Online Data Supplement. Impulse Oscillometry in Adults with Bronchiectasis
|
|
- Cora Stone
- 5 years ago
- Views:
Transcription
1 Online Data Supplement Impulse Oscillometry in Adults with Bronchiectasis Wei-jie Guan *1, Ph. D.; Yong-hua Gao *2, Ph. D.; Gang Xu *3, Ph. D.; Zhi-ya Lin 1, Ph. D.; Yan Tang 1, M. D.; Hui-min Li 1, M. T.; Zhi-min Lin 1, M. Med.; Jin-ping Zheng 1, M. D., Rong-chang Chen 1, M. D.; Nan-shan Zhong 1, M. D. 1. State Key Laboratory of Respiratory Disease, National Clinical Research center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China 2. Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China 3. Department of Geriatrics, Guangzhou First People s Hospital, Guangzhou, Guangdong, China Corresponding Author 1: Nan-shan Zhong, M. D., State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Address: 151 Yanjiang Road, Guangzhou, Guangdong, China, Fax: , Phone: , nanshan@vip.163.com Corresponding Author 2: Rong-chang Chen, M. D., State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Address: 151 Yanjiang Road, Guangzhou, Guangdong, China, Fax: , Phone: , chenrc@vip.163.com *Drs. Wei-jie Guan, Yong-hua Gao and Gang Xu contributed equally to the study. Author Contributions: W. J. G., Y. H. G. and G. X. drafted the manuscript; Z. M. L., Y. T., R. C. C. and N. S. Z. were responsible for patient recruitment; W. J. G., Y. H. G., G. X., H. M. L. and Z. M. L. collected individual data; W. J. G., Y. H. G. and G. X. performed statistical analyses; W. J. G., Y. H. G., G. X., J. P. Z., R. C. C. and N. S. Z. contributed to study conception; R. C. C. and N. S. Z. provided
2 critical review of the manuscript and approved the final submission. Primary Source of Funding: Changjiang Scholars and Innovative Research Team in University ITR0961, The National Key Technology R&D Program of the 12th National Five-year Development Plan 2012BAI05B01 and National Key Scientific & Technology Support Program: Collaborative innovation of Clinical Research for chronic obstructive pulmonary disease and lung cancer No. 2013BAI09B09 (to Profs. Zhong and Chen), National Natural Science Foundation No and 2014 Scientific Research Projects for Medical Doctors and Researchers from Overseas, Guangzhou Medical University No. 2014C21 (to Dr. Guan). Conflict of Interest: Profs. Zhong and Chen declared that they had received Changjiang Scholars and Innovative Research Team in University ITR0961, The National Key Technology R&D Program of the 12th National Five-year Development Plan 2012BAI05B01 and National Key Scientific & Technology Support Program: Collaborative innovation of Clinical Research for chronic obstructive pulmonary disease and lung cancer No. 2013BAI09B09. Dr. Guan declared that he has received National Natural Science Foundation No and 2014 Scientific Research Projects for Medical Doctors and Researchers from Overseas, Guangzhou Medical University No. 2014C21. All other authors declared no potential conflict of interest. None of the funding sources had any role on the study. E2
3 Methods Sputum Culture and Quantitative Assessment of Bacterial Load Fresh sputum sample was collected during the hospital visit between 9:00 and 11:00 am. Subjects were instructed to fully empty their mouth and remove oral remnants followed by chest physiotherapy for 10 to 15 minutes. This was followed by forced expectoration to collect sputum sample into a 50ml sterile plastic pot. The method for sputum culture has been introduced previously [E1]. Briefly, blood agar (Biomeurix Inc., France) and chocolate agar plates (Biomeurix Inc. France) were employed. The fresh sputum was homogenized using SPUTASOL (Oxoid SR089A) and serially diluted with natural saline (10-4, 10-5 and 10-6 ). This was followed by adding 10μl respective diluent to the agar plates with a micropipette tube and inoculation via a standardized inoculation ring. The culture media were placed in a thermostatic box containing 5% carbon dioxide at 37 for overnight inoculation. Pathogenic bacteria included Pseudomonas aeruginosa, Haemophilus influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis and other clinically significant bacteria at the investigator s discretion. Non-pathogenic bacteria (commensals) included Neisseria, α-streptococcus hemolyticus, Bacilli diphtheria and coagulase-negative staphylococcus. Prolonged culture was done for the negative plates. Bacterial load was determined on a daily basis, with a maximum of 4 consecutive days. E3
4 Results IOS Parameters Significantly Correlated with Clinical Indices and Spirometry in Steady-state Bronchiectasis All IOS parameters but X 5 were positively correlated with the duration of having bronchiectasis symptoms, number of bronchiectatic lobes, HRCT total scores and BSI (all P<0.05). In contrast, all IOS parameters but X 5 were negatively correlated with spirometric indices (all P<0.05). The number of exacerbations was positively correlated with Z 5, R 5, Fres and AX (all P<0.05). However, there were no remarkable correlation between IOS parameters and sputum bacterial density (all P>0.05). (Table E4) Comparison on IOS Parameters between Bronchiectasis Patients and COPD Patients We have reviewed the profiles of 20 patients with clinically stable COPD who were recruited from the out-patient clinics between 2011 and As shown in Table E8, higher GOLD stage was associated with higher levels of frequency dependence (AX), which has been the consequence of small airway dysfunction. Changes in other IOS parameters did not reach statistical significance, possibly because of our small sample sizes. Changes in MMEF were notable because the GOLD stage was classified based on FEV 1 % predicted. We have further selected the profiles of 20 bronchiectasis patients matched with FEV 1 % predicted. Our results showed that IOS parameters did not differ substantially between bronchiectasis patients and COPD patients matched with FEV 1 % predicted. This suggested that, given a similar magnitude of FEV 1 reduction, one would be less likely to anticipate varying IOS E4
5 parameters in different disease entities. (Table E9) References E1. Tsang KW, Chan KN, Ho PL, et al. Sputum Elastase in Steady-State Bronchiectasis. Chest 2000; 117:420 6 E5
6 Table E1: Baseline characteristics of patients enrolled in longitudinal exacerbation cohort Anthropometry Disease characteristics Parameter Exacerbation (n=16) Age (years) 44.7±18.2 Height (cm) 161.3±7.0 Weight (kg) 51.7±6.0 BMI (kg/m 2 ) 19.8±2.0 Never-smokers (No., %) 14 (87.5) Duration of symptom onset (years) 10 (14.0) Duration of diagnosis (years) 7.1±8.2 No. of exacerbations within 2 years 3.0 (3.0) Bronchiectasis etiology Sputum bacteriology No. of bronchiectatic lobes 4.3±1.4 HRCT total score 8.2±3.7 Bronchiectasis severity index 8.5±4.4 Idiopathic 6 (37.5) Post-infectious 2 (12.5) Immunodeficiency 1 (6.3) Asthma 2 (12.5) Gastroesophageal reflux 2 (12.5) Other known etiologies 1 (6.3) Pseudomonas aeruginosa 9 (56.3) Haemophilus parainfluenzae 1 (6.3) Haemophilus influenzae 0 (0.0) Medications ever used within 6 months Other PPMs 1 (6.3) Commensals 5 (31.3) Mucolytics 10 (62.7) Theophylline 11 (68.8) Macrolides 7 (43.8) Inhaled corticosteroids 5 (31.3) Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). Categorical data were expressed as number (percentage). E6
7 Table E2: Spirometry Baseline spirometric and IOS parameters in bronchiectasis patients and healthy subjects Parameter Bronchiectasis patients (n=100) Healthy subjects (n=28) P value FVC pred% 82.3 (28.2) 98.9±10.6 <0.01 FEV 1 pred% 69.0± ±11.1 <0.01 FEV 1 /FVC (%) 72.1± ±5.8 <0.01 MMEF pred% 54.7± ±26.2 <0.01 MEF 50% pred% 45.8± ±26.5 <0.01 MEF 25% pred% 38.5 (36.0) 76.3±23.3 <0.01 Impulse oscillometry Z 5 (kpa/l/s) 0.43 (0.23) 0.30±0.08 <0.01 R 5 (kpa/l/s) 0.35 (0.09) 0.29±0.08 <0.01 R 20 (kpa/l/s) 0.29 (0.07) 0.26±0.07 <0.01 X 5 (kpa/l/s) (0.12) (0.06) <0.01 Fres (kpa/l/s) (12.03) 8.86±1.46 <0.01 AX (kpa/l) 0.37 (1.44) 0.17±0.10 <0.01 Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). Categorical data were expressed as number (percentage). E7
8 Table E3: subjects Diagnostic value of IOS parameters and FEV 1 to discriminate bronchiectasis patients from healthy Area under 95% confidence interval IOS parameters P value Sensitivity Specificity curve Lower limit Upper limit Z 5 (kpa/l/s) < R 5 (kpa/l/s) < R 20 (kpa/l/s) < X 5 (kpa/l/s) < Fres (kpa/l/s) < AX (kpa/l) < FEV 1 pred% < E8
9 Table E4: Correlation between IOS parameters and clinical and spirometric indices in clinically stable bronchiectasis Clinical indices Z 5 (kpa/l/s) R 5 (kpa/l/s) R 20 (kpa/l/s) X 5 (kpa/l/s) Fres (kpa/l/s) AX (kpa/l) r P r P r P r P r P r P Disease duration (yrs) 0.28 < < < <0.01 No. of bronchiectatic lobes 0.35 < < < < <0.01 HRCT score 0.48 < < < < <0.01 No. of exacerbations within 2 years Sputum bacterial density (cfu/ml) Bronchiectasis Severity Index 0.37 < < < < <0.01 FVC (L) < < < < < <0.01 FEV 1 (L) < < < < < <0.01 MMEF (L/s) < < < < < <0.01 MEF 50% (L/s) < < < < < <0.01 MEF 25% (L/s) < < < < < <0.01 Data in boldface indicated the correlation with statistical significance. All r values denoted the Spearman s correlation coefficients. E9
10 Table E5: Anthropometry Disease characteristics Clinical characteristics in bronchiectasis patients with normal and increased airway resistance Parameter Normal resistance (n=27) 1-2 abnormal IOS indices (n=37) 3-4 abnormal IOS indices (n=12) 5-6 abnormal IOS indices (n=24) P value* Age (years) 46.5± ± ± ± Height (cm) (7.0) 159.3± ± ±6.8 <0.01 Weight (kg) 54.9± (8.0) 49.8 (22.0) 49.1± Duration of symptom onset (years) 5.0 (8.0) 10.0 (15.0) 10.0 (10.0) 20.5±14.4 <0.01 Duration of diagnosis (years) 1.0 (4.0) 4.0 (9.0) 5.6± (12.0) 0.06 No. of exacerbations within 2 years 3.4± (3.0) 4.4± ± No. of bronchiectatic lobes 3.0 (2.0) 4.0 (3.0) 4.0± (2.0) <0.01 HRCT total score 4.0 (4.0) 6.6± ± (7.0) <0.01 Bronchiectasis severity index 5.0± (5.0) 6.2± ±4.1 <0.01 Predominantly lower lobe bronchiectasis (No., %) 17 (63.0) 26 (70.3) 9 (75.0) 19 (79.2) 0.63 Bilateral bronchiectasis (No., %) 22 (81.5) 30 (81.1) 6 (50.0) 24 (100.0) <0.01 Sputum bacteriology Cystic bronchiectasis (No., %) 10 (37.0) 20 (54.1) 6 (50.0) 19 (79.2) 0.03 Dyshomogeneity (No., %) 13 (48.1) 21 (56.8) 6 (50.0) 23 (95.8) <0.01 Pseudomonas aeruginosa (No., %) 7 (25.9) 10 (27.0) 4 (33.3) 14 (58.3) 0.05 Haemophilus parainfluenzae (No., %) 3 (11.1) 3 (8.1) 1 (8.3) 1 (4.2) 0.84 Haemophilus influenzae (No., %) 1 (3.7) 4 (10.8) 1 (8.3) 1 (4.2) 0.66 Other PPMs (No., %) 2 (7.4) 2 (5.4) 1 (8.3) 3 (12.5) 0.80 Commensals (No., %) 15 (55.6) 18 (48.6) 5 (41.7) 5 (20.8) 0.07 The normative ranges for individual IOS parameters were as follows: measured Z5 being lower than 0.5 kpa/l/s; R5 and R20 being lower than 150% of their respective predicted value; X5 being higher than the predicted value minus 0.2 kpa/l/s; Fres and AX being less than their cut-off values (11.87 kpa/l/s and kpa/l). Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). Categorical data were expressed as number (percentage). Data in boldface indicated the comparisons with statistical significance. * P value denoted the comparison on individual clinical parameters, among the four groups. E10
