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Acute exacerbations of COPD

Vladislav Raclavsky, Nikola Stromerova, Dana Safarova, Jan Bardon, Jaromir Zatloukal, Martin Zapalka, Petr Jakubec, Lucie Navratilova, Radko Novotny
BACKGROUND AND AIMS: Haemophilus influenzae new strain acquisition has been demonstrated to increase the relative risk of acute exacerbation fourfold in contrast to colonisation or chronic infection by the same strain in chronic obstructive pulmonary disease (COPD). Unfortunately, molecular typing techniques are not suitable for routine use due to cost, labour-intensity and need for special expertise. We tested two techniques potentially useful for routine typing, namely the newly available MALDI-TOF MS and the modified McRAPD compared to MLST as the gold standard...
October 6, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Rachel Boxio, Julien Wartelle, Béatrice Nawrocki-Raby, Brice Lagrange, Laurette Malleret, Timothee Hirche, Clifford Taggart, Yves Pacheco, Gilles Devouassoux, Abderrazzaq Bentaher
BACKGROUND: In acutely injured lungs, massively recruited polymorphonuclear neutrophils (PMNs) secrete abnormally neutrophil elastase (NE). Active NE creates a localized proteolytic environment where various host molecules are degraded leading to impairment of tissue homeostasis. Among the hallmarks of neutrophil-rich pathologies is a disrupted epithelium characterized by the loss of cell-cell adhesion and integrity. Epithelial-cadherin (E-cad) represents one of the most important intercellular junction proteins...
October 17, 2016: Respiratory Research
Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Erin Davis, Carlo Marra, John-Michael Gamble, Jamie Farrell, Joe Lockyer, J Mark FitzGerald, Waseem Abu-Ashour, Charlie Gillis, John Hawboldt
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are often nonadherent with medications and have poor inhaler technique. Community pharmacists can help to improve health-related quality of life and overall outcomes in patients with COPD. We aim to measure the effectiveness of a systematic, pharmacist-driven intervention on patients with diagnosed COPD. METHODS/DESIGN: This pragmatic, parallel-group, cluster randomized controlled trial is designed to determine the effectiveness of a multifactorial, pharmacist-led intervention on medication adherence, inhaler technique, health-related quality of life, health care resource utilization including COPD exacerbations, and use of medications...
October 13, 2016: Trials
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
Andrea S Gershon, Alice M Newman, Hadas D Fischer, Peter C Austin, Nick Daneman, Chaim M Bell, Anne L Stephenson, Sudeep S Gill, Nicholas T Vozoris, Paula A Rochon
Inhaled, long-acting anticholinergic medication (LAA), commonly used for moderate-to-severe chronic obstructive pulmonary disease (COPD), has been shown to decrease COPD hospitalizations, emergency department visits, and acute exacerbations but has also been associated with urinary tract infection (UTI) in a prior meta-analysis. The objective of this study was to verify if there was an association between LAA and UTI in older individuals with COPD. A population-based, real-world cohort study using health administrative data from Ontario, Canada was conducted...
October 12, 2016: COPD
Rosa Faner, Patricia Sobradillo, Aina Noguera, Cristina Gomez, Tamara Cruz, Alejandra López-Giraldo, Eugeni Ballester, Nestor Soler, Juan I Arostegui, Pablo Pelegrín, Roberto Rodriguez-Roisin, Jordi Yagüe, Borja G Cosio, Manel Juan, Alvar Agustí
Chronic obstructive pulmonary disease (COPD) is characterised by pulmonary and systemic inflammation that bursts during exacerbations of the disease (ECOPD). The NLRP3 inflammasome is a key regulatory molecule of the inflammatory response. Its role in COPD is unclear. We investigated the NLRP3 inflammasome status in: 1) lung tissue samples from 38 patients with stable COPD, 15 smokers with normal spirometry and 14 never-smokers; and 2) sputum and plasma samples from 56 ECOPD patients, of whom 41 could be reassessed at clinical recovery...
July 2016: ERJ Open Research
Makedonka Gulcev, Cavan Reilly, Timothy J Griffin, Corey D Broeckling, Brian J Sandri, Bruce A Witthuhn, Shane W Hodgson, Prescott G Woodruff, Chris H Wendt
INTRODUCTION: Exacerbations are a leading cause of morbidity in COPD. The objective of this study was to identify metabolomic biomarkers of acute exacerbations of COPD (AECOPD). METHODS: We measured metabolites via mass spectrometry (MS) in plasma drawn within 24 hours of admission to the hospital for 33 patients with an AECOPD (day 0) and 30 days later and for 65 matched controls. Individual metabolites were measured via selective reaction monitoring with mass spectrometry...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Kubihal S, Daga Mk, Hira Hs
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Goutham Naresh Rudra
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Sivaraman A, Maniram Kumhar, Subash Saini, Manoj Mali, Gaurav Meratwal
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Hyun Jung Kwak, Dong Won Park, Jee Eun Kim, Min Kyung Park, Gun Woo Koo, Tai Sun Park, Ji-Yong Moon, Tae Hyung Kim, Jang Won Sohn, Ho Joo Yoon, Dong Ho Shin, Sang-Heon Kim
Exacerbations of chronic obstructive pulmonary disease (COPD) lead to high morbidity and mortality. Respiratory virus infection is considered as one of the important causes of COPD exacerbations. The aim of this study was to assess the prevalence of respiratory virus infection in COPD exacerbations and to find the factors associated with susceptibility to viral infections. Furthermore, we tried to examine if COPD exacerbations caused by viral infections have more severe clinical outcomes in comparison with those with non-viral causes...
