Latest & greatest articles for copd

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Top results for copd

101. Living with COPD: the struggle for breath and for lung volume reduction therapies Full Text available with Trip Pro

Living with COPD: the struggle for breath and for lung volume reduction therapies Access to lung volume reduction for advanced emphysema http://ow.ly/Iqru30jbvbE.

2018 ERJ open research

102. Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD. Full Text available with Trip Pro

Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD. The benefits of triple therapy for chronic obstructive pulmonary disease (COPD) with an inhaled glucocorticoid, a long-acting muscarinic antagonist (LAMA), and a long-acting β2-agonist (LABA), as compared with dual therapy (either inhaled glucocorticoid-LABA or LAMA-LABA), are uncertain.In this randomized trial involving 10,355 patients with COPD, we compared 52 weeks of a once-daily combination of fluticasone furoate (...) (an inhaled glucocorticoid) at a dose of 100 μg, umeclidinium (a LAMA) at a dose of 62.5 μg, and vilanterol (a LABA) at a dose of 25 μg (triple therapy) with fluticasone furoate-vilanterol (at doses of 100 μg and 25 μg, respectively) and umeclidinium-vilanterol (at doses of 62.5 μg and 25 μg, respectively). Each regimen was administered in a single Ellipta inhaler. The primary outcome was the annual rate of moderate or severe COPD exacerbations during treatment.The rate of moderate or severe exacerbations

2018 NEJM Controlled trial quality: predicted high

103. CRACKCast E169 – Paediatric Respiratory Emergencies: Lower Airway Obstruction

) significant atelectasis on the chest radiograph (when obtained). history of hemodynamically significant congenital heart disease, chronic lung disease, and immunocompromised state have been associated with higher morbidity and mortality among inpatients. [16] List potential complications of RSV. Apnea Respiratory failure Dehydration Hospitalization Secondary bacterial infection (otitis media, UTI, bacteremia, meningitis) Over investigation and overtreatment with antibiotics Wisecracks [1] What’s (...) CRACKCast E169 – Paediatric Respiratory Emergencies: Lower Airway Obstruction CRACKCast E169 - Paediatric Respiratory Emergencies: Lower Airway Obstruction - CanadiEM CRACKCast E169 – Paediatric Respiratory Emergencies: Lower Airway Obstruction In , , by Adam Thomas April 12, 2018 This episode of CRACKCast covers Rosen’s Chapter 168 (9th Ed.). Respiratory presentations are very common in kids, and you will be a pro at managing lower respiratory obstruction after listening to this episode

2018 CandiEM

104. CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections

of variable pitch caused by partial airway obstruction or collapse and the resultant turbulent airflow through some portion of the airway, from the nose to the trachea. Stridor is described by timing in the respiratory cycle (inspiratory, expiratory, biphasic) and quality (coarse or high-pitched). Inspiratory = pathology above the glottis Biphasic = pathology at the glottis Expiratory = pathology below the glottis I before E. (see figure 167.2 in R osens) [2] Provide a differential diagnosis for stridor (...) CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections - CanadiEM CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections In , , by Adam Thomas April 9, 2018 This episode of CRACKCast Covers Rosen’s Chapter 167, Pediatric Upper Airway Emergencies. Stridor is a very common presentation and this episode will help out with diagnosis

2018 CandiEM

105. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. (Abstract)

in a nationally representative sample of adults aged 20 years or older from ten provinces, autonomous regions, and municipalities in mainland China. All participants underwent a post-bronchodilator pulmonary function test. COPD was diagnosed according to 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.Between June, 2012, and May, 2015, 57 779 individuals were invited to participate, of whom 50 991 (21 446 men and 29 545 women) had reliable post-bronchodilator results and were (...) Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Although exposure to cigarette smoking and air pollution is common, the current prevalence of chronic obstructive pulmonary disease (COPD) is unknown in the Chinese adult population. We conducted the China Pulmonary Health (CPH) study to assess the prevalence and risk factors of COPD in China.The CPH study is a cross-sectional study

2018 Lancet

106. Noninvasive ventilation in stable hypercapnic COPD: what is the evidence? Full Text available with Trip Pro

Noninvasive ventilation in stable hypercapnic COPD: what is the evidence? Long-term noninvasive ventilation (NIV) to treat chronic hypercapnic respiratory failure is still controversial in severe chronic obstructive pulmonary disease (COPD) patients. However, with the introduction of high-intensity NIV, important benefits from this therapy have also been shown in COPD. In this review, the focus will be on the arguments for long-term NIV at home in patients with COPD. The rise of (high-intensity (...) ) NIV in COPD and the randomised controlled trials showing positive effects with this mode of ventilation will be discussed. Finally, the challenges that might be encountered (both in clinical practice and in research) in further optimising this therapy, monitoring and following patients, and selecting the patients who might benefit most will be reviewed.

