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Acute exacerbations of COPD

Gehan Hassan AboEl-Magd, Maaly Mohamed Mabrouk
OBJECTIVE: To evaluate the value of soluble urokinase-type plasminogen activator receptor (suPAR) in the diagnosis of acute exacerbation of COPD (AECOPD) and in monitoring treatment response, analyzing the relationship between suPAR and fibrinogen in AECOPD. AECOPD leads to increased airway inflammation, contributing to an exaggerated release of inflammatory mediators. METHODS: We recruited 45 patients with AECOPD and 20 healthy control subjects. Medical histories were taken, and all subjects underwent clinical examination, chest X-ray, pulmonary function tests, and blood gas analysis...
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Mario Malerba, Matteo Nardin, Giuseppe Santini, Nadia Mores, Alessandro Radaeli, Paolo Montuschi
Maintenance pharmacological treatment for stable chronic obstructive pulmonary disease (COPD) is based on inhaled drugs, including long-acting muscarinic receptor antagonists (LAMA), long-acting β2 -adrenoceptor agonists (LABA) and inhaled corticosteroids (ICS). Inhaled pharmacological treatment can improve patients' daily symptoms and reduce decline of pulmonary function and acute exacerbation rate. Treatment with all three inhaled drug classes is reserved for selected, more severe, patients with COPD when symptoms are not sufficiently controlled by dual LABA/LAMA therapy and exacerbations are frequent...
January 2018: Therapeutic Advances in Respiratory Disease
Theerasuk Kawamatawong, Jitsupa Onnipa, Thitiporn Suwatanapongched
Background: The prevalence rate of bronchiectasis in COPD is variable. Coexisting bronchiectasis and COPD may influence COPD severity and exacerbation. Objective: We investigated whether bronchiectasis is associated with frequent or severe COPD exacerbation. Lower airway bacterial and mycobacterial infections are a possible mechanism for bronchiectasis. Materials and methods: A cross-sectional study was conducted in 2013-2014. COPD exacerbations and hospitalizations were reviewed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Shawn D Aaron
No abstract text is available yet for this article.
March 12, 2018: American Journal of Respiratory and Critical Care Medicine
Rainer Gloeckl
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common condition that is becoming increasingly prevalent. It affects 13.2% of the population over age 40 in Germany. In 2020, it will be the third most common cause of morbidity and mortality around the world. It markedly impairs the quality of life of those who suffer from it and presents a major economic challenge to the health-care system. METHODS: This review is based on pertinent publications retrieved by a selective literature search and on the authors' clinical experience...
February 23, 2018: Deutsches Ärzteblatt International
Alpesh N Amin, Vamsi Bollu, Michael D Stensland, Logan Netzer, Vaidyanathan Ganapathy
PURPOSE: Medication treatment patterns for chronic obstructive pulmonary disease (COPD) in inpatient settings were examined, as were the characteristics of patients treated with long-acting bronchodilators (LABDs) during hospitalization. METHODS: This retrospective study was conducted using inpatient administrative data from hospitals and medical centers nationwide. All patients discharged from the hospital from January 1, 2010, through December 31, 2012, who were at least 40 years of age, had a primary discharge diagnosis of COPD or a secondary diagnosis of COPD with a primary diagnosis of a respiratory condition, and treatment with a bronchodilator were included...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
Matthew Cox, Catherine O'Connor, Katie Biggs, Daniel Hind, Oscar Bortolami, Matthew Franklin, Barbara Collins, Stephen Walters, Allan Wailoo, Julie Channell, Paul Albert, Ursula Freeman, Stephen Bourke, Michael Steiner, Jon Miles, Tom O'Brien, David McWilliams, Terry Schofield, John O'Reilly, Rodney Hughes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE: To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care...
March 2018: Health Technology Assessment: HTA
Christine Jenkins
No abstract text is available yet for this article.
March 6, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Karin Lisspers, Christer Janson, Kjell Larsson, Gunnar Johansson, Gunilla Telg, Marcus Thuresson, Björn Ställberg
BACKGROUND: Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. OBJECTIVE: To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. METHODS: Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers...
March 2018: Respiratory Medicine
Danny Epstein, Roni Nasser, Tanya Mashiach, Zaher S Azzam, Gidon Berger
BACKGROUND: Acute exacerbation of COPD (AECOPD) is one of the leading causes for hospitalization and readmission in developed countries. No laboratory indices were consistently found to be associated with readmission risk. Recent evidence attests that red blood cell distribution width (RDW), conveys important information for short and long term prognosis in a variety of medical conditions. Prognostic usefulness of RDW in patients with AECOPD has not been investigated. OBJECTIVE: To evaluate the usefulness of RDW in predicting early adverse outcomes in patients hospitalized due to AECOPD...
March 2018: Respiratory Medicine
Hao Zhang, Yue Niu, Yili Yao, Renjie Chen, Xianghong Zhou, Haidong Kan
The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for five main respiratory diseases and their medical expenditures in Shanghai, China. We used the overdispersed generalized additive model together with distributed lag models to fit the associations of criteria air pollutants with hospital visits, and used the linear models to fit the associations with medical expenditures...
