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COPD review

Ajay P Nayak, Deepak A Deshpande, Raymond B Penn
Airway remodeling (AR) is a progressive pathological feature of the obstructive lung diseases, including asthma and chronic obstructive pulmonary disease (COPD). The pathology manifests itself in the form of significant, progressive, and (to date) seemingly irreversible changes to distinct respiratory structural compartments. Consequently, AR correlates with disease severity and the gradual decline in pulmonary function associated with asthma and COPD. Although current asthma/COPD drugs manage airway contraction and inflammation, none of these effectively prevent or reverse features of AR...
2018: F1000Research
Nikolaos-Dimitrios Pantzaris, Diamantina-Xanthi Spilioti, Aikaterini Psaromyalou, Ioanna Koniari, Dimitrios Velissaris
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major complication in COPD patients which can be triggered by bacterial or viral infections, environmental pollutants and other causes. Procalcitonin (PCT), a peptide that markedly increases in cases of bacterial infection, has been extensively investigated as a biomarker in the diagnosis, prognosis and treatment in patients with AECOPD. A number of studies published in the last decade, tried to investigate whether PCT levels can differentiate between bacterial and other causes of exacerbations, if they can be used as a guide for optimal antibiotic therapy and if they can be a tool in the assessment of the severity and the need for further interventions in the management of those patients...
July 2018: Journal of Clinical Medicine Research
Maria Montes de Oca, Maria Eugenia Laucho-Contreras
Acute exacerbations in chronic obstructive pulmonary disease (AECOPD) are associated with increased mortality, rate of hospitalization, use of healthcare resources, and have a negative impact on disease progression, quality of life and lung function of patients with chronic obstructive pulmonary disease (COPD). There is an imperative need to homogenize the definition of AECOPD because the incidence of exacerbations has a significant influence or implication on treatment decision making, particularly in pharmacotherapy and could impact the outcome or change the statistical significance of a therapeutic intervention in clinical trials...
June 14, 2018: Medical Sciences: Open Access Journal
Paolo Vineis, Daniela Fecht
The proportion of total deaths attributable to environmental factors is estimated to be 23% of global deaths and 22% of global disability-adjusted life years (DALYs) according to one review. These estimates encompass all environmental agents including infectious agents but excluding behavioural factors. The authors of the review also estimated that 16% (95% CI: 7-41%) of cancer deaths are attributable to environmental risk factors (and 36% [95% CI: 17-52%] for lung cancer). In this article, we focus on the reasons why epidemiology is often unable to account for the whole burden of environmental carcinogens...
June 11, 2018: European Journal of Cancer
Takanobu Shioya, Susumu Sato, Masahiro Iwakura, Hitomi Takahashi, Yoshino Terui, Sachiko Uemura, Masahiro Satake
Physical activity (PA) is defined as bodily movement produced by skeletal muscles with energy expenditure beyond resting levels. PA is closely related to reduced morbidity and mortality in chronic obstructive pulmonary disease (COPD). Self-report questionnaires are often subject to recall bias, correlating poorly with objectively qualified PA, and do not provide an accurate estimate of free-living energy expenditure. PA may be objectively evaluated by newly developed tri-axial accelerometers by quantifying steps or body movements over a period of time...
June 11, 2018: Respiratory Investigation
Begum Ergan, Metin Akgun, Angela Maria Grazia Pacilli, Stefano Nava
Chronic obstructive pulmonary disease (COPD) is a challenging respiratory problem throughout the world. Although survival is prolonged with new therapies and better management, the magnitude of the burden resulting from moderate-to-severe disease is increasing. One of the major aims of the disease management is to try to break the vicious cycle of patients being homebound and to promote an active lifestyle. A fundamental component of active daily life is, of course, travelling. Today, the world is getting smaller with the option of travelling by air...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
I Gonçalves, M J Guimarães, M van Zeller, F Menezes, J Moita, P Simão
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease, and there is a clinical need for validated markers and biomarkers that can contribute to the assessment of patients, risk prediction, treatment guidance, and assessment of response. Although according to the 2018 GOLD guidelines clinically useful biomarkers for COPD patients in stable condition have yet to be identified, several clinical markers and biomarkers have been proposed for COPD. These include isolated clinical markers, such as symptoms and Health Status assessment, exercise tests, function tests and imaging, and also composite scores and molecular markers...
