Abstract: Hospitalizations for patients with acute exacerbations of COPD are associated with several adverse patient outcomes as well as with significant health-care costs. Despite many interventions targeted at reducing readmissions […]» Read more
Predicting response to benralizumab in chronic obstructive pulmonary disease: analyses of GALATHEA and TERRANOVA studies.
Abstract: Benralizumab did not significantly reduce exacerbations compared with placebo in the phase 3 GALATHEA and TERRANOVA trials of benralizumab for patients with chronic obstructive pulmonary disease (COPD). We aimed […]» Read more
Airway obstruction in young adults born extremely preterm or extremely low birth weight in the postsurfactant era.
Abstract: It is unknown if adults born» Read more
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An individualized prediction model for long-term lung function trajectory and risk of COPD in the general population.
Abstract: Prediction of future lung function will enable the identification of individuals at high risk of developing chronic obstructive pulmonary disease (COPD), but the trajectory of lung function decline greatly […]» Read more
Abstract: Low-dose CT (LDCT) screening detects early stage lung cancer and reduces mortality. We proposed a sequential approach targeted to a high-risk group as a potentially efficient screening strategy.LungSEARCH was […]» Read more
Abstract: Previous studies have associated marijuana exposure with increased respiratory symptoms and chronic bronchitis among long-term cannabis smokers.The long-term effects of smoked marijuana on lung function remain unclear.We determined the […]» Read more
Abstract: Inhaled corticosteroids (ICS) are widely prescribed for patients with chronic obstructive pulmonary disease (COPD), yet with variable outcomes and adverse reactions which may be genetically determined. The primary aim […]» Read more
Abstract: Heat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the […]» Read more
Abstract: Severe obstructive lung disease, which encompasses patients with asthma, chronic obstructive pulmonary disease (COPD) or features of both, remains a considerable global health problem and burden on healthcare resources. […]» Read more
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Home initiation of chronic non-invasive ventilation in COPD patients with chronic hypercapnic respiratory failure: a randomised controlled trial.
Abstract: Chronic non-invasive ventilation (NIV) has become evidence-based care for stable hypercapnic COPD patients. While the number of patients increases, home initiation of NIV would greatly alleviate the healthcare burden. […]» Read more
Abstract: Individual susceptibility to exacerbations in chronic obstructive pulmonary disease (COPD) is likely influenced by genetic factors; however, most such variance is unexplained. We hypothesised that ?2-adrenergic receptor genotypes, Gly16Arg […]» Read more
Efficacy and safety of inhaled alpha-1-antitrypsin in patients with severe alpha-1-antitrypsin deficiency and frequent exacerbations of Chronic Obstructive Pulmonary Disease.
Abstract: Patients with inherited alpha-1-antitrypsin (AAT) deficiency (ZZ-AATD) and severe chronic obstructive pulmonary disease (COPD) frequently suffer from exacerbations. We postulated that inhalation of nebulised AAT would be an effective […]» Read more
European Respiratory Society Guideline on Long-term Home Non-Invasive Ventilation for Management of Chronic Obstructive Pulmonary Disease.
Abstract: While the role of acute non-invasive ventilation (NIV) has been shown to improve outcome in acute life-threatening hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD), the evidence of […]» Read more
Abstract: The pathophysiological processes underlying bronchiectasis in COPD are not understood. In COPD, both small and large airways are progressively lost. It is currently not known to what extent the […]» Read more
CAT (COPD ASSESSMENT TEST) In Bronchiectasis: Minimum Clinically Important Difference and Psychometric Validation. A Prospective Study.
Abstract: Health-related Quality of Life (QoL) is one of the most important endpoints in bronchiectasis (BE). However, the majority of HRQoL questionnaires are time-consuming or not validated in BE. The […]» Read more
Radiographic Lung Volumes Predict Progression to COPD in Smokers with Preserved Spirometry in SPIROMICS.
