Latest & greatest articles for copd exacerbations

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Top results for copd exacerbations

81. Tiotropium versus salmeterol for the prevention of exacerbations of COPD. Full Text available with Trip Pro

Tiotropium versus salmeterol for the prevention of exacerbations of COPD. Treatment guidelines recommend the use of inhaled long-acting bronchodilators to alleviate symptoms and reduce the risk of exacerbations in patients with moderate-to-very-severe chronic obstructive pulmonary disease (COPD) but do not specify whether a long-acting anticholinergic drug or a β(2)-agonist is the preferred agent. We investigated whether the anticholinergic drug tiotropium is superior to the β(2)-agonist (...) salmeterol in preventing exacerbations of COPD.In a 1-year, randomized, double-blind, double-dummy, parallel-group trial, we compared the effect of treatment with 18 μg of tiotropium once daily with that of 50 μg of salmeterol twice daily on the incidence of moderate or severe exacerbations in patients with moderate-to-very-severe COPD and a history of exacerbations in the preceding year.A total of 7376 patients were randomly assigned to and treated with tiotropium (3707 patients) or salmeterol (3669

2011 NEJM Controlled trial quality: predicted high

82. The effects of `on-call/out of hours` physical therapy in acute exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial (Abstract)

The effects of `on-call/out of hours` physical therapy in acute exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial To assess the effectiveness of an on-call physical therapy programme in the management of acute exacerbations of chronic obstructive pulmonary diseases.Randomized controlled trial.Secondary care level, rural hospital.Thirty-eight patients with acute exacerbations of chronic obstructive pulmonary disease.Regular physical therapy and on-call (...) physical therapy was given to two groups of patients with 19 in each arm. On-call physical therapy included providing respiratory physical therapy as required by the patient out of business hours.Peak expiratory flow rate, sustained maximal inspiration, six-minute walk distance and rating of perceived exertion post six-minute walk test.In the group receiving on-call physical therapy, peak expiratory flow rate and six-minute walk test showed a significant difference (52.1 L/min and 98.16 m, respectively

2010 EvidenceUpdates Controlled trial quality: uncertain

83. Should I use 2.5mg or 5mg Nebulised Salbutamol in Acute Exacerbations of COPD?

the same effect? Search Strategy Medline OVID 1950–June week 3 2010. (exp Adrenergic β-Agonists OR exp albuterol OR salbutamol.mp OR b2 agonist.mp OR b agonist.mp OR β agonist.mp OR β 2 agonist.mp) AND (exp Administration, Inhalation OR exp ‘Nebulisers and Vaporizers’ OR (nebulised or nebuliser or nebulised or nebuliser).mp) AND (exp Dose-Response Relationship, Drug OR dose OR dosage) AND (exp Pulmonary Disease, Chronic Obstructive OR copd.mp OR coad.mp). The Cochrane Database of Systematic Reviews (...) (complete) Three Part Question In [patients admitted with acute exacerbations of COPD] is [5mg nebulised salbutamol superior to 2.5mg nebulised salbutamol] at [improving lung function and reducing length of hospital stay] Clinical Scenario While working a busy nightshift in A&E, you see a patient with an acute exacerbation of COPD. They require bronchodilators & the nurse asks you if you want 2.5mg or 5mg of nebulised salbutamol. You usually administer 5mg however wondered if 2.5mg salbutamol would have

2010 BestBETS

84. Oral immunotherapy with inactivated nontypeable Haemophilus influenzae reduces severity of acute exacerbations in severe COPD (Abstract)

Oral immunotherapy with inactivated nontypeable Haemophilus influenzae reduces severity of acute exacerbations in severe COPD Acute exacerbations of COPD reflect in part an inappropriate host response to abnormal bacterial colonization. Orally administered inactivated nontypeable Haemophilus influenzae (NTHi) can drive a specific T-cell response that by promoting intrabronchial phagocytosis down-regulates bronchus inflammation.Subjects with recurrent exacerbations of COPD were studied (...) in a randomized, multicenter, double-blind, placebo-controlled trial, to test efficacy of an NTHi oral immunotherapeutic (HI-164OV). This report describes the outcome in 38 subjects with severe COPD defined as having an FEV(1) < or = 50% of predicted normal.Exacerbations defined as an increase in volume and purulence of sputum were reduced by 16% (not significant) in the active group. However, moderate-to-severe exacerbations (defined as requiring corticosteroid therapy) were reduced by 63% (P = .05

2010 EvidenceUpdates Controlled trial quality: predicted high

85. A multicenter, randomized trial of noninvasive ventilation with helium-oxygen mixture in exacerbations of chronic obstructive lung disease (Abstract)

A multicenter, randomized trial of noninvasive ventilation with helium-oxygen mixture in exacerbations of chronic obstructive lung disease To assess the effect of a helium-oxygen mixture on intubation rate and clinical outcomes during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease.Multicenter, prospective, randomized, controlled trial.Seven intensive care units.A total of 204 patients with known or suspected chronic obstructive pulmonary disease and acute (...) of using helium during NIV to decrease the intubation rate in acute exacerbation of chronic obstructive pulmonary disease.

