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https://www.readbyqxmd.com/read/29928520/can-muscle-protein-metabolism-be-specifically-targeted-by-nutritional-support-and-exercise-training-in-chronic-obstructive-pulmonary-disease
#1
REVIEW
Ramzi Lakhdar, Roberto A Rabinovich
Chronic obstructive pulmonary disease (COPD) associates with several extra-pulmonary effects. Muscle dysfunction and wasting is one of the most prominent extra-pulmonary effects and contributes to exercise limitation and health related quality of life (HRQoL), morbidity as well as mortality. The loss of muscle mass is characterised by an impaired balance between protein synthesis (anabolism) and protein breakdown (catabolism) which relates to nutritional disturbances, muscle disuse and the presence of a systemic inflammation, among other factors...
May 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29926554/revised-2018-copd-clinical-practice-guideline-of-the-korean-academy-of-tuberculosis-and-respiratory-disease-a-summary
#2
REVIEW
Yong Bum Park, Chin Kook Rhee, Hyoung Kyu Yoon, Yeon Mok Oh, Seong Yong Lim, Jin Hwa Lee, Kwang Ha Yoo, Joong Hyun Ahn
Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients nationally and globally. The Korean clinical practice guideline for COPD was revised in 2018. The guideline was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. The revised guideline encompasses a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea...
June 19, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29925846/-a-palliative-end-stage-copd-patient-does-not-exist-a-qualitative-study-of-barriers-to-and-facilitators-for-early-integration-of-palliative-home-care-for-end-stage-copd
#3
Charlotte Scheerens, Luc Deliens, Simon Van Belle, Guy Joos, Peter Pype, Kenneth Chambaere
Early integration of palliative home care (PHC) might positively affect people with chronic obstructive pulmonary disease (COPD). However, PHC as a holistic approach is not well integrated in clinical practice at the end-stage COPD. General practitioners (GPs) and community nurses (CNs) are highly involved in primary and home care and could provide valuable perspectives about barriers to and facilitators for early integrated PHC in end-stage COPD. Three focus groups were organised with GPs (n = 28) and four with CNs (n = 28), transcribed verbatim and comparatively analysed...
June 20, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29924458/current-controversies-in-the-stepping-up-and-stepping-down-of-inhaled-therapies-for-copd-at-the-patient-level
#4
REVIEW
Jose Luis Lopez-Campos, Laura Carrasco Hernández, Xavier Muñoz, Víctor Bustamante, Esther Barreiro
The implementation of potential new step-up or step-down treatment recommendations in response to current guidelines is one of the main challenges currently faced in actual daily practice settings. In the present narrative review, we aim to discuss the relevance of these step-up and step-down proposals at the patient level in daily clinical practice. In particular, we aim to review the challenges associated with inhaled maintenance therapy for chronic obstructive pulmonary disease (COPD) in four clinical scenarios...
June 20, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29922406/early-outcomes-after-carotid-endarterectomy-and-carotid-artery-stenting-for-carotid-stenosis-in-the-acs-nsqip-database
#5
Mohammed Alhaidar, Mohanad Algaeed, Richard Amdur, Rami Algahtani, Shahram Majidi, Dimitri Sigounas, Christopher R Leon Guerrero
Background: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are both viable treatment options for carotid artery stenosis. We sought to compare perioperative outcomes after CEA and CAS for the management of carotid stenosis using a "real-world" sample. Methods: We conducted a retrospective observational study using the National Surgical Quality Improvement Program database to compare 30-day (periprocedural) outcomes in patients with carotid stenosis undergoing CEA versus CAS from 2005 to 2012...
June 2018: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29921879/recruitment-of-patients-with-chronic-obstructive-pulmonary-disease-copd-from-the-clinical-practice-research-datalink-cprd-for-research
#6
Jennifer K Quint, Elisabeth Moore, Adam Lewis, Maimoona Hashmi, Kirin Sultana, Mark Wright, Liam Smeeth, Lia Chatzidiakou, Roderic Jones, Sean Beevers, Sefki Kolozali, Frank Kelly, Benjamin Barratt
Databases of electronic health records (EHR) are not only a valuable source of data for health research but have also recently been used as a medium through which potential study participants can be screened, located and approached to take part in research. The aim was to assess whether it is feasible and practical to screen, locate and approach patients to take part in research through the Clinical Practice Research Datalink (CPRD). This is a cohort study in primary care. The CPRD anonymised EHR database was searched to screen patients with Chronic Obstructive Pulmonary Disease (COPD) to take part in a research study...
