Respiratory medicine
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Respiratory medicine · Feb 2009
Echocardiography and brain natriuretic peptide as prognostic indicators in idiopathic pulmonary fibrosis.
Pulmonary hypertension (PH) in idiopathic pulmonary fibrosis (IPF) is associated with poor prognosis. Recently echocardiography and brain natriuretic peptide (BNP) have been used as non-invasive markers for PH suggesting that they may also be used as markers for survival. The aim of this study was to evaluate the clinical usefulness of echocardiography and BNP by analyzing their association with survival. ⋯ Although both BNP level and PH by echocardiography are clinically useful non-invasive and easily repeatable markers of prognosis, BNP level seems to be better.
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Respiratory medicine · Feb 2009
Randomized Controlled TrialImpact of volume targeting on efficacy of bi-level non-invasive ventilation and sleep in obesity-hypoventilation.
Volume targeting by bi-level positive pressure ventilation (BPPV) has recently been made available by several manufacturers for home care ventilators. Although it may improve nocturnal ventilation, we hypothesized that increased pressure swings related to volume targeting may have a deleterious effect on sleep structure and patient comfort. ⋯ In stable patients treated by BPPV for obesity-hypoventilation, volume targeting improved control of nocturnal hypoventilation at the expense of a slight decrease in objective and subjective sleep quality, and comfort of ventilation.
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Respiratory medicine · Feb 2009
Multicenter StudyEpidemiology of community-acquired pneumonia in older adults: a population-based study.
This study assessed incidence, aetiology, clinical outcomes and risk factors for community-acquired pneumonia (CAP) in older adults. ⋯ CAP remains a major cause of morbidity and mortality in older adults. Incidence rates in this study largely doubled prior rates reported in Southern European regions.
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Respiratory medicine · Feb 2009
Impact of pulmonary hypertension on gas exchange and exercise capacity in patients with pulmonary fibrosis.
Pulmonary hypertension is a relevant interceding morbidity in patients with pulmonary fibrosis that has significant impact on exercise tolerance and outcome. The aim of this study was to further characterize the exercise intolerance, dyspnoea and ventilatory inefficiency of patients with pulmonary fibrosis in the presence or absence of pulmonary hypertension via cardiopulmonary exercise testing. Thirty-four patients underwent pulmonary function testing, symptom-limited exercise testing on a bicycle and dyspnoea evaluation according to the BORG scale. ⋯ In addition, the increased ventilatory requirements significantly influenced the extent of dyspnoea in patients with pulmonary hypertension. We conclude that pulmonary hypertension has a significant impact on exercise capacity and dyspnoea in patients with interstitial lung disease (ILD). The further impairment of exercise capacity as well as the extent of dyspnoea in patients with interceding PHT is attributable to a significantly impaired ventilatory inefficiency.