0000000000164565
AUTHOR
Eva Martínez-moragón
Prevalence of Hyperventilation Syndrome in Patients Treated for Asthma in a Pulmonology Clinic
Objective Although the presence of hyperventilation syndrome can affect the symptoms of patients with asthma, there is very little information available regarding its frequency in Spain. The aim of this study was to investigate the prevalence of hyperventilation syndrome in the asthmatic population treated as outpatients and establish its relationship with anxiety disorders. Patients and methods We studied 157 consecutive asthmatic patients (61 men and 96 women; mean [SD] age, 45 [17] years; forced expiratory volume in the first second, 84% [21%] of the predicted value) treated in our outpatients clinic. The patients had stable disease with varying degrees of severity. After collecting demo…
[Perception of dyspnea and treatment adherence in asthmatic patients].
OBJECTIVE: The majority of studies show that treatment adherence in chronic diseases such as asthma does not exceed 50%. Although the reasons may vary, it is clear that lack of treatment adherence is a determining factor in poor disease control. An association has also been observed between lack of perception of dyspnea and difficult-to-control asthma and with the occurrence of fatal or near-fatal asthma attacks. In this study we therefore attempted to demonstrate that one of the reasons that asthmatic patients do not adhere to treatment is a failure to perceive dyspnea associated with bronchial obstruction. PATIENTS AND METHODS: We analyzed 2 groups of patients with moderate persistent ast…
Does Experience Influence Perception of Dyspnea?
OBJECTIVE: The perception of somatic sensations like dyspnea can be influenced by such factors as an individuals personality, experiences, or ability to adapt to stimuli. Our aim was to determine whether the perception of acute bronchoconstriction is different for patients with asthma and patients who have never experienced an episode of airway obstruction. PATIENTS AND METHOD: We studied 2 groups of patients. The first consisted of 24 subjects with intermittent rhinitis and asthma (10 females and 14 males) with a mean (SD) age of 25 (7) years. All reported not feeling dyspnea at rest on a Borg scale. The second group consisted of 24 subjects who only had rhinitis but no lung disease (no ep…
[Evolution over time in over perceivers of dyspnea in asthma].
OBJECTIVE: In previous studies we identified a subgroup of patients whose perception of breathlessness was exaggerated during acute bronchoconstriction and who were termed “over perceivers” or “hyperperceivers.” In this study we aimed to determine whether such over perception is sporadic or stable over time. We also examined whether there is an association between over perception of dyspnea and hyperventilation syndrome. PATIENTS AND METHODS: The subjects were 22 stable asthmatics (11 men, 11 women) who had been over perceivers of dyspnea in a study 9 years earlier. After a medical history was taken, a patient performed forced spirometry and a severity classification was made according to t…
Assessment of the reliability, validity, and responsiveness of a Spanish Asthma Quality of Life questionnaire.
A Spanish-language questionnaire designed for measuring the impact of asthma on quality of life in adults was developed. It was derived, by the application of a rigorous translation protocol, from a previously validated, English-language Asthma Quality of Life (AQL) questionnaire which had been developed in Australia. The aim of this study was to evaluate the psychometric properties of the Spanish AQL questionnaire using a cross-sectional and longitudinal design. Two hundred ninety-four clinically stable subjects with asthma (168 women, mean baseline forced expiratory volume in 1 sec [FEV1] = 85% predicted), aged 17-70, attended for the initial baseline assessment. All subjects completed th…
Determinants of Dyspnea in Patients with Different Grades of Stable Asthma
Dyspnea is a main feature of symptomatology in asthma, and its perception does not necessarily correlates well with airway obstruction. The aim of this study was twofold: (1) to identify factors determining the subjective degree of dyspnea in patients with different grades of stable bronchial asthma and (2) to compare various clinical methods existing for grading dyspnea. The investigation comprised 153 outpatients with stable asthma. The parameters studied were the following: demographic characteristic of subjects, baseline dyspnea score by means of three clinical instruments (baseline dyspnea index [BDI], Medical Research Council [MRC] scale, and modified Borg scale), asthma severity, sta…
Concordancia entre la percepción de disnea del asmático durante la obstrucción aguda y crónica
Objetivo Durante la estabilidad clinica se pueden distinguir 3 tipos de asmaticos: hipoperceptores, normoperceptores e hiperperceptores. Cuando a esos mismos pacientes se les provoca una broncoconstriccion aguda, tambien existen hipo, normo e hiperperceptores de disnea. El objetivo del presente trabajo ha sido comprobar la concordancia entre ambas situaciones. Pacientes y metodos Se ha estudiado a 93 pacientes con asma persistente moderada (36 varones y 57 mujeres; edad media de 40 anos). Se les pidio que estimaran su disnea (escala modificada de Borg) en situacion de estabilidad y despues de cada dosis de histamina en una prueba de broncoprovocacion. Cuando la puntuacion de Borg en situaci…
Evolución temporal de la percepción exagerada de disnea en los pacientes con asma
Objetivo: En investigaciones previas para estudiar la percepcion de disnea de los asmaticos durante la broncoconstriccion aguda, encontramos un subgrupo de pacientes que presentaban una percepcion exagerada (hiperperceptores). En el presente trabajo hemos querido comprobar si esta alteracion perceptiva es un fenomeno esporadico o mantenido en el tiempo. Asimismo nos planteamos conocer si existe una asociacion entre la hiperpercepcion de la disnea y el sindrome de hiperventilacion. Pacientes y metodos: Se incluyo en el estudio a 22 asmaticos estables que en un estudio realizado 9 anos antes se habian mostrado hiperperceptores de disnea (11 varones y 11 mujeres). Tras una espirometria forzada…
¿Influye la experiencia en la percepción de disnea?
