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exacerbation of copd

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https://www.readbyqxmd.com/read/29663403/smoke-induced-neuromuscular-junction-degeneration-precedes-the-fibre-type-shift-and-atrophy-in-copd
#1
Sophia Kapchinsky, Madhusudanarao Vuda, Kayla Miguez, Daren Elkrief, Angela R de Souza, Carolyn J Baglole, Sudhakar Aare, Norah J MacMillan, Jacinthe Baril, Paul Rozakis, Vita Sonjak, Charlotte Pion, Mylène Aubertin-Leheudre, Jose A Morais, R Thomas Jagoe, Jean Bourbeau, Tanja Taivassalo, Russell T Hepple
A neurological basis for the fast fibre shift and atrophy seen in limb muscle of patients with chronic obstructive pulmonary disease (COPD) has not been considered previously. The objective of our study was: (i) to determine if denervation contributes to fast fibre shift and muscle atrophy in COPD; and (ii) to assess using a preclinical smoking mouse model whether chronic tobacco smoke (TS) exposure could initiate denervation by causing neuromuscular junction (NMJ) degeneration. Vastus lateralis muscle biopsies were obtained from severe COPD patients (n = 10 with low fat free mass index [FFMI], 65 y; n = 15 normal FFMI, 65 y) and healthy age- and activity-matched non-smoker control subjects (CON; n = 11, 67 y), to evaluate morphological and transcriptional markers of denervation...
April 16, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29663044/procalcitonin-algorithm-to-guide-initial-antibiotic-therapy-in-acute-exacerbations-of-copd-admitted-to-the-icu-a-randomized-multicenter-study
#2
Cédric Daubin, Xavier Valette, Fabrice Thiollière, Jean-Paul Mira, Pascal Hazera, Djillali Annane, Vincent Labbe, Bernard Floccard, François Fournel, Nicolas Terzi, Damien Du Cheyron, Jean-Jacques Parienti
PURPOSE: To compare the efficacy of an antibiotic protocol guided by serum procalcitonin (PCT) with that of standard antibiotic therapy in severe acute exacerbations of COPD (AECOPDs) admitted to the intensive care unit (ICU). METHODS: We conducted a multicenter, randomized trial in France. Patients experiencing severe AECOPDs were assigned to groups whose antibiotic therapy was guided by (1) a 5-day PCT algorithm with predefined cutoff values for the initiation or stoppage of antibiotics (PCT group) or (2) standard guidelines (control group)...
April 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29661670/-community-acquired-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease-treated-with-inhaled-corticosteroids-or-other-bronchodilators-study-pneumocort
#3
Rosa Morros, Cristina Vedia, Maria Giner-Soriano, Aina Casellas, Ester Amado, Jose Miguel Baena
OBJECTIVES: To analyse the risk of pneumonia and/or exacerbations in patients with chronic obstructive pulmonary disease (COPD) who receive treatment with inhaled corticosteroids (CI), in comparison with those who are not treated with inhaled corticosteroids (NCI). To estimate the risk of pneumonia according to CI dose. DESIGN: Population-based cohort study. SETTING: Primary Healthcare. Institut Català de la Salut. PARTICIPANTS: Patients ≥45 years-old diagnosed with COPD between 2007 and 2009 in the Information System for Research in Primary Care (SIDIAP)...
April 13, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29661354/fatal-hypermagnesemia-due-to-laxative-use
#4
REVIEW
Syed Rizwan Bokhari, Ravi Siriki, Federico J Teran, Vecihi Batuman
We report a case of fatal hypermagnesemia in a 53-year-old woman admitted for acute exacerbation of chronic obstructive pulmonary disease and with a history of chronic constipation treated regularly with magnesium-containing laxatives. On admission, her magnesium level was 2.0mg/dL, which rose to a peak of 10.8mg/dL despite hydration and diuresis in the presence of a normal kidney function. Continuous renal replacement therapy was promptly initiated, which reduced her serum magnesium levels, but her condition continued to deteriorate precipitously progressing to shock leading to oligoanuric renal failure, and she died 2 days later...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29658361/myd88-as-a-therapeutic-target-for-inflammatory-lung-diseases
#5
Franco Di Padova, Valerie F J Quesniaux, Bernhard Ryffel
Introduction Myeloid differentiation primary response protein 88 (MyD88) is a critical adaptor protein involved in Toll-like and IL-1 receptor family signaling controlling innate immune responses and inflammation. Genetic deletion of MyD88 function results in profound suppression of inflammation and reduced resistance of the host to pathogens indicating non-redundant roles of MyD88. The TIR domain is critical for MyD88 dimerization and signaling for TLR and IL-1R family receptor. Areas covered Emerging evidence suggests that chemical disruption of the TIR domain attenuates cell activation and inhibits in vivo MyD88-dependent inflammation...
April 16, 2018: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/29656319/nlrp3-inflammasome-involves-in-the-acute-exacerbation-of-patients-with-chronic-obstructive-pulmonary-disease
#6
Huaying Wang, Chun'er Lv, Shi Wang, Huajuan Ying, Yuesong Weng, Wanjun Yu
The NLR pyrin domain-containing protein 3 (NLRP3) inflammasome, a multi-protein complex, produces the pro-inflammatory cytokines interleukin (IL)-1β and IL-18, which may contribute to the development of airway inflammation in chronic obstructive pulmonary disease (COPD). The aim of this study was to explore the correlation between circulating and local airway NLRP3 inflammasome activation with acute exacerbation of COPD (AECOPD). mRNA levels of NLRP3, Caspase (Casp)-1, apoptosis-associated speck-like protein containing CARD (ASC), IL-18, and IL-1β in peripheral blood mononuclear cells (PBMCs) and bronchial tissues were determined by real-time PCR in 32 smokers, 65 patients with AECOPD, 50 COPD patients in recovery stage, and 30 COPD patients in stable stage...
April 14, 2018: Inflammation
https://www.readbyqxmd.com/read/29650563/blood-eosinophil-count-and-risk-of-pneumonia-hospitalisations-in-individuals-with-copd
#7
Signe Vedel-Krogh, Børge G Nordestgaard, Peter Lange, Jørgen Vestbo, Sune F Nielsen
Introduction: Blood eosinophil count in COPD is associated with higher exacerbation rate and favorable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could also elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population. Methods: We included 7,180 individuals with COPD, including 643 with FEV1 <50% of the predicted value from the Copenhagen General Population Study, from 2003-2011...
April 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29650284/-home-non-invasive-ventilation-for-chronic-obstructive-pulmonary-disease
#8
S Toujani, S Dabboussi, H Snene, M Mjid, S Kamoun, A Hedhli, S Cheikh Rouhou, R Cheikh, M Beji, Y Ouahchi, J Cherif
INTRODUCTION: The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial. AIM: To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population. METHODS: We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital...
April 9, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29649405/economic-impact-of-early-inpatient-palliative-care-intervention-in-a-community-hospital-setting
#9
James Fitzpatrick, Matthew Mavissakalian, Tisha Luciani, Yijing Xu, Amber Mazurek
BACKGROUND: Inpatient palliative care programs have demonstrated financial benefit for the hospital and improved quality of care for patients with advanced disease. Previous studies on this subject have focused on comparisons between palliative and traditional care. The financial and clinical effects of early versus late palliative care intervention are less well documented. OBJECTIVE: The aims of this study are to review the financial and quality outcomes that early palliative care intervention has on appropriate inpatients in the community hospital setting...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649230/lower-serum-iga-is-associated-with-copd-exacerbation-risk-in-spiromics
#10
Nirupama Putcha, Gabriel G Paul, Antoine Azar, Robert A Wise, Wanda K O'Neal, Mark T Dransfield, Prescott G Woodruff, Jeffrey L Curtis, Alejandro P Comellas, M Bradley Drummond, Allison A Lambert, Laura M Paulin, Ashraf Fawzy, Richard E Kanner, Robert Paine, MeiLan K Han, Fernando J Martinez, Russell P Bowler, R Graham Barr, Nadia N Hansel
BACKGROUND: Decreased but measurable serum IgA levels (≤70 mg/dL) have been associated with risk for infections in some populations, but are unstudied in COPD. This study tested the hypothesis that subnormal serum IgA levels would be associated with exacerbation risk in COPD. METHODS: Data were analyzed from 1,049 COPD participants from the observational cohort study SPIROMICS (535 (51%) women; mean age 66.1 (SD 7.8), 338 (32%) current smokers) who had baseline serum IgA measured using the Myriad RBM biomarker discovery platform...
