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COPD

GOLD 2022 includes infection control measures for prevention of COPD exacerbations

The 2022 GOLD report has for the first time advised patients with COPD to follow basic infection control measures over winter to prevent exacerbations, in light of evidence gathered over the COVID-19 pandemic. The report, Global Strategy for the Diagnosis,...

The 2022 GOLD report has for the first time advised patients with COPD to follow basic infection control measures over...

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Gaps in the provision of spirometry to confirm COPD are missed opportunities

Spirometry results are often either missing from charts of inpatients with a COPD diagnosis or inconsistent with the diagnosis, an Australian study has found. The results suggest spirometry for diagnosis of COPD is underutilised - representing a significant deviation in practice...

Spirometry results are often either missing from charts of inpatients with a COPD diagnosis or inconsistent with the diagnosis, an...
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Silent aspiration in COPD might explain exacerbations

There is growing evidence to suggest that prandial aspiration plays an important role in COPD exacerbations, according to research. According to an Australian study published in ERJ Open Research, prandial aspiration was detectable in about 20% of patients with COPD. The...

There is growing evidence to suggest that prandial aspiration plays an important role in COPD exacerbations, according to research. According to...
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Interventional bronchoscopy deserves wider use in COPD: Australian experts

Endoscopic lung volume reduction (ELVR) for advanced COPD that is refractory to standard care has been associated with significant improvements in lung function and exercise capacity - yet the procedure is rarely offered in Australia despite support of its use...

Endoscopic lung volume reduction (ELVR) for advanced COPD that is refractory to standard care has been associated with significant improvements...
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Inhaler technology faces boycott after ‘unethical’ takeover by tobacco giant

Inhaler technology company Vectura’s shareholders have backed a £1.1 billion takeover offer from tobacco giant Philip Morris International (PMI), giving a green light for the controversial deal to proceed amid strong objection from the healthcare community. PMI said it had bought...

Inhaler technology company Vectura’s shareholders have backed a £1.1 billion takeover offer from tobacco giant Philip Morris International (PMI), giving...
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Single blood eosinophil count accurately predicts ICS treatment response in COPD

A single blood eosinophil count taken in patients with COPD can predict treatment response to inhaled corticosteroids (ICS) just as accurately as two measurements, UK researchers have shown. An Oxford University team undertook a post-hoc analysis of data from the randomised...

A single blood eosinophil count taken in patients with COPD can predict treatment response to inhaled corticosteroids (ICS) just as...
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Daily statin shown to cut COPD exacerbations

Simvastatin has shown benefit as an adjunct therapy in COPD, significantly extending the time to first exacerbation as well as the overall rate of exacerbations, finds new research which contradicts previous trials. The double-blind randomised controlled trial conducted in Austria...

Simvastatin has shown benefit as an adjunct therapy in COPD, significantly extending the time to first exacerbation as well as...
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Australian smartphone app for cough detects worsening COPD symptoms

Australian respiratory clinicians are turning to AI and smartphones to pick up cough sounds of acute COPD exacerbation (AECOPD), prompting early intervention that could  prevent hospitalisations. Using technology similar to that used in speech recognition software,...

Australian respiratory clinicians are turning to AI and smartphones to pick up cough sounds of acute COPD exacerbation...
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‘Oversimplified’ asthma and COPD classifications miss important subgroups: NOVELTY study

The value of conventional asthma and COPD classifications has again been called into question as findings from a global real-world study show the labels do little to differentiate between clinically important phenotypes, potentially leading to unsuitable or unsafe...

The value of conventional asthma and COPD classifications has again been called into question as findings from a...
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Use CT to look for severe cardiac disease in patients with acute exacerbations of COPD: study

More than 40% of patients with acute exacerbations of COPD also have severe undiagnosed cardiac disease that is potentially detectable by CT imaging, an Australian study has shown. Researchers at Monash Lung and Sleep found severe coronary artery disease (CAD) in...

More than 40% of patients with acute exacerbations of COPD also have severe undiagnosed cardiac disease that is potentially detectable...
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HFNC a reasonable first option for patients with mild acute hypercapnic respiratory failure

High-flow nasal cannula (HFNC) oxygen therapy may be a reasonable initial treatment option for patients presenting with mild  acute hypercapnic respiratory failure, a Queensland study suggests. The treatment proved effective and better tolerated than non-invasive ventilation (NIV) in real world use according to results...

High-flow nasal cannula (HFNC) oxygen therapy may be a reasonable initial treatment option for patients presenting with mild  acute hypercapnic respiratory failure, a...
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Differences in sputum microbiome associated with bronchiectasis severity

Reduced sputum microbiome diversity is associated with greater disease severity in bronchiectasis, according to a new prospective study. It was also associated with a higher frequency and severity of exacerbations, as well as the risk of death. "Given the central role...

Reduced sputum microbiome diversity is associated with greater disease severity in bronchiectasis, according to a new prospective study. It was...
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3 major barriers to use of low-dose opioids for breathlessness: what patients think

Lack of knowledge, misinformation, and social stigma about opioids are some of the major barriers to their effective use in managing severe chronic breathlessness, Australian research shows. An analysis of  interviews with 24 outpatients with chronic breathlessness due to COPD or...

Lack of knowledge, misinformation, and social stigma about opioids are some of the major barriers to their effective use in...
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Lung transplantation feasible as a last resort for selected patients with severe COVID-19

Lung transplantation is a feasible option for COVID-19 patients with irreversible lung injury but should be reserved for carefully selected patients, early results suggest. Researchers led by Professor Ankit Bharat, of Northwestern University in Chicago, wrote in The Lancet Respiratory...

Lung transplantation is a feasible option for COVID-19 patients with irreversible lung injury but should be reserved for carefully selected...
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Alarming findings show need to prioritise COPD patients for COVID-19 vax

COPD is a significant risk factor for adverse outcomes from COVID-19 - justifying its inclusion as criteria for the phase 1b priority list for COVID-19 vaccination, an Australian respiratory physician says. A recent systematic review of the evidence has shown that...

COPD is a significant risk factor for adverse outcomes from COVID-19 - justifying its inclusion as criteria for the phase...
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Need to be BOLD about misdiagnosis of COPD

About half of patients who self-report a diagnosis of COPD have probably been misdiagnosed, according to an Australian study representative of community-living adults. A sub-study of more than 3,000 adults ≥40 years from the Burden of Obstructive Lung Disease (BOLD)...

About half of patients who self-report a diagnosis of COPD have probably been misdiagnosed, according to an Australian study representative...
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How is long-term azithromycin being used by respiratory physicians in Australia?

Long-term, low-dose azithromycin is effective but underused in patients with persistent asthma and other obstructive airway disease (OAD), according to findings from a study of real-world prescribing patterns of the macrolide in Australia. Investigators from Hunter Medical Research Institute (HMRI) in...

Long-term, low-dose azithromycin is effective but underused in patients with persistent asthma and other obstructive airway disease (OAD), according to...
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What can lockdowns tell us about reducing COPD exacerbations?

COVID-19 lockdowns resulted in substantial reductions in COPD exacerbations, according to a Spanish study. The reductions suggest that in the future, relatively simple efforts could help patients with COPD in the absence of the disruption of a pandemic. Researchers compared exacerbations...

COVID-19 lockdowns resulted in substantial reductions in COPD exacerbations, according to a Spanish study. The reductions suggest that in the...
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People with lung conditions must be prioritised in COVID-19 vaccination: LFA

People with serious lung conditions must be given priority for COVID-19 vaccination when it becomes available in Australia, according to Lung Foundation Australia. With the first phase of vaccination expected to start within weeks, the Lung Foundation is lobbying government to...

People with serious lung conditions must be given priority for COVID-19 vaccination when it becomes available in Australia, according to...
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‘Pre-COPD’ category in GOLD would improve early intervention, boost research

Adopting the category of “pre-COPD” in GOLD recommendations would raise awareness, improve early intervention and boost research into how to modify or prevent disease progression, researchers have suggested. In a review of current evidence, members of the GOLD (Global...

Adopting the category of “pre-COPD” in GOLD recommendations would raise awareness, improve early intervention and boost research into how...
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Additions to GOLD for 2021 provide guidance on pandemic and triple therapy

Key changes to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for 2021 include a whole new chapter on managing COVID-19 and COPD during the pandemic and a checklist for carrying out remote consultations. The additional section on COVID-19 recommends...

Key changes to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for 2021 include a whole new chapter on...
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Gut-lung axis: COPD patients have unique faecal microbiome signature

People with COPD have a unique gut microbiome signature that may provide a useful biomarker for the disease and also have potential for treatment targeting, Australian researchers say. A study led by scientists from the University of Queensland found significant variation...

People with COPD have a unique gut microbiome signature that may provide a useful biomarker for the disease and also...
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COPD hospitalisations place huge burden on EDs

People with COPD have high rates of unplanned hospitalisations that are hugely expensive and divert funding from services that could be better provided in the community, a Queensland study has found. The average cost of a hospital stay for people...

People with COPD have high rates of unplanned hospitalisations that are hugely expensive and divert funding from services that could...
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Pulmonary rehab programs don’t need to be fancy to be effective

It’s the skill of the staff and not having the latest gym equipment that makes a difference when it comes to reaping clinical benefits from pulmonary rehabilitation programs, new research shows. A UK study that compared supervised PR programs...

It’s the skill of the staff and not having the latest gym equipment that makes a difference when it...
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Inappropriate oxygen still a problem for hospitalised COPD patients

A Queensland study suggests that oxygen therapy is still being overused in patients admitted to hospital with COPD and hypercapnia. The study identified 157 eligible admissions to the Prince Charles Hospital in Brisbane during 12 months from June 2016-2017. Mean...

A Queensland study suggests that oxygen therapy is still being overused in patients admitted to hospital with COPD and hypercapnia. The...
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ICS overuse is a problem but don’t forget other aspects of COPD management

Inhaled corticosteroids are overused in patients with COPD and there is now clear evidence on which patients will most benefit, the European Respiratory Society 2020 virtual conference has heard. But there is a danger that too much focus is given to...

Inhaled corticosteroids are overused in patients with COPD and there is now clear evidence on which patients will most benefit,...
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Assisted dying scheme needs more respiratory specialists on board

Specialists utilising Victoria’s voluntary assisted dying laws to assist terminally-ill patients say there is a desperate need for more doctors to get involved, as new figures show the number of patients using the scheme has far surpassed initial estimates. A new...

Specialists utilising Victoria’s voluntary assisted dying laws to assist terminally-ill patients say there is a desperate need for more doctors...
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COPD-X guideline implementation is key, says Prof Ian Yang

Translation and implementation of clinical guidelines into practice remains an ongoing challenge, says Professor Ian Yang, as evidenced by responses to a survey of users of the joint Lung Foundation Australia /TSANZ COPD-X guidelines. The survey, presented by Prof Yang...

Translation and implementation of clinical guidelines into practice remains an ongoing challenge, says Professor Ian Yang, as evidenced by responses...
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Recent COPD exacerbations are not a reliable guide to treatment: study

Clinicians should not rely on the number of COPD exacerbations a patient has had in the previous 12 months to guide treatment say researchers who found rates can vary widely and randomly from year to year. A reanalysis of data from...

Clinicians should not rely on the number of COPD exacerbations a patient has had in the previous 12 months to...
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Age and persistence of symptoms key in whether chronic bronchitis increases COPD risk

Do not be too quick to discount chronic bronchitis symptoms and their association with the development of COPD, a UK expert has told delegates at the virtual American Thoracic Society 2020 conference. Dr James Allinson, consultant respiratory physician at the Royal...