June 19, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29908152/reducing-readmissions-in-patients-with-both-heart-failure-and-chronic-obstructive-pulmonary-disease
#7
REVIEW
Ravi Kalhan, R Kannan Mutharasan
Patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) pose particularly high costs to the healthcare system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population. 1: Diagnose the population accurately. 2: Detect admissions for exacerbations early and consider risk-stratification...
June 13, 2018: Chest
https://www.readbyqxmd.com/read/29904014/is-it-time-to-change-the-definition-of-acute-exacerbation-of-chronic-obstructive-pulmornary-disease-what-do-we-need-to-add
#8
REVIEW
Maria Montes de Oca, Maria Eugenia Laucho-Contreras
Acute exacerbations in chronic obstructive pulmonary disease (AECOPD) are associated with increased mortality, rate of hospitalization, use of healthcare resources, and have a negative impact on disease progression, quality of life and lung function of patients with chronic obstructive pulmonary disease (COPD). There is an imperative need to homogenize the definition of AECOPD because the incidence of exacerbations has a significant influence or implication on treatment decision making, particularly in pharmacotherapy and could impact the outcome or change the statistical significance of a therapeutic intervention in clinical trials...
June 14, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29890123/visual-estimate-of-coronary-artery-calcium-predicts-cardiovascular-disease-in-copd
#9
Surya P Bhatt, Ella A Kazerooni, John D Newell, John E Hokanson, Matthew J Budoff, Chandra A Dass, Carlos H Martinez, Sandeep Bodduluri, Francine L Jacobson, Andrew Yen, Mark T Dransfield, Carl Fuhrman, Hrudaya Nath
BACKGROUND: COPD is associated with cardiovascular disease (CVD), and coronary artery calcification (CAC) provides additional prognostic information. With increasing use of non-gated CT scans in clinical practice, we hypothesized that the visual Weston CAC score would perform as well as Agatston score in predicting prevalent and incident coronary artery (CAD) and CVD in COPD. METHODS: We measured CAC using Agatston and Weston scores on baseline CT scans in 1875 current and former smokers enrolled in the COPDGene study...
June 8, 2018: Chest
https://www.readbyqxmd.com/read/29887249/applicability-of-the-copd-lucss-dlco-score-for-patients-with-chronic-obstructive-pulmonary-disease-analysis-in-standard-clinical-practice-conditions
#10
J M Figueira Gonçalves, L I Pérez Mendez, N Gurbani, I García-Talavera, J L Pérez Pinilla
INTRODUCTION: The COPD-LUCSS-DLCO score had been validated as a predictive tool capable of identifying patients with chronic obstructive pulmonary disease (COPD) and a high mortality risk associated with lung cancer (LC); however, studies have not been conducted yet on its use in standard clinical practice. The aim of this study was to estimate the COPD-LUCSS-DLCO scores for patients with COPD treated in Pulmonology consultations and to determine the incidence of LC in each of the subgroups...
June 7, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29885688/pulmonary-hypertension-registry-of-kerala-india-pro-kerala-clinical-characteristics-and-practice-patterns
#11
S Harikrishnan, G Sanjay, M Ashishkumar, Jaideep Menon, Gopalan Nair Rajesh, Raman Krishna Kumar, A George Koshy, Thankachan V Attacheril, Raju George, Eapen Punnoose, S M Ashraf, S R Arun, Mohammed Cholakkal, Panniyammakal Jeemon
BACKGROUND: Epidemiological data on pulmonary hypertension (PH) are scarce from developing countries including India. METHODS: We established a multi-center registry of PH, the PRO-KERALA registry, in Kerala, India. Fifty hospitals enrolled consecutive adult (>18 years) patients for one year. Echocardiographic criteria (right ventricular systolic pressure - RVSP > 50 mmHg) or invasively obtained mean pulmonary artery pressure > 25 mmHg was the criteria for entry...
August 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29873642/-lung-and-heart-interaction-chronic-obstructive-pulmonary-disease-and-ischemic-heart-disease
#12
Sara Roversi, Leonardo M Fabbri
The interaction between the lung and the heart is a vast, complex, and fascinating topic and, from a clinical point of view, disorders of the one often influence and promote disorders of the other. This is especially true for chronic diseases, with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) representing a classic example. Epidemiologic data indicate that cardiovascular diseases are frequent in patients with COPD, and vice versa. Accordingly, rates of IHD in COPD vary from 4% up to 60%, while, on the other hand, COPD has been reported in up to 30% of patients with coronary artery disease...
