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Acute exacerbations of COPD

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https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#1
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28212205/spontaneous-breathing-during-extracorporeal-membrane-oxygenation-in-acute-respiratory-failure
#2
Stefania Crotti, Nicola Bottino, Giulia Maria Ruggeri, Elena Spinelli, Daniela Tubiolo, Alfredo Lissoni, Alessandro Protti, Luciano Gattinoni
BACKGROUND: We evaluate the clinical feasibility of spontaneous breathing on extracorporeal membrane oxygenation and the interactions between artificial and native lungs in patients bridged to lung transplant or with acute exacerbation of chronic obstructive pulmonary disease (COPD) or acute respiratory distress syndrome. METHODS: The clinical course of a total of 48 patients was analyzed. Twenty-three of 48 patients were enrolled in the prospective study (nine bridged to lung transplant, six COPD, and eight acute respiratory distress syndrome)...
February 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28209040/-establishment-and-application-effect-appraisement-of-community-chronic-obstructive-pulmonary-disease-integrated-management-system
#3
D X Zhao, S Y Chen, Y M Zhou, X C Li, W F Zou, X M Chen, P X Ran
Objective: To establish the COPD community integrated management system suitable for our national situation and assess its effects in the prevention and treatment for COPD. Methods: The COPD community integrated management system based on the electronic management system was established, including the functional modules of preliminary screening for COPD, electronic health record, grading management and dual referral system, ect. Two townships were randomly selected from the rural areas in north Guangdong as Observational Community and Control Community, respectively...
February 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#4
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28203071/long-acting-bronchodilators-with-or-without-inhaled-corticosteroids-and-30-day-readmission-in-patients-hospitalized-for-copd
#5
Raju Bishwakarma, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: The ability of a long-acting muscarinic antagonist (LAMA) and long-acting beta 2 agonists (LABAs; long-acting bronchodilators, LABDs) with or without inhaled corticosteroids (ICSs) to reduce early readmission in hospitalized patients with COPD is unknown. METHODS: We studied a 5% sample of Medicare beneficiaries enrolled in Medicare parts A, B and D and hospitalized for COPD in 2011. We examined prescriptions filled for LABDs with or without ICSs (LABDs±ICSs) within 90 days prior to and 30 days after hospitalization...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28203070/determining-prognosis-in-acute-exacerbation-of-copd
#6
Yves Flattet, Nicolas Garin, Jacques Serratrice, Arnaud Perrier, Jérome Stirnemann, Sebastian Carballo
BACKGROUND: Acute exacerbations are the leading causes of hospitalization and mortality in patients with COPD. Prognostic tools for patients with chronic COPD exist, but there are scarce data regarding acute exacerbations. We aimed to identify the prognostic factors of death and readmission after exacerbation of COPD. METHODS: This was a retrospective study conducted in the Department of Internal Medicine of Geneva University Hospitals. All patients admitted to the hospital with a diagnosis of exacerbation of COPD between 2008 and 2011 were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28198987/the-content-of-mucin-muc-2-3-and-4-antigens-in-the-bronchial-mucosa-membrane-of-chronic-obstructive-pulmonary-disease-patients-during-acute-exacerbation-initial-report
#7
Svetlana Kovalenko, Andrey Dorofieiev
INTRODUCTION: Changes in mucin production and dyscrinia are common features of inflammation in chronic obstructive pulmonary disease (COPD). Immunohistochemical assessment of MUC-2, MUC-3, MUC-4 expression in the integumentary epithelium, goblet cells, the epithelium of mucous glands and stroma fusiform cells of the bronchial mucosa of COPD patients during an infectious and noninfectious exacerbation was performed. MATERIAL AND METHODS: 30 patients with stage III COPD were enrolled to the study...
2017: Adv Respir Med
https://www.readbyqxmd.com/read/28191362/the-anti-inflammatory-effect-of-alpha-1-antitrypsin-in-rhinovirus-infected-human-airway-epithelial-cells
#8
Di Jiang, Reena Berman, Qun Wu, Connor Stevenson, Hong Wei Chu
OBJECTIVE: Excessive airway inflammation is seen in chronic obstructive pulmonary disease (COPD) patients experiencing acute exacerbations, which are often associated with human rhinovirus (HRV) infection. Alpha-1 antitrypsin (A1AT) has anti-inflammatory function in endothelial cells and monocytes, but its anti-inflammatory effect has not been investigated in COPD airway epithelial cells. We determined A1AT's anti-inflammatory function in COPD airway epithelial cells and the underlying mechanisms such as the role of caspase-1...
