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Copd exacerbations

Graham Devereux, Seonaidh Cotton, Shona Fielding, Nicola McMeekin, Peter J Barnes, Andrew Briggs, Graham Burns, Rekha Chaudhuri, Henry Chrystyn, Lisa Davies, Anthony De Soyza, Simon Gompertz, John Haughney, Karen Innes, Joanna Kaniewska, Amanda Lee, Alyn Morice, John Norrie, Anita Sullivan, Andrew Wilson, David Price
Importance: Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD. Objective: To investigate the effectiveness of adding low-dose theophylline to inhaled corticosteroids in COPD. Design, Setting, and Participants: The TWICS (theophylline with inhaled corticosteroids) trial was a pragmatic, double-blind, placebo-controlled, randomized clinical trial that enrolled patients with COPD between February 6, 2014, and August 31, 2016...
October 16, 2018: JAMA: the Journal of the American Medical Association
Gerard J Criner, Bartolome R Celli
No abstract text is available yet for this article.
October 16, 2018: JAMA: the Journal of the American Medical Association
Paul Brinkman, Anke-Hilse Maitland-van der Zee, Ariane H Wagener
PURPOSE OF REVIEW: The long-term management goals of the inflammatory airway diseases asthma and chronic obstructive pulmonary disease (COPD) are similar and focus on symptom control and reduction of exacerbation frequency and severity. Treatable traits have recently been postulated as a management concept which complements the traditional diagnostic labels 'asthma' and 'COPD', thereby focusing on therapy targeted to a patients' individual disease-associated characteristics. Exhaled volatile organic compounds (VOCs) may be utilized as noninvasive biomarker for disease activity or manifestation in asthma and COPD...
October 15, 2018: Current Opinion in Pulmonary Medicine
Eskandarain Shafuddin, Catherina L Chang, Manisha Cooray, Kim A McAnulty, Noel C Karalus, Marcus H S Lee, Robert J Hancox
BACKGROUND: Cardiac dysfunction is common in exacerbations of chronic obstructive pulmonary disease (COPD) even in patients without clinically suspected cardiac disorders. AIM: To investigate associations between electrocardiogram and chest radiograph abnormalities and biochemical evidence of cardiac dysfunction (N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin T) in patients hospitalised with exacerbations of COPD at Waikato Hospital. METHODS: Independent examiners, blinded to NT-proBNP and troponin T levels, assessed electrocardiograms for tachycardia, atrial fibrillation, ventricular hypertrophy and ischaemic changes in 389 patients and chest radiographs for signs of heart failure in 350 patients...
October 15, 2018: Internal Medicine Journal
Paola Rogliani, Luigino Calzetta, Fulvio Braido, Mario Cazzola, Enrico Clini, Girolamo Pelaia, Andrea Rossi, Nicola Scichilone, Fabiano Di Marco
Objectives: The aim of this study was to assess the current evidence for long-acting β2 -agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combinations (FDCs) in the treatment of COPD. Materials and methods: A systematic literature search of randomized controlled trials published in English up to September 2017 of LABA/LAMA FDCs vs LABA or LAMA or LABA/inhaled corticosteroid (ICS) FDCs in COPD patients was performed using PubMed, Embase, Scopus, and Google Scholar...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Jinfang Ma, Jinping Zheng, Nanshan Zhong, Chunxue Bai, Haoyan Wang, Juan Du, Fenglei Li, Yanwei Chen, Zhe Shi, Xin Li, Pingyan Chen
Purpose: Recurrence of acute exacerbations has a major impact on patients with COPD. Therefore, effective prevention and treatment of exacerbation is crucial in the management of COPD, especially for patients with moderate to severe disease. This study evaluated the effectiveness of YuPingFeng granule administration in preventing exacerbation and improving symptom score, as well as its long-term (1 year) safety profile, in patients with COPD. Patients and methods: This was a randomized, double-blind, parallel, placebo-controlled study of 240 patients from eight centers in China...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Juwhan Choi, Jee Youn Oh, Young Seok Lee, Gyu Young Hur, Sung Yong Lee, Jae Jeong Shim, Kyung Ho Kang, Kyung Hoon Min
Introduction: Acute exacerbation of COPD (AECOPD) leads to rapid deterioration of pulmonary function and quality of life. It is unclear whether the prognosis for AECOPD differs depending on the bacterium or virus identified. The purpose of this study is to determine whether readmission of patients with severe AECOPD varies according to the bacterium or virus identified. Methods: We performed a retrospective review of medical records of 704 severe AECOPD events at Korea University Guro Hospital from January 2011 to May 2017...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Jonathan I Levy, Lesliam Quirós-Alcalá, M Patricia Fabian, Komal Basra, Nadia N Hansel
Purpose of review: Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities. Recent findings: Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations...
