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https://www.readbyqxmd.com/read/29051276/precision-medicine-in-airway-diseases-moving-to-clinical-practice
#1
Alvar Agustí, Mona Bafadhel, Richard Beasley, Elisabeth H Bel, Rosa Faner, Peter G Gibson, Renaud Louis, Vanessa M McDonald, Peter J Sterk, Mike Thomas, Claus Vogelmeier, Ian D Pavord
On February 21, 2017, a European Respiratory Society research seminar held in Barcelona discussed how to best apply precision medicine to chronic airway diseases such as asthma and chronic obstructive pulmonary disease. It is now clear that both are complex and heterogeneous diseases, that often overlap and that both require individualised assessment and treatment. This paper summarises the presentations and discussions that took place during the seminar. Specifically, we discussed the need for a new taxonomy of human diseases, the role of different players in this scenario (exposome, genes, endotypes, phenotypes, biomarkers and treatable traits) and a number of unanswered key questions in the field...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29049458/long-term-outcomes-of-multiple-arterial-coronary-artery-bypass-grafting-a-population-based-study-of-patients-in-british-columbia-canada
#2
Aihua Pu, Lillian Ding, Jungwon Shin, Joel Price, Peter Skarsgard, Daniel R Wong, John Bozinovski, Guy Fradet, James G Abel
Importance: Although the long-term survival advantage of multiple arterial grafting (MAG) vs the standard use of left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG) has been demonstrated in several observational studies, to our knowledge its safety and other long-term clinical benefits in a large, population-based cohort are unknown. Objective: To compare the safety and long-term outcomes of MAG vs LITA+SVG among overall and selected subgroups of patients...
October 11, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#3
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049049/treatable-traits-of-chronic-airways-disease
#4
James Fingleton, Jo Hardy, Richard Beasley
PURPOSE OF REVIEW: To describe the rationale on which the treatable traits approach to the management of airways disease is based and the issues that need to be considered for its implementation in clinical practice. RECENT FINDINGS: In clinical practice, treatable traits can be classified according to both endotypes and phenotypes, broadly grouped within pulmonary, extrapulmonary, environmental and behavioural factors. Specific investigations and treatments are undertaken for each of the traits rather than a 'one size fits all' stepwise approach to pharmacological treatment which currently represents the core of asthma and chronic obstructive pulmonary disease (COPD) guidelines...
October 18, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29035604/biomarkers-for-differentiation-of-patients-with-asthma-and-chronic-obstructive-pulmonary-disease
#5
Shigeki Katoh, Masaki Ikeda, Ryo Shirai, Masaaki Abe, Yoshihiro Ohue, Yoshihiro Kobashi, Mikio Oka
OBJECTIVE: Asthma and chronic obstructive pulmonary disease (COPD) are airflow limitation diseases with similar clinical manifestations but different pathophysiologic mechanisms. To implement the appropriate treatment, it is important to distinguish between asthma and COPD which sometimes might result difficult in clinical practice. We evaluated biomarkers to distinguish between asthma and COPD. METHODS: Blood eosinophil counts and fractional exhaled nitric oxide (FeNO) levels were analyzed...
October 16, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#6
REVIEW
Timothy E Albertson, Susan Murin, Mark E Sutter, James A Chenoweth
The Salford Lung Study (SLS) of patients with asthma and chronic obstructive pulmonary disease (COPD) is a practical, community-based, randomized, open-label pragmatic study on the efficacy and safety of the once-daily dry powder inhaler that combines the inhaled corticosteroid fluticasone furoate (FF) with the long-acting beta2 agonist vilanterol (VI). The asthma component of the SLS is not yet reported but the COPD component, done over a 12-month period, found a statistically significant 8.4% reduction in COPD exacerbations when compared to usual care...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29033203/-reproducibility-of-strength-and-endurance-measurements-of-the-quadriceps-in-patients-with-copd
#7
M Beaumont, G Kerautret, L Peran, R Pichon, C Le Ber, M Cabillic
INTRODUCTION: Patients with COPD frequently have lower strength and endurance in their lower limbs compared to healthy subjects and evaluation of their quadriceps strength is recommended in practice. The handheld dynamometer has been validated and is easy to use for this measurement but its reproducibility has never been studied for endurance evaluation and only poorly for strength. The objective of this study was to estimate the inter and intra-operator reproducibility of maximal voluntary strength and endurance measurements of the quadriceps with a handheld dynamometer in patients with COPD...
