Faculty of Medicine

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Effects of Vitamin D Supplementation on Exacerbation in Patients with Severe COPD
(MedDocs Publishers LLC, 2022-07-12)
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Petrova, Tatjana
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Kamchevska Kochovska, Nade
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Introduction: Results from several studies indicated that vitamin D plays a role in a variety of immunologic processes such as modulation of inflammatory pathways and susceptibility to infections. Aim of the study: To assess the effects of vitamin D supplementation on bacterial exacerbations in patients with severe chronic obstructive pulmonary disease (COPD) with low vitamin D serum level. Methods: We performed an observational, non-randomized, open-label study including 36 patients with severe COPD who besides the recommended chronic treatment for stable disease took oral vitamin D supplementation in dose of 2000 IU daily during a six month-period (Group 1). In addition, 35 patients with severe COPD, matched to the study subjects of the Group 1 by sex, age and serum vitamin D level, who did not receive vitamin D supplementation served as controls (Group 2). Analysis of exacerbations, including their incidence and duration, as well as incidence of relapses and duration of exacerbation-free interval, was done for each study subjects based on daily diary cards maintained by all of them during the mentioned period. Results: Mean serum vitamin D levels at baseline did not differ significantly between examined groups (21.7 vs. 22.1; P = 0.457). At the end of the study its mean level was significantly higher in the Group 1 as compared to Group 2 (30.1 vs. 23.4; P = 0.000). Mean number of the first exacerbation over a six month-period was significantly lower in the Group 1 as compared to their mean number in the Group 2 (0.8 vs. 0.9; P = 0.001). Mean duration of the first exacerbation in the Group 1 (6.7 ± 1.2 days) was significantly lower as compared to its mean duration in the Group 2 (7.2 ± 1.3 days) (P = 0.033). Mean number of relapses registered in the Group 1 (0.2 ± 0.1) was significantly lower than its mean number registered in the Group 2 (0.4 ± 0.2) (P = 0.000). Mean exacerbation-free interval in the Group 1 (39.3 ± 10.1 days) was significantly longer than in the Group 2 (33.7 ± 11.8 days) (P = 0.052). Conclusion: Our findings indicated that vitamin D supplementation may impact the incidence and duration of bacterial exacerbations in patients with COPD. There is a need of further studies to elucidate the role of vitamin D supplementation on the course of COPD.
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Efficacy and Tolerability of Various Antimicrobial Regimens in the Treatment of Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease in Outpatients
(ID Design Press, 2009-06-01)
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Petrova, Tatjana
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Risteska-Kuc, Snezana
Objective. To compare the efficacy and tolerability of different antibiotics empirically administered for exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD). Methods. We performed an observational, non-randomized, open-label study including 226 outpatients with exacerbations of chronic bronchitis and mild or moderate COPD, 123 males and 103 females, aged 24 to 81. All patients were followed up for 30 days, with an intermediate visits at 5 and 10 days at which they were asked about the duration of symptoms (increased expectoration, increased dyspnea and/or presence of purulent sputum) and the side-effects of the drug. Five antibiotic regimens were evaluated: amoxicillin/clavulanic acid 875 mg/125 mg twice daily for 10 days, cefuroxime 250 mg twice daily for 10 days, cefixime 400 mg once daily for 10 days, clarithromycin 500 mg twice daily for 10 days, and ciprofloxacin 500 mg twice daily for 10 days. Results. The clinical success rate, defined as a complete resolution or a return of the symptoms to the baseline severity, in the groups receiving amoxicillin/clavulanic acid, cefuroxime, cefixime, clarithromycin, and ciprofloxacin was 68.9%, 75.0%, 73.5%, 72.7%, and 77.1%, respectively. The mean time to relief of symptoms varied from 6.8 days with amoxicillin/clavulanic acid to 6.1 days with cefuroxime. Relapse within the first month was registered in the group receiving clarithromycin and ciprofloxacin (3.1% and 2.6%, respectively). The prevalence of the adverse events varied from 10.4% with ciprofloxacin, following by 8.9% for amoxicillin/clavulanic acid, 7.5% for cefixime, 6.8% with clarithromycin to 6.1% with cefuroxime. Conclusion. Our findings suggest high efficacy and safety of all studied regimens in the treatment of exacerbations of chronic bronchitis and COPD.
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Effects of Pleuran (β-glucan from Pleurotus ostreatus) Supplementation on Incidence and Duration of Bronchiectasis Exacerbations
(Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia, 2020-09-15)
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Petrova, Tatjana
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BACKGROUND: Patients with non-cystic fibrosis bronchiectasis (BE) have frequent exacerbations that are causes of significant morbidity and sometimes mortality, and which it is desirable to prevent. AIM: We aimed to assess the effects of pleuran on the incidence and duration of exacerbations in patients with BE. METHODS: A prospective, observational, open-label, and active-controlled study was realized as a comparison of the frequency and duration of exacerbations between a group of patients with BE (30 patients, 14 males and 16 females, aged 44–72 years) who received a combination supplement containing pleuran 100 mg, Vitamin C 60 mg and zinc 5 mg over a 3-month period and a group of patients with BE (31 patients, 15 males and 16 females, aged 45–74 years) treated over a 3-month period with a combination supplement containing Vitamin C 60 mg and zinc 5 mg. RESULTS: Over the study period, altogether 46 exacerbations were documented (19 in the patients receiving pleuran and 27 in the patients who did not receive pleuran), nine of which required hospital treatment (four in the patients receiving pleuran [21.5%] and five in the patients who did not receive pleuran [18.6%]). The mean number of exacerbations over the study period was significantly lower in the patients receiving pleuran (0.6 ± 0.4) as compared to the mean number in the patients who did not receive pleuran (0.8 ± 0.3) (p = 0.0297). The mean duration of exacerbations, expressed in days, needed for cure or clinical improvement in the patients receiving pleuran (11.2 ± 1.7 days) was significantly shorter than that of exacerbations in the patients who did not receive pleuran (12.4 ± 1.3 days) (p = 0.0029). We found significantly lower incidence and significantly shorter duration of exacerbations in the patients with BE who received pleuran as compared to their incidence and duration in the patients with BE who did not receive pleuran. CONCLUSION: Our findings indicated a need for further investigations in this domain to define the possible role of pleuran in the prevention of BE exacerbations.
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Effects of a Long-Term Use of Carbocysteine on Frequency and Duration of Exacerbations in Patients with Bronchiectasis
(ID Design Press/Scientific Foundation SPIROSKI, 2019-12-15)
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Petrova, Tatjana
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The failure of mucus clearance in bronchiectasis can be improved by chest physiotherapy or/and mucoactive agents.
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Moxifloxacin in the Outpatient Treatment of Moderate Exacerbations of Chronic Obstructive Pulmonary Disease
(ID Design Press/Scientific Foundation SPIROSKI, 2018-11-25)
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Petrova, Tatjana
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Bacterial infections are involved in more than a half of the exacerbations of chronic obstructive pulmonary disease (COPD).

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