COPD

TORONTO -- Ambulatory oxygen, a big-ticket item for Medicare, may not be all it's cracked up to be for chronic obstructive pulmonary disease without resting hypoxemia.

ANN ARBOR, Mich.-- Only one in three patients who are told they have chronic obstructive pulmonary disease (COPD) have had that diagnosis confirmed with spirometry.

ANN ARBOR, Mich. -- Chronic obstructive pulmonary disease (COPD) with severe emphysema strikes women harder than men on clinical and physiological measures, researchers here affirmed.

My patient is an 82-year-old woman with a history of coronary artery bypass grafting (CABG), chronic obstructive pulmonary disease (COPD), pulmonary hypertension, and mild intermittent angina on exertion, which is relieved by sublingual nitroglycerin.

MONTREAL -- Chronic obstructive pulmonary disease patients who inhaled corticosteroids had a 70% increase in the risk of pneumonia hospitalization over those not given the drugs, researchers here reported.

CARDIFF, Wales -- Premature arterial stiffness and bone aging in patients with chronic obstructive pulmonary disease (COPD) may explain why they are at greater risk for cardiovascular disease, researchers reported.

Does adding an inhaled corticosteroid to treatment with a long-acting ß2-agonist help prevent exacerbations of chronic obstructive pulmonary disease (COPD)? According to Kardos and associates, the answer is yes.

SAN FRANCISCO -- Inhaled corticosteroid and long-acting beta2 agonist therapy significantly slows the progressive lung function decline of chronic obstructive pulmonary disease (COPD).

SAN FRANCISCO -- Nebulized formoterol (Perforomist) appears to treat chronic obstructive pulmonary disease as effectively as the dry-powder formulation (Foradil), researchers said here.

BOSTON -- The so-called Mediterranean diet -- high in fruits, vegetables, fish, and whole grains -- is associated with a 50% reduction in the risk of chronic obstructive pulmonary disease, according to researchers here.

OMAHA, Neb. -- Infliximab (Remicade), the tumor necrosis-factor alpha inhibitor, has proved ineffective for moderate to severe chronic obstructive pulmonary disease.

NEW YORK -- Eating too much bacon and sausage may increase the risk of chronic obstructive pulmonary disease, found researchers here.

ALBUQUERQUE, N.M. -- Moderate use of statins is associated with a sharply reduced risk of death from chronic obstructive pulmonary disease, researchers here found.

SEATTLE -- High doses of inhaled corticosteroids may reduce the risk of lung cancer in men with chronic obstructive pulmonary disease, suggested researchers here.

Sleep complaints are common in patients with chronic obstructive pulmonary disease (COPD). Many patients complain of morning tiredness, early awakenings, difficulty in falling asleep, restlessness, and daytime sleepiness. Functional status may eventually be impaired by the resulting chronic fatigue that is compounded by dyspnea.

BARCELONA Spain -- Smokers who get plenty of exercise regularly may slow the inevitable decline of their lung function and reduce their risk of chronic obstructive pulmonary disease, researchers here reported.

abstract: Depression and anxiety are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), and like COPD, they are often underrecognized. Both of these comorbidities can adversely affect the course of COPD. Anxiety, for example, is associated with more severe dyspnea, greater disability, and impaired functional status; it also is a significant predictor of hospitalizations for acute exacerbations of COPD. When evaluating depressive symptoms, it is important to rule out cognitive impairment, particularly in patients with severe COPD and hypoxemia. Treatment options include antidepressants and cognitive behavioral therapy. Participation in a pulmonary rehabilitation program also can help reduce anxiety and depressive symptoms in patients with COPD. (J Respir Dis. 2007;28(3):94-103)

LIVERPOOL, England -- The combination of an inhaled corticosteroid and a long-acting beta2 agonist did not quite reach a significant overall survival improvement in chronic obstructive pulmonary disease, investigators in the TORCH trial reported. But the drug duo significantly improved symptoms and overall health.

EDMONTON, Alberta -- A mixture of helium and oxygen allowed patients with chronic obstructive pulmonary disease to increase their exercise capacity, found researchers here.

Results of a large prospective study

FRANKFURT, Germany -- Therapy with inhaled corticosteroids plus a long-acting bronchodilator appears to significantly improve exacerbations and other outcomes for chronic obstructive pulmonary disease (COPD), according to German researchers.

PAVIA, Italy, Jan. 2 -- Chronic cough and phlegm in a young adult nearly double the risk of developing chronic obstructive pulmonary disease (COPD), researchers here said.

On a warm August day, a 79-year-old man is hospitalized because of progressive lethargy over the past week. Previously, he was alert and able to converse. He has no chest pain, dyspnea, or cough. His history includes hypertension of unknown duration, chronic obstructive pulmonary disease, and a recent hospitalization for pneumonia.

Patients with COPD are at greater risk for osteopeniaand osteoporosis than persons who do not haveCOPD. Studies have reported osteopenia in 35% to 72%and osteoporosis in 36% to 60% of patients with COPD.1,2

ABSTRACT: The key factor in reducing morbidityand mortality in patients with chronicobstructive pulmonary disease (COPD)continues to be smoking cessation. Newerformulations of nicotine replacementtherapy-a nasal spray and an inhaler-provide rapid delivery of nicotine and maybe appropriate for highly dependent smokers.Bupropion has been shown to improvesmoking cessation rates, either when usedalone or with a nicotine patch. Both theinfluenza and pneumococcal vaccines arerecommended to reduce the morbidity andmortality associated with respiratory infectionsin patients with COPD.

A46-year-old white man is hospitalized with increasing dyspnea of 3weeks’ duration. He has a history of stable chronic obstructive pulmonarydisease secondary to heavy smoking (2 packs of cigarettes a day for 27years, discontinued 6 years previously) and uses inhaled bronchodilators.

Q:Does theophylline still play a role in the treatment of chronicobstructive pulmonary disease (COPD), or has it been supersededby newer agents?

Q:What is the latest thinking on the use of dailyinhaled corticosteroids in the managementof chronic obstructive pulmonary disease (COPD)?

A:Theophylline remains useful in the maintenance management of COPD. It is most commonly prescribed as an adjunct to an inhaled β-agonist, ananticholinergic, or a combination of these agents.

Oral corticosteroids arecommonly used inambulatory patientsas short- or long-termtherapy for a numberof diseases. For example, patientswith acute exacerbations of asthmaor chronic obstructive pulmonary diseaseare routinely given 1- to 2-weekcourses of prednisone, methylprednisolone,or another oral corticosteroid.In addition, oral corticosteroidsare used as maintenance therapy inpatients with such conditions assystemic lupus erythematosus, sarcoidosis,and post-organ transplantcomplications.