2016: Tohoku Journal of Experimental Medicine
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
Irene Torres-Sánchez, Marie Carmen Valenza, Irene Cabrera-Martos, Isabel López-Torres, Ángela Benítez-Feliponi, Alicia Conde-Valero
The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease (COPD) during hospitalization due to an acute exacerbation. This study was a randomized, single-blind clinical trial. Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD (AECOPD) were included in this study. All patients received standard medical and pharmacological care. Patients assigned to the intervention group also received an exercise intervention...
August 11, 2016: COPD
Shih-Lung Cheng, Ching-Hsiung Lin
BACKGROUND: Blood eosinophil counts have been documented as a good biomarker for patients with chronic obstructive pulmonary disease (COPD) using inhaled corticosteroid (ICS) therapy. However, the effectiveness and safety of prescribing high or medium dose of ICS for patients with different eosinophil counts are unknown. METHODS: A post hoc analysis of a previous prospective randomized study was performed for COPD patients using higher dose (HD: Fluticasone 1,000 μg/day) or medium dose (MD: Fluticasone 500 μg/day) of ICS combined with Salmeterol (100 μg/day)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Feng-Sen Li, Yan-Li Zhang, Zheng Li, Dan Xu, Chun-Yan Liao, Huan Ma, Li Gong, Jun Su, Qi Sun, Qian Xu, Zhen Gao, Ling Wang, Jing Jing, Jing Wang, Min Jiang, Ge Tian, Bilal Hasan
In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012...
October 2016: Experimental and Therapeutic Medicine
Mark Orme, Amie Weedon, Dale Esliger, Paula Saukko, Mike Morgan, Michael Steiner, John Downey, Sally Singh, Lauren Sherar
INTRODUCTION: An acute exacerbation of chronic obstructive pulmonary disease (COPD) marks a critical life event, which can lower patient quality of life and ability to perform daily activities. Patients with COPD tend to lead inactive and highly sedentary lifestyles, which may contribute to reductions in functional capacity. Targeting sedentary behaviour (SB) may be more attainable than exercise (at a moderate-to-vigorous intensity) for behaviour change in patients following an exacerbation...
October 3, 2016: BMJ Open
Hamdi Boubaker, Mohamed Habib Grissa, Kaouther Beltaief, Zohra Dridi, Mohamed Fadhel Najjar, Wahid Bouida, Riadh Boukef, Soudani Marghli, Semir Nouira
BACKGROUND: The goal of this study was to determine the value of systolic time intervals and their change during Valsalva maneuver (VM) in the diagnosis of left ventricular dysfunction (LVD) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: We included 166 patients admitted to the emergency department for AECOPD. Measurement of systolic time intervals included electromechanical activation time (EMAT), left ventricular ejection time (LVET), and EMAT/LVET ratio...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Carmen Pizarro, Neele Herweg-Steffens, Martin Buchenroth, Wolfgang Schulte, Christian Schaefer, Christoph Hammerstingl, Nikos Werner, Georg Nickenig, Dirk Skowasch
BACKGROUND: In acute exacerbation of COPD, increased plasma levels of cardiac troponin are frequent and associated with increased mortality. Thus, we aimed at prospectively determining the diagnostic value of coronary angiography in patients with exacerbated COPD and concomitantly elevated cardiac troponin. PATIENTS AND METHODS: A total of 88 patients (mean age 72.9±9.2 years, 56.8% male) hospitalized for acute exacerbation of COPD with elevated plasma troponin were included...
2016: International Journal of Chronic Obstructive Pulmonary Disease
María José Bujalance-Zafra, Miguel Domínguez-Santaella, Antonio Baca-Osorio, Leovigildo Ginel-Mendoza, Francisco Jesús Fernández-Vargas, Rafael Poyato-Ramos
OBJECTIVE: To examine the impact of an intervention by Primary Care (PC) professionals of a Health District on the clinical outcomes for treating COPD exacerbations using a process and outcome indicators analysis (clinical audit). DESIGN: Observational, retrospective and prospective analysis cross-sectional audit of clinical practice SETTING: Malaga-Guadalhorce Sanitary District (DSMG). PARTICIPANTS: Patients with COPD exacerbations treated by the extra-hospital emergency services (n=523; 21% losses)...
September 27, 2016: Atencion Primaria
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