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clinical practice of copd

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https://www.readbyqxmd.com/read/28088797/automated-interpretation-of-pulmonary-function-tests-in-adults-with-respiratory-complaints
#1
Marko Topalovic, Stefan Laval, Jean-Marie Aerts, Thierry Troosters, Marc Decramer, Wim Janssens
BACKGROUND: The use of pulmonary function tests is primarily based on expert opinion and international guidelines. Current interpretation strategies are using predefined cutoffs for the description of a typical pattern. OBJECTIVES: We aimed to explore the predicted disease outcome based on the American Thoracic Society/European Respiratory Society (ATS/ERS) interpreting strategy. Subsequently, we investigated whether an unbiased machine learning framework integrating lung function with clinical variables may provide alternative decision trees resulting in a more accurate diagnosis...
January 12, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28066604/shifted-focus-of-bronchoalveolar-lavage-in-patients-with-suspected-thoracic-malignancy-an-analysis-of-224-patients
#2
Xin Zhang, Yukun Kuang, Yuan Zhang, Kai He, Noah Lechtzin, Mingying Zeng, Rex C Yung, Canmao Xie
BACKGROUND: Bronchoscopies are extensively adopted for diagnosing and staging thoracic malignancies, but studies are missing as how to keep the process streamlined and more efficient. To evaluate current role of bronchoalveolar lavage (BAL) for cancer and possible infection diagnosis when practicing comprehensive bronchoscopy for patients suspected with thoracic malignancy, and provide foundation for possible practice modification. METHODS: We retrospectively analyzed a prospectively kept database of immunocompetent patients undergoing bronchoscopy for suspected non-hematologic malignancies...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28047750/we-fg-206-08-pulmonary-functional-imaging-biomarkers-of-nsclc-to-guide-and-optimize-functional-lung-avoidance-radiotherapy
#3
Khadija Sheikh, Dante Pi Capaldi, Douglas A Hoover, David A Palma, Brian P Yaremko, Grace Parraga
PURPOSE: Functional lung avoidance radiotherapy promises optimized therapy planning by minimizing dose to well-functioning lung and maximizing dose to the rest of the lung. Patients with NSCLC commonly present with co-morbid COPD and heterogeneously distributed ventilation abnormalities stemming from emphysema, airways disease, and tumour burden. We hypothesized that pulmonary functional imaging methods may be used to optimize radiotherapy plans to avoid regions of well-functioning lung and significantly improve outcomes like quality-of-life and survival...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031708/trend-of-cost-and-utilization-of-copd-medication-in-korea
#4
Jongmin Lee, Jae Ha Lee, Jee-Ae Kim, Chin Kook Rhee
BACKGROUND: There are only a few longitudinal studies regarding medical utilization and costs for patients with COPD. The purpose of this study was to analyze the trend of medical utilization and costs on a long-term basis. METHODS: Using the Korean Health Insurance Review and Assessment Service (HIRA) data from 2008 to 2013, COPD patients were identified. The trend of medical utilization and costs was also analyzed. RESULTS: The number of COPD patients increased by 13...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28024131/-rating-criteria-for-selection-of-an-inhaler-and-instructing-its-use-in-patients-with-asthma-and-copd
#5
Rafał Ludwikowski, Tadeusz Płusa, Paweł Bijoś
: The clinical efficacy of inhaled therapy in patients with asthma and COPD is dependent on the choice of inhaler and proper use of it. The need to instruct patients in the use of the recommended inhaler seems obvious, but in clinical practice is not always followed. AIM: The aim of the study was the comparative evaluation of the selection criteria and the method of instructing in operating the device in asthma and COPD patients. MATERIALS AND METHODS: The study was conducted in 80 patients with asthma and COPD in 9 European countries: France, Germany, Italy, Spain, Great Britain, Holland, Belgium, Denmark, Sweden...
December 22, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28009153/is-neural-drive-the-missing-piece-in-the-puzzle-of-copd-exacerbation
#6
Giuseppe F Sferrazza Papa, Piero DE Giampaulis, Fabiano DI Marco, Massimo Corbo
The decision to discharge in patients affected by acute exacerbation of COPD remains a common problem due to the complexity of the assessment of clinical recovery, with early readmission perceived as a marker of incompleteness of the received treatment. The neural respiratory drive, assessed by parasternal muscle electromyography, represents an estimate of the load imposed to the respiratory muscles and it may identify early clinical deterioration. The test is noninvasive, may be executed bedside, but requires experienced operators...