11 Table E6: Comparison on clinical characteristics in bronchiectasis patients with different magnitude of FEV 1 reduction FEV 1 predicted% P Parameter 80% 51%-79% 31%-50% 30% value* (n=37) (n=39) (n=17) (n=7) Anthropometry Age (years) 46.0± ± ± ± Height (cm) 160.3± (8.0) 159.6± ± Weight (kg) 52.5± (10.0) 52.9± ± BMI (kg/m 2 ) 20.5± ± ± ± Disease characteristics Duration of symptom onset (years) 6.0 (13.0) 10.0 (15.0) 20.0 (19.0) 19.0±16.3 <0.01 Duration of diagnosis (years) 1.5 (8.0) 4.0 (8.0) 3.0 (14.0) 5.3± No. of acute exacerbations within 2 years 3.0 (4.0) 3.5± (6.0) 5.0 (2.0) 0.16 No. of bronchiectatic lobes 3.0 (2.0) 4.0± (2.0) 6.0 (0.0) <0.01 HRCT total score 4.0 (3.0) 7.1± ± ±3.3 <0.01 Bronchiectasis severity index 4.0 (6.0) 5.0 (6.0) 8.8± ±3.3 <0.01 Predominantly lower lobe bronchiectasis (No., %) 24 (64.9%) 29 (74.4%) 13 (76.5%) 5 (71.4%) 0.77 Cystic bronchiectasis (No., %) 12 (32.4%) 21 (53.8%) 15 (88.2%) 7 (100.0%) <0.01 Dyshomogeneity (No., %) 16 (43.2%) 25 (64.1%) 15 (88.2%) 7 (100.0%) <0.01 Sputum bacteriology Pseudomonas aeruginosa (No., %) 10 (27.0%) 10 (25.6%) 9 (52.9%) 5 (71.4%) 0.03 Haemophilus parainfluenzae (No., %) 4 (10.8%) 3 (7.7%) 2 (11.8%) 0 (0.0) 0.78 Haemophilus influenzae (No., %) 2 (5.4%) 4 (10.3%) 2 (11.8%) 0 (0.0) 0.67 Other PPMs (No., %) 2 (5.4%) 4 (10.3%) 2 (11.8%) 0 (0.0) 0.67 Commensals (No., %) 19 (51.4%) 18 (46.2%) 3 (17.6%) 2 (28.6%) 0.10 Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). Categorical data were expressed as number (percentage). * P value denoted the comparison on individual clinical parameters, among the four groups. E11
12 Table E7: Comparison on IOS parameters and FEV 1 reduction when stratified by chest HRCT scores in patients with mild bronchiectasis Chest HRCT scores Parameter (n=17) (n=23) (n=18) P value* IOS parameters Z 5 (kpa/l/s) 0.35± (0.12) 0.46 (0.26) 0.03 R 5 (kpa/l/s) 0.34± ± (0.25) 0.03 R 20 (kpa/l/s) 0.30± ± ± X 5 (kpa/l/s) -0.08± (0.05) (0.13) 0.02 Fres (kpa/l/s) 9.10 (3.25) 9.92 (5.51) (13.37) 0.04 AX (kpa/l) 0.21± (0.25) 0.34 (1.06) 0.03 Spirometry FEV 1 pred% 89.65± ± ± IOS parameters being abnormal Z 5 (No., %) 0 (0.0) 1 (4.3) 7 (38.9) <0.01 R 5 (No., %) 0 (0.0) 3 (13.0) 5 (27.8) <0.01 R 20 (No., %) 1 (5.9) 4 (17.4) 3 (16.7) 0.53 X 5 (No., %) 0 (0.0) 2 (8.7) 3 (16.7) 0.21 Fres (No., %) 4 (23.5) 8 (34.8) 10 (55.6) 0.14 AX (No., %) 6 (35.3) 13 (56.5) 13 (72.2) 0.09 Any single IOS parameter being abnormal 8 (47.1) 14 (60.9) 14 (77.8) 0.09 Spirometry being abnormal FEV 1 pred% (No., %) 4 (23.5) 9 (39.1) 12 (66.7) 0.03 Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). Categorical data were expressed as number (percentage). Since the lowest chest HRCT score was 2, we sought to perform comparisons by stratifying chest HRCT scores into 2-3, 4-5 and 6-7, respectively. The normative ranges for individual IOS parameters were as follows: measured Z5 being lower than 0.5 kpa/l/s; R5 and R20 being lower than 150% of their respective predicted value; X5 being higher than the predicted value minus 0.2 kpa/l/s; Fres and AX being less than their cut-off values (11.87 kpa/l/s and kpa/l). * P value denoted the comparison on individual clinical parameters, among the four groups. E12
13 Table E8: Spirometric parameters and IOS parameters in different GOLD stages of COPD GOLD stage (n=9) (n=4) (n=7) P IOS parameter R5 0.48± ± ± R ± ± ± X (0.05) -0.19± ± AX 1.32± ± ± Spirometry FVC pred% 91.79± ± ±8.27 <0.01 FEV 1 pred% 63.52± ± ±4.94 <0.01 MMEF pred% 26.16± ± ±2.81 <0.01 Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). E13
14 Table E9: Comparison on IOS parameters between bronchiectasis patients and COPD patients matched with FEV 1 % predicted Group IOS parameter Bronchiectasis (n=20) COPD (n=20) P R (0.35) 0.56± R ± ± X (0.28) -0.23± AX 1.42 (3.60) 2.14± Numerical data were presented as mean ± standard deviation for normal distribution or otherwise median (interquartile range). E14
Impulse Oscillometry and Spirometry Small-Airway Parameters in Mild to Moderate Bronchiectasis
Impulse Oscillometry and Spirometry Small-Airway Parameters in Mild to Moderate Bronchiectasis Wei-jie Guan PhD, Jing-jing Yuan MB, Yong-hua Gao PhD, Hui-min Li MT, Jin-ping Zheng MD, Rong-chang Chen MD,
More informationInflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations
Inflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations Wei-jie Guan PhD, Yong-hua Gao PhD, Gang Xu PhD, Zhi-ya Lin PhD, Yan Tang MD, Hui-min Li MT, Zhi-min
More informationThe Role of Viral Infection in Pulmonary Exacerbations of Bronchiectasis in Adults A Prospective Study
[ Original Research Bronchiectasis ] The Role of Viral Infection in Pulmonary Exacerbations of Bronchiectasis in Adults A Prospective Study Yong-hua Gao, PhD ; Wei-jie Guan, PhD ; Gang Xu, PhD ; Zhi-ya
