Latest & greatest articles for copd exacerbations

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Top results for copd exacerbations

61. Effect of long-acting beta-agonists on the frequency of COPD exacerbations: a meta-analysis

Effect of long-acting beta-agonists on the frequency of COPD exacerbations: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

62. Procalcitonin and C-Reactive Protein in Hospitalized Adult Patients With Community-Acquired Pneumonia or Exacerbation of Asthma or COPD (Full text)

Procalcitonin and C-Reactive Protein in Hospitalized Adult Patients With Community-Acquired Pneumonia or Exacerbation of Asthma or COPD Antibiotic overuse in respiratory illness is common and is associated with drug resistance and hospital-acquired infection. Biomarkers that can identify bacterial infections may reduce antibiotic prescription. We aimed to compare the usefulness of the biomarkers procalcitonin and C-reactive protein (CRP) in patients with pneumonia or exacerbations of asthma (...) or COPD.Patients with a diagnosis of community-acquired pneumonia or exacerbation of asthma or COPD were recruited during the winter months of 2006 to 2008. Demographics, clinical data, and blood samples were collected. Procalcitonin and CRP concentrations were measured from available sera.Sixty-two patients with pneumonia, 96 with asthma, and 161 with COPD were studied. Serum procalcitonin and CRP concentrations were strongly correlated (Spearman rank correlation coefficient [rs] = 0.56, P < .001). Patients

2011 EvidenceUpdates PubMed

63. Oral steroids are just as effective as intravenous steroids in acute exacerbations of COPD

Oral steroids are just as effective as intravenous steroids in acute exacerbations of COPD BestBets: Oral steroids are just as effective as intravenous steroids in acute exacerbations of COPD Oral steroids are just as effective as intravenous steroids in acute exacerbations of COPD Report By: Dr Peter Hulme - SHO Search checked by Craig Ferguson - SpR Institution: Trafford General Hospital Date Submitted: 21st June 2008 Date Completed: 3rd May 2011 Last Modified: 3rd June 2011 Status: Green (...) (complete) Three Part Question In [patients with an acute exacerbation of COPD] are [intravenous or oral steroids] better at [reducing length of hospital admission and mortality] Clinical Scenario A 73yr old man with COPD is seen in the Emergency Department. You give him salbutamol and atrovent nebulisers but he remains breathless. You wonder whether giving intravenous or oral steroids would reduce length of hospital stay and his risk of death. Search Strategy EMBASE from 1980 to 2011 Week 08, Ovid

2011 BestBETS

64. Tiotropium versus salmeterol for the prevention of exacerbations of COPD. (Full text)

Tiotropium versus salmeterol for the prevention of exacerbations of COPD. Treatment guidelines recommend the use of inhaled long-acting bronchodilators to alleviate symptoms and reduce the risk of exacerbations in patients with moderate-to-very-severe chronic obstructive pulmonary disease (COPD) but do not specify whether a long-acting anticholinergic drug or a β(2)-agonist is the preferred agent. We investigated whether the anticholinergic drug tiotropium is superior to the β(2)-agonist (...) salmeterol in preventing exacerbations of COPD.In a 1-year, randomized, double-blind, double-dummy, parallel-group trial, we compared the effect of treatment with 18 μg of tiotropium once daily with that of 50 μg of salmeterol twice daily on the incidence of moderate or severe exacerbations in patients with moderate-to-very-severe COPD and a history of exacerbations in the preceding year.A total of 7376 patients were randomly assigned to and treated with tiotropium (3707 patients) or salmeterol (3669

2011 NEJM PubMed

65. Azithromycin for prevention of exacerbations of COPD. (Full text)

Azithromycin for prevention of exacerbations of COPD. Acute exacerbations adversely affect patients with chronic obstructive pulmonary disease (COPD). Macrolide antibiotics benefit patients with a variety of inflammatory airway diseases.We performed a randomized trial to determine whether azithromycin decreased the frequency of exacerbations in participants with COPD who had an increased risk of exacerbations but no hearing impairment, resting tachycardia, or apparent risk of prolongation (...) , 143 to 215) among participants receiving placebo (P<0.001). The frequency of exacerbations was 1.48 exacerbations per patient-year in the azithromycin group, as compared with 1.83 per patient-year in the placebo group (P=0.01), and the hazard ratio for having an acute exacerbation of COPD per patient-year in the azithromycin group was 0.73 (95% CI, 0.63 to 0.84; P<0.001). The scores on the St. George's Respiratory Questionnaire (on a scale of 0 to 100, with lower scores indicating better

2011 NEJM PubMed

66. Impact of care pathways for in-hospital management of COPD exacerbation: a systematic review

Impact of care pathways for in-hospital management of COPD exacerbation: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2011 DARE.