December 2016: Minerva Medica
https://www.readbyqxmd.com/read/28005422/multilevel-dynamic-chronic-obstructive-pulmonary-disease-heterogeneity-a-challenge-for-personalized-medicine
#7
Rosa Faner, Álvar Agustí
This article summarizes how the multilevel (clinical, functional, structural, and biological) and dynamic (i.e., subjected to changes with time) heterogeneity of chronic obstructive pulmonary disease challenges a personalized approach for these patients. In particular, the following issues are discussed: (1) the conceptual differences between personalized and precision medicine, (2) how to frame the complexity and heterogeneity of chronic obstructive pulmonary disease by considering the precise meaning of the terms personalized medicine and precision medicine, and (3) how to translate all these novel concepts into clinical practice and move the field forward...
December 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28004591/long-acting-muscarinic-antagonists-for-the-treatment-of-chronic-obstructive-pulmonary-disease-a-review-of-current-and-developing-drugs
#8
Mark A Mastrodicasa, Christopher A Droege, Aaron M Mulhall, Neil E Ernst, Ralph J Panos, Muhammad A Zafar
Long acting muscarinic receptor antagonists (LAMA) reverse airflow obstruction by antagonizing para-sympathetic bronchoconstricting effects within the airways. For years, tiotropium, has been the cornerstone LAMA for chronic obstructive pulmonary disease (COPD) management. Recently, new agents, aclidinium bromide, glycopyrronium bromide, and umeclidinium bromide, have been developed and introduced into clinical practice. Areas Covered: This article reviews the clinical efficacy and adverse effects of currently available LAMAs in COPD treatment as well as developing LAMAs in early clinical trials and preclinical studies (V0162, TD-4208, CHF 5407, AZD9164, AZD8683, bencycloquidium)...
December 22, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27999149/time-required-to-rectify-inhaler-errors-among-experienced-subjects-with-a-faulty-technique
#9
Andrea S Melani, Marco Bonavia, Eliuccia Mastropasqua, Alessandro Zanforlin, Marco Lodi, Paola Martucci, Nicola Scichilone, Maria Aliani, Margherita Neri, Piersante Sestini
BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices. METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 experienced adult subjects (mean ± SD age 64 ± 15 y), mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27993360/the-quality-of-clinical-practice-guidelines-for-chronic-respiratory-diseases-and-the-reliability-of-the-agree-ii-an-observational-study
#10
Juliana Souza Uzeloto, Anne M Moseley, Mark R Elkins, Marcia Rodrigues Franco, Rafael Zambelli Pinto, Ana Paula Coelho Figueira Freire, Ercy Mara Cipulo Ramos
OBJECTIVES: To survey the quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy practice using the Appraisal of Guidelines for Research and Evaluation version II instrument (AGREE II) and to evaluate the inter-rater reliability of AGREE II. DESIGN: Observational survey. PROCEDURES: Guidelines indexed in the Physiotherapy Evidence Database (PEDro) on chronic respiratory diseases were evaluated by four assessors using AGREE II...
November 15, 2016: Physiotherapy
https://www.readbyqxmd.com/read/27940278/short-term-effects-of-supplemental-oxygen-on-6-minute-walk-test-outcomes-in-copd-patients-a-randomized-placebo-controlled-single-blind-cross-over-trial
#11
Inga Jarosch, Rainer Gloeckl, Eva Damm, Anna-Lena Schwedhelm, David Buhrow, Andreas Jerrentrup, Martijn A Spruit, Klaus Kenn
BACKGROUND: The acute effect of supplemental oxygen during exercise has been shown to differ largely among patients with COPD. It is unknown what the oxygen response is influenced by. METHODS: In a randomized and single-blinded fashion, 124 COPD patients underwent one 6-minute walk test on supplemental oxygen (6MWTO2) and one on compressed room air (6MWTRA) after a practice 6MWT. Both gases wedre delivered via standard nasal prongs (2 liters/min). For analyses, patients were stratified based on PaO2 values: (a) 34 patients with resting hypoxemia (HYX), (b) 43 patients with exercise-induced hypoxemia (EIH) and (c) 31 normoxemic patients (NOX) were compared...
December 8, 2016: Chest
https://www.readbyqxmd.com/read/27936016/a-tool-for-investigating-asthma-and-copd-exacerbations-a-newly-manufactured-and-well-characterised-gmp-wild-type-human-rhinovirus-for-use-in-the-human-viral-challenge-model
#12
Daniel J Fullen, Bryan Murray, Julie Mori, Andrew Catchpole, Daryl W Borley, Edward J Murray, Ganesh Balaratnam, Anthony Gilbert, Alex Mann, Fiona Hughes, Rob Lambkin-Williams
BACKGROUND: Human Rhinovirus infection is an important precursor to asthma and chronic obstructive pulmonary disease exacerbations and the Human Viral Challenge model may provide a powerful tool in studying these and other chronic respiratory diseases. In this study we have reported the production and human characterisation of a new Wild-Type HRV-16 challenge virus produced specifically for this purpose. METHODS AND STOCK DEVELOPMENT: A HRV-16 isolate from an 18 year old experimentally infected healthy female volunteer (University of Virginia Children's Hospital, USA) was obtained with appropriate medical history and consent...
2016: PloS One
https://www.readbyqxmd.com/read/27932873/coherence-between-self-reported-and-objectively-measured-physical-activity-in-patients-with-chronic-obstructive-lung-disease-a-systematic-review
#13
REVIEW
Mimi Thyregod, Uffe Bodtger
The beneficial effects of physical activity (PA) in patients with COPD, as well as the methods of their assessment, are well known and described. As objective measures of PA, such as the use of motion sensors, video recordings, exercise capacity testing, and indirect calorimetry, are not easily obtained in the daily clinical life, the reliability of the more accessible self-reported measurements of PA is important. In this review, we systematically identified original studies involving COPD patients and at least one parameter of self-reported and objective exercise testing, and analyzed every article for coherence between the objectively and self-reported measured PA...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27930519/who-are-the-users-of-a-traditional-chinese-sanfu-acupoint-herbal-patching-therapy-in-china-a-cross-sectional-survey
#14
Fen Zhou, Hong-Jun Wu, Jun-Ping Zhai, Gui-Yan Zhang, Yan Shao, Xia Tian, Ru-Yu Xia, Li-Yan Jia, Wen-Yuan Li, Ning Liang, Xiao-Yi Yan, Ruo-Han Wu, Kang Zhang, Xin-Lin Li, Cong-Cong Wang, Jian-Ping Liu
Sanfu acupoint herbal patching (SAHP) is a unique traditional Chinese medicine therapy, which has become popular for preventing acute attack of respiratory diseases such as asthma and chronic obstructive pulmonary disease, in many regions of mainland China. However, the knowledge about its users is lacking, especially the characteristics of the users and their experience and perspectives.To investigate the demographics of users, conditions for its use and the previous experience of SAHP, as well as users' perspectives to provide baseline information for its practice...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27923938/computerized-respiratory-sounds-novel-outcomes-for-pulmonary-rehabilitation-in-copd
#15
Cristina Jácome, Alda Marques
BACKGROUND: Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. METHODS: Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27920578/recording-of-hospitalizations-for-acute-exacerbations-of-copd-in-uk-electronic-health-care-records
#16
Kieran J Rothnie, Hana Müllerová, Sara L Thomas, Joht S Chandan, Liam Smeeth, John R Hurst, Kourtney Davis, Jennifer K Quint
BACKGROUND: Accurate identification of hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) within electronic health care records is important for research, public health, and to inform health care utilization and service provision. We aimed to develop a strategy to identify hospitalizations for AECOPD in secondary care data and to investigate the validity of strategies to identify hospitalizations for AECOPD in primary care data. METHODS: We identified patients with chronic obstructive pulmonary disease (COPD) in the Clinical Practice Research Datalink (CPRD) with linked Hospital Episodes Statistics (HES) data...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27920512/the-burden-of-chronic-obstructive-pulmonary-disease-associated-with-maintenance-monotherapy-in-the-uk
#17
Susan C Edwards, Sian E Fairbrother, Anna Scowcroft, Gavin Chiu, Andrew Ternouth, Brian J Lipworth
BACKGROUND: This study characterized a cohort of chronic obstructive pulmonary disease (COPD) patients on maintenance bronchodilator monotherapy for ≥6 months to establish their disease burden, measured by health care utilization. METHODS: Data were extracted from the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics. The monotherapy period spanned the first prescription of a long-acting β2-adrenergic agonist or a long-acting muscarinic antagonist until the end of the study (December 31, 2013) or until step up to dual/triple therapy, for example, addition of another long-acting bronchodilator, an inhaled corticosteroid, or both...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27917014/contextual-ecological-and-organizational-variations-in-risk-adjusted-copd-and-asthma-hospitalization-rates-of-rural-medicare-beneficiaries
#18
Thomas T H Wan, Yi-Ling Lin, Judith Ortiz
The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling...
2016: Research in the Sociology of Health Care
https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#19
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27882681/general-practice-consultations-diagnostic-investigations-and-prescriptions-in-the-year-preceding-a-lung-cancer-diagnosis
#20
Louise M Guldbrandt, Henrik Møller, Erik Jakobsen, Peter Vedsted
Patterns of general practice utilization in the period before lung cancer (LC) diagnosis may provide new knowledge to ensure timelier and earlier diagnosis of LC. This study aimed to explore the prediagnostic activity in general practice in the year preceding LC diagnosis. The activity was compared to a matched comparison group. We compared LC patients with different stage, and patients with and without chronic obstructive pulmonary disease (COPD). Using Danish registers, we performed a population-based matched cohort study including lung cancer patients (n = 34,017) and matched comparison subjects (n = 340,170)...
November 23, 2016: Cancer Medicine
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