February 28, 2018: International Journal of Environmental Research and Public Health
Ofra Kalter-Leibovici, Michal Benderly, Laurence S Freedman, Galit Kaufman, Tchiya Molcho Falkenberg Luft, Havi Murad, Liraz Olmer, Meri Gluch, David Segev, Avi Gilad, Said Elkrinawi, Tali Cukierman-Yaffe, Baruch Chen, Orit Jacobson, Calanit Key, Mordechai Shani, Gershon Fink
RATIONALE: The efficacy of disease management programs in the treatment of patients with chronic obstructive pulmonary disease (COPD) remains uncertain. OBJECTIVE: To study the effect of disease management (DM) added to recommended care (RC) in ambulatory COPD patients. MEASUREMENTS AND MAIN RESULTS: In this trial, 1,202 COPD patients (age >40 years), with moderate to very severe airflow limitation were randomly assigned either to DM plus RC (study intervention) or to RC alone (control intervention)...
March 1, 2018: American Journal of Respiratory and Critical Care Medicine
Alfred Burger, Chad Miller, Bradley A Sharpe, Rachel E Thompson
BACKGROUND: Hospital Medicine has a widening scope of practice. This article provides a summary of recent highimpact publications for busy clinicians who provide care to hospitalized adults. METHODS: The authors reviewed articles published between March 2016 and March 2017 for the Update in Hospital Medicine presentations at the 2017 Society of Hospital Medicine and Society of General Internal Medicine annual meetings. Nine of the 20 articles presented were selected for this review based on the article quality and potential to influence practice...
February 27, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Julia Budde, Parul Agarwal, Madhu Mazumdar, Jonathan Yeo, Sidney S Braman
Studies on observation unit (OU) use to avoid a hospital admission from the emergency department (ED) have found variable effects on health care resource utilization, and these effects have not been studied in acute exacerbation of chronic obstruction pulmonary disease (AECOPD). We retrospectively collected data for all AECOPD-related ED visits (age > 40) to an urban, academic medical center between February 2013 and April 2017. We examined the total proportion of visits admitted to the hospital before and after availability of an OU and the proportion of visits discharged directly from the ED using segmented regression analysis...
February 27, 2018: Lung
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
BACKGROUND: With increasing health care costs that have outpaced those of other industries, payers of health care are moving from a fee-for-service payment model to one in which reimbursement is tied to outcomes. Chronic obstructive pulmonary disease (COPD) is a disease where this payment model has been implemented by some payers, and COPD exacerbations are a quality metric that is used. Under an outcomes-based payment model, it is important for health systems to be able to identify patients at risk for poor outcomes so that they can target interventions to improve outcomes...
March 2018: Journal of Managed Care & Specialty Pharmacy
Kieran J Rothnie, Hana Müllerová, Liam Smeeth, Jennifer K Quint
Rationale Acute exacerbations (AECOPD) are important adverse events in the natural history of COPD. Objectives To investigate the natural history of AECOPD over 10-years of follow-up. Methods and Results We identified 99,574 patients with COPD 01/Jan/04-31/March/15 from the UK Clinical Practice Research Datalink. We defined moderate AECOPD as those managed outside hospital and severe as those requiring hospitalisation. During the baseline period (first year of follow-up), patients were grouped according to the number and severity of AECOPD and then followed for a maximum of 10 years (mean 4...
February 23, 2018: American Journal of Respiratory and Critical Care Medicine
Dimitra Lepida, Athanasios Papathanasiou, Eftychia Galiatsou, George Nakos, Ioannis Goudevenos, Vasilios Koulouras
BACKGROUND: Pulmonary hypertension (PH), regardless of its aetiology, is associated with an impaired outcome in patients with chronic obstructive pulmonary disease (COPD). The aim of our study was to determine the incidence, the cause and impact of PH as detected by echocardiography in COPD patients. METHODS: Patients with confirmed COPD of any stage were evaluated by echocardiography for the likelihood of PH according to the proposed criteria. Patients with possible/likely to have PH underwent right heart catheterization, upon agreement, to confirm the presence, severity and cause of PH...
February 19, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Maria B Ospina, Marta Michas, Lesly Deuchar, Richard Leigh, Mohit Bhutani, Brian H Rowe, Darcy Marciniuk, Donna Goodridge, Gail Dechman, Jean Bourbeau, Meyer Balter, Pat Camp, Paul Hernandez, Roger S Goldstein, Michael K Stickland
Introduction: Hospital and emergency department discharge for patients with chronic obstructive pulmonary disease (COPD) is often poorly organised. We developed a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbations of COPD. Methods: A purposeful sample of clinicians and patients were invited to participate in a two-round Delphi study (July-November 2015). In round 1, participants rated on a seven-point Likert scale (1=not at all important; 7=extremely important) the importance of 29 unique COPD care actions...
2018: BMJ Open Respiratory Research
Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
Little is known about the effect of long-term aspirin use on acute severity of COPD. We hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). We conducted a retrospective cohort study using large population-based data from 2012 through 2013. Among 206,686 patients (aged ≥40 years) hospitalized for AECOPD, aspirin users had lower in-hospital mortality (1...
February 21, 2018: NPJ Primary Care Respiratory Medicine
Olorunfemi A Oshagbemi, Andrea M Burden, Kimberly N Shudofsky, Johanna H M Driessen, Peter Vestergaard, Andreas Krings, Frits Franssen, Joop van den Bergh, Frank de Vries
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterised by persistent airflow obstruction and respiratory symptoms. While short course systemic GCs are prescribed in patients with acute COPD exacerbations, little is known of the risk of fractures with intermittent exposure to high-dose GC and the effect of proxies of disease severity. METHODS: A case-control study was conducted using the Danish National Hospital Discharge Registry (NHDR) between January 1996 to December 2011...
February 17, 2018: Bone
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