DSpace Collection:http://repository.usmf.md:80/handle/20.500.12710/1632024-03-29T09:23:30Z2024-03-29T09:23:30ZNatriuretic peptides in elderly patients with chronic obstructive pulmonary diseaseBodrug, NicolaeLuca, Ecaterinahttp://repository.usmf.md:80/handle/20.500.12710/236142023-01-31T12:25:24Z2022-01-01T00:00:00ZTitle: Natriuretic peptides in elderly patients with chronic obstructive pulmonary disease
Authors: Bodrug, Nicolae; Luca, Ecaterina
Abstract: Background
Natriuretic peptides (NPs) are considered a useful tool for diagnosing the cardiac or pulmonary origin of acute dyspnea in the emergency department. The aim of this study was to evaluate NP in elderly patients with chronic obstructive pulmonary disease (COPD).
Materials and methods
In the PubMed and Hinari databases, we identified 465 comprehensive articles in English, published in the years 1990–2021, which provided information on natriuretic peptides in elderly patients with COPD. The final bibliography contains 49 relevant sources.
Results
NP, specially BNP/NT-proBNP values are frequently elevated in patients with COPD, reflecting three complex aspects of the interrelated cardio-pulmonary continuum: (1) left ventricular systolic and diastolic dysfunction, (2) pulmonary vascular and right heart remodeling, (3) global cardiovascular risk and comorbidities. The additional increase in BNP/NT-proBNP values during acute exacerbation of COPD is probably a marker for both, acute estate of COPD and varying degrees of underlying cardiopulmonary disease.
The results of the studies suggest the role of natriuretic peptides as relevant prognostic biomarkers not only for patients with cardiovascular disease, but also for patients with chronic obstructive pulmonary disease, which has an important clinical implication. The determination of these biomarkers in patients with chronic obstructive pulmonary disease allows stratification for prognosis: it is able to select a subgroup of patients at higher risk, which requires increased attention and optimization of treatment.
Conclusion
NPs, especially BNP/NT-proBNP are relevant prognostic biomarkers not only for patients with cardiovascular disease, but also for patients with COPD, acute exacerbations and haemodynamic disorders like PH and cor pulmonale. Estimating BNP/NT-proBNP in COPD patients has an important clinical implication: it allows the selection of a subgroup of patients at higher risk, which requires increased attention and treatment optimization.2022-01-01T00:00:00ZThe frequency of pulmonary hypertension in chronic obstructive pulmonary disease of geriatric patients: a narrative literature reviewLuca, EcaterinaBodrug, Nicolaehttp://repository.usmf.md:80/handle/20.500.12710/236132023-01-30T08:14:08Z2022-01-01T00:00:00ZTitle: The frequency of pulmonary hypertension in chronic obstructive pulmonary disease of geriatric patients: a narrative literature review
Authors: Luca, Ecaterina; Bodrug, Nicolae
Abstract: Background
Pulmonary hypertension (PH) is a serious complication with complex pathogenesis in the natural history of chronic obstructive pulmonary disease COPD, with a progressively increasing frequency with a meanwhile decreasing in functional capacity.
Purpose
Assessment of the incidence, pathogenesis, peculiarities, and complications of PH in COPD in geriatric population worldwide.
Methods
We performed an analysis of randomized, retrospective, and prospective clinical, case-control and observational studies, published at the international level, according to the subject studied and target population. Four hundred ninety-seven full articles were identified after the search through engine Google Search and databases PubMed, Hinari, SpringerLink, and Scopus (Elsevier) according to the keywords and subsequent filters.
Results
Depending on various factors, like the population examined, the definition used for mPAP (mPAP> 20 mm Hg or ≥25 mm Hg), the severity of the lung disease, and the method of measuring PAP, a varied incidence of COPD patients with PH complication was discovered, namely 10–91%. PH prevalence increases with the COPD severity. The presence of PH is associated with acute exacerbations of COPD, reduced survival, and increasing expenses for healthcare programs. Mild to moderate levels of PH (mPAP 25–34 mm Hg) are relatively common in COPD and usually are associated with severe airflow obstruction or parenchymal destruction. Only a minority of patients (1–5%) have severe PH (mPAP ≥35 mm Hg).
