COPD Risk Phenotypes in Older Smokers: Evaluation in GLI- and GOLD-Defined Respiratory Impairment.

Purpose: In aging populations, the Global Initiative for Obstructive Lung Disease (GOLD) spirometry threshold may misclassify normal spirometry as airflow limitation. The Global Lung Initiative (GLI) method provides age-adjusted criteria. We investigated how the use of GOLD or GLI thresholds in an algorithm affects the classification of elderly smokers into COPD risk phenotypes.

Association of the risk of obstructive sleep apnoea with the severity of COVID-19.

Patients with coronavirus 2019 (COVID-19) and obstructive sleep apnoea (OSA) have a worse prognosis than COVID-19 patients without OSA. This study aimed to examine the relationship between OSA risk and the severity of COVID-19 in patients undiagnosed with OSA. Patients diagnosed with COVID-19 and hospitalized or admitted to a community hotel were recruited for the study after recovery during a clinic check-up visit 6-8 weeks after discharge.

Clinical Use of an Exposure, Symptom, and Spirometry Algorithm to Stratify Smokers into COPD Risk Phenotypes: A Case Finding Study Combined with Smoking Cessation Counseling.

Background: Chronic obstructive pulmonary disease (COPD) case-finding aims to detect airflow obstruction in symptomatic smokers and ex-smokers. We used a clinical algorithm including smoking, symptoms, and spirometry to classify smokers into COPD risk phenotypes. In addition, we evaluated the acceptability and effectiveness of including smoking cessation advice in the case-finding intervention.

Varenicline for Gradual Versus Abrupt Smoking Cessation in Poorly Motivated Smokers With COPD: A Prematurely Terminated Randomized Controlled Trial.

Background: Although smoking is the leading cause of chronic obstructive pulmonary disease (COPD), many patients with COPD smoke, highlighting the need for effective smoking cessation interventions in this population. This study examined the efficacy and safety of varenicline in increasing smoking cessation rates through "gradual" versus "abrupt" cessation in COPD patients with low motivation to quit smoking.

Methods: A randomized, open label, 30-week, controlled trial (ClinicalTrials.

Effect of Endobronchial Coils on Exercise Tolerance and Lung Functions in Patients with Severe Emphysema - A Retrospective Cohort Study of 48 Patients.

Background: Lung volume reduction with endobronchial coils treatment (ECT), for patients with severe emphysema, has shown modest improvement in exercise capacity and lung functions in clinical trials, yet the benefit of this procedure is still unclear.

Methods: We conducted a multicenter retrospective cohort study including all patients who underwent ECT in Israel and a propensity score matched control group of patients with chronic obstructive pulmonary disease (COPD) that were treated with usual care. The primary outcome was six-minute walk test distance (6MWTD), secondary outcomes were lung function tests and patient survival.

Homeopathic Treatment for COVID-19-Related Symptoms: A Case Series.

Background: Severe acute respiratory syndrome due to coronavirus 2 (SARS CoV-2) is a novel infectious disease, which has quickly developed into a pandemic. The spectrum of COVID-19 symptoms is broad, ranging from a mild, self-limiting respiratory tract illness to severe progressive pneumonia, multi-organ failure and possible death. Despite much effort and multiple clinical trials, there are, to date, no specific therapeutic agents to treat or cure the coronavirus infection.

Diffuse pulmonary calcifications: A case series and review of literature.

Pulmonary calcifications are usually incidental asymptomatic findings discovered on x-rays or computed tomography scans that can be easily overlooked, and their significance undermined, especially in a seemingly asymptomatic person. Calcifications can be a marker of chronicity or disease severity, and thus have diagnostic value. Rarely, calcification can be the direct cause of morbidity.

Early Detection of COPD: An Opportunistic Case Finding Study in Smokers and Ex-Smokers Visiting a Medical Centre.

Background: Different case finding approaches have been used to identify early COPD. The objective of this study was to assess the feasibility and the yield of opportunistic early COPD case finding in visitors to a large medical centre.

Patients And Methods: From May 2014 to June 2017, we consecutively recruited adults aged ≥ 18 years visiting the Shaare Zedek Medical Center, in Jerusalem.

[TREATMENT OF A PATIENT IN A TERMINAL CONDITION].

It is generally understood that Jewish law requires every effort to be made to extend the life of a terminally ill patient using routine treatments, whether he is conscious or not, and whether he wants his life prolonged or is opposed to it. The "Law for Patients Wishing to Die" proposes this approach with slight variations. This article discusses the patient who wishes to die from a Jewish viewpoint, illustrating that this is not the only Jewish approach.

[DIAPHRAGMATIC PARALYSIS].

One-sided diaphragmatic paralysis is a common phenomenon which is usually a-symptomatic. In case of acute onset or if there is an underlying lung disease, the phenomenon may be symptomatic and even limiting. In this article, we present a patient who arrived with subacute shortness of breath when lying down.

