scholarly journals What is asthma−COPD overlap syndrome? Towards a consensus definition from a round table discussion

2016 ◽  
Vol 48 (3) ◽  
pp. 664-673 ◽  
Author(s):  
Don D. Sin ◽  
Marc Miravitlles ◽  
David M. Mannino ◽  
Joan B. Soriano ◽  
David Price ◽  
...  
Keyword(s):  
Management Strategies ◽  
Round Table ◽  
Case Definition ◽  
Overlap Syndrome ◽  
Airflow Limitation ◽  
Round Table Discussion ◽  
Chronic Obstructive ◽  
Consensus Definition ◽  
Key Features ◽  
Definition Of

Patients with asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS) have been largely excluded from pivotal therapeutic trials and, as a result, its treatment remains poorly defined and lacking firm evidence. To date, there is no universally accepted definition of ACOS, which has made it difficult to understand its epidemiology or pathophysiology. Despite many uncertainties, there is emerging agreement that some of the key features of ACOS include persistent airflow limitation in symptomatic individuals 40 years of age and older, a well-documented history of asthma in childhood or early adulthood and a significant exposure history to cigarette or biomass smoke. In this perspective, we propose a case definition of ACOS that incorporates these key features in a parsimonious algorithm that may enable clinicians to better diagnose patients with ACOS and most importantly enable researchers to design therapeutic and clinical studies to elucidate its epidemiology and pathophysiology and to ascertain its optimal management strategies.

Review paper on Bronchiectasis

1970 ◽  
Vol 1 (1) ◽  
pp. 39-42
Author(s):  
Sudhir Lohani
Keyword(s):  
Internal Medicine ◽  
Chronic Infection ◽  
Review Paper ◽  
Management Strategies ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Airways Disease ◽  
Chronic Obstructive Airways Disease

Bronchiectasis is characterized by dilatation of bronchi, airflow limitation and chronic infection/ inflammation. The aetiology, pathology and management are discussed in this review. It is vital that we distinguish bronchiectasis from other obstructive airways disease like Asthma and Chronic obstructive airways disease as management strategies are different. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5839 Journal of Advances in Internal Medicine. 2012; 1(1): 39-42

Interventional Bronchoscopy in the Management of Chronic Obstructive Lung Disease

2019 ◽  
Vol 15 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Semra Bilaçeroğlu
Keyword(s):  
Management Strategies ◽  
Chronic Obstructive Lung Disease ◽  
Lifestyle Changes ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Interventional Bronchoscopy ◽  
Obstructive Pulmonary Disease ◽  
Mucosal Regeneration ◽  
Therapeutic Modalities ◽  
Collateral Ventilation

Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation, hyperinflation and reduced gas exchange that lead to progressive dyspnea. Pulmonary rehabilitation, lifestyle changes, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation and surgical therapeutic approaches are the basic management strategies. Purpose: In the last 15 years, various bronchoscopic therapeutic modalities have emerged for severe COPD. The aim of this review is to summarize the effects of these bronchoscopic treatments compared with lung rehabilitation and pharmacological therapies. Methods: A PubMed search for the eligible studies and reviews on interventional bronchoscopy and COPD has been conducted. Results: Bronchoscopic lung volume reduction (LVR) techniques are targeted to reduce hyperinflation. The efficacy of reversible valve implantation has been confirmed in several randomized controlled trials. It provides clinical benefit in the absence of interlobar collateral ventilation. Nonblocking bronchoscopic LVR with coils, thermal vapor or sealants is independent of collateral ventilation but has not been studied sufficiently. Partially irreversible coil implantation leads to parenchymal compression while irreversible LVR with thermal vapor or sealants induce an inflammatory reaction. Targeted lung denervation ablates parasympathetic pulmonary nerves in COPD for sustainable bronchodilation, and liquid nitrogen metered cryospray destroys hyperplastic goblet cells and excessive submucous glands in the central airways to induce mucosal regeneration in chronic bronchitis. Conclusion: The best-examined bronchoscopic LVR method is the valve therapy. The data from the other modalities are still limited. Further studies are required to select the patients that will optimally benefit from a particular treatment and to predict and treat the procedure-related complications.

