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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
Marcelo Cardoso Barros, Bruno Hochhegger, Stephan Altmayer, Guilherme Watte, Matheus Zanon, Ana Paula Sartori, Daniela Cavalet Blanco, Gabriel Sartori Pacini, Jose Miguel Chatkin
OBJECTIVE: To evaluate the quantitative computed tomography (QCT) phenotypes, airflow limitations, and exacerbation-like episodes in heavy smokers in Southern Brazil. METHODS: We enrolled 172 smokers with a smoking history ≥30 pack-years who underwent pulmonary function tests (PFTs) and CT scan for lung cancer screening. Patients were classified regarding airflow limitation (FEV1/FVC <0.7 forced expiratory volume in 1 second/forced vital capacity) and the presence of emphysema on the QCT...
2018: PloS One
Joo Hee Kim, Hun Soo Chang, Seung Woo Shin, Dong Gyu Baek, Ji Hye Son, Choon Sik Park, Jong Sook Park
PURPOSE: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. METHODS: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year...
November 2018: Allergy, Asthma & Immunology Research
Thomas J C Ruffles, Ryan Black, Wayne Nicholls, Barbara Laing, Alan Isles
Introduction: We describe the case of a 16-year old male with cystic fiborosis (CF) who presented with an osteosarcoma of his right distal tibia. Case Report: Treatment consisted of neoadjuvant chemotherapy of cisplatin, doxorubicin and high dose methotrexate followed by distal tibial resection and free fibula flap reconstruction and consolidation chemotherapy. Treatment was complicated by a pulmonary exacerbation, where Pseudomonas aeruginosa (PsA) and Staphylococcus aureus were grown on sputum culture which was treated with a 2-week course of intravenous piptazobactam and tobramycin...
2018: Frontiers in Pediatrics
Wei Wang, Wei Jing, Qingbin Liu
Objective: To explore the effects of Astragalus oral solution (AOS) on allergic asthma in children by investigating relative contents of CD4+ CD25high CD127low Treg cells. Methods: The contents of Astragaloside A in AOS were detected by using HPLC. Eighty children with allergic asthma were recruited from February 2016 to June 2017, and randomly assigned into the control group (received placebo, 0.1% quinine chloride in deionized water, daily) and the AOS group (received 10 mL AOS daily). After 6-month treatment, therapeutic results were compared between the two groups...
2018: Frontiers in Pediatrics
Jarred R Mondoñedo, Susumu Sato, Tsuyoshi Oguma, Shigeo Muro, Adam H Sonnenberg, Dean Zeldich, Harikrishnan Parameswaran, Toyohiro Hirai, Béla Suki
BACKGROUND: Distributions of low attenuation areas in 2D CT lung slices are used to quantify parenchymal destruction in patients with COPD. However, these segmental approaches are limited and may not reflect the true 3D tissue processes that drive emphysematous changes in the lung. The goal of this study was to instead evaluate distributions of 3D low-attenuation volumes, which we hypothesized would follow a power law distribution and provide a more complete assessment of the mechanisms underlying disease progression...
October 4, 2018: Chest
Brooks W Morgan, Matthew R Grigsby, Trishul Siddharthan, Muhammad Chowdhury, Adolfo Rubinstein, Laura Gutierrez, Vilma Irazola, J Jaime Miranda, Antonio Bernabe-Ortiz, Dewan Alam, Robert A Wise, William Checkley
BACKGROUND: Asthma-COPD Overlap (ACO) represents the confluence of bronchial airway hyper reactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. OBJECTIVE: We aimed to describe the prevalence and risk factors for ACO among adults across six low- and middle-income countries (LMICs). METHODS: We compiled cross-sectional data for 11,923 participants aged 35-92 years from four population-based studies in 12 settings...
October 3, 2018: Journal of Allergy and Clinical Immunology
Erick Forno, Neethu Abraham, Daniel G Winger, Christian Rosas-Salazar, Geoffrey Kurland, Daniel J Weiner
Background: Under-perception of pulmonary dysfunction may delay appropriate treatment, while over-perception may result in unnecessary treatments. Objectives: To evaluate the ability of patients with asthma or cystic fibrosis and their subspecialty caregivers to assess changes in lung function based on their subjective clinical impressions. Methods: Patients were asked to qualitatively describe how they felt compared to their prior visit (same/better/worse) and to quantitatively estimate their forced expiratory volume in 1 s (FEV1 ) after being reminded of their FEV1 at the prior visit...
