Speciality
Spotlight

 




 


Respiratory
– Pulmonary – Asthma



 

 





Chronic
Obstrctive Pulmonary Disease

       

  • PM
    Dorinsky, C Reisenr, GT Ferguson, et al (Boehringer Ingelheim Pharmaceuticals Inc, Ridgefiled, Conn; Wayne State Univ, Detroit)


    The combination of Ipratropium and Albuterol optimises pulmonary function reversibility testing in patients with
    COPD.


    Chest 115: 966-971, 1999

      


    Taking into consideration the fact that long-term use of a combination of ipratropium and albuterol have been recommended doses rather than a single agent alone in patients with COPD. A large recently concluded 3 month randomized double-blind parallel multicentre phase III trial study has been reported here. Where 1067 patients with stable COPD were randomized to treatment with ipratropium bromide and albuterol or an equivalent combination of ipratropium bromide and albuterol sulphate.

      


    The equivalent combination of ipratropium bromide and albuterol sulphate were superior to individual drugs. A 15% or greater increase in FEV1 was observed in 80% of the patients who received the combination. Thus this outcome suggest that combination of ipratropium bromide and albuterol sulphate was superior to the individual drugs in identifying PFT reversibility in patients with stable
    COPD.

        


  • RJ Cerfolio, RP Tummala, WL Holman, et al (Univ of alabam, Birmingham)


    A Prospective Algorithms for the Management of Air-Leaks After Pulmonary Section.


    Annals Thorac Surg 1998.

      


    Air leaks commonly occur following pulmonary resection leading to prolongation and the length of hospital stay. There have been very few objective data in regard to the management of these air leaks. The authors have reported an algorithm that was applied to the post-operative management of chest tubes and air leaks. In a prospective series of 101 consecutive patients who had been subjected to elective pulmonary section. 

      


    The newer classification suggested by them was applied to air leaks. Classifying them as those present only on forced expression, those present only during inspiration, those present during inspiration or those being continuous. All chest tubes were kept at 20cm suction on the postoperative day 2 and then they were converted to water seal. If both pneumothorax air leaks persisted on post operative day 3, the chest tube was placed to 10cm of suction. Air leaks persisting after postoperative day 7 were treated by using talc slurry pleurodesis. 

      


    It is indeed a novel approach and an organized approach as suggested by the authors. It is an interesting finding that most of the air leaks had disappeared by day 4 in the postoperative period, but those present on day 4 were still there on day 7. The authors have suggested on the basis of their findings that definite pleurodesis should be carried out as soon as day 5.

      

  • P
    Boffetta, G Pershagen, K-H Jockel, et al (Internatl Agency for Research on Cancer, Lyon, France; Karolinska Inst, Stockholm; Inst for Med Informatics, Essen, Germany; et al)


    Cigar and Pipe Smoking and Lung Cancer Risk: A Multicenter Study from Europe.


    J Natl Cancer Inst 91: 697-701, 1999.

      


    The association between the consumption of tobacco products other than cigarettes and lung cancer risk has not been well studied. The authors have presented a case-control study of this relationship.

      


    The case group comprised 5621 men with lung cancer in comparison with controlled group which included 7255men without lung cancer. The lung cancer odds ratio for smoking cigars and cigarillos only was 9, whereas the odds ratio for smoking a pipe only was 7.9 as compared to that of cigarettes being 14.9. A dose-response relationship for duration of use and cumulative consumption for cigars and cigarillos as well as for pipe tobacco was noted. The dose-response associations between lung-cancer risk and either smoking duration or mean and cumulative consumption were comparable for cigar and cigarillo smoking, pipe smoking, and cigarette smoking.

      


    The study concluded that cigars, cigarillos and pipe tobacco may have a carcinogenic effect on the lung that is comparable to that of cigarettes.

        

  • Donaldson GC, Seemungal T, Jeffries DJ, et al


    Effect of Temperature on Lung Function and Symptoms in COPD 



    Eur. Respir J 13: 844-849


        


    Seventy-six patients living in East London who had moderate to severe chronic obstructive pulmonary disease
    [COPD] were followed up for 12 months to see if cold weather had a deleterious effect on their symptoms and lung function.

        


    Patients completed questionnaires about the nature of night time heating and made daily records of symptoms, peak expiratory flow rate and indoor temperature in their bedroom on awakening. Data on outdoor temperatures were obtained from the meteorological office.

        


    The results showed drop in outdoor or bedroom temperature was correlated with increased exacerbation of symptoms and fall in lung function. Forced expiratory volume in 1 second
    [FEVI] and forced vital capacity dropped notably by a median of 45 ml, and 74 ml, respectively between the warmest and coolest weeks. Only 21% of patients heated their bedrooms and 10% kept their bedroom temperatures below 13 degrees Celsius and 48% kept the windows open in November.

       


    Cold weather does add to morbidity and mortality in patients with
    COPD.