Abstract: The characteristics that predict progression to overt COPD in smokers without spirometric airflow obstruction are not clearly defined.We conducted a post-hoc analysis of 849 current and former smokers (?20 […]» Read more
Abstract: Air travel is physically demanding and since obesity is rising physicians increasingly need to assess whether such patients can fly safely.Our aim was to compare the diagnostic accuracy of […]» Read more
Abstract: This international randomised controlled trial evaluated whether COPD patients with comorbidities, trained in using patient-tailored multi-disease exacerbation action plans, had fewer COPD exacerbation days than usual care (UC).COPD patients […]» Read more
Abstract: Viral respiratory tract infections have been implicated as the predominant risk factor for acute exacerbations of COPD (AECOPD). We aimed to evaluate, longitudinally, the association between upper respiratory tract […]» Read more
Abstract: The National Early Warning Score 2 (NEWS2) includes two oxygen saturation scales; the second adjusts target saturations to 88%-92% for those with hypercapnic respiratory failure. Using this second scale […]» Read more
Abstract: Switching inhalers to cheaper equivalent products is often advocated as a necessary cost saving measure, yet the impact on patient’s health and healthcare utilisation has not been measured.We identified […]» Read more
Eligibility for Lung Volume Reduction Surgery in Chronic Obstructive Pulmonary Disease patients identified in a UK primary care setting.
Abstract: Although lung volume reduction surgery (LVRS) improves survival in appropriately selected patients with Chronic Obstructive Pulmonary Disease (COPD), few procedures are performed. The National Institute for Clinical and Healthcare […]» Read more
Diffusing capacity of the lung for carbon monoxide (DLCO) is inconsistently obtained in patients with chronic obstructive pulmonary disease (COPD) and the added benefit of DLCO testing beyond more common tools is unknown.To determine whether lower DLCO is associated with increased COPD morbidity independent of spirometry and CT emphysema.Data for 1806 COPD participants from the COPDGene 5-year visit were analyzed, including pulmonary function testing, quality of life, symptoms, exercise performance, and exacerbation rates. DLCO % predicted was primarily analyzed as a continuous variable and additionally categorized into four groups: (1) DLCO and FEV1 >50% (reference), (2) only DLCO ?50%, (3) only FEV1 ?50%, and (4) both ?50% predicted. Outcomes were modelled using multivariable linear and negative binomial regression, including emphysema and FEV1 % predicted among other confounders.In multivariable analyses, every 10% predicted decrease in DLCO was associated with symptoms and quality of life (CAT: 0.53 p<0.001, SGRQ: 1.67 p<0.001, SF-36 physical functioning: -0.89 p<0.001), exercise performance (6MWD: -45.35 p<0.001), and severe exacerbation rate (RR 1.14 p<0.001). When categorized, severe impairment in DLCO alone, FEV1 alone, or both DLCO and FEV1 was associated with significantly worse morbidity as compared to the reference group (p<0.05 for all outcomes).Impairment in DLCO was associated with increased COPD symptoms, reduced exercise performance, and severe exacerbation risk even after accounting for spirometry and CT evidence of emphysema. These findings suggest that DLCO should be considered for inclusion in future multidimensional tools assessing COPD.» Read more
Prevalence and risk factors for osteoporosis in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
Osteoporosis is prevalent in individuals with chronic obstructive pulmonary disease (COPD). Updated evidence is required to complement the previous systematic review on this topic in order to provide best practice. The aim of this systematic review and meta-analysis was to quantitatively synthesize data from studies with respect to the prevalence and risk factors for osteoporosis among individuals with COPD.EMBASE, CINAHL MEDLINE, and PubMed databases were searched for articles containing the keywords “COPD”, “osteoporosis”, “prevalence”, and “risk factor”. Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. Meta-analyses were performed to determine osteoporosis prevalence and risk factors in individuals with COPD. Meta-regression analyses were conducted to explore the sources of heterogeneity.The pooled global prevalence from 58 studies was 38% (95% CI= 34, 43). The presence of COPD increased the likelihood of having osteoporosis (OR= 2.83). Other significant risk factors for osteoporosis in COPD patients were body mass index < 18.5 kg/m2 (OR=4.26) and the presence of sarcopenia (OR= 3.65).Osteoporosis is prevalent in individuals with COPD and the prevalence appears to be high and similar in many countries. COPD patients should be screened for osteoporosis and contributing risk factors.» Read more
