Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2007 Update

Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is both preventable and treatable. Our understanding of the pathophysiology of this complex condition continues to grow and our ability to offer effective treatment to those who suffer from it has improved considerably. The purpose of the present educational initiative of the Canadian Thoracic Society (CTS) is to provide up to date information on new developments in the field so that patients with this condition will receive optimal care that is firmly based on scientific evidence. Since the previous CTS management recommendations were published in 2003, a wealth of new scientific information has become available. The implications of this new knowledge with respect to optimal clinical care have been carefully considered by the CTS Panel and the conclusions are presented in the current document. Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies; and a new discussion on the prevention of acute exacerbations. A revised stratification system for severity of airway obstruction is proposed, together with other suggestions on how best to clinically evaluate individual patients with this complex disease. The results of the largest randomized clinical trial ever undertaken in COPD have recently been published, enabling the Panel to make evidence-based recommendations on the role of modern pharmacotherapy. The Panel hopes that these new practice guidelines, which reflect a rigorous analysis of the recent literature, will assist caregivers in the diagnosis and management of this common condition.

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Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2008 Update – Highlights for Primary Care

Canadian Respiratory Journal ◽

10.1155/2008/641965 ◽

2008 ◽

Vol 15 (suppl a) ◽

pp. 1A-8A ◽

Cited By ~ 38

Author(s):

Denis E O’Donnell ◽

Paul Hernandez ◽

Alan Kaplan ◽

Shawn Aaron ◽

Jean Bourbeau ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Scientific Evidence ◽

Severe Disease ◽

Respiratory Illness ◽

Chronic Obstructive ◽

Optimal Care ◽

Obstructive Pulmonary Disease ◽

Acute Exacerbations ◽

Targeted Screening

Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is preventable and treatable but unfortunately remains underdiagnosed. The purpose of the present article from the Canadian Thoracic Society is to provide up-to-date information so that patients with this condition receive optimal care that is firmly based on scientific evidence. Important summary messages for clinicians are derived from the more detailed Update publication and are highlighted throughout the document. Three key messages contained in the update are: use targeted screening spirometry to establish a diagnosis and initiate prompt management (including smoking cessation) of mild COPD; improve dyspnea and activity limitation in stable COPD using new evidence-based treatment algorithms; and understand the importance of preventing and managing acute exacerbations, particularly in moderate to severe disease.

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Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease - 2008 Update - Highlights for Primary Care

Canadian Respiratory Journal ◽

10.1155/2008/420268 ◽

2008 ◽

Vol 15 (suppl a) ◽

pp. 1A-8A ◽

Cited By ~ 4

Author(s):

Denis E O’donnell ◽

Paul Hernandez ◽

Alan Kaplan ◽

Shawn Aaron ◽

Jean Bourbeau ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Scientific Evidence ◽

Severe Disease ◽

Respiratory Illness ◽

Chronic Obstructive ◽

Optimal Care ◽

Obstructive Pulmonary Disease ◽

Acute Exacerbations ◽

Targeted Screening

Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is preventable and treatable but unfortunately remains underdiagnosed. The purpose of the present article from the Canadian Thoracic Society is to provide up-to-date information so that patients with this condition receive optimal care that is firmly based on scientific evidence. Important summary messages for clinicians are derived from the more detailed Update publication and are highlighted throughout the document. Three key messages contained in the update are: use targeted screening spirometry to establish a diagnosis and initiate prompt management (including smoking cessation) of mild COPD; improve dyspnea and activity limitation in stable COPD using new evidence-based treatment algorithms; and understand the importance of preventing and managing acute exacerbations, particularly in moderate to severe disease.

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Chronic Obstructive Pulmonary Disease: Epidemiology, Biomarkers, and Paving the Way to Lung Cancer

Journal of Clinical Medicine ◽

10.3390/jcm10132889 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2889

Author(s):

Klára Szalontai ◽

Nikolett Gémes ◽

József Furák ◽

Tünde Varga ◽

Patrícia Á. Neuperger ◽

...