2010 EvidenceUpdates Controlled trial quality: uncertain

86. Antibiotics in addition to systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease Full Text available with Trip Pro

Antibiotics in addition to systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease The role of antibiotics in acute exacerbations is controversial and their efficacy when added to systemic corticosteroids is unknown.We conducted a randomized, placebo-controlled trial to determine the effects of doxycycline in addition to corticosteroids on clinical outcome, microbiological outcome, lung function, and systemic inflammation in patients hospitalized with an acute (...) exacerbation of chronic obstructive pulmonary disease.Of 223 patients, we enrolled 265 exacerbations defined on the basis of increased dyspnea and increased sputum volume with or without increased sputum purulence. Patients received 200 mg of oral doxycycline or matching placebo for 7 days in addition to systemic corticosteroids. Clinical and microbiological response, time to treatment failure, lung function, symptom scores, and serum C-reactive protein were assessed.On Day 30, clinical success was similar

2010 EvidenceUpdates Controlled trial quality: predicted high

87. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study Full Text available with Trip Pro

(Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study Chronic obstructive pulmonary disease (COPD) is a chronic disease with a high prevalence and rapidly increasing incidence rates. The effect of self-treatment of COPD exacerbations on the severity of exacerbations during a 1-year period was examined and a cost-effectiveness analysis was performed.Patients were randomly allocated to four 2-hour self-management sessions (...) , with or without training in self-treatment of exacerbations. Patients in the self-treatment group received an action plan with the possibility to initiate a course of prednisolone (with or without antibiotics). During follow-up, all participants kept a daily symptom diary. These provided the data to calculate the frequency of exacerbations, the number of exacerbation days and mean daily severity scores.Data were analysed for 142 randomised patients (self-treatment: n = 70; control: n = 72). The frequency

2010 EvidenceUpdates Controlled trial quality: uncertain

88. Steroids for COPD Exacerbation

, Treatment Failure (Lack of resolution, worsening, or death) Harm Endpoints: Adverse Drug Effects Narrative: Chronic obstructive pulmonary disease (COPD), a term that encompasses both patients diagnosed with chronic bronchitis and emphysema, is an obstructive lung disease in many cases caused by years of tobacco smoking. It is thought that patients with COPDexacerbation’ (increased shortness of breath or change in their chronic cough and sputum) may benefit from steroids, presumably by reducing (...) Steroids for COPD Exacerbation Steroids for COPD Exacerbation – TheNNTTheNNT Systemic Steroids for Acute COPD Exacerbations 10 for prevented failed treatment In Summary, for those who took the steroids: Benefits in NNT 89.5% saw no benefit 10.5% were helped by not failing treatment 1 out of 10 were helped (preventing failed treatment) Harms in NNT 13.9% harmed by developing adverse drug effects 1 out of 7 were harmed (adverse drug effects) View As: NNT % Source: Efficacy Endpoints: Mortality

2010 theNNT

89. Antibiotics for COPD Exacerbation

Failure (Lack of resolution, worsening, or death) Harm Endpoints: Diarrhea Narrative: Chronic obstructive pulmonary disease (COPD), a term that encompasses both patients diagnosed with chronic bronchitis and emphysema, is an obstructive lung disease, in many cases caused by tobacco smoking. It is thought that patients with COPDexacerbation’ (increased shortness of breath or change in their chronic cough and sputum) may benefit from antibiotics, though the reasons for this are not well elucidated (...) Antibiotics for COPD Exacerbation Antibiotics for COPD Exacerbation – TheNNTTheNNT Antibiotics for Acute COPD Exacerbations 8 for mortality In Summary, for those who took the antibiotics: Benefits in NNT 88.4% saw no benefit 11.6% were helped by being saved from death 1 in 8 were helped (life saved) 1 in 3 were helped (preventing failed treatment) Harms in NNT 5% were harmed by developing diarrhea 1 in 20 were harmed (diarrhea) View As: NNT % Source: Efficacy Endpoints: Mortality, Treatment

2010 theNNT

90. Effect of airway clearance techniques in patients experiencing an acute exacerbation of chronic obstructive pulmonary disease: a systematic review

Effect of airway clearance techniques in patients experiencing an acute exacerbation of chronic obstructive pulmonary disease: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2010 DARE.

91. A randomised controlled equivalence trial to determine the effectiveness and cost utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX)

A randomised controlled equivalence trial to determine the effectiveness and cost utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX) A randomised controlled equivalence trial to determine the effectiveness and cost utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX) A randomised controlled equivalence trial to determine (...) the effectiveness and cost utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX) Cross J, Elender F, Barton G, Clark A, Shepstone L, Blyth A, Bachmann A, Harvey I Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Cross J, Elender F, Barton G, Clark A, Shepstone L, Blyth

2010 Health Technology Assessment (HTA) Database.

92. Does tiotropium lower exacerbation and hospitalization frequency in COPD patients? Results of a meta-analysis

Does tiotropium lower exacerbation and hospitalization frequency in COPD patients? Results of a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2010 DARE.

