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https://www.readbyqxmd.com/read/29735492/asthmatic-adult-with-marked-blood-eosinophilia-is-it-truly-asthma
#1
Shera Tan, Angela Takano, Aloysius Ho, Keng Leong Tan
A middle-aged woman presented with symptoms suggestive of allergic asthma but with markedly elevated peripheral eosinophilia. She did not respond to inhaled corticosteroids, thereby prompting further investigations. Chest radiograph was normal. CT of the chest revealed bi-apical ground glass opacities. Bronchoalveolar lavage revealed predominantly eosinophilic yield. Autoimmune screen was negative. Bone marrow biopsy showed a normocellular marrow with increased eosinophils. A diagnosis of chronic eosinophilic pneumonia (CEP) was made after exclusion of other causes of eosinophilia...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29731926/practical-approach-to-lung-health-experience-from-the-republic-of-macedonia
#2
Biljana Ilievska-Poposka, Maja Zakoska, Stefan Talevski
BACKGROUND: Among the adults and children aged 5 yrs who attend PHC settings, 20-30% seeks to care for respiratory symptoms. Over 80-90% of the respiratory patients suffer from acute respiratory infections (ARI), followed by chronic obstructive pulmonary diseases (COPD), asthma, and less frequently with pneumonia and tuberculosis (TB). To improve the quality of care in patients who seek assistance for respiratory symptoms in PHC settings and the efficiency of respiratory service delivery within healthcare systems, WHO has designated several initiatives among which one is PAL (Practical Approach to Lung Health)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29692381/current-status-of-community-acquired-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease
#3
REVIEW
De-Shun Liu, Xiu-Di Han, Xue-Dong Liu
Objective: Worldwide, community-acquired pneumonia (CAP) is a common infection that occurs in older adults, who may have pulmonary comorbidities, including chronic obstructive pulmonary disease (COPD). Although there have been clinical studies on the coexistence of CAP with COPD, there remain some controversial findings. This review presents the current status of COPD in CAP patients, including the disease burden, clinical characteristics, risk factors, microbial etiology, and antibiotic treatment...
May 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29666203/efficacy-and-safety-of-pulmonary-application-of-corticosteroids-in-preterm-infants-with-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#4
Mahin Delara, Bhupendrasinh F Chauhan, Mê-Linh Le, Ahmed M Abou-Setta, Ryan Zarychanski, Geert W 'tJong
BACKGROUND: Systemic corticosteroids as the frontline treatment of respiratory distress syndrome (RDS) in preterm infants are associated with adverse effects on growth and neurodevelopmental outcome, but the pulmonary administration of steroids may help prevent the development of bronchopulmonary dysplasia (BPD) without these side effects. OBJECTIVES: To evaluate the efficacy and safety of pulmonary application of corticosteroids in preterm infants with RDS. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials...
April 17, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29661670/-community-acquired-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease-treated-with-inhaled-corticosteroids-or-other-bronchodilators-study-pneumocort
#5
Rosa Morros, Cristina Vedia, Maria Giner-Soriano, Aina Casellas, Ester Amado, Jose Miguel Baena
OBJECTIVES: To analyse the risk of pneumonia and/or exacerbations in patients with chronic obstructive pulmonary disease (COPD) who receive treatment with inhaled corticosteroids (CI), in comparison with those who are not treated with inhaled corticosteroids (NCI). To estimate the risk of pneumonia according to CI dose. DESIGN: Population-based cohort study. SETTING: Primary Healthcare. Institut Català de la Salut. PARTICIPANTS: Patients ≥45 years-old diagnosed with COPD between 2007 and 2009 in the Information System for Research in Primary Care (SIDIAP)...
April 13, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29650563/blood-eosinophil-count-and-risk-of-pneumonia-hospitalisations-in-individuals-with-copd
#6
Signe Vedel-Krogh, Børge G Nordestgaard, Peter Lange, Jørgen Vestbo, Sune F Nielsen
Introduction: Blood eosinophil count in COPD is associated with higher exacerbation rate and favorable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could also elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population. Methods: We included 7,180 individuals with COPD, including 643 with FEV1 <50% of the predicted value from the Copenhagen General Population Study, from 2003-2011...