2018: PloS One
https://www.readbyqxmd.com/read/29648516/the-phosphodiesterase-4-inhibitor-roflumilast-reverts-proteolysis-in-skeletal-muscle-cells-of-patients-with-copd-cachexia
#11
Esther Barreiro, Ester Puig-Vilanova, Anna Salazar-Degracia, Sergi Pascual-Guardia, Carme Casadevall, Joaquim Gea
Peripheral muscle weakness and mass loss are characteristic features in severe COPD. We hypothesized that the phosphodiesterase-4 inhibitor roflumilast-induced cAMP may ameliorate proteolysis and metabolism in skeletal muscles of COPD patients with severe muscle wasting. In myogenic precursor cells (isolated from muscle biopsies and cultured up to obtain differentiated myotubes) from 10 severe COPD patients and 10 healthy controls, which were treated with 1 microM roflumilast N-oxide (RNO) for three time-cohorts (1h, 6h, and 24h), genes of antioxidant defense and oxidative stress marker, myogenesis and muscle metabolism, proteolysis (tyrosine release assay) and ubiquitin-proteasome system markers, autophagy, and myosin isoforms were analyzed using RT-PCR and immunoblotting...
April 12, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29643168/fatigue-in-patients-with-chronic-obstructive-pulmonary-disease-protocol-of-the-dutch-multicentre-longitudinal-observational-fantastigue-study
#12
Yvonne M J Goërtz, Milou Looijmans, Judith B Prins, Daisy J A Janssen, Melissa S Y Thong, Jeannette B Peters, Chris Burtin, Yvonne Meertens-Kerris, Arnold Coors, Jean W M Muris, Mirjam A G Sprangers, Emiel F M Wouters, Jan H Vercoulen, Martijn A Spruit
INTRODUCTION: Fatigue is the second most common symptom in patients with chronic obstructive pulmonary disease (COPD). Despite its high prevalence, fatigue is often ignored in daily practice. For this reason, little is known about the underlying determinants of fatigue in patients with COPD. The primary objectives of this study are to chart the course of fatigue in patients with COPD, to identify the physical, systemic, psychological and behavioural factors that precipitate and perpetuate fatigue in patients with COPD, to evaluate the impact of exacerbation-related hospitalisations on fatigue and to better understand the association between fatigue and 2-year all-cause hospitalisation and mortality in patients with COPD...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29643055/findings-of-the-chronic-obstructive-pulmonary-disease-sitting-and-exacerbations-trial-copd-seat-in-reducing-sedentary-time-using-wearable-and-mobile-technologies-with-educational-support-randomized-controlled-feasibility-trial
#13
Mark W Orme, Amie E Weedon, Paula M Saukko, Dale W Esliger, Mike D Morgan, Michael C Steiner, John W Downey, Lauren B Sherar, Sally J Singh
BACKGROUND: Targeting sedentary time post exacerbation may be more relevant than targeting structured exercise for individuals with chronic obstructive pulmonary disease. Focusing interventions on sitting less and moving more after an exacerbation may act as a stepping stone to increase uptake to pulmonary rehabilitation. OBJECTIVE: The aim of this paper was to conduct a randomized trial examining trial feasibility and the acceptability of an education and self-monitoring intervention using wearable technology to reduce sedentary behavior for individuals with chronic obstructive pulmonary disease admitted to hospital for an acute exacerbation...
April 11, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29642882/assessing-the-healthcare-resource-use-associated-with-inappropriate-prescribing-of-inhaled-corticosteroids-for-people-with-chronic-obstructive-pulmonary-disease-copd-in-gold-groups-a-or-b-an-observational-study-using-the-clinical-practice-research-datalink
#14
James D Chalmers, Chris Poole, Samantha Webster, Abigail Tebboth, Scott Dickinson, Alicia Gayle
BACKGROUND: Recent recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) position inhaled corticosteroids (ICS) for use in chronic obstructive pulmonary disease (COPD) patients experiencing exacerbations (≥ 2 or ≥ 1 requiring hospitalisation); i.e. GOLD groups C and D. However, it is known that ICS is frequently prescribed for patients with less severe COPD. Potential drivers of inappropriate ICS use may be historical clinical guidance or a belief among physicians that intervening early with ICS would improve outcomes and reduce resource use...
