A Case of Worsening Dyspnea and Cough

Bob is a 72-year-old male, with a 40-pack-year smoking history. He quit about 8 years ago, when severe COPD was diagnosed. Until last year, he had been stable on his regimen of Advair 250/50 and Spiriva Handihaler, other than an occasional “bronchitis,” usually treated with an antibiotic and/or steroids. Over the past year or so, however, he has noticed a marked turn for the worse. He no longer can walk up the steps in his house without stopping and gasping for breath.
Source: ConsultantLive - Category: Internal Medicine Authors: Tags: Respiratory Diseases Source Type: news

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CONCLUSIONS: In participants with chronic bronchitis or COPD, we are moderately confident that treatment with mucolytics leads to a small reduction in the likelihood of having an acute exacerbation, in days of disability per month and possibly hospitalisations, but is not associated with an increase in adverse events. There appears to be limited impact on lung function or health-related quality of life. Results are too imprecise to be certain whether or not there is an effect on mortality. Our confidence in the results is reduced by high levels of heterogeneity in many of the outcomes and the fact that effects on exacerbat...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusions: It is important to diagnose and treat anxiety and depression in patients with COPD for a better prognosis and higher efficacy of medical treatments. While treating such patients, it is preferable to use a cough monitoring device for objective assessments, since the patients may exaggerate or underestimate their symptoms. PMID: 31091811 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
AbstractPurpose of ReviewChronic cough, defined in adults as one lasting longer than 8  weeks, is among the commonest clinical problems encountered by doctors both in general practice and in hospital. It can exist as a distinct clinical problem or as a prominent and troublesome symptom for patients with common pulmonary conditions including asthma, chronic obstructive pulmonary disea se and idiopathic pulmonary fibrosis.Recent FindingsChronic cough impacts considerably on patients ’ daily-life activities and many patients are left frustrated by what they see as a complete lack of awareness among their doctors as...
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research
We report a case of mediastinal cryptococcosis with thyroid invasion in a patient who presented dry cough and persistent dyspnea. This patient has been treated for COPD, presenting no clinical responses. Spirometry showed fixed flattening of inspiratory and expiratory loops, suggesting extrinsic tracheal compression. A freezing biopsy revealed a mass consisting of lymph nodes and yeasts with characteristics of Cryptococcus spp. After surgical resection of the lesion, the patient was treated with fluconazole, showing total remission of the disease and symptomatology.
Source: Medical Mycology Case Reports - Category: Biology Source Type: research
Mark E. Gray1,2*, James Meehan2,3, Paul Sullivan4, Jamie R. K. Marland4, Stephen N. Greenhalgh1, Rachael Gregson1, Richard Eddie Clutton1, Carol Ward2, Chris Cousens5, David J. Griffiths5, Alan Murray4 and David Argyle1 1The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom 2Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom 3School of Engineering and Physical Sciences, Institute of Sensors, Signals and Systems, Heriot-Watt Univer...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Condition:   Cough Interventions:   Dietary Supplement: Three-seeds mixture;   Dietary Supplement: Control Sponsors:   Veterans Affairs Medical Center, Miami;   Dr. Robert Jackson Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Mario Malerba1,2*, Valentina Foci1,2, Filippo Patrucco1,2, Patrizia Pochetti1,2, Matteo Nardin3, Corrado Pelaia4 and Alessandro Radaeli5 1Respiratory Medicine, Department of Translational Medicine, University of Eastern Piedmont, Vercelli, Italy 2Respiratory Unit, Sant’Andrea Hospital, Vercelli, Italy 3Department of Medicine, Spedali Civili di Brescia, Brescia, Italy 4Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy 5Department of Emergency, Spedali Civili di Brescia, Brescia, Italy Chronic obstructiv...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: Animal production work, including insecticide use, was positively associated with chronic bronchitis symptoms; but not consistently with COPD diagnosis alone. Our results support the need for further investigation into the role of animal production-related exposures in the etiology of COPD and better respiratory protection for agricultural workers. PMID: 31029031 [PubMed - as supplied by publisher]
Source: Environment International - Category: Environmental Health Authors: Tags: Environ Int Source Type: research
Authors: Skoczyński S, Minarowski Ł, Tobiczyk E, Oraczewska A, Glinka K, Ficek K, Mróz R, Barczyk A Abstract Respiratory failure is one of the most important risk factors for diagnostic bronchofiberoscopy (BF), whereas therapeutic bronchoscopies are typically performed in intubated patients. Only a few published studies analyzed the outcomes of noninvasive mechanical ventilation (NIV)-facilitated BF. In this case series, we present our experiences with NIV-facilitated diagnostic and therapeutic BF performed in patients with respiratory failure that was associated with acute interstitial pulmonary disease, ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
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