June 2018: Current Epidemiology Reports
Maryse Bélanger, Simon Couillard, Josiane Courteau, Pierre Larivée, Thomas G Poder, Nathalie Carrier, Kim Girard, Felix-Antoine Vézina, Alain Vanasse
Purpose: Current evidence suggests that a higher blood eosinophil cell count at admission for acute exacerbation of COPD (AECOPD) is associated with a favorable response to systemic steroids. However, the impact of blood eosinophil counts at admission on post-hospitalization outcomes is still unclear. The main objective of this study is to investigate readmission outcomes associated with blood eosinophilia following severe COPD exacerbation in patients with infrequent COPD hospitalizations...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Dawn L DeMeo, Sreeram Ramagopalan, Abhishek Kavati, Ashok Vegesna, Meilan K Han, Anthony Yadao, Teresa K Wilcox, Barry J Make
Background: Previous studies suggest that gender differences exist in COPD diagnosis and symptoms; these differences may be more pronounced in younger adults. Our objective was to explore age-associated gender differences across a range of COPD severities. Materials and methods: A total of 4,484 current and former smokers with COPD from the Genetic Epidemiology of COPD cohort were investigated using regression modeling to explore the association between gender, age, disease severity, and the contributing elements of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system (symptoms, exacerbation risk, airflow limitation)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Brian Lipworth, Chris RuiWen Kuo, Sunny Jabbal
A single inhaler containing inhaled corticosteroid (ICS)/long-acting beta-agonist (LABA)/long-acting muscarinic antagonist (LAMA) is a more convenient way of delivering triple therapy in patients with COPD. Single triple therapy has been shown to be superior at reducing exacerbations and improving quality of life compared to LABA/LAMA, especially in patients with a prior history of frequent exacerbations and blood eosinophilia, who have ICS responsive disease. The corollary is that patients with infrequent exacerbations who are noneosinophilic may be safely de-escalated from triple therapy to LABA/LAMA without loss of control...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Killen Harold Briones-Claudett, Antonio Esquinas Rodriguez, Mónica H Briones-Claudett, Miguel Puga-Tejada, Mariuxi Del Pilar Cabrera Baños, Christian Roberto Pazmiño Dueñas, Carlos Israel Torres Herrera, Michelle Grunauer
BACKGROUND: This study was designed to determine the results associated with the use of noninvasive mechanical ventilation (NIV) using the BiPAP S/T-AVAPS ventilation strategy in subjects with mild to moderate de novohypoxaemicrespiratory failure. METHODS: This is a prospective study that includes subjects with de novohypoxaemic respiratory failure (not produced by acute exacerbations of COPD, chronic lung disease, or congestive heart failure) with mild to moderate PaO₂/FiO₂, who were admitted to the Intensive Care Unit (ICU) of Santa Maria Clinic in Guayaquil, Ecuador...
October 14, 2018: Anaesthesiology Intensive Therapy
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
BACKGROUND: Lung ultrasound can accelerate the diagnosis of life-threatening diseases in adults with respiratory symptoms. OBJECTIVE: Systematically review the accuracy of lung ultrasonography (LUS) for emergency diagnosis of pneumonia, acute heart failure, and exacerbation of chronic obstructive pulmonary disease (COPD)/asthma in adults. METHODS: PubMed, Embase, Scopus, Web of Science, and LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde; until 2016) were searched for prospective diagnostic accuracy studies...
October 9, 2018: Journal of Emergency Medicine
Pan-Woo Ko, Kyunghun Kang, Ho-Won Lee
INTRODUCTION: Parkinson disease is associated with various nonmotor symptoms, including rare respiratory dysfunction events. However, patients with Parkinson disease often have comorbid medical problems, such as respiratory distress, and differentiating nonmotor symptoms can be difficult. CASE PRESENTATION: A 78-year-old male presented with repetitive shortness of breath. He was diagnosed with Parkinson disease and chronic obstructive pulmonary disease (COPD) several years prior...
