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Acute exacerbation of chronic obstructive lung disease

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https://www.readbyqxmd.com/read/28506728/-the-effects-of-inhaled-steroids-withdrawal-in-copd
#1
G Jebrak, I Honore, P Serrier, J Dumoulin, P Terrioux, F Soyez, C Maurer, G Mangiapan, M Febvre, L-J Couderc, J-M Braun, T Chinet
The key pathophysiological feature of chronic obstructive pulmonary disease (COPD) is an abnormal inflammatory bronchial reaction after inhalation of toxic substances. The priority is the avoidance of such toxic inhalations, but the use of anti-inflammatory drugs also seems appropriate, especially corticosteroids that are the sole anti-inflammatory drug available for this purpose in France. The risks associated with the prolonged use of these parenteral drugs are well known. Inhalation is therefore the optimal route, but inhaled drugs may also lead to adverse consequences...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28502841/use-of-airway-epithelial-cell-culture-to-unravel-the-pathogenesis-and-study-treatment-in-obstructive-airway-diseases
#2
REVIEW
Tinne C J Mertens, Harry Karmouty-Quintana, Christian Taube, Pieter S Hiemstra
Asthma and chronic obstructive pulmonary disease (COPD) are considered as two distinct obstructive diseases. Both chronic diseases share a component of airway epithelial dysfunction. The airway epithelium is localized to deal with inhaled substances, and functions as a barrier preventing penetration of such substances into the body. In addition, the epithelium is involved in the regulation of both innate and adaptive immune responses following inhalation of particles, allergens and pathogens. Through triggering and inducing immune responses, airway epithelial cells contribute to the pathogenesis of both asthma and COPD...
May 11, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28483402/doxycycline-for-outpatient-treated-acute-exacerbations-of-copd-a-randomised-double-blind-placebo-controlled-trial
#3
Patricia van Velzen, Gerben Ter Riet, Paul Bresser, Jeroen J Baars, Bob T J van den Berg, Jan W K van den Berg, Paul Brinkman, Jennece W F Dagelet, Johannes M A Daniels, Dewi R G L Groeneveld-Tjiong, René E Jonkers, Coen van Kan, Frans H Krouwels, Karin Pool, Arjan Rudolphus, Peter J Sterk, Jan M Prins
BACKGROUND: Antibiotics do not reduce mortality or short-term treatment non-response in patients receiving treatment for acute exacerbations of COPD in an outpatient setting. However, the long-term effects of antibiotics are unknown. The aim of this study was to investigate if the antibiotic doxycycline added to the oral corticosteroid prednisolone prolongs time to next exacerbation in patients with COPD receiving treatment for an exacerbation in the outpatient setting. METHODS: In this randomised double-blind placebo-controlled trial, we recruited a cohort of patients with COPD from outpatient clinics of nine teaching hospitals and three primary care centres in the Netherlands...
May 5, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28468623/acute-cigarette-smoke-exposure-activates-apoptotic-and-inflammatory-programs-but-a-second-stimulus-is-required-to-induce-epithelial-to-mesenchymal-transition-in-copd-epithelium
#4
Lynne A Murray, Rebecca Dunmore, Ana Camelo, Carla A Da Silva, Malin J Gustavsson, David M Habiel, Tillie L Hackett, Cory M Hogaboam, Matthew A Sleeman, Darryl A Knight
BACKGROUND: Smoking and aberrant epithelial responses are risk factors for lung cancer as well as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. In these conditions, disease progression is associated with epithelial damage and fragility, airway remodelling and sub-epithelial fibrosis. The aim of this study was to assess the acute effects of cigarette smoke on epithelial cell phenotype and pro-fibrotic responses in vitro and in vivo. RESULTS: Apoptosis was significantly greater in unstimulated cells from COPD patients compared to control, but proliferation and CXCL8 release were not different...
