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COPD-OSA Overlap Syndrome The recognition of co-existing OSA in COPD patients has important clinical relevance as the management of patients with overlap syndrome is different from COPDalone, and the survival of overlap patients not treated with nocturnal positive airway pressure is significantly inferior to those overlap patients appropriately treated.
COPD patients significant effects on survival have been shown for several interventions , including. high-frequency neuromuscular electrical stimulation should initiated as the main training modality during his Pulmonary rehabilitation programme, weight gain in underweight patients , non-invasive positive pressure ventilation in chronic hypercapnic patients and lung volume reduction surgery or endobronchial valve treatment in patients with upper-lobe predominant emphysema and poor exercise capacity
Blood Eosinophils and Response to Maintenance Chronic Obstructive Pulmonary Disease Treatment. Data from the FLAME Trial. indacaterol/glycopyrronium provides superior or similar benefits over salmeterol/fluticasone regardless of blood eosinophil levels in patients with COPD The incidence of pneumonia was higher in patients receiving salmeterol/fluticasone than indacaterol/glycopyrronium in both the <2% and ≥2% subgroups Indacaterol/glycopyrronium was significantly superior to salmeterol/fluticasone for the prevention of exacerbations
COPD (Chronic obstructive pulmonary diseases or chronic bronchitis) Assessment of the risk of death in this patients depend on their BODE Index B stand for BMI, O- Obstruction depending on FEV1, D - Shortness of breath OR dyspnea using MMRC scale , E - Exercise capacity, measured by 6 minutes walk test 6MWT.This index calculated using a scale of 0 to 3 for each parameter, depending on severity. except BMI scale different < 21 is 0 and more than >21 is 1. BODE score of 7 to 10 falls in the higher chance of mortality. Other factors have also been associated with increased moribidity and mortality in COPD , For example : acute exacerbation of COPD, Hospitalization, cardiac comorbidities Survival benefit are smoking cessation and lung volume reduction surgery in selected patients .Oxygen is beneficial who are hypoxemic on room air. None of the medications consistently demonstrated to prolong life.
Use of Biological Agents in Asthma: Despite advances in asthma initiatives, there continues to be a large population of patients with severe asthma whose condition remains uncontrolled despite the use of inhaled combination corticosteroids and long-acting beta-agonist treatment. For this population, which may include as many as one-third of all patients with asthma, biological therapy is often a treatment consideration in specialist clinics.
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