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April 8, 2019: COPD
Danny Epstein, Yuval Barak-Corren, Yoni Isenberg, Gidon Berger
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant mortality, morbidity and increased risk for further exacerbations. Therefore, appropriate measures for prevention of further exacerbations should be initiated before discharge. Unfortunately, this opportunity for treatment review and change in disease course is often missed. We designed a decision support tool to automatically generate discharge recommendations for COPD patients based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report...
April 4, 2019: COPD
Yan Borné, Wafa Ashraf, Suneela Zaigham, Sophia Frantz
The association between socioeconomic circumstances and incidence of chronic obstructive pulmonary disease (COPD) was investigated in an urban population in Sweden. The study included all 40-89 year-old inhabitants in Malmö, Sweden (N = 117,479) without previous hospitalization due to COPD, who were followed over 14 years for COPD related hospital admissions. The Malmö Preventive Project (MPP) cohort (n = 27,358) with information on biological and lifestyle factors was also used to study the association between socioeconomic circumstances and COPD...
March 27, 2019: COPD
Yongzhe Hong, Michelle M Graham, Danielle Southern, Michael Sean McMurtry
Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of morbidity and mortality. There are conflicting results regarding the association between COPD and CAD. We sought to measure the association between COPD and angiographically diagnosed CAD in a population-based cohort. We performed a retrospective analysis using data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), a prospectively collected registry capturing all patients undergoing coronary angiography in Alberta, Canada, since 1995...
March 22, 2019: COPD
Narelle S Cox, Véronique Pepin, Angela T Burge, Catherine J Hill, Annemarie L Lee, Janet Bondarenko, Rosemary Moore, Caroline Nicolson, Aroub Lahham, Zohra Parwanta, Christine F McDonald, Anne E Holland
Abnormal sleep duration is associated with poor health. Upwards of 50% of people with chronic obstructive pulmonary disease (COPD) report poor sleep quality. The effect of pulmonary rehabilitation on self-reported sleep quality is variable. The aim of this study was to assess the effect of pulmonary rehabilitation on objectively measured sleep quality (via actigraphy) in people with COPD. Sleep quality was assessed objectively using the SenseWear Armband (SWA, BodyMedia, Pittsburgh, PA), worn for ≥4 days before and immediately after completing an 8-week pulmonary rehabilitation program...
March 19, 2019: COPD
Pere Almagro, Pablo Martínez-Camblor, Marc Miravitlles, Mónica Rodríguez-Carballeira, Annie Navarro, Bernd Lamprecht, Ana S Ramirez-Garcia Luna, Bernhard Kaiser, Inmaculada Alfageme, Ciro Casanova, Cristobal Esteban, Juan J Soler-Cataluña, Juan P de-Torres, Bartolome R Celli, Jose M Marin, Gerben Ter Riet, Patricia Sobradillo, Peter Lange, Judith Garcia-Aymerich, Josep M Anto, Alice M Turner, MeiLan K Han, Arnulf Langhammer, Alice Sternberg, Linda Leivseth, Per Bakke, Ane Johannessen, Toru Oga, Borja Cosío, Julio Ancochea, Andres Echazarreta, Nicolas Roche, Pierre-Régis Burgel, Don D Sin, Milo A Puhan, Joan B Soriano
The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored...
March 14, 2019: COPD
Guillaume Prieur, Yann Combret, Tristan Bonnevie, Francis-Edouard Gravier, Aurora Robledo Quesada, Jean Quieffin, Bouchra Lamia, Clement Medrinal
We previously showed that functional electrical stimulation during cycle ergometry (FES-cycling) increased oxygen consumption (VO2 ), indicating that metabolism during exercise was increased. However, the effects on muscle oxygenation have never been studied. The aim of this secondary analysis was to analyse changes in muscle oxygenation during an FES-cycling session. Eight patients with chronic obstructive pulmonary disease who were participating in a pulmonary rehabilitation programme were enrolled. Each participant carried out 30 minutes of cycle ergometry with a constant load at 50% of peak oxygen uptake, either (i) with FES or (ii) without (Placebo-FES)...
