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Copd exacerbations

Henrik Watz, Kay Tetzlaff, Helgo Magnussen, Achim Mueller, Roberto Rodriguez-Roisin, Emiel F M Wouters, Claus Vogelmeier, Peter M A Calverley
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function and poor outcomes for patients. However, there are limited data on the time course of changes in forced expiratory volume in 1 s (FEV1 ) preceding the first reported symptom and after the start of an exacerbation. METHODS: WISDOM was a multinational, randomized, double-blind, active-controlled, 52-week study in patients with severe-to-very severe COPD...
December 13, 2018: Respiratory Research
Samuel P Trethewey, Ross G Edgar, Alice M Turner, Rahul Mukherjee
Non-invasive ventilation (NIV) is frequently used as a treatment for acute hypercapnic respiratory failure (AHRF) in hospitalised patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In the UK, many patients with AHRF secondary to AECOPD are treated with ward-based NIV, rather than being treated in critical care. NIV has been increasingly used as an alternative to invasive ventilation and as a ceiling of treatment in patients with a 'do not intubate' order. This narrative review describes the evidence base for ward-based NIV in the context of AECOPD and summarises current practice and clinical outcomes in the UK...
December 9, 2018: Healthcare (Basel, Switzerland)
Zheng Liu, Fang Shi, Jun-Xia Liu, Chang-Lan Gao, Meng-Miao Pei, Jing Li, Pei-Xiu Li
The aim of the present study was investigate the association of the severity of emphysema of patients with chronic obstructive pulmonary disease (COPD) with airway inflammation and the COPD-specific comorbidity test (COTE) index. A total of 94 patients with COPD were divided into four groups according to the severity of their emphysema; in each patient, comorbidities were recorded and inflammatory biomarkers, including MMP-9 and TIMP-1 were determined in circulating blood. The unbalanced proportion of MMP-9 and its inhibitor, TIMP-1, led to the airway inflammation and lung remodeling in the patients with COPD...
December 2018: Experimental and Therapeutic Medicine
Daguo Zhao, Chunhua Ling, Qiang Guo, Jun Jin, Hua Xu
With the increase of environmental pollution, chronic obstructive pulmonary disease (COPD) has become a serious health threat. In the present study, the efficacy and safety of inhalation therapy of tiotropium bromide combined with budesonide/formoterol were assessed in 180 patients with moderate to severe COPD (clinical trial registry no. ChiCTR1800017584). Patients were treated by inhalation of budesonide/formoterol (control group) or inhalation of tiotropium bromide combined with budesonide/formoterol (intervention group)...
December 2018: Experimental and Therapeutic Medicine
C David, J Pouchot, B Ranque
BACKGROUND: Repeated use of inhaled β2 agonists is common in asthma or COPD exacerbations. It can lead to hyperlactatemia. CASE REPORTS: We report two asthmatic patients who presented in the emergency department for an asthma exacerbation. The first patient developed hyperlactatemia at 3.9 mmol/L and the second patient developed hyperlactatemia at 5.6 mmol/L after terbutaline treatment. Both patients had a favorable outcome after adjusting the aerosol dose to clinical parameters...
December 9, 2018: La Revue de Médecine Interne
Robert W V Flynn, Thomas M MacDonald, James D Chalmers, Stuart Schembri
BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity stage classifies Chronic Obstructive Pulmonary Disease (COPD) into groups based on symptoms, exacerbations and forced expiratory volume in one second (FEV1 ). This allows patients to change to less severe COPD stages, a novel aspect of assessment not previously evaluated. We aimed to investigate the association between temporal changes in GOLD severity stage and outcomes in COPD patients. METHODS: This was a record-linkage study using patients registered with a Scottish regional COPD network 2000-2015...