Do not be too quick to discount chronic bronchitis symptoms and their association with the development of COPD, a UK...
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High burden of undiagnosed breathlessness in Australian population

A national survey has found a high burden of breathlessness in the Australian population, including many people who do not have a diagnosis of respiratory or cardiovascular disease. Almost one in ten people (9.5%) reported clinically significant breathlessness in response to...

A national survey has found a high burden of breathlessness in the Australian population, including many people who do not...
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We’re not going back to how it was before: how respiratory teams adapt to COVID-19

Emma Wilkinson talks to respiratory healthcare professionals in the UK about how they have adapted their services to the COVID-19 pandemic - and how they have discovered that the new ways of working are often an improvement on ‘traditional models’ Now...

Emma Wilkinson talks to respiratory healthcare professionals in the UK about how they have adapted their services to the COVID-19...
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Low dose morphine puts people with chronic breathlessness back in the driving seat

Being able to drive is an important issue for people  with chronic breathlessness and many feel they should be able to do so safely when taking low-dose morphine, Australian research shows. With Australia the first country in the world to approve...

Being able to drive is an important issue for people  with chronic breathlessness and many feel they should be able...
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Triple therapy tops dual therapy in COPD in ETHOS study

There is more evidence for the benefit of triple therapy in patients with moderate to severe COPD. The ETHOS trial, published in the NEJM, comprised 8,509 patients with COPD from 26 countries including Australia. Patients with a diagnosis of active...

There is more evidence for the benefit of triple therapy in patients with moderate to severe COPD. The ETHOS trial, published...
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Avoid unnecessary testing of people with COPD near end of life

Many patients dying from COPD in hospital continue to have diagnostic tests until close to death, even after a decision has been made to provide comfort care only, an Australia study shows. While the prognosis of terminal COPD is challenging,...

Many patients dying from COPD in hospital continue to have diagnostic tests until close to death, even after a decision...
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Dysanapsis is a major COPD risk factor: study

People with small airways relative to the size of their lungs may have an increased risk for COPD, regardless of whether they smoke, new research shows. The retrospective observational study in JAMA of more than 6,500 older adults enrolled in three...

People with small airways relative to the size of their lungs may have an increased risk for COPD, regardless of...
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Adding spirometry to lung cancer screening picks up undiagnosed COPD

Including spirometry as part of a lung cancer screening check for smokers is both feasible and likely to identify a significant number of patients with undiagnosed COPD, UK research suggests. Analysis of data from the pilot of Lung Health Checks screening...

Including spirometry as part of a lung cancer screening check for smokers is both feasible and likely to identify a...
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Updated COPD-X guide reflects stronger evidence for triple therapy

Stronger evidence for triple therapy in COPD patients with exacerbations has driven one of the changes in the latest update of the Lung Foundation’s COPD-X Concise Guide. The Guide, endorsed by...

Stronger evidence for triple therapy in COPD patients with exacerbations has...
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Lung function testing can resume: TSANZ

Pulmonary function testing can be resumed with some safety precautions against the risk of COVID-19 transmission, professional organisations have advised. After suspending all but clinically essential testing in March due to the pandemic, the Thoracic Society Australia & New Zealand...

Pulmonary function testing can be resumed with some safety precautions against the risk of COVID-19 transmission, professional organisations have advised. After...
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Steroids can be stopped in COPD if blood eosinophil count is low

Patients with COPD who are not having frequent exacerbations can safely be taken off inhaled corticosteroids (ICS) as long as their blood eosinophil count is less than 300 μL−1, new guidance from the European Respiratory Society recommends. Those patients who are...

Patients with COPD who are not having frequent exacerbations can safely be taken off inhaled corticosteroids (ICS) as long as...
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Patients and carers share the experience of chronic breathlessness

Patients with severe chronic breathlessness associated with their COPD experience “good days” and “bad days” - but so do their carers. A qualitative study from South Australia, comprising separate, semi-structured interviews with nine patients and their carers, found a largely...

Patients with severe chronic breathlessness associated with their COPD experience “good days” and “bad days” - but so do their...
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Keep calm and carry on with steroids: living guidelines for COVID-19

People with asthma or COPD who have COVID-19 disease should continue taking corticosteroids as prescribed and avoid stopping them, according to a consensus recommendation in Australia’s ‘living guidelines’ for COVID-19. While acknowledging there is currently little available evidence about outcomes...

People with asthma or COPD who have COVID-19 disease should continue taking corticosteroids as prescribed and avoid stopping them, according...
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COPD practice gaps seen with pulmonary rehabilitation and spirometry

Clinical practice mostly reflects guidelines for the management of acute exacerbations of COPD (AECOPD) however there is room to improve in areas such as referral to pulmonary rehab, a study shows. An audit of practice at five tertiary hospitals covering 207...

Clinical practice mostly reflects guidelines for the management of acute exacerbations of COPD (AECOPD) however there is room to improve...
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COPD and asthma under-represented among COVID-19 patients

Both asthma and COPD are reported at lower than expected levels in patients with COVID-19 say researchers, who have called for more research into the possible reasons for the finding. It is “striking” that both COPD and asthma seem to be...

Both asthma and COPD are reported at lower than expected levels in patients with COVID-19 say researchers, who have called...
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Watch for cardiovascular events in COVID-19 survivors: experts

Survivors of COVID-19 should be closely followed after the acute phase of their illness as they will be at high risk of cardiovascular events, respiratory experts warn. In a letter to the European Respiratory Journal Bartolome Celli, from the Brigham...

Survivors of COVID-19 should be closely followed after the acute phase of their illness as they will be at high...
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COPD an independent risk factor for lung cancer

People with COPD are at high risk of lung cancer, irrespective of their smoking status, new research suggests. Researchers from Korea, who followed nearly 340,000 individuals without a history of lung cancer for seven years, found that never smokers with COPD...

People with COPD are at high risk of lung cancer, irrespective of their smoking status, new research suggests. Researchers from Korea,...
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Stop spirometry and respiratory therapies: TSANZ

Lung function testing and the use of respiratory therapies such as nebulisers should be stopped in all but medically essential cases because of the risk of COVID19 transmission, the Thoracic Society of Australia and New Zealand (TSANZ) has advised. There...

Lung function testing and the use of respiratory therapies such as nebulisers should be stopped in all but medically essential...
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Professional groups call to stop routine pulmonary function testing

Pulmonary function testing should be avoided for non-urgent cases professional groups say in light of the risks of COVID-19 transmission. The American Thoracic Society says that while the evidence for COVID-19 is rapidly changing, it believes that the risks of...

Pulmonary function testing should be avoided for non-urgent cases professional groups say in light of the risks of COVID-19 transmission. The...
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Screen patients for AATD: position statement from TSANZ

Respiratory physicians are being urged to screen all patients with chronic airflow obstruction and certain patients with adult onset asthma for the common but underdiagnosed genetic disorder Alpha 1 Antitrypsin Deficiency (AATD), which causes early onset emphysema. The new screening advice,...

Respiratory physicians are being urged to screen all patients with chronic airflow obstruction and certain patients with adult onset asthma...
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Experts question blood eosinophil cut-offs in GINA, GOLD 

The level of circulating blood eosinophils in healthy adults is much lower than currently believed and can be influenced by co-morbidities. The findings could have implications for the management of chronic respiratory diseases, experts say. ...

The level of circulating blood eosinophils in healthy adults is much lower than currently believed and can be influenced by...
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PBS broadens access to COPD triple therapy and lung cancer immunotherapy

For COPD patients the PBS is to remove the clinical criteria restricting access to patients with a FEV1 <50% of predicted for triple therapy Trelegy (fluticasone furoate with umeclidinium and vilanterol) from 1 March 2020. The move is expected to allow...

For COPD patients the PBS is to remove the clinical criteria restricting access to patients with a FEV1 <50% of...
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COPD patients offered virtual reality pulmonary rehabilitation program

  A virtual reality pulmonary rehabilitation program is now being offered in the UK to people with COPD to overcome waiting times and access problems for clinic-based rehab. A two-year program will be offered to around 1,000 COPD patients by the NHS...

  A virtual reality pulmonary rehabilitation program is now being offered in the UK to people with COPD to overcome waiting...
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Lung Foundation seeks help to counter Big Tobacco’s latest toxic product

Lung Foundation Australia is seeking clinician support for its advocacy campaign against Big Tobacco’s bid to market another harmful product in Australia: heat-not-burn (HnB) tobacco. Unlike e-cigarettes that use chemical liquids, HnB electronic devices contain tobacco leaf...

Lung Foundation Australia is seeking clinician support for its advocacy campaign against Big Tobacco’s bid to market another...
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Co-existent COPD and bronchiectasis common in the Top End

Co-existent COPD and bronchiectasis is a common finding in adult Aboriginal Australians living in regional and remote NT communities.  A five-year retrospective study identified 258 Aboriginal Australians living with COPD who also had a chest X-ray or...

Co-existent COPD and bronchiectasis is a common finding in adult Aboriginal Australians living in regional and remote NT...
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COPD, ozone pollution and talc for malignant pleural effusion: the standout respiratory papers of 2019

Studies into the diagnostic accuracy of spirometry thresholds in COPD, how ozone pollution might promote tumour metastasis in the lungs, and the best way of managing malignant pleural effusion have been highlighted as the three stand-out respiratory papers this year...

Studies into the diagnostic accuracy of spirometry thresholds in COPD, how ozone pollution might promote tumour metastasis in the lungs,...
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COPD exacerbations: we need to stop what we’re doing because it’s not working

Patients need to be asked about their priorities for research into COPD exacerbation if any progress is going to be made, the 2019 British Thoracic Society Winter Conference has heard. Professor John Hurst, professor of respiratory medicine at University College London,...

Patients need to be asked about their priorities for research into COPD exacerbation if any progress is going to be...
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Pulmonary rehab benefits lost after 12 months

The benefits of pulmonary rehabilitation in COPD  are evident for 12 months then diminish to below pre-program levels, Queensland research shows. Emergency department presentations and hospital lengths of stay for COPD were significantly reduced in 426 people who undertook an eight...

The benefits of pulmonary rehabilitation in COPD  are evident for 12 months then diminish to below pre-program levels, Queensland research...
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GOLD places greater emphasis on non-pharmacological approach

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has updated its strategy for the diagnosis, management and prevention of COPD, reinforcing the role for non-pharmacological treatment. GOLD board member Professor David Halpin, a UK respiratory physician, ...

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has updated its strategy for the diagnosis, management and...
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Negative findings should not deter beta blocker use in COPD patients

Beta blockers should still be used in patients with COPD and cardiovascular disease despite a trial showing they do not reduce exacerbations in patients without cardiovascular indications, researchers say. Published in the NEJM, findings from the BLOCK COPD trial showed...

Beta blockers should still be used in patients with COPD and cardiovascular disease despite a trial showing they do not...
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Non-thermal rheoplasty feasible in chronic bronchitis

A new endoscopic technology for treating chronic bronchitis in patients in COPD has been shown to be feasible, well tolerated and safe in an international trial, including sites in Australia. And there were early signals for effectiveness in the first in-human...

A new endoscopic technology for treating chronic bronchitis in patients in COPD has been shown to be feasible, well tolerated...
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Morphine listed on PBS for chronic breathlessness in palliative care

Sustained-release morphine (Kapanol) tablets will be listed on the PBS from 1 September for the management of chronic breathlessness in palliative care settings. The listing will provide subsidised treatment  for symptomatic relief of chronic breathlessness in patients with advanced COPD, cardiac...

Sustained-release morphine (Kapanol) tablets will be listed on the PBS from 1 September for the management of chronic breathlessness in...
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Air pollution as bad for emphysema as smoking

Long-term exposure to outdoor air pollutants accelerates the development of emphysema and age-related decline in lung function, new research shows.  The 18-year study involving 5780 adults across several centres in the US found a statistically significant association...