December 2016: Journal of Clinical & Cellular Immunology
https://www.readbyqxmd.com/read/28186686/combined-bone-marrow-derived-mesenchymal-stromal-cell-therapy-and-one-way-endobronchial-valve-placement-in-patients-with-pulmonary-emphysema-a-phase-i-clinical-trial
#9
Hugo Goulart de Oliveira, Fernanda Ferreira Cruz, Mariana Alves Antunes, Amarilio Vieira de Macedo Neto, Guilherme Augusto Oliveira, Fabio Munhoz Svartman, Tamara Borgonovo, Carmen Lucia Kuniyoshi Rebelatto, Daniel J Weiss, Paulo Roberto Slud Brofman, Marcelo Marcos Morales, José Roberto Lapa E Silva, Patricia Rieken Macedo Rocco
One-way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach...
December 9, 2016: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28185443/neutrophil-lymphocyte-ratio-better-addition-to-crp-than-cd64-index-as-marker-for-infection-in-copd
#10
Raymond Farah, Rabia Ibrahim, Majd Nassar, Dally Najib, Yifat Zivony, Elizabeth Eshel
OBJECTIVE: This study investigated the importance of neutrophil-lymphocyte ratio (NLR) and other new inflammatory markers including CD64 expression in patients with chronic obstructive pulmonary disease (COPD) for identifying the severity of inflammation and recognition of acute exacerbation and infection. METHODS: 72 patients with a diagnosis of COPD exacerbation who were admitted to Internal Medicine B department, 13 stable COPD, and control group of 15 healthy persons were enrolled in the study...
February 9, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28182569/chronic-obstructive-pulmonary-disease-exacerbation-and-inhaler-device-handling-real-life-assessment-of-2935-patients
#11
Mathieu Molimard, Chantal Raherison, Severine Lignot, Aurelie Balestra, Stephanie Lamarque, Anais Chartier, Cecile Droz-Perroteau, Regis Lassalle, Nicholas Moore, Pierre-Olivier Girodet
Acute exacerbations of chronic obstructive pulmonary disease (COPD) can be prevented by inhaled treatment. Errors in inhaler handling, not taken into account in clinical trials, could impact drug delivery and minimise treatment benefit. We aimed to assess real-life inhaler device handling in COPD patients and its association with COPD exacerbations.To this end, 212 general practitioners and 50 pulmonologists assessed the handling of 3393 devices used for continuous treatment of COPD in 2935 patients. Handling errors were observed in over 50% of handlings, regardless of the device used...
February 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28178959/il-8-predicts-early-mortality-in-patients-with-acute-hypercapnic-respiratory-failure-treated-with-noninvasive-positive-pressure-ventilation
#12
Brynja Jónsdóttir, Åsa Jaworowski, Carmen San Miguel, Olle Melander
BACKGROUND: Patients with Acute Hypercapnic Respiratory Failure (AHRF) who are unresponsive to appropriate medical treatment, are often treated with Noninvasive Positive Pressure Ventilation (NPPV). Clinical predictors of the outcome of this treatment are scarce. Therefore, we evaluated the role of the biomarkers IL-8 and GDF-15 in predicting 28-day mortality in patients with AHRF who receive treatment with NPPV. METHODS: The study population were 46 patients treated with NPPV for AHRF...
February 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28176465/self-determined-motivation-and-exercise-behavior-in-copd-patients
#13
Hui-Ling Cho, Heng-Hsin Tung, Ming-Shian Lin, Wan-Chun Hsu, Chi-Pin Lee
The purpose of this study was to evaluate the self-determined motivation predictors of exercise behavior following pulmonary rehabilitation in COPD recipients. This cross-sectional study was conducted with 135 COPD patients. A demographic questionnaire, clinical factors, behavioral regulations in exercise questionnaire, and leisure time exercise questionnaire were used to collect data. A logistic regression model was used to identify the predictors associated with demographics and self-determined motivation types regarding physical activity...
