The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Multicenter Study
Prevalence of residual excessive sleepiness in CPAP-treated sleep apnoea patients: the French multicentre study.
The percentage of compliant continuous positive airway pressure (CPAP)-treated apnoeic patients that continue to experience residual excessive sleepiness (RES) is unknown. RES was defined by an Epworth Sleepiness Scale (ESS) score of >or=11. In total, 502 patients from 37 French sleep centres using CPAP >3 h night(-1) attending their 1-yr follow-up visit were eligible. ⋯ The relative risk of having RES was 5.3 (95% CI 1.6-22.1), when ESS before treatment was >or=11. Scores of emotional and energy Nottingham Health Profile domains were two times worse in patients with RES. As 230,000 obstructive sleep apnoea patients are currently treated in France by continuous positive airway pressure, more than 13,800 of them might suffer from residual excessive sleepiness.
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The aim of the present systematic review was to assess the effectiveness and safety of real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with suspected or known bronchopulmonary carcinoma, as well as in other clinical indications presented by lymphatic adenopathies. A systematic review was carried out in November 2007 and updated in April 2008 using the main databases. Inclusion and exclusion criteria were applied to the papers retrieved. ⋯ None of the studies included in the present review reported important complications. Endobronchial ultrasound-guided transbronchial needle aspiration is a safe and highly accurate procedure for the examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy. The evidence is promising for sarcoidosis but is not sufficient for lymphoma.
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The present authors aimed to determine if the criteria for the diagnosis of chronic obstructive pulmonary disease (COPD) and its classification by severity as recommended by the Global Initiative for Chronic Obstructive Lung Disease are supported by measurements of respiratory health-related quality of life. A community-based sample of adults aged 25-75 yrs had pre- and post-bronchodilator spirometry and completed the St George's Respiratory Questionnaire (SGRQ). Loess scatter plot smoothers of the SGRQ versus post-bronchodilator forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) ratio and post-bronchodilator FEV(1) % predicted together with receiver operating characteristic (ROC) curve analysis were used to determine the relationship between spirometric variables and clinically important differences in the SGRQ score. ⋯ To represent a distance of 8 units on the SGRQ, the cut-off points for post-bronchodilator FEV(1) that delimit COPD severity stages were 80, 60 and 40% pred for mild, moderate and severe COPD, respectively. To diagnose chronic obstructive pulmonary disease the use of post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio of 0.7 is supported by health-related quality of life measurements. There may be advantages in using forced expiratory volume in one second cut-off points of 80, 60 and 40% predicted for the classification of mild, moderate and severe chronic obstructive pulmonary disease, respectively, similar to the approach recommended for asthma.
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The aim of the present study was to evaluate a method for calculating arterial values of pH, carbon dioxide tension (P(CO(2))) and oxygen tension (P(O(2))) from peripheral venous values. In total, 40 patients were studied. Arterial and peripheral venous blood were sampled at a department of respiratory diseases. ⋯ The present study evaluates a method for calculating arterial pH, carbon dioxide tension and oxygen tension from venous blood. It has been shown that arterial pH and carbon dioxide tension can be calculated precisely, and that oxygen tension can be calculated with reasonable precision in the vast majority of patients. This method might be useful in reducing the need for painful arterial punctures.