A study on the significance of anti-endothelial cell antibodies in chronic obstructive pulmonary disease and the effect of methylprednisolone intervention

COPD—more than just tobacco smoke

Introduction

De novo development of circulating anti-endothelial cell antibodies rather than pre-existing antibodies is associated with post-transplant allograft rejection

Do we really need asthma–chronic obstructive pulmonary disease overlap syndrome?

UK COPD treatment: failing to progress

Management of chronic obstructive pulmonary disease: Moving beyond the asthma algorithm

Review question/objective The objective of this systematic review is to identify the best available research evidence related to the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in people with chronic respiratory diseases, focusing on measures of adherence and health outcomes. The specific review questions to be addressed are: 1. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in terms of inhalation regimens and inhalation techniques in people with chronic respiratory diseases? 2. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy on health service utilization and patient outcomes including symptoms, pulmonary function, and quality of life? 3. What is the effectiveness of various designs, in terms of components, modes and intensities, of educational and supportive interventions for improving adherence to inhalation therapy? Inclusion criteria Types of participants This review will consider studies that include adults aged 18 or above, with a clinical diagnosis of chronic respiratory disease and prescribed self-administered inhalation therapy as a long term regular treatment, irrespective of the type of inhaler used. For the purposes of this review, "chronic respiratory diseases" is defined by WHO in 2007 as "the chronic diseases of the airways and other structures of the lung" (p.5). 1 Inhalation therapy is defined as "a treatment in which a substance is administered to the respiratory tract with inspired air". 6 This review will focus on inhalation of drugs. Those studies with prescribed administration of oxygen and water will be excluded. There is no universal standard for how long a treatment is undertaken to be defined as a "long term treatment". Acute episodic drug treatments, such as a course of antibiotics, will be excluded. Types of interventions of interest All educational interventions, with or without supportive programs, designed to improve the chronic respiratory disease sufferers inhalation technique and adherence to their prescribed inhalation therapy will be considered. Those studies that involve comparison of different types of inhalation medications, inhaler devices or inhalation methods to improve the adherence to inhalation therapy will be excluded. For the TRUNCATED AT 350 WORDS

Klaus Rabe: incoming President of the ERS

Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a possible relationship between right and left ventricular function and pulmonary function. Prospective substudy. Systematic screening at 11 centres. Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms corresponding to New York Heart Association class III-IV within a month prior to admission. Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry and ventricular function by echocardiography. The diagnosis of COPD and HF were made according to established criteria. The prevalence of COPD was 35%. Only 43% of the patients with COPD had self-reported COPD and one-third of patients with self-reported COPD did not have COPD based on spirometry. The prevalence of COPD in patients with preserved left ventricular ejection fraction (i.e. LVEF >or=45%) was significantly higher than in patients with impaired LVEF (41% vs. 31%, P = 0.03). FEV(1) and FVC were negatively correlated with right ventricular end-diastolic diameter and tricuspid annular plane systolic excursion and FVC positively correlated with systolic gradient across the tricuspid valve. Chronic obstructive pulmonary disease is frequent in patients admitted with HF and self-reported COPD only identifies a minority. The prevalence of COPD was high in both patients with systolic and nonsystolic HF.

BackgroundAutoimmune mechanisms have been recently recognized as being partly involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). Circulating autoantibodies have been detected in patients with COPD.ObjectivesThe aim of this study was to estimate the level of antiendothelial cell antibodies (AECA) in COPD patients in the various GOLD stages.Patients and methodsA comparative study assessed the level of AECA in three groups. COPD patients without cor pulmonale (18), with cor pulmonale (12), and the control group (10), from Beni-Suef University Hospital. Each group underwent background questionnaires and BMI measures. Enzyme-linked immunosorbent assay was used to measure the level of AECA in serum (ng/ml). Right ventricular systolic pressure (mm Hg) was measured in COPD patients with cor pulmonale.ResultsThe studied groups consisted of male patients (age: 50–80 years). BMI was significantly lower (20.36) in the COPD group with cor pulmonale. Spirometry forced expiratory volume and forced expiratory volume/forced vital capacity ratios showed significantly lower levels among the COPD patients without cor pulmonale. AECA showed a lower level in the control group (26.25) compared with the COPD without cor pulmonale (57.87) and much lowered when compared to cor pulmonale group (71.47). The level of AECD was higher in the patients in third (74.78) and fourth stages (79.10) compared with those in the second stage (58.75).ConclusionThere is a much higher level of AECA in COPD patients with cor pulmonale and in advanced stages in comparison with patients without cor pulmonale and at early stages, and a significant positive correlation was found between AECA levels and right ventricular systolic pressure.

The silent epidemic of COPD in Africa.

Towards better management of COPD

Association of β-blocker use with survival and pulmonary function in patients with chronic obstructive pulmonary and cardiovascular disease: a systematic review and meta-analysis

COPD Surveillance—United States, 1999-2011

No More Equivalence Trials for Antibiotics in Exacerbations of COPD, Please