Clinics in chest medicine
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Accurate diagnosis is essential for effective treatment. After history-taking, the physical examination is second in importance in assessing a pulmonary patient. The time-honored sequence of inspection, palpation, percussion, and auscultation is appropriate. ⋯ Its appropriate use improves medical practice and reduces costs. Improvements in sound recording and analysis techniques have spurred a renewed interest in lung sounds and their meaning. This is likely to lead to better understanding of what we hear, and perhaps to the development of new noninvasive diagnostic and monitoring techniques.
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Diaphragmatic dysfunction is an important entity, as it can cause severe dyspnea, ventilation-perfusion abnormalities, and ventilatory failure. The most frequent and important dysfunctions are diaphragmatic weakness, incoordination between the diaphragm and other respiratory muscles, fatigue, and paralysis. Methods for the diagnosis of dysfunction are reviewed and specific dysfunctions are briefly discussed with methods for their evaluation.
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This review assesses the role of controlled breathing techniques (breathing training) and chest physical therapy (PT) in the management and rehabilitation of patients with chronic obstructive pulmonary disease (COPD). The review focuses on pursed lip breathing, the head-down and bending forward postures, slow deep breathing, and diaphragmatic breathing exercises as methods of breathing training, and on postural drainage, chest percussion and vibration, and controlled cough as techniques of chest PT. These modalities may be beneficial in selected patients with COPD.
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Home oxygen therapy has been shown to prolong life in patients with hypoxemic chronic obstructive lung disease. Patients who are hypoxemic when stable (Po2 less than 55 torr or Po2 55 to 59 torr with evidence of cor pulmonale or polycythemia) should be so treated, with oxygen supplied as continuously as possible.
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Clinics in chest medicine · Sep 1986
ReviewThe pharmacology of respiratory depressants and stimulants.
This article reviews the pharmacology and respiratory actions of depressants and stimulants, and the use of these drugs in the management of dyspnea, respiratory failure, and sleep apnea syndrome.