1,721,124 research outputs found
Predicting poor prognosis in COPD patients: Looking for a lamp lit in the darkness of the night
No full textN/
A shadow in the GOLD ABCD classification system: measurement of perception of symptoms in COPD
No full textNot applicabl
Long-term weight loss and maintenance in morbidly obese individuals with obstructive sleep apnea
No full textN/
Predictors of Readmission in a Period of 30 Days or Less in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
No full textChronic obstructive pulmonary disease (COPD) is a highly prevalent disease worldwide; acute exacerbation of chronic obstructive pulmonary disease is a clinical condition characterized by a worsening of the patient's respiratory signs and symptoms, reducing the overall life expectancy. Readmission in a period of 30 days or less after discharge represents a new emerging clinical condition. In COPD patients, the rate of a 30-day readmission is reported to be approximately 20%; high rates of readmission may result from patients' complexity or from the complexity of the hospital system. Because a 30-day readmission has both clinical and economic impact, there is considerable interest in searching for factors that can predict readmission of COPD patients. In this paper, we describe the most important risk factors linked to readmission in a period of 30 days or less after discharge, and their role in the context of problems relating to readmission, in COPD patients primarily hospitalized for acute exacerbations of chronic obstructive pulmonary disease.
How may we improve clinical outcomes for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease? A narrative review about possible therapeutic and preventive strategies
No full textIntroduction: In a subset of chronic obstructive pulmonary disease (COPD)patients the course of the disease is complicated by a severe acute exacerbations (AECOPD) that may require hospitalization, at which time negative outcomes may occur up to 30 days after discharge. Several predictors of negative outcomes have been documented. Areas covered: We considered five negative outcomes related to patients hospitalized with AECOPD: treatment failure, noninvasive mechanical ventilation (NIMV) failure, prolonged length of hospital stay (LHS), short-term mortality (<= 90 days from admission and including the in-hospital mortality), and early readmission (<= 30 days from discharge). Possible therapeutic and preventive strategies to improve these outcomes are outlined and discussed. Expert opinion: Several strategies have been proposed to improve outcomes. Among these, steroid or antibiotic use may reduce the risks of treatment failure or of prolonged hospital stay. We note that operator-related factors may influence the outcome of NIMV. However, little has been documented about the short-term mortality or early readmission rates. In general, few interventions consistently improve negative outcomes and prognosis of AECOPD
Rehabilitation in COPD patients admitted for exacerbation
No full textRecovery of lung function is delayed by up to two months following acute exacerbation (AE) of COPD patients. After AE, even with optimal medical therapy, it takes a considerable time for COPD patients to recover to baseline ability to perform routine physical activities. Although pulmonary rehabilitation (PR) has long been considered a useful non-pharmacological therapy in stable COPD individuals, there have been only a few studies into the effects of rehabilitation during and/or just after AE. This review updates the application of early PR and main physical therapies both during hospital acute care and following discharge of COPD patients who have experienced exacerbation. It is only recently that literature has demonstrated the feasibility and effectiveness of early PR in COPD patients undergoing AE. Nonetheless, early PR clearly appears to be a treatment indicated just after, or even during, an acute episode in hospital. Future studies should be able to clarify the practical role and effects of a timely application of rehabilitation to acute COPD, as well as the preferred modalities, duration and techniques to apply in this condition
Peeping at COPD through the keyhole: time to broaden the view to the complexity of the disease by the heterogeneity of symptoms
No full text: The assessment of co-occurring nonrespiratory symptoms in COPD allow us to explore the true complexity of the disease and to plan specific integrated, multidimensional care strategies https://bit.ly/4dwdnBQ
Measures of dyspnea in pulmonary rehabilitation
Full text linkAbstract Dyspnea is the main symptom perceived by patients affected by chronic respiratory diseases. It derives from a complex interaction of signals arising in the central nervous system, which is connected through afferent pathway receptors to the peripheral respiratory system (airways, lung, and thorax). Notwithstanding the mechanism that generates the stimulus is always the same, the sensation of dyspnea is often described with different verbal descriptors: these descriptors, or linguistic 'clusters', are clearly influenced by socio-individual factors related to the patient. These factors can play an important role in identifying the etiopathogenesis of the underlying cardiopulmonary disease causing dyspnea. The main goal of rehabilitation is to improve dyspnea; hence, quantifying dyspnea through specific tools (scales) is essential in order to describe the level of chronic disability and to assess eventual changes after intervention. Improvements, even if modest, are likely to determine clinically relevant changes (minimal clinically important difference, MCID) in patients. Currently there exist a large number of scales to classify and characterize dyspnea: the most frequently used in everyday clinical practice are the clinical scales (e.g. MRC or BDI/TDI, in which information is obtained directly from the patients through interview) and psychophysical scales (such as the Borg scale or VAS, which assess symptom intensity in response to a specific stimulus, e.g. exercise). It is also possible to assess the individual's dyspnea in relation to specific situations, e.g. chronic dyspnea (with scales that classify patients according to different levels of respiratory disability); exertional dyspnea (with tools that can measure the level of dyspnea in response to a physical stimulus); and transitional (or 'follow up') dyspnea (with scales that measure the effect in time of a treatment intervention, such as rehabilitation).</p
Two for the price of one: GLP-1 analogues, a new approach in treating severe COPD patients with diabetes
No full text: Multimorbid severe COPD patients need to be treated with a complementary systemic approach. In this way, the patient, not only the airway disease, will be treated comprehensively, as two effects (metabolic and pulmonary) are better than one. https://bit.ly/3PHoygt
- …