67. Should I use 2.5mg or 5mg Nebulised Salbutamol in Acute Exacerbations of COPD?

Should I use 2.5mg or 5mg Nebulised Salbutamol in Acute Exacerbations of COPD? BestBets: Should I use 2.5mg or 5mg Nebulised Salbutamol in Acute Exacerbations of COPD? Should I use 2.5mg or 5mg Nebulised Salbutamol in Acute Exacerbations of COPD? Report By: Sandeep Rahul Kusre - Senior House Officer Search checked by Jonathan Costello - Consultant A&E Institution: Royal Free Hospital Date Submitted: 4th April 2009 Date Completed: 21st October 2010 Last Modified: 21st October 2010 Status: Green (...) (complete) Three Part Question In [patients admitted with acute exacerbations of COPD] is [5mg nebulised salbutamol superior to 2.5mg nebulised salbutamol] at [improving lung function and reducing length of hospital stay] Clinical Scenario While working a busy nightshift in A&E, you see a patient with an acute exacerbation of COPD. They require bronchodilators & the nurse asks you if you want 2.5mg or 5mg of nebulised salbutamol. You usually administer 5mg however wondered if 2.5mg salbutamol would have

2010 BestBETS

68. Oral immunotherapy with inactivated nontypeable Haemophilus influenzae reduces severity of acute exacerbations in severe COPD (PubMed)

Oral immunotherapy with inactivated nontypeable Haemophilus influenzae reduces severity of acute exacerbations in severe COPD Acute exacerbations of COPD reflect in part an inappropriate host response to abnormal bacterial colonization. Orally administered inactivated nontypeable Haemophilus influenzae (NTHi) can drive a specific T-cell response that by promoting intrabronchial phagocytosis down-regulates bronchus inflammation.Subjects with recurrent exacerbations of COPD were studied (...) in a randomized, multicenter, double-blind, placebo-controlled trial, to test efficacy of an NTHi oral immunotherapeutic (HI-164OV). This report describes the outcome in 38 subjects with severe COPD defined as having an FEV(1) < or = 50% of predicted normal.Exacerbations defined as an increase in volume and purulence of sputum were reduced by 16% (not significant) in the active group. However, moderate-to-severe exacerbations (defined as requiring corticosteroid therapy) were reduced by 63% (P = .05

2010 EvidenceUpdates

69. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study (Full text)

(Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study Chronic obstructive pulmonary disease (COPD) is a chronic disease with a high prevalence and rapidly increasing incidence rates. The effect of self-treatment of COPD exacerbations on the severity of exacerbations during a 1-year period was examined and a cost-effectiveness analysis was performed.Patients were randomly allocated to four 2-hour self-management sessions (...) , with or without training in self-treatment of exacerbations. Patients in the self-treatment group received an action plan with the possibility to initiate a course of prednisolone (with or without antibiotics). During follow-up, all participants kept a daily symptom diary. These provided the data to calculate the frequency of exacerbations, the number of exacerbation days and mean daily severity scores.Data were analysed for 142 randomised patients (self-treatment: n = 70; control: n = 72). The frequency

2010 EvidenceUpdates PubMed

70. Systematic review: Combination therapy with long-acting ?-agonists plus inhaled corticosteroids is no more effective than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adver

Systematic review: Combination therapy with long-acting ?-agonists plus inhaled corticosteroids is no more effective than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adver Combination therapy with long-acting β-agonists plus inhaled corticosteroids is no more effective than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adverse (...) For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Combination therapy with long-acting β-agonists plus inhaled corticosteroids is no more effective than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adverse effects Article Text Therapeutics Systematic review Combination therapy with long-acting β-agonists plus inhaled corticosteroids is no more effective

2010 Evidence-Based Medicine (Requires free registration)

71. Steroids for COPD Exacerbation

Steroids for COPD Exacerbation Steroids for COPD Exacerbation – TheNNTTheNNT Systemic Steroids for Acute COPD Exacerbations 10 for prevented failed treatment In Summary, for those who took the steroids: Benefits in NNT 89.5% saw no benefit 10.5% were helped by not failing treatment 1 out of 10 were helped (preventing failed treatment) Harms in NNT 13.9% harmed by developing adverse drug effects 1 out of 7 were harmed (adverse drug effects) View As: NNT % Source: Efficacy Endpoints: Mortality (...) , Treatment Failure (Lack of resolution, worsening, or death) Harm Endpoints: Adverse Drug Effects Narrative: Chronic obstructive pulmonary disease (COPD), a term that encompasses both patients diagnosed with chronic bronchitis and emphysema, is an obstructive lung disease in many cases caused by years of tobacco smoking. It is thought that patients with COPDexacerbation’ (increased shortness of breath or change in their chronic cough and sputum) may benefit from steroids, presumably by reducing

