Respiratory medicine
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Respiratory medicine · Mar 2011
Quantitative CT measures of emphysema and airway wall thickness are related to D(L)CO.
There is limited knowledge on the relationship between diffusing capacity of the lung for carbon monoxide (D(L)CO) and quantitative computed tomography (CT) measures of emphysema and airway wall thickness. ⋯ CT measured emphysema explains a large fraction of the variation of D(L)CO among COPD subjects, and more so in men. Airway wall thickness is also significantly associated with D(L)CO, but explains a much smaller fraction of the variation.
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Respiratory medicine · Mar 2011
Randomized Controlled Trial Multicenter StudyMK-0633, a potent 5-lipoxygenase inhibitor, in chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is associated with neutrophil-mediated inflammation, a potential target for treatment in COPD. We evaluated MK-0633, a 5-lipoxygenase inhibitor in patients with COPD. This was a 12 week, randomized, double-blind, multicenter study comparing MK-0633 100 mg and placebo in patients 40-75 years of age (N = 266) with COPD, post-β-agonist forced expiratory volume in 1 s (FEV(1)) 25%-75% predicted, and an FEV(1)/forced vital capacity ratio (FVC) ≤ 70%. ⋯ MK-0633 was well-tolerated and comparable to placebo. The 5-LO inhibitor MK-0633 was not significantly more effective than placebo in improving FEV(1) from baseline in patients with COPD, although more patients reported feeling improved with MK-0633. Clinicaltrials.gov identifier: NCT00418613.
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Respiratory medicine · Mar 2011
Outcome measurement for COPD: reliability and validity of the Dyspnea Management Questionnaire.
The Dyspnea Management Questionnaire (DMQ) is a measure of the psychosocial and behavioral responses to dyspnea for adults with COPD. The research objectives were to evaluate the reliability and validity of an expanded DMQ item pool, as a preliminary step for developing a computer adaptive test. ⋯ The DMQ demonstrated acceptable levels of reliability and validity for measuring multidimensional dyspnea outcomes after medical, psychological, and behavioral interventions for adults with COPD.
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Respiratory medicine · Mar 2011
Randomized Controlled TrialLong-term non-invasive ventilation in COPD after acute-on-chronic respiratory failure.
COPD patients who remain hypercapnic after acute respiratory failure requiring mechanical ventilation have a poor prognosis. Long-term nocturnal non-invasive ventilation (NIV) may be beneficial for these patients. We hypothesized that stable patients on long-term NIV would experience clinical worsening after withdrawal of NIV. ⋯ COPD patients who remain hypercapnic after acute respiratory failure requiring mechanical ventilation may benefit from long-term NIV.
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Respiratory medicine · Mar 2011
Randomized Controlled TrialContrasting pressure-support ventilation and helium-oxygen during exercise in severe COPD.
Helium-oxygen mixtures and pressure-support ventilation have been used to unload the respiratory muscles and increase exercise tolerance in COPD. Considering the different characteristics of these techniques, we hypothesized that helium-oxygen would be more effective in reducing exercise-induced dynamic hyperinflation than pressure-support. We also hypothesized that patients would experience greater increases in respiratory rate and minute ventilation with helium-oxygen than with pressure-support. ⋯ In conclusion, helium-oxygen reduced exercise-induced dynamic hyperinflation by improving the relationship between hyperinflation and minute ventilation. In contrast, pressure-support reduced hyperinflation solely as a result of lowering ventilation. Helium-oxygen was more effective in reducing exercise-induced dynamic hyperinflation in severe COPD, and was associated with greater increases in respiratory rate and minute ventilation than pressure-support.