October 13, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29021576/the-recording-and-characteristics-of-pulmonary-rehabilitation-in-patients-with-copd-using-the-health-information-network-thin-primary-care-database
#8
Ali Hakamy, Tricia M McKeever, Jack E Gibson, Charlotte E Bolton
Pulmonary rehabilitation is recommended for patients with COPD to improve physical function, breathlessness and quality of life. Using The Health Information Network (THIN) primary care database in UK, we compared the demographic and clinical parameters of patients with COPD in relation to coding of pulmonary rehabilitation, and to investigate whether there is a survival benefit from pulmonary rehabilitation. We identified patients with COPD, diagnosed from 2004 and extracted information on demographics, pulmonary rehabilitation and clinical parameters using the relevant Read codes...
October 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28987858/-effectiveness-of-an-educational-program-for-respiratory-rehabilitation-of-chronic-obstructive-pulmonary-disease-patients-in-primary-care-in-improving-the-quality-of-life-symptoms-and-clinical-risk
#9
Cristina Blánquez Moreno, Cristina Colungo Francia, M Carme Alvira Balada, Belchin Kostov, Luis González-de Paz, Antoni Sisó-Almirall
AIM: To determine the impact of an educational program to improve the management of chronic obstructive pulmonary disease (COPD) that contributes to an increase of the quality of life, exercise capacity, level of dyspnoea, and clinical risk. DESIGN: Intervention study without controls. LOCATION: Primary Healthcare Centre. PARTICIPANTS: 193 patients with COPD were invited, 73 accepted and 55 participated in the educational program...
October 4, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28979111/factors-facilitating-and-hindering-the-intention-to-promote-pulmonary-rehabilitation-for-patients-with-copd-among-respiratory-therapists
#10
Yun-Ju Chen, Jun-Yu Fan, Su-Er Guo, Su-Lun Hwang, Tsung-Ming Yang
PURPOSE: Pulmonary rehabilitation (PR) is recognized as the chief non-pharmacologic management approach for patients with COPD, but is clinically under-utilized. In Taiwan, respiratory therapists (RTs) are one of the first-line health care providers who spend vast amounts of time with COPD patients in PR programs. To better enhance patients' knowledge of and participation in PR, it is necessary to understand how PR is viewed by RTs, as well as how these views influence their behavioral intentions toward promoting PR...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28954781/multi-level-differential-network-analysis-of-copd-exacerbations
#11
Guillaume Noell, Borja G Cosío, Rosa Faner, Eduard Monsó, German Peces-Barba, Alfredo de Diego, Cristobal Esteban, Joaquim Gea, Robert Rodriguez-Roisin, Marian Garcia-Nuñez, Francisco Pozo-Rodriguez, Susana G Kalko, Alvar Agustí
Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation (ECOPD) that impact negatively the course of their disease. ECOPD are heterogeneous events of unclear pathobiology and non-specific diagnosis. Network analysis is a novel research approach that can help unravelling complex biological systems. We hypothesised that the comparison of multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and convalescence can yield novel patho-biologic information...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28951500/predictors-of-venous-thromboembolism-and-early-mortality-in-lung-cancer-results-from-a-global-prospective-study-cantarisk
#12
Nicole M Kuderer, Marek S Poniewierski, Eva Culakova, Gary H Lyman, Alok A Khorana, Ingrid Pabinger, Giancarlo Agnelli, Howard A Liebman, Eric Vicaut, Guy Meyer, Frances A Shepherd
BACKGROUND: Patients with lung cancer are known to be at increased risk for venous thromboembolism (VTE). Venous thromboembolism is associated with increased risk for early mortality. However, there have been no studies performing a comprehensive assessment of risk factors for VTE or early mortality in lung cancer patients undergoing systemic chemotherapy in a global real-world setting. MATERIALS AND METHODS: CANTARISK is a prospective, global, noninterventional cohort study including patients with lung cancer initiating a new cancer therapy...
