Abstract:
PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) imposes a large burden on the global population and even more so for the elderly who face significant obstacles in the diagnosis, management, and psychosocial effects of the disease. This review describes the current challenges and key points in the management of COPD in the elderly. RECENT FINDINGS:Lower limit rather than fixed cut off of the FEV1/FVC ratio can improve the diagnosis and better predict COPD mortality. High relative to standard dose influenza vaccination reduces confirmed cases of influenza overall and reduces hospitalizations in older nursing home residents. Simple interventions that include electronic health record tracking can significantly improve vaccination rates. Although many inhaler and nebulized medications are available for the elderly, the final regimen is usually determined by a combination of expense, issues with proper device use (from difficulty with coordination, hand grip, inspiratory flows or cognitive function) and the side effect profile. Fortunately, the switch to cheaper or better covered alternatives can be well tolerated with improvement in adherence and exacerbations of COPD. Finally, caution should be made against ageism, which may be a factor in the recommendation of rehabilitation or palliative care in the elderly COPD patient, as both are underused despite evidence of benefit. SUMMARY:Although care for the elderly COPD patient can be difficult, we summarize key points that the physician should be cognizant of to provide comprehensive care.
journal_name
Curr Opin Pulm Medjournal_title
Current opinion in pulmonary medicineauthors
Allen B,Aboussouan LSdoi
10.1097/MCP.0000000000000750subject
Has Abstractpub_date
2021-03-01 00:00:00pages
113-119issue
2eissn
1070-5287issn
1531-6971pii
00063198-202103000-00010journal_volume
27pub_type
杂志文章abstract::Patients infected with HIV are at risk of developing a variety of infectious and malignant pleuropulmonary disorders. The three most common causes of AIDS-related pleural effusions are parapneumonic effusions or empyemas, tuberculosis, and Kaposi's sarcoma. However, the relative frequency of these conditions varies fr...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199707000-00014
更新日期:1997-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Time to clinical worsening (TTCW) can be used to assess disease progression associated with pulmonary arterial hypertension (PAH). As a consequence, it is highly relevant to patients, clinicians, and regulatory agencies. The majority of clinical trials of PAH-specific drug therapies have included TTCW...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000370206.61003.7e
更新日期:2010-05-01 00:00:00
abstract::While the most recent trend in secondary prophylaxis after venous thromboembolism has been toward a prolonged duration, it has become obvious that individualization according to risk factors is crucial. Subgroup analyses in a long-term follow-up of a previous trial, as well as new trials on patients with idiopathic th...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200007000-00012
更新日期:2000-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Accurate diagnosis of interstitial lung diseases (ILDs) can be challenging, and a substantial percentage of ILD patients remain unclassifiable even after thorough assessment by an experienced multidisciplinary team. In this review, we summarize the recent literature on the definition, prevalence, diag...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000509
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:It is increasingly clear that asthma is not a single disease, but a disorder with vast heterogeneity in pathogenesis, severity, and treatment response. In this review, we discuss the present understanding of different asthma phenotypes and endotypes, and the prospects of personalized medicine for asth...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32835b10ec
更新日期:2013-01-01 00:00:00
abstract::In this review, three aspects of pleural disease are discussed. Although it was thought for many years that the origin of pleural fluid was the capillaries in the parietal or visceral pleura, recent evidence suggests that in many cases the origin of pleural fluid is the interstitial space of the lung. The interstitial...
journal_title:Current opinion in pulmonary medicine
pub_type: 社论,评审
doi:
更新日期:1995-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Survival for patients with cystic fibrosis (CF) continues to improve. The proportion of CF patients over the age of 18 years is nearly 50%, and care providers will need to better understand this patient population. Despite these improvements, young females continue to have a worse prognosis and lower ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328365af49
更新日期:2013-11-01 00:00:00
abstract:PURPOSE OF REVIEW:After the disappointing results of lung cancer screening trials conducted in the 1960s to the 1980s, a renewed interest in lung cancer screening emerged in the 1990s with the development of new technologies such as low-dose spiral CT. The literature regarding screening with biomarkers and CT continues...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000128432.79891.85
更新日期:2004-07-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current data on pathophysiologic mechanisms by which sleep-disordered breathing during pregnancy may cause harm, and explores biological pathways for associated adverse maternal and fetal outcomes, especially pregnancy-induced hypertension and gestational diabetes. RECENT FINDING...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833f0d55
更新日期:2010-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The use of noninvasive ventilatory support in patients with cystic fibrosis (CF) has increased exponentially over the past 2 decades. This review examines the current knowledge and considers potential future directions for use of noninvasive ventilation in CF patients. RECENT FINDINGS:Noninvasive ven...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000105
更新日期:2014-11-01 00:00:00
abstract::Pulmonary disease remains a major problem for the 33 million individuals who are thought to be infected with human immunodeficiency virus (HIV) worldwide. Respiratory infections are responsible for a large number of the 2 million deaths that occur each year in association with HIV disease. In countries where the major...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200005000-00013
更新日期:2000-05-01 00:00:00
abstract::Acute bronchitis in previously fit individuals is a common condition that is usually mild and self limiting. Chronic bronchitis remains a common cause of morbidity and mortality, and the cost to the nation due to lost working days and to health services is enormous. Cigarette smoking is the major etiologic factor, alt...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To review and compare the constellations of causes and consequences of the two current pandemics, Covid-19 and climate change. RECENT FINDINGS:There has been a transient counterbalancing, in which the response to Covid-19 has briefly mitigated pollution and greenhouse gasses. This divergence belies m...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/MCP.0000000000000756