Long-term exposure to outdoor air pollutants accelerates the development of emphysema and age-related decline in lung function, new...
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Home based pulmonary rehab not as effective as supervised programs

Home-based pulmonary rehab exercise programs are less effective than supervised outpatient programs for COPD patients, a study from the UK has shown. While producing some perceived benefit for patients, home-based exercise fell short in the primary outcome of exercise capacity. The...

Home-based pulmonary rehab exercise programs are less effective than supervised outpatient programs for COPD patients, a study from the...
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Can normal age-related lung decline lead to COPD diagnosis?

Older people without lung disease may be misdiagnosed with COPD due to normal age-related decline in lung function, Queensland researchers say. Bond University’s Institute for Evidence-Based Healthcare academics have proposed that age-specific ranges for FEV1, FVC and FEV1 /FVC may be...

Older people without lung disease may be misdiagnosed with COPD due to normal age-related decline in lung function, Queensland researchers...
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AURA: think about dose, duration & choice of antibiotic use in COPD

High levels of inappropriate prescribing of antibiotics in patients with COPD exacerbations can be improved with efforts such as multidisciplinary input into clinical guidelines and shared decision-making with patients, experts say. As highlighted in Antimicrobial use and Resistance in Australia...

High levels of inappropriate prescribing of antibiotics in patients with COPD exacerbations can be improved with efforts such as multidisciplinary...
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Low dose azithromycin may reduce treatment failure after COPD exacerbation

A three month course of low-dose azithromycin may protect people hospitalised with a severe acute exacerbation of COPD from recurrent attacks, a European trial suggests. The macrolide antibiotic may offer a targeted prevention approach for COPD patients by reducing treatment...

A three month course of low-dose azithromycin may protect people hospitalised with a severe acute exacerbation of COPD from recurrent...
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Eosinophil-guided therapy reduces steroids in COPD exacerbations

Blood eosinophil counts could be used to guide reductions in systemic corticosteroid dosing in patients with acute exacerbations of COPD without compromising outcomes, a Danish study has shown. A randomised, open-label trial in 358 patients hospitalised with acute exacerbations showed...

Blood eosinophil counts could be used to guide reductions in systemic corticosteroid dosing in patients with acute exacerbations of COPD...
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NHF therapy a more tolerable alternative to NIV for hypercapnic COPD

Nasal high-flow therapy (NHF)  may be an alternative option for hypercapnic COPD patients who cannot tolerate the ‘gold standard’ of non-invasive ventilation (NIV), a study from New Zealand suggests. In a single blind comparison of NHF and NIV in 24...

Nasal high-flow therapy (NHF)  may be an alternative option for hypercapnic COPD patients who cannot tolerate the ‘gold standard’ of...
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Lung disease patients have low health literacy

People with asthma have the lowest overall health literacy according to a national health survey conducted by Australian Bureau of Statistics (ABS). Alongside people with mental health and behaviour problems, those with asthma indicated they struggled more with managing their...

People with asthma have the lowest overall health literacy according to a national health survey conducted by Australian Bureau...
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Apathy undermines primary care COPD treatment model

A lack of urgency among patients about mild COPD symptoms may explain why a primary care-based interdisciplinary model of care based on COPD-X guidelines has failed to show benefit, Australian researchers say. There were few takers for a  program that offered...

A lack of urgency among patients about mild COPD symptoms may explain why a primary care-based interdisciplinary model of care...
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Why female artists and scientists are at risk of obstructive lung disease

Women exposed to aromatic solvents while working as painters, sculptors or lab technicians are at high risk of lung function decline and obstructive airways disease, Australian research shows. Men are also at risk of lung function decline through occupational exposure to...

Women exposed to aromatic solvents while working as painters, sculptors or lab technicians are at high risk of lung function...
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Ginseng of no benefit in COPD

Ginseng has no impact on the quality of life of people living with moderate COPD, a randomised trial concludes. The 24 week trial involved 168 patients with moderate COPD seen at...

Ginseng has no impact on the quality of life of people living with moderate COPD, a randomised trial...
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Functional decline at end of life shows ‘tipping point’ in respiratory patients

Functional decline at the end of life shows two distinct trajectories for patients with conditions such as lung cancer and COPD compared to those with more stable illnesses such as dementia, an Australian study has shown. The finding that functional decline for...

Functional decline at the end of life shows two distinct trajectories for patients with conditions such as lung cancer and COPD...
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Could FOT be the next home monitoring tool for COPD?

Home monitoring of COPD may benefit from the use of the forced oscillation technique (FOT) to measure lung mechanics during tidal breathing. Dr Sabine Zimmermann, a clinician researcher from the Woolcock Institute...

Home monitoring of COPD may benefit from the use of the...
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Views on palliative oxygen have changed but remain inconsistent between specialties

Doctors are prescribing palliative oxygen therapy less often for COPD patients than they did in the past but there's still a widespread belief that it can relieve breathlessness in some patients. A 2015 survey of 440 respiratory medicine and palliative...

Doctors are prescribing palliative oxygen therapy less often for COPD patients than they did in the past but there's still...
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Clues in the genome identify people at increased risk of developing COPD

GSK/British Lung Foundation Chair in Respiratory Research Professor Louise Wain from the University of Leicester has just had her latest research identifying genetic differences that put some people at higher risk than others of developing COPD published in Nature Genetics....

GSK/British Lung Foundation Chair in Respiratory Research Professor Louise Wain from the University of Leicester has just had her latest research...
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$4 million launch for National Strategic Action Plan for Lung Conditions

The Lung Foundation of Australia has welcomed government funding of $4 million for its National Strategic Action Plan for Lung Conditions, describing it as “a step in the right direction”. The Plan, launched in Canberra on by Federal Minister for...

The Lung Foundation of Australia has welcomed government funding of $4 million for its National Strategic Action Plan for...
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Low dose morphine now indicated for chronic breathlessness

Low dose morphine capsules have been licensed by the TGA for the treatment of chronic breathlessness. The re-purposing of Kapanol sustained-release capsules (10mg and 20mg) from use in chronic pain to chronic breathlessness has been welcomed by palliative care specialist Professor...

Low dose morphine capsules have been licensed by the TGA for the treatment of chronic breathlessness. The re-purposing of Kapanol sustained-release...
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Landmark trial should put e-cigs into smoking cessation programs

E-cigarettes are nearly twice as effective as nicotine-replacement therapy at helping smokers to quit cigarettes, according to a new randomised trial. The findings, published in the New England Journal of Medicine, showed the abstinence rate at one-year...

E-cigarettes are nearly twice as effective as nicotine-replacement therapy at helping smokers to quit cigarettes, according to a...
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Can respiratory guidelines be trusted to be unbiased?

Academics are questioning whether Australian respiratory guidelines can be trusted after finding that almost half the authors have undisclosed links with industry. A review of 33 NHMRC-endorsed clinical guidelines – including four covering asthma – found that only 14% of guideline...

Academics are questioning whether Australian respiratory guidelines can be trusted after finding that almost half the authors have undisclosed links...
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CBT effective for anxiety in COPD

A respiratory nurse-led cognitive behavioural therapy (CBT) intervention to help patients with COPD manage anxiety is both clinically and cost effective, UK research shows. Results published in ERJ Open Research showed that at three months patients with mild to very...

A respiratory nurse-led cognitive behavioural therapy (CBT) intervention to help patients with COPD manage anxiety is both clinically and cost...
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Latest GOLD: ‘clear separation of initial & subsequent therapy’

The 2019 update to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy for the diagnosis, management and prevention of COPD is now available and includes two key changes, according to GOLD board member Professor David Halpin. The first is...

The 2019 update to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy for the diagnosis, management and prevention...
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Sertraline no help in chronic breathlessness

Sertraline has no role in the management of chronic breathlessness in patients with advanced disease such as COPD, primary lung cancer and other restrictive lung disease. An Australian study randomised 249 patients to either daily oral sertraline (25-100mg) or placebo...

Sertraline has no role in the management of chronic breathlessness in patients with advanced disease such as COPD, primary lung...
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No role for add-on theophylline to prevent COPD exacerbations

Low-dose theophylline does not significantly reduce the number of exacerbations in patients with COPD when added to inhaled corticosteroids, new results show. The findings from the TWICS (Theophylline With Inhaled CorticoSteroids) trial do not support the use of low-dose theophylline...

Low-dose theophylline does not significantly reduce the number of exacerbations in patients with COPD when added to inhaled corticosteroids, new...
copd

Respiratory physicians need to talk to palliative care specialists about COPD

People with COPD are missing out on palliative care because respiratory physicians are not ‘on the same page’ as palliative medicine specialists, an Australian study suggests. Lack of communication and poor relationships between respiratory and palliative care specialists are key reasons...

People with COPD are missing out on palliative care because respiratory physicians are not ‘on the same page’ as palliative...
copd

New MBS items will increase fees for lung function testing

Revisions to MBS items for spirometry and complex lung function tests  from 1 November include two new items for FeNO with spirometry and Cardiopulmonary Exercise Testing. The revisions are based on recommendations of the MBS Review Taskforce and include a...

Revisions to MBS items for spirometry and complex lung function tests  from 1 November include two new items for FeNO...
copd

Respiratory trials still flouting the rules

A significant proportion of respiratory clinical trials  are registered after the trial has started despite a long-standing policy on mandatory prospective trial registration, a new study shows. The study published in ERJ Express reviewed all of the randomised trials published in...

A significant proportion of respiratory clinical trials  are registered after the trial has started despite a long-standing policy on mandatory...
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Promise in targeting parasympathetic nerve in COPD

Targeted lung denervation won’t replace drug therapy but instead has the potential to complement drug therapy for patients with moderate to severe COPD. Dr Dirk-Jan Slebos, from the University Medical Centre Groningen, Netherlands, presented the findings of AIRFLOW 2 - a...

Targeted lung denervation won’t replace drug therapy but instead has the potential to complement drug therapy for patients with moderate...
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Swallowing disorders increase risk in COPD

Respiratory physicians are advised to actively look for oropharyngeal dysphagia in their patients with COPD. Professor Eric Verin, from the Rouen University Hospital in France, told the ERS International Congress that waiting for a history of coughing after swallowing would mean...

Respiratory physicians are advised to actively look for oropharyngeal dysphagia in their patients with COPD. Professor Eric Verin, from the Rouen...
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Use of ICS in COPD should be individualised say experts

Inhaled corticosteroids should only be used as an add-on therapy in patients with COPD and their addition to LABA maintenance therapy in these patients must be personalised, agree international respiratory experts. Tackling the much-debated topic of the efficacy, safety and positioning...

Inhaled corticosteroids should only be used as an add-on therapy in patients with COPD and their addition to LABA maintenance...
copd

Deprescribing call for lung cancer patients taking unnecessary medicines

De-prescribing will help relieve the pill burden for lung cancer patients who are often taking unnecessary preventive medications such as statins and antihypertensives in the advanced stages of their disease, a study shows. A retrospective review of medical records for patients...

De-prescribing will help relieve the pill burden for lung cancer patients who are often taking unnecessary preventive medications such as...
copd

Big Tobacco vs Australia’s Plain Packaging

Australia was the first country in the world to mandate plain tobacco packaging and, despite ongoing litigation, the tobacco industry’s fears are being realised as others follow suit Australia’s starkly ‘plain’ tobacco packages are now a familiar sight. Since December 2012,...

Australia was the first country in the world to mandate plain tobacco packaging and, despite ongoing litigation, the tobacco industry’s...
copd

Be vigilant for cryptococcal infection in lung transplant patients

Immunosuppression and environmental exposures mean that cryptococcal infection is an ongoing risk for lung transplant recipients, according to the authors of a major case series from Victoria. Already known to be one of the most common invasive fungal infections in solid...

