Search results for "Exacerbation"
showing 10 items of 164 documents
Budesonide/formoterol for maintenance and reliever therapy in the management of moderate to severe asthma.
2008
The Global Initiative for Asthma (GINA) guidelines aim at improving asthma control and preventing future risk. For patients with moderate to severe asthma an inhaled corticosteroid (ICS) or an ICS/long-acting beta2-agonist (LABA) combination with a short-acting beta2-agonist (SABA) as reliever is recommended. Despite the availability of effective maintenance therapies, a large proportion of patients still fail to achieve guideline-defined asthma control, and overuse of SABA reliever medication at the expense of ICS is commonly observed. New simplified treatment approaches may offer a solution and assist physicians to achieve overall asthma control. One such treatment approach, which is reco…
Asthma bronchiale: neue Erkenntnisse und Entwicklungen
2011
In mild asthma low-dose steroid inhalation treatment reduces severe exacerbations and exacerbation associated loss of lung function. In patients with mild asthma, symptom-driven use of a combination of inhaled steroid and short-acting beta-2-sympathomimetics in a single inhaler is feasible. In moderate and severe asthma the fixed combination of formoterol and budesonide can be used a maintenance therapy but also as treatment of acute symptoms. Monotherapy with long-acting beta 2-sympathomimetics should be completely avoided. Long-acting anticholinergic drugs are equally efficacious as long-acting beta-2-sympathomimetics, but have not yet been approved for use in patients with asthma. The co…
LSC Abstract – Functional metagenomics of respiratoy microbiome in exacerbated COPD
2015
Background: The course of COPD is frequently aggravated by exacerbations. New molecular techniques have suggested that many bacterial groups, not only the common COPD pathogens, could trigger the exacerbations. Objective: to analyze the microbial community and the gene content of samples obtained during stability and exacerbation of COPD patients. Method: 16S rRNA was pyrosequenced to obtain the taxonomic information. The metabolic information was obtained with the Metagenomics RAST server (MG-RAST) with KEGG database. Results: 8 severe COPD patients were included. At genus level, 68 different OTUs were found. No significant differences in the relative abundance of any of the detected gener…
Factors associated with Pneumocystis colonization and circulating genotypes in chronic obstructive pulmonary disease patients with acute exacerbation…
2021
Abstract Pneumocystis jirovecii colonization is frequent during chronic obstructive pulmonary disease (COPD) and patients constitute potential contributors to its interhuman circulation. However, the existence of an environmental reservoir cannot be excluded. We assessed the prevalence and factors associated with Pneumocystis colonization during COPD, and studied circulation between patients and their domestic environment. Pneumocystis molecular detection and mtLSU genotyping were performed in oro-pharyngeal washes (OPW) sampled in 58 patients with COPD acute exacerbation, and in indoor dust, sampled in patients’ homes using electrostatic dust collectors (EDCs). Lung and systemic inflammati…
Predictors for early readmission after COPD exacerbation
2019
Aim: Identify predictors for early readmission in patients with COPD and severe exacerbation. Material and methods: Prospective study (July 2017-June 2018) that included all patients hospitalized for an acute exacerbations of COPD. Demographic date, clinical and spirometric parameters, arterial blood gases, length of stay, and evolutive parameters were collected. We used univariate and multivariate statistical techniques to identify risks for readmission. Results: 278 consecutive patients were enrolled. During the follow-up 31 (11%) patients were admitted within 30 days of discharge (early readmission). Univariate analysis showed that FEV1 (p=0.02), FEV1 (%) (p=0.01), total dose of steroids…
Roflumilast N-oxide combined with PI3Kδ inhibitor improves the phenotype of early-onset COPD
2016
Background: Severe, early-onset COPD (Chronic Obstructive Pulmonary Disease) is characterized by a rapid decline in lung function at an early age with neutrophil over-activation. Roflumilast is approved as treatment for moderate and severe COPD at risk of exacerbation as add on therapy. Recent evidence indicates that the combination of PDE4 and PI3Kδ inhibitors show synergic anti-inflammatory properties. Objectives: To explore the effects from adding a selective PI3Kδ inhibitor to roflumilast N-oxide (RNO) in neutrophils isolated from peripheral blood of severe, early-onset COPD patients in in vitro models. Methods: Neutrophils were isolated from peripheral blood of 20 severe, early-onset C…
Deep Neural Networks for Prediction of Exacerbations of Patients with Chronic Obstructive Pulmonary Disease
2018
Chronic Obstructive Pulmonary Disease (COPD) patients need help in daily life situations as they are burdened with frequent risks of acute exacerbation and loss of control. An automated monitoring system could lead to timely treatments and avoid unnecessary hospital (re-)admissions and home visits by doctors or nurses. Therefore we present a Deep Artificial Neural Networks for approach prediction of exacerbations, particularly Feed-Forward Neural Networks (FFNN) for classification of COPD patients category and Long Short-Term Memory (LSTM), for early prediction of COPD exacerbations and subsequent triage. The FFNN and LSTM models are trained on data collected from remote monitoring of 94 pa…
Inhaled steroids and prevalence of osteoporosis in chronic obstructive pulmonary disease: Data from the DACCORD cohort
2020
Introduction: Osteoporosis is a frequent COPD comorbidity with age, female gender, smoking, immobility and the use of oral steroids (OCS) as common risk factors. The role of inhaled steroids (ICS) is still under debate. Methods: Baseline data from the real life cohort DACCORD were analyzed. The diagnosis of osteoporosis was based on patients’ reports of physician-based diagnoses. Associations of ICS exposure at time of inclusion and osteoporosis were examined by group comparisons and multivariable logistic regression analyses with age, gender, smoking, exacerbation history (EH) and FEV1% as covariates. To avoid interactions with other steroid containing medications, exposure to any corticos…
Late Breaking Abstract - Relationship between clinical features and mortality in a cohort of COPD patients
2021
Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease with poor outcomes, including a high mortality. GULP is a multicenter Italian study that described clinical characteristics, exacerbation rates and survival of a cohort of COPD patients, as part of AstraZeneca’s AvoidEX program. Aims and objectives: To evaluate whether the clinical profile of subjects enrolled in the GULP study predicts mortality on a period of 3 years. Methods: Post-hoc analysis of an observational, multicenter, retrospective study. Patients were stratified according to survival status: alive (A) and dead (D). Clinical characteristics, comorbidities and exacerbation rates were reported in the…
“Real-life” inhaled corticosteroid withdrawal in COPD: a subgroup analysis of DACCORD
2017
Claus Vogelmeier,1 Heinrich Worth,2 Roland Buhl,3 Carl-Peter Criée,4 Nadine S Lossi,5 Claudia Mailänder,5 Peter Kardos6 1Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Marburg, 2Facharzt Forum Fürth, Fürth, 3Pulmonary Department, Mainz University Hospital, Mainz, 4Department of Sleep and Respiratory Medicine, Evangelical Hospital Göttingen-Weende, Bovenden, 5Clinical Research, Respiratory, Novartis Pharma GmbH, Nürnberg, 6Group Practice and Centre for Allergy, Respiratory and Sleep Medicine, Re…