Difficulties in differential diagnosis of COPD and asthma in primary care

Miravitlles, Marc; Andreu, I Romero; Romero, Yolanda; Sitjar, Salvador; Altés, Andreu; Antón, Ester

doi:10.3399/bjgp12x625111

Cited by 86 publications

(67 citation statements)

References 27 publications

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“…The overlap COPD-asthma phenotype has been defined as an incompletely reversible obstruction of airflow accompanied by symptoms or signals of increased reversibility of the obstruction [19,20], or as the diagnosis of COPD in a patient with a history of previously diagnosed asthma before the age of 40 years [21]. These patients share characteristics of both diseases and represent a challenge in differential diagnosis, particularly in primary care [22]. The prevalence of this mixed phenotype is unknown, but there are different estimates of its importance in the context of COPD.…”

Section: Which Are the Relevant Clinical Phenotypes?mentioning

confidence: 99%

Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice

Soler-Cataluña²,

et al. 2012

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The new Global Initiative for Chronic Obstructive Lung Disease update has moved the principles of treatment of stable chronic obstructive pulmonary disease (COPD) forward by including the concepts of symptoms and risks into the decision of therapy. However, no mention of the concept of clinical phenotypes is included. It is recognised that COPD is a very heterogeneous disease and not all patients respond to all drugs available for treatment. The identification of responders to therapies is crucial in chronic diseases to provide the most appropriate treatment and avoid unnecessary medications. The classically defined phenotypes of chronic bronchitis and emphysema, together with the newly described phenotypes of overlap COPD-asthma and frequent exacerbator, allow a simple classification of patients that share clinical characteristics and outcomes and, more importantly, similar responses to existing treatments.These clinical phenotypes can help clinicians identify patients that respond to specific pharmacological interventions. For example, frequent exacerbators are the only subjects with an indication for anti-inflammatory treatment in COPD. Among them, those with chronic bronchitis are the only candidates to receive phosphodiesterase-4 inhibitors. Patients with overlap COPDasthma phenotype show an enhanced response to inhaled corticosteroids and infrequent exacerbators should only receive bronchodilators. These well-defined clinical phenotypes could potentially be incorporated into treatment guidelines.

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Section: Which Are the Relevant Clinical Phenotypes?mentioning

confidence: 99%

Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice

Soler-Cataluña²,

et al. 2012

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“…(5) Differentiating between asthma and COPD is important, as the treatment algorithms, choices and objectives differ in each condition. (6) In persistent asthma, inhaled steroids are the basis of treatment, while in COPD, bronchodilators are the mainstay of treatment, with inhaled steroids only recommended in patients with severe COPD.…”

Section: Misdiagnosis Of Copdmentioning

confidence: 99%

Does this patient really have chronic obstructive pulmonary disease?

Li¹,

How²,

Tee³

2015

smedj

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“…Relevant examples are the use of thermal flow sensors in spirometry for monitoring expiratory and inspiratory gases to estimate some indexes to diagnose asthma and chronic obstructive pulmonary diseases [45]: Laghrouche et al realized a hot wire sensor, made of a thin polycrystalline silicon film, with a response time strongly dependent on hot wire size (from 367 µs down to 100 µs), a low power consumption (<10 mW) and with a wide measurement range (up to 179 L·min ) [46]; Hedrich et al described a thermal flow sensor for spirometric devices for long-term monitoring of patients in home-care applications. The sensor allowed diagnosing sleep-specific respiration disturbances that are a risk factor for basic cardiovascular diseases [47].…”

Section: Thermal Flow Sensors: Biomedical Applicationsmentioning

confidence: 99%

Micromachined Flow Sensors in Biomedical Applications

Silvestri

Schena

2012

Micromachines

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Application fields of micromachined devices are growing very rapidly due to the continuous improvement of three dimensional technologies of micro-fabrication. In particular, applications of micromachined sensors to monitor gas and liquid flows hold immense potential because of their valuable characteristics (e.g., low energy consumption, relatively good accuracy, the ability to measure very small flow, and small size). Moreover, the feedback provided by integrating microflow sensors to micro mass flow controllers is essential to deliver accurately set target small flows. This paper is a review of some application areas in the biomedical field of micromachined flow sensors, such as blood flow, respiratory monitoring, and drug delivery among others. Particular attention is dedicated to the description of the measurement principles utilized in early and current research. Finally, some observations about characteristics and issues of these devices are also reported.

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Difficulties in differential diagnosis of COPD and asthma in primary care

Cited by 86 publications

References 27 publications

Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice

Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice

Does this patient really have chronic obstructive pulmonary disease?

Micromachined Flow Sensors in Biomedical Applications

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