Respiratory medicine
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Respiratory medicine · Feb 2007
Randomized Controlled Trial Multicenter Study Comparative StudyRelative responsiveness of the Chronic Respiratory Questionnaire, St. Georges Respiratory Questionnaire and four other health-related quality of life instruments for patients with chronic lung disease.
Selection of heath-related quality of life (HRQL) instruments that are most responsive to changes in HRQL prevents investigators from drawing false-negative conclusions about the effectiveness of an intervention. The objective of this study was to compare the responsiveness of the Chronic Respiratory Questionnaire (CRQ), the St. Georges Respiratory Questionnaire (SGRQ) and four other HRQL instruments. ⋯ This study confirms that the CRQ and SGRQ are substantially more responsive than generic measures, and suggests particularly strong responsiveness for the self-administered CRQ.
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Respiratory medicine · Feb 2007
Randomized Controlled TrialInfluence of respiratory efforts on b2-agonist induced bronchodilation in mechanically ventilated COPD patients: a prospective clinical study.
Several in vitro studies have shown that at similar tidal volume (VT), bronchodilator delivery to target sites is significantly lower during controlled mechanical ventilation (CMV) than that during simulated spontaneous breathing. However, the influence of active respiratory efforts on the magnitude of b2-agonist induced bronchodilation in mechanically ventilated patients has not been examined. ⋯ Considering the use of propofol with its presumed bronchodilative properties as a shortcoming of our study, it is concluded that the magnitude of bronchodilation induced by salbutamol delivered by an MDI and a spacer device in mechanically ventilated COPD patients is not affected by the presence or absence of active respiratory efforts.
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Respiratory medicine · Feb 2007
Bronchoscopic diagnosis of pulmonary infiltrates in granulocytopenic patients with hematologic malignancies: BAL versus PSB and PBAL.
Treatment of patients with hematologic malignancies is often complicated by severe respiratory infections. Bronchoscopy is generally to be used as a diagnostic tool in order to find a causative pathogen. ⋯ Our results showed that modern bronchoscopic techniques such as PSB and PBAL did not yield better diagnostic results compared to BAL in granulocytopenic patients with hematologic malignancies and pulmonary infiltrates. In approximately half of the cases a presumptive diagnosis was made by bronchoscopic procedures.
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Respiratory medicine · Feb 2007
Case ReportsSubcutaneous emphysema secondary to pulmonary cavity in absence of pneumothorax or pneumomediastinum.
Subcutaneous emphysema is a common condition occurring after chest injury. It may also be observed in association with pneumothorax or pneumomediastinum as a result of pathological changes in the respiratory tract. Spontaneous subcutaneous emphysema in absence of pneumothorax or pneumomediastinum is rare. We report a case of spontaneous subcutaneous emphysema in isolation secondary to fibrocavitatory lesion in the chest along with review of the literature.
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Patients with asthma have intermittent or persistent airflow obstruction, most often manifested spirometrically by reduced forced expiratory volume in 1s (FEV(1)) and FEV(1)/vital capacity (VC) ratio. In some patients, the VC may be reduced by air trapping, with an increase in functional residual capacity (FRC) and residual volume (RV) (pseudorestriction). We have reported 12 asthmatic patients with reduced VC and no increase in RV, i.e., a true restrictive impairment [Gill et al. True restrictive impairment in bronchial asthma. Am J Respir Crit Care Med 1999:159:A652]. ⋯ True restrictive impairment was noted in at least 32 of 413 asthmatics (8%), consistent with previous observations in asthma and reactive airways dysfunction syndrome. This finding is not widely recognized and should not preclude the diagnosis of asthma, BD testing or appropriate therapy for asthma.