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https://www.readbyqxmd.com/read/29347939/prevalence-and-management-of-severe-asthma-in-primary-care-an-observational-cohort-study-in-sweden-pacehr
#1
Kjell Larsson, Björn Ställberg, Karin Lisspers, Gunilla Telg, Gunnar Johansson, Marcus Thuresson, Christer Janson
BACKGROUND: Severe and uncontrolled asthma is associated with increased risk of exacerbations and death. A substantial proportion of asthma patients have poor asthma control, and a concurrent COPD diagnosis often increases disease burden. The objective of the study was to describe the prevalence and managemant of severe asthma in a Swedish asthma popuöation. METHODS: In this observational cohort study, primary care medical records data (2006-2013) from 36 primary health care centers were linked to data from national mandatory Swedish health registries...
January 18, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29346430/estimation-of-inhalation-flow-profile-using-audio-based-methods-to-assess-inhaler-medication-adherence
#2
Terence E Taylor, Helena Lacalle Muls, Richard W Costello, Richard B Reilly
Asthma and chronic obstructive pulmonary disease (COPD) patients are required to inhale forcefully and deeply to receive medication when using a dry powder inhaler (DPI). There is a clinical need to objectively monitor the inhalation flow profile of DPIs in order to remotely monitor patient inhalation technique. Audio-based methods have been previously employed to accurately estimate flow parameters such as the peak inspiratory flow rate of inhalations, however, these methods required multiple calibration inhalation audio recordings...
2018: PloS One
https://www.readbyqxmd.com/read/29341360/comparison-of-respiratory-system-impedance-in-asthma-and-copd-a-prospective-observational-study
#3
Takahiro Kamada, Masahiro Kaneko, Hiromi Tomioka
BACKGROUND AND OBJECTIVE: A single assessment of within-breath variations of respiratory system reactance (Xrs) at 5 Hz (ΔX5) measured by the forced oscillation technique (FOT) has been reported to be useful for the detection of pathophysiological changes in chronic obstructive pulmonary disease (COPD) and asthma. We examined longitudinal changes in respiratory system resistance (Rrs) and Xrs during tidal breathing between stable asthma and COPD patients in order to clarify the features of changes of respiratory system impedance and airflow limitation for these conditions...
January 17, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29338973/asthma-copd-overlap-a-portuguese-survey
#4
E Padrão, D Araújo, A Todo Bom, C Robalo Cordeiro, J Correia de Sousa, J Cardoso, M Morais-Almeida, R Costa, F Pavão, R B Leite, A Marques
INTRODUCTION: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. METHODS: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology)...
January 12, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29338792/critical-inhaler-errors-in-asthma-and-copd-a-systematic-review-of-impact-on-health-outcomes
#5
REVIEW
Omar Sharif Usmani, Federico Lavorini, Jonathan Marshall, William Christopher Nigel Dunlop, Louise Heron, Emily Farrington, Richard Dekhuijzen
BACKGROUND: Inhaled drug delivery is the cornerstone treatment for asthma and chronic obstructive pulmonary disease (COPD). However, use of inhaler devices can be challenging, potentially leading to critical errors in handling that can significantly reduce drug delivery to the lungs and effectiveness of treatment. METHODS: A systematic review was conducted to define 'critical' errors and their impact on health outcomes and resource use between 2004 and 2016, using key search terms for inhaler errors in asthma and COPD (Search-1) and associated health-economic and patient burden (Search-2)...
January 16, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29337458/-pulmonary-diseases-asthma-copd-and-sleep-apnea-syndrome
#6
Béatrice Duxbury, Émilie Chappuis-Gisin, Salim Chucri, Jean-Paul Janssens
Among the novelties described in the management of pulmonary disorders during the year 2017, we chose to describe three. First, the indication for inhaled glucocorticosteroids (ICS) in COPD has been revisited, because of their relationship with an increased occurence of pneumonia : ICS are now recommended only in severe COPD (GOLD D) with frequent exacerbations as second line treatment. Secondly, azithromycine has shown very promising results in poorly controlled severe asthma, with a significant impact on symptoms and exacerbations...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29337379/interleukin-17a-and-vascular-remodeling-in-severe-asthma-lack-of-evidence-for-a-direct-role
#7
Alice Panariti, Carolyn J Baglole, Veronica Sanchez, David H Eidelman, Sabah Hussain, Ron Olivenstein, James G Martin, Qutayba Hamid
BACKGROUND: Bronchial vascular remodeling may contribute to the severity of airway narrowing through mucosal congestion. Interleukin (IL)-17A is associated with the most severe asthmatic phenotype but whether it might contribute to vascular remodeling is uncertain. OBJECTIVE: To assess vascular remodeling in severe asthma and whether IL-17A directly or indirectly may cause endothelial cell activation and angiogenesis. METHODS: Bronchial vascularization was quantified in asthmatic subjects, COPD and healthy subjects together with the number of IL-17A+ cells as well as the concentration of angiogenic factors in the sputum...