2018 ERJ open research

107. Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD(+)): a randomised controlled trial Full Text available with Trip Pro

Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD(+)): a randomised controlled trial We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety (...) and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups). We used zero-inflated Poisson models to examine emergency department visits and hospitalisation; Cox proportional hazard model for mortality.We randomised 470 participants (236 intervention, 234 control

2018 EvidenceUpdates

108. Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: controlled randomised trial Full Text available with Trip Pro

Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: controlled randomised trial The benefit of inspiratory muscle training (IMT) combined with a pulmonary rehabilitation programme (PRP) is uncertain. We aimed to demonstrate that, in severe and very severe chronic obstructive pulmonary disease (COPD) patients, IMT performed during a PRP is associated with an improvement of dyspnoea.In a single-blind randomised controlled trial, 150 severe (...) or very severe COPD patients were allocated to follow PRP+IMT versus PRP alone. The evaluations were performed at inclusion and after 4 weeks. The primary outcome was the change in dyspnoea using the Multidimensional Dyspnoea Profile questionnaire at the end of a 6-min walk test (6MWT) at 4 weeks. Secondary outcomes were changes in dyspnoea using the Borg (end of the 6MWT) and modified Medical Research Council scales and in functional parameters (maximal inspiratory pressure (PImax), inspiratory

2018 EvidenceUpdates

109. Chronic Obstructive Pulmonary Disease in Sweden: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy Full Text available with Trip Pro

Chronic Obstructive Pulmonary Disease in Sweden: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy Socioeconomic, ethnic and gender disparities in Chronic Obstructive Pulmonary Disease (COPD) risk are well established but no studies have applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) within an intersectional framework to study this outcome. We study individuals at the first level of analysis (...) and combinations of multiple social and demographic categorizations (i.e., intersectional strata) at the second level of analysis. Here we used MAIHDA to assess to what extent individual differences in the propensity of developing COPD are at the intersectional strata level. We also used MAIHDA to determine the degree of similarity in COPD incidence of individuals in the same intersectional stratum. This leads to an improved understanding of risk heterogeneity and of the social dynamics driving socioeconomic

2018 SSM - population health

110. The nurse′s challenge of caring for patients with chronic obstructive pulmonary disease in primary health care Full Text available with Trip Pro

The nurse′s challenge of caring for patients with chronic obstructive pulmonary disease in primary health care The aim was to describe asthma and chronic obstructive pulmonary disease nurses' experiences of caring for patients with chronic obstructive pulmonary disease in primary health care.Descriptive qualitative research.Ten asthma and chronic obstructive pulmonary disease specialized nurses were interviewed. Systematic Text Condensation by Malterud was used to analyse the data.Two main (...) categories were found: the patient-nurse relationship and available resources. Several challenges emerged when connecting with patients and the nurses found it difficult to individualize care. They struggled with a lack of time and support from other professionals. Being responsible for asthma and chronic obstructive pulmonary disease practice was experienced as positive, but could become overwhelming. The asthma and chronic obstructive pulmonary disease nurses described several challenges and the need

2018 Nursing open

111. COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD Full Text available with Trip Pro

at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned all-cause hospitalisation days in the intention-to-treat (ITT) population. Secondary end-points included acute care hospitalisation days, BODE (body mass index, airflow obstruction, dyspnoea and exercise) index and exacerbations. Safety end-points included adverse events and deaths.For the 157 (disease (...) COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices

2018 EvidenceUpdates

112. Fluticasone Furoate, Vilanterol, and Lung Function Decline in Patients with Moderate Chronic Obstructive Pulmonary Disease and Heightened Cardiovascular Risk Full Text available with Trip Pro

Fluticasone Furoate, Vilanterol, and Lung Function Decline in Patients with Moderate Chronic Obstructive Pulmonary Disease and Heightened Cardiovascular Risk Many patients with chronic obstructive pulmonary disease (COPD) have an accelerated loss of lung function. It is unclear whether drug treatment can modify this in patients with moderately severe disease.In a prespecified analysis of the key secondary outcome in SUMMIT (Study to Understand Mortality and Morbidity), we investigated whether (...) the inhaled corticosteroid fluticasone furoate (FF; 100 μg), the long-acting β-agonist vilanterol (VI; 25 μg), or their combination (FF/VI) modified the rate of decline in FEV1 compared with placebo. We also investigated how baseline covariates affected this decline.Spirometry was measured every 12 weeks in this event-driven, randomized, placebo-controlled trial of 16,485 patients with moderate COPD and heightened cardiovascular risk. An average of seven spirometric assessments per subject among

2018 EvidenceUpdates

113. Dapagliflozin for prednisone-induced hyperglycaemia in acute exacerbation of chronic obstructive pulmonary disease Full Text available with Trip Pro

