Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease.

BACKGROUND AND OBJECTIVES: Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS: Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire Short-Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS: A total of 64 male COPD patients were evaluated (mean age 61.1 ± 4.7 years, mean FSS score 39.8 ± 14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared = 0.84, F = 29.48, df = 60, p < .001). It showed that the MRC score (ß = .40), cigarette consumption (ß = .35), and physical activity level (ß = -.37) were significantly correlated with the severity of fatigue (p < .001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION: Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and HRQOL were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.

Factores que afectan a la gravedad de la fatiga en pacientes varones con enfermedad pulmonar obstructiva crónica / Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease

Antecedentes y objetivos La fatiga, el segundo síntoma más común tras la disnea en pacientes con enfermedad pulmonar obstructiva crónica, afecta a la capacidad funcional y a la calidad de vida de quienes la padecen. El objetivo de este estudio es predecir los factores que afectan a la gravedad de la fatiga e investigar los efectos de la fatiga en pacientes con enfermedad pulmonar obstructiva crónica. Métodos Se recogieron datos para evaluar las características demográficas y clínicas, el consumo de tabaco, la gravedad de la fatiga (escala de gravedad de la fatiga), la gravedad de la disnea (escala Medical Research Council Dyspnea), el nivel de actividad física (Cuestionario Internacional de Actividad Física versión corta) y la calidad de vida relacionada con la salud (Cuestionario de Salud SF-36). Resultados Se evaluaron un total de 64 pacientes varones con enfermedad pulmonar obstructiva crónica (media de edad 61,1±4,7 años, puntuación media de la escala de gravedad de la fatiga 39,8±14,4). El modelo de regresión lineal fue significativo y explicaba el 84% de la varianza de gravedad de la fatiga (R cuadrado ajustado=0,84; F=29,48; df=60; p<0,001). Los resultados pusieron de manifiesto que la escala Medical Research Council Dyspnea (β=0,40), el consumo de tabaco (β=0,35) y el nivel de actividad física (β=−0,37) estaban significativamente correlacionadas con la gravedad de la fatiga (p<0,001 para todos), y que contribuían de manera independiente en la predicción de la gravedad de la fatiga. Conclusión La disnea, el consumo de tabaco y el nivel de actividad física afectan a la gravedad de la fatiga. Además, el nivel de actividad física, las funciones pulmonares y la calidad de vida relacionada con la salud estaban asociados con la fatiga. Estos hallazgos nos demuestran que es importante identificar la fatiga y los factores que influyen en su gravedad (AU)

Background and objectives Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. Methods Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire-Short Form), and health-related quality of life (36-Item Short Form Health Survey). Results A total of 64 male chronic obstructive pulmonary disease patients were evaluated (mean age 61.1±4.7 years, mean Fatigue Severity Scale score 39.8±14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared=0.84, F=29.48, df=60, p<.001). It showed that the Medical Research Council Dyspnea Scale score (β=.40), cigarette consumption (β=.35), and physical activity level (β=−.37) were significantly correlated with the severity of fatigue (p<.001 for all) and that they independently contributed to the prediction of severity of fatigue. Conclusion Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and health-related quality of life were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity (AU)

Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease. / Factores que afectan a la gravedad de la fatiga en pacientes varones con enfermedad pulmonar obstructiva crónica.

BACKGROUND AND OBJECTIVES: Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS: Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire-Short Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS: A total of 64 male chronic obstructive pulmonary disease patients were evaluated (mean age 61.1±4.7 years, mean Fatigue Severity Scale score 39.8±14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared=0.84, F=29.48, df=60, p<.001). It showed that the Medical Research Council Dyspnea Scale score (ß=.40), cigarette consumption (ß=.35), and physical activity level (ß=-.37) were significantly correlated with the severity of fatigue (p<.001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION: Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and health-related quality of life were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.

Cognitive function and its effects on the quality of life status in the patients with chronic obstructive pulmonary disease (COPD).

The objective of the present study was to determine the relationships between the cognitive function and quality of life in the patients with chronic obstructive pulmonary disease (COPD). Thirty-two patients with stable COPD (mean age 66.7+/-2.5 years) and 26 healthy community residents (mean age 65.7+/-7.3 years) were included in the present study. Cognitive status was measured using a modified mini mental state examination (MMSE) and quality of life status using the health survey questionnaire short form-36 (SF-36). The patients with COPD were mildly hypoxemic and their lung function was significantly poorer than in the healthy group (p=0.001). The quality of life scores were lower in the patients with COPD than in the healthy subjects (p=0.01). Impaired cognitive function in the patients with COPD and healthy subjects was not found (the mean MMSE scores 24.8+/-2.0 versus 25.4+/-3.2 for COPD and healthy groups, respectively, p=0.49). No correlation was found between the SF-36 and MMSE and spirometric values in either of groups (p>0.05). In conclusion, the cognitive function of COPD patients with mild hypoxemia may not be impaired in spite of their poor quality of life status.

Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To discuss the utility of Sit-to-Stand Test (STST) compared to the 6min walking test (6MWT) for the evaluation of functional status in patients with chronic obstructive pulmonary disease (COPD). SUBJECTS: Fifty-three patients with stable COPD (mean forced expiratory volume in 1s (FEV(1)) 46+/-9% predicted, mean age 71+/-12 year) and 15 healthy individuals (mean FEV(1) 101+/-13% predicted and mean age 63+/-8) were included. INTERVENTIONS: Functional performance was evaluated by STST and 6MWT. During the tests, severity of dyspnea (by Modified Borg Scale), heart rate, pulsed oxygen saturation (SpO(2), by Modified Borg Scale) (by pulse oxymeter), blood pressure were measured. The pulmonary function (by spirometry), quadriceps femoris muscle strength (by manual muscle test) and quality of life (by Nottingham Health Profile Survey) were evaluated. RESULTS: The STST and 6MWT results were lower in COPD group than the healthy group (P<0.05). During the 6MWT the rise in the heart rate, systolic blood pressure and the decrease in SpO(2) were statistically significant according to STST in COPD groups (P<0.05). The STST and 6MWT were strongly correlated with each other in both groups (P<0.05). Similarly, they were correlated with age, quality of life, peripheral muscle strength and dyspnea severity in COPD groups (P<0.05). CONCLUSION: Similar to 6MWT, STST is also able to determine the functional state correctly. Additionally, it produces less hemodynamical stress compared to the 6MWT. In conclusion, STST can be used as an alternative of the 6MWT in patients with COPD.

Erectile dysfunction prevalence and sexual function status in patients with chronic obstructive pulmonary disease.

PURPOSE: We determined sexual status and erectile dysfunction (ED) in outpatients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Between October 2002 and June 2003 a total of 60 successive outpatients with COPD enrolled in the study with written informed consent. Patients completed International Index of Erectile Function (IIEF) and Duke Activity Status Index questionnaires. They also underwent physical examination including urogenital examination and pulmonary assessment with spirometry, 6-minute walk test and arterial blood sample. COPD severity was determined according to Global Initiative for Chronic Obstructive Lung Disease criteria. RESULTS: After exclusion criteria 53 patients were assessed for statistical analysis. Mean patient age was 63.4 +/- 7.3 years. COPD severity in these patients was mild in 13.2%, moderate in 34%, severe in 49.1% and very severe in 3.8%. Nearly half of the patients (49%) had no comorbid disease for ED and the most common comorbid disease was hypertension (34%). According to the erectile function domain of IIEF 75.5% of patients were found to have ED with varying degrees (severe 28.3%, moderate 11.3%, mild to moderate 15.1% and mild 20.8%). Mean scores of all IIEF domains except sexual desire decreased with the increasing disease severity. A correlation was determined between severity and physical restrictions of COPD, and ED severity. CONCLUSIONS: The limitation of physical activity due to COPD also diminishes the sexual function of patients. This point must be kept in mind in the evaluation of patients with COPD.

TAR syndrome with annular pancreas and anal atresia - a case report.

TAR syndrome is manifested by the presence of hypomegakaryocytic thrombocytopenia and the bilateral absence of radii. An 8-day-old female newborn was referred to our clinic with diagnosis of TAR syndrome and symptoms of intestinal obstruction. On perineal examination she also had anal atresia with rectovestibular fistula. Because of persistent bile-stained drainage from the nasogastric tube, an upper gastrointestinal contrast study was performed and partial duodenal obstruction was detected. At operation, an annular pancreas was encountered and side-to-side duodenoduodenostomy was performed. A small number of gastrointestinal system malformations associated with TAR syndrome has been reported. Our case is unique; the association with annular pancreas and anal atresia with rectovestibular fistula has never been previously reported.