Recommendations for Kübler Index standardization

Clay Minerals ◽  
2015 ◽  
Vol 50 (3) ◽  
pp. 283-286 ◽  
Author(s):  
L.N. Warr ◽  
R. Ferreiro Mählmann
Keyword(s):  
Lower Boundary ◽  
Crystallinity Index ◽  
Round Table ◽  
Rock Fragment ◽  
Round Table Discussion ◽  
Working Definition ◽  
Kübler Index ◽  
Definition Of ◽  
Boundary Limits ◽  
Index Standardization

AbstractFollowing a round-table discussion at the Mid-European Clay Conference in Dresden 2014, new recommendations for illite ‘crystallinity’ Kübler index standardization have been agreed upon. The use of Crystallinity Index standards in the form of rock-fragment samples will be continued, along with the same numerical scale of measurement presented by Warr & Rice (1994). However, in order to be compatible with the original working definition of Kübler's (1967) anchizone, the upper and lower boundary limits of the Crystallinity Index Standard (CIS) scale are adjusted appropriately from 0.25°2θ and 0.42°2θ to 0.32°2θ and 0.52°2θ. This adjustment is based on an inter-laboratory correlation between the laboratories of Basel, Neuchâtel and the CIS scale. The details of this correction are presented in this first note, as discussed at the round-table meeting and will be further substantiated by a correlation program between CIS and former Kübler–Frey–Kisch standards.

scholarly journals Risk factors of bronchial asthma, chronic obstructive lung disease and «OVERLAP» syndrome asthma-COPD among adults in Ekaterinburg

2018 ◽  
Vol 15 (4) ◽  
pp. 26-29
Author(s):  
V C Abdullaev ◽  
E K Beltyukov ◽  
V V Naumova
Keyword(s):  
Risk Factors ◽  
Bronchial Asthma ◽  
Chronic Obstructive Lung Disease ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Actual Risk ◽  
History Of ◽  
Definition Of ◽  
The Impact ◽  
Over 40 Years

Topicality. Prevalence of bronchial asthma (BA) and COPD achieves in different countries 18 and 20% respectively. The prevalence of «OVERLAP» syndrome - ASTHMA/COPD in Russia is unknown. Objective. To determine the prevalence ofBA, COPD and «OVERLAP» syndrome - ASTHMA/COPD. Materials and methods. The study included a survey using a specially developed questionnaire to identify asthma-like symptoms (ALS), risk factors for BA, COPD, and the definition of FEV^ FEV^FVC in adults in Ekaterinburg. Results. The study has revealed that the risk factors for developing ALS are exposure to tobacco smoke and age over 40 years. The impact of allergens and family history of allergy are less significant. Decrease of spirometry indices is associated with smoking, age over 40 years and the presence of ALS. The diagnostic criteria for the «OVERLAP» syndrome - ASTHMA/COPD were developed based on the answers to the questionnaire on ALS, risk factors and the results of the screening spirometry. Conclusions. Preliminary prevalence ofBA, COPD, «OVERLAP» syndrome - ASTHMA/COPD and actual risk factors have been established in Ekaterinburg in 2018. Unfavorable situation with prevalence of smoking in Ekaterinburg has been showing.

scholarly journals ROSE: Radiology, Obstruction, Symptoms and Exposure, a Delphi consensus definition of the association of COPD and Bronchiectasis by the EMBARC Airways Working Group

2021 ◽  
pp. 00399-2021
Author(s):  
Letizia Traversi ◽  
Marc Miravitlles ◽  
Miguel Angel Martinez-Garcia ◽  
Michal Shteinberg ◽  
Apostolos Bossios ◽  
...  
Keyword(s):  
Chronic Obstructive ◽  
Delphi Consensus ◽  
Consensus Definition ◽  
Obstructive Pulmonary Disease ◽  
European Consensus ◽  
Toxic Agents ◽  
And Gender ◽  
Definition Of ◽  
Bronchial Dilatation ◽  
Worse Prognosis