October 2018: Medicine (Baltimore)
Andrea S Melani
Inhaled bronchodilators are the key-stone of chronic obstructive pulmonary disease (COPD) management. Olodaterol 5 µg, a long-acting β2-adrenoceptor agonist (LABA) is one such bronchodilator indicated as a once-daily maintenance therapy. Areas covered: This article reviews the several trials that have assessed olodaterol as a COPD therapy. It covers safety and tolerability data and provides the reader with an expert opinion on its use as a treatment for COPD. Expert opinion: Olodaterol improves lung function for 24 h and reduces rescue medication use...
October 12, 2018: Expert Opinion on Pharmacotherapy
Roberto Chalela, Lluis Gallart, Sergi Pascual-Guardia, Antonio Sancho-Muñoz, Joaquim Gea, Mauricio Orozco-Levi
Background: Hypercapnic encephalopathy is relatively frequent in severe exacerbations of COPD (ECOPDs), with its intensity usually being evaluated through clinical scales. Bispectral index (BIS) is a relatively new technique, based on the analysis of the electroencephalographic signal, which provides a good approximation to the level of consciousness, having already been validated in anesthesia. Objective: The objective of the study was to evaluate the utility of BIS in the assessment of the intensity of hypercapnic encephalopathy in ECOPD patients...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Masayoshi Inoue
Mechanical ventilation is a useful treatment option for respiratory insufficiency following thoracic and cardiovascular surgery. Ventilation mode is classified as volume-controlled-ventilation(VCV) and pressure-controlled ventilation(PCV). Non-invasive ventilation(NIV) without tracheal intubation has been recently developed and is effective in patients with chronic obstructive pulmonary disease (COPD) exacerbation. Several pulmonary complications by mechanical ventilation such as ventilator-induced lung injury(VILI) or ventilator-associated pneumonia(VAP) could be avoided with NIV...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
A Orea-Tejeda, A Navarrete-Peñaloza, L Verdeja-Vendrell, A Jiménez-Cepeda, D González-Islas, R Hernández-Zenteno, C Keirns-Davis, R Sánchez-Santillán, A Velazquez-Montero, G A Puentes Rodríguez
BACKGROUND: The prognosis in patients with Chronic Obstructive Pulmonary Disease (COPD) depends in large part on the frequency of exacerbations. Cardiovascular diseases, including heart failure (HF), are risk factors for exacerbations. However, its unknown the importance of HF type over the exacerbations in COPD patients. OBJECTIVE: To determine whether right heart failure (RHF) is an independent risk factor for severe exacerbations in patients with COPD. METHODS: A prospective cohort study of 133 patients diagnosed with COPD with a follow-up period from 2010 to 2016...
October 11, 2018: Clinical Respiratory Journal
Louis McCusky Gendron, Andre Nyberg, Didier Saey, François Maltais, Yves Lacasse
BACKGROUND: Active mind-body movement therapies (AMBMTs), including but not limited to yoga, tai chi, and qigong, have been applied as exercise modalities for people with chronic obstructive pulmonary disease (COPD). AMBMT strategies have been found to be more effective than usual care; however, whether AMBMT is inferior, equivalent, or superior to pulmonary rehabilitation (PR) in people with COPD remains to be determined. OBJECTIVES: To assess the effects of AMBMTs compared with, or in addition to, PR in the management of COPD...
October 10, 2018: Cochrane Database of Systematic Reviews
Vicki Hunt, Dave Anderson, Richard Lowrie, Colette Montgomery Sardar, Susan Ballantyne, Graeme Bryson, John Kyle, Peter Hanlon
UK, home-based patients with COPD receive specialist care from respiratory physicians, nurses, and general practitioners (GPs), but increasing complexity of therapeutic options and a GP/Nurse workforce crisis suggests merit in testing the role of home visits by a clinical pharmacist. We conducted a non-randomised intervention study with a contemporaneous comparator group, in Glasgow (Scotland). A clinical pharmacist (working closely with a consultant respiratory physician) visited patients with COPD living at home, assessing respiratory and other co-morbid conditions, and medicines then, with patient approval, agreed treatment modifications with a consultant physician...
October 10, 2018: NPJ Primary Care Respiratory Medicine
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