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Corticosteroid use in copd

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https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#1
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28314480/airways-antiallergic-effect-and-pharmacokinetics-of-alkaloids-from-alstonia-scholaris
#2
Yun-Li Zhao, Jing Cao, Jian-Hua Shang, Ya-Ping Liu, Afsar Khan, Heng-Shan Wang, Yi Qian, Lu Liu, Min Ye, Xiao-Dong Luo
BACKGROUND: Alstonia scholaris (L.) R. Br. (Apocynaceae), an important herbal medicine, has been widely used to treat respiratory tract diseases, such as cough, asthma, phlegm, and chronic obstructive pulmonary disease. PURPOSE: To evaluate pharmacological effect of alkaloids from A. scholaris on ovalbumin induced airways allergic inflammatory model, and explore whether the dosing frequency is related to pharmacokinetics. STUDY DESIGN: After oral administration of total alkaloids, the pharmacokinetic study of it was investigated...
April 15, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/28300474/comparative-efficacies-of-inhaled-corticosteroids-and-systemic-corticosteroids-in-treatment-of-chronic-obstructive-pulmonary-disease-exacerbations-a-systematic-review-and-meta-analysis
#3
Yuhan Zhai, He Zhang, Tingli Sun, Maosheng Ye, Hongbo Liu, Rui Zheng
BACKGROUND: Corticosteroids play an important role in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations, and a global initiative has suggested the use of inhaled corticosteroids (ICSs) as an alternative to systemic corticosteroids (SCs). Here, we report results of a meta-analysis performed to systematically compare the efficacies of ICSs and SCs in the treatment of COPD exacerbations. METHODS: PubMed, EMBASE, and the Cochrane databases were searched for relevant human clinical trials describing the use of ICSs compared with SCs in the treatment of COPD exacerbations...
March 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#4
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28286842/methyl-prednisolone-vs-dexamethasone-in-management-of-copd-exacerbation-a-randomized-clinical-trial
#5
Mohammad Emami Ardestani, Elham Kalantary, Vajihe Samaiy, Keramat Taherian
INTRODUCTION: Corticosteroids are routinely used in management of chronic obstructive pulmonary disease (COPD) exacerbation. The main purpose of present study was to compare the efficacy of methyl prednisolone (MP) and dexamethasone (DXM) for this purpose. METHODS: Adult COPD patients entered the present clinical trial. All patients received standard treatment on admission and were then divided into 2 groups of intravenous MP and DXM. Patients were asked to rate their shortness of breath; sputum volume and viscosity; dyspnea; cough; and general wellbeing on a 0-5 scale...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28284262/respiratory-medication-use-in-primary-care-among-copd-subjects-in-four-latin-american-countries
#6
J R Jardim, R Stirbulov, D Moreno, G Zabert, M V Lopez-Varela, M Montes de Oca
OBJECTIVES: To assess respiratory medications used, factors predicting treatment and patterns of corticosteroid (CS) use in primary care in Latin America among chronic obstructive pulmonary disease (COPD) patients. METHODS: COPD was defined as post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) < 0.70 or previous medical diagnosis. To determine factors associated with respiratory medication use, crude and adjusted Poisson regression models were performed...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28275471/immunity-status-of-invasive-pulmonary-aspergillosis-patients-with-structural-lung-diseases-in-chinese-adults
#7
Shuo Liang, Rong Jiang, Hai-Wen Lu, Bei Mao, Man-Hui Li, Cheng-Wei Li, Shu-Yi Gu, Jiu-Wu Bai, Jin-Fu Xu
BACKGROUND: Invasive pulmonary aspergillosis (IPA) is a fungal infection frequently observed in patients with immune dysfunction, such as those suffering from structural lung diseases. Nevertheless, studies assessing IPA combined with other common respiratory diseases remain scarce, particularly those regarding the immune status of its patients. Different structural lung diseases are known to differently affect patient immune status; however, the mechanisms by which this is conferred have yet to be determined...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28255962/bringing-stability-to-the-chronic-obstructive-pulmonary-disease-patient-clinical-and-pharmacological-considerations-for-frequent-exacerbators
#8
REVIEW
Swati Gulati, J Michael Wells
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are critical events associated with an accelerated loss of lung function, increased morbidity, and excess mortality. AECOPD are heterogeneous in nature and this may directly impact clinical decision making, specifically in patients with frequent exacerbations. A 'frequent exacerbator' is a sub-phenotype of chronic obstructive pulmonary disease (COPD) and is defined as an individual who experiences two or more moderate-to-severe exacerbations per year...
