Respiratory medicine
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Respiratory medicine · Jan 2009
Randomized Controlled Trial Multicenter Study Comparative StudyThe efficacy of tiotropium administered via Respimat Soft Mist Inhaler or HandiHaler in COPD patients.
Tiotropium, a once daily inhaled anticholinergic delivered via HandiHaler, provides bronchodilation for >24h and improves patient-centred outcomes. The Respimat Soft Mist Inhaler (SMI), a novel, propellant-free inhaler, has been developed and proposed as an alternative delivery device for use with tiotropium. ⋯ Tiotropium 5 microg Respimat SMI is comparable with tiotropium 18 microg HandiHaler in terms of efficacy, pharmacokinetics and safety. Respimat SMI is an effective alternative, multi-dose delivery device for tiotropium.
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Respiratory medicine · Jan 2009
Comparative StudyA technological advance comparing epithelial lining fluid from different regions of the lung in smokers.
Cigarette smoking causes inflammatory responses in the airways. However, not all smokers exhibit the development of airflow limitation. This study was designed to determine the implications of small airways inflammation in the development of airflow limitation in smokers by our newly explored method. ⋯ Moreover, in smokers with airflow limitation, 8-isoprostane levels in central or peripheral airways were not significantly correlated with FEV(1). However, IL-8 levels in peripheral airways were inversely correlated with FEV(1), though those levels in central airways were not. Thus our technique provides a novel method for ELF sampling from central or peripheral airways separately, and the preliminary evidence that support differences in oxidative stress and neutrophil chemotactic stimulus in these two locations.
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Respiratory medicine · Jan 2009
Randomized Controlled Trial Comparative StudyLung function and asthma control with beclomethasone and formoterol in a single inhaler.
Lung deposition is crucial for asthma treatment. However, there is no study comparing the potential role of lung co-deposition of combination therapy (inhaled corticosteroid and long-acting beta2 agonist) in the same inhaler. In moderate to severe asthmatics, an extra-fine hydrofluoroalkane combination of beclomethasone dipropionate and formoterol given via a single pressurised metered-dose inhaler (pMDI) was compared with beclomethasone dipropionate chlorofluorocarbon (CFC) pMDI and formoterol dry powder inhaler (DPI) given via separate inhalers. ⋯ In patients with moderate to severe asthma, beclomethasone dipropionate/formoterol in a single inhaler was as effective as beclomethasone dipropionate plus formoterol and superior to beclomethasone dipropionate alone in improving lung function. For the first time with a single inhaler, beclomethasone dipropionate/formoterol was significantly superior to separate components for asthma control.
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Respiratory medicine · Jan 2009
Comparative StudyImpulse oscillometry in COPD: identification of measurements related to airway obstruction, airway conductance and lung volumes.
Impulse oscillometry system (IOS) assesses pulmonary resistance and reactance. We set out to investigate which IOS measurements are related to airflow obstruction, airway conductance and lung volumes in chronic obstructive pulmonary disease (COPD). ⋯ IOS reactance measurements are more closely related than resistance measurements to other pulmonary function measurements in COPD patients. The IOS reactance measurements appear to be indicative of changes in pulmonary compliance caused by airflow obstruction.
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Respiratory medicine · Jan 2009
Comparative StudyInhaled corticosteroids and risk of lung cancer among COPD patients who quit smoking.
COPD is associated with an increased risk of lung cancer. We examined whether inhaled corticosteroids (ICS) used concomitantly with long-acting beta(2)-agonists (LABA) were associated with reduction in lung cancer risk in COPD patients. ⋯ Regular use of ICS, with and without LABA, may reduce the risk of lung cancer among former smokers with diagnosed COPD.