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https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#1
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29068643/diagnosis-and-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-digest
#2
Van Holden, Donald Slack Iii, Michael T McCurdy, Nirav G Shah, Nachi Gupta, Jeffrey Nusbaum
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29066878/acute-exacerbated-copd-room-for-improvement-in-key-elements-of-care
#3
Stefan Markun, Daniel P Franzen, Kaba Dalla Lana, Swantje Beyer, Stephan Wieser, Thomas Hess, Malcolm Kohler, Thomas Rosemann, Oliver Senn, Claudia Steurer-Stey
INTRODUCTION: Hospitalizations because of acute exacerbated COPD (AECOPD) are a major burden to patients and the health care system. Interventions during acute and post-acute hospital care exist not only to improve short-term outcomes but also to prevent future exacerbations and disease progression. We aimed at measuring the implementation rates of acute and post-acute hospital care interventions for AECOPD. METHODS: We performed 24 months (January 1, 2012, to December 31, 2013) retrospective medical chart review of consecutive cases hospitalized to one of three public hospitals in the canton of Zurich due to AECOPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29062228/impact-and-prevention-of-severe-exacerbations-of-copd-a-review-of-the-evidence
#4
REVIEW
David Mg Halpin, Marc Miravitlles, Norbert Metzdorf, Bartolomé Celli
Severe exacerbations of COPD, ie, those leading to hospitalization, have profound clinical implications for patients and significant economic consequences for society. The prevalence and burden of severe COPD exacerbations remain high, despite recognition of the importance of exacerbation prevention and the availability of new treatment options. Severe COPD exacerbations are associated with high mortality, have negative impact on quality of life, are linked to cardiovascular complications, and are a significant burden on the health-care system...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28983645/-pseudomonas-aeruginosa-infections-in-chronic-obstructive-pulmonary-disease-role-of-long-term-antibiotic-treatment
#5
REVIEW
G G U Rohde, T Welte
Chronic Pseudomonas aeruginosa colonization in the airways of patients with chronic obstructive pulmonary disease (COPD) is probably associated with increased mortality and morbidity and a faster progress of COPD, although this has not been conclusively proven by studies. Studies demonstrating an improvement in prognosis in COPD patients by early eradication of Pseudomonas or at least a reduction of the bacterial burden by either inhaled or oral antibiotic maintenance therapy, are missing. An impact on the exacerbation rate has only been shown for macrolide maintenance treatment; however, this effect could be explained by the inclusion of patients with bronchiectasis in the studies...
November 2017: Der Internist
https://www.readbyqxmd.com/read/28981235/-lower-respiratory-tract-infections-in-immunocompetent-adult
#6
F Jacobs
Lower respiratory tract infections represent one of the main causes of mortality in the world. They essentially consist of bronchitis, acute exacerbations of chronic obstructive bronchopulmonary diseases (COPD) and acute pneumonia. If acute bronchitis is mainly of viral origin, acute exacerbations of COPD and pneumonia are mainly due to a trio of bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis). Other pathogens as many viruses and atypical bacteria such as Mycoplasma pneumoniae, Legionella, some Enterobacteriaceae and very rarely Pseudomonas aeruginosa are also implicated...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28969667/general-practitioner-use-of-a-c-reactive-protein-point-of-care-test-to-help-target-antibiotic-prescribing-in-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-the-pace-study-study-protocol-for-a-randomised-controlled-trial
#7
Janine Bates, Nick A Francis, Patrick White, David Gillespie, Emma Thomas-Jones, Rachel Breen, Nigel Kirby, Kerry Hood, Micaela Gal, Rhiannon Phillips, Gurudutt Naik, Jochen Cals, Carl Llor, Hasse Melbye, Mandy Wootton, Evgenia Riga, Ann Cochrane, Robin Howe, Deborah Fitzsimmons, Bernadette Sewell, Mohammed Fasihul Alam, Christopher C Butler
BACKGROUND: Most patients presenting with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in primary care are prescribed an antibiotic, which may not always be appropriate and may cause harm. C-reactive protein (CRP) is an acute-phase biomarker that can be rapidly measured at the point of care and may predict benefit from antibiotic treatment in AECOPD. It is not clear whether the addition of a CRP point-of-care test (POCT) to clinical assessment leads to a reduction in antibiotic consumption without having a negative impact on COPD health status...
September 29, 2017: Trials
https://www.readbyqxmd.com/read/28965921/therapeutic-approaches-of-asthma-and-copd-overlap
#8
REVIEW
Mitsuko Kondo, Jun Tamaoki
Asthma and COPD overlap (ACO) is an important clinical phenotype, due to the low-health-related quality of life (QOL), rapid decline in lung function, frequent exacerbation, and high economic burden. However, no large-scaled therapeutic trials of ACO have been conducted. At present, ACO is treated according to asthma/COPD guidelines. The goals of ACO treatment are to relieve symptoms and improve QOL and lung functions. Treatment must also prevent disease progression, airway remodeling, exacerbation, complications, and comorbidities...
September 28, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28949430/effectiveness-and-safety-of-outpatient-parenteral-antimicrobial-therapy-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#9
Miguel A Ponce González, Manuel Mirón Rubio, Abel Mujal Martinez, Oriol Estrada Cuxart, Dolores Fiuza Perez, Liliana Salas Reinoso, Estrella Fernández Fabrellas, Eusebi Chiner Vives
AIM: We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU). METHODS: Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period. RESULTS: Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV...
September 26, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28947018/blood-eosinophilia-as-a-marker-of-early-and-late-treatment-failure-in-severe-acute-exacerbations-of-copd
#10
Hendrik J Prins, Ruud Duijkers, Rene Lutter, Johannes M Daniels, Paul van der Valk, Margreet Schoorl, Huib A Kerstjens, Tjip S van der Werf, Wim G Boersma
BACKGROUND: Blood eosinophilia is frequently encountered in patients with AECOPD. However the impact of blood eosinophilia at admission in patients with AECOPD on outcome on the short and long term has not been extensively studied which was the objective of the present study. METHODS: We used data of 207 exacerbations from a randomized clinical trial on antibiotic prescription based upon CRP-levels versus GOLD guided strategy and analyzed the impact of blood eosinophils (≥2% of total white cell count and eosinophil count ≥300 cell/microliter) on clinical outcome...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28926214/diagnosis-and-management-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#11
Van Holden, Donald Slack III, Michael T. McCurdy, Nirav G. Shah
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28854829/profile-of-the-proaxsis-active-neutrophil-elastase-immunoassay-for-precision-medicine-in-chronic-respiratory-disease
#12
Holly R Keir, Christopher J Fong, Alison J Dicker, James D Chalmers
Neutrophil elastase (NE) is a 29kDa serine protease released from the azurophilic granules of neutrophils. It may be directly involved in the pathogenesis and disease progression in cystic fibrosis, bronchiectasis and COPD through the degradation of airway elastin and by impairing host defence. Areas covered: Measurement of NE activity has emerged as a promising biomarker strategy in inflammatory lung disease. The authors review studies where NE activity has been linked with clinical outcomes such as lung function decline, exacerbation frequency or other cross-sectional and longitudinal markers of disease severity...
September 7, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28841671/microbiome-balance-in-sputum-determined-by-pcr-stratifies-copd-exacerbations-and-shows-potential-for-selective-use-of-antibiotics
#13
Koirobi Haldar, Mona Bafadhel, Kelvin Lau, Adam Berg, Brenda Kwambana, Tatiana Kebadze, Mohammadali Yavari Ramsheh, Bethan Barker, Pranabashis Haldar, Sebastian Johnston, Julian M Ketley, Christopher E Brightling, Michael R Barer
BACKGROUND: While a subgroup of patients with exacerbations of chronic obstructive pulmonary disease (COPD) clearly benefit from antibiotics, their identification remains challenging. We hypothesised that selective assessment of the balance between the two dominant bacterial groups (Gammaproteobacteria (G) and Firmicutes (F)) in COPD sputum samples might reveal a subgroup with a bacterial community structure change at exacerbation that was restored to baseline on recovery and potentially reflects effective antibiotic treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28795838/hospital-procalcitonin-testing-and-antibiotic-treatment-of-patients-admitted-for-copd-exacerbation
#14
Peter K Lindenauer, Meng-Shiou Shieh, Mihaela S Stefan, Kimberly A Fisher, Sarah D Haessler, Penelope S Pekow, Michael B Rothberg, Jerry A Krishnan, Allan J Walkey
RATIONALE: Randomized trials suggest that assessment of serum procalcitonin (PCT) levels can be used to safely limit antibiotic use among patients hospitalized for exacerbations of COPD. OBJECTIVES: To determine the impact of PCT testing on antibiotic treatment of patients hospitalized for exacerbations of COPD in routine practice. METHODS: We conducted a series of cross-sectional and longitudinal multivariable analyses using data from 2009-2011 and 2013-2014 from a sample of 505 US hospitals Results: Of 203,177 patients hospitalized for COPD exacerbation in 2013-14, nearly 9 out of 10 were treated with antibiotics...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28768695/%C3%A2-strontium-ranelate-discontinued
#15
(no author information available yet)
▼ Strontium ranelate discontinued ● Limited treatment options for molluscum contagiosum ● Finasteride drug safety alert ● Does doxycycline delay the next COPD exacerbation? ● Support for WHO standards on reporting clinical trial results ● Delayed antibiotic prescription for lower respiratory tract infections ● Nystatin dose change - much ado about nothing?
