The place of inhaled corticosteroids in the treatment of chronic obstructive pulmonary disease: a narrative review.

Abstract:

:Inhaled corticosteroids (ICSs) belong to the armament for treatment of chronic obstructive pulmonary disease (COPD) and as such, they are widely used in real life. This is a narrative review on evidence-based papers published in the English language listed in Medline between 1990 and March 2016 discussing ICS application in COPD. Recent meta-analyses clearly show that ICSs are able to decrease the rate of exacerbation and to delay the decline of lung function, although they do not prolong life, nor stop the progression of the disease. ICSs are included in guidelines for COPD treatment, exclusively in combination with bronch-15 odilators. However, adverse effects as pneumonia, cataracts, osteoporosis, etc. seem obvious. Newer studies show that patients with COPD are not a homogeneous population, and recently several phenotypes were identified, including asthma-COPD overlap syndrome (ACOS), among others. The efficacy of ICSs seems to be unequal for different subpopulations of patients with COPD and further research is needed to address a personalized approach in the treatment of COPD patients, and to 20 identify predictors for ICS treatment success. Usage of ICSs in patients with COPD needs to be précised especially in patients with COPD without asthma.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Andreeva-Gateva PA,Stamenova E,Gatev T

doi

10.1080/00325481.2016.1186487

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

474-84

issue

5

eissn

0032-5481

issn

1941-9260

journal_volume

128

pub_type

杂志文章,评审
  • The Medical Bookshelf.

    abstract::Books received are listed as space permits, and those of particular interest to our readers are reviewed. ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1985.11699151

    authors: Scott D

    更新日期:1985-10-01 00:00:00

  • Conventional therapy with insulin.

    abstract::When considering conventional therapy with insulin for patients who have type 2 diabetes mellitus, healthcare providers must weigh the advantages and disadvantages of 3 primary approaches to treatment. Understanding the pros and cons of the various options will help physicians more readily identify the treatment appro...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.11.2002.suppl21.112

    authors: Nattrass M

    更新日期:2002-11-01 00:00:00

  • Pelvic inflammatory disease. Current diagnostic criteria and treatment guidelines.

    abstract::Pelvic inflammatory disease (PID) is a common infection in women of reproductive age. PID is actually a spectrum of disease, beginning with cervicitis and progressing to endometritis and eventually salpingitis. Sequelae include ectopic pregnancy, infertility, chronic pelvic pain, hydrosalpinx, and tubo-ovarian abscess...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1993.11701600

    authors: Ault KA,Faro S

    更新日期:1993-02-01 00:00:00

  • Follow-up after therapy for prostate cancer. Treating the problems and caring for the man.

    abstract::With prostate cancer being diagnosed and treated in more than 300,000 men each year, the pool of long-term survivors is dramatically increasing. Because these patients are usually elderly, they are often receiving follow-up care for unrelated problems in a primary care setting. This offers the physician an excellent o...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.1996.09.73

    authors: Freedman A,Hahn G,Love N

    更新日期:1996-09-01 00:00:00

  • No ice, no butter. Advice on management of burns for primary care physicians.

    abstract::It is often difficult to determine the true extent of a burn, but most small thermal burns can be easily evaluated and managed by primary care physicians. In this article, the authors review the characteristics of different types of burns, describe those that require treatment in a burn center, and discuss appropriate...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Clayton MC,Solem LD

    更新日期:1995-05-01 00:00:00

  • Irritable bowel syndrome. A cost-effective approach for primary care physicians.

    abstract::Recognition and appropriate treatment of IBS can be challenging. A rational approach to management focuses on a positive diagnosis based on the characteristic pattern of symptoms and the exclusion of organic disorders. Dietary modification and pharmacologic therapy may be useful for relieving symptoms. Patient educati...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.1997.03.184

    authors: Harris MS

    更新日期:1997-03-01 00:00:00

  • Achieve control: a pragmatic clinical trial of insulin glargine 300 U/mL versus other basal insulins in insulin-naïve patients with type 2 diabetes.

    abstract:OBJECTIVE:This study aims to compare the effectiveness of insulin glargine 300 U/mL (Gla-300) with its accompanying patient support program with that of other basal insulin and available patient support programs in patients with type 2 diabetes (T2D) in a real-world setting in terms of achieving HEDIS (Healthcare Effec...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1080/00325481.2016.1241663

    authors: Oster G,Sullivan SD,Dalal MR,Kazemi MR,Rojeski M,Wysham CH,Sung J,Johnstone B,Cali AM,Wei LJ,Traylor L,Anhalt H,Hull M,Van Vleet J,Meneghini LF

    更新日期:2016-11-01 00:00:00

  • Suprapubic bladder puncture in a private pediatric practice.