        


 



 

 

Speciality Spotlight

 

 

Chronic Obstrctive Pulmonary Disease
       

  • PM Dorinsky, C Reisenr, GT Ferguson, et al (Boehringer Ingelheim Pharmaceuticals Inc, Ridgefiled, Conn; Wayne State Univ, Detroit)
    The combination of Ipratropium and Albuterol optimises pulmonary function reversibility testing in patients with COPD.
    Chest 115: 966-971, 1999
      
    Taking into consideration the fact that long-term use of a combination of ipratropium and albuterol have been recommended doses rather than a single agent alone in patients with COPD. A large recently concluded 3 month randomized double-blind parallel multicentre phase III trial study has been reported here. Where 1067 patients with stable COPD were randomized to treatment with ipratropium bromide and albuterol or an equivalent combination of ipratropium bromide and albuterol sulphate.
      
    The equivalent combination of ipratropium bromide and albuterol sulphate were superior to individual drugs. A 15% or greater increase in FEV1 was observed in 80% of the patients who received the combination. Thus this outcome suggest that combination of ipratropium bromide and albuterol sulphate was superior to the individual drugs in identifying PFT reversibility in patients with stable COPD.
        

  • RJ Cerfolio, RP Tummala, WL Holman, et al (Univ of alabam, Birmingham)
    A Prospective Algorithms for the Management of Air-Leaks After Pulmonary Section.
    Annals Thorac Surg 1998.
      
    Air leaks commonly occur following pulmonary resection leading to prolongation and the length of hospital stay. There have been very few objective data in regard to the management of these air leaks. The authors have reported an algorithm that was applied to the post-operative management of chest tubes and air leaks. In a prospective series of 101 consecutive patients who had been subjected to elective pulmonary section. 
      
    The newer classification suggested by them was applied to air leaks. Classifying them as those present only on forced expression, those present only during inspiration, those present during inspiration or those being continuous. All chest tubes were kept at 20cm suction on the postoperative day 2 and then they were converted to water seal. If both pneumothorax air leaks persisted on post operative day 3, the chest tube was placed to 10cm of suction. Air leaks persisting after postoperative day 7 were treated by using talc slurry pleurodesis. 
      
    It is indeed a novel approach and an organized approach as suggested by the authors. It is an interesting finding that most of the air leaks had disappeared by day 4 in the postoperative period, but those present on day 4 were still there on day 7. The authors have suggested on the basis of their findings that definite pleurodesis should be carried out as soon as day 5.
      

  • P Boffetta, G Pershagen, K-H Jockel, et al (Internatl Agency for Research on Cancer, Lyon, France; Karolinska Inst, Stockholm; Inst for Med Informatics, Essen, Germany; et al)
    Cigar and Pipe Smoking and Lung Cancer Risk: A Multicenter Study from Europe.
    J Natl Cancer Inst 91: 697-701, 1999.
      
    The association between the consumption of tobacco products other than cigarettes and lung cancer risk has not been well studied. The authors have presented a case-control study of this relationship.
      
    The case group comprised 5621 men with lung cancer in comparison with controlled group which included 7255men without lung cancer. The lung cancer odds ratio for smoking cigars and cigarillos only was 9, whereas the odds ratio for smoking a pipe only was 7.9 as compared to that of cigarettes being 14.9. A dose-response relationship for duration of use and cumulative consumption for cigars and cigarillos as well as for pipe tobacco was noted. The dose-response associations between lung-cancer risk and either smoking duration or mean and cumulative consumption were comparable for cigar and cigarillo smoking, pipe smoking, and cigarette smoking.
      
    The study concluded that cigars, cigarillos and pipe tobacco may have a carcinogenic effect on the lung that is comparable to that of cigarettes.
        

  • Donaldson GC, Seemungal T, Jeffries DJ, et al
    Effect of Temperature on Lung Function and Symptoms in COPD 
    Eur. Respir J 13: 844-849
        
    Seventy-six patients living in East London who had moderate to severe chronic obstructive pulmonary disease [COPD] were followed up for 12 months to see if cold weather had a deleterious effect on their symptoms and lung function.
        
    Patients completed questionnaires about the nature of night time heating and made daily records of symptoms, peak expiratory flow rate and indoor temperature in their bedroom on awakening. Data on outdoor temperatures were obtained from the meteorological office.
        
    The results showed drop in outdoor or bedroom temperature was correlated with increased exacerbation of symptoms and fall in lung function. Forced expiratory volume in 1 second [FEVI] and forced vital capacity dropped notably by a median of 45 ml, and 74 ml, respectively between the warmest and coolest weeks. Only 21% of patients heated their bedrooms and 10% kept their bedroom temperatures below 13 degrees Celsius and 48% kept the windows open in November.
       
    Cold weather does add to morbidity and mortality in patients with COPD.
        

 

 

By |2022-07-20T16:41:49+00:00July 20, 2022|Uncategorized|Comments Off on Chronic Obstrctive Pulmonary Disease

About the Author: