Respiratory medicine
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Respiratory medicine · Oct 2007
Multicenter StudyEpidemiology of acute lung injury and acute respiratory distress syndrome in The Netherlands: a survey.
The characteristics, incidence and risk factors for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may depend on definitions and geography. ⋯ The effect of definitions of ALI/ARDS on mechanical ventilation in the Netherlands is small. Nevertheless, the incidence of ALI/ARDS may be higher than in other European countries but lower than in the USA, and the incidence of ALI by LIS may overestimate compared to that by NAECC. Aspiration, pneumonia, sepsis and chronic alcohol abuse are major risk factors, largely independent of definitions.
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Respiratory medicine · Oct 2007
Multicenter StudyOccupational exposure and severe pulmonary fibrosis.
External agents, especially metal and wood dust, are believed to be risk factors for development of idiopathic pulmonary fibrosis (IPF). The aim of this case-control study was to investigate which occupational exposure types are associated with development of severe pulmonary fibrosis (PF), and especially IPF. ⋯ Exposure for birch and hardwood dust may contribute to the risk for IPF in men.
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Respiratory medicine · Oct 2007
Diagnostic accuracy of bronchoalveolar lavage samples in immunosuppressed patients with suspected pneumonia: analysis of a protocol.
Fast and accurate etiologic diagnosis of pneumonia in immunocompromised patients is essential for a good outcome. Utility of bronchoalveolar lavage (BAL) samples has already been established, but studies about them are scarce and limited to few countries. We aimed to evaluate the accuracy of a diagnostic protocol, emphasizing on local epidemiology, rapidity, and yield of different techniques. ⋯ Systematical study of BAL samples has a high diagnostic yield in our immunocompromised patients with suspected pneumonia. As economical and epidemiological conditions of regions are different, it should be tried everywhere.
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Respiratory medicine · Oct 2007
Comparative StudyCharacteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease.
Community-acquired pneumonia is a frequent event in the course of chronic obstructive pulmonary disease (COPD). The aim of the present study was to provide information on clinical and microbiological characteristics and outcome of community-acquired pneumonia in these patients, in a comparative study with the non-COPD population. ⋯ Community-acquired pneumonia in patients with COPD was associated with epidemiological and clinical particularities mainly related to the underlying disease but showed only minor differences in outcome parameters. Gram-negative bacilli and P. aeruginosa are potential pathogens that need to be considered.
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Respiratory medicine · Oct 2007
Comparative StudyHypoxia-induced pulmonary hypertension: different impact of iloprost, sildenafil, and nitric oxide.
Chronic alveolar hypoxia induces pulmonary hypertension, evident from elevated pulmonary artery pressure (PAP), pulmonary vascular resistance, right ventricular hypertrophy (RVH), and increased muscularization of the pulmonary vasculature. Additionally, the vasoconstrictor response to acute hypoxia (HPV) may be reduced in the remodeled vasculature. However, no direct comparison of different treatments on the various parameters characterizing pulmonary hypertension has been performed yet. Against this background, we compared the effects of inhaled NO, infused iloprost, a stable prostacyclin analogue, and oral sildenafil, a phosphodiesterase 5 inhibitor, on hypoxia-induced pulmonary hypertension. ⋯ We demonstrated (a) that the parameters characterizing hypoxia-induced pulmonary hypertension are not functionally linked, (b) that the downregulation of HPV under chronic hypoxia can be prevented by inhaled NO but not by sildenafil and iloprost, and (c) that iloprost is particularly effective in preventing vascular remodeling and sildenafil in preventing RVH.