March 3, 2017: Drugs
https://www.readbyqxmd.com/read/28255905/inhaled-corticosteroid-use-and-the-risk-of-pneumonia-and-copd-exacerbations-in-the-uplift-study
#9
Jaymin B Morjaria, Alan Rigby, Alyn H Morice
RATIONALE: Unlike many other COPD studies, the 4-year UPLIFT trial permitted inhaled corticosteroid (ICS) use during run-in and treatment phases. This provided the opportunity to prospectively observe the continuing effects of ICS on respiratory events in closely observed COPD population. OBJECTIVES: We aimed to determine rate and number of episodes of pneumonia and exacerbations of COPD in patients entering the study on no ICS, fluticasone proprionate (FP), and other ICS...
March 3, 2017: Lung
https://www.readbyqxmd.com/read/28251670/retrospective-audit-of-antimicrobial-prescribing-practices-for-acute-exacerbations-of-chronic-obstructive-pulmonary-diseases-in-a-large-regional-hospital
#10
D J Brownridge, S T R Zaidi
WHAT IS KNOWN AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines...
March 1, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28245825/predictors-of-correct-technique-in-patients-using-pressurized-metered-dose-inhalers
#11
Kyra Bartolo, Martin Balzan, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon, Stephen Montefort
BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical...
February 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28243078/a-belgian-survey-on-the-diagnosis-of-asthma-copd-overlap-syndrome
#12
Didier Cataldo, Jean-Louis Corhay, Eric Derom, Renaud Louis, Eric Marchand, Alain Michils, Vincent Ninane, Rudi Peché, Charles Pilette, Walter Vincken, Wim Janssens
INTRODUCTION: Patients with chronic airway disease may present features of both asthma and COPD, commonly referred to as asthma-COPD overlap syndrome (ACOS). Recommendations on their diagnosis are diffuse and inconsistent. This survey aimed to identify consensus on criteria for diagnosing ACOS. METHODS: A Belgian expert panel developed a survey on ACOS diagnosis, which was completed by 87 pulmonologists. Answers chosen by ≥70% of survey respondents were considered as useful criteria for ACOS diagnosis...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28235977/use-of-concomitant-inhaled-corticosteroids-pooled-data-from-two-phase-iii-studies-of-aclidinium-plus-formoterol-in-copd
#13
Anthony D'Urzo, Dave Singh, Esther Garcia Gil
Bronchodilator therapy is the backbone of the management of chronic obstructive pulmonary disease. In some patients, inhaled corticosteroids can be prescribed in combination with bronchodilators. Through a subgroup analysis of pooled data from two large phase III clinical trials of bronchodilator therapy according to concomitant inhaled corticosteroid use (user vs. non-user), we sought to evaluate the clinical benefit of adding inhaled corticosteroids to dual bronchodilator therapy in chronic obstructive pulmonary disease...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28235797/inhaled-corticosteroids-and-respiratory-infections-in-children-with-asthma-a-meta-analysis
#14
REVIEW
Cristine Cazeiro, Cristina Silva, Susana Mayer, Vanessa Mariany, Claire Elizabeth Wainwright, Linjie Zhang
CONTEXT: Inhaled corticosteroids (ICS) are associated with an increased risk of pneumonia in adult patients with chronic obstructive pulmonary disease. OBJECTIVE: To assess the association between ICS use and risk of pneumonia and other respiratory infections in children with asthma. DATA SOURCES: We searched PubMed from inception until May 2015. We also searched clinicaltrials.gov and databases of pharmaceutical manufacturers. STUDY SELECTION: We selected randomized trials that compared ICS with placebo for at least 4 weeks in children with asthma...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28226405/comparative-effectiveness-of-long-acting-beta2-agonist-combined-with-a-long-acting-muscarinic-antagonist-or-inhaled-corticosteroid-in-chronic-obstructive-pulmonary-disease
#15
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
INTRODUCTION: Several dual bronchodilator fixed dose inhaler medications were recently approved for the treatment of chronic obstructive pulmonary disease (COPD). These products combine a long-acting beta2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA). In clinical trials, the separate mechanisms of the bronchodilators resulted in improved lung function. COPD treatment guidelines currently recommend combination LABA/LAMA as alternative therapy to combination LABA/ inhaled corticosteroid (ICS)...
