Single inhaler #triple therapy versus inhaled corticosteroid plus long-acting β2-agonist therapy for chronic #obstructive pulmonary disease (TRILOGY): a double-blind, parallel group, randomised controlled trial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31354-X/abstract
Interpretation
We provide evidence for the clinical benefits of stepping up patients with COPD from an inhaled corticosteroid/long-acting β2-agonist combination treatment to triple therapy using a single inhaler.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31354-X/abstract
Interpretation
We provide evidence for the clinical benefits of stepping up patients with COPD from an inhaled corticosteroid/long-acting β2-agonist combination treatment to triple therapy using a single inhaler.
A New Approach for Identifying Patients with #Undiagnosed Chronic #Obstructive Pulmonary Disease
http://www.atsjournals.org/doi/abs/10.1164/rccm.201603-0622OC#.WBIjqcnK5Kk
A 5-item questionnaire (CAPTURETM©) assesses exposure, breathing problems, tiring easily, and acute respiratory illnesses.
Conclusions: CAPTURETM© with PEF can identify COPD patients who would benefit from currently available therapy and require further diagnostic evaluation.
http://www.atsjournals.org/doi/abs/10.1164/rccm.201603-0622OC#.WBIjqcnK5Kk
A 5-item questionnaire (CAPTURETM©) assesses exposure, breathing problems, tiring easily, and acute respiratory illnesses.
Conclusions: CAPTURETM© with PEF can identify COPD patients who would benefit from currently available therapy and require further diagnostic evaluation.
Lung function reductions associated with #motor vehicle density in chronic #obstructive pulmonary disease: a cross-sectional study
http://respiratory-research.biomedcentral.com/articles/10.1186/s12931-016-0451-3
Vehicle traffic density was associated with significant reductions in lung function in people with COPD. Urban planning should consider the health impacts for those with pre-existing respiratory conditions.
http://respiratory-research.biomedcentral.com/articles/10.1186/s12931-016-0451-3
Vehicle traffic density was associated with significant reductions in lung function in people with COPD. Urban planning should consider the health impacts for those with pre-existing respiratory conditions.
Respiratory Research
Lung function reductions associated with motor vehicle density in chronic obstructive pulmonary disease: a cross-sectional study
Motor vehicle-related air pollution can potentially impair lung function. The effect of pollution in people with compromised pulmonary function such as in COPD has not been previously investigated. To examine the association of lung function with motor vehicle…
Screening for #Obstructive Sleep #Apnea in Adults
http://jamanetwork.com/journals/jama/fullarticle/2598778
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement)
http://jamanetwork.com/journals/jama/fullarticle/2598778
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement)
Jamanetwork
USPSTF Recommendation: Screening for Obstructive Sleep Apnea in Adults
This Recommendation Statement from the US Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in asymptomatic adults (I statement).
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Small #airways disease in mild and moderate chronic #obstructive pulmonary disease: a cross-sectional study
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(18)30196-6/fulltext?rss=yes
The 34 lung specimens provided 262 lung samples. Compared with control smokers, the number of terminal bronchioles decreased by 40% in patients with GOLD 1 COPD (p=0·014) and 43% in patients with GOLD 2 COPD (p=0·036), the number of transitional bronchioles decreased by 56% in patients with GOLD 1 COPD (p=0·0001) and 59% in patients with GOLD 2 COPD (p=0·0001), and alveolar surface area decreased by 33% in patients with GOLD 1 COPD (p=0·019) and 45% in patients with GOLD 2 COPD (p=0·0021). These pathological changes were found to correlate with lung function decline. We also showed significant loss of terminal and transitional bronchioles in lung samples from patients with GOLD 1 or GOLD 2 COPD that had a normal alveolar surface area. Remaining small airways were found to have thickened walls and narrowed lumens, which become more obstructed with increasing COPD GOLD stage.
Interpretation
These data show that small airways disease is a pathological feature in mild and moderate COPD. Importantly, this study emphasises that early intervention for disease modification might be required by patients with mild or moderate COPD
Small #airways disease in mild and moderate chronic #obstructive pulmonary disease: a cross-sectional study
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(18)30196-6/fulltext?rss=yes
The 34 lung specimens provided 262 lung samples. Compared with control smokers, the number of terminal bronchioles decreased by 40% in patients with GOLD 1 COPD (p=0·014) and 43% in patients with GOLD 2 COPD (p=0·036), the number of transitional bronchioles decreased by 56% in patients with GOLD 1 COPD (p=0·0001) and 59% in patients with GOLD 2 COPD (p=0·0001), and alveolar surface area decreased by 33% in patients with GOLD 1 COPD (p=0·019) and 45% in patients with GOLD 2 COPD (p=0·0021). These pathological changes were found to correlate with lung function decline. We also showed significant loss of terminal and transitional bronchioles in lung samples from patients with GOLD 1 or GOLD 2 COPD that had a normal alveolar surface area. Remaining small airways were found to have thickened walls and narrowed lumens, which become more obstructed with increasing COPD GOLD stage.
Interpretation
These data show that small airways disease is a pathological feature in mild and moderate COPD. Importantly, this study emphasises that early intervention for disease modification might be required by patients with mild or moderate COPD
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Fatty #Airways: Implications for #Obstructive Disease
Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway pathology
..BMI ranged from 15 to 45 (kg·m−2) and was greater in NFA (p<0.05). Adipose tissue was identified in the outer wall of large airways (Pbm>6 mm), but was rarely seen in small airways (Pbm<6 mm). Adipose tissue area correlated positively with BMI and airway wall thickness in all groups. Densities of neutrophils correlated with adipose tissue area in control subjects (Pbm>6 mm, p=0.04) and both neutrophils and eosinophils in FA (Pbm>12 mm, p<0.01).
