496790 DOI: 10.1016/j.rmr.2014.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 04/07/2014] [Indexed: 02/08/2023]
Abstract
One out of two smokers who smoke throughout their lifetime will die from a disease related to smoking. Tobacco smoking therefore represents a major global public health issue. Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Projections for 2020 indicate that by then, COPD will have become the third cause of death and the fifth cause of disability worldwide. Stopping smoking reduces the risk of developing COPD and is an essential treatment for this inflammatory disease. Smoking cessation decreases the prevalence of respiratory symptoms, number of hospitalizations, and decline in FEV1, as well as exacerbation frequency and overall mortality. Among the patients, 38-77% with COPD are smokers. Their daily cigarette consumption and level of nicotine dependence are often high. The combination of high intensity behavioral interventions and medication treatments (nicotine replacement therapy, varenicline, bupropion) is the most effective strategy for smokers with COPD. In contrast, behavioral interventions without medication are not more effective than simple advice to stop. Two factors seem to predict the success of the attempt to quit in smokers with COPD: a strong motivation to quit and the use of smoking cessation medications.
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Affiliation(s)
- M Underner
- Service de pneumologie, centre de lutte antituberculeuse (CLAT 86), unité de tabacologie, CHU de Poitiers, CHU la Milétrie, pavillon René-Beauchant, BP 577, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, centre de lutte antituberculeuse (CLAT 63), 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, consultation de tabacologie - CHR Metz-Thionville, 57038 Metz, France
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Profil psychologique et qualité de vie des patients atteints d’une bronchopneumopathie chronique obstructive issus de la réanimation. MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-013-0820-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Herer B. [Outcomes of a pulmonary rehabilitation program including singing training]. Rev Mal Respir 2012; 30:194-202. [PMID: 23497929 DOI: 10.1016/j.rmr.2012.10.602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Respiratory education by singing may be considered in the course of pulmonary rehabilitation to help control breathing and reduce dyspnoea. METHODS We have undertaken singing training during pulmonary rehabilitation in 45 patients, mean age 60.1 ± 10.0 years, suffering from COPD (n=37) or other chronic respiratory disorders (n=8). The parameters measured at the beginning and end of course of rehabilitation were: forced vital capacity, FEV1, total lung capacity, residual volume, 6 min walking distance, VO2max, maximum pressure, MRC dyspnoea score, Cincinnati questionnaires and VSRQ (simplified visual respiratory questionnaire). RESULTS The following were the principal significant variations observed (initial value, % variation, significance): 6 minutes walk (326 ± 114 m, +13.8%, P=0.006); VO2max (18,1 ± 6.1 ml/kg/min, +8.3%, P=0.01); P max (75 ± 31 W, +14.7%, P=0.001); MRC score (2.3 ± 0.6, -21.7%, P<10(-4)); VSRQ score (34 ± 13, +50.0%, P<10(-6)). There was no significant change in the level of dyspnoea evaluated by the Cincinnati score. CONCLUSION These results are in favor of a beneficial effect of singing during pulmonary rehabilitation.
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Affiliation(s)
- B Herer
- Service de pneumologie, centre médical de Forcilles, 77170 Férolles-Attilly, France.
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