Immunosuppression and environmental exposures mean that cryptococcal infection is an ongoing risk for lung transplant recipients, according to the authors...
copd

Cannabis vapour has no impact on breathlessness in COPD

A single dose of vapourised cannabis has no clinically meaningful effect on airway function, exertional breathlessness and exercise endurance in people with advanced COPD, Canadian researchers report. The single-centre, randomised, cross-over study published in the Annals of the American...

A single dose of vapourised cannabis has no clinically meaningful effect on airway function, exertional breathlessness and exercise endurance...
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COPD exacerbations definition needs bringing up to date: Dr Alvar Agusti

The current definition of COPD exacerbations is too vague and needs to be dragged into the 21st century, international experts say. Writing in a comment published in Lancet Respiratory Medicine, Dr Alvar Agusti, from the Respiratory Institute, Hospital Clinic, Barcelona, Spain and...

The current definition of COPD exacerbations is too vague and needs to be dragged into the 21st century, international experts say. Writing...
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Nurse prescribing model unveiled for chronic disease outpatient clinics

An extended scope of practice model proposed for nurses will enable them to prescribe in outpatient clinics to free up doctors' time for more complex patients. The “prescribing in partnership” model released for consultation by the Nursing and Midwifery Board of...

An extended scope of practice model proposed for nurses will enable them to prescribe in outpatient clinics to free up...
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Spirometry interpretation: still working towards clarity & consistency

Variations in spirometry interpretation between labs in Australia is leading to inconsistencies in diagnosis and management  of obstructive lung disease, a study suggests. Findings from a survey of 36 TSANZ-accredited lung function laboratories in Australia and New Zealand reveal 'substantial'...

Variations in spirometry interpretation between labs in Australia is leading to inconsistencies in diagnosis and management  of obstructive lung disease,...
copd

Have your say on National Strategic Action Plan for Lung Conditions

Input from respiratory specialists is being sought on Australia’s first National Strategic Action Plan for Lung Conditions. Working with support from the Federal Department of Health, the Lung Foundation of Australia (LFA) is working on a national plan that will define...

Input from respiratory specialists is being sought on Australia’s first National Strategic Action Plan for Lung Conditions. Working with support from...
copd

Breathlessness Clinic launched by respiratory and cardiology specialists

A Breathlessness Clinic that combines the skills of a respiratory specialist and a cardiologist in the same room has been launched by the Woolcock Institute of Medical Research in Sydney. Co-founder Dr Tracy Smith, a respiratory physician at the Woolcock, says...

A Breathlessness Clinic that combines the skills of a respiratory specialist and a cardiologist in the same room has been...
copd

Lung transplants: 8 things we have learned from the WA experience

Although the first lung transplant in Australia was done in 1986, patients in WA had to wait almost two decades before transplantatation started in the state in 2004. Since then, 115 lung transplants have been performed, and Professor Bill Musk...

Although the first lung transplant in Australia was done in 1986, patients in WA had to wait almost two decades...
copd

ICS/LABA safe and cut exacerbations: FDA explains why ‘black box’ removed

Members of an FDA safety committee have explained why they took the unusual step of removing 'black box' safety warnings from combined inhaled corticosteroid-long acting beta agonist inhalers in December 2017. The warnings were originally put in place in 2011...

Members of an FDA safety committee have explained why they took the unusual step of removing 'black box' safety...
copd

Why macrolides should remain a last resort in respiratory patients

Macrolide antibiotics are an important growth area in prescribing for respiratory disease but should be kept as back-up therapy, delegates at the British Thoracic Society Summer Meeting have heard. Ten years ago almost no respiratory patients would have been on long...

Macrolide antibiotics are an important growth area in prescribing for respiratory disease but should be kept as back-up therapy, delegates...
copd

Low-risk COPD exacerbations can be managed at home

Managing patients in their own home is a safe and cost-effective alternative to inpatient care for some patients with COPD excarbations, UK research shows. In a non-inferiority randomised control trial of 118 patients with a low-risk COPD exacerbation selected by...

Managing patients in their own home is a safe and cost-effective alternative to inpatient care for some patients with COPD...
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10 tips for a multidisciplinary breathlessness clinic

Much can be done to improve the management of breathlessness in patients with chronic lung diseases beyond usual medical care, the ATS 2018 meeting was told. Respiratory physician Dr Tracy Smith and clinical nurse consultant Mary Roberts reported on their experience...

Much can be done to improve the management of breathlessness in patients with chronic lung diseases beyond usual medical care,...
copd

Get moving on more exercise advice

Doctors are aware of the importance of physical activity for their patients with COPD but struggle to incorporate recommendations into their clinical practice. The findings from semi-structured interviews with 30 healthcare professionals suggest the need for more practical strategies to enhance...

Doctors are aware of the importance of physical activity for their patients with COPD but struggle to incorporate recommendations into...
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Call to refer early to palliative care

COPD patients should be referred to palliative care services at the same time as pulmonary rehabilitation, delegates at ATS 2018 were told. Dr Amanda Stephens, Hospice and Palliative Care Fellow at the University of Colorado, said both services have a lot...

COPD patients should be referred to palliative care services at the same time as pulmonary rehabilitation, delegates at ATS 2018...
copd

Pivotal findings for endobronchial valves

Patients with severe emphysema treated with endobronchial valves (EBV) have been shown to have improved lung function, exercise tolerance and quality of life one year following their procedure. However it comes with a pneumothorax rate of 26.6%. The LIBERATE trial, the largest...

Patients with severe emphysema treated with endobronchial valves (EBV) have been shown to have improved lung function, exercise tolerance and...
copd

Step down in therapy suits stable COPD

Patients with stable COPD and infrequent exacerbations can de-escalate from triple therapy to dual bronchodilator therapy with minimal change to lung function and no change to exacerbation rates. According to research presented at ATS 2018 and published in the American...

Patients with stable COPD and infrequent exacerbations can de-escalate from triple therapy to dual bronchodilator therapy with minimal change to...
copd

Pulmonary rehab: too good to ignore

It’s hard to improve on pulmonary rehabilitation for COPD when it is already so effective, the American Thoracic Society (ATS) 2018 International Conference was told. Speaking in a Clinical Year in Review session, Dr William Man, a lung and sleep specialist...

It’s hard to improve on pulmonary rehabilitation for COPD when it is already so effective, the American Thoracic Society (ATS)...
copd

Low-risk COPD exacerbations can be managed at home

Managing patients in their own home is a safe and cost-effective alternative to inpatient care for some patients with COPD, UK research shows. In a non-inferiority randomised control trial of 118 patients with a low-risk COPD exacerbation selected by DECAF...

Managing patients in their own home is a safe and cost-effective alternative to inpatient care for some patients with COPD,...
copd

Inhaler technique guide gets an update

The National Asthma Council Australia has published an update to its popular Inhaler technique for people with asthma or COPD  guide to incorporate new medicines and devices that have come to market in the last two years. “It’s really hard...

The National Asthma Council Australia has published an update to its popular Inhaler technique for people with asthma...
copd

Man’s death after missed pulmonary embolism serves as a warning

The death of a man from a missed pulmonary embolism serves as a cautionary tale for junior doctors to "look at the bigger clinical picture" when diagnosing patients with respiratory conditions, a coroner says. A Victorian coronial inquest heard that...

The death of a man from a missed pulmonary embolism serves as a cautionary tale for junior doctors to "look...
copd

No weekend effect on COPD mortality

Hospital staffers have no need to feel guilty about the level of care they provide on the weekend with evidence from New South Wales that weekend admissions are not associated with increased mortality. The retrospective analysis comprised 148,722 patients admitted...

Hospital staffers have no need to feel guilty about the level of care they provide on the weekend with evidence...
copd

6 different types of lung function trajectory traced over 50 years

Australian research has identified six distinct lung function trajectories from early childhood into the sixth decade - three of which contribute 75% of the disease burden of COPD. The national study, based on long-term follow-up of 2,438 participants in the...

Australian research has identified six distinct lung function trajectories from early childhood into the sixth decade - three of which...
copd

Ask the right questions for lung cancer symptom control: Prof David Currow

By asking the right questions, clinicians can do much more to help lung cancer patients avoid debilitating symptoms such as breathlessness, fatigue and cough, according to oncologist Professor David Currow. Patients often...

By asking the right questions, clinicians can do much more to...
copd

CHAT with COPD patients before winter

Lung Foundation Australia has launched a health professional campaign - Are you ready to have the CHAT - to help them prepare patients with COPD for the increased risk of...

Lung Foundation Australia has launched a health professional campaign - ...
copd

Role for low dose opioids in breathlessness

Low dose opioids are often recommended in clinical practice guidelines for the relief of refractory breathlessness in advanced COPD but physicians remain reluctant to prescribe them, an international expert says. Speaking during a TSANZ themed symposia on...

Low dose opioids are often recommended in clinical practice guidelines for the relief of refractory breathlessness in advanced...
copd

Oxygen no better than medical air for improving exercise capacity

Oxygen therapy during exercise training is no better than medical air in improving exercise capacity and quality of life  in people with COPD, a randomised trial presented at TSANZSRS 2018 reveals.  The findings show that people with COPD who are not...

Oxygen therapy during exercise training is no better than medical air in improving exercise capacity and quality of life  in...
copd

Too much testing for patients with end stage COPD

COPD patients are being unnecessarily pricked, probed and prodded in their last days of life - sometimes despite clear documentation that palliation was the goal of care. A review of COPD patients who died between 2004 and 2016 found patients typically...

COPD patients are being unnecessarily pricked, probed and prodded in their last days of life - sometimes despite clear documentation...
copd

Shared care in the home meeting end-of-life needs

A shared care program where people with advanced COPD are seen regularly by respiratory and palliative care teams in their own home has been met with enthusiasm from respiratory physicians and patients and their families. The program run out of...

A shared care program where people with advanced COPD are seen regularly by respiratory and palliative care teams in their...
copd

Lung rehab can be tailored for people with co-morbidities

Pulmonary rehabilitation can be tweaked to safely accommodate patients with heart disease and other common co-morbidities, a leading physiotherapy academic has told the conference. The presence of co-morbidities including metabolic syndrome, muscular skeletal dysfunction, osteoporosis, chronic pain, anxiety and depression is...

Pulmonary rehabilitation can be tweaked to safely accommodate patients with heart disease and other common co-morbidities, a leading physiotherapy academic...
copd

CBT effective for treating anxiety in COPD

COPD patients who have anxiety and are unable to exercise may benefit from cognitive behavioural therapy, TSANZSRS 2018 delegates were told. CBT, an umbrella term for a group of psychological interventions that facilitate people to reframe their thinking, is recommended for...

COPD patients who have anxiety and are unable to exercise may benefit from cognitive behavioural therapy, TSANZSRS 2018 delegates were...
copd

End of life discussions prove surprisingly popular with health professionals

An online course to open up discussion and remove the stigma around palliative care and dying has proved hugely popular with health professionals as well as the community. Dying2Learn, a free, five-week massive online open course (MOOC) developed by a team...

An online course to open up discussion and remove the stigma around palliative care and dying has proved hugely popular...
copd

Earlier access to home-based palliative care reduced hospital admissions

Terminally ill patients who have early access to home-based palliative care have fewer hospital admissions at the end of their lives, raising questions about the fiscal wisdom of time-based restrictions on such services. Researchers at Curtin University looked at the relationship between...

Terminally ill patients who have early access to home-based palliative care have fewer hospital admissions at the end of their...
copd

What’s the best ‘dose’ of physical activity to gain mortality benefit in COPD?

People with COPD can gain substantial mortality benefits from small amounts of exercise, even if they can’t achieve recommended physical activity levels, a new study shows. After finding a linear dose-response relationship between physical activity and mortality in COPD patients, Australian...

