Association of Long-term Ambient #Ozone Exposure With Respiratory Morbidity in #Smokers

..In adjusted analysis, a 5-ppb (parts per billion) increase in ozone concentration was associated with a greater percentage of emphysema (β = 0.94; 95% CI, 0.25-1.64; P = .007) and percentage of air trapping (β = 1.60; 95% CI, 0.16-3.04; P = .03); worse scores for the mMRC Dyspnea Scale (β = 0.10; 95% CI, 0.03-0.17; P = .008), CAT (β = 0.65; 95% CI, 0.05-1.26; P = .04), and SGRQ (β = 1.47; 95% CI, 0.01-2.93; P = .048); lower FEV1% predicted value (β = −2.50; … Continue reading Association of Long-term Ambient #Ozone Exposure With Respiratory Morbidity in #Smokers

Comparisons of exacerbations and mortality among regular inhaled therapies for patients with stable chronic obstructive pulmonary disease: Systematic review and Bayesian network meta-analysis

..Compared with placebo, all drug classes significantly reduced the total exacerbations and moderate to severe exacerbations. ICS/LAMA/LABA was the most efficacious treatment for reducing the exacerbation risk (odds ratio [OR] = 0.57; 95% credible interval [CrI] 0.50–0.64; posterior probability of OR > 1 [P(OR > 1)] < 0.001). In addition, in contrast to the other drug classes, ICS/LAMA/LABA and ICS/LABA were associated with a significantly … Continue reading Comparisons of exacerbations and mortality among regular inhaled therapies for patients with stable chronic obstructive pulmonary disease: Systematic review and Bayesian network meta-analysis

C-Reactive Protein Testing to Guide Antibiotic Prescribing for #COPD Exacerbations

Point-of-care testing of C-reactive protein (#CRP) may be a way to reduce unnecessary use of antibiotics without harming patients who have acute exacerbations of chronic obstructive pulmonary disease (COPD). A lower percentage of patients in the CRP-guided group than in the usual-care group received an antibiotic prescription at the initial consultation (47.7% vs. 69.7%, for a difference of 22.0 percentage points; adjusted odds ratio, 0.31; … Continue reading C-Reactive Protein Testing to Guide Antibiotic Prescribing for #COPD Exacerbations

Association Between Limited English #Proficiency and Revisits and Readmissions After #Hospitalization for Patients With Acute and Chronic Conditions in Toronto, Ontario, Canada

Patients with limited English proficiency (LEP) in predominantly Anglophone settings face barriers to safe and high-quality health care.1,2 We examined whether emergency department (ED) visits or readmissions differed between English-proficient (EP) and LEP patients discharged with acute and chronic conditionsEP ..Patients with LEP and heart failure had an increased risk of a 30-day ED visit (21.6% vs 14.7%; RR, 1.32; 95% CI, 1.12-1.55) compared with … Continue reading Association Between Limited English #Proficiency and Revisits and Readmissions After #Hospitalization for Patients With Acute and Chronic Conditions in Toronto, Ontario, Canada

#Metoprolol for the Prevention of Acute Exacerbations of #COPD

Observational studies suggest that beta-blockers may reduce the risk of exacerbations and death in patients with moderate or severe chronic obstructive pulmonary disease (COPD), but these findings have not been confirmed in randomized trials. .. There was no significant between-group difference in the median time until the first exacerbation, which was 202 days in the metoprolol group and 222 days in the placebo group (hazard … Continue reading #Metoprolol for the Prevention of Acute Exacerbations of #COPD

Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses

Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma. Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning surfaces only and 1.31 (95% CI, 1.07-1.61) for cleaning medical … Continue reading Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses