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Copd exacerbation

Y Q Zhu, S P Ma, B Li, C Y Zheng, J Ma
Objective: To investigate the serum level of interleukin-38 (IL-38) and its clinical significance in patients with chronic obstructive pulmonary disease (COPD). Methods: Totally 72 patients with acute exacerbation of COPD (AECOPD group) and 65 patients with stable COPD (S-COPD group) were recruited from Tianjin Chest Hospital from June 2016 to August 2017. In the same period 40 elderly healthy subjects were selected as control group (C group). The general data and laboratory examination results of these subjects were recorded...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Sarah Landis, Robert Suruki, Joe Maskell, Kerina Bonar, Emma Hilton, Chris Compton
Blood eosinophil count may be a useful biomarker for predicting response to inhaled corticosteroids and exacerbation risk in chronic obstructive pulmonary disease (COPD) patients. The optimal cut point for categorizing blood eosinophil counts in these contexts remains unclear. We aimed to determine the distribution of blood eosinophil count in COPD patients and matched non-COPD controls, and to describe demographic and clinical characteristics at different cut points. We identified COPD patients within the UK Clinical Practice Research Database aged ≥40 years with a FEV1 /FVC <0...
March 20, 2018: COPD
Paul P Walker, Pasquale P Pompilio, Paolo Zanaboni, Trine S Bergmo, Kaiu Prikk, Andrei Malinovschi, Josep M Montserrat, Jo Middlemass, Silvana Šonc, Giulia Munaro, Dorjan Marušič, Ruth Sepper, Roberto Rosso, A Niroshan Siriwardena, Christer Janson, Ramon Farre, Peter M A Calverley, Raffaele L Dellaca'
RATIONALE: Early detection of COPD exacerbations using tele-monitoring of physiological variables might reduce the frequency of hospitalisation. OBJECTIVES: To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique (FOT) and cardiac parameters in older COPD patients with co-morbidities. METHODS: This multicentre, randomized clinical trial recruited 312 GOLD grade II-IV COPD patients (median age 71 years [IQR:66-76], 49...
March 20, 2018: American Journal of Respiratory and Critical Care Medicine
Ariel Jaitovich, Esther Barreiro
Skeletal muscle dysfunction occurs in COPD patients and affects both ventilatory and non-ventilatory muscle groups. It represents a very important comorbidity that associates with poor quality of life and reduced survival, and results from a complex combination of functional, metabolic and anatomical alterations leading to suboptimal muscle work. Muscle atrophy, altered fiber type and metabolism and chest wall remodeling -in the case of the respiratory muscles- are relevant etiologic contributors to this process...
March 19, 2018: American Journal of Respiratory and Critical Care Medicine
Maha Al-Faqawi, Yousef Abuowda, Alaa Eldeen Elmassry, Bettina Böttcher
BACKGROUND: The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD 2015). METHODS: We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016...
February 21, 2018: Lancet
Julia Ae Walters, Daniel J Tan, Clinton J White, Richard Wood-Baker
BACKGROUND: Current guidelines recommend that patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) should be treated with systemic corticosteroid for seven to 14 days. Intermittent systemic corticosteroid use is cumulatively associated with adverse effects such as osteoporosis, hyperglycaemia and muscle weakness. Shorter treatment could reduce adverse effects. OBJECTIVES: To compare the efficacy of short-duration (seven or fewer days) and conventional longer-duration (longer than seven days) systemic corticosteroid treatment of adults with acute exacerbations of COPD...
March 19, 2018: Cochrane Database of Systematic Reviews
Shivani Jaswal, Varinder Saini, Jasbinder Kaur, Seema Gupta, Harjeet Kaur, Kranti Garg
Context: Chronic obstructive pulmonary disease (COPD) is not only restricted to the pulmonary inflammation and airway obstruction but is also associated with comorbidities, which affect the therapeutic intervention and the quality of life and survival. Markers that can predict the systemic inflammation and a decline in the pulmonary function are of scientific interest. Adiponectin (APN) appears to be one such biomarker and can be used as a potential indicator of severity and response to treatment in patients of COPD...
January 2018: International Journal of Applied and Basic Medical Research
Raju Bishwakarma, Wei Zhang, Yu-Li Lin, Yong-Fang Kuo, Victor J Cardenas, Gulshan Sharma
Background: Chronic obstructive pulmonary disease (COPD) is associated with persistent systemic inflammation. Anti-inflammatory therapies have been shown to decrease acute exacerbations of COPD. The antidiabetic medication metformin decreases oxidative stress and inflammation and may benefit patients with COPD. We aimed at investigating the effect of metformin on health care utilizations in patients with coexisting COPD and diabetes mellitus (DM). Methods: We studied 5% Medicare beneficiaries with coexisting COPD and DM prescribed metformin or other antidiabetics during the period 2007-2010...
2018: International Journal of Chronic Obstructive Pulmonary Disease
John R Hurst, Maria Dilleen, Kevin Morris, Siân Hills, Birol Emir, Rupert Jones
Purpose: Inappropriate use of an inhaled corticosteroid (ICS) for COPD has clinical and economic disadvantages. This retrospective analysis of The UK Health Improvement Network (THIN) database identified factors influencing treatment escalation (step-up) from a long-acting muscarinic antagonist (LAMA) to triple therapy (LAMA + long-acting β-agonist-ICS). Secondary objectives included time to step up from first LAMA prescription, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grouping (2011/2013, 2017), and Medical Research Council (MRC) grade prior to treatment escalation...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Akifumi Uchida, Kohta Sakaue, Hiromasa Inoue
The term "asthma-COPD overlap" (ACO) has been applied to the condition in which a person has persistent airflow limitation with clinical features of both asthma and COPD. The certain definition and diagnostic criteria for ACO have not yet been established, and ACO prevalence has varied widely in studies: from 0.9% to 11.1% in the general population, from 11.1% to 61.0% in asthma patients, and from 4.2% to 66.0% in COPD patients. Furthermore, the frequency of exacerbations and prognosis in ACO patients have not been clearly demonstrated...
