International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2006
ReviewIs there any treatment other than drugs to alleviate dyspnea in COPD patients?
Patients with chronic obstructive pulmonary disease (COPD) are often limited in their activities by breathlessness. In these patients, exercise training may result in significant improvements in dyspnea, exercise tolerance, and health related quality of life (HRQoL). ⋯ Ventilatory assistance during exercise reduces dyspnea and work of breathing and enhances exercise tolerance, although further studies should be required to define their applicability in the routine pulmonary rehabilitation programs. Lung volume resection surgery and lung transplantation in selected patients may control symptoms and improve HRQoL.
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Int J Chron Obstruct Pulmon Dis · Jan 2006
Comparative StudyDiagnosis of airway obstruction in primary care in the UK: the CADRE (COPD and Asthma Diagnostic/management REassessment) programme 1997-2001.
Asthma and COPD require different management strategies, but differentiation in primary care is difficult. This primary care support initiative observed the impact of spirometry and clinical assessment on the diagnosis of airway disease. ⋯ In this study, a clinical review supplemented by additional information including spirometry highlights apparent mislabeling of significant numbers of patients with chronic obstructive disease in general practice with significant implications for individual treatment and healthcare provision. This study shows that the addition of more clinical information can have a major effect on diagnostic tendency in patients with airway disease. An initial diagnosis of COPD seems less likely to change following review than an asthma diagnosis. While it is likely that greater information leads to a more accurate diagnosis, the differential effect of new information on diagnostic labeling highlights the insecurity of the diagnostic process in primary care in the UK.
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Int J Chron Obstruct Pulmon Dis · Jan 2006
Review Comparative StudyEosinophilic airway inflammation in COPD.
Chronic obstructive pulmonary disease is a common condition and a major cause of mortality. COPD is characterized by irreversible airflow obstruction. The physiological abnormalities observed in COPD are due to a combination of emphysema and obliteration of the small airways in association with airway inflammation. ⋯ Eosinophilic airway inflammation is resistant to inhaled corticosteroid therapy, but does respond to systemic corticosteroid therapy, and the degree of response is related to the intensity of the eosinophilic inflammation. In COPD, targeting treatment to normalize the sputum eosinophilia reduced the number of hospital admissions. Whether controlling eosinophilic inflammation in COPD patients with an airway eosinophilia will modify disease progression and possibly alter mortality is unknown, but warrants further investigation.