May 3, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28459622/respiratory-symptoms-items-from-the-copd-assessment-test-identify-ever-smokers-with-preserved-lung-function-at-higher-risk-for-poor-respiratory-outcomes-an-analysis-of-the-subpopulations-and-intermediate-outcome-measures-in-copd-study-cohort
#5
Carlos H Martinez, Susan Murray, R Graham Barr, Eugene Bleecker, Russell P Bowler, Stephanie A Christenson, Alejandro P Comellas, Christopher B Cooper, David Couper, Gerard J Criner, Jeffrey L Curtis, Mark T Dransfield, Nadia N Hansel, Eric A Hoffman, Richard E Kanner, Eric Kleerup, Jerry A Krishnan, Stephen C Lazarus, Nancy K Leidy, Wanda O'Neal, Fernando J Martinez, Robert Paine, Stephen I Rennard, Donald P Tashkin, Prescott G Woodruff, MeiLan K Han
RATIONALE: Ever-smokers without airflow obstruction scores greater than or equal to 10 on the COPD Assessment Test (CAT) still have frequent acute respiratory disease events (exacerbation-like), impaired exercise capacity, and imaging abnormalities. Identification of these subjects could provide new opportunities for targeted interventions. OBJECTIVES: We hypothesized that the four respiratory-related items of the CAT might be useful for identifying such individuals, with discriminative ability similar to CAT, which is an eight-item questionnaire used to assess chronic obstructive pulmonary disease impact, including nonrespiratory questions, with scores ranging from 0 to 40...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28435245/long-term-effects-of-beta-blocker-use-on-lung-function-in-japanese-patients-with-chronic-obstructive-pulmonary-disease
#6
Naohiro Oda, Nobuaki Miyahara, Hirohisa Ichikawa, Yasushi Tanimoto, Kazuhiro Kajimoto, Makoto Sakugawa, Haruyuki Kawai, Akihiko Taniguchi, Daisuke Morichika, Mitsune Tanimoto, Arihiko Kanehiro, Katsuyuki Kiura
BACKGROUND: Some recent studies have suggested that beta-blocker use in patients with chronic obstructive pulmonary disease (COPD) is associated with a reduction in the frequency of acute exacerbations. However, the long-term effects of beta-blocker use on lung function of COPD patients have hardly been evaluated. PATIENTS AND METHODS: We retrospectively reviewed 31 Japanese COPD patients taking beta-blockers for >1 year and 72 patients not taking them. The association between beta-blocker use and the annual change in forced expiratory volume in 1 second (FEV1) was assessed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#7
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28417478/point-of-care-lung-sonography-an-audit-of-1150-examinations
#8
Giuseppe Francesco Sferrazza Papa, Michele Mondoni, Giovanni Volpicelli, Paolo Carlucci, Fabiano Di Marco, Elena Maria Parazzini, Francesca Reali, Giulia Michela Pellegrino, Paola Fracasso, Simone Sferrazza Papa, Livio Colombo, Stefano Centanni
OBJECTIVES: Point-of-care lung sonography has theoretical usefulness in numerous diseases; however clinical indications and the impact of this technique have not been fully investigated. We aimed to describe the current use of point-of-care lung sonography. METHODS: A 2-year prospective observational study was performed by pulmonologists in an Italian university hospital. Techniques, indications, consequences of lung sonography, and barriers to the examination were analyzed...
April 18, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28416970/dna-methylation-profiling-in-peripheral-lung-tissues-of-smokers-and-patients-with-copd
#9
Isaac K Sundar, Qiangzong Yin, Brian S Baier, Li Yan, Witold Mazur, Dongmei Li, Martha Susiarjo, Irfan Rahman
BACKGROUND: Epigenetics changes have been shown to be affected by cigarette smoking. Cigarette smoke (CS)-mediated DNA methylation can potentially affect several cellular and pathophysiological processes, acute exacerbations, and comorbidity in the lungs of patients with chronic obstructive pulmonary disease (COPD). We sought to determine whether genome-wide lung DNA methylation profiles of smokers and patients with COPD were significantly different from non-smokers. We isolated DNA from parenchymal lung tissues of patients including eight lifelong non-smokers, eight current smokers, and eight patients with COPD and analyzed the samples using Illumina's Infinium HumanMethylation450 BeadChip...
2017: Clinical Epigenetics
https://www.readbyqxmd.com/read/28416930/what-are-the-prevalence-of-abdominal-aortic-aneurysm-in-patients-with-chronic-obstructive-pulmonary-diseases-and-the-characteristics-of-these-patients
#10
Ulku Aka Akturk, Nagihan Durmus Kocak, Suleyman Akturk, Mert Dumantepe, Aysun Sengul, Mehmet Arif Akcay, Makbule Ozlem Akbay, Feyyaz Kabadayi, Dilek Ernam
OBJECTIVE: To determine the prevalence of abdominal aortic aneurysm (AAA) in patients with chronic obstructive pulmonary disease (COPD) and to assess the characteristics of these patients. MATERIALS AND METHODS: Stable COPD patients (age, >40 years) were included in the study between January 2014 and June 2014. Patients with acute exacerbations and a previous lung resection were excluded. Data regarding demographic characteristics were recorded. The modified Medical Research Council (mMRC) dyspnea scale was used to assess the severity of breathlessness...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28396131/effectiveness-of-a-simple-intervention-on-management-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-and-its-cardiovascular-comorbidities-corepoc-study
#11
Jesús Díez-Manglano, Jesús Recio Iglesias, José Manuel Varela Aguilar, Pere Almagro Mena, Gabriel Zubillaga Garmendia
BACKGROUND AND OBJECTIVE: To determine the effectiveness of a simple educational intervention to improve the management of cardiovascular comorbidities in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Multicenter study participated in by 26 hospital centers. A panel of experts elaborated a set of recommendations about diagnostic and therapeutic management of acute exacerbation of COPD and cardiovascular comorbidities (coronary artery disease, atrial fibrillation, heart failure and diabetes)...
April 7, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28372712/outpatient-management-for-acute-exacerbations-of-obstructive-lung-diseases
#12
REVIEW
Brenda Marsh, Matthew G Drake
Primary care providers tasked with treating acute exacerbations of asthma and chronic obstructive pulmonary disease must be able to recognize exacerbation of symptoms and triage patients based on exacerbation severity to the appropriate level of care. Early treatment with bronchodilators and corticosteroids should be followed by repeated assessments of treatment efficacy. Primary care providers should also provide symptom-guided action plans to empower patients to manage their disease.
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28363903/ifn-regulatory-factor-3-potentiates-emphysematous-aggravation-by-lipopolysaccharide
#13
Takashi Ishii, Keisuke Hosoki, Yuichi Nikura, Naohide Yamashita, Takahide Nagase, Naomi Yamashita
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is often induced by infection and often has a poor prognosis. Bacterial LPS activates innate immune receptor TLR4 followed by activation of a transcriptional factor IFN regulatory factor-3 (IRF3) as well as NF-κB, resulting in upregulation of various inflammatory mediators. To clarify the role of IRF3 in the pathogenesis of LPS-triggered COPD exacerbation, porcine pancreatic elastase (PPE) followed by LPS was administered intranasally to wild-type (WT) or IRF3(-/-) male mice...
May 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28349353/management-of-chronic-obstructive-pulmonary-disease-in-patients-with-cardiovascular-diseases
#14
REVIEW
Mario Cazzola, Luigino Calzetta, Barbara Rinaldi, Clive Page, Giuseppe Rosano, Paola Rogliani, Maria Gabriella Matera
Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases often coexist. The mechanistic links between these two diseases are complex, multifactorial and not entirely understood, but they can influence the therapeutic approach. Therapy can be primarily directed towards treating the respiratory symptoms and reducing lung inflammation. Smoking cessation, bronchodilators and inhaled corticosteroids are central to this therapeutic approach. The underlying pathophysiological mechanisms that are responsible for the increased cardiovascular risk in COPD remain unclear, but might include arterial stiffness, inflammation and endothelial dysfunction as a consequence of systemic exposure to chemicals in cigarette smoke or airborne pollution...
May 2017: Drugs
https://www.readbyqxmd.com/read/28331305/colds-as-predictors-of-the-onset-and-severity-of-copd-exacerbations
#15
Neil W Johnston, Marita Olsson, Staffan Edsbäcker, Maria Gerhardsson de Verdier, Per Gustafson, Christopher McCrae, Peter V Coyle, R Andrew McIvor
RATIONALE: Common colds are associated with acute respiratory symptom exacerbations in COPD patients. OBJECTIVE: To determine exacerbation risk and severity in COPD patients with/without coincident self-reported colds. METHODS: Global initiative for chronic Obstructive Lung Disease stage I-IV COPD patients electronically transmitted respiratory symptom diaries to research staff daily between December 2006 and April 2009. Respiratory symptom worsening prompted contact by a study nurse and patient assessment to determine if a cold was present or an exacerbation underway...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28265524/relationship-between-severity-classification-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-clinical-outcomes-in-hospitalized-patients
#16
Pedro J Marcos, Pilar Sanjuán, Arturo Huerta, Irene Nieto-Codesido, Lucía Ferreira-Gonzalez, Oriol Sibila, Marcos I Restrepo
BACKGROUND: Limited data are available regarding the impact of the potential validation of the Canadian Thoracic Society (CTS) guidelines recommendations in classifying patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in simple and complex. The aim of the present study was to assess the CTS recommendations regarding risk stratification on clinical outcomes among patients hospitalized with an AECOPD. METHODS: We developed a retrospective cohort study of patients admitted to one tertiary hospital with a diagnosis of AECOPD...
January 22, 2017: Curēus
https://www.readbyqxmd.com/read/28260256/lung-ultrasound-b-lines-in-exacerbations-of-chronic-obstructive-pulmonary-disease
#17
Krishna B Sriram, Maninder Singh
We report on preliminary observations on performing lung ultrasound (LUS) in patients admitted to hospital with an exacerbation of chronic obstructive pulmonary disease (COPD). We found that LUS had high specificity and moderate sensitivity in identifying patients with elevated B-type natriuretic peptide. Thus, we hypothesise that LUS may have utility in screening COPD patients with an exacerbation to identify the sub-group with elevated natriuretic peptides and are at risk of increased cardiovascular mortality...
March 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28255962/bringing-stability-to-the-chronic-obstructive-pulmonary-disease-patient-clinical-and-pharmacological-considerations-for-frequent-exacerbators
#18
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...
April 2017: Drugs
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
#19
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...
June 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#20
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
April 2017: Drugs & Aging
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