Posts Tagged ‘COPD’

Origins of Chronic Obstructive Pulmonary Disease

Posted by • September 1st, 2016

The conventional thinking about chronic obstructive pulmonary disease (COPD) is that exposures in adult life, such as smoking, lead to a low FEV1:FVC ratio, the physiological hallmark of COPD (a frequent cause of illness and death). Although smoking is still considered a major culprit, it is now known that genetic, environmental, and developmental factors that… Read More…

A New Combination Therapy to Help Prevent COPD Exacerbations?

Posted by • June 8th, 2016

You walk into your office to see, once again, Mr. Jones, at 64-year-old male who suffers from chronic obstructive pulmonary disorder (COPD). Mr. Jones is recovering from a recent visit to the ED due to his third COPD exacerbation event this year. He’s frustrated with his recurrent COPD exacerbations, and wants to know if his… Read More…

COPD Is Not the Whole Story

Posted by • May 11th, 2016

Many diagnostic guidelines use black or white parameters – either patients meet the criteria and have the disease, or they don’t. While guidelines like this can be useful for developing clear definitions, in practice many patients fall within a gray area. The current diagnosis of Chronic Obstructive Pulmonary Disease (COPD), for example, relies on spirometry… Read More…

Easier Breathing When Treating a COPD Patient with Tiotropium

Posted by • October 16th, 2013

Mr. C, a 65-year-old male with a 30 pack-year smoking history and a cardiac arrhythmia, comes to your office for treatment of his COPD. He has been well controlled on a regimen including tiotropium delivered by a dry powder inhaler called a HandiHaler. He plans to move to Europe to be near his family, but… Read More…

Lung Protective Ventilation

Posted by • July 31st, 2013

Your patient is a 63-year-old smoker with COPD. He’d been in fairly good health until a few months ago, when his doctors found a suspicious mass on a screening colonoscopy. Now, surgery is planned to resect part of his colon. He’s anxious, not just about his cancer diagnosis, but also about how his lungs will tolerate… Read More…

Tiotropium and the ancient datura plant: Revisiting the role of antimuscarinic therapy in asthma

Posted by • September 6th, 2012

For centuries the datura plant has been used for treatment of respiratory disease. The plant, also known as jimson weed or devil’s trumpet, is a potent member of the alkaloid family with antimuscarinic properties. American physicians in the 19th century would commonly recommend patients to smoke datura leaves for relief of asthma and obstructive airway… Read More…

Small-Airway Obstruction and Emphysema in COPD

Posted by • October 26th, 2011

For more than four decades, we have known that peripheral airway resistance is increased in emphysema. But it is unclear what changes lead to this increase in resistance. Do the airways simply narrow, or are they destroyed altogether? Without the technology to resolve this question, it has remained largely unanswered. Until now. In this week’s issue… Read More…

Changes in Forced Expiratory Volume in 1 Second over Time in COPD

Posted by • September 28th, 2011

You see a 50-year-old woman for the first time in your office. She tells you she’s still smoking a pack per day. She’s trying to cut down, but it’s hard. For the past few years she’s had a cough each winter and can’t walk the stairs to her second floor apartment without getting winded. For… Read More…

Azithromycin to Prevent COPD Exacerbations

Posted by • August 26th, 2011

Exacerbations of chronic obstructive pulmonary disease (COPD) are a source of substantial morbidity. In a randomized, controlled trial involving patients with moderately severe COPD, daily treatment with azithromycin for 1 year was associated with fewer exacerbations. Acute exacerbations of chronic obstructive pulmonary disease (COPD) result in frequent visits to physicians’ offices and emergency rooms and numerous hospitalizations and… Read More…

Azithromycin for Prevention of COPD Exacerbations

Posted by • August 24th, 2011

Summer’s coming to a close and the patient sitting in your office is worried.  A bad cough and wheeze sent him to the hospital for three days last winter, and he feels like he’s never quite gotten back to normal. He stopped smoking a few years ago, and uses the long-acting bronchodilators and inhaled corticosteroids… Read More…