Respiratory medicine
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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.
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Respiratory medicine · Mar 2011
Treatment of COPD: relationships between daily dosing frequency, adherence, resource use, and costs.
Medication adherence is important in managing COPD. This study analyzed real-world use of inhaled medications for COPD to characterize relationships between daily dosing frequency, adherence, healthcare resource utilization, and cost. ⋯ COPD patients who initiated treatment with once-daily dosing had significantly higher adherence than other daily dosing frequencies. Better treatment adherence was found to yield reductions in healthcare resource utilization and cost.
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Respiratory medicine · Mar 2011
Advanced glycation end products and its receptor (RAGE) are increased in patients with COPD.
Advanced Glycation End products (AGEs) are the products of nonenzymatic glycation and oxidation of proteins and lipids. Formation of AGEs is increased in response to hyperglycaemia, reactive oxygen species and ageing. AGEs are proinflammatory and can modify the extracellular matrix. RAGE (Receptor for Advanced Glycation End Products) mediates some of the effects of AGEs. ⋯ The increased staining for both AGEs and RAGE in COPD lung raises the possibility that the RAGE-AGEs interaction may have a role in the pathogenesis of COPD.
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Respiratory medicine · Mar 2011
Potentially modifiable predictors of mortality in patients treated with long-term oxygen therapy.
Anemia is considered a systemic manifestation of Chronic Obstructive Pulmonary Disease (COPD); however, few studies have described its influence on chronic respiratory failure (CRF) prognosis. We aimed to test the hypotheses that anemia negatively influences survival and also to identify the cut-off points of hematocrit (Htc) and hemoglobin (Hb) associated with higher mortality in CRF patients using long-term oxygen therapy (LTOT). ⋯ Our study shows that anemia is a predictor of mortality in patients with CRF under LTOT treatment. Although anemia is potentially modifiable, the effects of raising hemoglobin on mortality remain undetermined.
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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.