International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2010
ReviewAn overview of the benefits and drawbacks of inhaled corticosteroids in chronic obstructive pulmonary disease.
The benefit harm profile of inhaled corticosteroids, and their effect on patient oriented outcomes and comorbid pneumonia, osteoporosis and cardiovascular disease in patients with chronic obstructive pulmonary disease remain uncertain. ⋯ Among patients with chronic obstructive pulmonary disease, clinicians should carefully balance these long-term risks of inhaled corticosteroid against their symptomatic benefits.
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Int J Chron Obstruct Pulmon Dis · Jan 2010
ReviewPotential role of stem cells in management of COPD.
Chronic obstructive pulmonary disease (COPD) is a worldwide epidemic affecting over 200 million people and accounting for more than three million deaths annually. The disease is characterized by chronic inflammation of the airways and progressive destruction of lung parenchyma, a process that in most cases is initiated by cigarette smoking. ⋯ Regeneration of lung tissue by stem cells from endogenous and exogenous sources is a promising therapeutic strategy. Herein we review the current literature on the characterization of resident stem and progenitor cell niches within the lung, the contribution of mesenchymal stem cells to lung regeneration, and advances in bioengineering of lung tissue.
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Int J Chron Obstruct Pulmon Dis · Jan 2010
Burden of COPD in a government health care system: a retrospective observational study using data from the US Veterans Affairs population.
Health care utilization and costs among US veterans with chronic obstructive pulmonary disease (COPD) were compared with those in veterans without COPD. ⋯ Veterans with COPD compared with those without COPD suffer a tremendous disease burden manifested by higher rates of all-cause and respiratory-related health care utilization and costs and a high prevalence of comorbidities. Furthermore, COPD patients do not receive appropriate treatment for their disease on diagnosis.
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Int J Chron Obstruct Pulmon Dis · Jan 2010
Factors associated with opioid dispensation for patients with COPD and lung cancer in the last year of life: A retrospective analysis.
For patients in late stages of chronic obstructive pulmonary disease (COPD), dyspnea is often refractory to conventional treatment. We know little about the use of opioids in ameliorating dyspnea in this population. In this study we explored factors associated with opioid dispensation within the last year of life and differences in opioid dispensation for persons with lung cancer or COPD. ⋯ These opioids are dispensed only for a small proportion of patients with COPD at the end of their lives. Future researchers could explore the efficacy and safety of opioid use for patients with advanced COPD, and whether their limited use is justified.
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Int J Chron Obstruct Pulmon Dis · Jan 2010
Lack of association of ischemic heart disease with COPD when taking into account classical cardiovascular risk factors.
The aim of our study is to determine whether chronic obstructive pulmonary disease (COPD) is an independent risk factor for ischemic heart disease and whether this association is related with a greater prevalence of classical cardiovascular risk factors. Ours is a case-control cross-sectional study design. Cases were hospital patients with ischemic heart disease in stable phase, compared with control hospital patients. ⋯ Therefore, COPD was not associated with ischemic heart disease: at the crude level (OR 1.19, 95% CI: 0.67-2.13) or after adjustment (OR 1.14, 95% CI:0.57-2.29). In conclusion, COPD was not associated with ischemic heart disease. The greater prevalence of classical cardiovascular risk factors in COPD patients could explain the higher occurrence of ischemic heart disease in these patients.