April 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29545274/acute-respiratory-distress-syndrome-in-mechanically-ventilated-patients-with-community-acquired-pneumonia
#7
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition.We prospectively enrolled consecutive mechanically ventilated adult ICU patients with CAP over 20 years, and compared them with mechanically ventilated patients without ARDS. The main outcome was 30-day mortality.Among 5334 patients hospitalised with CAP, 930 (17%) were admitted to the ICU and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29487790/a-case-of-cocaine-induced-eosinophilic-pneumonia-case-report-and-review-of-the-literature
#8
Felix Reyes, Vytas Vaitkus, Mohammad Al-Ajam
Cocaine is a commonly abused recreational drug in the United States. An adult man developed non-specific pleuritic chest pain, pharyngitis and odynophagia after inhaling cocaine. Initial laboratory results revealed eosinophilia. Bronchoalveolar lavage also showed eosinophilia in the lavage fluid. These findings suggested the diagnosis of eosinophilic pneumonia. Chest imaging revealed scattered bilateral opacities and interstitial infiltrates. After initiation of systemic corticosteroids, the patient reported symptomatic resolution and radiographic clearance was achieved at 2 months follow up...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29429593/extrafine-inhaled-triple-therapy-versus-dual-bronchodilator-therapy-in-chronic-obstructive-pulmonary-disease-tribute-a-double-blind-parallel-group-randomised-controlled-trial
#9
Alberto Papi, Jørgen Vestbo, Leonardo Fabbri, Massimo Corradi, Hélène Prunier, Géraldine Cohuet, Alessandro Guasconi, Isabella Montagna, Stefano Vezzoli, Stefano Petruzzelli, Mario Scuri, Nicolas Roche, Dave Singh
BACKGROUND: Evidence is scarce on the relative risk-benefit of inhaled triple therapy, consisting of inhaled corticosteroid, long-acting muscarinic antagonist, and long-acting β2 -agonist, versus dual bronchodilation for chronic obstructive pulmonary disease (COPD). We aimed to compare a single-inhaler triple combination of beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G) versus a single-inhaler dual bronchodilator combination of indacaterol plus glycopyrronium (IND/GLY) in terms of the rate of moderate-to-severe COPD exacerbations over 52 weeks of treatment...
March 17, 2018: Lancet
https://www.readbyqxmd.com/read/29403271/role-of-eosinophils-in-airway-inflammation-of-chronic-obstructive-pulmonary-disease
#10
REVIEW
Donald P Tashkin, Michael E Wechsler
COPD is a significant cause of morbidity and mortality. In some patients with COPD, eosinophils contribute to inflammation that promotes airway obstruction; approximately a third of stable COPD patients have evidence of eosinophilic inflammation. Although the eosinophil threshold associated with clinical relevance in patients with COPD is currently subject to debate, eosinophil counts hold potential as biomarkers to guide therapy. In particular, eosinophil counts may be useful in assessing which patients may benefit from inhaled corticosteroid therapy, particularly regarding exacerbation prevention...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29229103/effect-of-budesonide-formoterol-pressurized-metered-dose-inhaler-on-exacerbations-versus-formoterol-in-chronic-obstructive-pulmonary-disease-the-6-month-randomized-rise-revealing-the-impact-of-symbicort-in-reducing-exacerbations-in-copd-study
#11
Gary T Ferguson, Donald P Tashkin, Tor Skärby, Carin Jorup, Kristina Sandin, Michael Greenwood, Kristine Pemberton, Frank Trudo
BACKGROUND: Prevention of exacerbations is a primary goal for chronic obstructive pulmonary disease (COPD) therapy. This randomized, double-blind, double-dummy, parallel-group, multicenter study evaluated the effect of budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus formoterol dry powder inhaler (DPI) on reducing COPD exacerbations. METHODS: 1219 patients aged ≥40 years with moderate-to-very-severe COPD (per lung function) and a history of ≥1 COPD exacerbation received budesonide/formoterol pMDI 320/9 μg twice daily (BID) during a 4-week run-in...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29206637/effects-of-inhaled-corticosteroids-long-acting-agonists-in-a-single-inhaler-versus-inhaled-corticosteroids-alone-on-all-cause-mortality-pneumonia-and-fracture-in-chronic-obstructive-pulmonary-disease-a-nationwide-cohort-study-2002-2013
#12
Kyoung Hee Cho, Young Sam Kim, John A Linton, Chung Mo Nam, Young Choi, Eun-Cheol Park
BACKGROUND: Both inhaled corticosteroids (ICS) and long-acting ?-agonists (LABA) have been recommended for the treatment of severe/moderate chronic obstructive pulmonary disease (COPD), but mild COPD has not been frequently studied. METHODS: We performed a prospective cohort study to compare the effect of inhaled corticosteroid (ICS) and ICS/long-acting ?-agonist (LABA) in a single inhaler on all-cause mortality and adverse events, such as pneumonia and fracture, in patients with newly diagnosed chronic obstructive pulmonary disease (COPD)...
September 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29183382/a-proposal-for-the-withdrawal-of-inhaled-corticosteroids-in-the-clinical-practice-of-chronic-obstructive-pulmonary-disease
#13
REVIEW
Marc Miravitlles, Borja G Cosío, Aurelio Arnedillo, Myriam Calle, Bernardino Alcázar-Navarrete, Cruz González, Cristóbal Esteban, Juan Antonio Trigueros, José Miguel Rodríguez González-Moro, José Antonio Quintano Jiménez, Adolfo Baloira
According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting β2 agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy.Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations...
November 28, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29120273/triple-therapy-in-copd-what-we-know-and-what-we-don-t
#14
Peter M A Calverley, Helgo Magnussen, Marc Miravitlles, Jadwiga A Wedzicha
Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) consists of an inhaled corticosteroid (ICS), a long-acting β2 -agonist (LABA) and a long-acting muscarinic antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator (preferred initial therapy) or LABA/ICS combination (alternative initial therapy). Although there is evidence for the greater efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate, the efficacy of triple therapy when compared with dual bronchodilation (LABA/LAMA) is as yet unknown...
December 2017: COPD
https://www.readbyqxmd.com/read/29114418/stop-being-so-sensitive-an-exceptionally-rare-report-of-ustekinumab-induced-sub-acute-hypersensitivity-pneumonitis
#15
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29089754/scientific-rationale-for-the-possible-inhaled-corticosteroid-intraclass-difference-in-the-risk-of-pneumonia-in-copd
#16
REVIEW
Christer Janson, Georgios Stratelis, Anna Miller-Larsson, Tim W Harrison, Kjell Larsson
Inhaled corticosteroids (ICSs) treatment combined with long-acting β2 -adrenoceptor agonists (LABAs) reduces the risk of exacerbations in COPD, but the use of ICSs is associated with increased incidence of pneumonia. There are indications that this association is stronger for fluticasone propionate than for budesonide. We have examined systematic reviews assessing the risk of pneumonia associated with fluticasone propionate and budesonide COPD therapy. Compared with placebo or LABAs, we found that fluticasone propionate was associated with 43%-78% increased risk of pneumonia, while only slightly increased risk or no risk was found for budesonide...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29058249/a-2-year-step-down-withdrawal-from-inhaled-corticosteroids-in-asthmatic-children-receiving-immunotherapy
#17
Chun-Hui He, Xing Li, Jun-Hong Lin, Qiang Xiao, Jia-Lu Yu, Ying-Fen Liu, Wen-Hui Jiang, Chen Chen, Li Deng, Jie Zhou
BACKGROUND: Inhaled corticosteroids (ICSs) for treating asthma are controversial because of their negative effects on the growth of asthmatic children and without clearly defined withdrawal strategy. A 2-year ICS step-down and withdrawal strategy has been developed for asthmatic children receiving 3-year subcutaneous immunotherapy (SCIT). METHODS: Eleven children were included into the SCIT group and 13 children into the ICS group. ICSs were discontinued when children met the following criteria: requiring only 1 puffper day, with good control, for at least 6 months; having a forced expiratory volume in 1 second (FEV1 )/forced vital capacity ≥80%; and SCIT discontinued for ≥24 months...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29053714/atopic-asthmatic-immune-phenotypes-associated-with-airway-microbiota-and-airway-obstruction
#18
Benjamin A Turturice, Halvor S McGee, Brian Oliver, Melissa Baraket, Brian T Nguyen, Christian Ascoli, Ravi Ranjan, Asha Rani, David L Perkins, Patricia W Finn
BACKGROUND: Differences in asthma severity may be related to inflammation in the airways. The lower airway microbiota has been associated with clinical features such as airway obstruction, symptom control, and response to corticosteroids. OBJECTIVE: To assess the relationship between local airway inflammation, severity of disease, and the lower airway microbiota in atopic asthmatics. METHODS: A cohort of young adult, atopic asthmatics with intermittent or mild/moderate persistent symptoms (n = 13) were assessed via bronchoscopy, lavage, and spirometry...
2017: PloS One
https://www.readbyqxmd.com/read/29049325/effect-of-therapeutic-interchange-on-medication-reconciliation-during-hospitalization-and-upon-discharge-in-a-geriatric-population
#19
Jessica S Wang, Robert L Fogerty, Leora I Horwitz
BACKGROUND: Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. METHODS AND FINDINGS: Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS)...
2017: PloS One
https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#20
REVIEW
Timothy E Albertson, Susan Murin, Mark E Sutter, James A Chenoweth
The Salford Lung Study (SLS) of patients with asthma and chronic obstructive pulmonary disease (COPD) is a practical, community-based, randomized, open-label pragmatic study on the efficacy and safety of the once-daily dry powder inhaler that combines the inhaled corticosteroid fluticasone furoate (FF) with the long-acting beta2 agonist vilanterol (VI). The asthma component of the SLS is not yet reported but the COPD component, done over a 12-month period, found a statistically significant 8.4% reduction in COPD exacerbations when compared to usual care...
2017: Pragmatic and Observational Research
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