BACKGROUND International guidelines recommend long-acting bronchodilators in patients who remain symptomatic despite adequate treatment with short-acting bronchodilators. The purpose of this study is to estimate the effect of tiotropium, a long-acting anticholinergic inhalant, on exacerbation and hospitalisation frequency. METHODS Electronic databases (Medline, Embase, INAHTA, CRD databases, ...

OBJECTIVE To evaluate whether the use of inhaled albuterol via a metered-dose inhaler with a large-volume spacer with antistatic treatment modifies the bronchodilator test results when compared with the usual technique (no spacer). METHODS A prospective study involving 24 patients, 18-45 years of age, clinically suspected of having asthma, and under treatment at the Outpatient Pulmonary Clini...

BACKGROUND Bronchodilator response in patients with asthma is evaluated based on post-bronchodilator increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). However, the need for additional parameters, mainly among patients with severe asthma, has already been demonstrated. METHODS The aim of this study was to evaluate the usefulness of vital capacity (VC) a...

As many as 10 million Americans have chronic obstructive pulmonary disease and as a consequence experience disabling symptoms, high cost of care, and substantial mortality. Several new approaches are being investigated for possible benefit in managing (or even reversing) chronic obstructive pulmonary disease. This article reviews 4 new approaches that are either in or close to phase III trials:...

Asthma is a chronic inflammatory condition of the airway, characterised by the presence of airflow obstruction which is variable over short periods of time, or is reversible with treatment. Medication comprises of bronchodilators, corticosteroids and anticholinergic drugs. Most asthma drugs are inhaled using various forms of inhalers or nebulizers. Inhaled drugs must be used regularly. The effe...

The term phenotype in the field of COPD is defined as "a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes". Among all phenotypes described, there are three that are associated with prognosis and especially are associated with a different response to currently available therapies. There phenotypes...

Asthma is a chronic inflammatory disorder of the airways that is a major global burden on both individuals and healthcare systems. Despite guideline-directed treatment, a significant proportion of patients with asthma do not achieve control. This review focuses on the potential use of long-acting anticholinergics as bronchodilators in the treatment of asthma, with results published from clinica...

BACKGROUND Inhaled anticholinergics as single agent bronchodilators (or in combination with beta(2)-agonists) are one of the several medications available for the treatment of acute asthma in children. OBJECTIVES To determine the effectiveness of only inhaled anticholinergic drugs (i.e. administered alone), compared to a control in children over the age of two years with acute asthma. SEARC...

We read with interest the recent study by Fish et al (August 2001)1 showing that adding salmeterol to inhaled corticosteroid achieved superior control as compared to adding montelukast. However it is likely that the results were biased toward the long-acting 2-agonist as patients were required as an inclusion criteria to have at least 12% increase in FEV1 in response to albuterol. It is therefo...

Bronchiolitis is the commonest cause of hospital admission in infancy. Severity varies from mild and self-limiting through to respiratory failure requiring intensive care and ventilation. many viruses cause bronchiolitis, the commonest being respiratory syncytial virus (rSV). Supportive care is the mainstay of treatment, with emphasis on fluid replacement and oxygen therapy. agents with evidenc...