August 2, 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28720485/ceftaroline-modulates-the-innate-immune-and-host-defense-responses-of-immunocompetent-cells-exposed-to-cigarette-smoke
#16
A Bruno, C Cipollina, S Di Vincenzo, L Siena, P Dino, F Di Gaudio, M Gjomarkaj, E Pace
BACKGROUND: Cigarette smoke, the principal risk factor for chronic obstructive pulmonary disease (COPD), negatively influences the effectiveness of the immune system's response to a pathogen. The antibiotic ceftaroline exerts immune-modulatory effects in bronchial epithelial cells exposed to cigarette smoke. AIMS AND METHODS: The present study aims to assess the effects of ceftaroline on TLR2 and TLR4 expression, LPS binding and TNF-α and human beta defensin (HBD2) release in an undifferentiated and PMA-differentiated human monocyte cell line (THP-1) exposed or not to cigarette smoke extracts (CSE)...
September 5, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/28719893/treatment-of-copd-exacerbation-in-switzerland-results-and-recommendations-of-the-european-copd-audit
#17
Michael Buess, Daniel Schilter, Tino Schneider, Marc Maurer, Heinz Borer, Robert Thurnheer, Erich Köhler, Lilian Junker, Kathleen Jahn, Michael Grob, Jochen Rüdiger, Thomas Geiser, Erich Helfenstein, Markus Solèr, René Fiechter, Thomas Sigrist, Patrick Brun, Jürg Barandun, Eva Koltai, José Luis López-Campos, Sylvia Hartl, Michael Roberts, Desiree M Schumann, Michael Tamm, Daiana Stolz
BACKGROUND: The European COPD Audit initiated by the European Respiratory Society (ERS) evaluated the management of hospital admissions due to exacerbation of chronic obstructive pulmonary disease (COPD) in several European countries. Data on the treatment of severe acute exacerbations of COPD (AECOPDs) in Switzerland are scarce. OBJECTIVES: In light of the GOLD 2010 guidelines, this work aims to examine the quality of care for AECOPD and to provide specific recommendations for the management of severe AECOPD in Switzerland...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28694340/colonisation-of-irish-patients-with-chronic-obstructive-pulmonary-disease-by-streptococcus-pneumoniae-and-analysis-of-the-pneumococcal-vaccine-coverage-a-non-interventional-observational-prospective-cohort-study
#18
Hannah McCarthy, Mandy Jackson, Mary Corcoran, Martha McElligott, Elaine MacHale, Imran Sulaiman, Breda Cushen, Richard W Costello, Hilary Humpreys
OBJECTIVES: To characterise the pattern of colonisation and serotypes of Streptococcus pneumoniae among patients with chronic obstructive pulmonary disease (COPD) who currently receive the 23-valent pneumococcal polysaccharide vaccine (PPV-23) according to vaccination status, use of antibiotics and steroids. To investigate the prevalence of PPV-23 and 13-valent pneumococcal conjugate vaccine (PCV-13) serotypes within the study cohort. DESIGN: A non-interventional, observational, prospective cohort study with a 12 -month follow-up period inclusive of quarterly study visits...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28676846/inactivation-of-the-thymidylate-synthase-thya-in-non-typeable-haemophilus-influenzae-modulates-antibiotic-resistance-and-has-a-strong-impact-on-its-interplay-with-the-host-airways
#19
Irene Rodríguez-Arce, Sara Martí, Begoña Euba, Ariadna Fernández-Calvet, Javier Moleres, Nahikari López-López, Montserrat Barberán, José Ramos-Vivas, Fe Tubau, Carmen Losa, Carmen Ardanuy, José Leiva, José E Yuste, Junkal Garmendia
Antibacterial treatment with cotrimoxazol (TxS), a combination of trimethoprim and sulfamethoxazole, generates resistance by, among others, acquisition of thymidine auxotrophy associated with mutations in the thymidylate synthase gene thyA, which can modify the biology of infection. The opportunistic pathogen non-typeable Haemophilus influenzae (NTHi) is frequently encountered in the lower airways of chronic obstructive pulmonary disease (COPD) patients, and associated with acute exacerbation of COPD symptoms...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28664714/analysis-of-acinetobacter-baumannii-resistance-patterns-in-patients-with-chronic-obstructive-pulmonary-disease-copd-in-terms-of-choice-of-effective-empiric-antibiotic-therapy
#20
Aneta Grochowalska, Maria Kozioł-Montewka, Anna Sobieszczańska
<b>Introduction.</b> Multi-resistant Acinetobacter baumannii isolated from patients has become one of the most hazardous pathogens in health care settings. The aim of the study was to analyze pneumonia caused by Acinetobacter baumannii in patients hospitalized because of exacerbation of chronic obstructive pulmonary diseases (COPD), who were admitted to the Pulmonology Ward of the Masovian Specialistic Hospital in Radom (MSS). The incidence and drug sensitivity of these non-fermenting rods were evaluated, and compliance with antimicrobial procedure with the algorithm of the guidelines in applicable recommendations, was estimated...
June 12, 2017: Annals of Agricultural and Environmental Medicine: AAEM
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