2010 theNNT

72. Antibiotics for COPD Exacerbation

Antibiotics for COPD Exacerbation Antibiotics for COPD Exacerbation – TheNNTTheNNT Antibiotics for Acute COPD Exacerbations 8 for mortality In Summary, for those who took the antibiotics: Benefits in NNT 88.4% saw no benefit 11.6% were helped by being saved from death 1 in 8 were helped (life saved) 1 in 3 were helped (preventing failed treatment) Harms in NNT 5% were harmed by developing diarrhea 1 in 20 were harmed (diarrhea) View As: NNT % Source: Efficacy Endpoints: Mortality, Treatment (...) Failure (Lack of resolution, worsening, or death) Harm Endpoints: Diarrhea Narrative: Chronic obstructive pulmonary disease (COPD), a term that encompasses both patients diagnosed with chronic bronchitis and emphysema, is an obstructive lung disease, in many cases caused by tobacco smoking. It is thought that patients with COPDexacerbation’ (increased shortness of breath or change in their chronic cough and sputum) may benefit from antibiotics, though the reasons for this are not well elucidated

2010 theNNT

73. Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials

Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials Agarwal R, Aggarwal AN, Gupta D, Jindal SK CRD summary The review found (...) a modest reduction in risk of exacerbations in patients with severe to very severe chronic obstructive pulmonary disease with use of inhaled corticosteroids that was not related to the level of baseline lung function. The authors suggested that the role of inhaled corticosteroids needed to be further evaluated. Their cautious conclusions are appropriate and reliable. Authors' objectives To assess the efficacy of inhaled corticosteroids in reducing chronic obstructive pulmonary disease (COPD

2010 DARE.

74. Does tiotropium lower exacerbation and hospitalization frequency in COPD patients? Results of a meta-analysis

Does tiotropium lower exacerbation and hospitalization frequency in COPD patients? Results of a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2010 DARE.

75. Use of dry powder inhalers in acute exacerbations of asthma and COPD

Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Selroos O, Borgstrom L, Ingelf J CRD summary This review concluded that dry powder inhalers functioned equally as well as established therapies with other inhaler devices in patients with acute asthma or chronic obstructive pulmonary disease. Given poor reporting of the review process (...) (Planet) were searched for publications or congress abstracts to April 2008; search terms were reported. Reference lists were searched to identify additional articles. Study selection Clinical trials that evaluated rapid-acting β 2 -agonists in patients with asthma or COPD treated at emergency departments or hospitals that assessed exacerbation severity (measured as forced expiratory volume (FEV 1 ) percentage of predicted normal) were eligible for inclusion; included studies comprised randomised

2009 DARE.

76. Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications

Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your (...) username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications Article Text Therapeutics

2009 Evidence-Based Medicine (Requires free registration)

77. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study

(Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 NHS Economic Evaluation Database.

78. Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies (Full text)

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies A study was undertaken to determine whether a short course of antibiotic treatment (< or = 5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD).MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Studies considered (...) eligible were double-blind randomised clinical trials including adult patients > or = 18 years of age with a clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment for < or = 5 days versus > 5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis.21 studies with a total of 10 698 patients were included. The average quality of the studies was high

2008 EvidenceUpdates PubMed

79. Contemporary Management of Acute Exacerbations of COPD: A Systematic Review and Metaanalysis (Full text)

Contemporary Management of Acute Exacerbations of COPD: A Systematic Review and Metaanalysis Systemic corticosteroids, antibiotics, and noninvasive positive pressure ventilation (NPPV) are recommended for patients with acute exacerbation of COPD. However, their clinical benefits in various settings are uncertain. We undertook a systematic review and metaanalysis to systematically evaluate the effectiveness of these therapies.MEDLINE and EMBASE were searched to identify relevant randomized (...) , 2.40 to 14.41). Compared with placebo, antibiotics reduced treatment failure by 46% (95% CI, 0.32 to 0.92) and in-hospital mortality by 78% (95% CI, 0.08 to 0.62). Compared with standard therapy, NPPV reduced the risk of intubation by 65% (95% CI, 0.26 to 0.47), in-hospital mortality by 55% (95% CI, 0.30 to 0.66), and the length of hospitalization by 1.9 days (95% CI, 0.0 to 3.9).For acute COPD exacerbations, systemic corticosteroids are effective in reducing treatment failures, while antibiotics

2008 EvidenceUpdates PubMed

80. Review: anticholinergics but not B2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD

Review: anticholinergics but not B2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD Review: anticholinergics but not β2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log (...) in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: anticholinergics but not β2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD Article Text

2008 Evidence-Based Medicine (Requires free registration)