More informationHow To Assess Severity and Prognosis
How To Assess Severity and Prognosis Gregory Tino, M.D. Chief, Department of Medicine Penn Presbyterian Medical Center Associate Professor of Medicine Perelman School of Medicine at the University of Pennsylvania
More informationBronchiectasis Domiciliary treatment. Prof. Adam Hill Royal Infirmary and University of Edinburgh
Bronchiectasis Domiciliary treatment Prof. Adam Hill Royal Infirmary and University of Edinburgh Plan of talk Background of bronchiectasis Who requires IV antibiotics Domiciliary treatment Results to date.
More informationan inflammation of the bronchial tubes
BRONCHITIS DEFINITION Bronchitis is an inflammation of the bronchial tubes (or bronchi), which are the air passages that extend from the trachea into the small airways and alveoli. Triggers may be infectious
More informationThe Bacteriology of Bronchiectasis in Australian Indigenous children
The Bacteriology of Bronchiectasis in Australian Indigenous children Kim Hare, Amanda Leach, Peter Morris, Heidi Smith-Vaughan, Anne Chang Presentation outline What is bronchiectasis? Our research at Menzies
More informationImportance of fractional exhaled nitric oxide in diagnosis of bronchiectasis accompanied with bronchial asthma
Original Article Importance of fractional exhaled nitric oxide in diagnosis of bronchiectasis accompanied with bronchial asthma Feng-Jia Chen, Huai Liao, Xin-Yan Huang, Can-Mao Xie Department of Respiratory
More informationBronchiectasis in Adults - Suspected
Bronchiectasis in Adults - Suspected Clinical symptoms which may indicate bronchiectasis for patients Take full respiratory history including presenting symptoms, past medical & family history Factors
More informationNON-CF BRONCHIECTASIS IN ADULTS
Séminaire de Pathologie Infectieuse Jeudi 25 juin 2008 Cliniques Universitaires UCL de Mont-Godinne, Yvoir NON-CF BRONCHIECTASIS IN ADULTS Dr Robert Wilson Royal Brompton Hospital, London, UK Aetiology
More informationManagement of Acute Exacerbations
15 Management of Acute Exacerbations Cenk Kirakli Izmir Dr. Suat Seren Chest Diseases and Surgery Training Hospital Turkey 1. Introduction American Thoracic Society (ATS) and European Respiratory Society
More informationAssessing response to treatment of exacerbations of bronchiectasis in adults
Eur Respir J 2009; 33: 312 317 DOI: 10.1183/09031936.00122508 CopyrightßERS Journals Ltd 2009 Assessing response to treatment of exacerbations of bronchiectasis in adults M.P. Murray, K. Turnbull, S. MacQuarrie
More informationAirway Bacterial Concentrations and Exacerbations of Chronic Obstructive Pulmonary Disease
Airway Bacterial Concentrations and Exacerbations of Chronic Obstructive Pulmonary Disease Sanjay Sethi 1,2, Rohin Sethi 2, Karen Eschberger 2, Phyllis Lobbins 3, Xueya Cai 4, Brydon J. B. Grant 1,2, and
More informationClinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene
Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene Emily S. Wan, John E. Hokanson, James R. Murphy, Elizabeth A. Regan, Barry J. Make, David A. Lynch, James D. Crapo, Edwin K.
More informationThe characteristics of bacterial pathogens in cases of children with respiratory tract infection in Eastern area.
Biomedical Research 2018; 29 (5): 1008-1013 ISSN 0970-938X www.biomedres.info The characteristics of bacterial pathogens in 15000 cases of children with respiratory tract infection in Eastern area. Guiting
More informationJUERGEN FROEHLICH, JANICE DAHMS, DAVID CIPOLLA,
Reduction in Frequency of Pulmonary Exacerbations With Inhaled ARD-315 in Non-Cystic Fibrosis Bronchiectasis (NCFB) Patients is Independent of Pseudomonas aeruginosa Susceptibility at Baseline JUERGEN
More informationNon-cystic fibrosis bronchiectasis in childhood: longitudinal growth and lung function
1 Portex Anaesthesia, Intensive Therapy and Respiratory Unit, UCL, Institute of Child Health, London, UK; 2 Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Trust, London,
More informationSystemic markers of inflammation in stable bronchiectasis
Eur Respir J 1998; 12: 820 824 DOI: 10.1183/09031936.98.12040820 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1998 European Respiratory Journal ISSN 0903-1936 Systemic markers of inflammation
More informationThe team. Medical staff Dr Adam Hill Vacant post- Dr Lithgow Dr Ruzanna Frangulyan Specialist Trainee
Bronchiectasis The team Medical staff Dr Adam Hill Vacant post- Dr Lithgow Dr Ruzanna Frangulyan Specialist Trainee Specialist staff Kim Turnbull Denise Gillian Jenny Scott Jo Pentland Research nurses
More informationSkin reactivity to autologous bacteria isolated from respiratory tract of patients with obstructive pulmonary disease
Skin reactivity to autologous bacteria 149 Original Article Skin reactivity to autologous bacteria isolated from respiratory tract of patients with obstructive pulmonary disease J. Halasa 1, M. Halasa
More informationDr Conroy Wong. Professor Richard Beasley. Dr Sarah Mooney. Professor Innes Asher
Professor Richard Beasley University of Otago Director Medical Research Institute of New Zealand Wellington Dr Sarah Mooney Physiotherapy Advanced Clinician Counties Manukau Health NZ Respiratory and Sleep
More informationBronchiectasis. What is bronchiectasis? What causes bronchiectasis?
