Search results for "Chronic Obstructive"

Clinical implications of airway hyper-responsiveness in COPD

2006

COPD represents one of the leading causes of mortality in the general population. This study aimed at evaluating the relationship between airway hyperresponsiveness (AHR) and COPD and its relevance for clinical practice. We performed a MEDLINE search that yielded a total of 1919 articles. Eligible studies were defined as articles that addressed specific aspects of AHR in COPD, such as prevalence, pathogenesis, or prognosis. AHR appears to be present in at least one out of two individuals with COPD. The occurrence of AHR in COPD is influenced by multiple mechanisms, among which impairment of factors that oppose airway narrowing plays an important role. The main determinants of AHR are reduct…

Physician specialty as a source of heterogeneity in the care of patients with COPD.

2011

An Official American Thoracic Society Workshop Report: Evaluation and Management of Asthma in the Elderly.

2016

Asthma in the elderly (>65 yr old) is common and associated with higher morbidity and mortality than asthma in younger patients. The poor outcomes in this group are due, in part, to underdiagnosis and undertreatment. There are a variety of factors related to aging itself that affect the presentation of asthma in the elderly and influence diagnosis and management. Structural changes in the aging lung superimposed on structural changes due to asthma itself can worsen the disease and physiologic function. Changes in the aging immune system influence the cellular composition and function in asthmatic airways. These processes and differences from younger individuals with asthma are not well u…

CAT score single item analysis in patients with COPD: results from COSYCONET

2019

Abstract The COPD Assessment Test (CAT) is in widespread use for the evaluation of patients with chronic obstructive pulmonary disease (COPD). We assessed whether the CAT items carry additional information beyond the sum score regarding COPD characteristics including emphysema. Patients of GOLD grades 1 to 4 from the COPD cohort COSYCONET (German COPD and Systemic Consequences - Comorbidities Network) with complete CAT data were included (n = 2270), of whom 493 had chest CT evaluated for the presence of emphysema. Comorbidities and lung function were assessed following standardised procedures. Cross-sectional data analysis was based on multiple regression analysis of the single CAT items ag…

Why small particle fixed dose triple therapy? An excursus from COPD pathology to pharmacological treatment evolution

2022

Although bronchodilators are the cornerstone in chronic obstructive pulmonary disease (COPD) therapy, the treatment with a single-agent bronchodilator may not provide adequate symptoms control in COPD. The combination of drugs with different mechanisms of action may be more effective in inducing bronchodilation and preventing exacerbations, with a lower risk of side-effects in comparison with the increase of the dose of a single molecule. Several studies comparing the triple therapy with the association of long-acting ß2 agonist (LABA)/inhaled corticosteroid (ICS) or long-acting muscarinic antagonist (LAMA)/LABA reported improvement of lung function and quality of life. A significant reduc…

Do Saharan Dust Days Carry a Risk of Hospitalization From Respiratory Diseases for Citizens of the Canary Islands (Spain)?

2021

Background: Saharan dust meets the Canary Islands at the beginning of its westward path across the North Atlantic, exceeding the European daily levels for PM10; for this reason, their two provincial capital cities, constitute optimal sites where to evaluate the health effects of this natural event. Objectives: To assess the short-term association between Saharan Dust Days (SDDs) and respiratory morbidity in the two capital cities. Methods: We carried out a time-series analysis with daily emergency hospital admissions due to all respiratory system diseases, chronic obstructive pulmonary disease (COPD) and asthma between 2001 and 2005, assessing the independent effect of SDDs, defined accordi…

Short-term benefit of smoking cessation along with glycopirronium on lung function and respiratory symptoms in mild COPD patients: a retrospective st…

2018

Introduction. Tobacco smoke is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking cessation can change the natural history of COPD, as we know from the GOLD guidelines. Little is known about the short-term clinical and functional effects of smoking cessation treatment combined with anti-muscarinic bronchodilators. Objective. To determine whether quitting smoking, obtained by smoking cessation treatment combined with the use of a new long-acting muscarinic antagonist bronchodilator (LAMA), can improve lung function tests and respiratory symptoms more than the use of LAMA alone. Methods. We evaluated, in a retrospective analysis, the functional and clinical data, colle…

Blinded 12-week comparison of once-daily indacaterol and tiotropium in COPD.

2011

Two, once daily (q.d.) inhaled bronchodilators are available for the treatment of chronic obstructive pulmonary disease (COPD): the β(2)-agonist indacaterol and the anticholinergic tiotropium. This blinded study compared the efficacy of these two agents and assessed their safety and tolerability. Patients with moderate-to-severe COPD were randomised to treatment with indacaterol 150 μg q.d. (n=797) or tiotropium 18 μg q.d. (n=801) for 12 weeks. After 12 weeks, the two treatments had similar overall effects on "trough" (24 h post-dose) forced expiratory volume in 1 s. Indacaterol-treated patients had greater improvements in transition dyspnoea index (TDI) total score (least squares means 2.0…

Alternative ways of expressing FEV1 and mortality in elderly people with and without COPD

2013

Expressing forced expiratory volume in 1 s (FEV1) as % predicted relies on the assumption of proportional variability and generalisability of prediction equations that may be unrealistic, especially for elderly people. We evaluated the prognostic implications of alternative ways of expressing FEV1. We enrolled 318 patients with chronic obstructive pulmonary disease (COPD) and 475 controls in the Salute Respiratoria nell'Anziano (SARA) study. The risk for 5-, 10- and 15-year mortality associated with FEV1 was studied by expressing FEV1 % pred, standardised by height cubed (FEV1 · Ht(-3)) and as a multiple of the sex-specific first percentile (FEV1 quotient (FEV1Q)). In the group with COPD, t…

Why chronic obstructive pulmonary disease patients get so short of breath with limited activity

2013

equivalence despite the simplicity of MPT versus CPET as a surrogate to detect DH in COPD patients, by measuring the decrease in inspiratory capacity to reflect the increase in end-expiratory lung volume [3] . Lahaije et al. [2] have investigated whether DH as measured in the laboratory settings (CPET and MPT) reflects DH that is associated with dyspnea-limiting ADL. The authors conclude that both CPET and MPT can serve as a screening tool to identify patients who are susceptible to develop DH during ADL. In practice, MPT is simpler to obtain and is an inexpensive surrogate. However, sensitivity of MPT may not be optimal. When DH does not occur during CPET, it is unlikely to occur during AD…