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Acute exacerbations of COPD

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https://www.readbyqxmd.com/read/29166411/a-machine-learning-approach-to-triaging-patients-with-chronic-obstructive-pulmonary-disease
#1
Sumanth Swaminathan, Klajdi Qirko, Ted Smith, Ethan Corcoran, Nicholas G Wysham, Gaurav Bazaz, George Kappel, Anthony N Gerber
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set...
2017: PloS One
https://www.readbyqxmd.com/read/29166179/imbalance-between-subpopulations-of-regulatory-t-cells-in-patients-with-acute-exacerbation-of-copd
#2
Xia Yang, Bo Huo, Xiaoning Zhong, Wenyan Su, Wenting Liu, Yumei Li, Zhiyi He, Jing Bai
Human regulatory T cells (Tregs) have been reported to be not significantly different in the peripheral blood of patients with chronic obstructive pulmonary disease (COPD) and healthy controls. Recent research has identified some new markers for Tregs and indicated that Tregs are composed of distinct subpopulations. The aim of the study was to describe the changing patterns of circulating Treg subpopulations in patients with acute exacerbation of COPD (AECOPD) and healthy controls, and to explore their potential roles in AECOPD pathogenesis...
November 22, 2017: COPD
https://www.readbyqxmd.com/read/29148205/inhaled-corticosteroids-and-the-risks-of-low-energy-fractures-in-patients-with-chronic-airway-diseases-a-propensity-score-matched-study
#3
Chun-Hao Tsai, Lin-Yu Laio, Cheng-Li Lin, Wei-Sheng Chung
BACKGROUND AND AIMS: Inhaled corticosteroids (ICSs) are crucial anti-inflammatory medications for chronic airway diseases. Studies investigating the relationship between ICSs and fractures in Asian populations are scant. We investigated whether ICSs increased the risk of low-energy fractures in patients with chronic airway diseases. METHODS: We used the Longitudinal Health Insurance Database to select patients aged 20 years and older with chronic airway diseases (asthma and COPD) between 2000 and 2011 as the base cohort...
November 17, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#4
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#5
Susanne Burgemeister, Alexander Kutz, Antoinette Conca, Thomas Holler, Sebastian Haubitz, Andreas Huber, Ulrich Buergi, Beat Mueller, Philipp Schuetz
Background: Benchmarking of real-life quality of care may improve evaluation and comparability of emergency department (ED) care. We investigated process management variables for important medical diagnoses in a large, well-defined cohort of ED patients and studied predictors for low quality of care. Methods: We prospectively included consecutive medical patients with main diagnoses of community-acquired pneumonia, urinary tract infection (UTI), myocardial infarction (MI), acute heart failure, deep vein thrombosis, and COPD exacerbation and followed them for 30 days...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29118578/changes-in-definition-lead-to-changes-in-the-clinical-characteristics-across-copd-categories-according-to-gold-2017-a-national-cross-sectional-survey-in-china
#6
Lina Sun, Yahong Chen, Rui Wu, Ming Lu, Wanzhen Yao
Purpose: To investigate how the changes of definition in assessment of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stratification 2017 lead to changes of chronic obstructive pulmonary disease (COPD) patient clinical characteristics across categories in China. Patients and methods: COPD patients from 11 medical centers in China were stratified into old and new groups A-D twice according to the GOLD 2011 and 2017 comprehensive assessment. Demography and clinical characteristics were compared between old and new groups A-D...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29117796/effects-of-varenicline-therapy-in-combination-with-advanced-behavioral-support-on-smoking-cessation-and-quality-of-life-in-inpatients-with-acute-exacerbation-of-copd-bronchial-asthma-or-community-acquired-pneumonia-a-prospective-open-label-preference-based
#7
Alexios Politis, Vasileios Ioannidis, Konstantinos I Gourgoulianis, Zoe Daniil, Chrissi Hatzoglou
Quitting smoking is the most important element in the therapeutic management of chronic respiratory diseases. Combining pharmacotherapy with behavioral support increases smoking cessation success rates. In addition, hospitalized smokers have increased motivation to quit. We investigated the efficacy on smoking cessation, of varenicline in combination with behavioral support, in smokers hospitalized due to (a) acute exacerbation of chronic obstructive pulmonary disease (COPD), or (b) bronchial asthma attack, or (c) community-acquired pneumonia (CAP)...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#8
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29113693/the-value-of-lactate-clearance-in-admission-decisions-of-patients-with-acute-exacerbation-of-copd
#9
Uğur Durmuş, Nurettin Özgür Doğan, Murat Pekdemir, Serkan Yılmaz, Elif Yaka, Adnan Karadaş, Seda Güney Pınar
BACKGROUND: Lactate and lactate clearance are being used as biomarkers in several critical conditions. The aim of this study was to examine the value of sixth hour lactate clearance in patients who were hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations. METHODS: This single-center, cross-sectional study was conducted in a tertiary emergency department (ED) on patients who presented with acute exacerbation of COPD. Discharge or admission decisions were specified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and the clinician's decision...
