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Top results for copd

141. Chronic obstructive pulmonary disease in over 16s: diagnosis and management

recommendations 1.2.11 to 1.2.14) they do not smoke they can complete a 6-minute walk distance of at least 140 m (if limited by breathlessness). [2018] [2018] 1.2.85 At the respiratory review, refer the person with COPD to a lung volume reduction multidisciplinary team to assess whether lung volume reduction surgery or endobronchial valves are suitable if they have: hyperinflation, assessed by lung function testing with body plethysmography and and Chronic obstructive pulmonary disease in over 16s: diagnosis (...) 53 Oral prophylactic antibiotic therapy 54 Long-term oxygen therapy 55 Ambulatory and short-burst oxygen therapy 56 Managing pulmonary hypertension and cor pulmonale 57 Lung volume reduction procedures, bullectomy and lung transplantation 58 Risk factors for COPD exacerbations 59 Self-management, education and telehealth monitoring 60 Context 62 Finding more information and resources 63 Update information 64 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) ©

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

142. Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing

implications 24 Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24This guideline should be read in conjunction with NG115. Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce (...) antibiotic resistance. See a 2-page visual summary of the recommendations, including tables to support prescribing decisions. See the NICE guideline on COPD in over 16s for other recommendations on preventing and managing an acute exacerbation of COPD, including self-management. Who is it for? Health professionals People with COPD, their families and carers Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing (NG114) © NICE 2019. All rights reserved. Subject to Notice

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

143. Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta-analysis Full Text available with Trip Pro

). The objectives are as follows: To assess the effects of different prophylactic antibiotics on exacerbations, quality of life and serious adverse events in people with COPD. Background Description of the condition Chronic obstructive pulmonary disease (COPD) is a common and preventable disease, which is characterised by persistent respiratory symptoms and airways obstruction, with or without alveolar abnormalities usually caused by significant exposure to noxious particles or gases ( ). Tobacco smoking (...) Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta-analysis Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta‐analysis - Janjua, S - 2018 | Cochrane Library Cookies Our site uses cookies to improve your experience. You can find out more about our use of cookies in About Cookies, including instructions on how to turn off cookies if you wish to do so. By continuing to browse this site you agree to us using

2018 Cochrane Database of Systematic Reviews

144. Randomised controlled trial of cognitive behavioural therapy in COPD Full Text available with Trip Pro

Randomised controlled trial of cognitive behavioural therapy in COPD Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective. Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were measured at baseline, 3, 6 and 12 months. A cost-effectiveness analysis (...) Subscale was 1.52, 95% CI 0.49-2.54, p=0.003). Importantly, the CBT intervention was more cost-effective than leaflets at 12 months, significantly lowering hospital admissions and attendance at emergency departments. CBT delivered by respiratory nurses is a clinically and cost-effective treatment for anxiety in patients with COPD relative to self-help leaflets.

2018 ERJ open research Controlled trial quality: uncertain

145. COPD

COPD COPD - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  COPD Last reviewed: February 2019 Last updated: November 2018 Summary Progressive disease state characterised by airflow limitation that is not fully reversible. Suspected in patients with a history of smoking, occupational and environmental risk factors, or a personal or family history of chronic lung disease. Presents with progressive shortness of breath, wheeze, cough, and sputum production, including haemoptysis (...) characterised by airflow limitation that is not fully reversible. It encompasses both emphysema and chronic bronchitis. The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases. It is primarily caused by cigarette smoking. Although COPD affects the lungs, it also has significant systemic consequences. Exacerbations and comorbidities are important contributors to the overall condition and prognosis in individual patients

2018 BMJ Best Practice

146. Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbations have high rehospitalization rates and reduced quality of life.To evaluate a hospital-initiated program that combined transition and long-term self-management support for patients hospitalized due to COPD (...) by the St George's Respiratory Questionnaire (SGRQ) at 6 months after discharge (score, 0 [best] to 100 [worst]; 4-point difference is clinically meaningful).Among 240 patients who were randomized (mean [SD] age, 64.9 [9.8] years; females, 61.7%), 203 (85%) completed the study. The mean (SD) baseline SGRQ score was 63.1 (19.9) in the intervention group and 62.6 (19.3) in the usual care group. The mean number of COPD-related acute care events per participant at 6 months was 0.72 (95% CI, 0.45-0.97

2018 JAMA Controlled trial quality: predicted high

147. Association of low income with pulmonary disease progression in smokers with and without chronic obstructive pulmonary disease Full Text available with Trip Pro

Association of low income with pulmonary disease progression in smokers with and without chronic obstructive pulmonary disease Low socioeconomic status has been associated with chronic obstructive pulmonary disease (COPD) but little is known about its impact on disease progression. We assessed the association of income to symptoms, pulmonary disease severity and progression in smokers with and without COPD. The COPDGene cohort of 4826 smokers who reported annual income in phase 2 was analysed (...) the effects of race and current smoking is an important factor for disease progression. Worldwide, poverty and its consequences: associated respiratory exposures, limited healthcare access, and inadequate education about smoking risks, may exacerbate chronic lung disease.

2018 ERJ open research

148. Azithromycin treatment modifies airway and blood gene expression networks in neutrophilic COPD Full Text available with Trip Pro

Azithromycin treatment modifies airway and blood gene expression networks in neutrophilic COPD Long-term, low-dose azithromycin reduces exacerbation frequency in chronic obstructive pulmonary disease (COPD), yet the mechanism remains unclear. This study characterised genome-wide gene expression changes in patients with neutrophilic COPD following long-term, low-dose azithromycin treatment. Patients with neutrophilic COPD (>61% or >162×104 cells per mL sputum neutrophils) were randomised (...) of genes regulating antigen presentation, interferon and T-cell responses, and numerous inflammatory pathways in the airways and blood of neutrophilic COPD patients.

2018 ERJ open research Controlled trial quality: uncertain

149. What Is the Utility of Noninvasive Ventilation in the Management of Acute Hypercapnic Respiratory Failure Associated With Chronic Obstructive Pulmonary Disease?

from the Cochrane Airways Trials Register and evaluated reference lists of included randomized controlled trials for additional studies. STUDY SELECTION Studies chosen were randomized controlled trials of noninvasive ventilation (inspiratory and expiratory support) to usual care in adult patients admitted to the hospital with acute exacerbations of chronic obstructive pulmonary disease causing acute hypercapnic respiratory failure, de?ned as arterial pH less than 7.35 and mean PaCO 2 greater than (...) What Is the Utility of Noninvasive Ventilation in the Management of Acute Hypercapnic Respiratory Failure Associated With Chronic Obstructive Pulmonary Disease? TAKE-HOME MESSAGE In patients with acute respiratory failure from chronic obstructive pulmonary disease exacerbation, noninvasive ventilation reduces death and intubation compared with standard treatments. WhatIstheUtilityofNoninvasiveVentilationinthe Management of Acute Hypercapnic Respiratory Failure Associated With Chronic

2018 Annals of Emergency Medicine Systematic Review Snapshots

150. Nebulized terbutaline & ipratropium bromide vs terbutaline alone in acute exacerbation of COPD requiring noninvasive ventilation: a randomized double blind controlled trial (Abstract)

Nebulized terbutaline & ipratropium bromide vs terbutaline alone in acute exacerbation of COPD requiring noninvasive ventilation: a randomized double blind controlled trial Short-acting β2 -agonists are the mainstay of treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the emergency department (ED). It is still unclear whether the addition of short-acting anticholinergics is clinically more effective care compared to treatment with β2 -agonists (...) regarding baseline demographic and clinical characteristics. Hospital admission was observed in 70 patients (59.8%) in the terbutaline/IB group and in 75 patients (65.2%) in the terbutaline group (respiratory rate [RR] = 1.09, 95% confidence interval [CI] = 0.93 to 1.27, p = 0.39). ICU admission was required in 37 (32.2%) patients in the terbutaline/IB group and 30 patients (25.6%) in terbutaline group (RR = 1.25, 95% CI = 1.02 to 1.54, p = 0.27). There were no significant differences in dyspnea score

2018 EvidenceUpdates

151. Efficacy of Dexamethasone in Preventing Acute Mountain Sickness in COPD Patients: Randomized Trial (Abstract)

and Global Initiative for Obstructive Lung Disease grade 1 to 2 who were living below 800 m. Patients were randomized to receive dexamethasone (8 mg/d) or placebo starting on the day before ascent and while staying in a high-altitude clinic at 3,100 m for 2 days. The primary outcome assessed during the altitude sojourn was the combined incidence of AMS/ARAHE, defined as an Environmental Symptoms Questionnaire cerebral score evaluating AMS ≥ 0.7 or ARAHE requiring descent or an intervention.In 60 patients (...) Efficacy of Dexamethasone in Preventing Acute Mountain Sickness in COPD Patients: Randomized Trial Patients with COPD may experience acute mountain sickness (AMS) and other altitude-related adverse health effects (ARAHE) when traveling to high altitudes. This study evaluated whether dexamethasone, a drug used for the prevention of AMS in healthy individuals, would prevent AMS/ARAHE in patients with COPD.This placebo-controlled, double-blind, parallel-design trial included patients with COPD