?1-antitrypsin deficiency (AATD) remains the only readily identified genetic cause of chronic obstructive pulmonary disease (COPD). Furthermore, there is growing evidence that even a moderate deficiency increases the risk of lung disease among smokers. Despite these facts, the uptake of testing for AATD in at-risk populations remains low for many reasons, and a lack of clarity among clinicians regarding the most appropriate diagnostic techniques presents a major deterrent. This Personal View addresses the benefits of diagnosis, the technical basis of the available diagnostic methods, and possible clinical confounders for each test. We include a series of unusual cases encountered at our National Centre of Expertise to provide context. The topics covered should equip clinicians with the core knowledge required to confidently assess patients for AATD.» Read more
Increased reactive oxygen species (ROS) have been implicated in the pathophysiology of chronic obstructive pulmonary disease (COPD).This study examined the effect of exogenous and endogenous oxidative stress on macrophage phagocytosis in patients with COPD.Monocyte-derived macrophages (MDM) were generated from non-smoker, smoker and COPD subjects, differentiated in either GM-CSF (G-M?) or M-CSF (M-M?). Alveolar macrophages were isolated from lung tissue or bronchoalveolar lavage. Macrophages were incubated +/- 200?µM H2O2 for 24?h, then exposed to fluorescently-labelled H. influenzae or S. pneumoniae for 4?h, after which phagocytosis, mitochondrial ROS (mROS), and mitochondrial membrane potential (??m) were measured.Phagocytosis of bacteria was significantly decreased in both G-M? and M-M? from COPD patients, compared to non-smoker controls. In non-smokers and smokers, bacterial phagocytosis did not alter mROS or ??m, however in COPD, phagocytosis increased early mROS and decreased ??m in both G-M? and M-M?. Exogenous oxidative stress reduced phagocytosis in non-smoker and COPD alveolar macrophages, and non-smoker MDM, associated with reduced mROS production.COPD macrophages show defective phagocytosis, which is associated with altered mitochondrial function and an inability to regulate mROS production. Targeting mitochondrial dysfunction may restore the phagocytic defect in COPD.» Read more
Nanomedicine is a multidisciplinary research field with an integration of traditional sciences such as chemistry, physics, biology and materials science. The application of nanomedicine for lung diseases as a relatively new area of interdisciplinary science has grown rapidly over the last 10 years. Promising research outcomes suggest that nanomedicine will revolutionise the practice of medicine, through the development of new approaches in therapeutic agent delivery, vaccine development and nanotechnology-based medical detections. Nano-based approaches in the diagnosis and treatment of lung diseases will, in the not too distant future, change the way we practise medicine. This review will focus on the current trends and developments in the clinical translation of nanomedicine for lung diseases, such as in the areas of lung cancer, cystic fibrosis, asthma, bacterial infections and COPD.» Read more
Ambient air pollution increases the risk of respiratory mortality but evidence for impacts on lung function and chronic obstructive pulmonary disease (COPD) is less well established. The aim was to evaluate whether ambient air pollution is associated with lung function and COPD, and explore potential vulnerability factors.We used UK Biobank data on 3?03?887 individuals aged 40-69?years, with complete covariate data and valid lung function measures. Cross-sectional analyses examined associations of Land Use Regression-based estimates of particulate matter (PM2.5, PM10 and PMcoarse) and nitrogen dioxide (NO2) concentrations with forced expiratory volume in 1?s (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio, and COPD (FEV1/FVC