The clinical respiratory journal
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Comparative Study
Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance.
To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs. ⋯ Different degrees of immunologic and fibroelastotic airway remodeling processes occur in the major types of IIPs with impact on physiological tests and survival.
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Comparative Study
COPD 'diagnosis' based on spirometric reference equations.
Chronic obstructive pulmonary disease (COPD) is suspected if the ratio between forced expired volume in 1 s (FEV(1)) and forced vital capacity is below 0.7 after bronchodilatation, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). As this ratio varies with age and gender, the lower limit of normality (LLN) of appropriate reference equations appears more adequate. ⋯ The GOLD criterion is inadequate because of substantial overestimation in 60-year-old never-smokers. LLNs of the various reference equations are unreliable because of obvious lack of consistency. Spirometric criteria for airway obstruction, and suspicion of COPD, therefore need to be revised.
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Obstructive sleep apnoea syndrome (OSAS) is a prevalent condition that covaries with cardiovascular complications and most likely with arterial hypertension and diabetes mellitus. ⋯ The diagnosis of OSAS should be performed with a polygraph, and the first-line treatment of moderate to severe OSAS is CPAP. Lastly, compliance for this treatment should be optimised with regular clinical controls.
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Requirements for diagnostic tests include high validity and good repeatability. ⋯ When designing a study to examine a diagnostic test, the following principles should be followed. First, the order of performance of the diagnostic test and the gold standard in repeated measurements should be randomised. Second, in repeated measurements, the test situations should be equal. Third, the technicians performing the tests should be blinded to the data obtained in the other test or to the result of the gold standard. A pilot study is recommended before conducting the study to examine the diagnostic test.
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The role of inhaled corticosteroids (ICS) on disease progression in asthmatic children is not yet clear. ⋯ One-fifth of young children with recurrent bronchial obstruction had received inhaled corticosteroids by age 2 years. Lung function appeared to improve in children using ICS from the start of symptoms of OAD until 2 years of age, mostly in children with the longest duration of treatment. However, use of ICS during the first 2 years of life in children with OAD did not reduce asthma present 8 years later. A scoring system based on severity and frequency of OAD during the first 2 years of life predicted current asthma at 10 years of age. One in five 10-year-old children in the city of Oslo at some time had asthma.