CONCLUSION: Fluticasone/salmeterol combination confers greater improvements in airway hyper-responsiveness and airway caliber in smoking asthmatics compared to double the dose of fluticasone. We hypothesize that in the presence of relative steroid resistance, the smooth muscle stabilization conferred by salmeterol is of greater clinical importance in smokers than in non-smokers. Trial Registration: ClinicalTrials.gov:NCT00830505. PMID: 21636667 [PubMed - as supplied by publisher] (Source: Chest)

Authors: Jarad N Chronic obstructive pulmonary disease (COPD) in old age is an increasing problem. Understanding the features of COPD in older patients is important in order to introduce effective interventions and to inform efforts for health resource allocation. Features of importance to old age include increased prevalence of COPD in non-smokers and rise in the rate of systemic comorbidities. In addition, acute exacerbations in older patients have poorer outcome, manifesting by increase in the rate of hospitalisation, greater length of stay, increase of the rate of re-hospitalisation and in mortality rate. Impaired cognitive functions as well as problems affecting hand joints make using inhaled medications less reliable which leads to further deterioration of outcome of care. Even f...

In conclusion poor access to transport and lack of perceived benefit affect uptake of pulmonary rehabilitation. Current smokers and patients who are depressed are at increased risk of non-completion. Enhancing attendance in pulmonary rehabilitation will require more attention to transportation, support for those at risk of non-completion and greater involvement of patients in informed decisions about their care. PMID: 21596892 [PubMed - in process] (Source: Chronic Respiratory Disease)

Authors: Beauchamp MK, Janaudis-Ferreira T, Goldstein RS, Brooks D The purpose of this review was to determine the impact of duration of pulmonary rehabilitation on measures of health-related quality of life and exercise tolerance in individuals with chronic obstructive pulmonary disease (COPD). Randomized controlled trials (RCTs) comparing different lengths of pulmonary rehabilitation in patients with COPD were identified after searches of six electronic databases (MEDLINE, PubMed, CINAHL, EMBASE, Physiotherapy Evidence Database [PEDro] and the Cochrane Library of clinical trials) and reference lists of pertinent articles. Two reviewers performed the searches and assessed trial quality using PEDro and Jadad scales. Five RCTs met inclusion criteria. The mean PEDro score was 6 (range 3-...