People with COPD can gain substantial mortality benefits from small amounts of exercise, even if they can’t achieve recommended physical...
copd

Funding plea for early-onset emphysema therapies

Patients with Alpha 1 Antitrypsin Deficiency (AATD), which causes early onset emphysema, will have to wait at least a year for any decision on funding for TGA-listed augmentation treatments, the government...

Patients with Alpha 1 Antitrypsin Deficiency (AATD), which causes early onset ...
copd

Prof Guy Marks: why it’s time to quit research into smoking

Researchers in COPD epidemiology should be investing their time, energy and skills into areas other than smoking, according to a leading respiratory and public health physician. In an editorial in Thorax, Professor Guy Marks said policy and practice regarding smoking...

Researchers in COPD epidemiology should be investing their time, energy and skills into areas other than smoking, according to a...
copd

COPD flying under the radar in RA patients

When a rheumatoid arthritis patient presents with respiratory symptoms, clinicians would do well to consider COPD, a new commentary in The Lancet Respiratory Medicine suggests. While the most feared pulmonary manifestation in...

When a rheumatoid arthritis patient presents with respiratory symptoms, clinicians would...
copd

First COPD triple therapy recommended for PBS listing

The first triple therapy inhaler for COPD containing a LAMA, LABA and inhaled steroid has been recommended for PBS listing. At its December 2017 meeting the Pharmaceutical Benefits Advisory Committee recommended an Authority Required (Streamlined) listing for GSK’s Trelegy Ellipta...

The first triple therapy inhaler for COPD containing a LAMA, LABA and inhaled steroid has been recommended for PBS listing. At...
copd

ED study reveals gaps in managing COPD exacerbations

A five-country study of emergency department presentations by patients with acute exacerbations of COPD has shown clinical management is not matching evidence-based guidelines. The study of more than 400 patients in Australia, New Zealand, Singapore, Hong Kong and Malaysia found...

A five-country study of emergency department presentations by patients with acute exacerbations of COPD has shown clinical management is not...
copd

Mandatory end-of-life care standards to be introduced in 2019

All hospitals and healthcare providers will need to have systems to support optimum end-of-life care under new national quality standards to be introduced in 2019. Routine provision of advanced care plans, substitute decision makers and shared decision making will be key...

All hospitals and healthcare providers will need to have systems to support optimum end-of-life care under new national quality standards...
copd

Microbiome linked to COPD exacerbations

Knowing the composition of the lung microbiome in COPD may one day make it possible to predict the nature of future exacerbations and better target treatment, new findings from the AERIS study suggest. The results published in Thorax confirm that subtypes...

Knowing the composition of the lung microbiome in COPD may one day make it possible to predict the nature of...
copd

“Mostly positive”: respiratory physician welcomes PBS review of COPD therapies

A PBS review of COPD therapies has recommended a mix of prescribing restrictions to encourage spirometry and easing of criteria for starting some combination inhalers. The final report from the Post-market Review of Chronic Obstructive Pulmonary Disease (COPD) Medicines was...

A PBS review of COPD therapies has recommended a mix of prescribing restrictions to encourage spirometry and easing of criteria...
copd

Date set for MBS pulmonary rehab decision

There are high hopes that community-based pulmonary rehabilitation will be subsidised by Medicare before the end of the year, after the government set a date to consider the request. It’s been more than three years since the Lung Foundation Australia first...

There are high hopes that community-based pulmonary rehabilitation will be subsidised by Medicare before the end of the year, after...
copd

Follow-up is critical after discharge on bridging oxygen

About half of respiratory patients discharged from hospital on bridging domiciliary oxygen will ultimately go on to require continuous long-term oxygen therapy (LTOT). According to a retrospective study conducted at Alfred...

About half of respiratory patients discharged from hospital on bridging domiciliary...
copd

Respiratory disease the focus for many Australian clinical trials: report

Respiratory conditions are among the top ten study areas for clinical trials in Australia, with latest figures showing there have been 620 trials studying asthma, COPD and sleep apnoea over the last decade. In its latest report, the Australian New...

Respiratory conditions are among the top ten study areas for clinical trials in Australia, with latest figures showing there have...
copd

What does 2018 hold for respiratory medicine?

What will be biggest challenges in respiratory medicine in 2018? We ask Australia's respiratory physicians. AsthmaIn 2018 Australia has found itself losing the battle for asthma control, says Professor Peter Gibson, respiratory physician and co-director of the University of Newcastle’s Priority...

What will be biggest challenges in respiratory medicine in 2018? We ask Australia's respiratory physicians. AsthmaIn 2018 Australia has found itself...
copd

Primary care needs to lift its game re: COPD

COPD is being misdiagnosed and missed in general practice while smoking cessation, one of the best ways GPs can help their patients, is also under-done according to new research. Baseline data from the Review of Airway Dysfunction and Interdisciplinary Community-based...

COPD is being misdiagnosed and missed in general practice while smoking cessation, one of the best ways GPs can help...
copd

Respiratory drugs highlighted in PBS costs report

Fixed dose combination inhalers for COPD have been flagged as high growth prescription items for the Pharmaceutical Benefits Scheme. In its annual expenditure report, the PBS highlights the LABA/LAMA combo tiotropium/olodaterol (Spiolto Respimat) as one of the products with the...

Fixed dose combination inhalers for COPD have been flagged as high growth prescription items for the Pharmaceutical Benefits Scheme. In its...
copd

LABA adverse effects may be chiral

The rare but unexplained asthma exacerbations and deaths seen with long term LABA treatment may be due one of the two optical isomers, an Australian toxicologist says. The pharmacological effects of beta...

The rare but unexplained asthma exacerbations and deaths seen with long...
copd

NIV keeps COPD patients out of hospital, extends life

Non-invasive mechanical ventilation (NIV) at home not only keeps people out of hospital, it also extends life and reduces COPD exacerbations. Re-analysis of results from a trial adding home NIV to oxygen therapy for patients with persistent hypercapnia after a COPD...

Non-invasive mechanical ventilation (NIV) at home not only keeps people out of hospital, it also extends life and reduces COPD...
copd

Flexible delivery of pulmonary rehab stacks up

Home-based pulmonary rehabilitation for COPD patients not only has clinical equivalence to centre-based programs but has also been shown to be as cost effective. The Asian Pacific Society of Respirology (APSR) Congress in Sydney heard direct healthcare costs per patient in...

Home-based pulmonary rehabilitation for COPD patients not only has clinical equivalence to centre-based programs but has also been shown to...
copd

Watch for false negatives with eosinophils

Variability of blood eosinophil counts with food, exercise, medications and the time of testing has the potential to affect patients’ eligibility for targeted therapy. Writing in Respirology, Professor Peter Gibson said ‘the most clinically accessible biomarker to aid in the...

Variability of blood eosinophil counts with food, exercise, medications and the time of testing has the potential to affect patients’...
copd

COPD patients need more than the right puffers

The latest update of the COPD-X guidelines continues to reinforce the importance of managing the multiple comorbidities common in patients with COPD. The September 2017 version of COPD-X and a Guidelines Summary in the MJA highlight the higher mortality...

The latest update of the COPD-X guidelines continues to reinforce the importance of managing the multiple comorbidities common in patients...
copd

Two specialists better than one for breathless patients

The Woolcock Institute of Medical Research in Sydney has launched a multispeciality breathlessness clinic to fast track diagnosis and treatment for referred patients. Patients who have been breathless for more than four weeks despite treatment will be able to see both...

The Woolcock Institute of Medical Research in Sydney has launched a multispeciality breathlessness clinic to fast track diagnosis and treatment...
copd

Bronchoscopy in high-risk needs different approach

Clinicians carrying out bronchoscopy in high-risk patients under ‘conscious sedation’ may need to adapt their approach, a series of patient accounts reveals. Post-procedure interviews with 13 people with COPD who had undergone day-case bronchoscopy under low-dose sedation...

Clinicians carrying out bronchoscopy in high-risk patients under ‘conscious sedation’ may need to adapt their approach, a series...
copd

Exercise and education embedded in latest Stepwise guide

The importance of regular exercise and an interactive way to help people with COPD use their inhalers correctly are just some of the new additions to the updated stepwise guidelines. Spokesman for Lung Foundation Australia Professor Ian Yang told the limbic...

The importance of regular exercise and an interactive way to help people with COPD use their inhalers correctly are just...
copd

PBS restrictions on COPD meds a nudge towards best practice

The PBAC has recommended increasing the PBS restriction level to Authority Required (Streamlined) for ICS/LABA inhalers in COPD and removing the current restrictions to stabilise patients on individual monotherapy inhalers before commencing a LAMA/LABA combination. The recommendations follow the yet to...

The PBAC has recommended increasing the PBS restriction level to Authority Required (Streamlined) for ICS/LABA inhalers in COPD and removing...
copd

ICS use linked to lung infections

Inhaled corticosteroid use is associated with an increased risk of non-tuberculous mycobacterial pulmonary disease in older patients with obstructive lung disease. The Canadian study of more than 417,000 patients aged ≥66 years with asthma, COPD or asthma-COPD overlap syndrome (ACOS)...

Inhaled corticosteroid use is associated with an increased risk of non-tuberculous mycobacterial pulmonary disease in older patients with obstructive lung...
copd

Mixed results for biologic in eosinophilic COPD

A subgroup of patients with COPD may benefit from biologic therapies, results of two Phase III trials suggest, but the jury is out on exactly which patients will benefit the most. The METREX trial, presented at ERS and published in the NEJM found 100...

A subgroup of patients with COPD may benefit from biologic therapies, results of two Phase III trials suggest, but the...
copd

Revised GOLD criteria under scrutiny

The recent reclassification of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria has been put through its paces by several researchers at this years ERS congress, with some authors concluding that the revised criteria will have an impact on...

The recent reclassification of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria has been put through its paces by...
copd

CT scans can help guide treatment in emphysema

The degree of emphysema present on CT scans could help clinicians pinpoint which patients need to be treated, the ERS congress has heard. Professor MeiLan K Han from Ann Arbour in Michigan in the US told delegates that thoracic imaging was...

The degree of emphysema present on CT scans could help clinicians pinpoint which patients need to be treated, the ERS...
copd

Disinfectants linked to COPD

Healthcare professionals who regularly use disinfectants as part of their job have an increased risk of developing COPD. Nurses who used disinfectants to clean surfaces on a regular basis – at least once a week – had a 22% increased risk...

Healthcare professionals who regularly use disinfectants as part of their job have an increased risk of developing COPD. Nurses who used...
copd

Musts and no-go therapies for COPD and heart disease

Delegates have been given a low-down on the therapies that should and should not be used in people with COPD and heart disease. Taking ERS congress delegates through the evidence on the safety and efficacy of therapies in a session called...

Delegates have been given a low-down on the therapies that should and should not be used in people with COPD...
copd

Fan-tastic intervention for chronic breathlessness

Patients with breathlessness are using hand-held fans to delay the use of oxygen therapy and inhaled beta-agonists, according to a secondary analysis of clinical trials in the area. The trials included qualitative interviews with 133 patients with non-malignant diseases such as...

Patients with breathlessness are using hand-held fans to delay the use of oxygen therapy and inhaled beta-agonists, according to a...
copd

COPD and asthma contribute to global burden of disease

COPD caused 3.2 million deaths worldwide in 2015 - up almost 12% from 1990 as population growth and ageing outweighed any downward trend in age-standardised death rates. The prevalence of the disease has also increased by 44.2% from 1990 to a...