March 15, 2018: Allergology International: Official Journal of the Japanese Society of Allergology
Maida Rakanović Todić, Sanita Maleškić, Lejla Burnazović Ristić, Aida Kulo Ćesić, Jasna Kusturica, Besim Prnjavorac
Aim To analyse frequency of chronic obstructive pulmonary disease (COPD) exacerbation in patients on therapy with inhaled corticosteroids (ICS) and relevant factors that influence the rate of COPD exacerbations in a subgroup of moderate illness, like FEV1, comorbidities and other concomitant therapy. Methods The study included patients with moderate COPD with at least 10 pack-years history of smoking and accompanying cardiovascular comorbidity. Demographic data, frequency of exacerbations and information about proscribed treatments - ICS alone or in combination with long acting beta agonist (LABA), were collected from medical records for the previous 12 months from the index date...
February 1, 2018: Medicinski Glasnik
Anne Lindberg, Per S Bakke, Johann Christian Virchow, Bo Lundbäck
No abstract text is available yet for this article.
March 5, 2018: Respiratory Medicine
Masamichi Sato, Sumito Inoue, Akira Igarashi, Yoshikane Tokairin, Kento Sato, Hiroshi Nakano, Yuki Abe, Maki Kobayashi, Tomomi Kimura, Keiko Yamauchi, Michiko Nishiwaki, Yukihiro Minegishi, Sujeong Yang, Kodai Furuyama, Tomoka Yamamoto, Hiroyoshi Machida, Yoko Shibata
BACKGROUND: The designation of some cardiac-specific proteins as prognostic biomarkers in chronic obstructive pulmonary disease (COPD) exacerbations suggest that the process of exacerbation involves cardiomyocyte injury. Among these cardiac biomarkers, heart-type fatty acid binding protein (h-FABP) is considered a very sensitive diagnostic marker for cardiomyocyte injury and a prognostic marker in chronic heart failure. However, the prognostic usefulness of h-FABP in patients with COPD remains unclear...
March 2018: Respiratory Investigation
Martin A Bewley, Richard C Budd, Eilise Ryan, Joby Cole, Paul Collini, Jennifer Marshall, Umme Kolsum, Gussie Beech, Richard D Emes, Irina Tcherniaeva, Guy A M Berbers, Sarah R Walmsley, Gavin Donaldson, Jadwiga A Wedzicha, Iain Kilty, William Rumsey, Yolanda Sanchez, Christopher E Brightling, Louise E Donnelly, Peter J Barnes, Dave Singh, Moira K B Whyte, David H Dockrell
RATIONALE: Previous studies have identified defects in bacterial phagocytosis by alveolar macrophages (AM) in patients with chronic obstructive pulmonary disease (COPD) but the mechanisms and clinical consequences remain incompletely defined. OBJECTIVES: To examine the effect of COPD on AM phagocytic responses and identify the mechanisms, clinical consequences and potential for therapeutic manipulation of these defects. METHODS: We isolated alveolar macrophages (AM) and monocyte-derived macrophages (MDM) from a cohort of COPD patients and controls within the MRC COPD-MAP consortium and measured phagocytosis of bacteria in relation to opsonic conditions and clinical features...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Augustine Tee, Wai Leng Chow, Colin Burke, Guruprasad Basavarajaiah
INTRODUCTION: In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations in the Singapore healthcare setting. METHODS: A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs...
March 16, 2018: Singapore Medical Journal
Yung-Che Chen, Meng-Chih Lin, Chih-Hung Lee, Shih-Feng Liu, Chin-Chou Wang, Wen-Feng Fang, Tung-Ying Chao, Chao-Chien Wu, Yu-Feng Wei, Huang-Chih Chang, Chia-Cheng Tsen, Hung-Chen Chen
BACKGROUND: Controversy exists in previous studies on macrophage M1/M2 polarization in chronic obstructive pulmonary disease (COPD). We hypothesized that formyl peptide receptor (FPR), a marker of efferocytosis and mediator of M1/M2 polarization, may be involved in the development of COPD. METHODS: We examined FPR 1/2/3 expressions of blood M1/M2a monocyte, neutrophil, natural killer (NK) cell, NK T cell, T helper (Th) cell, and T cytotoxic (Tc) cell by flowcytometry method in 40 patients with cigarette smoking-related COPD and 16 healthy non-smokers...
March 15, 2018: Journal of Translational Medicine
Heather M Young, Fumin Guo, Rachel L Eddy, Geoffrey Maksym, Grace Parraga
Ventilation heterogeneity is a hallmark finding in obstructive lung disease and may be evaluated using a variety of methods including multiple-breath gas-washout and pulmonary imaging. Such methods provide an opportunity to better understand the relationships between structural and functional abnormalities in the lungs, and their relationships with important clinical outcomes. We measured ventilation heterogeneity and respiratory impedance in 100 subjects (50 asthmatics, 22 ex-smokers and 28 COPD), using oscillometry and hyperpolarized3 He magnetic resonance imaging (MRI) and determined their relationships with quality-of-life scores and disease control/exacerbations...
March 15, 2018: Journal of Applied Physiology
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
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
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