Objetivo: En la percepcion de las sensaciones somaticas, como la disnea, pueden influir factores tales como la propia personalidad del individuo, su experiencia previa o su capacidad de adaptacion a los estimulos. El objetivo del presente estudio ha sido conocer si los pacientes con asma perciben una situacion de broncoconstriccion aguda de forma diferente de los pacientes que nunca han sufrido un episodio previo de obstruccion de la via aerea. Pacientes y metodo: Estudiamos 2 grupos de pacientes. El primero estaba formado por 24 sujetos con rinitis y asma intermitente (10 mujeres y 14 varones, con una edad media ± desviacion estandar de 25 ± 7 anos), que no referian sentir disnea basal en …
Percepción de la disnea durante la broncoconstricción aguda en los pacientes con asma
El objetivo del estudio fue analizar las variaciones de la percepcion de obstruccion bronquial aguda en los asmaticos de nuestra poblacion e intentar definir las variables que condicionan dichas diferencias interindividuales. Se estudio a 153 asmaticos en situacion estable, midiendo la disnea que percibian en una escala de Borg durante la realizacion de una prueba de provocacion bronquial con histamina. Para el analisis de la percepcion individual se valoraron tanto la PS20 (disnea en la escala de Borg al caer el FEV 1 un 20%) como la diferencia matematica entre la PS20 y la disnea ba-sal (”cambio en Borg“ [CB]). Segun nuestros resultados: a) el conjunto de factores que determinan la PS20 (…
Percepción de mejoría en los pacientes con asma
Objetivo Investigar la capacidad de los pacientes con asma estable de reconocer la mejoria de su obstruccion bronquial con el tratamiento Metodo Seleccionamos a 75 asmaticos estables (44 mujeres y 31 varones, con una media de edad de 43 ± 17 anos), que referian sentir disnea basal en la escala modificada de Borg, y les provocamos en el laboratorio una broncodilatacion aguda del 15%; en esta situacion los pacientes fueron interrogados acerca del cambio de disnea experimentado Resultados 1. Globalmente, 19 asmaticos (25%) no percibieron mejoria de su disnea con la broncodilatacion. 2. La media del cambio en el nivel de disnea fue de 1,17 ± 1,11; sin embargo, este cambio fue mayor en los pacie…
Agreement in Asthmatics' Perception of Dyspnea During Acute and Chronic Obstruction
Objective Three types of asthmatic patients can be identified during periods of clinical stability: “poor perceivers,” “normal perceivers,” and “over perceivers.” When asthmatics undergo bronchial challenge in the laboratory, the same distinctions in type of perception can be observed. The aim of the present study was to determine the level of agreement between the 2 situations. Patients and methods A total of 93 patients with persistent moderate asthma (36 men and 57 women; mean age 40 years) were studied. We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test. When a patient's Borg scale assessment in stable…
Prevalencia del síndrome de hiperventilación en pacientes tratados por asma en una consulta de neumología
Objetivo Aunque la presencia del sindrome de hiperventilacion (SH) puede influir en los sintomas de los pacientes con asma, existe escasa informacion acerca de su frecuencia en nuestro medio. Nuestro objetivo ha sido investigar la prevalencia de SH entre la poblacion asmatica controlada ambulatoriamente y establecer su relacion con los trastornos de ansiedad. Pacientes y metodo Con este proposito hemos estudiado a 157 asmaticos consecutivos (61 varones, 96 mujeres; edad media ± desviacion estandar de 45 ± 17 anos; volumen espiratorio forzado en el primer segundo: 84 ± 21%), controladosen nuestras consultas externas, en situacion estable y con diferentes grados de gravedad. Tras recoger los …
Percepción de la disnea y cumplimiento terapéutico en pacientes con asma
Objetivo El cumplimiento terapeutico en una enfermedad cronica como el asma no supera el 50% en la mayoria de las series. Aunque las razones sean de muy diversa indole, es evidente que el incumplimiento es un factor determinante en el mal control de la enfermedad. Por otra parte, la falta de percepcion de la disnea se ha asociado con el asma de control dificil y con la aparicion de crisis de asma fatal o casi fatal. Asi pues, el objetivo del presente estudio ha sido intentar demostrar que una de las razones por las cuales los asmaticos no toman su medicacion es que no tienen percepcion de disnea cuando sus bronquios se obstruyen. Pacientes y metodos Hemos estudiado a 2 grupos de pacientes c…
Gender Differences in Health‐Related Quality of Life Among Patients with Asthma
This study has a twofold objective: 1) to explore to what extent suffering from asthma affects the HRQL of men and women differently at several stages of disease severity and 2) to analyze whether the informed poorer HRQL of asthmatic women is related to their higher scores on instruments measuring emotionally disordered symptoms. One hundred fifty-one outpatient asthmatics (84 women and 67 men) completed the Spanish versions of the Asthma Quality of Life questionnaire (AQL), as well as anxiety and depression inventories. A full history, physical examination, and pulmonary function test were performed on all subjects. Patients were classified into one of four asthma severity categories foll…