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https://www.readbyqxmd.com/read/29210599/obesity-in-copd-revealed-and-unrevealed-issues
#1
S Zewari, P Vos, F van den Elshout, R Dekhuijzen, Y Heijdra
The interactions between obesity and chronic obstructive pulmonary disease (COPD) are being increasingly explored. In part, this is due to the globally increasing prevalence rates of obesity. The prevalence of obesity in COPD patients is variable, and it seems that obesity is more common in COPD patients compared with subjects who do not have COPD. However, further studies are encouraged in this area due to observed inconsistencies in the current data. In this review, we focus on the knowledge of the effects of obesity on dyspnea, pulmonary function, exercise capacity and exacerbation risk...
December 2017: COPD
https://www.readbyqxmd.com/read/29197415/variability-in-adherence-to-clinical-practice-guidelines-and-recommendations-in-copd-outpatients-a-multi-level-cross-sectional-analysis-of-the-epoconsul-study
#2
Myriam Calle Rubio, José Luis López-Campos, Juan J Soler-Cataluña, Bernardino Alcázar Navarrete, Joan B Soriano, José Miguel Rodríguez González-Moro, Manuel E Fuentes Ferrer, Juan Luis Rodríguez Hermosa
BACKGROUND: Clinical audits have reported considerable variability in COPD medical care and frequent inconsistencies with recommendations. The objectives of this study were to identify factors associated with a better adherence to clinical practice guidelines and to explore determinants of this variability at the the hospital level. METHODS: EPOCONSUL is a Spanish nationwide clinical audit that evaluates the outpatient management of COPD. Multilevel logistic regression with two levels was performed to assess the relationships between individual and disease-related factors, as well as hospital characteristics...
December 2, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29196693/relationship-between-erectile-dysfunction-and-the-neutrophil-to-lymphocyte-and-platelet-to-lymphocyte-ratios
#3
Murat Sambel, Metin Kilic, Murat Demirbas, Efe Onen, Sedat Oner, Abdullah Erdogan, Mustafa Murat Aydos
The most important cause of erectile dysfunction (ED) among aging men is organic disease due to vascular disturbance that is often caused by atherosclerosis. Recently, studies have shown that atherosclerosis can manifest as an active inflammatory process rather than as passive vascular injury caused by lipid infiltration. Our study aimed to examine the association of ED with the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR), both of which are markers of inflammation. Between December 2014 and May 2015, 101 male patients aged 40-70 years who were seen at our institute due to ED were included in this study...
December 1, 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/29193631/an-audit-of-change-in-clinical-practice-from-oxygen-driven-to-air-driven-nebulisers-for-prehospital-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-aecopd
#4
Deborah Heys, Andrew Swain, Sarah Knowles, Amy Waugh, Mark Bailey
BACKGROUND: In developed countries, ambulances normally carry oxygen cylinders but not compressed air. Treatment of acute exacerbations of COPD (AECOPD) with oxygen-driven nebulisers can result in hypercapnia and acidosis. Attempts to avoid this have involved interrupted administration of oxygen.1 However, small battery-powered air nebulisers are now available. AIMS: This study aims to compare the prehospital oxygen saturations and treatment of patients suffering from AECOPD before and after the introduction of air nebulisers...
November 29, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29183382/a-proposal-for-the-withdrawal-of-inhaled-corticosteroids-in-the-clinical-practice-of-chronic-obstructive-pulmonary-disease
#5
REVIEW
Marc Miravitlles, Borja G Cosío, Aurelio Arnedillo, Myriam Calle, Bernardino Alcázar-Navarrete, Cruz González, Cristóbal Esteban, Juan Antonio Trigueros, José Miguel Rodríguez González-Moro, José Antonio Quintano Jiménez, Adolfo Baloira
According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting β2 agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy.Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations...
November 28, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29183318/the-development-implementation-and-evaluation-of-clinical-pathways-for-chronic-obstructive-pulmonary-disease-copd-in-saskatchewan-protocol-for-an-interrupted-times-series-evaluation
#6
Thomas Rotter, Christopher Plishka, Mohammed Rashaad Hansia, Donna Goodridge, Erika Penz, Leigh Kinsman, Adegboyega Lawal, Sheryl O'Quinn, Nancy Buchan, Patricia Comfort, Prakesh Patel, Sheila Anderson, Tanya Winkel, Rae Lynn Lang, Darcy D Marciniuk
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has substantial economic and human costs; it is expected to be the third leading cause of death worldwide by 2030. To minimize these costs high quality guidelines have been developed. However, guidelines alone rarely result in meaningful change. One method of integrating guidelines into practice is the use of clinical pathways (CPWs). CPWs bring available evidence to a range of healthcare professionals by detailing the essential steps in care and adapting guidelines to the local context...
November 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29180158/assessment-of-students-ability-to-incorporate-a-computer-into-increasingly-complex-simulated-patient-encounters
#7
Sarah Ray, Katie Valdovinos
BACKGROUND AND PURPOSE: Pharmacy students should be exposed to and offered opportunities to practice the skill of incorporating a computer into a patient interview in the didactic setting. Faculty sought to improve retention of student ability to incorporate computers into their patient-pharmacist communication. EDUCATIONAL ACTIVITY AND SETTING: Students were required to utilize a computer to document clinical information gathered during a simulated patient encounter (SPE)...
January 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29167787/medicine-availability-and-prescribing-policy-for-non-communicable-diseases-in-the-western-balkan-countries
#8
Tanja Pekez-Pavlisko, Maja Racic, Srebrenka Kusmuk
Background: During the transition processes, the Western Balkan countries were affected by conflicts and transition-related changes. Life expectancy in these countries is lower, while the mortality from non-communicable diseases (NCDs) is higher in comparison with western and northern parts of Europe. The primary aim of this study was to analyze the treatment possibilities for the most common NCDs in the Western Balkan countries. The secondary aim was to understand and compare the policies regarding prescribing-related competencies of family physicians...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/29163942/development-of-non-invasive-ventilation-treatment-practice-for-patients-with-chronic-obstructive-pulmonary-disease-results-from-a-participatory-research-project
#9
Helle M Christensen, Ingrid L Titlestad, Lotte Huniche
Objectives: Non-invasive ventilation treatment for patients with acute exacerbation of chronic obstructive pulmonary disease is well documented. Communication with patients during treatment is inhibited because of the mask, the noise from the machine and patient distress. Assessing life expectancy and identifying end-stage chronic obstructive pulmonary disease posed difficulties and caused doubts concerning initiation and continuation of non-invasive ventilation as life-sustaining treatment...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29150178/-relationships-between-copd-and-nontuberculous-mycobacteria-pulmonary-infections
#10
REVIEW
C Balavoine, C Andréjak, S Marchand-Adam, F X Blanc
Nontuberculous mycobacteria (NTM) pulmonary infections are increasingly frequent in pneumological practice. The diagnosis is based on an association of clinical, microbiological and radiological criteria. Some risk factors for NTM disease have been described, including chronic respiratory diseases, but without specific focus on chronic obstructive pulmonary disease (COPD). COPD patients have more risk to be infected by NTM than patients with the main other chronic respiratory diseases (except cystic fibrosis) (odds ratio [OR] at 15...
November 14, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#11
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29138554/characteristics-of-copd-patients-according-to-gold-classification-and-clinical-phenotypes-in-the-russian-federation-the-support-trial
#12
Vladimir Arkhipov, Daria Arkhipova, Marc Miravitlles, Andrey Lazarev, Ekaterina Stukalina
Background: The high prevalence of COPD in the Russian Federation has been demonstrated in several epidemiological studies. However, there are still no data on the clinical characteristics of these patients according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups and phenotypes, which could provide additional understanding of the burden of COPD, routine clinical practice, and ways to improve the treatment of patients with COPD in Russia. Patients and methods: SUPPORT was an observational multicenter study designed to obtain data about the distribution of patients with previously diagnosed COPD according to the severity of bronchial obstruction, symptom severity, risk of exacerbation, COPD phenotypes, and treatment of COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29135485/update-on-questionnaires-for-assessing-adherence-to-inhaler-devices-in-respiratory-patients
#13
Vicente Plaza
PURPOSE OF REVIEW: It has been estimated that adherence to inhaled medications in patients with asthma and chronic obstructive pulmonary disease (COPD) is around 50%. This low adherence rate increases morbidity and mortality of these disorders. The objective of this review was to update information on main questionnaires used in daily for assessing adherence to inhalers of patients with chronic respiratory diseases. RECENT FINDINGS: The test of the adherence to inhalers (TAI) is a recently developed and validated 12-item questionnaire to assess adherence to inhalers of aerosolized drugs in patients with asthma or COPD...
November 11, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29112185/monocyte-to-large-platelet-ratio-as-a-diagnostic-tool-of-pulmonary-embolism-in-patients-with-acute-exacerbation-of-copd-pilot-study
#14
Adam J Białas, Kamil Kornicki, Maciej Ciebiada, Adam Antczak, Przemysław Sitarek, Joanna Miłkowska-Dymanowska, Wojciech J Piotrowski, Paweł Górski
INTRODUTION    Higher prevalence of pulmonary embolism (PE) has been noted among patients with chronic obstructive pulmonary disease (COPD), which may particularly occur during acute exacerbations (AECOPD). Due to similar clinical presentation, and the lack of highly-specific laboratory tests, there is a common overuse of computed tomography pulmonary angiogram (CTPA). The introduction of an additional, simple and inexpensive diagnostic tool to help in the diagnosis of PE in patients with AECOPD would be of special interest for everyday clinical practice...
