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Respirology 2019 Mar 21. Epub 2019 Mar 21.

Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.

Background And Objective: Exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with increased in-hospital and short-term mortality. Developing an easy-to-use model to predict adverse outcomes will be useful in daily clinical practice and will facilitate management decisions. We aimed to assess mortality rates and potential predictors for short-term mortality after severe ECOPD. Read More

PLoS One 2019 21;14(3):e0214246. Epub 2019 Mar 21.

School of Health and Biomedical Sciences, RMIT University, BUNDOORA, VIC, Australia.

Chronic obstructive pulmonary disease (COPD) is currently the third leading cause of death globally and is characterized by airflow limitation that is progressive and not fully reversible. Cigarette smoking is the major cause of COPD. Fifty percent of deaths in the COPD population are due to a cardiovascular event and it is now recognised that COPD is a risk factor for stroke. Read More

PLoS One 2019 21;14(3):e0214058. Epub 2019 Mar 21.

Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.

Background And Objectives: This study explored whether, for people with chronic obstructive pulmonary disease (COPD), changes to the 24-hour composition of physical activity (PA), sedentary behaviour (SB) and sleep were associated with changes in symptoms and health-related quality of life (HRQoL); and how time re-allocations between these behaviours were associated with changes in outcomes.

Methods: This study pools data on people with COPD drawn from two previous studies: a randomised controlled trial of cognitive behavioural therapy and pulmonary rehabilitation and a usual care cohort. Participants recalled behaviours and completed symptom and HRQoL assessments at baseline (T0) and four months (T1). Read More

Med Image Comput Comput Assist Interv 2018 Sep 26;11070:502-510. Epub 2018 Sep 26.

Computer Science Department, University of Pittsburgh, USA.

We propose an attention-based method that aggregates local image features to a subject-level representation for predicting disease severity. In contrast to classical deep learning that requires a fixed dimensional input, our method operates on a of image patches; hence it can accommodate variable length input image without image resizing. The model learns a clinically interpretable subject-level representation that is reflective of the disease severity. Read More

ERJ Open Res 2019 Feb 18;5(1). Epub 2019 Mar 18.

National Heart and Lung Institute, Imperial College London, London, UK.

The annual European Respiratory Society (ERS) International Congress (held in Paris in 2018) was once again a platform for discussion of the highest-quality scientific research, cutting-edge techniques and innovative new therapies within the respiratory field. This article discusses only some of the high-quality research studies presented at this year's Congress, with a particular focus on airway diseases including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cough, as presented through Assembly 5 of the ERS (Airway Diseases: Asthma and COPD). The authors establish the key take-home messages of these studies, compare their findings and place them in the context of current understanding. Read More

Open Access Maced J Med Sci 2019 Feb 25;7(4):567-572. Epub 2019 Feb 25.

Faculty of Physiotheraphy, STIKES Siti Hajar, Medan, Indonesia.

Background: Exercise tolerance is one of the main impacts of COPD. COPD patients often experience dyspnea and fatigue after doing daily activities using their limb parts, even in simple thing such as lifting or grooming. Nowadays, many pulmonologists concerned in pulmonary rehabilitation to modify some limb training with breathing manoeuvre to get positive impact in stable COPD patient. Read More

BMJ Qual Saf 2019 Mar 20. Epub 2019 Mar 20.

QURE Healthcare, San Francisco, California, USA

Background: Hospitalist medicine was predicated on the belief that providers dedicated to inpatient care would deliver higher quality and more cost-effective care to acutely hospitalised patients. The literature shows mixed results and has identified care variation as a culprit for suboptimal quality and cost outcomes. Using a scientifically validated engagement and measurement approach such as Clinical Performance and Value (CPV), simulated patient vignettes may provide the impetus to change provider behaviour, improve system cohesion, and improve quality and cost efficiency for hospitalists. Read More

COPD 2018 Dec;15(6):588-599

c DRK-Kliniken Berlin-Westend, Klinik für Kardiologie , Berlin , Germany.

While right heart catheterization (RHC) at rest is the gold standard to assess pulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH), the invasive measurement of exercise hemodynamics is less well established in this group. Since exercise hemodynamics are increasingly recognized as important clinical information in patients with PH, our goal was to review the literature in this field to provide a basis for clinical use, further studies, and future recommendations. We identified 69 studies (published since 1968) reporting RHC data in 2819 patients with COPD, of whom 2561 underwent exercise testing. Read More

PLoS One 2019 20;14(3):e0208687. Epub 2019 Mar 20.

