Respiratory medicine
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Respiratory medicine · Dec 2012
Multicenter StudyManagement of chronic obstructive pulmonary disease in the Middle East and North Africa: results of the BREATHE study.
Chronic obstructive pulmonary disease (COPD) is a potentially severe chronic progressive respiratory condition requiring long-term treatment and frequently involving episodic hospitalisations to manage exacerbations. The objective of this analysis was to document diagnosis, evaluation, treatment and management of COPD-related respiratory symptoms in 1,392 subjects fulfilling an epidemiological definition of COPD identified in a general population sample of 62,086 individuals aged ≥ 40 years in ten countries in the Middle East and North Africa region (Algeria, Egypt, Jordan, Lebanon, Morocco, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates), together with Pakistan. 442 subjects (31.8%) claimed to have received a diagnosis of COPD from a physician and 287 (20.6%) had undergone spirometry in the previous year. Use of specific treatments for respiratory symptoms was reported by 218 subjects (15.7%). ⋯ Use of all healthcare resources was significantly higher (p < 0.001) in subjects with CAT scores ≥ 10 than in those with scores < 10, and greater in those with exacerbations than in those without. In conclusion, COPD in the region is under-diagnosed, inadequately evaluated and inadequately treated. Nonetheless, COPD symptoms are responsible for considerable healthcare consumption, with high levels of physician consultation and hospitalisation.
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Respiratory medicine · Sep 2012
Multicenter Study Clinical TrialIdentifying patients at risk of late recovery (≥ 8 days) from acute exacerbation of chronic bronchitis and COPD.
To identify factors associated with late recovery (≥ 8 days from exacerbation start) in patients with acute exacerbations of chronic bronchitis/COPD (AECB/AECOPD). ⋯ In a large cohort of patients, all treated with the same antibiotic for an exacerbation of chronic bronchitis or COPD, the main factors associated with late recovery (≥ 8 days) were: older age, history of frequent exacerbations, current exacerbation type of Anthonisen I/II, history of prior hospitalizations and cardiac comorbid conditions.
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Respiratory medicine · Jun 2012
Multicenter StudyReal-life effectiveness of extrafine beclometasone dipropionate/formoterol in adults with persistent asthma according to smoking status.
The efficacy and safety of extrafine beclomethasone dipropionate 100 μg/formoterol 6 μg (BDP/F HFA) pressurized metered dose inhaler (pMDI) in patients with moderate-to-severe persistent asthma, has been demonstrated in randomised controlled trials (RCTs). The aim of this prospective observational study was to assess real-life effectiveness in terms of asthma control in smoking (most of the time excluded from RCTs) and non-smoking asthmatics. ⋯ This prospective cohort study demonstrates the real-life effectiveness and safety of BDP/F HFA in adult asthma patients, including smokers, in normal clinical practice.
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Respiratory medicine · Apr 2012
Randomized Controlled Trial Multicenter StudyAZD9668, a neutrophil elastase inhibitor, plus ongoing budesonide/formoterol in patients with COPD.
Neutrophil elastase (NE) is implicated in chronic obstructive pulmonary disease (COPD). AZD9668 is a reversible and selective inhibitor of NE, well tolerated at doses of 60 mg bid during Phase I/IIa development. ⋯ Three months' treatment with AZD9668 did not improve lung function, respiratory signs and symptoms or SGRQ-C score when added to budesonide/formoterol maintenance therapy in patients with COPD. In the absence of definitive biomarkers of short-term disease progression, further research is needed to determine the optimal duration of studies to evaluate NE inhibitors as disease-modifying agents.
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Respiratory medicine · Mar 2012
Multicenter StudyGuideline adherence and macrolides reduced mortality in outpatients with pneumonia.
For outpatients with pneumonia, guidelines recommend empiric antibiotics and some suggest macrolides are preferred agents. We hypothesized that both guideline-concordant antibiotics and macrolides would be associated with reduced mortality. ⋯ In outpatients with pneumonia, treatment with guideline-concordant antibiotics and macrolides were both associated with mortality reduction.