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Obstructive lung diseases

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276 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28688465/chronic-obstructive-pulmonary-disease-phenotypes-implications-for-care
#1
REVIEW
Shireen Mirza, Roberto Benzo
Chronic obstructive pulmonary disease (COPD) phenotyping can help define clusters of patients with common characteristics that relate to clinically meaningful outcomes. In this review, we describe 7 clinically meaningful COPD phenotypes that can be identified by primary care physicians as well as specialists and that have specific management and prognostic implications: (1) asthma-COPD overlap phenotype, (2) frequent exacerbator phenotype, (3) upper lobe-predominant emphysema phenotype, (4) rapid decliner phenotype, (5) comorbid COPD phenotype, (6) physical frailty phenotype, and (7) emotional frailty phenotype...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28331347/environmental-triggers-and-avoidance-in-the-management-of-asthma
#2
REVIEW
Clarisse Gautier, Denis Charpin
Identifying asthma triggers forms the basis of environmental secondary prevention. These triggers may be allergenic or nonallergenic. Allergenic triggers include indoor allergens, such as house dust mites (HDMs), molds, pets, cockroaches, and rodents, and outdoor allergens, such as pollens and molds. Clinical observations provide support for the role of HDM exposure as a trigger, although avoidance studies provide conflicting results. Molds and their metabolic products are now considered to be triggers of asthma attacks...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28860828/the-evolving-role-of-tiotropium-in-asthma
#3
REVIEW
Emma R McIvor, R Andrew McIvor
Tiotropium is a long-acting muscarinic antagonist (LAMA) that exerts its bronchodilatory effect by blocking endogenous acetylcholine receptors in the airways. Its safety and efficacy are well established for the treatment of COPD, and it is now being recognized for its role in improving lung function and control in asthma. This review discusses the evolving role of tiotropium delivered by the Respimat(®) in patients across the range of asthma severities and ages, and provides an overview of safety and efficacy data...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28919788/innovative-treatments-for-severe-refractory-asthma-how-to-choose-the-right-option-for-the-right-patient
#4
REVIEW
Francesco Menzella, Carla Galeone, Francesca Bertolini, Claudia Castagnetti, Nicola Facciolongo
The increasing understanding of the molecular biology and the etiopathogenetic mechanisms of asthma helps in identification of numerous phenotypes and endotypes, particularly for severe refractory asthma. For a decade, the only available biologic therapy that met the unmet needs of a specific group of patients with severe uncontrolled allergic asthma has been omalizumab. Recently, new biologic therapies with different mechanisms of action and targets have been approved for marketing, such as mepolizumab. Other promising drugs will be available in the coming years, such as reslizumab, benralizumab, dupilumab and lebrikizumab...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28864055/tracheobronchopathy-from-inhaled-corticosteroids
#5
REVIEW
Bryan C Husta, Suhail Raoof, Serpil Erzurum, Atul C Mehta
Inhaled corticosteroids (ICSs) have become the mainstay of asthma control. They are also recommended as an add-on therapy to long-acting beta agonists and anticholinergics in moderate to severe COPD with recurrent exacerbations. Ultimately this clinical practice has led to the widespread use of ICSs, which are supported by a more favorable side effect profile than that of systemic steroids.
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#6
REVIEW
Klaus F Rabe, Henrik Watz
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease...
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28622013/acetazolamide-use-in-severe-chronic-obstructive-pulmonary-disease-pros-and-cons
#7
Rosemary Adamson, Erik R Swenson
Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving oxygenation, reducing carbon dioxide retention, and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex, because CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28812906/recent-advances-in-ct-imaging-in-chronic-obstructive-pulmonary-disease
#8
Sandeep Bodduluri, Joseph M Reinhardt, Eric A Hoffman, John D Newell, Surya P Bhatt
Lung imaging is increasingly being used to diagnose, quantify and phenotype chronic obstructive pulmonary disease (COPD). Although spirometry is the gold standard for the diagnosis of COPD and for severity staging, the role of computed tomography (CT) imaging has expanded in both clinical practice and research. COPD is a heterogeneous disease with considerable variability in clinical features, radiographic disease, progression and outcomes. Recent studies have examined the utility of CT imaging in enhancing diagnostic certainty, improving phenotyping, predicting disease progression and prognostication, patient selection for intervention, and also in furthering our understanding of the complex pathophysiology of this disease...
August 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28548545/mild-chronic-obstructive-pulmonary-disease-why-spirometry-is-not-sufficient
#9
Amany F Elbehairy, Grace Parraga, Katherine A Webb, J Alberto Neder, Denis E O'Donnell
Chronic obstructive pulmonary disease (COPD) - an inflammatory disease of the airways, alveoli and lung microvasculature - is a leading cause of death worldwide. Smokers with milder airway obstruction constitute the majority of patients with this disease. Many studies have shown increased morbidity, activity-related dyspnea, exercise intolerance and mortality in such patients, compared with age-matched healthy populations. Clinical evaluation of symptomatic smokers with ostensibly mild airway obstruction poses a challenge in clinical practice as spirometry can obscure extensive heterogeneous pathophysiological impairment...
July 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28752776/efficacy-and-safety-of-inhaled-corticosteroids-relative-to-fluticasone-propionate-a-systematic-review-of-randomized-controlled-trials-in-asthma
#10
See-Hwee Yeo, Bhumika Aggarwal, Sumitra Shantakumar, Aruni Mulgirigama, Peter Daley-Yates
Many trials have been published comparing inhaled corticosteroid (ICS) treatments in asthma. However, mixed results necessitate the summarization of available evidence to aid in decision-making. Areas covered: This systematic review evaluated randomized controlled trials (RCTs) that compared the efficacy and safety of inhaled fluticasone propionate (FP) with other ICS including beclomethasone dipropionate (BDP), budesonide (BUD) and ciclesonide (CIC). PubMed was searched and 54 RCTs that fit pre-determined criteria were included...
August 4, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28591866/effectiveness-of-influenza-vaccines-in-asthma-a-systematic-review-and-meta-analysis
#11
Eleftheria Vasileiou, Aziz Sheikh, Chris Butler, Karim El Ferkh, Beatrix von Wissmann, Jim McMenamin, Lewis Ritchie, Jürgen Schwarze, Nikolaos G Papadopoulos, Sebastian L Johnston, Lilly Tian, Colin R Simpson
There is uncertainty about the effectiveness of influenza vaccination in persons with asthma and its impact on asthma outcomes, which may contribute to the suboptimal vaccination rates in persons with asthma. This systematic review and meta-analysis involved searching 12 international databases for randomized controlled trials (RCTs) and high-quality quasi-experimental and epidemiological studies (1970-2016). The risk of bias was low for 3 included RCTs. The quality of 3 included observational studies was moderate...
October 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28776330/multidimensional-assessment-of-severe-asthma-a-systematic-review-and-meta-analysis
#12
REVIEW
Vanessa L Clark, Peter G Gibson, Grayson Genn, Sarah A Hiles, Ian D Pavord, Vanessa M McDonald
The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries)...
October 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28561247/asthma-during-pregnancy-exacerbations-management-and-health-outcomes-for-mother-and-infant
#13
Vanessa E Murphy, Megan E Jensen, Peter G Gibson
One in 10 pregnant women worldwide has asthma and of these, 10% will have a severe exacerbation requiring oral corticosteroids (OCSs) in pregnancy. This review of recent publications in the field will describe the effects of exacerbation on maternal and neonatal health, the use of asthma medications during pregnancy, and will suggest novel management approaches for asthma in pregnancy. Pregnancy results in unpredictable changes in the disease; therefore, regular monitoring of symptoms is recommended. Uncontrolled asthma is frequently described in cohorts of pregnant women with asthma, and some recent studies show associations with adverse perinatal outcomes, as previously demonstrated with exacerbations...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28169105/current-evidence-on-prevalence-and-clinical-outcomes-of-co-morbid-obstructive-sleep-apnea-and-chronic-obstructive-pulmonary-disease-a-systematic-review
#14
REVIEW
Md Shajedur R Shawon, Jennifer L Perret, Chamara V Senaratna, Caroline Lodge, Garun S Hamilton, Shyamali C Dharmage
The objective of this systematic review is to synthesize the evidence on prevalence, polysomnographic findings and clinical outcomes of co-morbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) - known as the "overlap syndrome". We systematically searched PubMed on 1 December 2015 using appropriate medical subject headings (MeSH) and text words to capture prevalence studies and comparative studies of any observational design examining the clinical outcomes in patients with co-existent COPD and OSA...