September 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28934249/variability-in-objective-and-subjective-measures-affects-baseline-values-in-studies-of-patients-with-copd
#13
MULTICENTER STUDY
Wayne H Anderson, Jae Wook Ha, David J Couper, Wanda K O'Neal, R Graham Barr, Eugene R Bleecker, Elizabeth E Carretta, Christopher B Cooper, Claire M Doerschuk, M Bradley Drummond, MeiLan K Han, Nadia N Hansel, Victor Kim, Eric C Kleerup, Fernando J Martinez, Stephen I Rennard, Donald Tashkin, Prescott G Woodruff, Robert Paine, Jeffrey L Curtis, Richard E Kanner
RATIONALE: Understanding the reliability and repeatability of clinical measurements used in the diagnosis, treatment and monitoring of disease progression is of critical importance across all disciplines of clinical practice and in clinical trials to assess therapeutic efficacy and safety. OBJECTIVES: Our goal is to understand normal variability for assessing true changes in health status and to more accurately utilize this data to differentiate disease characteristics and outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28932111/the-use-of-the-practice-walk-test-in-pulmonary-rehabilitation-program-national-copd-audit-pulmonary-rehabilitation-workstream
#14
Ali Hakamy, Tricia M McKeever, Michael C Steiner, C Michael Roberts, Sally J Singh, Charlotte E Bolton
Our aim was to evaluate the use and impact of the practice walk test on enrolment, completion, and clinical functional response to pulmonary rehabilitation (PR) using the 2015 UK National Chronic Obstructive Pulmonary Disease (COPD) Pulmonary Rehabilitation audit data. Patients were assessed according to whether a baseline practice walk test was performed or not. Study outcomes included use of the practice walk test, baseline and change in incremental shuttle walk test distance (ISWD) or 6-minute walk test distance (6MWD), and enrolment to and completion of PR program...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#15
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28928190/interdisciplinary-model-of-care-radicals-for-early-detection-and-management-of-chronic-obstructive-pulmonary-disease-copd-in-australian-primary-care-study-protocol-for-a-cluster-randomised-controlled-trial
#16
Jenifer Liang, Michael J Abramson, Nicholas Zwar, Grant Russell, Anne E Holland, Billie Bonevski, Ajay Mahal, Benjamin van Hecke, Kirsten Phillips, Paula Eustace, Eldho Paul, Kate Petrie, Sally Wilson, Johnson George
INTRODUCTION: Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. METHODS AND ANALYSIS: A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS - Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers)...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28919728/chronic-obstructive-pulmonary-disease-with-mild-airflow-limitation-current-knowledge-and-proposal-for-future-research-a-consensus-document-from-six-scientific-societies
#17
REVIEW
Andrea Rossi, Bojana Butorac-Petanjek, Marco Chilosi, Borja G Cosío, Matjaz Flezar, Nikolaos Koulouris, José Marin, Neven Miculinic, Guido Polese, Miroslav Samaržija, Sabina Skrgat, Theodoros Vassilakopoulos, Andrea Vukić-Dugac, Spyridon Zakynthinos, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, with high and growing prevalence. Its underdiagnosis and hence under-treatment is a general feature across all countries. This is particularly true for the mild or early stages of the disease, when symptoms do not yet interfere with daily living activities and both patients and doctors are likely to underestimate the presence of the disease. A diagnosis of COPD requires spirometry in subjects with a history of exposure to known risk factors and symptoms...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28918400/healthcare-resource-use-and-costs-of-severe-uncontrolled-eosinophilic-asthma-in-the-uk-general-population
#18
Marjan Kerkhof, Trung N Tran, Joan B Soriano, Sarowar Golam, Danny Gibson, Elizabeth V Hillyer, David B Price
BACKGROUND: Little is known about the prevalence of severe, uncontrolled eosinophilic asthma (SUEA) and associated costs. AIMS: We sought to determine the prevalence of SUEA and compare asthma-related healthcare resource use (HCRU) and associated costs with overall means for a general asthma population. METHODS: This cohort study evaluated anonymised medical record data (December 1989 through June 2015) from the Clinical Practice Research Datalink and the Optimum Patient Care Research Database to study UK patients with active asthma (diagnostic code and one or more drug prescriptions in the baseline year), aged 5 years and older, without concomitant COPD, and with recorded eosinophil count...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28887061/advances-in-audio-based-systems-to-monitor-patient-adherence-and-inhaler-drug-delivery
#19
REVIEW
Terence E Taylor, Yaniv Zigel, Céline De Looze, Imran Sulaiman, Richard W Costello, Richard B Reilly
Hundreds of millions of people suffer from asthma and chronic obstructive pulmonary disease (COPD) worldwide. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler (pMDI) and dry powder inhaler (DPI). Providing that they are used as prescribed, inhalers can improve patients' clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions and increased mortality rates, particularly in low-middle income countries...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28885968/diagnosing-chronic-obstructive-pulmonary-disease-among-afghanistan-and-iraq-veterans-veterans-affair-s-concordance-with-clinical-guidelines-for-spirometry-administration
#20
Aaron I Schneiderman, Deborah D Dougherty, Vincent P Fonseca, Charles L Wolters, Robert M Bossarte, Mehrdad Arjomandi
BACKGROUND: Early diagnosis and treatment of chronic obstructive pulmonary disease (COPD) can slow disease progression. The Department of Veterans Affairs (VA)/Department of Defense Clinical Practice Guidelines (CPG), established to improve patient outcomes, recommend the use of spirometry in the COPD diagnostic process. The aims of this study were to assess VA health care providers' performance related to CPG-recommended spirometry administration in the evaluation of newly diagnosed COPD among veterans, determine the patient characteristics that may influence the adherence rate, and compare VA concordance rates to those of other health plans...
September 2017: Military Medicine
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