March 1, 2019: COPD
Tuula Vasankari, Tommi Härkänen, Annette Kainu, Katri Sääksjärvi, Tiina Mattila, Pekka Jousilahti, Tarja Laitinen
In the present study we aimed to investigate the incidence and predictors of spirometry based airway obstruction in a representative population-based sample. Altogether 3,863 subjects, 1,651 males and 2,212 females aged ≥30 years had normal spirometry in year 2000. Fifty-three percent of them were never and 23% current smokers. A re-spirometry was performed 11 years later. Several characteristics, such as level of education, use of alcohol, physical activity, diet using Alternate healthy eating (AHEI) index, body mass index, circumwaist, sensitive C reactive protein (CRP) and cotinine of the laboratory values and co-morbidities including asthma, allergic rhinitis, sleep apnoea and chronic bronchitis, as potential risk factors for airway obstruction were evaluated...
March 1, 2019: COPD
Amanda R Mathew, Miriam Guzman, Cherylee Bridges, Susan Yount, Ravi Kalhan, Brian Hitsman
Telephone quitlines are an effective population-based strategy for smoking cessation, particularly among individuals with tobacco-related diseases such as chronic obstructive pulmonary disease (COPD). Expanding quitline services to provide COPD-focused self-management interventions is potentially beneficial; however, data are needed to identify specific treatment needs in this population. We conducted a telephone-based survey (N = 5,772) to examine educational needs, behavioral health characteristics, and disease-related interference among individuals with COPD who received services from the American Lung Association (ALA) Lung Helpline...
February 21, 2019: COPD
Alexa Nuñez, Mikel Sarasate, Eduardo Loeb, Cristina Esquinas, Marc Miravitlles, Miriam Barrecheguren
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality around the world. COPD is characterised by a heterogeneous clinical presentation and prognosis which may vary according to the clinical phenotype. One of the phenotypes of COPD most frequently studied is the asthma-COPD overlap (ACO), however, there are no universally accepted diagnostic criteria for ACO. It is recognised that the term ACO includes patients with clinical features of both asthma and COPD, such as more intense eosinophilic bronchial inflammation, more severe respiratory symptoms and more frequent exacerbations, but in contrast, it is associated with a better prognosis compared to COPD...
February 21, 2019: COPD
Yoshinori Fuseya, Shigeo Muro, Susumu Sato, Atsuyasu Sato, Kazuya Tanimura, Koichi Hasegawa, Kiyoshi Uemasu, Yoko Hamakawa, Yoshimitsu Takahashi, Takeo Nakayama, Naoki Sakai, Motonari Fukui, Hideo Kita, Tadashi Mio, Michiaki Mishima, Toyohiro Hirai
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. Since patients with severe COPD may experience exacerbations and eventually face mortality, advanced care planning (ACP) has been increasingly emphasized in the recent COPD guidelines. We conducted a multicenter, cross-sectional study to survey the current perspectives of Japanese COPD patients toward ACP. "High-risk" COPD patients and their attending physicians were consecutively recruited. The patients' family configurations, understanding of COPD pathophysiology, current end-of-life care communication with physicians and family members, and preferences for invasive life-sustaining treatments including mechanical ventilation (MV) and cardiopulmonary resuscitation (CPR) were evaluated using a custom-made, structured, self-administered questionnaire...
February 21, 2019: COPD
K Schoovaerts, N Lorent, P Goeminne, S Aliberti, L Dupont
The increasing prevalence and incidence of bronchiectasis leads to a substantial health care burden. Quality standards for the management of bronchiectasis were formulated by the British Thoracic Society following publication of guidelines in 2010. They can be used as a benchmark for quality of care. It is, however, unclear how and whether they apply outside of the UK. Between May and November 2017, we conducted an online survey among respiratory physicians caring for adult bronchiectasis patients in Belgium...
February 21, 2019: COPD
Nicholas Zareifopoulos, Aggeliki Bellou, Agathi Spiropoulou, Kostas Spiropoulos
The disease burden associated with schizophrenia and bipolar disorder is substantial, with affected individuals having a shorter life expectancy and a high risk of severe physical comorbid conditions. These individuals are more likely to smoke and have a longer smoking history compared to the general population. Furthermore, use of antipsychotic drugs has also been linked to active smoking. Chronic obstructive pulmonary disease (COPD) is a respiratory condition affecting elderly individuals with a long smoking history, so it would be expected that individuals suffering from major mental disorders may exhibit a higher prevalence of COPD compared to the general population...
