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Copd exacerbations

Ana Agudo-Tabuenca, José Antonio Gimeno-Orna, Daniel Sáenz-Abad
INTRODUCTION: There are no agreed protocols on hospital management of hyperglycemic decompensation induced by pharmacological doses of glucocorticoids (GCs). The study objective was to assess the efficacy and safety of an insulin therapy protocol specific for patients treated with glucocorticoids (CP) as compared to a general protocol (GP) in diabetes decompensation secondary to glucocorticoids. Materials and methods An experimental study in patients with glucocorticoids-induced decompensated diabetes admitted to a respiratory ward including a non-randomized control group...
March 18, 2019: Endocrinología, Diabetes y Nutrición
Roy T M Sprooten, Gernot G U Rohde, Glenn Lawyer, Wouter T Leijte, Emiel F M Wouters, Frits M E Franssen
BACKGROUND AND OBJECTIVE: Exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with increased in-hospital and short-term mortality. Developing an easy-to-use model to predict adverse outcomes will be useful in daily clinical practice and will facilitate management decisions. We aimed to assess mortality rates and potential predictors for short-term mortality after severe ECOPD. Classification and Regression Tree (CART) model was used to identify predictors of adverse outcome...
March 21, 2019: Respirology: Official Journal of the Asian Pacific Society of Respirology
Clemens Kruse, Brandon Pesek, Megan Anderson, Kacey Brennan, Hilary Comfort
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of death throughout the world. Telemedicine has been utilized for many diseases and its prevalence is increasing in the United States. Telemonitoring of patients with COPD has the potential to help patients manage disease and predict exacerbations. OBJECTIVE: The objective of this review is to evaluate the effectiveness of telemonitoring to manage COPD. Researchers want to determine how telemonitoring has been used to observe COPD and we are hoping this will lead to more research in telemonitoring of this disease...
March 20, 2019: JMIR Medical Informatics
Riad Alharbey, Samir Chatterjee
BACKGROUND: Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients' lives, which leads to physical and psychological limitations. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence...
March 19, 2019: JMIR Formative Research
Erxiang Gao, Chi Zhang, Jianping Wang
Objective: Our objective is to explore the effects of budesonide combined with noninvasive ventilation on procalcitonin (PCT), soluble myeloid cell triggering receptor-1 (sTREM-1), thoracic and lung compliance, humoral immune function, and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type II respiratory failure. Methods: There were 82 patients with AECOPD complicated with type II respiratory failure admitted into our hospital between March, 2016-September, 2017...
2019: Open Medicine (Warsaw, Poland)
Rob Cook, Vaughan Thomas, Rosie Martin
The studyJolliffe D, Greenberg L, Hooper R, Mathyssen C, Rafiq R, de Jongh R, Camargo C, Griffiths C, Janssens W, Martineau A. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 2019. doi:10.1136/thoraxjnl-2018-212092This project was funded by the National Institute for Health Research Health Technology Appraisal programme (project number 13/03/25).To read the full NIHR Signal, go to: https://discover.dc.nihr...
March 18, 2019: BMJ: British Medical Journal
Deviyani M Rao, Della T Phan, Michelle J Choo, Michael R Weaver, Rebecca E Oberley-Deegan, Russell P Bowler, Fabienne Gally
BACKGROUND: Although cigarette smoking (CS) is by far the most important risk factor of chronic obstructive pulmonary disease (COPD), repeated and sustained infections are clearly linked to disease pathogenesis and are responsible for acute inflammatory flares (i.e. COPD exacerbations). We have previously identified Fatty Acid Binding Protein 5 (FABP5) as an important anti-inflammatory protein in primary airway epithelial cells. RESULTS: In this study we found decreased FABP5 mRNA and protein levels in peripheral blood mononuclear cells (PBMCs) of COPD patients, especially among those who reported episodes of COPD exacerbations...