April 11, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29630123/il-33-induced-inflammation-exacerbated-the-development-of-chronic-obstructive-pulmonary-disease-through-oxidative-stress
#15
S-C Zou, J Jiang, J Song
OBJECTIVE: We aimed at exploring the role of IL-33 in mouse chronic obstructive pulmonary disease and its potential molecular mechanism. MATERIALS AND METHODS: The chronic obstructive pulmonary disease (COPD) mice model was established by cigarette smoking (CS). COPD mice were randomly assigned into PBS group and IL-33 antibody group. The peripheral blood and lung tissues of mice from two groups were collected for the following experiments. Pathological changes of the lung tissues in both groups were analyzed by hematoxylin and eosin (HE) staining...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29629405/evaluation-of-systemic-corticosteroids-in-patients-with-an-acute-exacerbation-of-copd-and-a-diagnosis-of-pneumonia
#16
Tyler Scholl, Tyree H Kiser, Sheryl F Vondracek
Background: Chronic obstructive pulmonary disease (COPD) and pneumonia are leading causes of morbidity and mortality and are frequently comorbid. Studies of systemic corticosteroids in pneumonia have shown conflicting outcomes, whereas studies in acute exacerbations of COPD (AECOPD) have shown significant benefits. No studies have evaluated systemic corticosteroids in patients with both an AECOPD and pneumonia. Purpose: To evaluate the use of systemic corticosteroids in patients with both an AECOPD and pneumonia...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29629403/effectiveness-of-umeclidinium-vilanterol-for-protocolized-management-of-chronic-obstructive-pulmonary-disease-exacerbation-in-hospitalized-patients-a-sequential-period-analysis
#17
Todd W Chapin, Michael A Mann, Gary L Brown, Traci L Leitheiser, Becky Anderson, David D Leedahl
Background: Bronchodilator therapy is a foundation of chronic obstructive pulmonary disease (COPD) exacerbation treatment. Although international guidelines recommend short-acting formulations given multiple times per day, long-acting formulations have not been adequately evaluated. The objective of our study was to determine the effectiveness of umeclidinium-vilanterol (UME/VIL), long-acting beta2-agonist/long-acting muscarinic antagonist (LABA/LAMA) as a once-daily alternative for treating COPD exacerbations in hospitalized patients...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29629402/the-short-term-impact-of-symptom-defined-copd-exacerbation-recovery-on-health-status-and-lung-function
#18
Lindsey T Murray, Nancy K Leidy
Background: This study examined the short-term effects of symptom-defined exacerbation recovery on health status and pulmonary function in moderate to severe chronic obstructive pulmonary disease (COPD) patients. Methods: Secondary analyses of pooled data from two 12-week Phase II international, randomized controlled trials using the EXA cerbations of C hronic Pulmonary Disease T ool (EXACT) to identify symptom-defined exacerbations were conducted. Recovery was categorized as recovered, unrecovered (persistent worsening), or censored...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29629401/pattern-and-adherence-to-maintenance-medication-use-in-medicare-beneficiaries-with-chronic-obstructive-pulmonary-disease-2008-2013
#19
Shawn P E Nishi, Matthew Maslonka, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
Background: Maintenance medications provide symptomatic relief, improve lung function and reduce the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Despite their proven benefits, limited information exists on maintenance medication use and adherence among users. Objective: We examined the patterns and factors associated with the receipt of and adherence to maintenance medication in individuals with COPD. Methods: A retrospective cross-sectional study of 5% of Medicare beneficiaries enrolled in Parts A, B and D with COPD who received maintenance medication from 2008 to 2013 was conducted...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29629400/long-term-evaluation-of-the-effects-of-aclidinium-bromide-on-major-adverse-cardiovascular-events-and-copd-exacerbations-in-patients-with-moderate-to-very-severe-copd-rationale-and-design-of-the-ascent-copd-study
#20
Robert A Wise, Kenneth R Chapman, Benjamin M Scirica, David A Schoenfeld, Deepak L Bhatt, Sami Z Daoud, Beatriz Seoane, Colin Reisner, Esther Garcia Gil
Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous illness characterized by persistent airflow obstruction and exacerbations. Patients typically experience a decline in lung function, increasingly impaired health-related quality of life, and high mortality. Poor lung function and exacerbations are associated with an increased risk of cardiovascular (CV) and cerebrovascular events, and approximately 30% of patients with COPD die from CV‑related disease. Treatment with inhaled long-acting bronchodilators, such as long-acting muscarinic antagonists (LAMAs), is recommended; however, some studies have suggested that LAMAs may increase the risk of CV events...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
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