Respiration; international review of thoracic diseases
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Obstructive sleep apnoea syndrome (OSAS) has been suggested to be an independent risk factor for non-alcoholic fatty liver disease (NAFLD), possibly via intermittent hypoxia that influences blood pressure, lipid levels and insulin resistance, factors themselves known to cause NAFLD. In observational studies, OSAS has been associated with elevated levels of liver enzymes. Continuous positive airway pressure (CPAP) is the treatment for OSAS, but the effects of CPAP on liver enzymes have not been studied in a randomized controlled trial. ⋯ Four weeks of active CPAP has no beneficial effect on aminotransferase levels when compared to sub-therapeutic CPAP in patients with OSAS. Therefore, CPAP does not seem to improve biochemical markers of potential NAFLD in OSAS patients.
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Clinical Trial
Vibration response imaging as a new tool for interventional-bronchoscopy outcome assessment: a prospective pilot study.
In many patients, the benefit of interventional bronchoscopy cannot be appropriately objectified. ⋯ Obstruction location and procedure outcome were reliably identified according to specific patterns of lung images. VRI proved at least as good as standard tests in locating CAO and has the potential for becoming a valuable complementary tool in evaluating treatment outcome in patients with CAO. If our results are confirmed by further studies, VRI may replace PFT or imaging procedures in cases in which such tests cannot be performed or are not readily available at the time of the intervention.
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Comparative Study
Home non-invasive mechanical ventilation and long-term oxygen therapy in stable hypercapnic chronic obstructive pulmonary disease patients: comparison of costs.
A cost analysis of nocturnal non-invasive ventilation (NNV) in stable chronic obstructive pulmonary disease (COPD) patients would be helpful in decision making, when the balance between the increased demand and the availability of resources should be checked. ⋯ The present report suggests that long-term management with addition of non-invasive ventilation does not increase costs compared with the usual LTOT regimen: the hospital-related costs were reduced when using the ventilator in these hypercapnic COPD patients.
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Comparative Study
Comparison of 8-isoprostane and interleukin-8 in induced sputum and exhaled breath condensate from asymptomatic and symptomatic smokers.
Markers of airway inflammation and oxidative stress have been mainly investigated in moderate/severe chronic obstructive pulmonary disease (COPD) or during its exacerbation. They have not been compared in noninvasive specimens such as exhaled breath condensate (EBC) and induced sputum in healthy nonsymptomatic smokers or in those who have symptoms and are at risk for COPD development. ⋯ The levels of both potential markers were clearly higher in the induced sputum than in EBC. The results point to an advantage of induced sputum over EBC for assessing the degree of airway oxidative stress and inflammation in smokers with a potential risk for COPD development.
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Specimens from transbronchial lung biopsies lack sufficient quality due to crush artifact and are generally too small for diagnosis of diffuse lung diseases. Flexible cryoprobes have been shown to be useful in therapeutic bronchoscopy. We introduce a novel technique for obtaining lung biopsies bronchoscopically, using a flexible cryoprobe. ⋯ Transbronchial cryobiopsy is a novel technique which allows to obtain large biopsy samples of lung parenchyma that exceed the size and quality of forceps biopsy samples. Prospective trials are needed to compare this technique with surgical lung biopsy for diagnosis of diffuse lung diseases.