COPD caused 3.2 million deaths worldwide in 2015 - up almost 12% from 1990 as population growth and ageing outweighed...
copd

Oxygen misadventure leads to macabre death

A COPD patient suffered a “horrific” death after mainline oxygen supply was connected to his urinary catheter, causing his abdomen to blow up “like a balloon”. It should have been a straightforward treat-and-discharge scenario when Stephen Herczeg presented for a urinary...

A COPD patient suffered a “horrific” death after mainline oxygen supply was connected to his urinary catheter, causing his abdomen...
copd

The clinical implications of cardiac dysfunction in COPD

Can you describe the aim of your research in 10 words? Exploration of cardiac dysfunction in COPD and its clinical implication What do you know/have discovered about this topic so far? High levels of biochemical markers of cardiac dysfunction, natriuretic peptides and troponins,...

Can you describe the aim of your research in 10 words? Exploration of cardiac dysfunction in COPD and its clinical implication What...
copd

NIV improves outcomes in hospitalised COPD patients

A Cochrane Review has confirmed that non-invasive bi-level positive pressure ventilation (NIV) should form part of the initial management of patients admitted to hospital with acute hypercapnic respiratory failure due to acute COPD exacerbations. The systematic review, including 17 trials...

A Cochrane Review has confirmed that non-invasive bi-level positive pressure ventilation (NIV) should form part of the initial management of...
copd

The semantics of COPD exacerbations

COPD exacerbation as a result of pneumonia? During a recent morning report, a resident presented the case of a 67 year old COPD patient who was referred to the emergency department in the previous evening because of increased shortness of breath,...

COPD exacerbation as a result of pneumonia? During a recent morning report, a resident presented the case of a 67 year...
copd

Lung disease remains sixth in burden of disease list

The burden of chronic respiratory conditions such as COPD and asthma has declined slightly but still ranks sixth as a disease group in terms of its contribution to the total burden of disease in Australia. The latest AIHW data from...

The burden of chronic respiratory conditions such as COPD and asthma has declined slightly but still ranks sixth as a...
copd

Call to fix “unfair” rules for work-related lung disease compo

There are calls to expand the list of work-related lung disorders eligible for government compensation in NSW, amid concerns many with life-threatening conditions are missing out. There are 13 dust diseases for which workers can receive financial and health care support...

There are calls to expand the list of work-related lung disorders eligible for government compensation in NSW, amid concerns many...
copd

Puffer problems for patients with COPD

The latest update of the Australian and New Zealand guidelines for the management of COPD has highlighted the problems arising from the plethora of different inhaler devices on the market. The TSANZ and Lung Foundation Australia COPD-X guidelines have for...

The latest update of the Australian and New Zealand guidelines for the management of COPD has highlighted the problems arising...
copd

Survey reveals breathtaking attitude change to opioids  

Junior doctors may be a little too enthusiastic about the use of opioids for the management of refractory breathlessness in patients with COPD. According to a survey of basic trainees in Victoria, most (87%) believed that opioids have a role...

Junior doctors may be a little too enthusiastic about the use of opioids for the management of refractory breathlessness in...
copd

Chronic breathlessness as a distinct clinical entity

Recognition of chronic breathlessness as a distinct clinical entity will help overcome the therapeutic nihilism that pervades the management of patients with respiratory, cardiac and neurodegenerative diseases. With that goal in mind, an international group of experts has reached consensus...

Recognition of chronic breathlessness as a distinct clinical entity will help overcome the therapeutic nihilism that pervades the management of...
copd

Black lung disease report calls for industry shake up

Responsibility for the health and safety of coal workers should be separated from the government department that promotes and supports the industry, Queensland’s parliamentary inquiry into Coal Workers’ Pneumoconiosis has found. The report Black Lung, White Lies recommends the establishment...

Responsibility for the health and safety of coal workers should be separated from the government department that promotes and supports...
copd

Integrated respiratory-palliative care to benefit COPD patients

A proposed model of a care for embedding palliative care into the routine care of patients with COPD will help counter patient and physician concerns, an expert says. Dr Natasha Smallwood, who leads the Advanced Lung Disease Service at the Royal...

A proposed model of a care for embedding palliative care into the routine care of patients with COPD will help...
copd

NIV reduces COPD re-admissions

The addition of noninvasive ventilation to home oxygen and standard care following an exacerbation of COPD can reduce the risk of hospital readmission or death. A multi-centre UK study recruited 116 patients with persistent hypercapnia (PaCO2 >53mmHg) and hypoxaemia (PaO2...

The addition of noninvasive ventilation to home oxygen and standard care following an exacerbation of COPD can reduce the risk...
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ACOS not a useful disease concept: experts

Australian respiratory researchers have once again challenged the ongoing usefulness of asthma-COPD overlap syndrome (ACOS) as a disease entity. In an editorial in the European Respiratory Journal, Professors Vanessa McDonald and Peter Gibson from the Hunter Medical Research Institute suggested...

Australian respiratory researchers have once again challenged the ongoing usefulness of asthma-COPD overlap syndrome (ACOS) as a disease entity. In an...
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The clinicians perspective: Moving away from therapeutic nihilism in COPD

Living with advanced COPD in 2002 While in training to become a respiratory physician, a 57 year old formerly smoking man with severe chronic obstructive pulmonary disease (COPD) and chronic respiratory failure frequently visited my outpatient clinic in Maastricht University Medical...

Living with advanced COPD in 2002 While in training to become a respiratory physician, a 57 year old formerly smoking man...
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The Lancet Summit: COPD and lung cancer

The summit organised by The Lancet Respiratory and Lancet Oncology will be held in Perth on 28-29 July and will cover a wide range of topics ranging from prevention, diagnosis, treatment, and palliative care of people living with COPD...

The summit organised by The Lancet Respiratory and Lancet Oncology will be held in Perth on 28-29 July and...
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No evidence LABA/ICS inhalers raise risk of CV events in COPD: SUMMIT

Inhalers used to treat COPD carry no excess cardiovascular risk – a finding that could finally quash long-held concerns about use of the drugs in COPD patients who also have cardiovascular disease. Researchers from the SUMMIT trial – the largest...

Inhalers used to treat COPD carry no excess cardiovascular risk – a finding that could finally quash long-held concerns about...
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Most influential respiratory paper of 2016 goes to Australian researchers

An Australian study has been highlighted by the American College of Physicians as one of the most influential studies in respiratory medicine to be published last year. The study published in Thorax by Professor Anne Holland and colleagues from Alfred Health...

An Australian study has been highlighted by the American College of Physicians as one of the most influential studies in...
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Short on drug options for short of breath patients

Morphine is still the best pharmacological treatment for chronic breathlessness, according to an extensive review of the literature. Co-author of the review published in Expert Review of Respiratory Medicine  Professor David Currow told the limbic the inability to tolerate morphine was relatively...

Morphine is still the best pharmacological treatment for chronic breathlessness, according to an extensive review of the literature. Co-author of ...
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GPs too passive in their approach to COPD

GPs hold back on formerly diagnosing people with COPD and delay offering interventions such as smoking cessation or pulmonary rehabilitation, a survey shows. The findings from 233 mostly urban GPs found most (60%) delay recording a formal diagnosis of COPD until after...

GPs hold back on formerly diagnosing people with COPD and delay offering interventions such as smoking cessation or pulmonary rehabilitation,...
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Evidence for pulmonary rehab reflected in updated COPD-X guidelines

The evidence for the benefits of pulmonary rehabilitation has been strengthened in the latest update of the Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease (COPD-X). Professor Ian Yang, chair of the Lung Foundation Australia COPD...

The evidence for the benefits of pulmonary rehabilitation has been strengthened in the latest update of the Australian and New...
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Stakeholder forum to discuss post-market review of COPD medicines

Members of the respiratory community will meet in Sydney at the end of the month to discuss the ongoing post-market review of COPD medicines. The review was launched by the PBAC in 2015 following concerns about the multiple use of a...

Members of the respiratory community will meet in Sydney at the end of the month to discuss the ongoing post-market...
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Healthy diet could prevent COPD in smokers

A diet with a high intake of fruits and vegetables may have the potential to prevent COPD in ex-smokers and current smokers, new research suggests. The Swedish prospective cohort study involving over 44,000 men aged between 45 and 79 found...

A diet with a high intake of fruits and vegetables may have the potential to prevent COPD in ex-smokers and...
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Inhaler technique hasn’t improved in 40 years

Most COPD patients are not using their inhalers correctly which is contributing to poor patient outcomes, a large confirms . The French study of almost 3,000 patients observed using their inhalers by GPs or respiratory physicians, found more than 50% of...

Most COPD patients are not using their inhalers correctly which is contributing to poor patient outcomes, a large confirms . The...
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Pulmonary rehab dropouts need more support

Tweaking pulmonary rehabilitation programs to help re-engage COPD patients who drop out because of severe exacerbations is worth the effort. According to new research from the COPD, Health Status and Comorbidities (CHANCE) Study, patients with severe exacerbations requiring hospital admission...

Tweaking pulmonary rehabilitation programs to help re-engage COPD patients who drop out because of severe exacerbations is worth the effort. According...
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More evidence for early life determinants of COPD

Lung function at seven years of age can help predict both COPD and Asthma-COPD Overlap Syndrome (ACOS) in later life, according to findings from one of the world’s longest running cohort studies on respiratory health. Professor Paul Thomas, a respiratory physician...

Lung function at seven years of age can help predict both COPD and Asthma-COPD Overlap Syndrome (ACOS) in later life,...
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Watershed moment for COPD research

A genome-wide association study of almost 50,000 people representing the extremes of  lung function has helped uncover 68 high priority genes as targets for future COPD drug development. The findings, published in Nature Genetics, also demonstrated the magnitude of the...

A genome-wide association study of almost 50,000 people representing the extremes of  lung function has helped uncover 68 high priority...
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Precision respiratory medicine in clinical practice: at the balance between facts and trivia

Approximately half of the smoking population is considered susceptible to, and will develop, chronic obstructive pulmonary disease (COPD)(1). However, the risk of developing COPD is about 23% lower in active smokers with moderate to high levels of physical activity, compared to...

Approximately half of the smoking population is considered susceptible to, and will develop, chronic obstructive pulmonary disease (COPD)(1). However, the risk...
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Global COPD guidelines updated; consistent with COPD-X

Spirometry remains important for the diagnosis and assessment of COPD but its value in making treatment decisions has been downgraded in the latest version of the Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. According to...

Spirometry remains important for the diagnosis and assessment of COPD but its value in making treatment decisions has been downgraded...
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COPD diagnosis must improve, says audit

The accuracy of COPD diagnosis needs to improve to avoid high cost, unsafe, and clinically ineffective treatments being provided to people who do not have COPD, a damning report has found. Published by the UK’s Royal College of Physicians the report,...

The accuracy of COPD diagnosis needs to improve to avoid high cost, unsafe, and clinically ineffective treatments being provided to...
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Beta-blockers under-prescribed in COPD

More use of beta-blockers in COPD patients with heart failure or a history of acute myocardial infarction presents a significant opportunity for better quality care, Melbourne doctors claim. Dr Pieter Neef and colleagues including Professors Christine McDonald and Lou Irving found...

More use of beta-blockers in COPD patients with heart failure or a history of acute myocardial infarction presents a significant...
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Too much oxygen for too little benefit

Long term oxygen therapy has no benefit in patients with stable COPD and moderate resting hypoxemia or exercise-induced desaturation, according to US research. Professor Christine McDonald, director of respiratory and sleep medicine at Austin Health, said the findings were largely consistent...

Long term oxygen therapy has no benefit in patients with stable COPD and moderate resting hypoxemia or exercise-induced desaturation, according...
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‘Alarming’ study links high intensity exercise to mortality in COPD

A leading Melbourne researcher has urged caution over a new ‘alarming’ study that links increased mortality in COPD patients with high intensity exercise. The small study conducted by researchers at the University of Copenhagen revealed one third of the 15 patients...