February 4, 2019: COPD
Ashley G Henderson, Wayne H Anderson, Agathe Ceppe, Raymond D Coakley, Brian Button, Neil E Alexis, David B Peden, Eduardo R Lazarowski, C W Davis, Fred Fuller, Martha Almond, Bahjat Qaqish, Mehmet Kesimer, Richard C Boucher
Mucus hydration is important in mucus clearance and lung health. This study sought to test the relative utility of spontaneous sputum (SS) versus the reasonably noninvasive induced sputum (IS) samples for measurement of mucus hydration. SS and IS samples were collected over a 2-day study interval. Sputum was induced with escalating inhaled nebulized 3-5% hypertonic saline. Viscous portions of the samples ("plugs") were utilized for percent solids and total mucin analyses. Cytokines, nucleotides/nucleosides and cell differentials were measured in plugs diluted into 0...
February 4, 2019: COPD
Astrid Blondeel, Heleen Demeyer, Wim Janssens, Thierry Troosters
Pulmonary rehabilitation is an important treatment for patients with chronic obstructive pulmonary disease (COPD). Although this intervention leads to large and clinically meaningful improvements in exercise capacity and quality of life, the effect of pulmonary rehabilitation on physical activity is controversial. Physical activity is lower in patients with COPD as compared to healthy age-matched controls and it is related to important health outcomes (e.g. increased risk of mortality and hospitalization). It is an important goal for rehabilitation programs to enhance physical activity to more normal levels in order to achieve the ultimate goal of rehabilitation 'to improve adherence to health enhancing behaviors'...
February 4, 2019: COPD
Bhagwan Singh Patidar, Anil Meena, Manoj Kumar, Balakrishnan Menon, Vishwajeet Rohil, Surendra Kumar Bansal
Adenosine is a signaling molecule which is produced in high concentrations during airway inflammation. Airway inflammation is a characteristic feature of COPD. Therefore, the current study was designed to evaluate the changes in adenosine metabolism in COPD and correlate these changes with severity of the disease. The study was conducted on 50 healthy controls (25 healthy non-smokers and 25 healthy smokers) and 46 COPD patients (21 moderate, 15 severe and 10 very severe). The patients were sub-divided into moderate, severe and very severe categories as per the GOLD spirometric classification...
January 19, 2019: COPD
L K Teja Boppana, Sateesh Sakhamuri, Terence Seemungal
Globally, mortality, morbidity and the economic burden of chronic obstructive pulmonary disease (COPD) are on the rise. In addition, its diagnosis continues to pose challenges to the physicians, which is compounded further by its new feature "spirometric instability." Based on the findings from the two recent observational studies, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommended repeat spirometry for the individuals with a fixed ratio between 0.6 and 0.8. In this perspective, we discuss the uncertainties and consequences of this critical update in the 2018 GOLD report...
December 30, 2018: COPD
Ana Oliveira, Ana Machado, Alda Marques
Interpreting clinical changes during acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is challenging due to the absence of established minimal detectable (MDD) and important (MID) differences for most respiratory measures. This study established MDD and MID for respiratory measures in outpatients with AECOPD following pharmacological treatment. COPD assessment test (CAT), modified Borg scale (MBS), modified British Medical Research Council (mMRC) questionnaire, peripheral oxygen saturation (SpO2 ), computerised respiratory sounds and forced expiratory volume in one second (FEV1 ) were collected within 24-48 hour of an AECOPD and after 45 days of pharmacological treatment...
December 4, 2018: COPD
Ralf Ewert, Alexander Heine, Tom Bollmann, Annegret Müller-Heinrich, Sven Gläser, Christian F Opitz
While right heart catheterization (RHC) at rest is the gold standard to assess pulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH), the invasive measurement of exercise hemodynamics is less well established in this group. Since exercise hemodynamics are increasingly recognized as important clinical information in patients with PH, our goal was to review the literature in this field to provide a basis for clinical use, further studies, and future recommendations...
December 2018: COPD
Michele Vitacca, Simona Marino, Laura Comini, Linda Fezzardi, Mara Paneroni
Bacterial colonization is a well-known phenomenon in acute care, but scant information is available regarding the rehabilitation setting. We retrospectively analyzed, in COPD patients admitted to a Respiratory Rehabilitative unit in 2010, the number of cultures requested, of positive cultures, and of cultures showing multiple drug resistant (MDR) organisms. We also compared hospital admissions (HA) with versus without positive cultures and with versus without MDR and investigated which baseline variables may predict length of stay (LOS) > 30 days...
December 2018: COPD
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