- Dual combination therapy versus long-acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a systematic review and network meta-analysis. [Review]
- CDCochrane Database Syst Rev 2018 Dec 03; 12:CD012620
- CONCLUSIONS: The LABA/LAMA combination was the highest ranked treatment group to reduce COPD exacerbations although there was some uncertainty in the results. LAMA containing inhalers may have an advantage over those without a LAMA for preventing COPD exacerbations based on the rank statistics. Combination therapies appear more effective than monotherapies for improving symptom and quality-of-life scores. ICS-containing inhalers are associated with an increased risk of pneumonia.Our most comprehensive review including intraclass/group comparisons, free combination therapies, 99 studies, and 20 outcomes for each high- and low-risk population summarises the current literature and could help with updating existing COPD guidelines.
- [Individualised treatment of patients with bronchoectasis]. [Journal Article]
- ULUgeskr Laeger 2018 Dec 03; 180(49)
- Bronchiectasis is characterised by chronic cough, airway inflammation, infection and bronchial dilatation. The disease may lead to impaired lung function and premature death. An underlying inflammato...
Bronchiectasis is characterised by chronic cough, airway inflammation, infection and bronchial dilatation. The disease may lead to impaired lung function and premature death. An underlying inflammatory disease or immunodeficiency may be present, but 40% of the cases are idiopathic. The diagnosis is based on high-resolution CT scan. Treatment is aimed at reducing symptoms and risk of exacerbations, and includes antibiotics, bronchodilators and pulmonary rehabilitation. Assessment of disease severity and individual phenotypes may help to modify treatment strategies in the future.
- RISK EFFECTS OF NEAR-ROADWAY POLLUTANTS AND ASTHMA STATUS ON BRONCHITIC SYMPTOMS IN CHILDREN. [Journal Article]
- EEEnviron Epidemiol 2018; 2(2)
- CONCLUSIONS: Near-roadway air pollution was associated with bronchitic symptoms, especially among children with asthma and those living in communities with lower regional particulate matter. Better characterization of traffic pollutants from non-freeway roads is needed since many children live in close proximity to this source.
- The effect of erdosteine on airway defence mechanisms and inflammatory cytokines in the settings of allergic inflammation. [Journal Article]
- PPPulm Pharmacol Ther 2018 Nov 28
- CONCLUSIONS: In summary, we can state, that erdosteine is multi-action drug and it seems to have many beneficial and complementary effect in the management of chronic inflammatory airway diseases complicated by viscous mucus.
- Impact of Previous Physical Activity Levels on Symptomatology, Functionality, and Strength during an Acute Exacerbation in COPD Patients. [Journal Article]
- HHealthcare (Basel) 2018 Nov 29; 6(4)
- The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and...
The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and strength of acute exacerbated chronic obstructive pulmonary disease (COPD) patients. In this observational study, all data were taken during the patient's first day in hospital. Patients were divided into two groups (a PA group, and a physical inactivity (PI) group), according to the PA level evaluated by the Baecke questionnaire. Cough status was evaluated by the Leicester Cough Questionnaire (LCQ), and dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Functionality was measured by the Functional Independence Measure (FIM) and the London Chest Activity of Daily Living scale (LCADL). Exercise capacity was evaluated by the two-minute step-in-place (2MSP) test, and strength assessed by dynamometry. A total of 151 patients were included in this observational study. Patients in the PI group obtained worse results compared to the PA group, and significant differences (p < 0.05) were found in all of the variables. Those COPD patients who regularly perform PA have less dyspnea and cough, as well as better functionality, exercise capacity and strength during an exacerbation, without relationship to the severity of the pathology.
- Use and inhalation technique of inhaled medication in patients with asthma and COPD: data from a randomized controlled trial. [Journal Article]
- RRRespir Res 2018 Dec 03; 19(1):237
- CONCLUSIONS: Correct inhalation of prescribed medication is associated with improved health status and lung function. These findings should encourage health professionals to provide instructions on correct inhalation technique and to regularly re-evaluate the patients' inhalation technique.
- Relationships between home ventilation rates and respiratory health in the Colorado Home Energy Efficiency and Respiratory Health (CHEER) study. [Journal Article]
- EREnviron Res 2018 Nov 16; 169:297-307
- CONCLUSIONS: While prior studies have highlighted the potential hazards of low ventilation rates in residences, this study suggests high ventilation rates in single-family homes, duplexes and town-homes in urban areas may also have negative impacts on respiratory health, possibly due to the infiltration of outdoor pollutants.
- Paediatric and adult bronchiectasis: Monitoring, cross-infection, role of multidisciplinary teams and self-management plans. [Review]
- RRespirology 2018 Nov 30
- Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Earl...
Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimize further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (forced expiratory volume in 1 s (FEV1 )% predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with Pseudomonas aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalization. Other tools that are currently used in research settings such as health-related quality of life (QoL) questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multidisciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalized self-management plans are also important despite limited evidence it improves QoL or frequency of exacerbations.
- Assessing the referral of clients with respiratory symptoms to general physicians: a survey of community pharmacists in Beirut. [Journal Article]
- IJInt J Pharm Pract 2018 Nov 27
- CONCLUSIONS: This study has shown that there is a need for further investigation into the practices of community pharmacists of Beirut. An action plan may be advised to alleviate the burden of patients who might currently be under-referred and experience morbidity as a result.
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- Identification of Mycobacterium genavense natural infection in a domestic ferret. [Journal Article]
- JVJ Vet Diagn Invest 2018 Nov 26; :1040638718812137
- A 6-y-old neutered male ferret ( Mustela putorius furo) was presented because of a 1-mo history of progressive weight loss, chronic cough, and hair loss. On clinical examination, the animal was cough...
A 6-y-old neutered male ferret ( Mustela putorius furo) was presented because of a 1-mo history of progressive weight loss, chronic cough, and hair loss. On clinical examination, the animal was coughing, slightly depressed, moderately hypothermic, and had bilateral epiphora. Thoracic radiography was suggestive of severe multinodular interstitial pneumonia. Abdominal ultrasound examination revealed hepatosplenomegaly and mesenteric and pancreaticoduodenal lymphadenopathy. Fine-needle aspiration of the pancreaticoduodenal lymph node, followed by routine Romanowsky and Ziehl-Neelsen stains, revealed numerous macrophages containing myriad acid-fast bacilli, leading to identification of mycobacteriosis. Autopsy and histologic examination confirmed the presence of disseminated, poorly defined, acid-fast, bacilli-rich granulomas in the pancreaticoduodenal and mesenteric lymph nodes, intestines, and lungs. Destaining of May-Grünwald/Giemsa-stained slides with alcohol, and then restaining with Ziehl-Neelsen, revealed acid-fast rods and avoided repeat tissue sampling without affecting the Ziehl-Neelsen stain quality and cytologic features. Tissue samples were submitted for a PCR assay targeting the heat shock protein gene ( hsp65) and revealed 100% homology with Mycobacterium genavense. We emphasize the use of special stains and PCR for identification of this potential zoonotic agent.