A leading Melbourne researcher has urged caution over a new ‘alarming’ study that links increased mortality in COPD patients with...
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Simple home based rehab offers hope for COPD patients missing out on care

Home-based pulmonary rehabilitation delivered using minimal resources has similar – and in some cases even superior - outcomes to centre-based pulmonary rehabilitation, Australian researchers have found. The findings offer hope that more people with COPD could have meaningful access to pulmonary...

Home-based pulmonary rehabilitation delivered using minimal resources has similar – and in some cases even superior - outcomes to centre-based...
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Re-set required on use of oxygen therapy for acute care patients

Australian and New Zealand experts are claiming the scientific high ground on an inconsistency between TSANZ and British Thoracic Society guidelines for acute use of oxygen therapy. In a letter published recently in the journal Respirology, TSANZ representatives have reiterated...

Australian and New Zealand experts are claiming the scientific high ground on an inconsistency between TSANZ and British Thoracic Society...
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Push towards consensus definition on asthma?COPD overlap syndrome

A push to have asthma–chronic obstructive pulmonary disease overlap syndrome  declared a disease in its own right is gathering momentum with the release of a draft operational definition. An article in the European Journal of Respirology details key features of...

A push to have asthma–chronic obstructive pulmonary disease overlap syndrome  declared a disease in its own right is gathering momentum...
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Thermal ablation benefits confirmed: STEP-UP

Targeted thermal vapour ablation of severely emphysematous lung tissue improves lung function and quality of life with an acceptable safety profile, 12 month results of the joint Australian-European STEP-UP study confirm. As reported by the limbic, six-month results from the...

Targeted thermal vapour ablation of severely emphysematous lung tissue improves lung function and quality of life with an acceptable safety...
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Opioids and COPD could be a fatal mix

Older adults with chronic obstructive pulmonary disease who start using opioids have a more than two-fold higher risk of dying from a respiratory-related complication compared to non-opioid users, research shows. When researchers looked specifically at more potent opioids, they found the...

Older adults with chronic obstructive pulmonary disease who start using opioids have a more than two-fold higher risk of dying...
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Philip Morris speaks at and promotes an obscure conference on lung disease

Over the past decade, every researcher’s email inbox has been crammed daily with junk from what have come to be known as predatory journals and conferences. Last week I had 21 offers to send my non-existent research to open-access journals...

Over the past decade, every researcher’s email inbox has been crammed daily with junk from what have come to be...
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Is the palliative care tide turning for COPD patients?

Patients with COPD are still missing out on specialist palliative care services in Australia, prompting calls for national guidelines to help improve access and public awareness. Senior respiratory physician, Dr Natasha Smallwood, of the Royal Melbourne Hospital’s Department of Respiratory and Sleep Medicine,...

Patients with COPD are still missing out on specialist palliative care services in Australia, prompting calls for national guidelines to...
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Early and late adult asthma: similar but different

Early and late onset adult asthma has similar clinical manifestations but major phenotypic differences, the world’s longest running population study of respiratory diseases confirms. The Tasmanian Longitudinal Health Study spanning over four decades found that early-onset adult asthma was associated...

Early and late onset adult asthma has similar clinical manifestations but major phenotypic differences, the world’s longest running population study...
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Call to revisit COPD guidelines

A leading Australian thoracic specialist and researcher has called for a revision of current COPD criteria to include cough and sputum as red flags for the disease. Professor Christine Jenkins, head of Respiratory Trials at The George institute for Global Health,...

A leading Australian thoracic specialist and researcher has called for a revision of current COPD criteria to include cough and...
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COPD more common in women

Clinicians should be alert to the stereotype that the typical COPD patient is an elderly male, as the majority are now women. Dr Seppo Rinne, from Yale University, told the ATS meeting that women with COPD dominated every age group in...

Clinicians should be alert to the stereotype that the typical COPD patient is an elderly male, as the majority are...
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COPD highlights of 2015

Last year saw a plethora of COPD research hit the journals but what were the significant findings that could change practice as we know it? In a 'year in review' session international expert Dr Craig Hersh from the Brigham and...

Last year saw a plethora of COPD research hit the journals but what were the significant findings that could change...
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Peter Gibson unravels the chaos of ACOS

Identifying ‘treatable traits’ is more useful than debating the validity of the diagnosis in patients with asthma-COPD overlap syndrome, TSANZ President Professor Peter Gibson has told delegates attending the American Thoracic Society conference here in San Francisco. In a session titled...

Identifying ‘treatable traits’ is more useful than debating the validity of the diagnosis in patients with asthma-COPD overlap syndrome, TSANZ...
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Does palliative care need a new name?

Australia is a world leader in the delivery of palliative care services, but still has a long way to go to address stigma attached to the specialty. Professor Ian Maddocks, Senior Australian of the Year 2013 and regarded as one of...

Australia is a world leader in the delivery of palliative care services, but still has a long way to go...
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‘Futile’ treatment can cause confusion: study

The debate over how to define ‘futile’ treatment has hit the headlines again, with a new study showing doctors support the concept but more than half have difficulty coming to a consensus on how to approach it in a clinical...

The debate over how to define ‘futile’ treatment has hit the headlines again, with a new study showing doctors support...
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Chantal Donovan answers the holy grail

  Research by Chantal Donovan from the Priority Research Centre for Healthy Lungs at Newcastle University and colleagues has attracted a lot of attention in the press this week. To find out...

  Research by Chantal Donovan from the Priority Research Centre for...
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Time to think beyond the lungs

Respiratory clinicians need to start looking beyond the lung and towards the heart - they may also need to start being nice to cardiologists, an expert says. Speaking at a session on the impact of comorbidities in COPD Associate Professor Bob...

Respiratory clinicians need to start looking beyond the lung and towards the heart - they may also need to start...
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Specialised clinics needed for advanced COPD

Patients with advanced lung disease need specialised care to help address issues such as end-of-life care planning, says a respiratory physician who has set up an innovative clinic in Melbourne. Dr Natasha Smallwood and colleagues set up the clinic for patients...

Patients with advanced lung disease need specialised care to help address issues such as end-of-life care planning, says a respiratory...
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Home-based lung rehab a feasible option

Pulmonary rehabilitation in the home is a feasible option for COPD patients who cannot access centre-based programs, the conference has heard. Physiotherapist Dr Anne Holland from La Trobe University and colleagues found that COPD patients with stable disease taking part in...

Pulmonary rehabilitation in the home is a feasible option for COPD patients who cannot access centre-based programs, the conference has...
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PPIs do not reduce COPD exacerbations

Reflux is a well known trigger for exacerbations in people with COPD yet treatment with proton pump inhibitors do not appear to reduce the risk, research shows. Writing in Respirology the researchers from Switzerland and The Netherlands noted that previous studies had...

Reflux is a well known trigger for exacerbations in people with COPD yet treatment with proton pump inhibitors do not appear...
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Updated: Post-market review of COPD medicines

The final terms of reference for the post-market review of COPD medicines is now open for public comment. The PBAC considered the draft Review Terms of Reference and comments from stakeholders at the December 2015 PBAC meeting. Following the December 2015 PBAC...

The final terms of reference for the post-market review of COPD medicines is now open for public comment. The PBAC considered...
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COPD patients who lose weight have better outcomes

Weight loss involving low-energy diet and resistance training has shown promising results for obese patients with COPD. The pilot study, published in Respirology, suggested weight reduction with maintenance of skeletal muscle mass improved COPD outcomes and called for further research. “Given...

Weight loss involving low-energy diet and resistance training has shown promising results for obese patients with COPD. The pilot study,...
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Hyperglycaemia different in COPD

Metformin does not reduce elevated blood glucose levels in COPD patients with severe exacerbations, researchers report. Writing in Thorax  the team from St George’s in London said elevated blood glucose concentrations occurred in the majority of patients admitted to hospital...

Metformin does not reduce elevated blood glucose levels in COPD patients with severe exacerbations, researchers report. Writing in Thorax  the...
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Thermal vapour ablation effective in severe emphysema

Targeted thermal vapour ablation of severely emphysematous lung tissue improves lung function and quality of life with an acceptable safety profile, the joint Australian-European STEP-UP study has concluded. The study recruited 70 patients with severe, upper lobe-prominent emphysema, an FEV1...

Targeted thermal vapour ablation of severely emphysematous lung tissue improves lung function and quality of life with an acceptable safety...
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Evidence for pulmonary rehab ‘uncontestable’

UK experts have welcomed the recent addition of pulmonary rehabilitation to UK COPD guidelines, saying the scientific evidence for its benefit is now 'uncontestable'. Its recognition as best practice in updated National Institute for Health and Care Excellence (NICE) guidelines means...

UK experts have welcomed the recent addition of pulmonary rehabilitation to UK COPD guidelines, saying the scientific evidence for its...
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Good bugs may have a role to play in treatment of COPD

Balancing both good and bad bacteria in the airways of patients with COPD may reduce inflammation and improve lung health and quality of life, a study has found. The research, published in Respirology, is one of few to date that have...

Balancing both good and bad bacteria in the airways of patients with COPD may reduce inflammation and improve lung health...
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COPD guidelines updated

New therapies for the management of COPD are a focus of the latest update to the internationally recognised COPD-X Plan. These include two new combination therapies and a new LAMA medicine device. The guidelines also provide updates on the safety,...

New therapies for the management of COPD are a focus of the latest update to the internationally recognised COPD-X Plan. These...
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Experts call for label-free approach to asthma and COPD

The current approach to defining a patient's symptoms using the diagnostic labels of asthma and COPD is outdated and fails to provide optimal care in a significant number of patients, experts claim. Writing in a perspective article in the European...

The current approach to defining a patient's symptoms using the diagnostic labels of asthma and COPD is outdated and fails...
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Evidence grows for efficacy of endobronchial coils

Evidence is growing to support the use of endobronchial coils in patients with severe emphysema, with the release of one of the most significant studies to date. However questions still remain over whether the treatment is best suited to patients with...

Evidence is growing to support the use of endobronchial coils in patients with severe emphysema, with the release of one...
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Judicious use of opioids justified in COPD: expert

There is an urgent need to dispel myths about the risks of using regular low-dose opioids in patients with COPD, according to Adelaide palliative care physician Professor David Currow and his colleagues. Writing to the British Journal of Clinical Pharmacology in...

There is an urgent need to dispel myths about the risks of using regular low-dose opioids in patients with COPD,...
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Does COPD begin in childhood?

COPD is traditionally diagnosed in adults but research now shows that signs for its development can be identified earlier in life. To mark World COPD day paediatric pulmonologist Lystra Hayden explores the relationship between childhood pneumonia and COPD development in...

COPD is traditionally diagnosed in adults but research now shows that signs for its development can be...
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Update: COPD medicines under review

The deadline for submissions to the post-market review of COPD medicines has been extended. The review was given the green light by the PBAc in August following concerns about the multiple use of a number of new combinations available on the PBS,...

The deadline for submissions to the post-market review of COPD medicines has been extended. The review was given the green light by...
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Overuse of triple therapy in COPD common

Inappropriate prescribing of inhaled corticosteroids for patients with mild to moderate COPD is common practice in Australia despite the availability of comprehensive treatment guidelines, an expert says. Professor Greg King from the Woolcock Institute of Medical Research in Sydney said inhaled...

Inappropriate prescribing of inhaled corticosteroids for patients with mild to moderate COPD is common practice in Australia despite the availability...
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Swim between the oxygen flags: guidelines

More is not better when it comes to delivering oxygen to patients in acute medical settings is the key message of new TSANZ guidelines released in full this week.  As reported by the limbic in August, the guidelines aim to bring evidence-based...

More is not better when it comes to delivering oxygen to patients in acute medical settings is the key message...
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COPD medicines under review

The post-market review of COPD medicines recommended by the PBAC in August is now open for public comment. The review was given the green light following concerns about the multiple use of a number of new combinations available on the PBS,...

The post-market review of COPD medicines recommended by the PBAC in August is now open for public comment. The review was...
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Lung Foundation push for pulmonary rehab MBS item

Patients with chronic lung disease will be referred by their GP to an eight-week course of pulmonary rehabilitation if a new proposal currently being considered by the Medicare Services Advisory Committee goes ahead. Eligible patients will include those diagnosed with COPD,...

Patients with chronic lung disease will be referred by their GP to an eight-week course of pulmonary rehabilitation if a...
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Researchers uncover lung function genes

An international team of researchers have identified lung tissue genes that they say drives variations in lung function and susceptibility to COPD. Led by Ma’en Obeidat...

An international team of researchers have identified lung tissue...
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SABA use predicts exacerbation risk in COPD

SABA reliever use predicts both current control and future risk of exacerbations in patients with moderate to severe COPD, Australian research confirms. Writing in BMC Pulmonary Medicine Christine Jenkins and colleagues from The George Institute of Global Health noted that debate existed...

SABA reliever use predicts both current control and future risk of exacerbations in patients with moderate to severe COPD, Australian...
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Beta-blockers reduce exacerbations in COPD

Beta-blockers significantly reduce exacerbations in COPD patients regardless of the severity of their airflow obstruction and appear to be safe, data from the COPDGene study suggests. Analysis of 3,464 patients in the study, just published in Thorax, found 474 (14%) were...

Beta-blockers significantly reduce exacerbations in COPD patients regardless of the severity of their airflow obstruction and appear to be safe,...
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COPD patients falling down

Up to 40% of patients with COPD experience falls, with more than 75% of patients falling multiple times, a study from Melbourne finds. The preliminary study that followed 41 patients with stable COPD for a year found factors linked with an increased...

Up to 40% of patients with COPD experience falls, with more than 75% of patients falling multiple times, a study from Melbourne...
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Oxygen is a drug: guidelines

New TSANZ guidelines on the use of oxygen in acute medical settings aim to bring evidence-based clarity to a "currently confusing clinical area", experts say. Writing in the MJA Professor E. Haydn Walters, from the University of Tasmania, and...

New TSANZ guidelines on the use of oxygen in acute medical settings aim to bring evidence-based clarity to a "currently...
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Statin use may need re-assessing in COPD

Cardiovascular disease is up to five times more common in people with COPD, the largest systematic review to date finds. The analysis of 29 studies published over a 15 year period found a nearly 2·5 times increased...

Cardiovascular disease is up to five times more common in people with COPD, the largest...
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Long-term antibiotics unhelpful in stable COPD

Three months of antibiotic treatment is no better than placebo in reducing the airway bacterial load in patients with stable COPD, a new study has shown. There was also no difference in total bacterial load assessed by quantitative PCR rather than...

Three months of antibiotic treatment is no better than placebo in reducing the airway bacterial load in patients with stable...
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A hitchhiker’s guide to COPD

Chronic obstructive pulmonary disease (COPD) is a global epidemic afflicting 200–300 million people worldwide and causing deaths and suffering for millions of people each year.[1] The greatest burden of COPD is found in Asia, which has...

Chronic obstructive pulmonary disease (COPD) is a global epidemic afflicting 200–300 million people worldwide and causing deaths and...
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Matrix guides personalised treatment of COPD exacerbations

Spanish experts have proposed a new way of  classifying COPD exacerbations that they say may help provide better personalised care to patients. In a viewpoint in The Lancet, Drs Jose Luis Lopez-Campos and...

Spanish experts have proposed a new way of  classifying COPD exacerbations that they say may help provide better personalised care...
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First COPD biomarker approved by FDA

The FDA has approved the first COPD biomarker for use in interventional clinical trials. The blood biomarker plasma fibrinogen can now be used in studies that examine exacerbations and/or all-cause mortality in patients with COPD, the regulatory body said in a statement. The initial...

The FDA has approved the first COPD biomarker for use in interventional clinical trials. The blood biomarker plasma fibrinogen can now be used...
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Ditch GOLD for LLN, say experts

Clinicians should ditch GOLD and instead adopt lower limits of normal (LLN) criteria for defining airflow when assessing patients for COPD, experts have argued in a Too Much Medicine paper in the BMJ. Retired respiratory physician Professor Martin Miller and General...

Clinicians should ditch GOLD and instead adopt lower limits of normal (LLN) criteria for defining airflow when assessing patients for...
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Endobronchial valves improve lung function similar to LVRS: study

In selected patients with emphysema endobronchial valve placement results in improvements in lung function similar to that seen with lung volume reduction surgery, an independent randomised trial finds. The single-centre, double-blind...

In selected patients with emphysema endobronchial valve placement results in improvements in lung function similar...
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Augmentation slows ?1 antitrypsin deficiency related emphysema

Augmentation treatment for α1 antitrypsin deficiency may slow the progression of emphysema, a study in the Lancet shows. Findings from observational and cohort studies had shown...

Augmentation treatment for α1 antitrypsin deficiency may slow the progression...
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Indigenous lung study ‘a call to arms’ : expert

The findings of a recent study on lung health in Indigenous Australians should serve as a call to arms for all respiratory researchers, an expert says. Professor Graham Hall a respiratory scientist at the Telethon Kids Institute in Western Australia was...

The findings of a recent study on lung health in Indigenous Australians should serve as a call to arms for...
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New GOLD no better than old GOLD at predicting mortality

Both GOLD classification systems are unable to predict mortality in COPD patients at an individual level, an analysis of data from 22 studies involving over 15,000 patients finds. Neither the 2007 or the enhanced 2011 classification system had sufficient discriminatory power...

Both GOLD classification systems are unable to predict mortality in COPD patients at an individual level, an analysis of data...
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Aspirin may slow emphysema

Regular use of aspirin may help slow the progression of early emphysema, according to research presented at the 2015 American Thoracic Society International Conference. The study of 4,471 individuals participating in the Multi-Ethnic Study of Atherosclerosis Lung Study...

Regular use of aspirin may help slow the progression of early emphysema, according to research presented at the...
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Umbrella terms not keeping the rain off: Bush

The editor of Thorax agrees with a recent review by Peter Gibson and Vanessa McDonald recommending the term ACOS be abandoned, but he goes even further by saying the terms...

The editor of Thorax agrees with a recent review by...
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Abandon ACOS as a specific phenotype

Asthma-COPD overlap syndrome should be abandoned as a specific phenotype, say Peter Gibson and Vanessa McDonald. Writing in a review published in Thorax the  authors note that there are several phenotypes that might fall under the asthma-COPD overlap (ACOS) banner but appear to have...

Asthma-COPD overlap syndrome should be abandoned as a specific phenotype, say Peter Gibson and Vanessa McDonald. Writing in a review published in Thorax the...
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Inhalers underused and overused: Report

There is substantial over- and under-use of certain medications for asthma and COPD, reveals a new report from the Australian Centre for Airways disease Monitoring. Prescription respiratory medications were dispensed to over 2 million people in Australia in 2013 but figures from...

There is substantial over- and under-use of certain medications for asthma and COPD, reveals a new report from the Australian Centre...
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Lancet series addresses challenges in COPD

Experts from the US take a look at the challenges that come with defining, assessing and ultimately preventing the third leading cause of death worldwide. In what is the first paper in a two-part Lancet series the review notes that...

Experts from the US take a look at the challenges that come with defining, assessing and ultimately preventing the third...
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Clinical controversies addressed in oxygen guidelines

Updated guidelines on the use of oxygen in the home address clinical controversies such as oxygen prescription to smokers, provision of oxygen on discharge from hospital, and the use of palliative oxygen. Published in Thorax this week the guidelines from...

Updated guidelines on the use of oxygen in the home address clinical controversies such as oxygen prescription to smokers, provision...
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Paramedics over-oxygenating COPD patients

The majority of COPD patients arriving at hospital by ambulance are given too much oxygen, research shows. The study of 263 patients found 222 (84.4%) had an SpO2 reading of ≥93% at the last ambulance reading despite guidelines recommending oxygen therapy be carefully titrated...

The majority of COPD patients arriving at hospital by ambulance are given too much oxygen, research shows. The study of 263 patients found...
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Blood eosinophils a promising biomarker in COPD

Blood eosinophils are a promising biomarker to predict the therapeutic response to inhaled corticosteroids in patients with COPD, research suggests. The post- hoc analysis of data from two double-blind, randomised...

Blood eosinophils are a promising biomarker to predict the therapeutic response to inhaled corticosteroids in...
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Many more COPD studies needed

If you're thinking about conducting research into COPD you may want to take a look at this joint statement from the American Thoracic Society and the European Respiratory Society on the research questions that still need answering. Great strides...

If you're thinking about conducting research into COPD you may want to take a look at this joint statement...
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TB and COPD ‘intimately’ connected

Tuberculosis is strongly linked to COPD an Australian review finds, calling into question the belief that people who recover from the disease do not have longer-term problems. Adults over the age of 40 with tuberculosis (TB) were three times more...

Tuberculosis is strongly linked to COPD an Australian review finds, calling into question the belief that people who recover...
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COPD by numbers

More than 1 in 20 Australians have COPD and there were almost 60,000 hospitalisations for the disease in 2012-13. These are just some of the facts published by the AIHW in their a snapshot of the latest statistics on...

More than 1 in 20 Australians have COPD and there were almost 60,000 hospitalisations for the disease in...
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Lung denervation the next COPD revolution?

Targeted lung denervation may be a potential new therapy for COPD authors of a first-in-human study say, but an expert says that while the study is interesting it's too early to get excited by the results. In patients with COPD parasympathetic pulmonary...

Targeted lung denervation may be a potential new therapy for COPD authors of a first-in-human study say, but an expert...
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COPD no more likely in Indigenous Australians

COPD is no more prevalent in Australian indigenous populations than non-indigenous, new research shows. Using the Burden of Lung Disease protocol the study of 704 Indigenous and non-indigenous Australians from the Kimberly region of WA found the prevalence...

COPD is no more prevalent in Australian indigenous populations than non-indigenous, new research shows. Using the Burden of Lung...
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New risk factor for COPD

A diet rich in whole grains, polyunsaturated fats and nuts can lower the risk of COPD by up to a third, a BMJ study reports. The study compared the AHEI-2010 diet scores of more than 120,000 US health professionals. A higher...

A diet rich in whole grains, polyunsaturated fats and nuts can lower the risk of COPD by up to a...
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Shorter steroid course okay for COPD flares: Cochrane

Shorter courses of systemic steroids are just as effective as conventional longer courses in treating COPD exacerbations, a Cochrane review finds.  The analysis of eight studies that included 582 people with COPD flares requiring hospitalisation found no differences between shorter...

Shorter courses of systemic steroids are just as effective as conventional longer courses in treating COPD exacerbations, a Cochrane...
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Vit D supplements prevent COPD exacerbations

Vitamin D supplements can protect COPD patients against moderate or severe exacerbation, but not upper respiratory infection, a randomised placebo study in Lancet Respiratory Medicine shows. Supplements were only protective in patients with a baseline level of less than...

Vitamin D supplements can protect COPD patients against moderate or severe exacerbation, but not upper respiratory infection, a randomised...
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Support keeps COPD patients active

Exercise support keeps COPD patients active. in the long term, a study finds. Patients randomised to a 12 week supported exercise programme kept more active at 15 months compared to patients receiving usual care....

Exercise support keeps COPD patients active. in the long term, a study finds. Patients randomised to a 12...