Lege Artis Medicinae

[The asthma-COPD overlap syndrome]

NAGY László Béla

DECEMBER 15, 2015

Lege Artis Medicinae - 2015;25(11-12)

[The asthma bronchiale and chronic obstructive pulmonary disease (COPD) are not simple diseases, but heterogenous syndromes. In their most typical forms, asthma and COPD are clearly distinguishable, but many patients demonstrate features of both conditions. This is the asthma - COPD overlap syndrome (ACOS). We present the latest findings in the pathogenesis, clinical characterisation, diagnosis, and management of ACOS. Because the limitations of the studies need future research, mainly to develop targeted therapy. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Paths and mispaths - the current challanges of the treatment of schizophrenia: a cognitive perspective]

VÁRADI Enikő

[Schizophrenia is a severe chronic mental disorder accompanied by acute psychotic episodes. The prognosis for and the quality of life of the patients is not primarily determined by the psychotic episodes that often require hospitalization, but rather by the disorder-specific cognitive deficits that persist and progress during the illness and precede the manifestation of the disorder. The greatest challenge in treating the disease is the treatment of the cognitive impairments, since our pharmacological therapeutic repertoire is mainly effective in controlling and preventing manifestation of the psychotic symptoms. The study provides a brief report on the anomalies of the current pharmacology- and hospital-centered care that are however a considerable obstacle to a modern neurocognitive developmental rehabilitation of people with schizophrenia with the aim of promoting social integration. This paper also summarizes the importance of the pharmacological treatments from the neurocognitive perspective, and finally presents the possibilities and results of the psychosocial rehabilitation in the treatment of the neurocognitive deficits in the hope of encouraging changing and a therapeutic paradigm shift. ]

Lege Artis Medicinae

[Leaving Paradise ]

GEREVICH József

Lege Artis Medicinae

[Experiences learned from fulvestrant treatment of a 86 years old female patient]

ÁDÁM J. László

Lege Artis Medicinae

[Death-Telling Traumas of Physicians and Residents in Practice]

BERTA Emese, ZELENA András

Lege Artis Medicinae

[Community participation in sustainable development - in the wake of community medicine]

BRYS Zoltán, HARANGOZÓ Judit, SZARVAS Hajnalka

[Sustainable development aims to secure the living conditions of the next generations. Currently it fails to achieve its goal as the human destruction of ecosystem is accelerated. Institutions of the developed countries can not control the environmental crisis. The increased environmental degradation is caused by overconsumption, which is mainly driven by the widespread consumption-culture. Failure of institutional solutions drew the attention to the empowerment of communities. Aarhus Convention has legally empowered the local communities and various scientific fields examines community participation. Community Based Mental Health Services has gathered a significant knowledge about the psychosocial processes of community participation and about the participatory-culture. According to our assumption this knowledge can be used in the field of sustainable development. Besides the empowerment of the independent, local communities, concordance, affective experiencing diversity of the members, involvement of experiential experts are all important in the operation of self-organizing, responsible, local communities. We believe that the empowerment and support of eco-conscious communities is an important, new intervention in the field of sustainable development. ]

All articles in the issue

Related contents

Lege Artis Medicinae

[Oral allergy syndrome in childhood]

CSIMA Eszter, CSERHÁTI Endre, MEZEI Györgyi

[As the prevalence of pollen allergy is increasing, the incidence of oral allergy syndrome is becoming more frequent. We expect, therefore, an increasing incidence of this syndrome among in children as well. The prevalence of oral allergy syndrome among adults with birch pollen allergy is estimated to be 20-70%. The prevalence of the disease among children is currently unknown. The aims of our study were to identify the characteristics of oral allergy syndrome in children and to assess its frequency. In order to identify children with oral allergy syndrome, we have used the children’s medical history, measured total IgE and serum specific IgE levels, performed skin prick tests and food challenge tests. Among the 743 children suffering from allergic rhinitis and/or bronchial asthma we found 463 children with pollen allergy, 6 of who had oral allergy syndrome. Thus, the prevalence of oral allergy syndrome among children with pollen allergy was 1.3%.]