Keyword(s):

Lung Cancer ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Alveolar Wall ◽

Obstructive Pulmonary Disease ◽

Major Health Problem ◽

Chronic Inflammatory Response ◽

Disease Epidemiology

Chronic obstructive pulmonary disease (COPD), the frequently fatal pathology of the respiratory tract, accounts for half a billion cases globally. COPD manifests via chronic inflammatory response to irritants, frequently to tobacco smoke. The progression of COPD from early onset to advanced disease leads to the loss of the alveolar wall, pulmonary hypertension, and fibrosis of the respiratory epithelium. Here, we focus on the epidemiology, progression, and biomarkers of COPD with a particular connection to lung cancer. Dissecting the cellular and molecular players in the progression of the disease, we aim to shed light on the role of smoking, which is responsible for the disease, or at least for the more severe symptoms and worse patient outcomes. We summarize the inflammatory conditions, as well as the role of EMT and fibroblasts in establishing a cancer-prone microenvironment, i.e., the soil for ‘COPD-derived’ lung cancer. We highlight that the major health problem of COPD can be alleviated via smoking cessation, early diagnosis, and abandonment of the usage of biomass fuels on a global basis.

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DNA methylation in chronic obstructive pulmonary disease

Epigenomics ◽

10.2217/epi-2021-0111 ◽

2021 ◽

Author(s):

XinXin Huo ◽

SiHui Jin ◽

YiGe Wang ◽

Li Ma

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Dna Methylation ◽

Pulmonary Disease ◽

Complex Disease ◽

Genetic Factors ◽

Dna Methyltransferases ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Important Health ◽

New Ideas

Chronic obstructive pulmonary disease (COPD), a complex disease with polygenetic tendency, is one of the most important health problems in the world. Recently, in the study of the pathogenesis of the COPD, epigenetic changes caused by environmental factors, such as DNA methylation, started to attract more attention than genetic factors. In this review, we discuss the main features of DNA methylation, such as DNA methyltransferases and the methylation sites that modulate the DNA methylation level, and their roles in COPD progression. Finally, to promote new ideas for the prevention and treatment of COPD, we focus on the potential of DNA methylation as a COPD therapeutic target.

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Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

JMIR mhealth and uhealth ◽

10.2196/16343 ◽

2020 ◽

Vol 8 (6) ◽

pp. e16343 ◽

Cited By ~ 2

Author(s):

Sara Lundell ◽

Mari Modig ◽

Åsa Holmner ◽

Karin Wadell

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Health Care ◽

Pulmonary Disease ◽

Self Management ◽

Easy Access ◽

Chronic Obstructive ◽

Successful Implementation ◽

Obstructive Pulmonary Disease ◽

Major Health Problem ◽

Home Telemonitoring

Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

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Influence of the phenotype of the disease on the parameters of the antioxidant defense system and the level of some interleukins in the blood of patients with chronic obstructive pulmonary disease

Pediatrician (St Petersburg) ◽

10.17816/ped8638-41 ◽

2017 ◽

Vol 8 (6) ◽

pp. 38-41 ◽

Cited By ~ 1

Author(s):

Ivan I. Pavlyuchenko ◽

Evgenii A. Kokov ◽

Lyudmila N. Kokova ◽

Olga S. Okhremenko

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Adaptive Systems ◽

Complex Disease ◽

Antioxidant Properties ◽

The Body ◽

Chronic Obstructive ◽

Common Disease ◽

Obstructive Pulmonary Disease ◽

Active Forms Of Oxygen

Chronic obstructive pulmonary disease (COPD) is a common disease involving the pathological process, of bronchopulmonary and cardiovascular systems. This is a complex disease in which inflammation plays a leading role in the formation of the whole complex of pathological changes. COPD accompanies local deficit of antiproteases, excessive formation of active forms of oxygen, inducing uncontrolled lipid peroxidation and oxidative stress. An increase in the level of proinflammatory cytokines, such as IL-6, IL-8, TNF-α, is particularly significant in the combination of chronic obstructive disease with metabolic syndrome. Determination of a specific phenotype of COPD, and the degree of disruption of protective and adaptive systems in these forms of the disease course allows optimizing the treatment regimens for patients. The purpose of this work was to identify additional biochemical and biophysical markers of phenotyping and monitoring of therapy in patients with COPD of different phenotype and severity level in the acute stage on the basis of studying the main indicators of the system of antioxidant protection of blood and some cytokines. Significant differences in antioxidant system (AOS) indices in patients with COPD of different phenotype and severity were determined. The established differences in the activity of erythrocyte enzymes and the overall antioxidant activity of blood plasma can serve as an important additional link for the phenotyping of COPD. Complex treatment with the use of anticoagulants, normalizing the rheological properties of blood and mucolytics with pronounced antioxidant properties, reduces the level of prooxidant load on the body due to correction of metabolic processes and has the most pronounced effect on AOS blood parameters and cytokine profile.

