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Top results for copd

41. Bronchoscopic thermal vapour ablation for upper-lobe emphysema

and procedure The condition, current treatments and procedure The condition 2.1 Emphysema is a chronic lung disease that typically happens with chronic obstructive pulmonary disease. In emphysema, the walls of the air sacs (alveoli) in the lungs weaken and disintegrate. This leaves behind abnormally large air spaces that stay filled with air even when the patient breathes out. The most common symptoms of emphysema are shortness of breath, coughing, fatigue and weight loss. Recurrent illnesses (such as chest (...) . Lung volume reduction surgery is an option for patients who experience breathlessness, and whose pulmonary function tests and CT scans show severe disease and enlarged air spaces. Surgery can be done thoracoscopically or using an open approach. Endoscopic lung volume reduction techniques include implanting valves or coils. The aim is to reduce the morbidity and mortality associated with conventional surgery. The procedure 2.3 Bronchoscopic thermal vapour (steam) ablation for upper-lobe emphysema

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

42. Care bundles to reduce re-admissions for patients with chronic obstructive pulmonary disease: a mixed-methods study Full Text available with Trip Pro

Care bundles to reduce re-admissions for patients with chronic obstructive pulmonary disease: a mixed-methods study Care bundles to reduce re-admissions for patients with chronic obstructive pulmonary disease: a mixed-methods study Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find (...) the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} There was no evidence that care bundles reduced 28-day re-admission rates for chronic obstructive pulmonary disease and were challenging to implement. {{author}} {{($index , , , , , , , , , , , & . Katherine Morton 1 , Emily Sanderson 1, 2 , Padraig Dixon 1 , Anna King 1 , Sue Jenkins 3 , Stephanie J MacNeill 1, 2 , Alison Shaw 1 , Chris Metcalfe 1, 2 , Melanie Chalder 1 , William

2019 NIHR HTA programme

43. [Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease]. Full Text available with Trip Pro

[Effectiveness of a brief educational intervention relating to the correct use of inhalers on the prevention of exacerbation in patients suffering from chronic obstructive pulmonary disease]. To predict the effect of a brief educational intervention aimed at improving the inhaler technique on the reduction of exacerbations in patients with COPD over a year.A triple blind, randomised controlled clinical trial with parallel design.to be between 40-75 years, having been diagnosed with COPD (...) of exacerbations in each group was checked.social and demographic, study, dyspnoea level, body-mass index, tobacco use, FEV1, FEV1/FVC, COPD stage, BODEX index, number, type, and inhaler technique, number of previous exacerbations. Bayesian inference analysis was performed using logistic regression models.A total of 56 patients were assigned to de intervention group and 41 to the control one. There were 16 and 14 lost to follow-up, respectively. In the intervention group, 44.6% of the patients had

2019 Semergen Controlled trial quality: uncertain

44. Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. (Abstract)

Head-to-head oral prophylactic antibiotic therapy for chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD; including chronic bronchitis and emphysema) is a chronic respiratory condition characterised by shortness of breath, cough and recurrent exacerbations. Long-term antibiotic use may reduce both bacterial load and inflammation in the airways. Studies have shown a reduction of exacerbations with antibiotics in comparison to placebo in people with COPD (...) ).Overall, we judged the evidence presented to be of very low-certainty, mainly due to imprecision, but we also had concerns about indirectness and methodological quality of the included studies. The primary outcome measures for this review included exacerbations, quality of life, drug resistance and serious adverse events.Macrolide + tetracycline versus macrolide There was no clear difference between treatments in improvement in quality of life as assessed by the Chronic Respiratory Questionnaire (CRQ

2019 Cochrane

45. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. (Abstract)

Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Individuals with chronic bronchitis or chronic obstructive pulmonary disease (COPD) may suffer recurrent exacerbations with an increase in volume or purulence of sputum, or both. Personal and healthcare costs associated with exacerbations indicate that therapies that reduce the occurrence of exacerbations are likely to be useful. Mucolytics are oral medicines that are believed to increase (...) = 11; I² = 0%; moderate-certainty evidence).In participants with chronic bronchitis or COPD, we are moderately confident that treatment with mucolytics leads to a small reduction in the likelihood of having an acute exacerbation, in days of disability per month and possibly hospitalisations, but is not associated with an increase in adverse events. There appears to be limited impact on lung function or health-related quality of life. Results are too imprecise to be certain whether

