Latest & greatest articles for copd

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Top results for copd

101. Intrinsic factors influence self-management participation in COPD: effects on self-efficacy Full Text available with Trip Pro

Intrinsic factors influence self-management participation in COPD: effects on self-efficacy Personal traits should be addressed before offering self-management programmes to patients with COPD http://ow.ly/DtNh30k1A15.

2018 ERJ open research

102. Influence of dietary nitrate supplementation on lung function and exercise gas exchange in COPD patients. Full Text available with Trip Pro

Influence of dietary nitrate supplementation on lung function and exercise gas exchange in COPD patients. During exercise as pulmonary blood flow rises, pulmonary capillary blood volume increases and gas exchange surface area expands through distention and recruitment. We have previously demonstrated that pulmonary capillary recruitment is limited in COPD patients with poorer exercise tolerance. Hypoxia and endothelial dysfunction lead to pulmonary vascular dysregulation possibly in part (...) related to nitric oxide related pathways.To determine if increasing dietary nitrate might influence lung surface area for gas exchange and subsequently impact exercise performance.Subjects had stable, medically treated COPD (n = 25), gave informed consent, filled out the St George Respiratory Questionnaire (SGRQ), had a baseline blood draw for Hgb, performed spirometry, and had exhaled nitric oxide (exNO) measured. Then they performed the intra-breath (IB) technique for lung diffusing capacity

2018 Nitric oxide : biology and chemistry Controlled trial quality: uncertain

103. Chronic obstructive pulmonary disease: beclometasone, formoterol and glycopyrronium (Trimbow)

with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an ICS and a LABA. Ov Overview erview This evidence summary discusses 3 randomised controlled trials (TRILOGY, TRINITY and TRIBUTE) looking at the safety and efficacy of beclometasone/formoterol/glycopyrronium in people with COPD with severe or very severe airflow limitation, symptoms despite treatment and a history of exacerbations. © NICE 2018. All rights reserved. Subject to Notice (...) , quality assured and approved for publication. Expert advisers Professor Peter Calverley, professor of respiratory medicine, University of Liverpool. Dr Anastasios Lekkas, consultant respiratory physician, University Hospital Southampton NHS Foundation Trust. Dr Sarah Scrivener, consultant respiratory physician, Portsmouth Hospitals NHS Trust. Professor Jadwiga Wedzicha, professor of respiratory medicine, Imperial College London. Chronic obstructive pulmonary disease: beclometasone, formoterol

2018 National Institute for Health and Clinical Excellence - Advice

104. Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD: A Randomized Controlled Trial Full Text available with Trip Pro

Tai Chi and Pulmonary Rehabilitation Compared for Treatment-Naive Patients With COPD: A Randomized Controlled Trial In COPD, functional status is improved by pulmonary rehabilitation (PR) but requires specific facilities. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world. We hypothesized that Tai Chi is equivalent (ie, difference less than ±4 St (...) . George's Respiratory Questionnaire [SGRQ] points) to PR.A total of 120 patients (mean FEV1, 1.11 ± 0.42 L; 43.6% predicted) bronchodilator-naive patients were studied. Two weeks after starting indacaterol 150 μg once daily, they randomly received either standard PR thrice weekly or group Tai Chi five times weekly, for 12 weeks. The primary end point was change in SGRQ prior to and following the exercise intervention; measurements were also made 12 weeks after the end of the intervention.The between

2018 EvidenceUpdates

105. Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation Full Text available with Trip Pro

Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation Previous models of Hospital at Home (HAH) for COPD exacerbation (ECOPD) were limited by the lack of a reliable prognostic score to guide patient selection. Approximately 50% of hospitalised patients have a low mortality risk by DECAF, thus are potentially suitable.In a non-inferiority randomised controlled trial, 118 patients admitted with a low-risk ECOPD (DECAF 0 (...) or 1) were recruited to HAH or usual care (UC). The primary outcome was health and social costs at 90 days.Mean 90-day costs were £1016 lower in HAH, but the one-sided 95% CI crossed the non-inferiority limit of £150 (CI -2343 to 312). Savings were primarily due to reduced hospital bed days: HAH=1 (IQR 1-7), UC=5 (IQR 2-12) (P=0.001). Length of stay during the index admission in UC was only 3 days, which was 2 days shorter than expected. Based on quality-adjusted life years, the probability of HAH

