Elucidating the Link: Chronic Obstructive Pulmonary Disease and the Complex Interplay of Gastroesophageal Reflux Disease and Reflux-Related Complications

Helicobacter pylori infection in patients with chronic obstructive pulmonary disease. A systematic review and meta-analysis

OBJECTIVE

To determine the association of HP infection with COPD, assessing its prevalence and influence on symptoms, lung function, quality of life, exacerbations, hospitalizations, mortality, and healthcare costs.

METHODS

We performed a systematic review and meta-analysis after conducting a systematic literature search in PubMed, Embase, Cochrane Library, Virtual Health Library, ScienceDirect, Scopus, Researchgate, and GoogleScholar, from database inception to 31/12/2022. We used the Der Simonian-Laird method to calculate pooled HP prevalence, the Mantel-Haenszel model to determine the association of HP with COPD, and the inverse variance method to compare the pulmonary function tests between infected and uninfected patients, always with a fixed-effect model.

RESULTS

Twenty-eight studies included a total of 8647 patients with COPD. The pooled prevalence of HP infection was 29.8% (95%CI 29.0-30.7%). The more severe stage of COPD lesser the prevalence of HP (p < 0.001). HP infection was associated with COPD, estimated odds ratio 1.90 (95%CI 1.71, 2.12), p < 0.001. The mean differences for p%FEV1, p%FVC and FEV1/FVC ratio between HP infected and uninfected patients with COPD were -13.06 (95%CI -14.54, -11.58), -3.72 (95%CI -5.64, -1.79) and -0.01 (95%CI -0.02, -0.00) respectively.

CONCLUSION

Our meta-analysis suggests an appreciable relationship between HP infection and COPD. Further longitudinal studies considerating confounders and investigating causality are required.

Maximum Phonation Times as Biomarkers of Lung Function

PURPOSE

To verify whether measurements of maximal phonation times are biomarkers of forced vital capacity in patients with chronic obstructive pulmonary disease, and to characterize the vocal aspects of these patients, taking into account variables, such as age, body mass index, use of bronchodilators, presence of symptoms, and quality of life related to voice.

METHODS

Complete records of 25 subjects with chronic obstructive pulmonary disease, both sexes, aged 31 to 85 years, evaluated by forced vital capacity, maximum phonation times of /a/, and numerical count and number reached at this count, Vocal Symptom Scale, Voice Quality of Life. Data were presented descriptively and statistically analyzed using Student's t test for independent samples and Mann-Whitney U test. A significance level of 5% was accepted. The receiver operating characteristic curve was plotted and the standardized value of forced vital capacity <80% was considered as an indicator of pulmonary dysfunction.

RESULTS

Patients exhibited reduced maximum phonation times for /a/, numeric counting, and reached digits in counting; discrepancies in Vocal Signs and Symptoms and Voice Quality of Life Scale scores. Numeric counting times of up to 12.5 seconds indicated that forced vital capacity may be impaired.

CONCLUSION

The patients with chronic obstructive pulmonary disease examined in this study exhibited vocal deviations as evidenced by reduced maximum phonation times of /a/, numeric counting, and the digit reached during counting, as well as deviations in vocal self-assessment. Maximum phonation time in numerical counting was considered a biomarker of pulmonary function impairment.