scholarly journals Clinical Predictors of Bacterial Involvement in Exacerbations of Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 39 (7) ◽  
pp. 980-986 ◽  
Author(s):  
Paul van der Valk ◽  
Evelyn Monninkhof ◽  
Job van der Palen ◽  
Gerhard Zielhuis ◽  
Cees van Herwaarden ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Clinical Predictors ◽  
Obstructive Pulmonary Disease

scholarly journals Clinical predictors of frequent exacerbations in subjects with severe chronic obstructive pulmonary disease (COPD)

2011 ◽  
Vol 105 (4) ◽  
pp. 588-594 ◽  
Author(s):  
Emily S. Wan ◽  
Dawn L. DeMeo ◽  
Craig P. Hersh ◽  
Steven D. Shapiro ◽  
Richard A. Rosiello ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Clinical Predictors ◽  
Obstructive Pulmonary Disease

scholarly journals Clinical predictors of exacerbation frequency in chronic obstructive pulmonary disease

2010 ◽  
Vol 5 (4) ◽  
pp. 227-234 ◽  
Author(s):  
Marjolein Brusse-Keizer ◽  
Job van der Palen ◽  
Paul van der Valk ◽  
Ron Hendrix ◽  
Huib Kerstjens
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Clinical Predictors ◽  
Obstructive Pulmonary Disease ◽  
Exacerbation Frequency

scholarly journals Triple therapy in a single inhaler for chronic obstructive pulmonary disease: clinical studies and case report (real practice)

2021 ◽  
pp. 174-184
Author(s):  
V. V. Salukhov ◽  
E. V. Kryukov ◽  
M. A. Kharitonov ◽  
V. P. Sereda ◽  
A. A. Minakov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Case Report ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Clinical Success ◽  
Chronic Obstructive ◽  
Additional Contribution ◽  
Clinical Predictors ◽  
Obstructive Pulmonary Disease

Algorithms for de-escalation of basic therapy, including the abolition of inhaled corticosteroids (ICS), in patients with chronic obstructive pulmonary disease (COPD), as well as the development of clear criteria for prescribing triple therapy in clinical practice remain the subject of numerous studies and discussions. The given case report of managing a patient with a long experience of smoking and severe COPD demonstrated an unsuccessful experience of de-escalation of therapy with the abolition of ICS due to concerns about the fact of pneumonia. The dual bronchodilator therapy prescribed in accordance with modern recommendations was insufficiently effective in preventing exacerbations, and the stabilization of the patient’s condition was observed after the appointment of a fixed triple combination of drugs in a single inhaler (VI/UMEC/FF), which contains vilanterol (VI), umeclidinium bromide (UMEC) and ICS fluticasone furoate (FF). An additional contribution to ensuring clinical success was made by such factors as strict compliance with medical prescriptions by the patient, smoking cessation and compliance with recommendations for maintaining physical activity, compliance with a strict self-isolation regime during the pandemic, which reduced the risks of respiratory viral infections. Additional clinical predictors of the effectiveness of ICS in COPD were the bronchitis type, the persistence of symptoms and the recurrence of exacerbations of the disease after discontinuation of the drug, the level of blood eosinophilia. When deciding whether to prescribe or cancel triple therapy, it is recommended to take into account the data on the effect of ICS on improving the functional parameters and clinical course of the disease with a decrease in symptoms, on reducing the risk of exacerbations, on increasing patient survival and a positive prognosis during COPD.

scholarly journals Unmet needs in the management of exacerbations of chronic obstructive pulmonary disease

2021 ◽  
Vol 16 (3) ◽  
pp. 559-569
Author(s):  
Kiki Waeijen-Smit ◽  
Sarah Houben-Wilke ◽  
Antonio DiGiandomenico ◽  
Ulf Gehrmann ◽  
Frits M. E. Franssen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Unmet Needs ◽  
Activity Level ◽  
Chronic Obstructive ◽  
Clinical Predictors ◽  
Microbial Composition ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
The Impact

AbstractExacerbations of chronic obstructive pulmonary disease (COPD) are episodes of acute worsening of respiratory symptoms that require additional therapy. These events play a pivotal role in the natural course of the disease and are associated with a progressive decline in lung function, reduced health status, a low physical activity level, tremendous health care costs, and increased mortality. Although most exacerbations have an infectious origin, the underlying mechanisms are heterogeneous and specific predictors of their occurrence in individual patients are currently unknown. Accurate prediction and early diagnosis of exacerbations is essential to develop novel targets for prevention and personalized treatments to reduce the impact of these events. Several potential biomarkers have previously been studied, these however lack specificity, accuracy and do not add value to the available clinical predictors. At present, microbial composition and host-microbiome interactions in the lung are increasingly recognized for their role in affecting the susceptibility to exacerbations, and may steer towards a novel direction in the management of COPD exacerbations. This narrative review describes the current challenges and unmet needs in the management of acute exacerbations of COPD. Exacerbation triggers, biological clusters, current treatment strategies, and their limitations, previously studied biomarkers and prediction tools, the lung microbiome and its role in COPD exacerbations as well as future directions are discussed.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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