November 7, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29108938/fractional-exhaled-nitric-oxide-as-a-predictor-of-response-to-inhaled-corticosteroids-in-patients-with-non-specific-respiratory-symptoms-and-insignificant-bronchodilator-reversibility-a-randomised-controlled-trial
#15
David B Price, Roland Buhl, Adrian Chan, Daryl Freeman, Elizabeth Gardener, Clifford Godley, Kevin Gruffydd-Jones, Lorcan McGarvey, Ken Ohta, Dermot Ryan, Jörgen Syk, Ngiap Chuan Tan, TzeLee Tan, Mike Thomas, Sen Yang, Priyanka Raju Konduru, Marcus Ngantcha, Martina Stagno d'Alcontres, Therese S Lapperre
BACKGROUND: Chronic non-specific respiratory symptoms are difficult to manage. This trial aimed to evaluate the association between baseline fractional exhaled nitric oxide (FeNO) and the response to inhaled corticosteroids in patients with non-specific respiratory symptoms. METHODS: In this double-blind randomised placebo-controlled trial, we enrolled undiagnosed patients, aged 18-80 years, with cough, wheeze, or dyspnoea and less than 20% bronchodilator reversibility across 26 primary care centres and hospitals in the UK and Singapore...
November 3, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29097318/systematic-review-for-the-2017-aha-acc-hrs-guideline-for-management-of-patients-with-ventricular-arrhythmias-and-the-prevention-of-sudden-cardiac-death-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#16
Fred M Kusumoto, Kent R Bailey, Ahmad Sami Chaouki, Abhishek J Deshmukh, Sandeep Gautam, Robert J Kim, Daniel B Kramer, Litsa K Lambrakos, Naseer H Nasser, Dan Sorajja
BACKGROUND: Although large randomized clinical trials have found that primary prevention use of an implantable cardioverter-defibrillator (ICD) improves survival in patients with cardiomyopathy and heart failure symptoms, patients who receive ICDs in practice are often older and have more comorbidities than patients who were enrolled in the clinical trials. In addition, there is a debate among clinicians on the usefulness of electrophysiological study for risk stratification of asymptomatic patients with Brugada syndrome...
October 25, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29097297/systematic-review-for-the-2017-aha-acc-hrs-guideline-for-management-of-patients-with-ventricular-arrhythmias-and-the-prevention-of-sudden-cardiac-death-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#17
Fred M Kusumoto, Kent R Bailey, Ahmad Sami Chaouki, Abhishek J Deshmukh, Sandeep Gautam, Robert J Kim, Daniel B Kramer, Litsa K Lambrakos, Naseer H Nasser, Dan Sorajja
BACKGROUND: Although large randomized clinical trials have found that primary prevention use of an implantable cardioverter-defibrillator (ICD) improves survival in patients with cardiomyopathy and heart failure symptoms, patients who receive ICDs in practice are often older and have more comorbidities than patients who were enrolled in the clinical trials. In addition, there is a debate among clinicians on the usefulness of electrophysiological study for risk stratification of asymptomatic patients with Brugada syndrome...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29084188/-evaluation-of-effect-of-indacaterol-onbrez-and-or-glycopyrronium-seebri-treatment-on-quality-of-life-of-copd-patients-in-medical-practice-in-poland-observational-study-osqo
#18
Tadeusz Płusa, Group Of Physicians From Medical Centers In Poland
Indacaterol, as well glycopyronium has been reimbursed lately in Poland, so patients have a greater access to this treatment in medical practice. Physicians do not realize the potential benefit of once daily ultra-LABA indacaterol and/or modern LAMA with fast-acting glycopyrronium on treatment results. AIM: The aim of the study was to evaluate the impact of routinely administered treatment with either indacaterol (Onbrez) or glycopyrronium (Seebri) or both on patient reported outcomes in form of the health status (CCQ score - clinical COPD questionnaire) and level of dyspnoea (mMRC - modified Medical Research Council) in treatment naive COPD patients after the change of treatment as addon from any other COPD treatment in "real life" settings...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29084018/assessing-patient-reported-outcomes-in-asthma-and-copd-patients-which-can-be-recommended-in-clinical-practice
#19
Janwillem W H Kocks, Sven F Seys, Titia S van Duin, Zuzana Diamant, Ioanna G Tsiligianni
PURPOSE OF REVIEW: There is a clear need for simple and reliable patient-reported outcome measures for chronic obstructive pulmonary disease (COPD) and asthma in daily practice. The purpose of this review is to facilitate the choice for clinicians of patient-reported outcomes which they can use in their daily practice. RECENT FINDINGS: More than 50 patient-reported outcome measures for asthma and COPD exist and clinicians are often left confused on which to use...
October 27, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29074814/exacerbation-risk-and-characterisation-of-the-uk-s-asthma-population-from-infants-to-old-age
#20
Chloe I Bloom, Francis Nissen, Ian J Douglas, Liam Smeeth, Paul Cullinan, Jennifer K Quint
BACKGROUND: Few studies have examined the characteristics of a general asthma population; most have focused on more severe patients or severe exacerbations. METHODS: This population-based cohort study, from April 2007 to September 2015, used linked primary and secondary care electronic healthcare records (Clinical Practice Research Datalink, Hospital Episode Statistics). Characteristics of four age cohorts, 'Under 5s', '5 to 17s', '18 to 54s', '55+', were described...
October 26, 2017: Thorax
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