Reactive oxygen metabolites as an index of chronic obstructive pulmonary disease severity.

AIM: The purpose of this study was to determine whether reactive oxygen metabolite species (ROMs) correlated with lung function in patients with chronic obstructive pulmonary disease (COPD) and to investigate whether ROMs could be used as an index of COPD severity. METHODS: ROMs were evaluated in plasma by a colorimetric method (d-ROM-test) in 94 patients with COPD and in 31 healthy nonsmokers subjects. Spirometry, exhaled carbon monoxide and pulse oxymetry was performed in all patients. RESULTS: Mean plasma ROMs were significantly increased (330.38 Carratelli units) in patients with COPD. There was a negative correlation of ROMs with forced expiratory volume in the first second (r= -0.275, P<0.007), with forced vital capacity (r= -0.278, P<0.007), with forced expiratory flow (r= -0.226, P<0.029) and with oxygen saturation (r= -0.315, P<0.010). In addition a positive correlation was found between the age of the patients and the oxidative stress (r= 0.366, P<0.000). CONCLUSIONS: These data indicate the presence of systemic oxidative stress in patients with COPD. The increased oxidative stress in COPD patients was concomitant with the impairment of lung function.

Global initiative for chronic obstructive lung disease for chronic obstructive pulmonary disease: GOLD opportunity for lung disorders.

BACKGROUND: The purpose of this study was to assess the agreement of asthma and chronic obstructive pulmonary disease (COPD) treatment prescribed by physicians and pulmonologists in comparison to asthma and COPD guidelines and the need of the implementation of COPD guidelines in primary health care physicians. METHODS: Eighty-three asthma patients and 100 COPD patients were chosen and classified in relation to the agreement of their treatment prescribed by a health care physician and that mentioned by global initiative for chronic obstructive lung disease (GOLD) The COPD patients were classified according to their stage of the disease too. RESULTS: Both pulmonologists and primary health care physicians manage asthma patients following asthma guidelines, while great proportion of COPD patients are undertreated by primary health care physicians. The proportion of undertreated COPD patients is decreased as the stage of disease is progressing. CONCLUSIONS: COPD patients mainly are undertreated by primary health care physicians when they are in the primary stages of the disease. The overtreatment of some patients consists of high doses of inhaled steroids prescribed by both pulmonologists, and mainly, primary health care physicians. Therefore, it can be concluded that there is the need of the implementation of COPD guideline by primary health care physicians and the need of COPD patients to be diagnosed in early stages by performing spirometry.