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Statins as adjunct therapy in COPD: how do we cope after STATCOPE?

Introduction Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase that are widely used to reduce cardiovascular (CVS) disease risk yet have pleiotropic effects in other organs, including the lungs.1 2 The results of the Simvastatin for the Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE) study, that investigated their potential effects on exacerbations of COPD, have been recently published in the New England Journal of Medicine.3 In this Hot off the breath editorial, we review the rationale for the study, discuss its design, main results, strengths and limitations, and speculate on the future of statins in COPD. Rationale: hints from observational studies Statins reduce the recruitment of neutrophils and macrophages into the lung, alter bronchial remod...

What's hot that the other lot got

Domicillary NIV in severe stable COPD A great deal of evidence exists supporting the use of in-hospital non-invasive ventilation (NIV) for acute exacerbations of COPD resulting in hypercapnic respiratory failure. However, the evidence is weak for the ability of long term NIV to improve outcomes in patients with stable hypercapnic COPD. This prospective, multicentre, randomised, controlled trial (Lancet Respir Med 2014. doi:10.1016/S2213-2600(14)70153-5) enrolled patients with stable severe COPD and a PaCO2 of 7 kPa or higher and pH higher than 7.35. NIV was targeted to reduce baseline PaCO2 by at least 20%, or to achieve PaCO2 value of <6.5 kPa. Results showed a substantial improvement in the primary outcome. One-year mortality in the NIV group was 12% versus 33% in the contro...

Enterovirus D68: What Every Parent Should Know

Parents should be prepared for a new virus that is infecting the Midwest and looking to sweep the nation. Since mid-August 2014, around 82 people have been confirmed by the Centers for Disease Control and Prevention to be infected with the dangerous Enterovirus D68, or EV-D68, in six different states. Recent reports have shown most cases popping up in Missouri and Illinois, but Southern states like Alabama have gotten their first cases along with more western cities like Denver. With a new outbreak of disease spreading, it’s important to become familiar with what could plague much of the nation this fall and winter. Just in time for flu season. What is Enterovirus? Enteroviruses are actually very common, however it is the strain of Enterovirus D68 that is causing all of the current t...

Outbreaks: Enterovirus, Ebola, and Mumps (CME/CE)

(MedPage Today) -- A multistate outbreak of respiratory disease caused by a rare virus is both challenging to public health and fascinating to science, a well-known infectious diseases specialist said. (Source: MedPage Today Infectious Disease)

Upper Airway Obstruction during Noninvasive Ventilation Induced by the Use of an Oronasal Mask

We report a case indicating another cause of upper airway obstruction: use of an oronasal mask can induce obstructive events in the upper airways, possibly resulting in sleep fragmentation and decreased efficiency of NIV.Citation:Vrijsen B, Buyse B, Belge C, Testelmans D. Upper airway obstruction during noninvasive ventilation induced by the use of an oronasal mask. J Clin Sleep Med 2014;10(9):1033-1035. (Source: Journal of Clinical Sleep Medicine : JCSM)

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