This factsheet explains what bronchiectasis is, what causes it, and how it is diagnosed and managed. More detailed information is available on the Bronchiectasis Patient Priorities website: www.europeanlunginfo.org/bronchiectasis
More informationInfluenza A (H1N1)pdm09 in Minnesota Epidemiology
Influenza A (H1N1)pdm09 in Minnesota Epidemiology Infectious Disease Epidemiology, Prevention and Control Division PO Box 64975 St. Paul, MN 55164-0975 Number of Influenza Hospitalizations by Influenza
More informationBronchiectasis. Introduction. Key points
15 Bronchiectasis Introduction i Key points Patients with bronchiectasis typically have chronic airway infection, punctuated by acute exacerbations and accompanied by progressive airflow obstruction. Bronchiectasis
More informationOnline Data Supplement. Prevalence of Chronic Obstructive Pulmonary Disease in Korea: Results of a Population-based Spirometry Survey
Online Data Supplement Prevalence of Chronic Obstructive Pulmonary Disease in Korea: Results of a Population-based Spirometry Survey Dong Soon Kim, MD, Young Sam Kim MD, Kee Suk Chung MD, Jung Hyun Chang
More information66YM Chronic obstructive pulmonary disease annual review. H Chronic obstructive pulmonary disease
Supplementary materials Table S1. Read codes to define COPD Read code Medical code Clinical event Read term 66YM.00 11287 382901 Chronic obstructive pulmonary disease annual review H3...00 1001 338812
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Goyal V, Grimwood K, Byrnes CA, et al. Amoxicillin
More informationThe Role Of Antibiotics In Microbial Interactions Of Copd
Yale University EliScholar A Digital Platform for Scholarly Publishing at Yale Public Health Theses School of Public Health January 2013 The Role Of Antibiotics In Microbial Interactions Of Copd Kimberly
More informationRespiratory Pathogen Panel TEM-PCR Test Code:
Respiratory Pathogen Panel TEM-PCR Test Code: 220000 Tests in this Panel Enterovirus group Human bocavirus Human coronavirus (4 types) Human metapneumovirus Influenza A - Human influenza Influenza A -
More informationInfluenza-Associated Pediatric Deaths Case Report Form
STATE USE ONLY DO NOT SEND INFORMATION IN THIS SECTION TO CDC Form approved OMB No. 0920-0007 Last Name: First Name: County: Address: City: State, Zip: Patient Demographics 1. State: 2. County: 3. State
More informationSession Guidelines. This is a 15 minute webinar session for CNC physicians and staff
Respiratory Disease Session Guidelines This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars monthly to address topics related to risk adjustment documentation and coding
More informationA Place For Airway Clearance Therapy In Today s Healthcare Environment
A Place For Airway Clearance Therapy In Today s Healthcare Environment Michigan Society for Respiratory Care 2015 Fall Conference K. James Ehlen, MD October 6, 2015 Objectives Describe patients who will
More informationCOPD Update. Muhammad Talha Khan MD. COPD Exacerbations. COPD Clinical Importance. COPD Pathophysiology. Overview/Objectives
Overview/Objectives COPD Update Muhammad Talha Khan MD Pulmonologist St Croix Regional Medical Center, St Croix Falls, WI. Overview of COPD and disease impact Classification of COPD Severity Treatment
More informationEvaluation of Antibacterial Effect of Odor Eliminating Compounds
Evaluation of Antibacterial Effect of Odor Eliminating Compounds Yuan Zeng, Bingyu Li, Anwar Kalalah, Sang-Jin Suh, and S.S. Ditchkoff Summary Antibiotic activity of ten commercially available odor eliminating
More informationImpulse oscillometry for leukotriene D 4 inhalation challenge in asthma
Impulse oscillometry for leukotriene D 4 inhalation challenge in asthma Wei-jie Guan 1, Ph. D.; Jin-ping Zheng 1, M. D.; Yi Gao 1, M. Med.; Cai-yu Jiang 2, Xu Shi 1, Ph. D.; Yan-qing Xie 1, Ph. D.; Qing-xia
More informationAirway Vista Background
Airway Vista 2013 Chronic Obstructive Airway Diseases Symposium Asan Medical Center, Seoul, South Korea When Should Macrolide Antibiotics be Prescribed to Prevent COPD Exacerbations in Usual Clinical Practice?
More informationInfluenza-Associated Pediatric Mortality Case Report Form Form Approved OMB No
Influenza-Associated Pediatric Mortality Case Report Form Form Approved OMB No. 0920-0004 STATE USE ONLY DO NOT SEND INFORMATION IN THIS SECTION TO CDC Last Name: First Name: County: Address: City: State,
More informationAnyway I think AA need to improve the paper, particularly on statistical analysis.