State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, P.R. China.

There is limited evidence linking the impacts of reduced air pollution on hospital admissions. The potential biological mechanisms are still not completely understood. This study examined the effects of mitigated ambient pollution on hospital admissions and inflammatory biomarker levels in chronic obstructive pulmonary disease (COPD) COPD patients. Read More

Curr Opin Pulm Med 2019 Mar 18. Epub 2019 Mar 18.

Pneumology Department, Hospital Universitari Vall d' Hebron (HUVH), Institut de Recerca Vall d'Hebron (VHIR), Barcelona, Spain.

Purpose Of Review: Bronchiectasis is a chronic respiratory disease with heterogeneous clinical manifestations and outcomes. Identifying clinical phenotypes could help in managing bronchiectasis patients and hopefully improve disease prognosis by adopting personalized treatment. We review the current literature on clinical phenotypes of bronchiectasis and try to highlight priorities for future research. Read More

Int J Palliat Nurs 2019 Mar;25(3):129-141

Associate Professor, Director of the Thailand, Center for Evidence-Based Health Care: A collaborating Excellent Centre of Joanna Briggs Institute, Faculty of Nursing Chiang Mai University, Thailand.

Background:: There is limited understanding of the symptoms that older people living with cancer, chronic obstructive pulmonary disease and chronic kidney disease experience during the last year of life in Thailand, in addition to their health service preferences.

Aims:: To survey the symptom experiences and health service preferences at the end of life of older people with chronic illnesses from the perspective of bereaved carers.

Methods:: The study used a retrospective post-bereavement approach to collect quantitative data. Read More

Health Rep 2019 Mar;30(3):12-23

College of Health Solutions, Arizona State University, Phoenix, Arizona, United States.

Background: Sitting time and physical activity may be modifiable determinants of lung function. The purpose of this study was to assess the effect that replacing various movement behaviours has on lung function among individuals with and without obstructive lung disease.

Data And Methods: For analysis, data were used from participants of the Canadian Longitudinal Study on Aging, recruited between 2012 and 2015. Read More

Rev Bras Epidemiol 2019 Mar 14;22:e190010. Epub 2019 Mar 14.

Universidade do Sul de Santa Catarina - Florianópolis (SC), Brasil.

Objective: To analyze the trends in hospitalization and mortality rates for ambulatory care sensitive conditions (ACSC) among older adults in the state of Santa Catarina, Brazil, from 2008 to 2015.

Method: Ecological time-series study based on data from the Hospital Information System (Sistema de Informações Hospitalares - SIH) of the public health system (Sistema Único de Saúde - SUS), using hospital admission authorization forms as data source, from 2008 to 2015, in Santa Catarina. Data were analyzed by gender and age, which was stratified into two age groups: 60 to 79 years and 80 years or older. Read More

JMIR Med Inform 2019 Mar 20;7(1):e11496. Epub 2019 Mar 20.

School of Health Administration, Texas State University, San Marcos, TX, United States.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death throughout the world. Telemedicine has been utilized for many diseases and its prevalence is increasing in the United States. Telemonitoring of patients with COPD has the potential to help patients manage disease and predict exacerbations. Read More

Am J Physiol Lung Cell Mol Physiol 2019 Mar 20. Epub 2019 Mar 20.

Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, China.

An excessive inflammatory response in terminal airways, alveoli, and the lung interstitium eventually leads to pulmonary hypertension and chronic obstructive pulmonary disease. Proinflammatory cytokine interleukin-17A (IL-17A) has been implicated in the pathogenesis of pulmonary inflammatory diseases. MLN4924, an inhibitor of NEDD8-activating enzyme (NAE), is associated with the treatment of various types of cancers, but its role in the IL-17A-mediated inflammatory response has not been identified. Read More

Am J Physiol Lung Cell Mol Physiol 2019 Mar 20. Epub 2019 Mar 20.

Center of Translational Medicine, Thomas Jefferson University, United States.

Cellular senescence is a biological process by which cells lose their capacity to proliferate yet remain metabolically active. Although originally considered a protective mechanism to limit the formation of cancer, it is now appreciated that cellular senescence also contributes to the development of disease, including common respiratory ailments, such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. While many factors have been linked to the development of cellular senescence, mitochondrial dysfunction has emerged as an important causative factor. Read More

Am J Respir Crit Care Med 2019 Mar 20. Epub 2019 Mar 20.

Dartmouth, Geisel School of Medicine, Hanover, New Hampshire, United States ;

Ann Am Thorac Soc 2019 Mar 20. Epub 2019 Mar 20.

University of Southampton, Faculty of medicine, Clinical and Experimental Sciences, Southampton, United Kingdom of Great Britain and Northern Ireland.

Rationale: Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation, caused by emphysema and small airways disease (SAD). CT, coupled with image analysis enables the quantification of these abnormalities, however the optimum method for doing so has not been determined.

Objectives: This study aims to compare two quantitative analysis techniques, disease probability measure (DPM), and parametric response mapping (PRM) and assess their relationship with specific physiological measures of SAD. Read More

Respirology 2019 Mar 19. Epub 2019 Mar 19.

Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.

Pulmonary rehabilitation (PR) improves exercise capacity, health-related quality of life (HRQoL) and dyspnoea in patients with COPD and other lung conditions. Once PR is completed, the benefits gained begin to decline unless patients continue to exercise regularly. Due to limited evidence in other lung conditions, this review aims to examine the current evidence regarding maintenance exercise programmes for patients with COPD and to determine the types of programmes that are able to maintain the benefits gained from PR to 12 months and longer. Read More

Ann N Y Acad Sci 2019 Mar 19. Epub 2019 Mar 19.

Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba, Canada.

Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by narrowed airways, resulting in serious breathing difficulty. Previous studies have demonstrated that inflammatory infiltration of leukocytes in the airway is associated with the pathogenesis of COPD. In the present study, we employed a microfluidic approach to assess the effect of COPD sputum on activated human peripheral blood T cell migration and chemotaxis under well-controlled gradient conditions. Read More

Int J Environ Res Public Health 2019 Mar 18;16(6). Epub 2019 Mar 18.

School of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA.

Epidemiological studies consistently show an association between wildfire-related smoke exposure and adverse respiratory health. We conducted a systematic review of evidence in published literature pertaining to heterogeneity of respiratory effects from this exposure in North America. We calculated the within-study ratio of relative risks (RRR) and 95% confidence intervals (CI) to examine heterogeneity of effect by population subgroup, and then summarized the RRRs using meta-analysis. Read More

Acta Biomed 2018 Oct 16;90(1):37-43. Epub 2018 Oct 16.

Kars Harakani State Hospital.

Introduction: Chronic obstructive pulmonary disease (COPD) is a disease that causes obstructed air flow from the lungs. The disease also has a dramatic role in increasing rate of mortality and morbidity in recent years. Air pollution, long-term exposure to particulate matter and irritating gases, especially cigarette smoke, genetic inheritance which has an impact on the initial forced expiratory volume one in second (FEV1), and alpha-1-antitrypsin (AAT) deficiency are among common COPD risk factors. Read More

Subcell Biochem 2019 ;91:45-74

Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK.

Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis are regarded as a diseases of accelerated lung ageing and show all of the hallmarks of ageing, including telomere shortening, cellular senescence, activation of PI3 kinase-mTOR signaling, impaired autophagy, mitochondrial dysfunction, stem cell exhaustion, epigenetic changes, abnormal microRNA profiles, immunosenescence and a low grade chronic inflammation due to senescence-associated secretory phenotype (SASP). Many of these ageing mechanisms are driven by exogenous and endogenous oxidative stress. There is also a reduction in anti-ageing molecules, such as sirtuins and Klotho, which further accelerate the ageing process. Read More

JMIR Form Res 2019 Mar 19;3(1):e12489. Epub 2019 Mar 19.

Center for Information Systems & Technology, Claremont Graduate University, Claremont, CA, United States.

Background: Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients' lives, which leads to physical and psychological limitations. Read More

Expert Rev Vaccines 2019 Mar 19. Epub 2019 Mar 19.

a GSK , Avenue Fleming 20, 1300 Wavre , Belgium.

Introduction: Pertussis (whooping cough) is a vaccine-preventable disease; however, neither natural- nor vaccine-induced protection is life-long. Although generally not severe in adults, pertussis can be associated with complications in patients with chronic conditions such as asthma or chronic obstructive pulmonary disease, and can be readily transmitted to more vulnerable populations, including neonates before they complete their primary vaccination. Furthermore, as the global population ages, the health and economic burden of the disease is expected to rise. Read More

Korean J Radiol 2019 Apr;20(4):683-692

Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Objective: We aimed to evaluate correlations between computed tomography (CT) parameters and pulmonary function test (PFT) parameters according to disease severity in patients with chronic obstructive pulmonary disease (COPD), and to determine whether CT parameters can be used to predict PFT indices.