February 8, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28158267/trends-in-assisted-ventilation-and-outcome-for-obstructive-pulmonary-disease-exacerbations-a-nationwide-study
#14
Anne Pernille Toft-Petersen, Christian Torp-Pedersen, Ulla Møller Weinreich, Bodil Steen Rasmussen
BACKGROUND: Non-invasive ventilation (NIV) has been used for decades in treatment of exacerbations of chronic obstructive pulmonary disease (COPD). The impact of the changing use of assisted ventilation in acute exacerbations on outcomes has not been fully elucidated and we aimed to describe these changes in the Danish population and describe their consequences for mortality. METHODS: A register-based study was conducted of a cohort of 12,847 patients admitted for acute exacerbation of COPD (AECOPD) from 2004 through 2011, treated with invasive mechanical ventilation (IMV) or NIV for the first time...
2017: PloS One
https://www.readbyqxmd.com/read/28154818/%C3%AE-blockers-in-exacerbations-of-copd-feasibility-of-a-randomised-controlled-trial
#15
Catherina L Chang, Conroy Wong, Lutz Beckert, Eskandarain Shafuddin, Richard Beasley, Robert Young, Robert J Hancox
A feasibility randomised controlled trial of β-blockers in acute exacerbations of COPD http://ow.ly/lVcy305B36D.
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28149573/current-situation-of-asthma-copd-overlap-syndrome-acos-in-chinese-patients-older-than-40-years-with-airflow-limitation-rationale-and-design-for-a-multicenter-cross-sectional-trial-study-protocol
#16
Jian Kang, Wanzhen Yao, Baiqiang Cai, Ping Chen, Xia Ling, Hongyan Shang
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are the frequently occurring chronic airway diseases, and the overlapping syndrome observed in the majority of patients has been recently defined as asthma-COPD overlap syndrome (ACOS) by the Global Initiative for Chronic Obstructive Lung (GOLD, 2014) and Global initiative for Asthma (GINA, 2015). The proportion, features, and clinical practice of ACOS still remain elusive in China. We are conducting this multicenter, cross-sectional, observational study (NCT02600221) to investigate the distributions of chronic obstructive diseases in patients >40 years of age with chronic airflow limitation in China along with determination of the main clinical practice and features of these diseases...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28146642/randomized-double-blind-controlled-trial-of-roflumilast-at-acute-exacerbations-of-copd
#17
Alex J Mackay, Anant Rc Patel, Richa Singh, Raymond J Sapsford, Gavin C Donaldson, Niyati Prasad, Udo-Michael Goehring, Tsz Keung Nip, Jadwiga A Wedzicha
No abstract text is available yet for this article.
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28144133/real-life-data-on-antibiotic-prescription-and-sputum-culture-diagnostics-in-acute-exacerbations-of-copd-in-primary-care
#18
Erik Bathoorn, Feikje Groenhof, Ron Hendrix, Thys van der Molen, Bhanu Sinha, Huib Am Kerstjens, Alex W Friedrich, Janwillem Wh Kocks
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are generally treated with optimization of bronchodilation therapy and a course of oral corticosteroids, mostly without antibiotics. The Dutch guidelines recommend prudent use of antibiotics, with amoxicillin or doxycycline as first choice. Here we evaluate adherence to these guidelines with regard to antibiotic prescription in AECOPD in primary care and the use of sputum cultures. METHODS: We retrospectively analyzed a longitudinal cohort of patients in three primary care practices in the north-eastern region of the Netherlands from 2009 to 2013 (n=36,172 subjects) participating in the Registration Network Groningen...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28144052/evaluation-of-plasma-leptin-tumor-necrosis-factor-%C3%AE-and-prealbumin-as-prognostic-biomarkers-during-clinical-recovery-from-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#19
Anant Mohan, Sneh Arora, Arvind Uniyal, Rosemary Poulose, Kalpana Luthra, R M Pandey, Randeep Guleria
BACKGROUND: Inflammatory and nutritional biomarkers have an important bearing on outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but the temporal profile of these compounds during an acute episode is unclear. PATIENTS AND METHODS: Plasma leptin, prealbumin, and tumor necrosis factor-alpha (TNF-α) were estimated at baseline and before hospital discharge in patients with AECOPD. RESULTS: A total of 82 patients were evaluated (66 males; mean (standard deviation) age, 61...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28143877/procalcitonin-to-guide-antibiotic-administration-in-copd-exacerbations-a-meta-analysis
#20
REVIEW
Alexander G Mathioudakis, Victoria Chatzimavridou-Grigoriadou, Alexandru Corlateanu, Jørgen Vestbo
Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
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