June 10, 2018: Pulmonology
Makoto M Jones, Kevin L Winthrop, Scott D Nelson, Scott L Duvall, Olga V Patterson, Kevin E Nechodom, Kimberly E Findley, Lewis J Radonovich, Matthew H Samore, Kevin P Fennelly
OBJECTIVE: We identified patients with non-tuberculous mycobacterial (NTM) disease in the US Veterans Health Administration (VHA), examined the distribution of diseases by NTM species, and explored the association between NTM disease and the frequency of clinic visits and mortality. METHODS: We combined mycobacterial isolate (from natural language processing) with ICD-9-CM diagnoses from VHA data between 2008 and 2012 and then applied modified ATS/IDSA guidelines for NTM diagnosis...
2018: PloS One
Yosuke Wada, Yoshiaki Kitaguchi, Masanori Yasuo, Fumika Ueno, Satoshi Kawakami, Kiyoyasu Fukushima, Keisaku Fujimoto, Masayuki Hanaoka
Introduction: This study was conducted in order to investigate the diversity of respiratory physiology, including the respiratory impedance and reversibility of airway obstruction, based on quantitative computed tomography (CT) in patients with COPD. Patients and methods: Medical records of 174 stable COPD patients were retrospectively reviewed to obtain the patients' clinical data, including the pulmonary function and imaging data. According to the software-based quantification of the degree of emphysema and airway wall thickness, the patients were classified into the "normal by CT" phenotype, the airway-dominant phenotype, the emphysema-dominant phenotype, and the mixed phenotype...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Jiajia Wang, Jiansheng Li, Xueqing Yu, Yang Xie
Objective: This study aimed to evaluate the efficacy and safety of acupuncture therapy (AT) for improving functional effects and quality of life in COPD patients. Methods: PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), and Wanfang Data were searched. The randomized controlled trials (RCTs) evaluating the effect of AT on COPD patients were included...
2018: BioMed Research International
Leopoldo N Segal, Fernando J Martinez
The diagnosis and treatment of chronic obstructive pulmonary disease (COPD) has been based largely on a one-size-fits-all approach. Diagnosis of COPD is based on meeting the physiologic criteria of fixed obstruction in forced expiratory flows and treatment focus on symptomatic relief, with limited effect on overall prognosis. However, patients with COPD have distinct features that determine very different evolutions of the disease. In this review we highlight distinct subgroups of COPD characterized by unique pathophysiologic derangements, response to treatment, and disease progression...
June 2018: Journal of Allergy and Clinical Immunology
Michael Stellefson, Samantha R Paige, Julia M Alber, Margaret Stewart
People living with chronic obstructive pulmonary disease (COPD) commonly report feelings of loneliness and social isolation due to lack of support from family, friends, and health care providers. COPD360social is an interactive and disease-specific online community and social network dedicated to connecting people living with COPD to evidence-based resources. Through free access to collaborative forums, members can explore, engage, and discuss an array of disease-related topics, such as symptom management. This social media review provides an overview of COPD360social, specifically its features that practitioners can leverage to facilitate patient-provider communication, knowledge translation, and community building...
June 1, 2018: Health Promotion Practice
Agnieszka Strzelak, Aleksandra Ratajczak, Aleksander Adamiec, Wojciech Feleszko
Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS...