    abstract::Suprapubic bladder puncture was performed 185 times in 126 girls in a private pediatric practice. Cultures of urine obtained by aspiration confirmed symptoms as indicative of urinary tract infection in 59% of instances and confirmed positive cultures of urine obtained by voiding in 57% of instances. Since suprapubic b...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1982.11716120

    authors: Simon G

    更新日期:1982-07-01 00:00:00

  • Arthritis associated with common viral infections: mumps, coxsackievirus, and adenovirus.

    abstract::Arthritis complicating the common viral infections--mumps, coxsackievirus, and adenovirus--can be enigmatic. Mumps arthritis is often difficult to identify, especially when parotitis is mild, because the arthritic syndrome generally follows complete clearing of salivary adenitis by one to two weeks. Migratory polyarth...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1980.11715487

    authors: Bayer AS

    更新日期:1980-07-01 00:00:00

  • Anorectal disorders. Five common causes of pain, itching, and bleeding.

    abstract::Hemorrhoids are a common source of anorectal symptoms, which are determined by their size. A helpful measure in small hemorrhoids is a high-fiber diet; in moderate lesions, ligature therapy is effective. Surgery should be reserved for large hemorrhoids. Anal fissures, probably caused by trauma to the anal canal during...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Metcalf A

    更新日期:1995-11-01 00:00:00

  • Drug management of stable angina pectoris.

    abstract::Nitroglycerin and long-acting nitrates are the pharmacologic mainstays of antianginal therapy, both for acute attacks and for prophylaxis. Propranolol is often effective for prophylaxis in patients incompletely helped by nitrates. A holistic approach is stressed. Appropriate drug use will effect marked improvement in ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1977.11714674

    authors: Richtsmeier TE,Preston TA

    更新日期:1977-11-01 00:00:00

  • Community-acquired pneumonia: An overview.

    abstract::Community-acquired pneumonia is still a significant cause of morbidity and mortality and is often misdiagnosed and inappropriately treated. Although it can be caused by a wide variety of micro-organisms, the pneumococcus, atypicals, such as Mycoplasma pneumoniae and Chlamydophila pneumoniae, Staphylococcus aureus and ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.2015.1074030

    authors: Mandell LA

    更新日期:2015-08-01 00:00:00

  • Intervention in family violence. A role for the physician-and for society.

    abstract::Contrary to long-standing mores, what goes on in the person's home is not always sacred. When family relationships break down and family members deal violently with various stresses and problems, intervention is in order. Certain changes in societal attitudes would help prevent the problem. Physicians-alone or working...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1982.11716255

    authors: Pelton CL

    更新日期:1982-11-01 00:00:00

  • Drug-induced jaundice. An uncommon but puzzling reaction.

    abstract::Drug-induced jaundice is relatively uncommon but can be a diagnostic puzzle. Because so many pharmaceutical classes and individual agents can produce jaundice, a thorough history of medications taken should be obtained from a patient presenting with jaundice. Jaundice usually resolves when the offending agent is disco...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1988.11700445

    authors: Garabedian-Ruffalo SM,Ruffalo RL

    更新日期:1988-10-01 00:00:00

  • The aging process.

    abstract::Preview Although no one theory on aging explains satisfactorily why or how this process occurs, we know that aging causes physiologic changes and a progressive decline of functional organ reserve. The implications of these changes are increasingly important as the elderly segment of the population grows. In this artic...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1996.11946121

    authors: Troncale JA

    更新日期:1996-05-01 00:00:00

  • Alcoholic liver disease. Treatment strategies for the potentially reversible stages.

    abstract::Even modest alcohol ingestion can increase the risk of steatosis, and long-term, excessive consumption can lead to alcoholic hepatitis and eventually cirrhosis. Most patients with clinically significant alcoholic liver disease have histologic findings typical of all three conditions. The only clearly beneficial treatm...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.1998.04.462

    authors: Hill DB,Kugelmas M

    更新日期:1998-04-01 00:00:00

  • Primary health care in the People's Republic of China.

    abstract::In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1981.11715824

    authors: Taylor RB

    更新日期:1981-08-01 00:00:00

  • Malnutrition, inflammation, and lipids in a cohort of dialysis patients.

    abstract:BACKGROUND:This study aimed to determine if there is an association between lipid levels, serum albumin, and C-reactive protein (CRP) levels in patients on dialysis. METHODS:Lipid profiles, albumin, and CRP levels were collected after a 12-hour fast from patients with end-stage renal disease (N = 105) who were on chro...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.3810/pgm.2010.05.2158

    authors: Bowden RG,Wilson RL

    更新日期:2010-05-01 00:00:00

  • Vasculitis. A practical approach to management.