Author s response to reviews Title: Asthma control and severe exacerbations in patients with moderate or severe asthma in Jilin Province, China: a multicenter cross-sectional survey Authors: Bing-di Yan
More informationCOPD in Korea. Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center Park Yong Bum
COPD in Korea Division of Pulmonary, Allergy and Critical Care Medicine of Hallym University Medical Center Park Yong Bum Mortality Rate 1970-2002, USA JAMA,2005 Global Burden of Disease: COPD WHO & World
More informationSupplementary Online Content
Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published
More informationAntibiotics, Expectorants, and Cough Suppressants. Center For Cardiac Fitness Pulmonary Rehab The Miriam Hospital
Antibiotics, Expectorants, and Cough Suppressants Center For Cardiac Fitness Pulmonary Rehab The Miriam Hospital Objectives Review the mechanism of action (MOA), dosing, benefits, and various options for:
More informationC.S. HAWORTH 1, A. WANNER 2, J. FROEHLICH 3, T. O'NEAL 3, A. DAVIS 4, I. GONDA 3, A. O'DONNELL 5
Inhaled Liposomal Ciprofloxacin in Patients With Non-Cystic Fibrosis Bronchiectasis and Chronic Pseudomonas aeruginosa: Results From Two Parallel Phase III Trials (ORBIT-3 and -4) C.S. HAWORTH 1, A. WANNER
More informationRespiratory Disease. Dr Amal Damrah consultant Neonatologist and Paediatrician
Respiratory Disease Dr Amal Damrah consultant Neonatologist and Paediatrician Signs and Symptoms of Respiratory Diseases Cardinal Symptoms Cough Sputum Hemoptysis Dyspnea Wheezes Chest pain Signs and Symptoms
More informationResearch in Real Life
Research in Real Life Study 1: Exploratory study - identifying the benefits of pmdi versus Diskus for delivering fluticasone/salmeterol combination therapy in patients with chronic obstructive pulmonary
More informationIncreased difference between slow and forced vital capacity is associated with reduced exercise tolerance in COPD patients
Yuan et al. BMC Pulmonary Medicine 2014, 14:16 RESEARCH ARTICLE Open Access Increased difference between slow and forced vital capacity is associated with reduced exercise tolerance in COPD patients Wei
More informationCystic Fibrosis Care Guidelines for Challenging Cystic Fibrosis
Cystic Fibrosis Care Guidelines for Challenging Cystic Fibrosis APRIL 2018 Authors Steve Kent MD, CF Clinic Director, Victoria General Hospital (VGH), Victoria Mark Chilvers MD, CF Clinic Director, B.C.
More informationNon-CF bronchiectasis: Alexander Duarte, MD Pulmonary, Critical Care & Sleep Medicine University of Texas Medical Branch Galveston, TX
Non-CF bronchiectasis: Alexander Duarte, MD Pulmonary, Critical Care & Sleep Medicine University of Texas Medical Branch Galveston, TX Pioneer of Respiratory Medicine 2016 marked 200th anniversary of his
More informationCombined pulmonary fibrosis and emphysema; prevalence and follow up among health-care personnel
Combined pulmonary fibrosis and emphysema; prevalence and follow up among health-care personnel Poster No.: C-0698 Congress: ECR 2013 Type: Scientific Exhibit Authors: K. Chae, G. Jin, S. Chon, Y. Lee;
More informationChronic productive cough: An approach to management
Chronic productive cough: An approach to management Key Points Conditions most likely to cause chronic productive cough outlined. Epidemiology, clinical presentation, pathology and treatment of these conditions
More informationSerological evidence of Legionella species infection in acute exacerbation of COPD
Eur Respir J 2002; 19: 392 397 DOI: 10.1183/09031936.02.00256702 Printed in UK all rights reserved Copyright #ERS Journals Ltd 2002 European Respiratory Journal ISSN 0903-1936 Serological evidence of Legionella
More informationMonitoring of Enhanced Surveillance for Severe and Fatal Pneumonia, 1 st January 31 st March 2015
Monitoring of Enhanced Surveillance for Severe and Fatal Pneumonia, 1 st January 31 st March 2015 1. The cumulative cases report since December 2010 and cases report during January to March 2015 During
More informationVibration Response Imaging in Idiopathic Pulmonary Fibrosis: A Pilot Study
Vibration Response Imaging in Idiopathic Pulmonary Fibrosis: A Pilot Study Qing-xia Liu MMed, Wei-jie Guan PhD, Yan-qing Xie PhD, Jia-ying An MB, Mei Jiang PhD, Zheng Zhu MMed, E Guo MMed, Xin-xin Yu MB,
More informationClinical phenotypes in adult patients with bronchiectasis
ORIGINAL ARTICLE BRONCHIECTASIS Clinical phenotypes in adult patients with bronchiectasis Stefano Aliberti 1, Sara Lonni 1, Simone Dore 2, Melissa J. McDonnell 3, Pieter C. Goeminne 4,5, Katerina Dimakou
More informationDoes the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD?
AUTHOR COPY ORIGINAL RESEARCH Does the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD? Kian-Chung Ong 1 Suat-Jin Lu 1 Cindy Seok-Chin Soh 2 1 Department
More informationCOPD Treatable. Preventable.
My COPD Action Plan Patient s Copy (Patient s Name) Date Canadian Respiratory COPD Treatable. Preventable. This is to tell me how I will take care of myself when I have a COPD flare-up. My goals are My
More informationUpdate on bronchiectasis guidelines. James Chalmers MD, PhD, FRCPE, FERS University of Dundee, UK
Update on bronchiectasis guidelines James Chalmers MD, PhD, FRCPE, FERS University of Dundee, UK University of Dundee Bronchiectasis guidelines 2017 2010 2006 2008 2015 2015 Currently valid guidelines
More informationSpirometry Workshop for Primary Care Nurse Practitioners
Spirometry Workshop for Primary Care Nurse Practitioners Catherine Casey S. Jones PhD, RN, AE-C, ANP-C Certified Adult Nurse Practitioner Texas Pulmonary & Critical Care Consultants P.A. and Adjunct Professor
More informationIdentifyingRiskFactorsforAcuteExacerbationsofChronicObstructivePulmonaryDisease
Global Journal of Medical Research: F Diseases Volume 18 Issue 5 Version 1.0 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Online ISSN: 2249-4618 & Print ISSN:
More informationCommunity Acquired Pneumonia. Abdullah Alharbi, MD, FCCP
Community Acquired Pneumonia Abdullah Alharbi, MD, FCCP A 68 y/ male presented to the ED with SOB and productive coughing for 2 days. Reports poor oral intake since onset due to nausea and intermittent
More informationAsthma COPD Overlap (ACO)
Asthma COPD Overlap (ACO) Dr Thomas Brown Consultant Respiratory Physician Thomas.Brown@porthosp.nhs.uk Dr Hitasha Rupani Consultant Respiratory Physician Hitasha.rupani@porthosp.nhs.uk What is Asthma
More information11/19/2012. The spectrum of pulmonary diseases in HIV-infected persons is broad.
