Respiratory medicine
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Respiratory medicine · Feb 2003
Randomized Controlled Trial Clinical TrialLongitudinal trends in exercise capacity and health status after pulmonary rehabilitation in patients with COPD.
Pulmonary rehabilitation (PR) programmes produce initial improvements in exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). However, there is limited data on the longer term effects of PR. This study has examined whether the initial benefits gained in exercise tolerance and health status may be maintained after a 1-year follow-up programme. ⋯ At 1 year there was a significant difference between the Exercise and Control groups in terms of exercise tolerance due to a considerable decline experienced by the Control group. However, neither group had maintained improvements in health status at 1 year. Further study is required to assess whether benefit may be sustained for a longer period using alternative follow-up strategies.
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Respiratory medicine · Feb 2003
Not 15 but 50% of smokers develop COPD?--Report from the Obstructive Lung Disease in Northern Sweden Studies.
The prevalence of chronic obstructive pulmonary disease (COPD) according to guidelines of today seems considerably higher than has been reported also in recent literature. ⋯ In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, and it was 14% according to the GOLD criteria. Fifty percent of elderly smokers had developed COPD. The large majority of subjects having COPD were symptomatic, while the proportion of those diagnosed as having COPD or similar diagnoses was small.
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Respiratory medicine · Feb 2003
Effects of PEEP on inspiratory and expiratory mechanics in adult respiratory distress syndrome.
The purpose of the present study was to assess the mechanical behavior of the respiratory system separately during inspiration and expiration in adult respiratory distress syndrome (ARDS) and the influence of PEEP on any phasic variations ofthe mechanical respiratory parameters. Airways pressure (P), flow (V), and volume (V) signals were recorded in nine patients with ARDS and 10 patients without known respiratory disorder (control group). All patients were artificially ventilated at three levels of positive end-expiratory pressure (PEEP): 0, 5, and 10 hPa. ⋯ In the ARDS group expiratory Ers (ErsEXP=45.58 +/- 4.24 hPa/L) was substantially higher (p<0.01) than inspiratory Ers (ErsINSP=36.76 +/- 2.55) with a marked effect of applied PEEP in diminishing the difference between ErsEXP and ErsINSP (p<0.01). For the ARDS group inspiratory Rrs (RrsINSP) decreased significantly with increasing PEEP (PEEP=0: RrsINSP=16.43, PEEP=10: RrsINSP=13.28, p<0.01). The found differences between ErsEXP and ErsINSP could be attributable to an influence of mechanical ventilation by positive airway pressure on pulmonary edemaand interstitial fluid during the inspiratory phase of the respiratory cycle.