2019 Cochrane

46. Benralizumab for the Prevention of COPD Exacerbations. Full Text available with Trip Pro

Benralizumab for the Prevention of COPD Exacerbations. The efficacy and safety of benralizumab, an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody, for the prevention of exacerbations in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) are not known.In the GALATHEA and TERRANOVA trials, we enrolled patients with COPD (at a ratio of approximately 2:1 on the basis of eosinophil count [≥220 per cubic millimeter vs. <220 per cubic millimeter (...) ]) who had frequent exacerbations despite receiving guideline-based inhaled treatment. Patients were randomly assigned to receive benralizumab (30 or 100 mg in GALATHEA; 10, 30, or 100 mg in TERRANOVA) every 8 weeks (every 4 weeks for the first three doses) or placebo. The primary end point was the treatment effect of benralizumab, measured as the annualized COPD exacerbation rate ratio (benralizumab vs. placebo) at week 56 in patients with baseline blood eosinophil counts of 220 per cubic millimeter

2019 NEJM Controlled trial quality: predicted high

47. Effect of Aclidinium Bromide on Major Cardiovascular Events and Exacerbations in High-Risk Patients With Chronic Obstructive Pulmonary Disease: The ASCENT-COPD Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Aclidinium Bromide on Major Cardiovascular Events and Exacerbations in High-Risk Patients With Chronic Obstructive Pulmonary Disease: The ASCENT-COPD Randomized Clinical Trial. There is concern that long-acting muscarinic antagonists increase cardiovascular morbidity or mortality in patients with chronic obstructive pulmonary disease (COPD).To determine the cardiovascular safety (noninferiority) and efficacy (superiority) of aclidinium bromide, 400 μg twice daily, in patients (...) with COPD and cardiovascular disease or risk factors.Multicenter, randomized, placebo-controlled, double-blind, parallel-design study conducted at 522 sites in North America. A total of 3630 patients with moderate to very severe COPD and either a history of cardiovascular disease or at least 2 atherothrombotic risk factors were randomized; follow-up occurred for up to 3 years until at least 122 major adverse cardiovascular events (MACE) occurred. The first patient was enrolled on October 16, 2013

2019 JAMA Controlled trial quality: predicted high

48. Reducing Chronic Obstructive Pulmonary Disease Hospital Readmissions: A Workshop Report Full Text available with Trip Pro

Respiratory Research Network. Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing . CMAJ 2017 ;189: E530 – E538 . , , 35 . Gershon AS , Thiruchelvam D , Chapman KR , Aaron SD , Stanbrook MB , Bourbeau J , et al .; Canadian Respiratory Research Network. Health services burden of undiagnosed and overdiagnosed COPD . Chest 2018 ;153: 1336 – 1346 . , , 36 . Wu H , Wise RA , Medinger AE . Do patients hospitalized with COPD have airflow (...) for Chronic Obstructive Lung Disease. GOLD 2017: Global Strategy for the Diagnosis, Management and Prevention of COPD. Final revised 2017 Nov 20 [accessed 2017 Mar 12]. Available from: . 46 . Feemster LC , Au DH . Penalizing hospitals for chronic obstructive pulmonary disease readmissions . Am J Respir Crit Care Med 2014 ;189: 634 – 639 . , , 47 . Sjoding MW , Cooke CR . Readmission penalties for chronic obstructive pulmonary disease will further stress hospitals caring for vulnerable patient populations

2019 American Thoracic Society

49. Dual bronchodilation with tiotropium/olodaterol further reduces activity-related breathlessness versus tiotropium alone in COPD Full Text available with Trip Pro

Dual bronchodilation with tiotropium/olodaterol further reduces activity-related breathlessness versus tiotropium alone in COPD The 3-min constant speed shuttle test (CSST) was used to examine the effect of tiotropium/olodaterol compared with tiotropium at reducing activity-related breathlessness in patients with chronic obstructive pulmonary disease (COPD).This was a randomised, double-blind, two-period crossover study including COPD patients with moderate to severe pulmonary impairment, lung (...) -min CSST from baseline with both tiotropium (mean -0.968, 95% CI -1.238- -0.698; n=100) and tiotropium/olodaterol (mean -1.325, 95% CI -1.594- -1.056; n=101). The decrease in breathlessness was statistically significantly greater with tiotropium/olodaterol versus tiotropium (treatment difference -0.357, 95% CI -0.661- -0.053; p=0.0217).Tiotropium/olodaterol reduced activity-related breathlessness more than tiotropium in dyspnoeic patients with moderate to severe COPD exhibiting lung

2019 EvidenceUpdates

50. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review. (Abstract)

to therapy. The diagnosis and treatment of COPD is rapidly changing, so understanding recent advances is important for the delivery of optimal patient care.Chronic obstructive pulmonary disease is characterized by incompletely reversible expiratory airflow limitation. Spirometry is the reference standard for diagnosing and assessing the severity of COPD. All patients should be counseled about and receive preventive measures such as smoking cessation and vaccination. Treatment should be guided (...) Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review. There are 30 million adults (12%) in the United States who have chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease accounts for 3.2% of all physician office visits annually and is the fourth leading cause of death (126 000 deaths per year). Most patients are diagnosed by their primary care clinicians who must address the highly variable clinical features and responses

2019 JAMA

51. People with chronic obstructive pulmonary disease exacerbations prefer early discharge, then treatment at home. (Abstract)

People with chronic obstructive pulmonary disease exacerbations prefer early discharge, then treatment at home. The studyHome treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluationEchevarria C, Gray J, Hartley T, Miller J, Simpson AJ, Gibson GJ, Bourke SCPublished on 24 April 2018 Thorax 2018;73:713-22This project was funded by the National Institute for Health Research-Research for Patient Benefit Programme (project number (...) PB-PG-0213-30105).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000691/hospital-at-home-treatment-for-copd-flare-ups.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

2019 BMJ Controlled trial quality: uncertain

52. Glycopyrronium / formoterol fumarate dihydrate (Bevespi Aerosphere) - chronic obstructive pulmonary disease (COPD)

Glycopyrronium / formoterol fumarate dihydrate (Bevespi Aerosphere) - chronic obstructive pulmonary disease (COPD) EMA/752588/2018 EMEA/H/C/004245 Bevespi Aerosphere (glycopyrronium bromide / formoterol) An overview of Bevespi Aerosphere and why it is authorised in the EU What is Bevespi Aerosphere and what is it used for? Bevespi Aerosphere is a medicine used in adults to relieve the symptoms of chronic obstructive pulmonary disease (COPD). COPD is a long-term disease in which the airways (...) only be obtained with a prescription. For more information about using Bevespi Aerosphere, see the package leaflet or contact your doctor or pharmacist. How does Bevespi Aerosphere work? The two active substances in Bevespi Aerosphere work in different ways to widen the airways and improve breathing in COPD. Glycopyrronium bromide is a muscarinic receptor antagonist. This means that it blocks muscarinic receptors (targets) in muscle cells in the lungs. Because these receptors help control

2019 European Medicines Agency - EPARs

53. Capturing Exacerbations of Chronic Obstructive Pulmonary Disease with EXACT. A Subanalysis of FLAME Full Text available with Trip Pro

Capturing Exacerbations of Chronic Obstructive Pulmonary Disease with EXACT. A Subanalysis of FLAME Chronic obstructive pulmonary disease exacerbations accelerate lung function decline, reduce quality of life, and increase mortality. A subset of patients (n = 457) from the FLAME (Effect of Indacaterol Glycopyrronium vs. Fluticasone Salmeterol on COPD Exacerbations) study used the Exacerbations of COPD Tool (EXACT) to capture symptom-defined exacerbations.To evaluate the effect of indacaterol

2019 EvidenceUpdates

54. Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Full Text available with Trip Pro

Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally (...) , quality of death and dying was assessed in patients who died during 2-year follow-up.A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.165 patients were

