Approximately 25% to 40% of patients with chronic obstructive pulmonary disease (COPD) have the eosinophilic endotype. It is important to identify this group accurately because they are more symptomatic and are at increased risk for exacerbations and accelerated decline in forced expiratory volume in the 1st second. Importantly, this endotype is a marker of treat ment responsiveness to inhaled corticosteroid (ICS), resulting in decreased mortality risk. In this review, we highlight differences in the biology of eosinophils in COPD compared to asthma and the different definitions of the COPD eosinophilic endotype based on sputum and blood eosinophil count (BEC) with the corresponding limitations. Although BEC is useful as a biomarker for eosinophilic COPD endotype, optimal BEC cut-offs can be combined with clinical characteristics to improve its sensitivity and specificity. A targeted approach comprising airway eosinophilia and appropriate clinical and physiological features may improve identification of subgroups of patients who would benefit from biologic therapy or early use of ICS for disease modification.

INTRODUCTION: Cigarette smoking is a leading cause of morbidity and mortality, and has a deleterious effect on dermatological conditions, such as skin cancers, hidradenitis suppurativa and psoriasis. The study aimed to evaluate the efficacy of a pharmacist-led smoking cessation clinic in reducing cigarette smoking at a tertiary referral dermatology centre. We described the impact of this clinic to provide guidance on how such a model could be further improved and implemented more widely. METHODS: In this single-centre, retrospective study, 74 currently smoking patients who received counselling at a structured smoking cessation clinic between January 2010 and March 2013 were identified. Information on baseline demographic characteristics and detailed past medical history, including smoking history, was collected. Follow-up was conducted at two weeks and three months. RESULTS: At the first follow-up at two weeks, which was attended by 57 patients, 9 (15.8%) had stopped smoking and 26 (45.6%) showed reduction in the number of cigarette sticks smoked per day, with an average reduction of 4.1 cigarette sticks per day. However, a few patients also reported no change or increased number of cigarette sticks smoked per day following counselling. CONCLUSION A structured pharmacist-led smoking cessation clinic is effective and can be made a part of the holistic management of dermatological conditions.
Adolescent ; Adult ; Dermatology ; organization & administration ; Female ; Hidradenitis Suppurativa ; complications ; Humans ; Male ; Middle Aged ; Program Development ; Psoriasis ; complications ; Retrospective Studies ; Skin Neoplasms ; complications ; Smoking Cessation ; methods ; Tobacco Use Disorder ; therapy ; Treatment Outcome ; Young Adult

INTRODUCTION: Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with a high mortality rate, though outcomes of the different lung compliance phenotypes are unclear. We aimed to measure lung compliance and examine other factors associated with mortality in COVID-19 patients with ARDS. METHODS: Adult patients with COVID-19 ARDS who required invasive mechanical ventilation at 8 hospitals in Singapore were prospectively enrolled. Factors associated with both mortality and differences between high (<40mL/cm H RESULTS: A total of 102 patients with COVID-19 who required invasive mechanical ventilation were analysed; 15 (14.7%) did not survive. Non-survivors were older (median 70 years, interquartile range [IQR] 67-75 versus median 61 years, IQR 52-66; CONCLUSION COVID-19 ARDS patients with higher compliance on the day of intubation and a longitudinal decrease over time had a higher risk of death.
COVID-19 ; Humans ; Lung Compliance ; Phenotype ; Respiratory Distress Syndrome/therapy* ; SARS-CoV-2