September 1, 2018: Pediatric Allergy, Immunology, and Pulmonology
Ewa Rębacz-Maron, Anna Stangret, Iwona Teul
A lower socio-economic status (SES) associates with increased morbidity and mortality. The goal of this study was to define the influence of SES on lung function in indigenous male adolescents (aged 12.8-24.5 years) in Tanzania. The subjects were subdivided into two age groups: <17.5 (n = 189) and ≥ 17.5 years of age (n = 101). They underwent anthropometric and spirometry evaluation. The SES was assessed on the basis of economic family resources and the subjects' nutritional status, and was stratified into three categories: SES-1 (low), SES-2 (average), and SES-3 (high)...
October 2, 2018: Advances in Experimental Medicine and Biology
Miriam Barrecheguren, Mónica Monteagudo, Marc Miravitlles
This epidemiological study aimed to describe and compare the characteristics and outcomes of COPD patients starting treatment with a long-acting anti-muscarinic (LAMA) or a combination of a long-acting beta-2 agonist (LABA)/LAMA in primary care in Catalonia (Spain) over a one-year period. Data were obtained from the Information System for the Development in Research in Primary Care (SIDIAP), a population database containing information of 5.8 million inhabitants (80% of the population of Catalonia). Patients initiating treatment with a LAMA or LABA/LAMA in 2015 were identified, and information about demographic and clinical characteristics was collected...
September 28, 2018: NPJ Primary Care Respiratory Medicine
Peter Wark, Vanessa M McDonald
BACKGROUND: Impaired mucociliary clearance characterises lung disease in cystic fibrosis (CF). Hypertonic saline enhances mucociliary clearance and may lessen the destructive inflammatory process in the airways. This is an update of a previously published review. OBJECTIVES: To investigate efficacy and tolerability of treatment with nebulised hypertonic saline on people with CF compared to placebo and or other treatments that enhance mucociliary clearance. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register, comprising references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings...
September 27, 2018: Cochrane Database of Systematic Reviews
Narda Ontiveros, David Eapen-John, Natasha Osorio, Juhee Song, Liang Li, Ajay Sheshadri, Xin Tiang, Natasha Ghosh, Ara Vaporciyan, Arlene Correa, Garrett Walsh, Horiana B Grosu, David E Ost
BACKGROUND: Predictions that overestimate post-lobectomy lung function are more likely than underestimates to lead to lobectomy. Studies of post-lobectomy lung function have included only surgical patients, so overestimates are overrepresented. This selection bias has led to incorrect estimates of prediction bias, which has led to inaccurate threshold values for determining lobectomy eligibility. OBJECTIVE: The objective of this study was to demonstrate and adjust for this selection bias in order to arrive at correct estimates of prediction bias, the 95% limits of agreement, and adjusted threshold values for determining when exercise testing is warranted...
September 26, 2018: Respiration; International Review of Thoracic Diseases
Sandeep Bodduluri, Abhilash S Kizhakke Puliyakote, Sarah E Gerard, Joseph M Reinhardt, Eric A Hoffman, John D Newell, Hrudaya P Nath, MeiLan K Han, George R Washko, Raúl San José Estépar, Mark T Dransfield, Surya P Bhatt
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airway remodeling. Characterization of airway changes on computed tomography has been challenging due to the complexity of the recurring branching patterns, and this can be better measured using fractal dimensions. METHODS: We analyzed segmented airway trees of 8135 participants enrolled in the COPDGene cohort. The fractal complexity of the segmented airway tree was measured by the Airway Fractal Dimension (AFD) using the Minkowski-Bouligand box-counting dimension...
September 17, 2018: Journal of Clinical Investigation
Eduardo Foschini Miranda, Welton Alves Diniz, Marcos Vinicius Nogueira Gomes, Marcelo Ferreira Duarte de Oliveira, Paulo de Tarso Camillo de Carvalho, Ernesto Cesar Pinto Leal-Junior
Chronic obstructive pulmonary disease (COPD) is characterized by dyspnea, as well as musculoskeletal and systemic manifestations. Photobiomodulation therapy (PBMT) with use of low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) is an electrophysical intervention that has been found to minimize or delay muscle fatigue. The aim of this study was to evaluate the acute effect of PBMT with combined use of lasers diodes, light-emitting diodes (LEDs), magnetic field on muscle performance, exercise tolerance, and metabolic variables during the 6-minute stepper test (6MST) in patients with COPD...
September 25, 2018: Lasers in Medical Science
Elias Taylor Gunnell, Dora K Franceschi, Christina R Inscoe, Allison Hartman, Jennifer L Goralski, Agathe Ceppe, Brian Handly, Cassandra Sams, Lynn Ansley Fordham, Jianping Lu, Otto Zhou, Yueh Z Lee
OBJECTIVE: The imaging evaluation of cystic fibrosis currently relies on chest radiography or computed tomography. Recently, digital chest tomosynthesis has been proposed as an alternative. We have developed a stationary digital chest tomosynthesis (s-DCT) system based on a carbon nanotube (CNT) linear x-ray source array. This system enables tomographic imaging without movement of the x-ray tube and allows for physiological gating. The goal of this study was to evaluate the feasibility of clinical CF imaging with the s-DCT system...
September 25, 2018: European Radiology
Hye Jung Park, Min Kwang Byun, Chin Kook Rhee, Kyungjoo Kim, Hyung Jung Kim, Kwang-Ha Yoo
BACKGROUND: Preserved ratio impaired spirometry (PRISm) is an incompletely understood respiratory condition. We investigated the incidence and significant predictive factors of chronic obstructive pulmonary disease (COPD) in PRISm patients. METHODS: From 11,922 subjects registered in the Korea National Health and Nutrition Examination Survey, never or light smokers, young subjects, and those already medically diagnosed with COPD (defined by ICD-10 code and prescribed medication) were excluded...
September 24, 2018: Respiratory Research
L V Marino, A Harris, C Johnstone, A Friend, C Newell, E A Miles, J S Lucas, P C Calder, W T Walker
INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare, heterogeneous genetic disorder where impaired mucociliary clearance is caused by dysfunctional motile cilia leading to bronchiectasis. There is limited evidence characterising the nutritional status of children with PCD, although lower body mass index (BMI) z-score has been associated with worse lung function (FEV1 ). METHODS: All children (n = 43) with PCD, aged <16 years, from a single tertiary centre were prospectively enrolled...
September 7, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jonathon Schubert, Anuk Kruavit, Sumit Mehra, Sanji Wasgewatta, Anne B Chang, Subhash Heraganahally
BACKGROUND AND OBJECTIVE: Poor lung function is a predictor of future all-cause mortality. In Australia, respiratory diseases are particularly prevalent among the Indigenous population, especially in remote communities. However, there are little published pulmonary function tests (PFT) data of remote-based adult Indigenous patients. We aimed to evaluate the severity of airflow obstruction and other PFT abnormalities of adults referred to specialist respiratory clinics in remote Indigenous communities...
September 21, 2018: Internal Medicine Journal
Bo Ding, Davneet Judge, Mark Small, Nawal Bent-Ennakhil, Shahid Siddiqui
Background: Data suggesting that low physical activity levels are associated with increased mortality and exacerbations in patients with COPD have led to increasing interest in the role of physical activity in COPD. This study evaluated self-reported functional performance, a measure of physical activity impairment, according to current treatment regimen, lung function, symptoms, and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 groups in a large sample of patients with COPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Gary T Ferguson, Klaus F Rabe, Fernando J Martinez, Leonardo M Fabbri, Chen Wang, Masakazu Ichinose, Eric Bourne, Shaila Ballal, Patrick Darken, Kiernan DeAngelis, Magnus Aurivillius, Paul Dorinsky, Colin Reisner
BACKGROUND: Inhaled corticosteroids have been used in patients with chronic obstructive pulmonary disease (COPD), but the potential benefits of their use in triple therapy are not well known. We aimed to compare the efficacy of a triple therapy with corresponding dual therapies in symptomatic patients with moderate to very severe COPD, without a requirement for a history of exacerbations. METHODS: In this double-blind, parallel-group, multicentre phase 3 randomised controlled trial, we recruited patients from hospitals and care centres in Canada, China, Japan, and the USA...
September 14, 2018: Lancet Respiratory Medicine
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