{"title":"Bronchiectasis Exacerbations: Clinical Relevance and Management","authors":"M. A. Mendes, A. Shoemark, J. Chalmers","doi":"10.23866/BRNREV:2017-0016","DOIUrl":"https://doi.org/10.23866/BRNREV:2017-0016","url":null,"abstract":"Bronchiectasis is a clinico-radiological syndrome with variable course. Some patients are stable for years and others develop frequent exacerbations, characterised by symptoms such as increased cough and change in sputum and/or systemic features. Bacterial infections are the most frequent recognised trigger, and consequently the majority of these events are treated with systemic antibiotics. As a major cause of morbidity, mortality and healthcare related costs, exacerbations have been used as primary outcomes in clinical trials of new treatments in bronchiectasis. Furthermore, implementing prevention strategies in patients at risk of future exacerbations is a major goal of bronchiectasis management. However, evidence-based knowledge on bronchiectasis exacerbations is limited and there is no specific licensed-treatment. Further studies using the recently developed consensus-based definition are needed to clarify the unanswered questions regarding the pathophysiology, prevention and treatment of bronchiectasis exacerbations. This review summarises the existing evidence and the gaps in our knowledge of bronchiectasis exacerbations. (BRN Rev. 2018;4(3):169-84) Corresponding author: James D. Chalmers, jchalmers@dundee.ac.uk","PeriodicalId":87223,"journal":{"name":"Barcelona respiratory network reviews","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41731008","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":"Chronic Obstructive Pulmonary Disease and Bronchodilator Response: Does it Matter?","authors":"D. Tashkin","doi":"10.23866/BRNREV:2017-0031","DOIUrl":"https://doi.org/10.23866/BRNREV:2017-0031","url":null,"abstract":"A positive bronchodilator response is found in most patients with moderate-to-very-severe chronic obstructive pulmonary disease (COPD), although its presence varies over time within the same patient as well as across patients depending, in part, on the severity of the pre-bronchodilator level of airflow obstruction. Consequently, the response to a bronchodilator does not reliably distinguish COPD from asthma, although a particularly marked response suggests the presence of asthma/COPD overlap. The absence of an acute response to a bronchodilator in COPD does not preclude a favourable long-term response to maintenance bronchodilator therapy, although it may predict a reduced magnitude of the long-term response. Bronchodilator responsiveness does not appear to define a distinct phenotype of COPD or predict most clinically meaningful outcomes. However, performing spirometry after a bronchodilator may have practical utility in clinical practice as an indicator of the maximum (“ceiling”) lung function that patients are capable of attaining as a goal to attempt to achieve with pharmacotherapy. (BRN Rev. 2018;4(3):200-13) Corresponding author: Donal P. Tashkin, dtashkin@mednet.ucla.edu","PeriodicalId":87223,"journal":{"name":"Barcelona respiratory network reviews","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676651","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":"Exercise Pulmonary Hypertension","authors":"H. Olschewski","doi":"10.21693/1933-088X-10.4.237","DOIUrl":"https://doi.org/10.21693/1933-088X-10.4.237","url":null,"abstract":"In healthy subjects, exercise causes a complex cardiovascular and ventilatory response that allows for a 20-fold increase of oxygen consumption as compared to rest. In pulmonary hypertension (PH) t...","PeriodicalId":87223,"journal":{"name":"Barcelona respiratory network reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68107431","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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