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LABA in patients with stage I COPD and mild sleep apnea syndrome: a pilot study

100%

Kopitovic I., Kojicic M., Drvenica M., Ilic M.

Open Medicine

2011

vol. 6

issue 1

26-30

Patients suffering from both sleep apnea-hypopnea syndrome (SAHS) and chronic obstructive pulmonary disease (COPD) have a more severe form of sleep apnea. Knowing all pathophysiological aspects that mutually interact in sleep disorders and COPD, we aimed to investigate if the introduction of long-acting β2 agonists (LABA) during the night could improve overnight oxygenation and the ability to perform daily activities in stage I COPD patients with mild SAHS. We conducted a prospective study of 22 patients with stage I COPD and SAHS confirmed by overnight polygraph screening, without nocturnal CPAP treatment. During twelve weeks, all patients used LABA (salmeterol 50 mcg) with a metered dose inhaler before bedtime. The levels of apnea hypopnea index, oxygen saturation, heart rate, and Epworth daytime sleepiness scale (ESS) were recorded before and after the treatment. There was a significant improvement of lowest and average overnight oxygenation compared to baseline (mean difference 2.1±0.42, p<0.0001; 1.7±0.3, p<0.0001, respectively). In addition, patients reported reduction in daytime sleepiness according to ESS (mean difference 1.23±0.51; p=0.03). Fewer patients exhibited tachycardia when on salmeterol (68 vs. 41%; p=0.01). Use of inhaled salmeterol improves overnight oxygenation in patients with stage I COPD and SAHS. Future prospective studies are warranted to confirm this potentially beneficial effect of long-acting β2 agonists.

Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome

76%

Hromis S., Zvezdin B., Kopitovic I., Milutinov S., Kolarov V., Vukoja M., Zaric B.

Open Medicine

2014

vol. 9

issue 5

642-647

Spontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.

Tuberculosis in a developing country - how much patients know about disease

64%

Ilic M., Kuruc V., Pavlovic S., Kopitovic I., Kasikovic-Lecic S., Zvezdin B., Zaric B., Kojicic M.

Open Medicine

2012

vol. 7

issue 2

249-257

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3 Open Medicine

1 2014

1 2012

1 2011

3 Kopitovic I.

2 Ilic M.

2 Kojicic M.

2 Zaric B.

2 Zvezdin B.

1 Drvenica M.

1 Hromis S.

1 Kasikovic-Lecic S.

1 Kolarov V.

1 Kuruc V.

1 Milutinov S.

1 Pavlovic S.

1 Vukoja M.

Search results

LABA in patients with stage I COPD and mild sleep apnea syndrome: a pilot study

Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome

Tuberculosis in a developing country - how much patients know about disease