March 15, 2019: Clinical and Translational Medicine
Despo Ierodiakonou, Maria Kampouraki, Ioannis Poulonirakis, Polyvios Papadokostakis, Eleftheria Lintovoi, Dimitris Karanassos, Kyriakos Maltezis, Maria Chorti, Evangelos Petrovitsos, Sofia Dimopoulou, Sam Hamind, Ioannis Gialamas, Polyxeni Athanasiou, Vasiliki Bempi, Irene Lambraki, Ioanna Tsiligianni
BACKGROUND: Frailty is a state of increased vulnerability that has a significant risk of unfavorable outcomes such as increased dependency and/or death, but little is known about frailty in people with chronic obstructive pulmonary disease (COPD). METHOD: We aimed to determine the prevalence of frailty in COPD patients and to identify the associated risk factors. Two hundred fifty-seven COPD patients enrolled from primary care in Greece between 2015 and 2016. Physicians used structured interviews to collect cross-sectional data including demographics, medical history, symptoms and COPD Assessment Tool (CAT) or modified Medical Research Council Dyspnea scale (mMRC) score...
March 15, 2019: BMC Pulmonary Medicine
Dermot Linden, Hong Guo-Parke, Peter V Coyle, Derek Fairley, Danny F McAuley, Clifford C Taggart, Joe Kidney
Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of global mortality. Acute exacerbations of COPD frequently necessitate hospital admission to enable more intensive therapy, incurring significant healthcare costs. COPD exacerbations are also associated with accelerated lung function decline and increased risk of mortality. Until recently, bacterial pathogens were believed to be responsible for the majority of disease exacerbations. However, with the advent of culture-independent molecular diagnostic techniques it is now estimated that viruses are detected during half of all COPD exacerbations and are associated with poorer clinical outcomes...
March 31, 2019: European Respiratory Review: An Official Journal of the European Respiratory Society
Junqiao Chen, David Chun, Milesh Patel, Epson Chiang, Jesse James
BACKGROUND: Clinical data synthesis aims at generating realistic data for healthcare research, system implementation and training. It protects patient confidentiality, deepens our understanding of the complexity in healthcare, and is a promising tool for situations where real world data is difficult to obtain or unnecessary. However, its validity has not been fully examined, and no previous study has validated it from the perspective of healthcare quality, a critical aspect of a healthcare system...
March 14, 2019: BMC Medical Informatics and Decision Making
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
Martine Hoogendoorn, Isaac Corro Ramos, Michael Baldwin, Laura Luciani, Cecile Fabron, Bruno Detournay, Maureen P M H Rutten-van Mölken
Purpose: Combinations of long-acting bronchodilators are recommended to reduce the rate of COPD exacerbations. Evidence from the DYNAGITO trial showed that the fixed-dose combination of tiotropium + olodaterol reduced the annual rate of total exacerbations ( P <0.05) compared with tiotropium monotherapy. This study aimed to estimate the cost-effectiveness of the fixed-dose combination of tiotropium + olodaterol vs tiotropium monotherapy in COPD patients in the French setting. Patients and methods: A recently developed COPD patient-level simulation model was used to simulate the lifetime effects and costs for 15,000 patients receiving either tiotropium + olodaterol or tiotropium monotherapy by applying the reduction in annual exacerbation rate as observed in the DYNAGITO trial...
2019: International Journal of Chronic Obstructive Pulmonary Disease
Noriane A Sievi, Malcolm Kohler, Robert Thurnheer, Joerg D Leuppi, Sarosh Irani, Martin Frey, Martin Brutsche, Thomas Brack, Christian F Clarenbach
Introduction: COPD exacerbations are associated with a concomitant profound reduction in daily physical activity (PA). Thereby, exacerbation frequency and severity may have an amplifying effect. Whether the reduced level of PA returns to the level prior to exacerbation or has a sustained negative impact on activity behavior over time is unclear. Methods: The number of steps per day over 1 week, as a measure of daily PA, was assessed annually in a cohort of patients with COPD...
