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Resistance to fluoroquinolones and second-line injectable drugs: meta-analysis of impact on MDR-TB outcomes

Source: European Respiratory Journal Area: News Treatment of multidrugresistant tuberculosis (MDR-TB) is difficult and current regimens are less effective compared to those used to treat drug-susceptible TB, as well as being more costly, toxic and lengthy. Due to the lack of published randomised trials on the treatment of MDR-TB patients, the evidence supporting current recommendations is of low quality, based largely on observational studies. There is even less evidence on treatment of patients with more advanced patterns of resistance, such as extensively (X) DR-TB, thus the current WHO treatment recommendations for this group are based on expert opinion.   Researchers therefore conducted an individual patient data meta-analysis to explore the effect of patient characteristics,...

The Public Health Benefits Of 'Smoke-Free' Laws- Fewer Hospitalizations And Deaths

Laws that end smoking at work and other public places result in significantly fewer hospitalizations for heart attacks, strokes, asthma and other respiratory conditions, a new UCSF analysis has found. The research provides evidence that smoke-free laws that cover workplaces, restaurants and bars have the biggest impacts on hospitalizations, reduce health care costs and also raise quality of life, the researchers said. The research is published in the current issue of the American Heart Association journal Circulation... (Source: Health News from Medical News Today)

Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease.

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Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease.

Ann Med. 2012 Oct 30;

Authors: Macnee W

Abstract
Chronic obstructive pulmonary disease (COPD) can no longer be considered as a disease affecting only the lungs. Increasing evidence supports the presence of a systemic inflammatory component which is thought to provide the link between COPD and the co-morbidities commonly associated with this disease. These include cardiovascular disorders, skeletal muscle dysfunction, diabetes, and osteoporosis. The majority of current therapies for COPD have been developed to improve airway obstruction or to target airway inflammation, leaving an unmet medical need with respect to the systemic inflammatory component of COPD and its extra-pulmonary manifestations. This review describes systemic biomarkers in COPD and their relationship with both the local lung and systemic manifestations of the disease. A summary is provided of the most promising biomarkers that have been investigated in COPD and its co-morbidities. Such biomarkers may be used to assess and manage the systemic effects of COPD, and may guide future development of novel therapeutic interventions to provide a more holistic approach to treating this multi-faceted disease.

PMID: 23110517 [PubMed - as supplied by publisher]

The use of moxifloxacin for acute exacerbations of chronic obstructive pulmonary disease and chronic bronchitis.

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The use of moxifloxacin for acute exacerbations of chronic obstructive pulmonary disease and chronic bronchitis.

Expert Rev Respir Med. 2012 Oct 31;

Authors: Wilson R, Macklin-Doherty A

Abstract
Chronic obstructive pulmonary disease is a common condition which causes considerable morbidity and mortality. It is a heterogenous disorder in which the majority of patients have chronic bronchitis. Bacterial infections are a major cause of acute exacerbations of both conditions which have a major impact on healthcare resources, quality of life and disease progression. Antibiotics are used to treat exacerbations involving purulent sputum production, together with increased breathlessness and/or sputum volume. Moxifloxacin is a quinolone antibiotic and is one of the treatment options. This article discusses pathophysiology of these diseases, moxifloxacin clinical studies and appropriate use of moxifloxacin.

PMID: 23113693 [PubMed - as supplied by publisher]

Association Between Emphysema Score, Six-Minute Walk and Cardiopulmonary Exercise Tests in COPD.

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Association Between Emphysema Score, Six-Minute Walk and Cardiopulmonary Exercise Tests in COPD.

Open Respir Med J. 2012;6:104-10

Authors: Chen LF, Wang CH, Chou PC, Ho SC, Joa WC, Sheng TF, Kuo HP

Abstract
BACKGROUND: High-resolution computed tomography (HRCT) has allowed in detection of airway wall abnormalities and emphysema, whose extent may correlate with the clinical severity of the disease in patients with chronic obstructive pulmonary disease (COPD). Six minute walk test (6MWT) and cardiopulmonary exercise test (CPET) can determine functional status.
METHODS: A study was undertaken to investigate whether the extent of emphysema in COPD patients quantitatively confirmed by HRCT scoring was associated with distance walked, inspiratory capacity (IC) changes after exercise, anaerobic threshold of cardiopulmonary exercise and the BODE index (body mass index, airflow obstruction, dyspnea, exercise performance).
RESULTS: Seventeen patients with COPD underwent HRCT scanning, 6MWT and CPET. The emphysema score was highly correlated to forced vital capacity (FVC) (r=-0.748, p<0.001), forced expiratory volume in 1 second (FEV1) (r=-0.615, p<0.01), IC post exercise (r=-0.663, p<0.01) and dyspnea score post exercise (r=0.609, p<0.01), but was not associated with the BODE index. The distance walked during 6MWT was inversely correlated to emphysema score (r=-0.557, p<0.05). IC before exercise was highly related to the 6MWT. The change in IC after exercise was associated with the percent decline of oxygen saturation after exercise (r=0.633, p<0.01). Severity of lung emphysema in COPD patients was inversely correlated to VO(2) max (r=-0.514, p<0.05) and anaerobic threshold (r=-0.595, p<0.01) of cardiopulmonary exercise.
CONCLUSIONS: These results suggest that COPD associated with emphysema on HRCT is characterized by more severe lung function impairment, greater exercise impairment and cardiopulmonary dysfunction.

PMID: 23115601 [PubMed]

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