Dapagliflozin for prednisone-induced hyperglycaemia in acute exacerbation of chronic obstructive pulmonary disease The aim of the present study was to compare the effectiveness and safety of add-on treatment with dapagliflozin to placebo in patients with prednisone-induced hyperglycaemia during treatment for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We enrolled 46 patients hospitalized for an AECOPD in a multicentre double-blind randomized controlled study in which

2018 EvidenceUpdates

114. Long-term Use of Inhaled Corticosteroids in COPD and the Risk of Fracture (Abstract)

Long-term Use of Inhaled Corticosteroids in COPD and the Risk of Fracture 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.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. In a nested case-control analysis, each case of fracture was matched with 20 control subjects on age, sex, and follow-up time. The adjusted rate ratio (RR) of fracture with ICS use, by duration and dose, was estimated using conditional logistic regression, with an interaction term to compare the risk in men and women.In the cohort of 240,110 subjects, 19,396 sustained a fracture during a mean 5.3 years (rate

2018 EvidenceUpdates

115. Management of chronic obstructive pulmonary disease exacerbations at the Nasser Medical Complex: a clinical audit. Full Text available with Trip Pro

Management of chronic obstructive pulmonary disease exacerbations at the Nasser Medical Complex: a clinical audit. The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung (...) Disease guidelines (GOLD 2015).We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016. Clinical practice was compared with GOLD guidelines. Ethical approval was obtained from the General Directorate of Human Resources.55 patient records were reviewed. The mean age was 66·4 years (SD 8·5), and 54 (98%) patients were male. All patients received inhaled bronchodilators. 36 (65%) patients received short

2018 Lancet

116. COPD: time to improve its taxonomy? Full Text available with Trip Pro

COPD: time to improve its taxonomy? Due to well-conducted epidemiological studies and advances in genetics, molecular biology, translational research, the advent of computed tomography of the lungs and bioinformatics, the diagnosis of chronic obstructive pulmonary disease (COPD) as a single entity caused by susceptibility to cigarette smoke is no longer tenable. Furthermore, the once-accepted concept that COPD results from a rapid and progressive loss of lung function over time is not true (...) for a sizeable proportion of adults with the disease. Now we know that some genetic predisposition and/or different environmental interactions (nutritional, infectious, pollution and immunological) may negatively modulate post-natal lung development and lead to poorly reversible airflow limitation later in life, consistent with COPD. We believe it is time to rethink the taxonomy of this disease based on the evidence at hand. To do so, we have followed the principles outlined in the 1980s by J.D. Scadding who

2018 ERJ open research

117. Do-not-resuscitate orders as part of advance care planning in patients with COPD Full Text available with Trip Pro

Do-not-resuscitate orders as part of advance care planning in patients with COPD There is growing awareness of the need for advance care planning in patients with chronic obstructive pulmonary disease (COPD). However, do-not-resuscitate (DNR) order implementation remains a challenge in clinical practice. We retrospectively analysed an observational cohort of 569 COPD patients with 2.5-8 years of follow-up in secondary care, to evaluate potential determinants and the prognostic significance (...) with a DNR order died within the first year after admission; of them, 66% died in the hospital. Age, forced expiratory volume in 1 s, chronic oxygen dependency and previous mechanical ventilation were significantly and independently associated with DNR order implementation. DNR order specification was significantly associated with increased mortality, even after adjustment for age and disease severity. These findings identify DNR orders as independent determinants of mortality, mainly implemented just

2018 ERJ open research

118. Advance care planning in severe COPD: it is time to engage with the future Full Text available with Trip Pro

Advance care planning in severe COPD: it is time to engage with the future Advance care planning should be part of our clinical routine in severe COPD http://ow.ly/Cshs30i8FS9.

2018 ERJ open research

119. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Full Text available with Trip Pro

Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. 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.This randomised, parallel-group, double-blind, double-dummy study was done at 187 sites across 17 countries. Eligible patients had symptomatic COPD, severe or very severe airflow limitation, at least one moderate or severe exacerbation

2018 Lancet Controlled trial quality: predicted high

120. Inhaled long acting Beta-2 (?2) agonists for COPD

- tive pulmonary disease (COPD). We concluded “There are no proven clinically meaningful benefits in terms of reduc- tion in mortality or total serious adverse events…” for this indication based on 12 trials in 6,947 patients. In this Letter we report systematic reviews of 3 other inhaled LABA drugs licensed for COPD: formoterol, arformoterol and salmeterol. Objective To determine the clinical efficacy of inhaled formoterol, arformoterol and salmeterol as compared to placebo for chronic maintenance (...) Inhaled long acting Beta-2 (?2) agonists for COPD Inhaled long acting ß2 agonists for COPD November - December 2017 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: 604 822 0700 Fax: 604 822 0701 E-mail: info@ti.ubc.ca www.ti.ubc.ca 109 I n Therapeutics Letter #102 1 we reviewed the inhaled long acting ß2 agonist (LABA) indacaterol for chronic obstruc

2018 Therapeutics Letter