Chest
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Patients with COPD experience more frequent exacerbations in the winter. However, little is known about the impact of the seasons on exacerbation characteristics. ⋯ Exacerbations are more severe between November and February. This contributes to the increased morbidity during the winter seasons.
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Randomized Controlled Trial Multicenter Study Comparative Study
The impact of tiotropium on mortality and exacerbations when added to inhaled corticosteroids and long-acting β-agonist therapy in COPD.
Tiotropium has been shown to improve lung function, quality of life, and exacerbations and reduce mortality when compared with placebo in COPD. It remains unclear whether benefits are seen when tiotropium is used in conjunction with inhaled corticosteroids (ICSs) plus long-acting β-agonists (LABAs). ⋯ The study suggests that the addition of tiotropium to ICSs and LABA therapy may confer benefits in reducing all-cause mortality, hospital admissions, and oral corticosteroid bursts in patients with COPD. Triple therapy is widely used in the real-life management of COPD, with only limited scientific support. The study supports the use of triple therapy in COPD and provides a platform for randomized controlled trials specifically addressing this topic.
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Comparative Study
Detection of MALT1 gene rearrangements in BAL fluid cells for the diagnosis of pulmonary mucosa-associated lymphoid tissue lymphoma.
Mucosa-associated lymphoid tissue (MALT) lymphoma constitutes approximately 90% of primary pulmonary lymphoma, and the diagnosis of pulmonary MALT lymphoma often requires invasive methods such as surgical lung biopsy. Chromosomal rearrangements involving MALT lymphoma translocation gene 1 (MALT1) have been reported to be specific for MALT lymphoma. The combination of BAL and cytologic approaches with molecular methods is useful for the diagnosis of lymphoproliferative disorders. Therefore, we examined the detection of MALT1 gene rearrangements in BAL fluid (BALF) cells for the diagnosis of MALT lymphoma. ⋯ These results suggest that the detection of MALT1 gene rearrangements in BALF cells is useful for the diagnosis of pulmonary MALT lymphoma, as it is a specific method that is less invasive than surgical biopsy. Because of the small number of patients in this study, further investigations are necessary to evaluate the detection rate of MALT1 gene rearrangements in BALF cells from patients with pulmonary MALT lymphoma.
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Multicenter Study Comparative Study
Interpreting lung function data using 80% predicted and fixed thresholds identifies patients at increased risk of mortality.
The GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages for COPD use a fixed ratio of the postbronchodilator FEV(1)/FVC ratio of 0.70 as a threshold to define obstruction. Others advocate using the lower limit of normal (LLN) for the FEV(1)/FVC ratio, FEV(1), and FVC to define abnormality. This study investigated mortality in a representative sample of the US adult population with COPD by comparing abnormality determined using GOLD criteria to that determined using LLN criteria. ⋯ In the nationally representative Third National Health and Nutrition Examination Survey data, subjects classified as normal using LLN criteria but obstructed or restricted using GOLD criteria have a higher risk of mortality.