The spectrum of pulmonary diseases in HIV-infected persons is broad. HIV-associated Opportunistic infections Neoplasms Miscellaneous conditions Non HIV-associated Antiretroviral therapy (ART)-associated
More informationLife-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton
Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary
More informationValidity of Spirometry for Diagnosis of Cough Variant Asthma
http:// ijp.mums.ac.ir Original Article (Pages: 6431-6438) Validity of Spirometry for Diagnosis of Cough Variant Asthma Iman Vafaei 1, *Nemat Bilan 2,3, Masoumeh Ghasempour 41 1 Resident of Pediatrics,
More informationThe Importance of Appropriate Treatment of Chronic Bronchitis
...CLINICIAN INTERVIEW... The Importance of Appropriate Treatment of Chronic Bronchitis An interview with Antonio Anzueto, MD, Associate Professor of Medicine, University of Texas Health Science Center,
More informationImpulse Oscillometry for Leukotriene D 4 Inhalation Challenge in Asthma
Impulse Oscillometry for Leukotriene D 4 Inhalation Challenge in Asthma Wei Jie Guan PhD, Jin Ping Zheng MD, Yi Gao MMed, Cai Yu Jiang, Xu Shi PhD, Yan Qing Xie PhD, Qing Xia Liu MMed, Mei Jiang PhD, Jia
More informationDo processing time and storage of sputum influence quantitative bacteriology in bronchiectasis?
Journal of Medical Microbiology (), 59, 89 833 DOI.99/jmm..6683- Do processing time and storage of sputum influence quantitative bacteriology in bronchiectasis? Maeve P. Murray, Catherine J. Doherty, John
More informationBronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing
National Institute for Health and Care Excellence Bronchiectasis (non-cystic fibrosis), acute exacerbation: antimicrobial prescribing Evidence review NICE guideline NG117 December 2018 Disclaimer The
More informationChanges in the management of children with Cystic Fibrosis. Caroline Murphy & Deirdre O Donovan CF Nurses
Changes in the management of children with Cystic Fibrosis Caroline Murphy & Deirdre O Donovan CF Nurses What Is Cystic Fibrosis? Cystic fibrosis (CF) is an inherited chronic disease that primarily affects
More informationOutline FEF Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications?
Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications? Fernando Holguin MD MPH Director, Asthma Clinical & Research Program Center for lungs and Breathing University of Colorado
More information(cilia) that help sweep away fluids and/or particles International Journal of Pharmaceutical Sciences and Research 2055
IJPSR (2014), Vol. 5, Issue 5 (Research Article) Received on 29 November, 2013; received in revised form, 21 February, 2014; accepted, 16 April, 2014; published 01 May, 2014 EVALUATION OF EFFICACY AND
More informationProtocols for Laboratory Verification of Performance of the BioFire FilmArray Pneumonia Panel
Protocols for Laboratory Verification of Performance of the BioFire FilmArray Pneumonia Panel Laboratory Protocols for Use with a ZeptoMetrix NATtrol Verification Panel Purpose The Clinical Laboratory
More informationTBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than
TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than PAP) BAL is not required as a diagnostic tool in patients
More informationBacterial and Viral Identification Rate in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Korea
Original Article Yonsei Med J 219 Feb;6(2):216-222 pissn: 513-5796 eissn: 1976-2437 Bacterial and Viral Identification Rate in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Korea Juwhan
More informationOutcomes: Initially, our primary definitions of pneumonia was severe pneumonia, where the subject was hospitalized
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationThis is a cross-sectional analysis of the National Health and Nutrition Examination
SUPPLEMENTAL METHODS Study Design and Setting This is a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2007-2008, 2009-2010, and 2011-2012. The NHANES is
More informationPatient characteristics Intervention Comparison Length of followup
ORAL MUCOLYTICS Ref ID: 2511 Bachh AA, Shah NN, Bhargava R et al. Effect oral N- in COPD - A randomised controlled trial. JK Practitioner. 2007; 14(1):12-16. Ref ID: 2511 RCT Single blind; unclear allocation
More informationAnalysis of the microbiome in smokers without COPD and with COPD in China
Analysis of the microbiome in smokers without COPD and with COPD in China (2011-2014) JI Pulmonary 2014-10-03 1 Overall Hypothesis Smoking Chronic inflammation Foods, antibiotics, BMI, etc? Change of lung
More informationHospital-acquired Pneumonia
Hospital-acquired Pneumonia Hospital-acquired pneumonia (HAP) Pneumonia that occurs at least 2 days after hospital admission. The second most common and the leading cause of death due to hospital-acquired
More informationCOPD or not COPD, that is the question.
COPD or not COPD, that is the question. Asthma-COPD Overlap Syndrome: ACOS Do we really need this? Michelle Harkins Disclosure Slide Slide help - William Busse, MD Organizational Interests ATS, ACCP, ACP
More informationPathology of Pneumonia
Pathology of Pneumonia Dr. Atif Ali Bashir Assistant Professor of Pathology College of Medicine Majma ah University Introduction: 5000 sq meters of area.! (olympic track) Filters >10,000 L of air / day!
