Whither pulmonary rehabilitation? Will alternative modes help or hurt?
Chronic obstructive pulmonary disease (COPD) causes great misery to those afflicted. While it would be nice to think that a cure is near at hand, this remains only a distant dream. Symptom relief is the best we can do for the time being. We look for therapies to provide important patient-centred benefits such as improved exercise tolerance, reduced dyspnoea and better health-related quality of life. When we consider available therapies, we might consider comparing the magnitude of benefits of bronchodilators with those of pulmonary rehabilitation. A recent informal comparison of these benefits gleaned from meta-analyses in the literature reveals that, for exercise tolerance, dyspnoea and quality of life, the yield of pulmonary rehabilitation is several-fold greater than for bronchodilators . In this analysis, pulmonary rehabilitation benefits well exceed thresholds of clinical importance in all three of these domains. Moreover, over the past 25 years, pulmonary rehabilitation has gained a bulletproof physiological basis [2, 3]; the strategies employed, especially in the area of exercise training, are highly evidence-based.
This article summarizes the milestones in the development of revefenacin leading to this first global appr oval.
We report two asthmatic patients who presented in the emergency department for an asthma exacerbation. The first patient developed hyperlactatemia at 3.9 mmol/L and the second patient developed hyperlactatemia at 5.6 mmol/L after terbutaline treatment. Both patients had a favorable outcome after adjusting the aerosol dose to clinical parameters. DISCUSSION: Lactic acidosis induced by the use of inhaled β2 agonists is not synonymous of clinical deterioration. However, this side effect may be complicated by a tachypnea compensating for metabolic acidosis and should be known to avoid unnecessary therapeutic...
Study Objectives:To investigate the association between non-apnea sleep disorders (NSD) and subsequent benign paroxysmal positional vertigo (BPPV) risk.Methods:This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database from 2000 to 2013. We established an NSD group (n = 24,624) and an age-, sex- and index year-matched comparison group (n = 98,496). The primary outcome was the occurrence of BPPV. The incidence rates of BPPV in the two cohorts were compared with a 14-year follow-up. Cox proportional hazard regression analysis was used to evaluate the effects of NSD on BPPV risk...
Take this short 5-question quiz to find out what you know--or, what you may have missed--about the latest developments in COPD.
Researchers investigated whether first-line chemotherapy improved overall survival in NSCLC patients with severe to very severe COPD.
We examined annual costs through 5 years, standardized to 2016 dollars, using multivariate regression models, controlling for site and baseline patient factors.ResultsIn the first year, including the CABG surgery, annual average costs were $66,599 (SE, $1,946) for the on-pump group and $70,552 (SE, $1,954) for the off-pump group. In years 2 to 5, average costs ranged from $15,000 to $20,000 per year. There was no significant difference between on-pump and off-pump across the 5 years. We explored differences among high-risk subgroups (diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, cerebrovascu...
(MedPage Today) -- Symptoms of undertreated HF are too often confused with COPD
Conclusion: The SVS represents a novel approach for the treatment of severe emphysema with a clinically acceptable risk-benefit profile.Respiration
Conclusions: Presenting initial respiratory symptoms was the common cause for medical consultation in patients undergoing lung cancer surgery. Patients with lung cancer in larger tumor size or squamous cell carcinoma more likely presented initial and even multiple initial respiratory symptoms.
Annals of the American Thoracic Society,Volume 15, Issue Supplement_4, Page S227-S233, December 2018.