2018 EvidenceUpdates

152. Effect of Bronchodilation, Exercise Training, and Behavior Modification on Symptoms and Physical Activity in Chronic Obstructive Pulmonary Disease (Abstract)

Effect of Bronchodilation, Exercise Training, and Behavior Modification on Symptoms and Physical Activity in Chronic Obstructive Pulmonary Disease Bronchodilation and exercise training (ExT) improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD); however, behavior modification is required to impact daily physical activity (PA).To assess whether tiotropium/olodaterol, with or without ExT, would improve exercise endurance time (EET) and PA compared with placebo (...) in patients participating in a self-management behavior-modification (SMBM) program.This was a 12-week, randomized, partially double-blind, placebo-controlled, parallel-group trial in patients with COPD (PHYSACTO; NCT02085161). All patients were enrolled into SMBM and randomized 1:1:1:1 to once-daily placebo, tiotropium 5 μg, tiotropium/olodaterol 5/5 μg, or tiotropium/olodaterol 5/5 μg plus 8 weeks ExT. EET, measured by endurance shuttle walk test after 8 weeks, was the primary endpoint. Additional

2018 EvidenceUpdates

153. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE) Full Text available with Trip Pro

to 15% (P < 0.001). ΔEBV-SoC at 12 months was statistically and clinically significant: for FEV1, 0.106 L (P < 0.001); 6-minute-walk distance, +39.31 m (P = 0.002); and St. George's Respiratory Questionnaire, -7.05 points (P = 0.004). Significant ΔEBV-SoC were also observed in hyperinflation (residual volume, -522 ml; P < 0.001), modified Medical Research Council Dyspnea Scale (-0.8 points; P < 0.001), and the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (-1.2 (...) A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE) This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months.To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe.Subjects were enrolled with a 2

2018 EvidenceUpdates

154. Budesonide/formoterol MDI with co-suspension delivery technology in COPD: the TELOS study Full Text available with Trip Pro

Budesonide/formoterol MDI with co-suspension delivery technology in COPD: the TELOS study TELOS compared budesonide (BD)/formoterol fumarate dihydrate (FF) metered dose inhaler (BFF MDI), formulated using innovative co-suspension delivery technology that enables consistent aerosol performance, with its monocomponents and budesonide/formoterol fumarate dihydrate dry powder inhaler (DPI) in patients with moderate to very severe chronic obstructive pulmonary disease (COPD), without a requirement (...) assessed.BFF MDI 320/10 µg improved pre-dose trough FEV1versus FF MDI (least squares mean (LSM) 39 mL; p=0.0018), and BFF MDI 320/10 µg and 160/10 µg improved FEV1 AUC0-4versus BD MDI (LSM 173 mL and 157 mL, respectively; both p<0.0001) at week 24. BFF MDI 320/10 µg and 160/10 µg improved time to first and rate of moderate/severe exacerbations versus FF MDI. Treatments were well tolerated, with pneumonia incidence ranging from 0.5-1.4%.BFF MDI improved lung function versus monocomponents and exacerbations

2018 EvidenceUpdates

155. Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema. Full Text available with Trip Pro

improvement in the treated cohort compared to the control. Adverse events, occurring post procedure, included COPD exacerbations, haemoptysis, pneumothorax and pneumonia. In our centre we treated 30 patients, between January 2009 and February 2012, with variable improvement of lung function and only mild postoperative complications. The case we report here appears very interesting for the unusual near-fatal complication (massive alveolar haemorrage) followed by delayed strong functional improvement (FEV1 (...) Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema. Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional

2018 Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace Controlled trial quality: uncertain

156. Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial. Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD.To investigate the effectiveness of adding low-dose theophylline to inhaled corticosteroids (...) in COPD.The TWICS (theophylline with inhaled corticosteroids) trial was a pragmatic, double-blind, placebo-controlled, randomized clinical trial that enrolled patients with COPD between February 6, 2014, and August 31, 2016. Final follow-up ended on August 31, 2017. Participants had a ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) of less than 0.7 with at least 2 exacerbations (treated with antibiotics, oral corticosteroids, or both) in the previous year and were

2018 JAMA

157. Preventing clinically important deterioration with single-inhaler triple therapy in COPD Full Text available with Trip Pro

Preventing clinically important deterioration with single-inhaler triple therapy in COPD Clinically important deterioration (CID) is a novel composite end-point (lung function, health status, exacerbations) for assessing disease stability in patients with chronic obstructive pulmonary disease (COPD). We prospectively analysed CID in the FULFIL study. FULFIL (ClinicalTrials.gov NCT02345161; randomised, double-blind, double-dummy, multicentre study) compared 24 weeks of once daily, single-inhaler (...) fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 µg with twice daily budesonide/formoterol (BUD/FOR) 400/12 μg in patients aged ≥40 years with symptomatic advanced COPD (Global Initiative for Chronic Obstructive Lung Disease group D). A subset of patients received study treatment for up to 52 weeks. Time to first CID event was assessed over 24 and 52 weeks using two approaches for the health status component: St George's Respiratory Questionnaire and COPD assessment test. FF/UMEC/VI

2018 ERJ open research Controlled trial quality: predicted high

158. myAIRVO2 for the treatment of chronic obstructive pulmonary disease

airways (tracheostomy patients). Other features of myAIRVO2 are that it allows clinicians to titrate flow (from 10 to 60 litres/min on adult mode) and oxygen independently from one another and does not need a sealed interface. The product is marketed as AIRVO2 and myAIRVO2. myAIRVO2 is a device that is being used in the home or other domiciliary care environment. This briefing focuses on myAIRVO2 delivering nasal high-flow therapy for treating chronic obstructive pulmonary disease (COPD), including (...) in a community setting. Innovations myAIRVO2 differs from standard respiratory gas devices in being designed to allow the delivery of nasal high-flow therapy in a community setting. It also uses room air, removing the need for piped medical air, and humidifies the delivered air to reduce the risk of dryness and trauma to the upper airway mucosa. Current care pathway The NICE guideline on chronic obstructive pulmonary disease recommends treatment options including smoking cessation, inhaled therapy, oral

2018 National Institute for Health and Clinical Excellence - Advice

159. Telemonitoring in Chronic Obstructive Pulmonary Disease (CHROMED). A Randomized Clinical Trial Full Text available with Trip Pro

Telemonitoring in Chronic Obstructive Pulmonary Disease (CHROMED). A Randomized Clinical Trial Early detection of chronic obstructive pulmonary disease (COPD) exacerbations using telemonitoring of physiological variables might reduce the frequency of hospitalization.To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique and cardiac parameters in older patients with COPD and comorbidities.This multicenter, randomized clinical trial recruited 312 (...) patients with Global Initiative for Chronic Obstructive Lung Disease grades II to IV COPD (median age, 71 yr [interquartile range, 66-76 yr]; 49.6% grade II, 50.4% grades III-IV), with a history of exacerbation in the previous year and at least one nonpulmonary comorbidity. Patients were randomized to usual care (n = 158) or telemonitoring (n = 154) and followed for 9 months. All telemonitoring patients self-assessed lung mechanics daily, and in a subgroup with congestive heart failure (n = 37) cardiac

2018 EvidenceUpdates

160. Patient-facing Technology for Identification of COPD in Primary Care. Full Text available with Trip Pro

Patient-facing Technology for Identification of COPD in Primary Care. The proliferation of mobile devices and emergence of interoperable 'mHealth' apps is accelerating development and deployment of patient-facing risk assessments in primary care. The present study describes a user-centered design and an agile development approach to creation of an app for assessing lungfunction as part of a randomized controlled trial for the   dentification of chronic obstructive lung disease in primary (...) care.Seventeen patients recruited from a hospital-based, ambulatory family medicine clinic agreed to be videotaped while using the app, Lung Age, on a first-generation iPad prior to their provideR encounter. Subsequently, participants were interviewed using a semi-structured interview guide upon exiting their medical visit.Observational data indicated that participants took advantage of the portability and flexibility of the tablet device in the exam room to engage with the Lung Age app with the optionto

2018 Journal of innovation in health informatics Controlled trial quality: uncertain