These data show that adipose tissue is present within the airway wall and is related to BMI, wall thickness and the number of inflammatory cells. The accumulation of airway adipose tissue in overweight individuals may therefore contribute to airway pathophysiology.
https://erj.ersjournals.com/content/early/2019/09/02/13993003.00857-2019
Fatty #Airways: Implications for #Obstructive Disease
Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway pathology
..BMI ranged from 15 to 45 (kg·m−2) and was greater in NFA (p<0.05). Adipose tissue was identified in the outer wall of large airways (Pbm>6 mm), but was rarely seen in small airways (Pbm<6 mm). Adipose tissue area correlated positively with BMI and airway wall thickness in all groups. Densities of neutrophils correlated with adipose tissue area in control subjects (Pbm>6 mm, p=0.04) and both neutrophils and eosinophils in FA (Pbm>12 mm, p<0.01).
These data show that adipose tissue is present within the airway wall and is related to BMI, wall thickness and the number of inflammatory cells. The accumulation of airway adipose tissue in overweight individuals may therefore contribute to airway pathophysiology.
https://erj.ersjournals.com/content/early/2019/09/02/13993003.00857-2019
European Respiratory Society
Fatty Airways: Implications for Obstructive Disease
Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway…
Pharmacologic Therapies in Patients With Exacerbation of Chronic #Obstructive #Pulmonary Disease: A Systematic Review With Meta-analysis
https://2medical.news/2020/03/03/pharmacologic-therapies-in-patients-with-exacerbation-of-chronic-obstructive-pulmonary-disease-a-systematic-review-with-meta-analysis/
..Compared with placebo or management without antibiotics, antibiotics given for 3 to 14 days were associated with increased exacerbation resolution at the end of the intervention (odds ratio [OR], 2.03 [95% CI, 1.47 to 2.80]; moderate SOE) and less treatment failure at the end of the intervention (OR, 0.54 [CI, 0.34 to 0.86]; moderate SOE), independent of severity of exacerbations in out- and inpatients. Compared …
https://2medical.news/2020/03/03/pharmacologic-therapies-in-patients-with-exacerbation-of-chronic-obstructive-pulmonary-disease-a-systematic-review-with-meta-analysis/
..Compared with placebo or management without antibiotics, antibiotics given for 3 to 14 days were associated with increased exacerbation resolution at the end of the intervention (odds ratio [OR], 2.03 [95% CI, 1.47 to 2.80]; moderate SOE) and less treatment failure at the end of the intervention (OR, 0.54 [CI, 0.34 to 0.86]; moderate SOE), independent of severity of exacerbations in out- and inpatients. Compared …
Chronic #obstructive pulmonary disease and lung cancer incidence in never smokers: a cohort study
https://2medical.news/2020/04/08/chronic-obstructive-pulmonary-disease-and-lung-cancer-incidence-in-never-smokers-a-cohort-study/
There has been limited evidence for the association between chronic obstructive pulmonary disease (COPD) and the incidence of lung cancer among never smokers. We aimed to estimate the risk of lung cancer incidence in never smokers with COPD, and to compare it with the risk associated with smoking. This cohort study involved 338 548 subjects, 40 to 84 years of age with no history of lung …
https://2medical.news/2020/04/08/chronic-obstructive-pulmonary-disease-and-lung-cancer-incidence-in-never-smokers-a-cohort-study/
There has been limited evidence for the association between chronic obstructive pulmonary disease (COPD) and the incidence of lung cancer among never smokers. We aimed to estimate the risk of lung cancer incidence in never smokers with COPD, and to compare it with the risk associated with smoking. This cohort study involved 338 548 subjects, 40 to 84 years of age with no history of lung …
Factors associated with #sleep disturbance in patients with chronic #obstructive pulmonary disease
https://2medical.news/2020/08/07/factors-associated-with-sleep-disturbance-in-patients-with-chronic-obstructive-pulmonary-disease/
Poor sleep quality in patients with chronic obstructive pulmonary disease (#COPD ) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD.. This was a prospective, multicenter cross‐sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient‐reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to …
https://2medical.news/2020/08/07/factors-associated-with-sleep-disturbance-in-patients-with-chronic-obstructive-pulmonary-disease/
Poor sleep quality in patients with chronic obstructive pulmonary disease (#COPD ) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD.. This was a prospective, multicenter cross‐sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient‐reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to …
Randomized Trial of Nocturnal #Oxygen in Chronic #Obstructive Pulmonary Disease
https://2medical.news/2020/09/22/randomized-trial-of-nocturnal-oxygen-in-chronic-obstructive-pulmonary-disease/
Long-term oxygen therapy improves survival in patients with chronic obstructive pulmonary disease (COPD) and chronic severe daytime hypoxemia. However, the efficacy of oxygen therapy for the management of isolated nocturnal hypoxemia is uncertain.. ..Patients with an oxygen saturation of less than 90% for at least 30% of the recording time on nocturnal oximetry were assigned, in a 1:1 ratio, to receive either nocturnal oxygen or …
https://2medical.news/2020/09/22/randomized-trial-of-nocturnal-oxygen-in-chronic-obstructive-pulmonary-disease/
Long-term oxygen therapy improves survival in patients with chronic obstructive pulmonary disease (COPD) and chronic severe daytime hypoxemia. However, the efficacy of oxygen therapy for the management of isolated nocturnal hypoxemia is uncertain.. ..Patients with an oxygen saturation of less than 90% for at least 30% of the recording time on nocturnal oximetry were assigned, in a 1:1 ratio, to receive either nocturnal oxygen or …