Materials And Methods: A total of 370 patients with COPD were grouped based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I-IV criteria. Emphysema index (EI), air-trapping index, and airway parameters such as the square root of wall area of a hypothetical airway with an internal perimeter of 10 mm (Pi10) were measured using automatic segmentation software. Read More

Res Nurs Health 2019 Mar 18. Epub 2019 Mar 18.

Department of Pulmonary and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou Medical University, Binzhou, China.

High flow nasal cannula (HFNC) has been shown to improve extubation outcomes in patients with hypoxemia, but the role of HFNC in weaning patients with chronic obstructive pulmonary disease (COPD) with hypercapnia from invasive ventilation is unclear. We compared the effects of HFNC to noninvasive ventilation (NIV) on postextubation vital signs and arterial blood gases (ABGs) among patients with COPD. Other outcomes included comfort scores, need for bronchoscopy, use of pulmonary medications, and chest physiotherapy. Read More

Z Rheumatol 2019 Mar 18. Epub 2019 Mar 18.

Klinik für Rheumatologie, Kantonsspital St. Gallen, St. Gallen, Schweiz.

Pulmonary involvement in patients with rheumatoid arthritis, in particular interstitial lung diseases (RA-ILD) is of great clinical importance. Patients should be asked about symptoms of pulmonary involvement and the lungs should be clinically examined even during the diagnostic procedure and regularly during the course of the disease. Before initiation of a basic pharmacological treatment an X‑ray examination of thoracic organs is obligatory. Read More

Open Med (Wars) 2019 2;14:271-278. Epub 2019 Mar 2.

Department of Emergency, 1st Hospital of Yulin, Yulin City, Shaanxi Province 719000, China.

Objective: Our objective is to explore the effects of budesonide combined with noninvasive ventilation on procalcitonin (PCT), soluble myeloid cell triggering receptor-1 (sTREM-1), thoracic and lung compliance, humoral immune function, and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type II respiratory failure.

Methods: There were 82 patients with AECOPD complicated with type II respiratory failure admitted into our hospital between March, 2016-September, 2017. They were selected and randomly divided into observation group (n=41) and control group (n=41). Read More

J Pharmacol Exp Ther 2019 Mar 18. Epub 2019 Mar 18.

GlaxoSmithKline;

Nemiralisib (GSK2269557) is a potent inhaled inhibitor of phosphoinositide 3-kinase delta (PI3Kδ) which is being developed for the treatment of respiratory disorders including COPD (Chronic Obstructive Pulmonary Disease). Determining the pharmacokinetic (PK) and pharmacodynamic (PD) responses of inhaled drugs early during drug development is key to informing the appropriate dose and preferred dose regimen in patients. We set out to measure PD changes in induced sputum in combination with drug concentrations in plasma and bronchoalveolar lavage (BAL) taken from healthy smokers (n=56) treated for up to 14 days with increasing doses of inhaled nemiralisib (0. Read More

BMJ 2019 Mar 18;364:l1025. Epub 2019 Mar 18.

Bazian, Economist Intelligence Unit healthcare, London, UK.

The studyJolliffe D, Greenberg L, Hooper R, Mathyssen C, Rafiq R, de Jongh R, Camargo C, Griffiths C, Janssens W, Martineau A. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. 2019. Read More

COPD 2019 Mar 19:1-5. Epub 2019 Mar 19.

c Discipline of Physiotherapy, Department of Physiotherapy, Alfred Health, Institute for Breathing and Sleep , La Trobe University , Melbourne , Australia.

Abnormal sleep duration is associated with poor health. Upwards of 50% of people with chronic obstructive pulmonary disease (COPD) report poor sleep quality. The effect of pulmonary rehabilitation on self-reported sleep quality is variable. Read More

Zhonghua Yi Xue Za Zhi 2019 Mar;99(10):739-743

Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China.