2019 EvidenceUpdates

55. Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India. Full Text available with Trip Pro

Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India. Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may (...) at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included.There could be a key role for pharmacists as educators for COPD patients

2019 PharmacoEconomics - open Controlled trial quality: uncertain

56. Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial. Full Text available with Trip Pro

Comparing the effects of upper limb and breathing exercises on six-minute walking distance among patients with chronic obstructive pulmonary disease: a three-group randomized controlled clinical trial. Physical exercise can improve patient outcomes and reduce hospitalization and mortality rates among subjects with chronic obstructive pulmonary disease. This study aimed to compare the effects of upper limb and breathing exercises on six-minute walking distance among these patients.This three (...) significant (p > 0.05).Upper limb exercise is more effective than breathing exercise in increasing walking distance among patients with chronic obstructive pulmonary disease. Therefore, upper limb exercise can be used as a safe, simple, and inexpensive rehabilitation technique for these patients.

2019 Advances in respiratory medicine Controlled trial quality: uncertain

57. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: a randomised controlled proof-of-concept trial. Full Text available with Trip Pro

Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: a randomised controlled proof-of-concept trial. The APPLE COPD-ICON2 trial is a prospective 2×2 factorial, double-blinded proof-of-concept randomised controlled trial targeting patients with chronic obstructive pulmonary disease (COPD) without prior history of cardiovascular disease. The primary goal of this trial is to investigate if treatment with antiplatelet (...) recruited with mean age of 67.5 years; 47.5% patients were male. The per-protocol ASPI test response rate to aspirin was 68.3% (95% CI 52.3-80.9%). The per-protocol ADP test response rate to ticagrelaor was 68.8% (95% CI 50.4-82.6%). Platelet response to antiplatelet therapy with aspirin and ticagrelor was not observed in nearly one-third of COPD patients without prior history of cardiovascular disease. These findings support the high pro-thrombotic milieu and the need for further research to determine

2019 ERJ open research Controlled trial quality: predicted high

58. COPD exacerbation: no systematic use of antibiotics

of moderate aggravation in patients with chronic obstructive pulmonary disease (COPD), it is preferable to prescribe antibiotics as a first-line treatment only when the suspicion of bacterial infection is reinforced by an increase in sputum purulence. Patients with chronic obstructive pulmonary disease (COPD) are subject to exacerbations of their disease, i.e. episodes of prolonged aggravation. The known causes are mainly viral and bacterial infections. Some exacerbations justify hospitalisation: severe (...) amoxicillin is not appropriate. Whether or not antibiotic treatment is chosen, patient monitoring is useful during the first few days to detect any aggravation that warrants a change in treatment. ©Prescrire 1 January 2019 Share Share Download the full review. See also: Chronic obstructive pulmonary disease. Useful medications for patients with recurrent symptoms Prescrire Int 2016 ; 25 (176) : 272-27 | | | Prescrire Your change of address has been received and will be processed promptly

2019 Prescrire

59. Revefenacin (Yupelri) - To treat patients with chronic obstructive pulmonary disease (COPD)

Revefenacin (Yupelri) - To treat patients with chronic obstructive pulmonary disease (COPD) Drug Approval Package: Yupelri (revefenacin) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Yupelri (revefenacin) Company: Theravance Biopharma Ireland Limited Application Number: 210598 Approval Date: 11/09/2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling

2019 FDA - Drug Approval Package

60. Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department Full Text available with Trip Pro

Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department The Ottawa chronic obstructive pulmonary disease (COPD) Risk Scale (OCRS), which consists of 10 criteria, was previously derived to identify patients in the emergency department with COPD who were at high risk for short-term serious outcomes. We sought to validate, prospectively and explicitly, the OCRS when applied by physicians in the emergency (...) department.We conducted this prospective cohort study involving patients in the emergency departments at 6 tertiary care hospitals and enrolled adults with acute exacerbation of COPD from May 2011 to December 2013. Physicians evaluated patients for the OCRS criteria, which were recorded on a data form along with the total risk score. We followed patients for 30 days and the primary outcome, short-term serious outcomes, was defined as any of death, admission to monitored unit, intubation, noninvasive

2019 EvidenceUpdates