May 21, 2018: International Journal of Environmental Research and Public Health
Vasyl M Mykhalchuk, Averian G Vasyliev
OBJECTIVE: Introduction: Out of all respiratory diseases COPD is the leading cause of death and is characterized with diffuse non-reversible airway obstruction. Many various components play role in development and progression of this disease, while COPD risk factors play the most prominent role. Further progress in healthcare system development around COPD in Ukraine requires analysis of legislation, regulating pulmonological medical service in Ukraine. The aim: To analyze the influence of major risk factors on the development of chronic obstructive pulmonary disease and to determine key legislative aspects of the organization of medical care for COPD patients in Ukraine...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Hideki Yasui, Naoki Inui, Tomoyuki Fujisawa, Masato Karayama, Noriyuki Enomoto, Yutaro Nakamura, Shigeki Kuroishi, Hisano Ohba, Koshi Yokomura, Jun Sato, Masaki Sato, Naoki Koshimizu, Mikio Toyoshima, Takashi Yamada, Masafumi Masuda, Toshihiro Shirai, Takafumi Suda
Inhaled corticosteroids are widely used in the treatment of chronic obstructive pulmonary disease (COPD). However, their use has been questioned for appropriate dose and a possible increased risk of pneumonia. Here, we reviewed patients with COPD who had received fluticasone-salmeterol combination treatment using data from a linked electronic medical record database. A total of 180 patients received salmeterol with 250 µg fluticasone propionate twice daily and 78 received salmeterol and 100 µg fluticasone propionate twice daily...
2018: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
Sarah Houben-Wilke, Ingrid M Augustin, Jan H Vercoulen, Dirk van Ranst, Eline Bij de Vaate, Johan B Wempe, Martijn A Spruit, Emiel F M Wouters, Frits M E Franssen
Chronic obstructive pulmonary disease (COPD) has extensively been reported as a complex disease affecting patients' health beyond the lungs with a variety of intra- and extrapulmonary components and considerable variability between individuals. This review discusses the assessment of this complexity and underlines the importance of transdisciplinary management programmes addressing the physical, emotional and social health of the individual patient.COPD management is challenging and requires advanced, sophisticated strategies meeting the patient's individual needs...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Sara Roversi, Leonardo M Fabbri
The interaction between the lung and the heart is a vast, complex, and fascinating topic and, from a clinical point of view, disorders of the one often influence and promote disorders of the other. This is especially true for chronic diseases, with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) representing a classic example. Epidemiologic data indicate that cardiovascular diseases are frequent in patients with COPD, and vice versa. Accordingly, rates of IHD in COPD vary from 4% up to 60%, while, on the other hand, COPD has been reported in up to 30% of patients with coronary artery disease...
March 2018: Giornale Italiano di Cardiologia
Sarah Alton, Lisa Farndon
Chronic obstructive pulmonary disease (COPD) is a common long-term condition involving restricted airflow, which reduces quality of life. Treatments include lifestyle changes (smoking cessation), pulmonary rehabilitation and medication with inhaled therapies. However, medication adherence is often suboptimal, resulting in poor health outcomes. A pilot project assessed the impact of medicines management support from a community pharmacy team for people with COPD, delivered in their own homes. Individuals were given a medication review and an assessment of their inhaler technique and were followed up at 3 and 6 months...
June 2, 2018: British Journal of Community Nursing
Hayley Robinson, Veronika Williams, Ffion Curtis, Christopher Bridle, Arwel W Jones
Pulmonary rehabilitation has short-term benefits on dyspnea, exercise capacity and quality of life in COPD, but evidence suggests these do not always translate to increased daily physical activity on a patient level. This is attributed to a limited understanding of the determinants of physical activity maintenance following pulmonary rehabilitation. This systematic review of qualitative research was conducted to understand COPD patients' perceived facilitators and barriers to physical activity following pulmonary rehabilitation...
June 4, 2018: NPJ Primary Care Respiratory Medicine
Panagiotis Paliogiannis, Alessandro G Fois, Salvatore Sotgia, Arduino A Mangoni, Elisabetta Zinellu, Pietro Pirina, Ciriaco Carru, Angelo Zinellu
AIM: The aim of this meta-analysis was to review the available evidence regarding the blood concentrations of the oxidative stress marker malondialdehyde (MDA) in chronic obstructive pulmonary disease (COPD) patients in comparison to healthy individuals. METHODS: Fourteen studies were included in the meta-analysis (from inception to October 2017) with a total of 817 COPD patients and 530 healthy controls. RESULTS: Pooled MDA concentrations were significantly higher in patients with COPD than controls (standardized mean differences = 2...
June 5, 2018: Biomarkers in Medicine
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