To investigate the effect of obstructive sleep apnea (OSA) on the severity of acute pulmonary thromboembolism (PTE). Clinical data of patients with acute PTE and OSA who were admitted to Anzhen Hospital from January 2015 to December 2017 were retrospectively analyzed in this study.According to the apnea hypopnea index (AHI), patients were divided into AHI≤15/h group and AHI>15/h group. Read More

Zhonghua Liu Xing Bing Xue Za Zhi 2019 Mar;40(3):277-283

National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Read More

Cytokine 2019 Mar 15;119:57-61. Epub 2019 Mar 15.

Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil. Electronic address:

Chronic moderate-intensity exercise is an efficient non-pharmacological strategy to prevent and treat several diseases such as type 2 diabetes mellitus, cardiovascular and chronic obstructive pulmonary diseases, cancers, and Parkinson's disease. On the other hand, improving an athlete's performance requires completing high-intensity and volume exercise sessions. When the delicate balance between high-load exercise sessions and adequate recovery periods is disrupted, excessive training (known as overtraining) can lead to performance decline. Read More

Respirology 2019 Mar 18. Epub 2019 Mar 18.

Faculty of Science, School of Human Sciences and School of Agriculture and Environment, The University of Western Australia, Perth, WA, Australia.

Respiratory diseases, such as influenza infection, acute tracheal bronchitis, pneumonia, tuberculosis, chronic obstructive pulmonary disease, asthma, lung cancer and nasopharyngeal carcinoma, continue to significantly impact human health. Diseases of the lung and respiratory tract are influenced by environmental conditions and socio-economic factors; however, many of these serious respiratory disorders are also rooted in genetic or epigenetic causes. Clustered regularly interspaced palindromic repeats (CRISPR) and CRISPR-associated (Cas) proteins, isolated from the immune system of prokaryotes, provide a tool to manipulate gene sequences and gene expression with significant implications for respiratory research. Read More

PLoS One 2019 18;14(3):e0214083. Epub 2019 Mar 18.

Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.

Background: Breathlessness is prevalent in the general population and may be associated with adverse health outcomes. This study aimed to evaluate the association of breathlessness with Chronic Obstructive Pulmonary Disease (COPD) events, cardiac events and all-cause mortality from middle-age throughout life.

Methods: Breathlessness was measured in 699, 55-year old men residing in Malmö, Sweden using modified Medical Research Council (mMRC). Read More

Anesth Prog 2019 ;66(1):44-51

Private Practice, CarePoint Anesthesia, Denver, Colorado.

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Read More

Medicine (Baltimore) 2019 Mar;98(11):e14837

The Second Affiliated Hospital, School of Medicine.

Background: Nowadays, there is growing recognition that chronic obstructive pulmonary disease (COPD) may have influence on lung cancer. However, coexisted COPD related to prognosis of lung cancer is still elusive. We conducted this meta-analysis to examine the association between COPD and 5-year overall survival (OS) and postoperative pulmonary complications of patients with lung cancer. Read More

Crit Care Med 2019 Mar 15. Epub 2019 Mar 15.

Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.

Objectives: Assessing gas exchange, diaphragm function, respiratory rate, and patient comfort during high-flow oxygen therapy and standard oxygen at the time of noninvasive ventilation discontinuation.

Design: Randomized crossover physiologic study.

Setting: Two ICUs. Read More

Anesthesiology 2019 Mar 14. Epub 2019 Mar 14.

From the Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart (D.L.G., G.M.A., A.R., F.B., F.C., L.P., B.R., A.M.D., L.S., G.C., M.A.) Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS (D.L.G., G.M.A., A.R., F.B., F.C., L.P., B.R., A.M.D., L.S., G.C., M.A.) Department of Obstetrics and Gynecology, Catholic University of The Sacred Heart (B.C., M.D., L.T., V.G., G.S.) Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS (B.C., M.D., L.T., V.G., G.S.) Department of Internal Medicine, Catholic University of The Sacred Heart (F.V.) Respiratory Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS (F.V.), Rome, Italy.

What We Already Know About This Topic: Airway closure has been described in chronic obstructive pulmonary disease, acute respiratory distress syndrome, and cardiac arrest patientsThis phenomenon makes tidal inflation start only after a critical airway opening pressure is overcomeAlthough previously reported during general anesthesia, airway closure was partially misinterpreted WHAT THIS ARTICLE TELLS US THAT IS NEW: Airway closure affects a relevant proportion of obese patients undergoing general anesthesia in supine position, with a variable degree of airway opening pressureWith Trendelenburg pneumoperitoneum, airway opening pressure increases consistently with esophageal pressure and pneumoperitoneum insufflation pressure: consequently, transalveolar pressure, lung volumes, and alveolar recruitment do not varyAirway closure yields bedside misinterpretation of respiratory mechanics and underestimation of actual alveolar pressure in the intraoperative settingIt is an occult phenomenon that generates an airway pressure threshold, whereby inspiratory gas does not inflate the lung unless the airway opening pressure is exceeded BACKGROUND:: Airway closure causes lack of communication between proximal airways and alveoli, making tidal inflation start only after a critical airway opening pressure is overcome. The authors conducted a matched cohort study to report the existence of this phenomenon among obese patients undergoing general anesthesia.

