Respiratory medicine
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Respiratory medicine · Dec 2010
Randomized Controlled TrialBeclomethasone/formoterol in the management of COPD: a randomised controlled trial.
To evaluate the effect of beclomethasone/formoterol versus budesonide/formoterol (non-inferiority) and versus formoterol (superiority) in patients with severe stable chronic obstructive pulmonary disease (COPD). ⋯ Beclomethasone/formoterol (400/24 μg) treatment for 48 weeks improved pulmonary function, reduced symptoms compared to formoterol, was safe and well-tolerated in patients with severe stable COPD. Neither of the long-acting β2-agonist/inhaled corticosteroid combinations affected the low exacerbation rate seen in this population.
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Respiratory medicine · Dec 2010
Predictors of mortality in chest wall disease treated with noninvasive home mechanical ventilation.
The long-term evolution of patients with chest wall disease and chronic respiratory failure treated with noninvasive home mechanical ventilation (NIHMV) is poorly known. ⋯ Our results suggest that PaCO2 levels ≥50 mmHg at 1 month after starting noninvasive home mechanical ventilation and the presence of comorbid conditions are risk factors for mortality in patients with chest wall disease. The importance of early detection of suboptimal home ventilation as well as comorbidities is highlighted.
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Respiratory medicine · Dec 2010
Sensitivity of Lung Clearance Index and chest computed tomography in early CF lung disease.
It is widely accepted that CF lung disease starts before clinical symptoms become apparent or spirometry deteriorates. Computed chest tomography (CT) is the reference method for identifying structural changes in CF; however, radiation exposure limits its use as a monitoring tool. It has been suggested that the Lung Clearance Index (LCI) measured by Multiple Breath Washout (MBW) for assessing ventilation inhomogeneity is a more sensitive surrogate marker than spirometry allowing non-invasive monitoring of CF lung disease. ⋯ Results indicate that structural changes are unlikely if a normal LCI is measured. We speculate that serial measurements of the LCI for assessing ventilation inhomogeneity may help to identify early structural lung disease and help to reduce the individual cumulative radiation dose. The LCI may be a suitable surrogate marker for monitoring progression of CF lung disease and effect of treatment in both, clinical care and research settings.
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Respiratory medicine · Dec 2010
Multicenter StudyGlobal muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations.
Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with several modifiable (sedentary life-style, smoking, malnutrition, hypoxemia) and non-modifiable (age, co-morbidities, severity of pulmonary function, respiratory infections) risk factors. We hypothesise that most of these risk factors may have a converging and deleterious effects on both respiratory and peripheral muscle function in COPD patients. ⋯ Muscle dysfunction, adjusted by GOLD stage, is associated with an increased risk of hospital admissions due to acute episodes of exacerbation of the disease. Current exacerbations further deteriorate muscle dysfunction.