November 4, 2017: American Journal of Emergency Medicine
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
#10
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/29098995/two-year-mortality-in-survivors-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-a-north-indian-study
#11
Parvaiz A Koul, Hilal A Dar, Rafi A Jan, Sanaullah Shah, Umar Hafiz Khan
OBJECTIVES: Data about long-term mortality of Indian patients following acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are scant. We set out to study the 2-year mortality in north Indian patients following discharge after AECOPD. MATERIALS AND METHODS: One hundred and fifty-one (96 male) patients admitted for AECOPD and discharged were followed for 2 years at 3, 6, 12, 18, and 24 months for mortality. Statistical analysis was performed to identify risk factors associated with mortality...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29098341/acute-administration-of-roflumilast-enhances-sensory-gating-in-healthy-young-humans-in-a-randomized-trial
#12
Pim R A Heckman, Marlies A Van Duinen, Arjan Blokland, Tolga Uz, Jos Prickaerts, Anke Sambeth
INTRODUCTION: Sensory gating is a process involved in early information processing which prevents overstimulation of higher cortical areas by filtering sensory information. Research has shown that the process of sensory gating is disrupted in patients suffering from clinical disorders including attention deficit hyper activity disorder, schizophrenia, and Alzheimer's disease. Phosphodiesterase (PDE) inhibitors have received an increased interest as a tool to improve cognitive performance in both animals and man, including sensory gating...
November 3, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/29090990/handgrip-strength-in-chronic-obstructive-pulmonary-disease-associations-with-acute-exacerbations-and-body-composition
#13
Carlos H Martinez, Alejandro A Diaz, Catherine A Meldrum, Merry-Lynn N McDonald, Susan Murray, Gregory L Kinney, John E Hokanson, Jeffrey L Curtis, Russell P Bowler, MeiLan K Han, George R Washko, Elizabeth A Regan
RATIONALE: Handgrip strength (HGS) predicts mortality in the elderly, but its determinants and clinical significance in chronic obstructive pulmonary disease (COPD) has not been defined. OBJECTIVES: We tested associations of HGS with pectoralis muscle area (PMA), subcutaneous adipose tissue (SAT), imaging characteristics, and lung function in smokers with COPD, and evaluated the cross-sectional and longitudinal associations of HGS with acute respiratory events. METHODS: We analyzed demographic, clinical, spirometry, HGS, and imaging data of 272 subjects with COPD, obtaining measures of airway thickness, emphysema, PMA, and SAT from chest computed tomography scans...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29089755/cost-effectiveness-of-the-aerobika-oscillating-positive-expiratory-pressure-device-in-the-management-of-copd-exacerbations
#14
Shoghag Khoudigian-Sinani, Stacey Kowal, Jason A Suggett, Dominic P Coppolo
INTRODUCTION: COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying disease processes that drive exacerbation development. The Aerobika* oscillating positive expiratory pressure (OPEP) device has been shown in a real-world effectiveness study to lower the frequency of moderate-to-severe exacerbations during a 30-day post-exacerbation period...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29089752/beta-blocker-under-use-in-copd-patients
#15
Kuan Pin Lim, Sarah Loughrey, Michael Musk, Melanie Lavender, Jeremy P Wrobel
BACKGROUND: Cardiovascular (CVS) comorbidities are common in COPD and contribute significantly to morbidity and mortality, especially following acute exacerbations of COPD (AECOPD). Beta-blockers (BBs) are safe and effective in COPD patients, with demonstrated survival benefit following myocardial infarction. We sought to determine if BBs are under-prescribed in patients hospitalized with AECOPD. We also sought to determine inpatient rates of CVS and cerebrovascular complications, and their impact on patient outcomes...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29083268/advances-in-remote-respiratory-assessments-for-people-with-chronic-obstructive-pulmonary-disease-a-systematic-review
#16
Sidney Baroi, Renae J McNamara, David K McKenzie, Simon Gandevia, Matthew A Brodie
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. Advances in remote technologies and telemedicine provide new ways to monitor respiratory function and improve chronic disease management. However, telemedicine does not always include remote respiratory assessments, and the current state of knowledge for people with COPD has not been evaluated. OBJECTIVE: Systematically review the use of remote respiratory assessments in people with COPD, including the following questions: What devices have been used? Can acute exacerbations of chronic obstructive pulmonary disease (AECOPD) be predicted by using remote devices? Do remote respiratory assessments improve health-related outcomes? MATERIALS AND METHODS: The review protocol was registered (PROSPERO 2016:CRD42016049333)...
