Effects of clenbuterol on horses

2013 ◽  
Vol 9 (3-4) ◽  
pp. 181-187
Author(s):  
S.D. Drake ◽  
L.E. Hansen ◽  
C. Harris ◽  
W.C. Lewis ◽  
E. Miller ◽  
...  
Keyword(s):  
Airway Disease ◽  
Chronic Obstructive ◽  
Oxygen Intake ◽  
Negative Effects ◽  
Obstructive Pulmonary Disease ◽  
Maximum Oxygen Intake ◽  
Reactive Airway Disease ◽  
The Us ◽  
Horse Industry ◽  
Multiple Species

Clenbuterol was intended as a treatment for respiratory diseases in horses, but has been used in multiple species, including humans, for its repartitioning of fat to lean effects (free fatty acids are released from adipose tissue to be used by tissues of higher priority). In the horse industry clenbuterol application is restricted to the treatment of chronic obstructive pulmonary disease and reactive airway disease (heaves). Negative effects of clenbuterol exposure include a decrease in maximum oxygen intake and increased muscle fatigue upon exercise. As a result of these and other negative effects, clenbuterol remains strictly controlled by the US Food and Drug Administration.

scholarly journals A 3D-CNN model with CT-based parametric response mapping for classifying COPD subjects

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thao Thi Ho ◽  
Taewoo Kim ◽  
Woo Jin Kim ◽  
Chang Hyun Lee ◽  
Kum Ju Chae ◽  
...  
Keyword(s):  
Neural Network ◽  
Pulmonary Function Tests ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Respiratory Disorder ◽  
Obstructive Pulmonary Disease ◽  
Response Mapping ◽  
Small Airway Disease ◽  
3D Cnn ◽  
Parametric Response

AbstractChronic obstructive pulmonary disease (COPD) is a respiratory disorder involving abnormalities of lung parenchymal morphology with different severities. COPD is assessed by pulmonary-function tests and computed tomography-based approaches. We introduce a new classification method for COPD grouping based on deep learning and a parametric-response mapping (PRM) method. We extracted parenchymal functional variables of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%) with an image registration technique, being provided as input parameters of 3D convolutional neural network (CNN). The integrated 3D-CNN and PRM (3D-cPRM) achieved a classification accuracy of 89.3% and a sensitivity of 88.3% in five-fold cross-validation. The prediction accuracy of the proposed 3D-cPRM exceeded those of the 2D model and traditional 3D CNNs with the same neural network, and was comparable to that of 2D pretrained PRM models. We then applied a gradient-weighted class activation mapping (Grad-CAM) that highlights the key features in the CNN learning process. Most of the class-discriminative regions appeared in the upper and middle lobes of the lung, consistent with the regions of elevated fSAD% and Emph% in COPD subjects. The 3D-cPRM successfully represented the parenchymal abnormalities in COPD and matched the CT-based diagnosis of COPD.

scholarly journals Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea

2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  
Keyword(s):  
Racial Differences ◽  
Large Scale ◽  
Ecological Model ◽  
Prevalence Ratio ◽  
Poor Quality ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Us

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

scholarly journals Household Food Insecurity, Lung Function, and COPD in US Adults

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2098
Author(s):  
Francisca de Castro Mendes ◽  
Kirstie Ducharme-Smith ◽  
Gustavo Mora-Garcia ◽  
Saleh A. Alqahtani ◽  
Maria Stephany Ruiz-Diaz ◽  
...  
Keyword(s):  
Lung Function ◽  
Food Insecurity ◽  
Representative Sample ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Us ◽  
Nationally Representative ◽  
Lung Health

Increasing epidemiological evidence suggests that optimal diet quality helps to improve preservation of lung function and to reduce chronic obstructive pulmonary disease (COPD) risk, but no study has investigated the association of food insecurity (FI) and lung health in the general population. Using data from a representative sample of US adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2007–2012 cycles, we investigated the association between FI with lung function and spirometrically defined COPD in 12,469 individuals aged ≥ 18 years of age. FI (high vs. low) was defined using the US Department of Agriculture’s Food Security Scale). Population-weighted adjusted regression models were used to investigate associations between FI, and forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), their ratio, and spirometrically defined restriction (FVC below the lower limit of normal) and airflow obstruction (COPD). The prevalence of household FI was 13.2%. High household FI was associated with lower FVC (adjusted β-coefficient −70.9 mL, 95% CI −116.6, −25.3), and with higher odds (OR) of spirometric restriction (1.02, 95% CI 1.00, 1.03). Stratified analyses showed similar effect sizes within specific ethnic groups. High FI was associated with worse lung health in a nationally representative sample of adults in the US.