    abstract::Vasculitis encompasses a wide variety of diseases. Because diagnosis may be difficult, a careful evaluation is essential, including a detailed patient history, thorough physical examination, and appropriate laboratory studies. Diagnosis is based on clinicopathologic features that permit identification of the condition...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1991.11700988

    authors: Semble EL,Chmelewski WL,Pisko EJ

    更新日期:1991-07-01 00:00:00

  • Oral anticoagulant therapy: practical aspects of management.

    abstract::Careful attention to the practical aspects of oral anticoagulant therapy can improve patient compliance and lessen the risk of bleeding complications. A variety of risk factors for bleeding associated with oral anticoagulant therapy have been defined and should be assessed before initiating therapy. Recent investigati...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Brigden ML

    更新日期:1996-06-01 00:00:00

  • Antibiotics: how to use them in 1977-1978. Cases 21, 22, and 23.

    abstract::Self-assessment case studies illustrating prudent selection of antimicrobial agents in septic shock following urinary catheterization, bacteremia and skin lesions in an immunocompromised patient, and endocarditis in a patient with a prosthetic heart valve. ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1978.11714791

    authors: Rahal JJ Jr,Simberkoff MS

    更新日期:1978-03-01 00:00:00

  • Drug-induced aseptic meningitis. Diagnosis leads to quick resolution.

    abstract::Drug-induced aseptic meningitis is a syndrome that should be considered in the differential diagnosis of acute and recurrent aseptic meningitis. It has been observed in all age-groups and can occur following the use of a wide spectrum of pharmaceutical agents. Presumptive diagnosis is made by demonstrating the resolut...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1991.11701123

    authors: Chaudhry HJ,Cunha BA

    更新日期:1991-11-15 00:00:00

  • Concomitant major vessel resection in pancreatic adenocarcinoma.

    abstract::Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association w...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.2015.1032180

    authors: Tsuchikawa T,Hirano S,Nakamura T,Okamura K,Tamoto E,Shichinohe T

    更新日期:2015-04-01 00:00:00

  • Patterns of naloxone use in hospitalized patients.

    abstract:OBJECTIVES:Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS:Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were adm...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.2017.1263139

    authors: Yung L,Lee KC,Hsu C,Furnish T,Atayee RS

    更新日期:2017-01-01 00:00:00

  • Containing methicillin-resistant S aureus. Surveillance, control, and treatment methods.

    abstract::In the past two decades, the prevalence of MRSA has increased in healthcare facilities in many countries around the world. The organism, which has caused nosocomial outbreaks, also has become endemic in many hospitals and long-term care facilities. Recently, reports of community-acquired MRSA in persons without known ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2001.10.1043

    authors: Simor AE

    更新日期:2001-10-01 00:00:00

  • The epidemic challenge of chronic kidney disease in older patients.

    abstract::Since the introduction of estimated glomerular filtration rate (GFR), the number of patients with chronic kidney disease (CKD) has considerably increased. This is particularly true for elderly patients as the majority have a low GFR. Chronic kidney disease has a significant impact on a patient's outcome. We have revie...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2008.11.1943

    authors: Abdelhafiz AH,Tan E,El Nahas M

    更新日期:2008-11-01 00:00:00

  • Middle ear symptoms while flying. Ways to prevent a severe outcome.

    abstract::In an era when air travel is commonplace, middle ear block is not unusual. Educating patients about the simple techniques they can perform at the first signs of a problem may save a business trip or vacation from becoming a trip to the emergency department and a train ride home. The most important preventive measure i...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Brown TP

    更新日期:1994-08-01 00:00:00

  • Thyroid dysfunction in the severely ill and elderly.

    abstract::Preview Manifestations of thyroid dysfunction may be totally misleading in severely ill and elderly patients, often confounding clinical diagnosis. To prevent undue morbidity and mortality in these patients, appropriate selection and accurate interpretation of thyroid function tests are crucial. In this article, Dr Is...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1993.11945709

    authors: Isley WL

    更新日期:1993-09-01 00:00:00

  • Percutaneous endoscopic gastrostomy. What are the benefits, what are the risks?

    abstract::One way to nutritionally support patients who cannot swallow is to administer formula directly into the stomach. Placing a gastrostomy tube percutaneously using endoscopy avoids the risks of general anesthesia and wound healing that accompany surgical gastrostomy. Although certain conditions (eg, sepsis, coagulation d...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1992.11701183

    authors: DiLorenzo J,Dalton B,Miskovitz P

    更新日期:1992-01-01 00:00:00

  • Hematuria. When is it cause for alarm?

    abstract::The urine of less than 3% of healthy persons shows more than three red cells per high-power field, which is about the limit of sensitivity of test strips for occult blood. Even minimal hematuria may herald serious problems and must be investigated. Common causes include infection, urethritis, and urethrotrigonitis (25...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1987.11699979

    authors: Brown DC

    更新日期:1987-09-15 00:00:00