January 16, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29334861/copd-management-by-swedish-general-practitioners-baseline-results-of-the-primair-study
#8
Hanna Sandelowsky, Natalia Natalishvili, Ingvar Krakau, Sonja Modin, Björn Ställberg, Anna Nager
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common cause of suffering and death. Evidence-based management of COPD by general practitioners (GPs) is crucial for decreasing the impact of the disease. Efficient strategies include early diagnosis, smoking cessation and multimodal treatment. AIM: To describe knowledge about and skills for managing COPD in GPs in Sweden. METHODS: Prior to COPD education (the PRIMAIR Study), GPs at primary health care centers (PHCCs) in Stockholm replied to 13 written, patient-case based, multiple choice and free-text questions about COPD...
January 15, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29334676/statins-in-the-treatment-of-copd-and-asthma-where-do-we-stand
#9
REVIEW
Jennifer Y So, Santosh Dhungana, Joanna J Beros, Gerard J Criner
Asthma and chronic obstructive pulmonary disease (COPD) are the two most prevalent obstructive lung diseases that account for tremendous morbidity and mortality throughout the world. These diseases have strong inflammatory components, with multiple prior studies showing elevated levels of various inflammatory markers and cells in those with COPD and asthma. Therefore, efforts to target inflammation in management of these diseases are of great interest. Statins, which define a class of drugs that are HMG-CoA inhibitors, are used to decrease cholesterol levels and have also been described to have many pleotropic effects that include anti-inflammatory and anti-oxidative properties...
January 12, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29334526/airborne-particulate-matter-human-exposure-health-effects
#10
Jonathan E Thompson
OBJECTIVE: Exposure to airborne particulate matter (PM) is estimated to cause millions of premature deaths annually. This work conveys known routes of exposure to PM and resultant health effects. METHODS: Review of available literature. RESULTS: Estimates for daily PM exposure are provided. Known mechanisms by which insoluble particles are transported and removed from the body are discussed. Biological effects of PM, including immune response, cytotoxicity, and mutagenicity are reported...
January 12, 2018: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29331768/the-cholinergic-anti-inflammatory-pathway-an-innovative-treatment-strategy-for-respiratory-diseases-and-their-comorbidities
#11
REVIEW
Mitsuhiro Yamada, Masakazu Ichinose
Over the past few decades, it has been clarified that the nervous system and immune system have overlapping distributions and their interactions are critical in the regulation of immunological and inflammatory responses. The cholinergic anti-inflammatory pathway, including the parasympathetic nerve systems and humoral factors orchestrate the immune responses to protect the body during infection and tissue injury. Recent investigations have attempted to clarify how the parasympathetic nerve systems attenuate the systemic inflammatory responses and identified the α7 nicotinic acetylcholine receptor (α7nAChR) as a crucial target for attenuating the release of inflammatory cytokines from inflammatory cells including macrophages and dendritic cells...
January 11, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#12
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331313/predictors-of-exacerbation-risk-and-response-to-budesonide-in-patients-with-chronic-obstructive-pulmonary-disease-a-post-hoc-analysis-of-three-randomised-trials
#13
Mona Bafadhel, Stefan Peterson, Miguel A De Blas, Peter M Calverley, Stephen I Rennard, Kai Richter, Malin Fagerås
BACKGROUND: The peripheral blood eosinophil count might help identify those patients with chronic obstructive pulmonary disease (COPD) who will experience fewer exacerbations when taking inhaled corticosteroids (ICS). Previous post-hoc analyses have proposed eosinophil cutoffs that are both arbitrary and limited in evaluating complex interactions of treatment response. We modelled eosinophil count as a continuous variable to determine the characteristics that determine both exacerbation risk and clinical response to ICS in patients with COPD...
January 10, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29326334/clinical-and-inflammatory-phenotyping-by-breathomics-in-chronic-airway-diseases-irrespective-of-the-diagnostic-label
#14
Rianne de Vries, Yennece W F Dagelet, Pien Spoor, Erik Snoey, Patrick M C Jak, Paul Brinkman, Erica Dijkers, Simon K Bootsma, Fred Elskamp, Frans H C de Jongh, Eric G Haarman, Johannes C C M In 't Veen, Anke-Hilse Maitland-van der Zee, Peter J Sterk
Asthma and chronic obstructive pulmonary disease (COPD) are complex and overlapping diseases that include inflammatory phenotypes. Novel anti-eosinophilic/anti-neutrophilic strategies demand rapid inflammatory phenotyping, which might be accessible from exhaled breath.Our objective was to capture clinical/inflammatory phenotypes in patients with chronic airway disease using an electronic nose (eNose) in a training and validation set.This was a multicentre cross-sectional study in which exhaled breath from asthma and COPD patients (n=435; training n=321 and validation n=114) was analysed using eNose technology...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29322217/-functional-diagnostics-in-pneumology
#15
REVIEW
M Held, S Baron, B Jany
Alongside imaging techniques, pulmonary function testing helps in the diagnosis of underlying disorders such as asthma and chronic obstructive pulmonary disease (COPD) or fibrosing lung disease. However, disease severity grading is also important, as well as disease follow-up under therapy. The value of spirometry as a first-line diagnostic test, whole-body plethysmography in advanced diagnostics, the measurement of transfer factor, as well as blood gas analysis are outlined. The importance of spiroergometry, echocardiography, and right-heart catheterization, particularly in the functional assessment of pulmonary vascular disorders, is described...