The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation: Literature review

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Rodríguez Miguel ◽  
◽  
Chinta Siddharth ◽  
Vittorio Timothy ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
The Other ◽  
Beta Agonist ◽  
Beta Blockade ◽  
Chronic Obstructive ◽  
Agonist Therapy ◽  
Obstructive Pulmonary Disease

Background: New advances have been made in medicine, but the incidence and prevalence of Chronic Obstructive Pulmonary Disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and beta-receptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1-selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient. Keywords: atrial fibrillation; pulmonary disease; obstructive pulmonary disease; chronic obstructive pulmonary disease (COPD); B-Agonist; B-Block (selective; non-selective); digitalis; other antiarrhythmic.

scholarly journals The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

2018 ◽  
Vol 52 (3) ◽  
pp. 1800328 ◽  
Author(s):  
Eva Polverino ◽  
Katerina Dimakou ◽  
John Hurst ◽  
Miguel-Angel Martinez-Garcia ◽  
Marc Miravitlles ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Upper Airway ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Future Directions ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Recurrent Respiratory Infections ◽  
Sputum Production ◽  
Syndromic Approach

Bronchiectasis is a clinical and radiological diagnosis associated with cough, sputum production and recurrent respiratory infections. The clinical presentation inevitably overlaps with other respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). In addition, 4–72% of patients with severe COPD are found to have radiological bronchiectasis on computed tomography, with similar frequencies (20–30%) now being reported in cohorts with severe or uncontrolled asthma. Co-diagnosis of bronchiectasis with another airway disease is associated with increased lung inflammation, frequent exacerbations, worse lung function and higher mortality. In addition, many patients with all three disorders have chronic rhinosinusitis and upper airway disease, resulting in a complex “mixed airway” phenotype.The management of asthma, bronchiectasis, COPD and upper airway diseases has traditionally been outlined in separate guidelines for each individual disorder. Recognition that the majority of patients have one or more overlapping pathologies requires that we re-evaluate how we treat airway disease. The concept of treatable traits promotes a holistic, pathophysiology-based approach to treatment rather than a syndromic approach and may be more appropriate for patients with overlapping features.Here, we review the current clinical definition, diagnosis, management and future directions for the overlap between bronchiectasis and other airway diseases.

scholarly journals Shall We Focus on the Eosinophil to Guide Treatment with Systemic Corticosteroids during Acute Exacerbations of COPD?: PRO

2018 ◽  
Vol 6 (3) ◽  
pp. 74 ◽  
Author(s):  
James Camp ◽  
Jennifer Cane ◽  
Mona Bafadhel
Keyword(s):  
Precision Medicine ◽  
Corticosteroid Treatment ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Correct Identification ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Blood Eosinophil ◽  
Increased Risk ◽  
Oral Corticosteroids

In an era of precision medicine, it seems regressive that we do not use stratified approaches to direct treatment of oral corticosteroids during an exacerbation of chronic obstructive pulmonary disease (COPD). This is despite evidence suggesting that 40% of COPD patients have eosinophilic inflammation and this is an indicator of corticosteroid response. Treatments with oral corticosteroids are not always effective and not without harm, with significant and increased risk of hyperglycemia, sepsis, and fractures. Eosinophils are innate immune cells with an incompletely understood role in the pathology of airway disease. They are detected at increased levels in some patients and can be measured using non-invasive methods during states of exacerbation and stable periods. Despite the eosinophil having an unknown mechanism in COPD, it has been shown to be a marker of length of stay in severe hospitalized exacerbations, a predictor of risk of future exacerbation and exacerbation type. Although limited, promising data has come from one prospective clinical trial investigating the eosinophil as a biomarker to direct systemic corticosteroid treatment. This identified that there were statistically significant and clinically worsened symptoms in patients with low eosinophil levels who were prescribed prednisolone, demonstrating the potential utility of the eosinophil. In an era of precision medicine our patients’ needs are best served by accurate diagnosis, correct identification of maximal treatment response and the abolition of harm. The peripheral blood eosinophil count could be used towards reaching these aims.