Methods: Within the procedures of a clinical trial during gynecological surgery, obese patients underwent respiratory/lung mechanics and lung volume assessment both before and after pneumoperitoneum, in the supine and Trendelenburg positions, respectively. Read More

Ann Plast Surg 2019 Mar 13. Epub 2019 Mar 13.

From the Division of Plastic and Reconstructive Surgery, School of Medicine, University of Utah, Salt Lake City, UT.

Background: Males represent a significant portion of patients undergoing abdominal contouring. Despite this, there are few studies examining the implication of gender on complications.

Objective: The aim of this study was to examine the association between gender and early postoperative outcomes in patients undergoing abdominal contouring procedures. Read More

JMIR Res Protoc 2019 Mar 18;8(3):e9228. Epub 2019 Mar 18.

Research and Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.

Background: A high proportion of the costs for respiratory diseases are generated by a relatively small group of patients with severe disease (recognized or unrecognized) or complex problems that include multimorbidity, at-risk behaviors, and socioeconomic disadvantage. These patients often struggle to engage with the structured, proactive, care approaches for chronic disease management advocated for asthma and chronic obstructive pulmonary disease (COPD), resulting in repeated emergency use of both primary and secondary health care. An integrated approach for the management of complex patients, incorporating both specialist and primary care teams' expertise, may be effective in improving outcomes for such high-risk patients. Read More

Anesth Pain Med 2019 Feb 16;9(1):e81785. Epub 2019 Feb 16.

Department of Anesthesiology, Pain and Critical Care, Tehran University of Medical Sciences, Tehran, Iran.

Background: Respiratory failure and hypoxemia are the known complications of anesthesia and surgery. As a major surgery mainly at advanced ages, the coronary artery bypass graft (CABG) surgery could lead to hypoxemia in the early post-operative phase. Currently, the fraction of partial pressure of arterial oxygen to the fraction of inspired oxygen (PiO/FiO) is used to determine the severity of the respiratory assault. Read More

Int J Chron Obstruct Pulmon Dis 2019 1;14:585-595. Epub 2019 Mar 1.

Division of Pulmonary Diseases and Critical Medicine, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,

Purpose: Adequate peak inspiratory flow rate (PIFR) is required for drug dispersion with dry powder inhalers (DPIs). Prevalence of PIFR discordance (suboptimal PIFR with prescribed inhalers) and factors influencing device-specific PIFR are unclear in COPD. The objective of this study was to determine the prevalence of PIFR discordance and associated clinical factors in a stable COPD population. Read More

Int J Chron Obstruct Pulmon Dis 2019 1;14:565-573. Epub 2019 Mar 1.

Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,

Introduction: The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes.

Methods: This was a cross-sectional study of patients with COPD attending the respiratory medicine clinic of University of Malaya Medical Centre from 1 June 2017 to 31 May 2018. Read More

Int J Chron Obstruct Pulmon Dis 2019 28;14:531-546. Epub 2019 Feb 28.

Section of Cardiorespiratory and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.

Background: Current pharmacological therapies for COPD improve quality of life and symptoms and reduce exacerbations. Given the progressive nature of COPD, it is arguably more important to understand whether the available therapies are able to delay clinical deterioration; the concept of "clinically important deterioration" (CID) has therefore been developed. We evaluated the efficacy of the single-inhaler triple combination beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G), using data from three large 1-year studies. Read More

Int J Chron Obstruct Pulmon Dis 2019 27;14:499-508. Epub 2019 Feb 27.

Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,

Introduction And Aim: Abnormal brain structure and function in COPD has been reported on MRI. However, the deficit in local synchronization of spontaneous activity in patients with stable COPD remains unknown. The main aim of the present study was to explore spontaneous brain activity in patients with COPD compared with normal controls using the regional homogeneity (ReHo) method based on resting-state functional MRI. Read More