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Human Coronavirus and Acute Respiratory Illness in Older Adults with Chronic Obstructive Pulmonary Disease

Yearbook of Pulmonary Disease ◽

10.1016/s8756-3452(09)79285-0 ◽

2010 ◽

Vol 2010 ◽

pp. 204-205

Author(s):

J.R. Maurer

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Older Adults ◽

Pulmonary Disease ◽

Respiratory Illness ◽

Chronic Obstructive ◽

Acute Respiratory Illness ◽

Human Coronavirus ◽

Obstructive Pulmonary Disease

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Asthma-COPD overlap szindróma

Orvosi Hetilap ◽

10.1556/650.2016.30520 ◽

2016 ◽

Vol 157 (33) ◽

pp. 1304-1313

Author(s):

Balázs Odler ◽

Veronika Müller

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Overlap Syndrome ◽

Chronic Obstructive ◽

Therapeutic Approaches ◽

Obstructive Pulmonary Disease ◽

Major Health Problem ◽

Prognostic Features ◽

Reversible Airway Obstruction ◽

Scientific Challenge

Obstructive lung diseases represent a major health problem worldwide due to their high prevalence associated with elevated socioeconomic costs. Bronchial asthma and chronic obstructive pulmonary disease are chronic obstructive ventilatory disorders with airway inflammation, however they are separate nosological entities based on thedifferent development, diagnostic and therapeutic approaches, and prognostic features. However, these diseases may coexist and can be defined as the coexistence of increased variability of airflow in a patient with incompletely reversible airway obstruction. This phenotype is called asthma – chronic obstructive pulmonary disease overlap syndrome. The syndrome is a clinical and scientific challenge as the majority of these patients have been excluded from the clinical and pharmacological trials, thus well-defined clinical characteristics and therapeutic approaches are lacking. The aim of this review is to summarize the currently available literature focusing on pathophysiological and clinical features, and discuss possible therapeutic approaches of patients with asthma – chronic obstructive pulmonary disease overlap syndrome. Orv. Hetil., 2016, 157(33), 1304–1313.

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Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology

Clinical Science ◽

10.1042/cs20140344 ◽

2014 ◽

Vol 128 (5) ◽

pp. 283-295 ◽

Cited By ~ 8

Author(s):

Afroditi K. Boutou ◽

Nicholas S. Hopkinson ◽

Michael I. Polkey

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Growth Hormone Level ◽

Symptom Burden ◽

Patient Characteristics ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Major Health Problem ◽

Copd Exacerbations ◽

Pulmonary Manifestations

Chronic obstructive pulmonary disease (COPD) is a major health problem, with increasing morbidity and mortality. There is a growing literature regarding the extra-pulmonary manifestations of COPD, which can have a significant impact on symptom burden and disease progression. Anaemia is one of the more recently identified co-morbidities, with a prevalence that varies between 4.9% and 38% depending on patient characteristics and the diagnostic criteria used. Systemic inflammation seems to be an important factor for its establishment and repeated bursts of inflammatory mediators during COPD exacerbations could further inhibit erythropoiesis. However, renal impairment, malnutrition, low testosterone levels, growth hormone level abnormalities, oxygen supplementation, theophylline treatment, inhibition of angiotensin-converting enzyme and aging itself are additional factors that could be associated with the development of anaemia. The present review evaluates the published literature on the prevalence and significance of anaemia in COPD. Moreover, it attempts to elucidate the reasons for the high variability reported and investigates the complex pathophysiology underlying the development of anaemia in these patients.

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