To Fly Or Not To Fly? Aviation and Respiratory Diseases.

For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some travelers may experience hypoxia at sea level but may not need supplemental oxygen during air travel in a hypobaric hypoxic environment. For some individuals compensatory pulmonary mechanisms may be inadequate, causing profound hypoxia.

Validation of Lung EpiCheck, a novel methylation-based blood assay, for the detection of lung cancer in European and Chinese high-risk individuals.

Aim: Lung cancer screening reduces mortality. We aim to validate the performance of Lung EpiCheck, a six-marker panel methylation-based plasma test, in the detection of lung cancer in European and Chinese samples.

Methods: A case-control European training set (n=102 lung cancer cases, n=265 controls) was used to define the panel and algorithm.

Medical Cannabis in Asthmatic Patients.

Background: With the increased use of cannabis in the medicinal and recreational domains, it is becoming more important for physicians to better understand its harmful and beneficial effects. Although medical cannabis comes in several forms, the preferred route of administration is smoking or inhalation. After caring for three asthmatic patients who were treated with medical cannabis and who reported improvement in their symptoms, we decided to review the available data on the effects of medical cannabis on asthmatic patients.

Extending varenicline preloading to 6 weeks facilitates smoking cessation: A single-site, randomised controlled trial.

Background: Initiating varenicline use 4 weeks before the target quit date (TQD) reduces smoking in the run-in phase and increases end-treatment cessation rates; however, the lack of a smoke intake plateau suggests longer preloading periods are required. This study assessed whether varenicline preloading for 6 weeks reduced pre-quit smoke intake and enhanced 6-month abstinence outcomes compared with the standard 1-week preloading.

Methods: In this randomised single-centre controlled trial, (ClinicalTrials.

Clinical Characteristics Of Patients With Asthma COPD Overlap (ACO) In Australian Primary Care.

Purpose: Many older adults with a history of smoking and asthma develop clinical features of both asthma and COPD, an entity sometimes called asthma-COPD overlap (ACO). Patients with ACO may be at higher risk of poor health outcomes than those with asthma or COPD alone. However, understanding of ACO is limited in the primary care setting and more information is needed to better inform patient management.

Identification of Asthma-COPD Overlap, Asthma, and Chronic Obstructive Pulmonary Disease Phenotypes in Patients with Airway Obstruction: Influence on Treatment Approach.

Background: Many studies have described asthma-COPD overlap (ACO) among patients diagnosed with asthma or chronic obstructive pulmonary disease (COPD), but less so in broad populations of patients with chronic airway obstruction.

Objective: This study aimed to (i) examine the prevalence of ACO, asthma, and COPD phenotypes among subjects referred for pulmonary function testing (PFT), who had airway obstruction in spirometry (forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC] <0.7); and (ii) delineate the therapeutic approach of each group.

The Effect of Pulmonary Rehabilitation on Non-chronic Obstructive Pulmonary Disease Patients.

Background: Pulmonary rehabilitation has shown significant benefit for patients with chronic obstructive pulmonary disease (COPD). The effect on non-COPD pulmonary patients is less well established.

Objectives: To determine whether pulmonary rehabilitation is also beneficial for non-COPD pulmonary patients.

Symptom evaluation during the methacholine test: Does it add to the interpretation of the test results based on the PC20FEV1?

Purpose: Conventionally, symptoms occurring during the methacholine test are not taken into account when interpreting the test results. We examined whether the evaluation of methacholine-induced symptoms (MIS) added to the test interpretation based on the PC20FEV1 by assessing their prevalence, their similarity with symptoms justifying referral and their relationship with airway responsiveness.

Methods: Eighty-two patients with suspected asthma completed a questionnaire of symptoms and underwent bronchial challenge with methacholine.

Avoiding Routine Chest Radiography after Transbronchial Biopsy Is Safe.

Background: Fiberoptic bronchoscopy (FOB) with transbronchial biopsy (TBB) is complicated by a pneumothorax in 1-4% of cases. Performance of routine post-TBB chest radiography (CXR) results in an extremely low diagnostic yield but nevertheless is the common clinical practice prevailing today. It has previously been suggested that routine post-TBB CXR could be avoided in asymptomatic patients.

Bronchial Reactivity and Lung Function After World Trade Center Exposure.

Background: World Trade Center (WTC)-exposed rescue/recovery workers endured massive respiratory insult from inhalation of particulate matter and gases, resulting in respiratory symptoms, loss of lung function, and, for many, bronchial hyperreactivity (BHR). The persistence of respiratory symptoms and lung function abnormalities has been well-documented, whereas persistence of BHR has not been investigated.

Methods: A total of 173 WTC-exposed firefighters with bronchial reactivity measured within 2 years after September 11, 2001 (9/11) (baseline methacholine challenge test), were reevaluated in 2013 and 2014 (follow-up methacholine challenge test).