April 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28030992/macrolides-a-promising-pharmacologic-therapy-for-chronic-obstructive-pulmonary-disease
#15
REVIEW
Shilin Qiu, Xiaoning Zhong
Chronic inflammation plays a central role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, there are no effective anti-inflammatory pharmacologic therapies available for COPD so far. Recent evidence suggests that an immunologic mechanism has a role in the pathogenesis of COPD. Macrolides possess anti-inflammatory and immune-modulating effects may be helpful in the treatment of COPD. Several clinical studies have shown that long-term use of macrolides reduces the frequency of COPD exacerbations...
March 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28683596/reslizumab-in-the-treatment-of-inadequately-controlled-asthma-in-adults-and-adolescents-with-elevated-blood-eosinophils-clinical-trial-evidence-and-future-prospects
#16
Jorge Máspero
Eosinophils have long been implicated as playing a central role in the pathophysiology of asthma in many patients, and eosinophilic asthma is now recognized as an important asthma endotype. Eosinophil differentiation, maturation, migration, and survival are primarily under the control of interleukin-5 (IL-5). Reslizumab is a humanized monoclonal (immunoglobulin G4/κ) antibody that binds with high affinity to circulating human IL-5 and downregulates the IL-5 signaling pathway, potentially disrupting the maturation and survival of eosinophils...
July 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28687678/occupational-exposure-to-pesticides-are-associated-with-fixed-airflow-obstruction-in-middle-age
#17
Sheikh M Alif, Shyamali C Dharmage, Geza Benke, Martine Dennekamp, John A Burgess, Jennifer L Perret, Caroline J Lodge, Stephen Morrison, David Peter Johns, Graham G Giles, Lyle C Gurrin, Paul S Thomas, John Llewelyn Hopper, Richard Wood-Baker, Bruce R Thompson, Iain H Feather, Roel Vermeulen, Hans Kromhout, E Haydn Walters, Michael J Abramson, Melanie Claire Matheson
RATIONALE: Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD. OBJECTIVES: To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry...
July 7, 2017: Thorax
https://www.readbyqxmd.com/read/28416951/spirometry-and-bronchodilator-test
#18
REVIEW
Yun Su Sim, Ji-Hyun Lee, Won-Yeon Lee, Dong In Suh, Yeon-Mok Oh, Jong-Seo Yoon, Jin Hwa Lee, Jae Hwa Cho, Cheol Seok Kwon, Jung Hyun Chang
Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28583618/new-anti-eosinophil-drugs-for-asthma-and%C3%A2-copd-targeting-the-trait
#19
REVIEW
Elisabeth H Bel, Anneke Ten Brinke
Asthma and COPD are prevalent chronic inflammatory airway diseases that are responsible for a large global disease burden. Both diseases are complex and heterogeneous, and they are increasingly recognized as overlapping syndromes that may share similar pathophysiologic mechanisms and treatable traits. Eosinophilic airway inflammation is considered the most influential treatable trait of chronic airway disease, and over the last decade, several monoclonal antibodies and small molecule therapies have been developed to target this trait...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28716642/long-term-use-of-inhaled-corticosteroids-in-copd-and-the-risk-of-fracture
#20
Anne V Gonzalez, Janie Coulombe, Pierre Ernst, Samy Suissa
BACKGROUND: It is uncertain whether long-term use of inhaled corticosteroids (ICSs), widely used to treat COPD, increases the risk of fracture, particularly in women, in view of the postmenopausal risks. We assessed whether long-term ICS use in patients with COPD increases the risk of hip or upper extremity fractures, and examined sex-related differences. METHODS: The Quebec health-care databases were used to form a cohort of patients with COPD over 1990 to 2005, followed until 2007 for the first hip or upper extremity fracture...
July 14, 2017: Chest
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