December 12, 2018: Respiratory Research
Alexa Núñez, Cristina Esquinas, Miriam Barrecheguren, Myriam Calle, Ricard Casamor, Marc Miravitlles
Purpose: The aim of this study was to evaluate the impact of morning symptoms in COPD using the Capacity of Daily Living during the Morning (CDLM) questionnaire and to determine the clinical variables that are related to CDLM scores. Methods: This was an observational, cross-sectional, and multicenter study conducted in stable COPD patients. CDLM scores ranged from 0 to 5 and were transformed into a qualitative variable according to tertile values to compare patient characteristics...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Yanan Cui, Lijuan Luo, Chenbei Li, Ping Chen, Yan Chen
Background: Acute exacerbation of COPD (AECOPD) is associated with an increased hospitalization and mortality. Azithromycin and erythromycin are the recommended drugs to reduce the risk of exacerbations. However, the most suitable duration of therapy and drug-related adverse events are still a matter of debate. The aim of this meta-analysis was to assess the current evidence regarding the efficacy and safety of long-term macrolide treatment for COPD. Materials and methods: We comprehensively searched PubMed, Embase, the Cochrane Library, and the Web of Science and performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) and retrospective studies...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Ana Oliveira, Vera Afreixo, Alda Marques
Purpose: Acute exacerbations of COPD (AECOPD) are associated with pulmonary/systemic changes; however, quantification of those changes during AECOPD managed on an outpatient basis and factors influencing recovery are lacking. This study aimed to characterize patients' changes during AECOPD and identify factors influencing their recovery. Methods: Body mass index, the modified British Medical Research Council questionnaire, number of exacerbations in the previous year, and the Charlson comorbidity index (independent variables) were collected within 24-48 hours of hospital presentation (T0)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Eugenia Quiros-Roldan, Maria Chiara Pezzoli, Marialma Berlendis, Elena Raffetti, Alice Ferraresi, Martina Properzi, Paola Rodari, Francesco Castelli
BACKGROUND: COPD screening guidelines in patients with HIV are lacking, and data about its under-diagnosis are still limited. This study aimed to determinate the feasibility of a case-finding program and the prevalence of COPD under-diagnosis in a large cohort of HIV-infected subjects. METHODS: All out-patients attending their routine visit for HIV monitoring at Spedali Civili General Hospital in Brescia, Italy, from February 2015 to January 2016, were enrolled...
December 11, 2018: Respiratory Care
Han Ni, Soe Moe, Zay Soe, Kay Thi Myint, K Neelakantan Viswanathan
BACKGROUND: Several dual bronchodilator combinations of long-acting beta2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA) have been approved for treatment of stable chronic obstructive pulmonary disease (COPD). The current GOLD (Global Initiative for Chronic Obstructive Lung Disease) recommendations suggest the use of LABA/LAMA combinations in people with group B COPD with persistent symptoms, group C COPD with further exacerbations on LAMA therapy alone and group D COPD with or without inhaled corticosteroids (ICS)...
December 11, 2018: Cochrane Database of Systematic Reviews
John M Atack, Timothy F Murphy, Lauren O Bakaletz, Kate L Seib, Michael P Jennings
Nontypeable Haemophilus influenzae (NTHi) is an important bacterial pathogen that causes otitis media and exacerbations of chronic obstructive pulmonary disease (COPD). Here, we report the complete genome sequences of NTHi strains 10P129H1 and 84P36H1, isolated from COPD patients, which contain the phase-variable epigenetic regulators ModA15 and ModA18, respectively.