More informationLab 4. Blood Culture (Media) MIC AMAL-NORA-ALJAWHARA 1
Lab 4. Blood Culture (Media) 2018 320 MIC AMAL-NORA-ALJAWHARA 1 Blood Culture 2018 320 MIC AMAL-NORA-ALJAWHARA 2 What is a blood culture? A blood culture is a laboratory test in which blood is injected
More information320 MBIO Microbial Diagnosis. Aljawharah F. Alabbad Noorah A. Alkubaisi 2017
320 MBIO Microbial Diagnosis Aljawharah F. Alabbad Noorah A. Alkubaisi 2017 Blood Culture What is a blood culture? A blood culture is a laboratory test in which blood is injected into bottles with culture
More informationTable S1. Data on IgG substitution for participants that were included in the per protocol analysis (n=62/arm).
Bergman et al, Vitamin D 3 supplementation in patients with frequent respiratory tract infections - a randomised, double blind intervention study Supplementary tables Table S1. Data on IgG substitution
More informationProf Neil Barnes. Respiratory and General Medicine London Chest Hospital and The Royal London Hospital
Prof Neil Barnes Respiratory and General Medicine London Chest Hospital and The Royal London Hospital ASTHMA: WHEN EVERYTHING FAILS WHAT DO YOU DO? South GP CME 2013, Dunedin Saturday 17 th August 2013
More informationTORCH: Salmeterol and Fluticasone Propionate and Survival in COPD
TORCH: and Propionate and Survival in COPD April 19, 2007 Justin Lee Pharmacy Resident University Health Network Outline Overview of COPD Pathophysiology Pharmacological Treatment Overview of the TORCH
More informationDescription of Respiratory Microbiology of Children With Long-Term Tracheostomies
Description of Respiratory Microbiology of Children With Long-Term Tracheostomies Rachael McCaleb PharmD, Robert H Warren MD, Denise Willis RRT-NPS, Holly D Maples PharmD, Shasha Bai PhD, and Catherine
More informationEfficacy of NaCl nebulized hypertonic solutions in cystic fibrosis
Acta Biomed 2014; Vol. 85, Supplement 4: 10-18 Mattioli 1885 Original article Efficacy of NaCl nebulized hypertonic solutions in cystic fibrosis Azienda Ospedaliero Universitaria Policlinico, DAI Scienze
More informationIntegrated Cardiopulmonary Pharmacology Third Edition
Integrated Cardiopulmonary Pharmacology Third Edition Chapter 13 Pharmacologic Management of Asthma, Chronic Bronchitis, and Emphysema Multimedia Directory Slide 7 Slide 12 Slide 60 COPD Video Passive
More informationChronic obstructive pulmonary disease
0 Chronic obstructive pulmonary disease Implementing NICE guidance June 2010 NICE clinical guideline 101 What this presentation covers Background Scope Key priorities for implementation Discussion Find
More informationPulmonary Pearls. Medical Pearls. Case 1: Case 1 (cont.): Case 1: What is the Most Likely Diagnosis? Case 1 (cont.):
Pulmonary Pearls Christopher H. Fanta, MD Pulmonary and Critical Care Division Brigham and Women s Hospital Partners Asthma Center Harvard Medical School Medical Pearls Definition: Medical fact that is
More informationIJMDS July 2017; 6(2) 1468
Original Article A study of prevalence of aerobic bacteria and fungi in sputum specimens of patients with post tubercular bronchiectasis Kumar GS 1, Lal SB 2, Laxmikanth M 3 ABSTRACT Background: Patients
More informationCiliary central microtubular orientation is of no clinical significance in bronchiectasis
Title Ciliary central microtubular orientation is of no clinical significance in bronchiectasis Author(s) Tsang, KW; Tipoe, GL; Mak, JC; Sun, J; Wong, M; Leung, R; Tan, KC; MedStat, CKM; Ho, JC; Ho, PL;
More informationPulmonary function abnormalities in adult patients with acute exacerbation of bronchiectasis: A retrospective risk factor analysis
Original Article Pulmonary function abnormalities in adult patients with acute exacerbation of bronchiectasis: A retrospective risk factor analysis Chronic Respiratory Disease 2015, Vol. 12(3) 222 229
More informationExample of features used to assess asthma (not complete, please see link)
Asthma: diagnosis in adults The 2008 British Thoracic Society guidelinesmarked a subtle change in the approach to diagnosing asthma. This approach is supported in the updated 2011 guidelines. It suggests
More informationSinusitis & its complication. MOHAMMED ALESSA MBBS,FRCSC Assistant Professor,Consultant Otolaryngology, Head & Neck Surgery King Saud University
Sinusitis & its complication MOHAMMED ALESSA MBBS,FRCSC Assistant Professor,Consultant Otolaryngology, Head & Neck Surgery King Saud University Definition Types Clinical manifestation Complications Diagnosis
More informationEfficacy of moxifloxacin in the treatment of bronchial colonisation in COPD
Eur Respir J 2009; 34: 1066 1071 DOI: 10.1183/09031936.00195608 CopyrightßERS Journals Ltd 2009 Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD M. Miravitlles*, A. Marín #,
More informationPIDS AND RESPIRATORY DISORDERS
PRIMARY IMMUNODEFICIENCIES PIDS AND RESPIRATORY DISORDERS PIDS AND RESPIRATORY DISORDERS 1 PRIMARY IMMUNODEFICIENCIES ABBREVIATIONS COPD CT MRI IG PID Chronic obstructive pulmonary disease Computed tomography
More informationWhat s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university
What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university Management stable COPD Relieve symptoms Improve exercise tolerance Improve health status Prevent
More informationThe Role of Infection in Acute Exacerbations of Chronic Obstructive Pulmonary Disease
...SYMPOSIUM PROCEEDINGS... The Role of Infection in Acute Exacerbations of Chronic Obstructive Pulmonary Disease Robert E. Hillberg, MD Presentation Summary Chronic obstructive pulmonary disease (COPD)
More informationChronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease 07 Contributor Dr David Tan Hsien Yung Definition, Diagnosis and Risk Factors for (COPD) Differential Diagnoses Goals of Management Management of COPD THERAPY AT EACH
More information