IntroductionThe coexistence of chronic obstructive pulmonary disease (COPD) and bronchiectasis (BE) seems to be common and associated with a worse prognosis than for either disease individually. However, no definition of this association exists to guide researchers and clinicians.MethodsWe conducted a Delphi survey involving expert pulmonologists and radiologists from Europe, Turkey and Israel in order to define the “COPD-BE association”.A panel of 16 experts from EMBARC selected 35 statements for the survey after reviewing scientific literature. Invited participants, selected on the basis of expertise, geographical and gender distribution, were asked to express agreement on the statements. Consensus was defined as a score of ≥6 points (scale 0 to 9) in ≥70% of answers across two scoring rounds.ResultsA-hundred-and-two (72.3%) out of 141 invited experts participated the first round. Their response rate in the second round was 81%. The final consensus definition of “COPD-BE association” was: “The coexistence of (1) specific radiological findings (abnormal bronchial dilatation, airways visible within 1 cm of pleura and/or lack of tapering sign in ≥1 pulmonary segment and in >1 lobe) with (2) an obstructive pattern on spirometry (FEV1/FVC<0.7), (3) at least two characteristic symptoms (cough, expectoration, dyspnoea, fatigue, frequent infections) and (4) current or past exposure to smoke (≥10 pack-years) or other toxic agents (biomass, etc.)”. These criteria form the acronym “ROSE” (Radiology, Obstruction, Symptoms, Exposure).ConclusionsThe Delphi process formulated a European consensus definition of “COPD-BE association”. We hope this definition will have broad applicability across clinical practice and research in the future.

Asthma and COPD Overlap Syndrome (ACOS)

2015 ◽  
Vol 69 (1) ◽  
pp. 8-11
Author(s):  
Deska Dimitrievska ◽  
Marija Zdraveska ◽  
Dejan Todevski ◽  
Elena Janeva ◽  
Suzana Arbutina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Randomized Clinical Trials ◽  
Significant Proportion ◽  
Overlap Syndrome ◽  
Airflow Limitation ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Acute Exacerbations

Abstract Asthma and chronic obstructive pulmonary disease (COPD) have traditionally been viewed as distinct clinical entities. Recently, however, much attention has been focused on patients with overlapping features of both asthma and COPD: those with asthma COPD overlap syndrome (ACOS). A significant proportion of patients who present with symptoms of a chronic airways disease have features of both asthma and COPD. Several diagnostic terms, most including the word “overlap”, have been applied to such patients, and the topic has been extensively reviewed. However, there is no generally agreed term or defining features for this category of chronic airflow limitation, although a definition based upon consensus has been published for overlap in patients with existing COPD. In spite of these uncertainties, there is broad agreement that patients with features of both asthma and COPD experience frequent exacerbations, have poor quality of life, a more rapid decline in lung function and high mortality, and consume a disproportionate amount of healthcare resources than asthma or COPD alone. ACOS accounts for approximately 15-25% of the obstructive airway diseases and patients experience worse outcomes compared to asthma or COPD alone. Patients with ACOS often have the combined risk factors of smoking and atopy, are generally younger than patients with COPD and experience acute exacerbations with higher frequency and greater severity than in COPD alone. Pharmacotherapeutic considerations require an integrated approach, first to identify the relevant clinical phenoltype( s), then to determine the best available therapy. The authors discuss the array of existing and emerging classes of drugs which patients with ACOS could benefit from and share their therapeutic approach. A consensus international definition of ACOS is needed to design prospective. Randomized clinical trials are necessary to evaluate specific influence of drug interventions on important outcomes such as lung function, acute exacerbations, quality of life and mortality.

scholarly journals Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research

2017 ◽  
Vol 49 (6) ◽  
pp. 1700051 ◽  
Author(s):  
Adam T. Hill ◽  
Charles S. Haworth ◽  
Stefano Aliberti ◽  
Alan Barker ◽  
Francesco Blasi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Working Group ◽  
Exercise Tolerance ◽  
Research Collaboration ◽  
Round Table ◽  
Consensus Definition ◽  
The Us ◽  
Sputum Volume ◽  
Definition Of