Lege Artis Medicinae

[NONINVASIVE MECHANICAL VENTILATION IN CHRONIC OBSTRUCTIVE LUNG DISEASES WITH ACUTE OR CHRONIC RESPIRATORY FAILURE]

BALIKÓ Zoltán

[Over the past decade, the use of noninvasive ventilation in the setting of acute exacerbations of chronic obstructive pulmonary disease (COPD) has gained popularity, and is recommended by evidence-based guidelines. The evidence that it should be effective in chronic COPD is much weaker, and large, prospective, randomised, controlled studies that would also provide a guide for the selection of the best candidates, are still lacking. It has bee established, however, that home mechanical ventilation is certainly beneficial for a well-defined subgroup of patients. This includes the so called “blue bloater” patients (with hypercapnia and polyglobulia), other cases with increased hypercapnia, and patients with "overlapping" syndrome (COPD accompanied by sleep apnoe). Also, for patients with acute respiratory failure who refuse intratracheal intubation noninvasive mechanical ventilation remains the only choice. The past years have unequivocally proved the superiority of the positive pressure ventilation mode for either short term or long term use.]

Lege Artis Medicinae

[NEW METHODS FOR NON-INVASIVE ASSESSMENT OF AIRWAY DISEASES]

HORVÁTH Ildikó

[In chronic obstructive airway diseases there are several unsolved questions regarding the early diagnosis, monitoring treatment, simple detection of exacerbations and the questions of differential diagnosis. These problems indicate the need for the development of new diagnostic methods and their application in clinical practice. This need is further emphasized by the fact that in most chronic airway diseases, including asthma and chronic obstructive pulmonary disease inflammation has a central role in the pathomechanism and its suppression is the main aim of treatment, but so far, we do not have adequate method for the assessment of inflammation intensity in clinical practice. In recent decades non-invasive sampling techniques directly from the airways have made a progress in respiratory research and at present some of them are available for clinical use. Among these techniques sputum induction, measurement of exhaled biomarkers including exhaled nitric oxide and mediators in exhaled breath condensate samples are used increasingly. The present review summarises our current knowledge on these methods and the most important findings obtained by their applications.]

Lege Artis Medicinae

[QUALITY OF LIFE MEASUREMENTS IN BRONCHIAL ASTHMA]

MÉSZÁROS Ágnes

[Bronchial asthma is a chronic disease with symptoms that significantly influence the daily life of patients causing difficulties in almost every area of life. The author reviews his own results and those published by others on the impact of asthma on the quality of life. The patients' quality of life was assessed using the general quality of life questionnaire EuroQol as well as the disease-specific St. George's Respiratory Questionnaire. Asthma was classified by severity according to GINA, an international classification system. The results of the study provide numerical proof of the concept that due to their disease, patients with asthma have lower quality of life indices than the non-asthmatic population. On examining the effect of age, sex and respiratory functions as factors that influence quality of life, the results indicate that the quality of life of women with asthma is lower compared to men, which is a warning that more attention should be paid on the care of women with bronchial asthma. Since there is only a moderate correlation between respiratory functions and quality of life (r=0.37), the extent of respiratory tract obstruction assessed by objective measurements is not indicative of how the patient is doing. Despite of having normal values, some patients are commonly anxious, are subjects to many real or pseudo-attacks, which in turn leads to greater drug consumption, and judge their state more severe in the symptom diary than actually it is. The findings indicate that beside considering clinical state, symptoms and laboratory results, asthma care should place greater emphasis on the patients’ self-judged quality of life and their own view on their disease.]

Lege Artis Medicinae

[TREATMENT OF BRONCHIAL ASTHMA]

BÖSZÖRMÉNYI Nagy György

[Although it has no cure, bronchial asthma can be efficiently treated. The use of inhaled corticosteroids and, more recently, long-acting β2- agonist aerosols have produced extraordinary improvement in clinical outcomes, particularly in relation to chronic breathing complaints. Today the aim of pharmacotherapy is to achieve a symptom-free state by the combined administration of long-acting β2-agonist and inhaled corticosteroids in the form of aerosol.]