2018 EvidenceUpdates

106. VIDAvision for lung volume analysis in emphysema

, parenchyma and a range of CT biomarkers – such as fissure integrity – and analytics. This visualisation can then be used to assess a patient's suitability for therapies. VIDAvision can be used to do a range of analyses including: airway mapping for bronchoscopy biopsy lung cancer resection precision reports lung density air trapping information in people with chronic obstructive pulmonary disease (COPD) and asthma lung volume analysis to support treatment selection planning for endobronchial lung volume (...) and few patients in the UK receive bronchoscopy to assess whether ELVR surgery is needed. The following NICE guidance has been identified as being relevant to this care pathway: Chronic obstructive pulmonary disease in over 16s: diagnosis and management VIDAvision for lung volume analysis in emphysema (MIB148) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 10Lung volume reduction surgery for advanced emphysema

2018 National Institute for Health and Clinical Excellence - Advice

107. Beclometasone dipropionate anhydrous / formoterol fumarate dihydrate / glycopyrronium (Riarify - (previously CHF 5993 Chiesi Farmaceutici S.p.A.)) - Chronic Obstructive Pulmonary Disease

Clinical Endpoint Committee CHMP Committee for Medicinal Products for Human Use CI confidence interval COPD chronic obstructive pulmonary disease CPRD Clinical Practice Research Database CRF/eCRF case report form/electronic case report form CSR clinical study report CT computed tomography CV cardiovascular ECG electrocardiogram EMA European Medicines Agency EPAR European Public Assessment Report ERS European Respiratory Society EXACT-RS Exacerbations of Chronic Pulmonary Disease Tool EXT Extension (...) the centralised procedure under Article 3 (2)(b) of Regulation (EC) No 726/2004. The eligibility to the centralised procedure was agreed upon by the EMA/CHMP on 18 May 2017. The eligibility to the centralised procedure under Article 3(2)(b) of Regulation (EC) No 726/2004 was based on demonstration of interest of patients at Community level. The applicant applied for the following indication: Maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) who

2018 European Medicines Agency - EPARs

108. Beclometasone dipropionate / formoterol fumarate dihydrate / glycopyrronium (Trydonis) - COPD, Chronic Obstructive Pulmonary Disease

for Medicinal Products for Human Use CI confidence interval COPD chronic obstructive pulmonary disease CPRD Clinical Practice Research Database CRF/eCRF case report form/electronic case report form CSR clinical study report CT computed tomography CV cardiovascular ECG electrocardiogram EMA European Medicines Agency EPAR European Public Assessment Report ERS European Respiratory Society EXACT-RS Exacerbations of Chronic Pulmonary Disease Tool EXT Extension (Population) FDA Food and Drug Administration FEV 1 (...) Beclometasone dipropionate / formoterol fumarate dihydrate / glycopyrronium (Trydonis) - COPD, Chronic Obstructive Pulmonary Disease 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 22 February 2018 EMA/155337/2018 Committee

2018 European Medicines Agency - EPARs

109. Chronic obstructive pulmonary disease: fluticasone furoate, umeclidinium and vilanterol (Trelegy)

and current guidance The NICE guideline on chronic obstructive pulmonary disease (COPD) is currently being updated (expected publication date November 2018). The current COPD guideline states that COPD is characterised by airflow obstruction that is usually progressive and not fully reversible, and is predominantly caused by smoking. COPD causes symptoms, disability and impaired quality of life, which may respond to pharmacological and other therapies that have limited or no measurable impact (...) chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an ICS and a LABA (summary of product characteristics). Ov Overview erview This evidence summary discusses 2 randomised controlled trials (RCTs) looking at the safety and efficacy of fluticasone furoate/umeclidinium/vilanterol (an ICS/LAMA and LABA combination inhaler) in people with COPD who were symptomatic despite regular maintenance treatment and who either had a history, or were at risk

2018 National Institute for Health and Clinical Excellence - Advice

110. Core IM: Mind the Gap on Steriods in COPD

with COPD exacerbations do not return to baseline within 3 months of an exacerbation. Many thanks to Dr. Melissa Lesko, Pulmonologists at NYU, for peer reviewing this episode. References (2:44 to end) Vogelmeier CF et al. “Global Strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary.” Am J Respir Crit Care Med. 2017 Mar 1;195(5):557-582. (3:04) Wedzicha JA “Oral corticosteroids for exacerbations of chronic obstructive pulmonary (...) Initiative for Chronic Obstructive Lung Disease) define a COPD exacerbation? (2:44) What outcomes do steroids actually improve in treating a COPD exacerbation? (5:08) What is the evidence behind a 5 day steroid “burst”? (7:20) Are IV steroids more powerful than PO? (9:00) Subscribe to CORE IM on any podcast app! Follow us on Facebook || Twitter || Instagram . Please give any feedback at . Show Notes A moderate to severe COPD exacerbation is defined as at least 2 of the 3 cardinal symptoms : change

2018 Clinical Correlations

111. Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease Full Text available with Trip Pro

Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is characterised by a progressive loss of pulmonary function. Often patients do not adhere to inhaled therapies and this leads clinicians to switch treatments in order to improve control of the symptoms. Narrative medicine is a useful approach that helps healthcare professionals to think over the doctor-patient relationship and how (...) patients live with their disease. The aim of this training project was to teach pulmonologists the basics of narrative medicine: to carefully listen to patients and to practice reflective writing in their relationship with them. Training on narrative medicine and parallel charts was provided through a webinar and a weekly newsletter. Across 362 narratives, written by 74 Italian pulmonologists, 92% of patients had activity limitations at their first visit. The main factor influencing the effectiveness

2018 ERJ open research

112. Single-inhaler triple therapy in symptomatic COPD patients: FULFIL subgroup analyses Full Text available with Trip Pro

Single-inhaler triple therapy in symptomatic COPD patients: FULFIL subgroup analyses Triple inhaled corticosteroid (ICS)/long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) therapy is recommended for symptomatic patients with chronic obstructive pulmonary disease (COPD) and at risk of exacerbations. However, the benefits versus side-effects of triple inhaled therapy for COPD, based on distinct patient clinical profiles, are unclear. FULFIL, a phase III, randomised, double (...) -blind study, compared 24 weeks of once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 µg using the Ellipta inhaler with twice-daily budesonide/formoterol (BUD/FOR) 400/12 µg using the Turbuhaler. Subgroup analyses of forced expiratory volume in 1 s (FEV1), St George's Respiratory Questionnaire (SGRQ) Total score and exacerbation rates were carried out. Subgroups were defined by COPD medication at screening (ICS+LABA, BUD+FOR, ICS+LABA+LAMA, LAMA alone, tiotropium alone

2018 ERJ open research Controlled trial quality: predicted high

113. Inspiratory muscle training does not improve clinical outcomes in 3-week COPD rehabilitation: results from a randomised controlled trial Full Text available with Trip Pro

Inspiratory muscle training does not improve clinical outcomes in 3-week COPD rehabilitation: results from a randomised controlled trial The value of inspiratory muscle training (IMT) in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) is unclear. The RIMTCORE (Routine Inspiratory Muscle Training within COPD Rehabilitation) randomised controlled trial examined the effectiveness of IMT added to pulmonary rehabilitation.In total, 611 COPD patients (Global Initiative (...) for Chronic Obstructive Lung Disease stage II-IV) received a 3-week inpatient pulmonary rehabilitation, of which 602 patients were included in the intention-to-treat analyses. The intervention group (n=300) received highly intensive IMT and the control group (n=302) received sham IMT. The primary outcome was maximal inspiratory pressure (PImax). The secondary outcomes were 6-min walk distance, dyspnoea, quality of life and lung function. Outcomes were assessed pre- and post-pulmonary rehabilitation

2018 EvidenceUpdates

114. 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

115. 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

116. 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

117. 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

118. 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

119. 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

120. 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