2019: International Journal of Chronic Obstructive Pulmonary Disease
S Gaduzo, V McGovern, J Roberts, J E Scullion, D Singh
While single-inhaler triple therapy (SITT) devices were not available when the Global Initiative for Chronic Obstructive Lung Disease strategy and National Institute for Health and Care Excellence guidelines were developed, two devices are now available in the UK. This paper offers practical, patient-focused advice to optimize placement of SITT in the management of COPD. A survey of UK health care professionals (HCPs) identified issues around, and attitudes toward, SITT, which informed a multidisciplinary expert panel's discussions...
2019: International Journal of Chronic Obstructive Pulmonary Disease
Renard Xaviero Adhi Pramono, Syed Anas Imtiaz, Esther Rodriguez-Villegas
Chronic Respiratory Diseases (CRDs), such as Asthma and Chronic Obstructive Pulmonary Disease (COPD), are leading causes of deaths worldwide. Although both Asthma and COPD are not curable, they can be managed by close monitoring of symptoms to prevent worsening of the condition. One key symptom that needs to be monitored is the occurrence of wheezing sounds during breathing since its early identification could prevent serious exacerbations. Since wheezing can happen randomly without warning, a long-term monitoring system with automatic wheeze detection could be extremely helpful to manage these respiratory diseases...
2019: PloS One
Young Seok Lee, Kyung Hoon Min, Chin Kook Rhee, Yong Hyun Kim, Seong Yong Lim, Soo-Jung Um, Chang-Hoon Lee, Ki-Suck Jung, Kwang Ha Yoo
PURPOSE: The economic effect of regular follow-up and early management in patients with early chronic obstructive pulmonary disease (COPD) has not yet been clarified. Therefore, this study aimed to estimate the economic effect of regular follow-up and early management in these patients. METHODS: Patients with early COPD were identified from the Korea National Health and Nutrition Examination Survey. We analyzed medical utilization and cost for 2 years without any missing data by using the Korean National Health Insurance data...
March 11, 2019: Lung
N A Karoli, A V Borodkin, A P Rebrov
AIM: To elucidate clinical and diagnostic features of chronic heart failure (CHF) in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: The study included 239 patients with COPD and 42 patients with CHF without COPD. The first subgroup consisted of 60 patients with a history of myocardial infarction (MI) and the second subgroup consisted of 79 patients without a history of MI. A general clinical examination, EchoCG, measurements of N-terminal pro B-type natriuretic peptide (NT-proBNP), galectin 3, and high-sensitivity C-reactive protein (hsCRP) were performed for all patients...
March 7, 2019: Kardiologiia
Marco Proietti, Pasquale Agosti, Chiara Lonati, Salvatore Corrao, Francesco Perticone, Pier Mannuccio Mannucci, Alessandro Nobili, Sergio Harari
OBJECTIVES: We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. DESIGN: Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. SETTING AND PARTICIPANTS: Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD...
March 6, 2019: Journal of the American Medical Directors Association
Dave Singh, Alvar Agusti, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Gerard J Criner, Peter Frith, David M G Halpin, Meilan Han, M Victorina López Varela, Fernando Martinez, Maria Montes de Oca, Alberto Papi, Ian D Pavord, Nicolas Roche, Donald D Sin, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha, Claus Vogelmeier
Precision medicine is a patient specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICS) in COPD patients. Blood eosinophil counts are a biomarker with potential to be used in clinical practice, to help target ICS treatment with more precision in COPD patients with a history of exacerbations despite appropriate bronchodilator treatment...
March 7, 2019: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Renata Rubinsztajn, Tadeusz Przybyłowski, Marta Maskey-Warzęchowska, Krzysztof Karwat, Ryszarda Chazan
BACKGROUND: Testosterone has been recognized for its anabolic properties. It has been documented that in patients with chronic obstructive pulmonary disease (COPD), chronic hypoxia, disease severity, smoking, and corticosteroid treatment may contribute to low testosterone levels. OBJECTIVES: The aim of the study was to evaluate the incidence of decreased serum testosterone concentration in male COPD patients and its influence on their condition. MATERIAL AND METHODS: The study group consisted of 90 male patients, aged 67...
March 6, 2019: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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