BACKGROUND: Constipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients. METHODS: We conducted a retrospective case-control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis. RESULTS: Approximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF. CONCLUSIONS: Approximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.

Lėtinė obstrukcinė plaučių liga (LOPL) – šiuo metu pasaulyje viena svarbiausių didelį sergamumą ir mirtingumą sąlygojančių ligų. Pacientams, kuriems pasunkėja kasdieniai LOPL simptomai pasireiškia LOPL paūmėjimas. Šio tyrimo tikslas – įvertinti nespecifinį uždegimą paūmėjus lėtinei obstruk¬cinei plaučių ligai. Nustatyti periferinio kraujo ir indukuotų skreplių ląstelių sudėties skirtumai ir įvertintos sąsajos su plaučių funkcijos rodikliais bakterinio ir nebakterinio lėtinės obstrukcinės plaučių ligos paūmėji¬mo metu. Tirtos sergančiųjų bakterinės kilmės lėtinės obstrukcinės plaučių li¬gos paūmėjimo indukuotų skreplių neutrofilų ir makrofagų funkcijos (apoptozė, fagocitozė ir reaktyvių deguonies formų susidarymas) bei palygintos su nebakteriniu paūmėjimu. Įvertinti sergančiųjų bakterinės ir nebakterinės kilmės lėtinės obs¬trukcinės plaučių ligos paūmėjimo periferinio kraujo neutrofilų ir monocitų apoptozė ir chemotaksis, bei periferinio kraujo neutrofilų fagocitozė ir reaktyvių deguonies formų susidarymas. Ištirta sergančiųjų bakterinės ir nebakterinės kilmės lėtinės obstruk¬cinės plaučių ligos paūmėjimu interleukino-8 koncentracija ir sąsajos su periferinio kraujo neutrofilų chemotaksiu bei C reaktyviojo baltymo koncentracijos periferinio kraujo serume sąsajos su plaučių funkcija ir rūkymo intensyvumu. / Chronic obstructive pulmonary disease (COPD) – a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. An acute exacerbation of COPD (AECOPD) is an acute event characterized by a worsening of the patient’s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medication. The aim of this study was to evaluate the non-specific inflammation during acute exacerbation of COPD to investigate change of cellular activity (apoptosis, chemotaxis, phagocytosis and production of reactive oxygen species) during AECOPD depending on infection agent. Subjects with AECOPD and the same in remission were investigated. Increased count of induced sputum neutrophils and macrophages as well peripheral blood neutrophils and monocytes during bacterial and non-bacterial AECOPD was related with impaired pulmonary function and smoking history. Induced sputum neutrophils and macrophage apoptosis and phagocytosis were weaker, but production of reactive oxygen species was strongly activated during bacterial acute exacerbation of chronic obstructive pulmonary disease than non-bacterial AECOPD. This study showed differences of peripheral blood neutrophil and monocyte apoptosis, chemotaxis, as well as peripheral blood neutrophil phagocytosis and the production of reactive oxygen species... [to full text]