October 30, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29082624/emergence-of-aspergillus-fumigatus-azole-resistance-in-azole-na%C3%A3-ve-copd-patients-and-their-homes
#17
Camille Dauchy, Nathalie Bautin, Saad Nseir, Gabriel Reboux, René Wintjens, Olivier Le Rouzic, Boualem Sendid, Eric Viscogliosi, Patrice Le Pape, Maiken Cavling Arendrup, Philippe Gosset, Stéphanie Fry, Emilie Fréalle
Azole-resistant Aspergillus fumigatus (ARAF) has been reported in COPD patients, but has not been specifically assessed so far. Here, we evaluated ARAF prevalence in azole-naïve COPD patients and their homes, and assessed whether CYP51A mutations were similar in clinical and environmental reservoirs. Sixty respiratory samples from 41 COPD patients with acute exacerbation, and environmental samples from 36 of these patient's homes were prospectively collected. A. fumigatus was detected in respiratory samples from 11/41 patients (27%) and in 15/36 domiciles (42%)...
October 30, 2017: Indoor Air
https://www.readbyqxmd.com/read/29080708/classification-of-cough-as-a-symptom-in-adults-and-management-algorithms-chest-guideline-and-expert-panel-report
#18
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29071072/effect-of-high-flow-nasal-therapy-during-acute-aerobic-exercise-in-patients-with-chronic-obstructive-pulmonary-disease-after-exacerbation-protocol-for-a-randomised-controlled-cross-over-trial
#19
Guillaume Prieur, Clement Medrinal, Yann Combret, Aurora Robledo Quesada, Fabrice Prieur, Jean Quieffin, Jean Christian Borel, Gregory Reychler
INTRODUCTION: Early pulmonary rehabilitation is recommended after a severe exacerbation of chronic obstructive pulmonary disease (COPD). However, this is difficult to implement, particularly for exercise training. High-flow nasal therapy (HFNT) may reduce the work of breathing and dyspnoea and may improve exercise tolerance. METHODS AND ANALYSIS: This is a single-centre, prospective, controlled, randomised, cross-over study. Eligible patients will have a diagnosis of COPD (postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of <0...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29070459/-neutrophil-to-lymphocyte-ratio-as-a-predictor-for-type-2-diabetes-mellitus-in-patients-with-chronic-obstructive-pulmonary-disease-a-cohort-study-of-404-cases
#20
Tao Ye, Yin Yang, Kai Wang, Mei Wang, Jia Sun, Yue DU, Xin Chen
OBJECTIVE: To assess the value of neutrophil?to?lymphocyte ratio (NLR) for predicting type 2 diabetes mellitus (T2DM) in patients with chronic obstructive pulmonary disease (COPD). METHODS: A cohort of 404 non?diabetic patients diagnosed with stable COPD between January, 2010 and December, 2012 at Zhujiang Hospital were enrolled and followed up for 3 years, during which fast blood glucose (FBG) was monitored every 6 months. The primary endpoint was the occurrence of T2DM, and the cumulative incidence of T2DM in this cohort was calculated...
October 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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