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Detection of chronic obstructive pulmonary disease in community‐based annual lung cancer screening: Chiba Chronic Obstructive Pulmonary Disease Lung Cancer Screening Study Group

ConclusionsCOPD screening added to a community‐based lung cancer screening programme may be effective in the detection of patients with COPD. (Source: Respirology)

Adenovirus infections

Abstract: Adenoviruses are common causes of febrile illness in early childhood. They are most often associated with respiratory tract disease, but can also cause gastrointestinal, ophthalmological, cardiac, neurological and genitourinary manifestations. Viral culture is a sensitive method for detecting most adenoviruses. Most adenoviral diseases are self-limiting, and treatment is supportive. However, fatal invasive disease can occur in immunocompromised patients and, occasionally, in healthy children and adults. Monitoring blood samples for adenoviral DNA by quantitative polymerase chain reaction analysis is useful for early detection of infection in haematopoietic stem cell recipients. Although there have been no controlled trials, a number of reports suggest that cidofovir has clinical ...

Human bocavirus 1 may suppress rhinovirus-associated immune response in wheezing children

Rhinovirus (RV) and human bocavirus 1 (HBoV1) are common causes of respiratory tract infections in early childhood. While RV is an RNA virus and causes recurrent infections with new strains, HBoV1 is a DNA virus that may cause prolonged shedding and is mostly found simultaneously with other respiratory viruses. Both viruses are associated with early wheezing: RV has been detected in approximately 20% to 40% of the cases, acute HBoV1 infection has been serodiagnosed in 19% of the cases, and RV-HBoV1 coinfection has been detected in 6% of the cases. Unlike RV wheeze, HBoV1 wheeze has not been linked with an increased risk of asthma in early childhood. The asthma and atopy in children are closely interrelated with increased TH2-type cells, and decreased type I/II/III interferon (IFN) response...

Association Between Physical Activity and Inflammatory Markers Among U.S. Adults with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) may cause not only inflammation in the lungs but also systemic effects. One potential strategy to reduce systemic inflammation and attenuate disease progression is physical activity (PA). However, no nationally representative studies, to our knowledge, have examined the association between objectively measured physical activity and inflammation among those with COPD.

Design . Cross-sectional.
Setting . National Health and Nutrition Examination Survey 2003-2006.
Subjects . Two hundred thirty-eight former or current smokers with self-reported COPD who had complete data on study variables.
Measures . Participants wore an accelerometer for ≥4 days to assess light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and total physical activity (TPA); completed questionnaires to assess self-reported COPD and smoking status; and had their blood taken to assess white blood cell (WBC) and neutrophil levels.
Analysis . Multivariable linear regression analysis was used.

Results . LPA (β = -.0004), MVPA (β = -.04), and TPA (β = -.0004) were significantly inversely associated with WBC level. Similarly, LPA (β = -.001) and TPA (β = -.001) were significantly inversely associated with neutrophils; however, MVPA was marginally associated with neutrophils (β = -.05; p =.06).

Conclusion . These analyses demonstrate an inverse association between objectively measured PA and inflammation among current or former smokers with COPD. If these findings are confirmed elsewhere, then PA among those with COPD may serve as an anti-inflammatory strategy to possibly decrease cardiovascular and metabolic disease occurrence.

Treatment of Stable Chronic Obstructive Pulmonary Disease: the GOLD Guidelines.

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Chronic obstructive pulmonary disease (COPD) is a common problem in primary care. COPD is diagnosed with spirometry only in clinically stable patients with a postbronchodilator forced expiratory volume in one second/forced vital capacity ratio of less than 0.70. All patients with COPD who smoke should be counseled about smoking cessation. Influenza and pneumococcal vaccinations are recommended for all patients with COPD.

The Global Initiative for Chronic Obstructive Lung Disease assigns patients with COPD into four groups based on the degree of airflow restriction, symptom score, and number of exacerbations in one year. Pulmonary rehabilitation is recommended for patients in groups B, C, and D. Those in group A should receive a short-acting anticholinergic or short-acting beta2 agonist for mild intermittent symptoms. For patients in group B, long-acting anticholinergics or long-acting beta2 agonists should be added. Patients in group C or D are at high risk of exacerbations and should receive a long-acting anticholinergic or a combination of an inhaled corticosteroid and a long-acting beta2 agonist. For patients whose symptoms are not controlled with one of these regimens, triple therapy with an inhaled corticosteroid, long-acting beta2 agonist, and anticholinergic should be considered.

Prophylactic antibiotics and oral corticosteroids are not recommended for prevention of COPD exacerbations. Continuous oxygen therapy improves mortality rates in patients with severe hypoxemia and COPD. Lung volume reduction surgery can improve survival rates in patients with severe, upper lobe-predominant COPD with heterogeneous emphysema distribution.

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