93. Systematic review: Combination therapy with long-acting ?-agonists plus inhaled corticosteroids is no more effective than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adver

-Rodriguez JA , Plaza V . Safety and efficacy of combined long-acting beta-agonists and inhaled corticosteroids vs long-acting beta-agonists monotherapy for stable COPD: a systematic review . Rodrigo and colleagues' systematic review of research examines an important, unresolved question relating to a common and disabling condition, chronic obstructive pulmonary disease (COPD). The trials included in the review used clinically important outcomes, unlike those evaluated a decade ago. Perhaps because, like (...) than LABA monotherapy for mortality outcomes and severe exacerbations in moderate to very severe COPD and is associated with serious adverse effects Peter Anthony Frith Correspondence to Peter Anthony Frith Professor in Respiratory Medicine, Flinders University of South Australia, Bedford Park 5042, Respiratory Allergy and Sleep Services, Repatriation General Hospital, Daw Park 5041, Australia; peter.frith{at}health.sa.gov.au Statistics from Altmetric.com Commentary on: Rodrigo GJ , Castro

2010 Evidence-Based Medicine

94. Mortality and need for mechanical ventilation in acute exacerbations of chronic obstructive pulmonary disease: development and validation of a simple risk score Full Text available with Trip Pro

Mortality and need for mechanical ventilation in acute exacerbations of chronic obstructive pulmonary disease: development and validation of a simple risk score Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) often require hospitalization, may necessitate mechanical ventilation, and can be fatal. We sought to develop a simple risk score to determine its severity.We analyzed 88,074 subjects admitted with an AECOPD between 2004 and 2006. We used recursive partition

2009 EvidenceUpdates

95. A randomized, single-blind study of lansoprazole for the prevention of exacerbations of chronic obstructive pulmonary disease in older patients (Abstract)

A randomized, single-blind study of lansoprazole for the prevention of exacerbations of chronic obstructive pulmonary disease in older patients To investigate whether proton pump inhibitor (PPI) therapy reduces the frequency of common colds and exacerbations in patients with chronic obstructive pulmonary disease (COPD).Twelve-month, randomized, observer-blind, controlled trial.A university hospital and three city hospitals in Miyagi prefecture in Japan.One hundred patients with COPD (mean age (...) +/- SD 74.9 +/- 8.2) participated. They were all ex-smokers and had received conventional therapies for COPD, including smoking cessation and bronchodilators. Patients with gastroesophageal reflux disease or gastroduodenal ulcer were excluded.Patients were randomly assigned to conventional therapies (control group) or conventional therapies plus PPI (lansoprazole 15 mg/d; PPI group) and observed for 12 months.Frequency of common colds and COPD exacerbations.The number of exacerbations per person

2009 EvidenceUpdates Controlled trial quality: uncertain

96. Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications Full Text available with Trip Pro

Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your (...) username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications Article Text Therapeutics

2009 Evidence-Based Medicine

97. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study

(Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 NHS Economic Evaluation Database.

98. Use of dry powder inhalers in acute exacerbations of asthma and COPD Full Text available with Trip Pro

in acute exacerbations of asthma and COPD. Therapeutic Advances in Respiratory Disease 2009; 3(2): 81-91 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Adrenergic beta-Agonists /administration & Albuterol /administration & Asthma /drug therapy /physiopathology; Bronchodilator Agents /administration & Disease Progression; Ethanolamines /administration & Formoterol Fumarate; Humans; Nebulizers and Vaporizers; Pulmonary Disease, Chronic Obstructive /drug therapy (...) Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Use of dry powder inhalers in acute exacerbations of asthma and COPD Selroos O, Borgstrom L, Ingelf J CRD summary This review concluded that dry powder inhalers functioned equally as well as established therapies with other inhaler devices in patients with acute asthma or chronic obstructive pulmonary disease. Given poor reporting of the review process

2009 DARE.

99. Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations (Abstract)

Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations Frequent chronic obstructive pulmonary disease (COPD) exacerbations are a major cause of hospital admission and mortality and are associated with increased airway inflammation. Macrolides have airway antiinflammatory actions and may reduce the incidence of COPD exacerbations.To determine whether regular therapy with macrolides reduces exacerbation frequency.We performed a randomized (...) , double-blind, placebo-controlled study of erythromycin administered at 250 mg twice daily to patients with COPD over 12 months, with primary outcome variable being the number of moderate and/or severe exacerbations (treated with systemic steroids, treated with antibiotics, or hospitalized).We randomized 109 outpatients: 69 (63%) males, 52 (48%) current smokers, mean (SD) age 67.2 (8.6) years, FEV1 1.32 (0.53) L, FEV1% predicted 50 (18)%. Thirty-eight (35%) of the patients had three or more

2008 EvidenceUpdates Controlled trial quality: predicted high

100. Review: anticholinergics but not B2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD

Review: anticholinergics but not B2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD Review: anticholinergics but not β2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log (...) in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: anticholinergics but not β2 agonists reduce exacerbations requiring hospital admission and respiratory deaths in COPD Article Text

2008 Evidence-Based Medicine