Abstract P073: Co-morbidities and Cardiac Associated Mortality in Smokers

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Gregory L Kinney ◽  
Kendra A Young ◽  
Katherine Pratte ◽  
Elizabeth A Regan ◽  
Lindsey Duca ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Latent Class ◽  
Proportional Hazards ◽  
Airway Disease ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Longitudinal Assessment ◽  
Vascular Effects ◽  
Obstructive Pulmonary Disease ◽  
Cvd Mortality

Background: Chronic Obstructive Pulmonary Disease (COPD) is a complex syndrome involving all aspects of the lungs which is strongly associated with cigarette smoking. Parenchymal destruction and remodeling are disease processes involving inflammatory pathways likely to have systemic vascular effects outside of the lungs. Indeed cardiovascular disease (CVD) is a leading cause of mortality in people affected by COPD and many co-morbid conditions are also associated with the disease. We explored CVD mortality in smokers considering aspects of COPD as well as co-morbidities in the longitudinal follow-up of the COPDGene study. Methods: The COPDGene study includes baseline and longitudinal assessment of mortality for 8,157 participants with (3,604) and without COPD (4,553) all of whom reported >10 pack-years smoking exposure. Aspects of COPD including CT phenotyping and pulmonary function were combined using Principal Components Analysis (PCA), co-morbidities were combined using Latent Class Analysis (LCA) and cause specific mortality was assessed using study center reports, SSRI searches and single clinician adjudication. Cox Proportional Hazards models accounting for the effects of competing risks were used to assess the association between PCA factors and CVD mortality and PCA factors plus LCA classes and CVD mortality. Results: PCA analysis resulted in 5 factors describing emphysema, airway disease, gas trapping, BMI and its effect on CT measurement and hyperinflation and LCA analysis identified 7 classes of co-morbidities. CVD associated mortality occurred in 128 participants and competing causes of mortality occurred in 605. The PCA factor describing airway disease predicted CVD mortality in the PCA only model (HR 1.8, 95%C.I. 1.4-2.3,p<0.0001), as well as in the LCA model (HR 1.7, 95% C.I. 1.3-2.2, p<0.0001). LCA classes associated with CVD mortality include a class describing diabetes, high BP and high Cholesterol (HR 3.5, 95% C.I. 1.8-6.8, p=0.0003) and a class describing known CVD (HR 2.9, 95% C.I. 1.3-6.7, p=0.01). Conclusions: Co-morbidities of COPD represent independent predictors of CVD associated mortality in smokers accounting for pulmonary disease and competing mortality risks. Clustering of comorbidities using LCA is an approach that may be informative in complex diseases.

scholarly journals Case report: recurrent biventricular Takotsubo cardiomyopathy in a middle-aged man with fatal outcome after full recovery

2019 ◽  
Vol 3 (4) ◽  
pp. 1-6
Author(s):  
Elton Lian Chen Luo ◽  
Attila Kardos
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Fatal Outcome ◽  
Apical Ballooning ◽  
Airway Disease ◽  
Full Recovery ◽  
Chronic Obstructive ◽  
Middle Aged ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Post Intubation

Abstract Background Takotsubo cardiomyopathy (TC) usually manifests as transient apical ballooning of the left ventricle and may mimic acute coronary syndrome. Concomitant right ventricle involvement may occur in about a third of the cases. Recurrence had been observed in up to 10% of TC with variable ventricular involvement. Despite this knowledge, there had been no report of a patient with multiple biventricular TC in the literature to date. In this study, we describe a rare case of a patient who presented twice with biventricular TC. Case summary A 52-year-old man with a previous episode of biventricular TC 5 months ago presented to our hospital with a 1 day history of shortness of breath and wheeze. He was treated initially for infective exacerbation of chronic obstructive airway disease. He was eventually intubated following a trial of non-invasive ventilation. He became hypotensive post-intubation and required intensive care support. An inpatient echocardiogram revealed biventricular apical ballooning. Invasive coronary angiogram showed no coronary artery disease. A repeat echocardiogram 14 days post-admission demonstrated full recovery of both ventricles. These findings were consistent with a second biventricular TC. Two months later, he was found deceased in the community seemingly from an unrelated cause. Discussion This case describes a middle-aged gentleman who suffered recurrent biventricular TC with no consistent triggers and an unrelated fatal sequel. None of these features were typical, and to our best knowledge had not been reported before. We hypothesize that his recurrent chronic obstructive pulmonary disease exacerbations and various substance misuse might have predisposed him to this unusual presentation.

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