February 22, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28223227/mitogen-activated-protein-kinases-as-therapeutic-targets-for-asthma
#16
REVIEW
MirHojjat Khorasanizadeh, Mahsa Eskian, Erwin W Gelfand, Nima Rezaei
Corticosteroid-resistant asthmatics, although comprising only a portion of the asthma population, account for most of the morbidity, mortality and economic burden associated with asthma. Moreover, corticosteroids are not effective inhibitors of airway remodeling changes, and their long-term use is associated with debilitating systemic side effects. Therefore, potent and safe novel therapeutic alternatives, targeting basic pathophysiological mechanisms responsible for the severe asthmatic phenotype are urgently needed...
February 14, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28214911/-risk-of-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease-treated-with-inhaled-corticosteroids-evidence-and-uncertainties
#17
Cristoforo Incorvaia, Bruna Gritti, Irene Martignago, Gian Galeazzo Riario-Sforza, Erminia Ridolo
A large number of studies, evaluated by several meta-analyses, indicate that patients with chronic obstructive pulmonary disease (COPD) treated with inhaled corticosteroids have a significantly increased risk of pneumonia which, however, is not associated with a corresponding increase in mortality. The increased risk seems to be exclusive of COPD, since meta-analyses involving patients with asthma treated with inhaled corticosteroids did not show a risk of pneumonia higher than that of the general population...
November 2016: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28212436/antibody-deficiency-in-patients-with-frequent-exacerbations-of-chronic-obstructive-pulmonary-disease-copd
#18
Brian N McCullagh, Alejandro P Comellas, Zuhair K Ballas, John D Newell, M Bridget Zimmerman, Antoine E Azar
Chronic Obstructive Pulmonary Disease is the third leading cause of death in the US, and is associated with periodic exacerbations, which account for the largest proportion of health care utilization, and lead to significant morbidity, mortality, and worsening lung function. A subset of patients with COPD have frequent exacerbations, occurring 2 or more times per year. Despite many interventions to reduce COPD exacerbations, there is a significant lack of knowledge in regards to their mechanisms and predisposing factors...
2017: PloS One
https://www.readbyqxmd.com/read/28203095/burden-and-treatment-patterns-of-invasive-fungal-infections-in-hospitalized-patients-in-the-middle-east-real-world-data-from-saudi-arabia-and-lebanon
#19
Adel F Alothman, Abdulhakeem O Althaqafi, Madonna J Matar, Rima Moghnieh, Thamer H Alenazi, Fayssal M Farahat, Shelby Corman, Caitlyn T Solem, Nirvana Raghubir, Cynthia Macahilig, Claudie Charbonneau, Jennifer M Stephens
OBJECTIVES: The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon. METHODS: A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus, which was culture proven or suspected based on clinical criteria...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28203071/long-acting-bronchodilators-with-or-without-inhaled-corticosteroids-and-30-day-readmission-in-patients-hospitalized-for-copd
#20
Raju Bishwakarma, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: The ability of a long-acting muscarinic antagonist (LAMA) and long-acting beta 2 agonists (LABAs; long-acting bronchodilators, LABDs) with or without inhaled corticosteroids (ICSs) to reduce early readmission in hospitalized patients with COPD is unknown. METHODS: We studied a 5% sample of Medicare beneficiaries enrolled in Medicare parts A, B and D and hospitalized for COPD in 2011. We examined prescriptions filled for LABDs with or without ICSs (LABDs±ICSs) within 90 days prior to and 30 days after hospitalization...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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