March 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29857993/what-can-we-learn-about-copd-from-impulse-oscillometry
#13
REVIEW
Brian J Lipworth, Sunny Jabbal
Impulse oscillometry (IOS) is the most commonly used type of forced oscillation technique in clinical practice, although relatively little is known about its application in COPD. Resistance at 20 Hz (R20) is unrelated to COPD severity and does not improve with bronchodilatation or bronchoconstriction, inferring a lack of large airway involvement in COPD. Peripheral airway resistance expressed as frequency dependent heterogeneity between 5 Hz and 20 Hz (R5-R20), and peripheral airway compliance as area under the reactance curve (AX), are both closely related to COPD severity and exacerbations...
June 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29797692/upper-airway-obstruction-assessment-peak-inspiratory-flow-and-clinical-copd-questionnaire
#14
Jose Sanchez-Guerrero, Joanne Guerlain, Sabine Samaha, Alice Burgess, Jean Lacau St Guily, Sophie Périé
OBJECTIVES: Spirometric evaluation of upper airway obstruction (UAO) is not commonly performed by Otolaryngologists. In addition, functional evaluation of UAO by flow volume loops (FVL) is not available in all clinical settings. More recently, peak inspiratory flow (PIF) has proven to be a useful tool to monitor UAO at the patient's bedside. The aim of this work is to assess the role of PIF measured with a simple flow-meter (In-Check method) as a standardized, simple, non-invasive tool in quantifying chronic and subacute UAO in a routine clinical practice...
May 24, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#15
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29777660/chronic-obstructive-pulmonary-disease-exacerbations-a-need-for-action
#16
Antonio Anzueto, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, with exacerbations contributing strongly to the overall severity and burden of disease at the individual level. Many patients with COPD are managed predominantly in the primary care setting; therefore, primary care physicians (PCPs) must have awareness and understanding of the causes, effects, and management of exacerbations in COPD. This review offers practical information regarding how exacerbations are defined in the treatment setting, pathogenic and environmental causes, options for exacerbation treatment and prevention, and suggestions for improving care in the clinic...
May 16, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29770729/group-sequential-designs-for-negative-binomial-outcomes
#17
Tobias Mütze, Ekkehard Glimm, Heinz Schmidli, Tim Friede
Count data and recurrent events in clinical trials, such as the number of lesions in magnetic resonance imaging in multiple sclerosis, the number of relapses in multiple sclerosis, the number of hospitalizations in heart failure, and the number of exacerbations in asthma or in chronic obstructive pulmonary disease (COPD) are often modeled by negative binomial distributions. In this manuscript, we study planning and analyzing clinical trials with group sequential designs for negative binomial outcomes. We propose a group sequential testing procedure for negative binomial outcomes based on Wald statistics using maximum likelihood estimators...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29765213/health-status-in-patients-with-copd-treated-with-roflumilast-two-large-noninterventional-real-life-studies-dino-and-dacota
#18
Peter Kardos, Ingo Mokros, Rüdiger Sauer, Claus F Vogelmeier
Purpose: DINO and DACOTA were prospective, noninterventional studies assessing the health status and quality of life of patients with COPD newly treated with roflumilast 500 μg once-daily add-on therapy. Patients and methods: Patients were evaluated over 6 months. Clinical COPD questionnaire (CCQ) and COPD assessment test (CAT) scores were recorded at baseline and after 3 and 6 months. In DACOTA, post-bronchodilator FEV1 was recorded at each time point. Results: Of 5,462 and 3,645 patients recruited into DINO and DACOTA, respectively, 3,274 patients in DINO and 916 patients in DACOTA completed the 6-month visit...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29740896/gold-assessment-of-copd-severity-in-the-clinical-practice-research-datalink-cprd
#19
Cristina Rebordosa, Estel Plana, Jaume Aguado, Steven Thomas, Esther García-Gil, Susana Perez-Gutthann, Jordi Castellsague
PURPOSE: To evaluate availability of spirometry and symptom data in the Clinical Practice Research Datalink (United Kingdom) to assess COPD severity using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016 definition and comparing it with an algorithm used in other studies. METHODS: This was a descriptive, noninterventional, secondary database cohort study of patients with COPD aged 40 years or older, who initiated treatment with specific COPD medications...
May 8, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29737943/real-world-outcomes-in-patients-with-chronic-obstructive-pulmonary-disease-initiating-long-acting-mono-bronchodilator-therapy
#20
Lindsay G S Bengtson, Michael DePietro, Jeffrey McPheeters, Kathleen M Fox
BACKGROUND: Randomized clinical trials have shown long-acting mono bronchodilator therapy to be efficacious in improving lung function and dyspnea, while reducing exacerbations; however, less is known regarding the effectiveness in routine clinical practice. This study examined treatment patterns, rescue medication use, healthcare resource utilization and costs, and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who initiated long-acting mono bronchodilator therapy in real-world settings...
January 2018: Therapeutic Advances in Respiratory Disease
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