There is a need for a clear definition of exacerbations used in clinical trials in patients with bronchiectasis. An expert conference was convened to develop a consensus definition of an exacerbation for use in clinical research.A systematic review of exacerbation definitions used in clinical trials from January 2000 until December 2015 and involving adults with bronchiectasis was conducted. A Delphi process followed by a round-table meeting involving bronchiectasis experts was organised to reach a consensus definition. These experts came from Europe (representing the European Multicentre Bronchiectasis Research Collaboration), North America (representing the US Bronchiectasis Research Registry/COPD Foundation), Australasia and South Africa.The definition was unanimously approved by the working group as: a person with bronchiectasis with a deterioration in three or more of the following key symptoms for at least 48 h: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; haemoptysis AND a clinician determines that a change in bronchiectasis treatment is required.The working group proposes the use of this consensus-based definition for bronchiectasis exacerbation in future clinical research involving adults with bronchiectasis.

scholarly journals COPD Diagnosis: Time for Disruption

2021 ◽  
Vol 10 (20) ◽  
pp. 4660
Author(s):  
Emiel F. M. Wouters ◽  
Marie K. Breyer ◽  
Robab Breyer-Kohansal ◽  
Sylvia Hartl
Keyword(s):  
Respiratory System ◽  
Process Integration ◽  
Disease Process ◽  
Diagnostic Procedures ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Disease Definition ◽  
Definition Of ◽  
Copd Diagnosis

Articulating a satisfactory definition of a disease is surprisingly difficult. Despite the alarming individual, societal and economic burden of chronic obstructive pulmonary disease (COPD), diagnosis is still largely based on a physiologically dominated disease conception, with spirometrically determined airflow limitation as a cardinal feature of the disease. The diagnostic inaccuracy and insensitivity of this physiological disease definition is reviewed considering scientific developments of imaging of the respiratory system in particular. Disease must be approached as a fluid concept in response to new scientific and medical discoveries, but labelling as well as mislabelling someone as diseased, will have enormous individual, social and financial implications. Nosology of COPD urgently needs to dynamically integrate more sensitive diagnostic procedures to detect the breadth of abnormalities early in the disease process. Integration of broader information for the identification of abnormalities in the respiratory system is a cornerstone for research models of underlying pathomechanisms to create a breakthrough in research.

scholarly journals PROBLEMS OF PHILOSOPHICAL CONCEPTUALIZATION OF LANGUAGE: PERPETUUM MOBILE

2020 ◽  
Vol 30 (2) ◽  
pp. 123-131
Author(s):  
N.B. Polyakova ◽  
V.V. x V.V. Skobeleva ◽  
A.A. Shadrin ◽  
A.A. Shamshurin ◽  
A.V. Yarkeev
Keyword(s):  
Round Table ◽  
Round Table Discussion ◽  
Human Language ◽  
Philosophical Concept ◽  
Language Origin ◽  
Traditional Definition ◽  
Table Discussion ◽  
Definition Of ◽  
Linguistic Structures ◽  
Innate Ability

The work of the 5th round table discussion "Philosophy: hermeneutics of concepts" is devoted to the topic "Problems of philosophical conceptualization of language: Perpetuum Mobile". This topic is considered in the context of the problem of glottogenesis, which has a long history. In a speech by A.A. Shadrin, the problem of the language origin is revealed through an appeal to the concepts of Perpetuum Mobile and Tabula rasa. Turning to these concepts allows us to represent the language in the aspect of the implementation or neutralization of the innate ability to speak, which characterizes a person in his being. The innate ability to speak is defined as congenital but not natural. In relation to the problem of glottogenesis, the concept of Perpetuum Mobile is defined as a self-sufficient productive construct, each time returning thinking to its language source. The idea of Tabula rasa serves as a metaphor for a "clean board" on which any linguistic structures that can exist within any human language, as a whole and / or system, can appear. Thus, the traditional definition of a person as a bio-social being gives way to the philosophical concept of a person as a linguo-social being.

scholarly journals Pediatric Inflammatory Multisystem Syndrome: Time to Collaborate

2020 ◽  
Author(s):  
Hari Krishnan Kanthimathinathan ◽  
Barnaby R Scholefield
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Management Strategies ◽  
Case Definition ◽  
Significant Variability ◽  
Definition Of

Abstract There is significant variability in the names and case definition of pediatric inflammatory multisystem syndrome associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Such variability leads to adverse consequences in the quest for further knowledge and management strategies. It is time to collaborate to gain consensus.

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