Active clinical trials for "Lung Diseases, Obstructive"

Background. Exercise intolerance is one of the most devastating consequences of chronic obstructive pulmonary disease (COPD). Abnormalities in peripheral muscle function such as weakness and reduction in oxidative enzyme activities are commonly found in these patients and may contribute to exercise intolerance.To evaluate whether a systemic weightlifting exercise may improve exercise capacity better than endurance training, or a combined training is more effective, the investigators compared three different training regimens, endurance training alone, systemic weightlifting training alone or a combination of both endurance and weightlifting training. Methods.36 patients with stable COPD will be evaluated before and after a 4 month training program. Each evaluation include a stepwise exercise test on an ergocycle up to the individual maximal capacity during which minute ventilation (VE), oxygen consumption (VO2), carbon dioxide production (VCO2), and arterial lactic acid concentration will be measured and the peripheral muscle strength will be determined with the one repetition maximum for eight different muscle groups. Percutaneous needle muscle biopsy from the M.vastus lateralis will be performed before and after the training period in order to determine the fiber-type proportions. Patients are assigned to one of the following three groups (1) endurance training consisted of 20 min exercise sessions on a calibrated ergocycle two times a week, with a target training intensity at 60% of individual maximum oxygen uptake, (2) systemic weightlifting training two times a week with eight different exercises, each session consist of 15 repetitions of each muscle group, (3) combination of endurance training and systemic weightlifting training. Statistical analysis. Baseline data for all patients enrolled in the study will be compared by one-way analysis of variance for the three study groups. Results before and after training will be analyzed by two- way analysis of variance.

The aim of this study is the first aim of a NIH project that consists of 3 aims. The first aim examines the acute effects of two high-quality milk proteins (casein vs. whey) on whole-body and muscle protein metabolism in COPD patients with severe loss of muscle mass and the effects of adding leucine. The principal endpoints will be the extent of stimulation of net whole body protein synthesis as this is the principal mechanism by which either amino acid or protein intake causes muscle anabolism. After determining the optimal nutritional formulation based on the first aim we will continue to work on the second and third aim where fish oil supplementation will be part of the nutritional intervention as well.

Care pathways are complex interventions to support the interprofessional team in the redesign of their care process. This international cluster randomised trial will analyse the impact of the development and implementation of care pathways on the interprofessional teamwork.

The purpose of this study is to evaluate the relative effectiveness of two different ways to teach subjects while hospitalized how to use respiratory inhalers and to follow-up after discharge home from the hospital to determine durability of the education. Teach-to-Goal (TTG) education employs instruction followed by patient "teach-back," then repeated cycles of learning and assessment until a skill is mastered. By contrast, Brief Intervention (BI) education only consists of providing the patient with verbal and written instruction. The investigators hypothesize that hospital-based TTG compared to BI increases a patient's ability to retain instructions on respiratory inhaler technique. The investigators will test this hypothesis separately for the MDI and Diskus® devices after discharge.

The main purpose of this study is to determine feasibility and effects of tai chi and mind-body breathing in patients with COPD.

On the basis of published data and investigators results indicating that systemic redox in balance may contribute to the peripheral muscle dysfunction in COPD patients, the investigators propose a study testing the effects of antioxidants and exercise training in COPD patients. The results may have major implication in the improvement of pulmonary rehabilitation benefits

Aims: To design a proactive implementation strategy for a chronic-disease-management-programme. To describe effects of the active implementation of a programme for COPD-patients measured on patient-related goals and use of health resources. To describe stakeholders' evaluation of the implementation. Materials and method: An intervention study with 3000 COPD-patients cluster-randomized after a bloc-randomization of their GP-practice. 18 GP-practices in Ringkøbing-Skjern-Municipality are randomized to receive an active implementation or to an "as usual" group. A neighboring municipality acts as "sleeping" control. With data from registers and a questionnaire-survey the effect on COPD-patients self reported-health, evaluation of health system and changes in distribution of health resources is analyzed. How health professionals perceive the implementation and how it influences their conception, interactions and culture is illustrated by interviews with stakeholders. We expect to see improved health related quality of life, enhanced evaluation of the health system and a more appropriate distribution of health resources in the intervention group.

This project will evaluate the translation of the Gold (the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease) COPD guidelines into primary care practice. During phase I, a needs assessment will evaluate barriers and facilitators to implementation of COPD guidelines into clinical practice through focus groups of primary care patients and providers. Using formative evaluation and feedback from the focus groups, three tools will be developed, refined and pilot tested. The effectiveness of the materials developed in phase I will be tested in phase II (a randomized clinical trial conducted with one year of intervention within non-academic primary care practices) regarding physician performance of COPD guideline implementation and improvement in the clinically relevant outcomes (appropriate screening, diagnosis and management of COPD) compared to usual care.

The purpose of the study is to investigate the tolerability and safety of AZD2423 in Patients with chronic obstructive pulmonary disease.

The purpose of this study is to characterize the clinical, physiologic, and molecular profiles of healthy participants, participants with mild, moderate, and severe asthma; and participants with moderate to severe Chronic Obstructive Pulmonary Disease (COPD).