July 2018: Microbiology resource announcements
Margit Tőkés-Füzesi, István Ruzsics, Orsolya Rideg, Péter Kustán, Gábor L Kovács, Tihamér Molnár
Background: Microparticles (MPs) are shedding membrane vesicles released from activated blood and endothelial cells under inflammatory conditions. The role of endothelial MPs (EMPs) in pathophysiology of COPD is relatively well known. However, the release and function of MPs of other cellular origins, eg, platelets, red blood cells and leukocytes, are not clearly evaluated in COPD. Purpose: The aim of this study was to measure EMPs and other cell-derived circulating MPs in stable and exacerbated COPD patients...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Juan José Soler-Cataluña, Maribel Marzo, Pablo Catalán, Cristina Miralles, Bernardino Alcazar, Marc Miravitlles
Background: It has recently been proposed that the concept of clinical control in COPD may be useful for deciding treatment in COPD, but the original control criteria (OCC) were considered too restrictive. Objective: Define and subsequently validate "modified" control criteria (MCC) of COPD. Method: Prospective observational study in COPD patients with a 1-year follow-up. Control was defined as the presence of low clinical impact and clinical stability...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Jinjun Ran, Shengzhi Sun, Aimin Yang, Lin Yang, Lefei Han, Tonya G Mason, King-Pan Chan, Jinhui Li, Linwei Tian
BACKGROUND: Although numerous studies have demonstrated that the criteria air pollutants increased the risk of exacerbation of chronic obstructive pulmonary disease (COPD), few have explored the effects of ambient benzene and toluene on COPD. OBJECTIVE: This study aimed to evaluate the short-term effects of ambient benzene and toluene on emergency COPD (eCOPD) hospitalizations. METHODS: We obtained daily mean and maximum concentrations of benzene and toluene during April 1, 2011 - December 31, 2014 from the Hong Kong Environmental Protection Department, and daily counts of eCOPD hospitalizations from the Hospital Authority...
December 4, 2018: Science of the Total Environment
Anne M van der Does, Marieke Heijink, Oleg A Mayboroda, Louise J Persson, Marianne Aanerud, Per Bakke, Tomas M Eagan, Pieter S Hiemstra, Martin Giera
INTRODUCTION: Disturbances in onset and resolution of inflammation in chronic obstructive pulmonary disease (COPD) are incompletely understood. Dietary polyunsaturated fatty acids (PUFAs) can be converted into lipid mediators here collectively named oxylipins. These include classical eicosanoids, but also pro-resolving mediators. A balanced production of pro-inflammatory and pro-resolving oxylipins is of importance for adequate inflammatory responses and subsequent return to homeostasis...
December 4, 2018: Biochimica et biophysica acta. Molecular and cell biology of lipids
Linn T Aalstad, Jon A Hardie, Birgitte Espehaug, Einar Thorsen, Per S Bakke, Tomas M L Eagan, Bente Frisk
BACKGROUND: Lung hyperinflation contributes to dyspnea, morbidity and mortality in chronic obstructive pulmonary disease (COPD). The inspiratory-to-total lung capacity (IC/TLC) ratio is a measure of lung hyperinflation and is associated with exercise intolerance. However, knowledge of its effect on longitudinal change in the 6-min walk distance (6MWD) in patients with COPD is scarce. We aimed to study whether the IC/TLC ratio predicts longitudinal change in 6MWD in patients with COPD...
December 6, 2018: BMC Pulmonary Medicine
C L Zhao, J W Huang, L Zhang, Q R Zhang, Q M Li, M Zhou
Objective: To investigate the characteristics of respiratory viral infections, and correlation between inflammatory cytokines and respiratory virus infections in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A prospective cohort of patients with acute exacerbations of COPD was enrolled. The sputum of all patients were collected, and 15 respiratory viruses were detected using multi-channel real-time fluorescence quantitative PCR. The clinical characteristics associated with viral infections were analyzed...
December 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Yuji Oba, Edna Keeney, Namratta Ghatehorde, Sofia Dias
BACKGROUND: Long-acting bronchodilators such as long-acting β-agonist (LABA), long-acting muscarinic antagonist (LAMA), and LABA/inhaled corticosteroid (ICS) combinations have been used in people with moderate to severe chronic obstructive pulmonary disease (COPD) to control symptoms such as dyspnoea and cough, and prevent exacerbations. A number of LABA/LAMA combinations are now available for clinical use in COPD. However, it is not clear which group of above mentioned inhalers is most effective or if any specific formulation works better than the others within the same group or class...
December 3, 2018: Cochrane Database of Systematic Reviews
Carolina Bonfanti Mesquita, Caroline Knaut, Laura Miranda de Oliveira Caram, Renata Ferrari, Silmeia Garcia Zanati Bazan, Irma Godoy, Suzana Erico Tanni
OBJECTIVE: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. METHODS: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen...
September 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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