Conclusions
Diagnosis of PH in COPD is difficult, especially in a mild form, and requires a clinical approach associated with a comprehensive set of investigations for confirming the etiology, evaluation of the functional and hemodynamical impairment severity, and important factors in the appropriate treatment election.2022-01-01T00:00:00ZInnovative approaches to the treatment of gastroesophageal reflux disease complicated with metaplasia of columnar esophagusFosa, Doinahttp://repository.usmf.md:80/handle/20.500.12710/198492022-01-31T10:19:34Z2019-01-01T00:00:00ZTitle: Innovative approaches to the treatment of gastroesophageal reflux disease complicated with metaplasia of columnar esophagus
Authors: Fosa, Doina2019-01-01T00:00:00ZElectrical stimulation of lower esophageal sphincter in patients with gastroesophageal reflux diseaseUngureanu, SergiuLepadatu, CornelSipitco, NataliaVidiborschii, Vladimirhttp://repository.usmf.md:80/handle/20.500.12710/59482020-05-08T15:17:48Z2016-01-01T00:00:00ZTitle: Electrical stimulation of lower esophageal sphincter in patients with gastroesophageal reflux disease
Authors: Ungureanu, Sergiu; Lepadatu, Cornel; Sipitco, Natalia; Vidiborschii, Vladimir
Abstract: Introduction
Effective treatment of gastro-esophageal reflux disease (GERD) can be achieved by direct modulation
of the lower esophageal sphincter (LES) pressure. Recently the possibility of LES tonus increasing by
the means of implantable electrical stimulator was described. Although this method is already used in
clinical practice, optimal parameters of LES electrical stimulation are still unknown.
Study Aims
To obtain clinical data regarding effects of different modes of electrical stimulation of LES tonus.
Methods
LES electrical stimulation using external pulse generator was assessed in 9 patients with severe
GERD and decreased LES tonus. These patients underwent standard laparoscopic antireflux intervention
with additional insertion of 2 temporary electrodes at the level of gastroesophageal junction. Three sets
of parameters were studied: 1) low- frequency, long pulse (375 ms pulses, 6 mA at 6 pulse/min); 2) highfrequency
stimulation (0.3 ms, 6 mA at 40 Hz); 3) high-frequency, high-amplitude (0.3 ms, 10 mA at 40 Hz,
5 min intervals). High resolution esophageal manometry was used to assess changes in LES tonus. Each
set of parameters was used in three patients. Duration of postoperative LES electrical stimulation session
was 20 min. Esophageal manometry data during the stimulation were compared with postoperative
baseline (20 min), poststimulation period (20 min) and with preoperative manometric values as well.
Results
The low-frequency, long pulse stimulation produces moderate increase in LES pressure, which
is maintained in poststimulation period. The second set of parameters (used in commercially available
implantable stimulators) generates moderate relaxation of LES during the stimulation period and
significant increase of sphincter tonus in the poststimulation period. Patients stimulated with the third
set of parameters did not demonstrated modification of LES tonus during the stimulation with moderate
increase of the LES pressured in poststimulation period.
Conclusions
Electrical stimulation of LES produces changes in its tonus. Modifications in LES pressure during
the stimulation and after the stimulation period depend on many factors, including frequency, pulse
amplitude, waveform and duration of the stimulation. Further clinical studies are necessary for selection
of optimal stimulation parameters, which can be applied in the treatment of GERD.
Description: VII Latvian Gastroenterology Congress with International participation
“Gastroenterology in the world and Latvia: Science for practice”
5 December 2015, Rīga, Latvia
Catedra de chirurgie nr. 4, Facultatea de rezidențiat și secundariat clinic, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu" din Republica Moldova
Clinical Republican Hospital, Laboratory of minimally invasive surgery, Kishinau, Moldova, State University of Medicine and Pharmacy “Nicolae Testemitanu”
Department of Surgery, Kishinau, Moldova
Medical engineering company Labromed, Kishinau, Moldova2016-01-01T00:00:00Z