January 10, 2018: Der Internist
https://www.readbyqxmd.com/read/29321831/changes-in-smoking-prevalence-and-cessation-support-and-factors-associated-with-successful-smoking-cessation-in-swedish-patients-with-asthma-and-copd
#16
Marcus Stegberg, Mikael Hasselgren, Scott Montgomery, Karin Lisspers, Björn Ställberg, Christer Janson, Josefin Sundh
Introduction: Our aim was to investigate changes in smoking prevalence, smoking cessation support and factors associated with successful smoking cessation in patients with asthma and COPD. Methods: Questionnaires about available smoking cessation resources were completed by 54 primary health-care centers and 14 hospitals in central Sweden in 2005 and 2012. Patient data were collected using record reviews and patients questionnaires for two cohorts of randomly selected asthma and COPD patients in 2005 (n = 2306; with a follow up in 2012), and in 2014/2015 (n = 2620)...
2018: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29319364/comparative-study-of-il-33-and-il-6-levels-in-different-respiratory-samples-in-mild-to-moderate-asthma-and-copd
#17
Katarzyna Gorska, Patrycja Nejman-Gryz, Magdalena Paplinska-Goryca, Piotr Korczynski, Monika Prochorec-Sobieszek, Rafal Krenke
IL-6 and IL-33 are involved in the inflammatory process in obstructive lung diseases. In contrast to IL-6, few data on the expression of IL-33 in different biological samples from asthma and COPD patients are available. The aim was to evaluate the expressions of IL-33 and IL-6 in bronchial mucosa and to compare these expressions with the concentrations of both cytokines in various respiratory samples from patients with mild-to-moderate asthma and COPD. Serum, induced sputum and exhaled breath condensate IL-6 and IL-33 levels, as well as their expression in bronchial mucosa were evaluated in 22 asthma and 33 COPD patients...
January 10, 2018: COPD
https://www.readbyqxmd.com/read/29319215/considerations-of-prescribers-and-pharmacists-for-the-use-of-non-selective-%C3%AE-blockers-in-asthma-and-copd-patients-an-explorative-study
#18
Esther Kuipers, Michel Wensing, Peter A G M De Smet, Martina Teichert
RATIONALE, AIMS, AND OBJECTIVES: Despite recommendations in prevailing guidelines to avoid the use of non-selective (NS) β-blockers in patients with asthma or COPD, on average, 10 patients per community pharmacy receive NS β-blockers monthly. The aim of our study was to identify the reasons of prescribers and pharmacists to treat asthma and COPD patients with NS β-blockers. METHODS: Fifty-three community pharmacists in the Netherlands selected patients with actual concurrent use of inhalation medication and NS β-blockers...
January 10, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29317923/identification-of-inhaler-technique-errors-with-a-routine-procedure-in-portuguese-community-pharmacy
#19
M Margarida Castel-Branco, Ana Fontes, Isabel V Figueiredo
Background: A correct selection of drugs prescribed, but also the choice of the appropriate inhaler device, is crucial for the control of respiratory diseases. Objective: To evaluate the inhaler technique and identify potential errors of patients when treated with inhalers by testing a routinary procedure to be implemented in any community pharmacy. Methods: Adults with asthma/COPD and under inhalation therapy were invited to demonstrate how they use their inhalers...
October 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/29316890/risk-factors-of-postoperative-pulmonary-complications-in-patients-with-asthma-and-copd
#20
Takanori Numata, Katsutoshi Nakayama, Satoko Fujii, Yoko Yumino, Nayuta Saito, Masahiro Yoshida, Yusuke Kurita, Kenji Kobayashi, Saburo Ito, Hirofumi Utsumi, Haruhiko Yanagisawa, Mitsuo Hashimoto, Hiroshi Wakui, Shunsuke Minagawa, Takeo Ishikawa, Hiromichi Hara, Jun Araya, Yumi Kaneko, Kazuyoshi Kuwano
BACKGROUND: Postoperative pulmonary complications (PPC) in patients with pulmonary diseases remain to be resolved clinical issue. However, most evidence regarding PPC has been established more than 10 years ago. Therefore, it is necessary to evaluate perioperative management using new inhalant drugs in patients with obstructive pulmonary diseases. METHODS: April 2014 through March 2015, 346 adult patients with pulmonary diseases (257 asthma, 89 chronic obstructive pulmonary disease (COPD)) underwent non-pulmonary surgery except cataract surgery in our university hospital...
January 9, 2018: BMC Pulmonary Medicine
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