{"title":"Does the presence of panic attacks in C.O.P.D. heighten awareness of dyspnea?","authors":"","doi":"10.1016/j.rmedu.2009.10.004","DOIUrl":"https://doi.org/10.1016/j.rmedu.2009.10.004","url":null,"abstract":"","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"5 3","pages":"Pages 81-82"},"PeriodicalIF":0.0,"publicationDate":"2009-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2009.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136401113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What are the long-term pulmonary sequelae of bronchopulmonary dyplasia in adult survivors?","authors":"","doi":"10.1016/j.rmedu.2009.10.007","DOIUrl":"https://doi.org/10.1016/j.rmedu.2009.10.007","url":null,"abstract":"","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"5 3","pages":"Pages 85-86"},"PeriodicalIF":0.0,"publicationDate":"2009-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2009.10.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136401114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lansoprazole reduce frequency of COPD exacerbations in older patients","authors":"","doi":"10.1016/j.rmedu.2009.10.006","DOIUrl":"https://doi.org/10.1016/j.rmedu.2009.10.006","url":null,"abstract":"","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"5 3","pages":"Page 84"},"PeriodicalIF":0.0,"publicationDate":"2009-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2009.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136401278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diabetes and metabolic dysfunction in COPD","authors":"J.R.H. Archer, E.H. Baker","doi":"10.1016/j.rmedu.2009.10.001","DOIUrl":"10.1016/j.rmedu.2009.10.001","url":null,"abstract":"<div><p><span>Diabetes mellitus and metabolic syndrome are common </span>in patients<span><span> with chronic obstructive pulmonary disease (COPD). </span>Metabolic disorders are associated with worse cardiovascular and pulmonary outcomes in COPD patients. This review will consider the prevalence, detection and management of metabolic disorders in COPD.</span></p><p><span><span>Diabetes mellitus is more common in stable COPD patients than in matched controls. COPD may directly increase insulin resistance through effects of chronic inflammation<span> on insulin receptor signalling and through chronic </span></span>hypoxia<span> and systemic corticosteroid treatment<span>. COPD patients with diabetes have increased risk of pulmonary infection, structural lung damage, hospitalisation and death. Management of diabetes in COPD should follow treatment guidelines for type 2 diabetes. However oral </span></span></span>hypoglycaemic<span> treatment may need to be modified in those with respiratory failure, cachexia or heart failure.</span></p><p><span><span>Glucose tolerance deteriorates during COPD exacerbations due to </span>physiological stress<span><span><span> of acute illness and to increased inflammation, acidosis<span> and corticosteroid dose. Acute hyperglycaemia during COPD exacerbations is associated with prolonged hospital stay, </span></span>NIV failure and increased risk of death. There is little evidence to guide management of acute hyperglycaemia in COPD, however attention should be given to nutrition and to minimising corticosteroid dose. Intravenous insulin to maintain </span>blood glucose 8–10</span></span> <!-->mmol.L<sup>−1</sup> may also be of therapeutic value.</p><p>Insulin resistance commonly occurs with obesity, dyslipidaemia<span> and hypertension. Together these make up the ‘metabolic syndrome’, which is a major determinant of cardiovascular morbidity and mortality. Coordinated management of diverse aspects of the metabolic syndrome is essential to optimise cardiovascular outcomes. Retrospective cohort and population studies have found that use of statins, ACE inhibitors<span><span> and angiotensin II receptor blocker by COPD patients is associated with improvement in </span>pulmonary function and exercise capacity and reduction in exacerbations and COPD-related mortality. These observations need to be confirmed in large interventional studies.</span></span></p></div>","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"5 3","pages":"Pages 67-74"},"PeriodicalIF":0.0,"publicationDate":"2009-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2009.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87627220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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