更新日期:2021-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The Sleep Heart Health Study began in 1994 as a prospective cohort study of cardiovascular disease. The results of longitudinal analysis are not yet available, but numerous analyses of cross-sectional data have been published. This review provides an overview of study results so far. RECENT FINDINGS:...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328312ed61
更新日期:2008-11-01 00:00:00
abstract::The bronchiolitides can be categorized broadly as constrictive or proliferative, each with characteristic CT features. The cardinal CT signs of constrictive bronchiolitis are mosaic perfusion, enhanced on expiratory CT scan and variably associated with bronchiectasis and, less frequently, centrilobular branching struc...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199803000-00005
更新日期:1998-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Asthma is a chronic inflammatory disease in which changes in macrophage polarization have been shown to contribute to the pathogenesis. The present review discusses the contribution of changes in macrophage function to asthma related to polarization changes and elaborates on possible therapeutic strat...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000647
更新日期:2020-01-01 00:00:00
abstract::This review summarizes the recent literature published on the microbiology, diagnosis, and medical and surgical management of acute and chronic frontal sinus disease. Two retrospective studies investigated the microbiology of frontal sinusitis in patients that underwent sinus surgery. Streptococcus pneumoniae, Haemoph...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200305000-00003
更新日期:2003-05-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we highlight some of the developments achieved over the past 2 years in the field of novel antimicrobial compounds. RECENT FINDINGS:Modification of existing compound classes to create more powerful compounds capable of overcoming pathogen resistance and the introduction of completely ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200405000-00008
更新日期:2004-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Nowadays tuberculosis is becoming a worldwide problem, and according to the World Health Organization, which declared tuberculosis a global health emergency in 1993, each year 8 million people worldwide develop the active disease and almost 3 million die. RECENT FINDINGS:Due to this problem there is ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000219264.42686.c9
更新日期:2006-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) is caused by a mixture of small airway disease (obstructive bronchitis) and parenchymal lung tissue destruction (emphysema). The relative contributions of these two pathologic states vary from person to person. Having the ability to phenotype patients into ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32835ceefc
更新日期:2013-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Diagnosis of idiopathic interstitial pneumonias (IIPs) requires the exclusion of, among others, concomitant connective tissue diseases (CTDs), which may present as interstitial lung disease (ILD). This review focuses on the evaluation required to separate these entities through serology, although not ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283560840
更新日期:2012-09-01 00:00:00
abstract::It is usually assumed that upper airway pressure receptors mediate the reflexes involved in sleep apneas, but many other receptors may be involved, including those responding to chemical stimuli. The reflexes to upper airway negative pressure have been further studied, and the timing of their inputs shown to be import...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199811000-00013
更新日期:1998-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The use of inhaled corticosteroids is one of the most controversial issues in COPD pharmacotherapy. Experts disagree about the benefits and harms of ICS for patients with COPD, yet a majority of patients with COPD are being treated with inhaled corticosteroids. This is a review of the most recent lite...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200403000-00005
更新日期:2004-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Idiopathic pulmonary fibrosis (IPF) is a progressive, invariably fatal condition with a median survival from diagnosis of only 3 years. Despite improvements in disease understanding, challenges remain in establishing a diagnosis and predicting prognosis in individual patients. Furthermore, limited und...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328363f4b7
更新日期:2013-09-01 00:00:00
abstract::The pleural space in healthy humans was thought to contain a few milliliters of fluid, based on extrapolation from animal studies. However, because of the obvious technical difficulties in atraumatically retrieving such a small volume of fluid, the exact volume and cellular content of human pleural fluid has not been ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200107000-00002
更新日期:2001-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Malignant pleural effusion (MPE) is common. However, regardless of the differences between patients, their underlying cancer type, and pleural fluid characteristics, management options are often limited. These have not advanced significantly over the last 80 years since pleurodesis was first described...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283615b67
更新日期:2013-07-01 00:00:00
abstract:PURPOSE OF REVIEW:This review looks at what is currently known about liver disease in cystic fibrosis (CF) in light of the literature over the past year, and what the ongoing challenges are from a clinical and research perspective for the optimal management of cystic fibrosis liver disease (CFLD). RECENT FINDINGS:Pati...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32834b7f51
更新日期:2011-11-01 00:00:00
abstract::An important advance in our understanding of the pathophysiology of asthma has been the discovery that airway inflammation is not confined to severe asthma but also characterizes mild and moderate asthma. Inflammation in asthma may be the result of a peculiar type of lymphocytic inflammation whereby Th2 lymphocytes se...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200001000-00004
更新日期:2000-01-01 00:00:00
abstract::Interstitial lung diseases are characterized by disruption of the distal pulmonary parenchyma. The clinical history manifestations, cough and dyspnea, and physical exam manifestations, inspiratory crackles, are nonspecific. Pulmonary function testing aids in the evaluation and management of patients with interstitial ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200009000-00003
更新日期:2000-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Bronchial and bronchiolar abnormalities in interstitial lung diseases (ILDs) are an issue often underestimated. However, new interstitial patterns with bronchiolar involvement are being described and the concept is still evolving. The scope of this review is to introduce a comprehensive approach to ai...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328349ae94
更新日期:2011-09-01 00:00:00