Respiratory medicine
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Respiratory medicine · Mar 2012
Multicenter StudyGuideline adherence and macrolides reduced mortality in outpatients with pneumonia.
For outpatients with pneumonia, guidelines recommend empiric antibiotics and some suggest macrolides are preferred agents. We hypothesized that both guideline-concordant antibiotics and macrolides would be associated with reduced mortality. ⋯ In outpatients with pneumonia, treatment with guideline-concordant antibiotics and macrolides were both associated with mortality reduction.
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Respiratory medicine · Mar 2012
ReviewAcute exacerbation of IPF following diagnostic bronchoalveolar lavage procedures.
Bronchoalveolar lavage (BAL) is generally regarded as a safe diagnostic procedure. However, acute exacerbation after BAL is increasingly recognized as a specific complication for patients with idiopathic pulmonary fibrosis (IPF). So far little is known about the correlation between BAL and acute exacerbation of IPF (AE-IPF). ⋯ These results suggest that IPF patients should be carefully monitored after BAL, especially those with functional impairment or active inflammation.
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Respiratory medicine · Mar 2012
Barriers to adherence to COPD guidelines among primary care providers.
Despite efforts to disseminate guidelines for managing chronic obstructive pulmonary disease (COPD), adherence to COPD guidelines remains suboptimal. Barriers to adhering to guidelines remain poorly understood. ⋯ Poor familiarity with recommendations, low self-efficacy, and time constraints are important barriers to adherence to COPD guidelines. This information can be used to develop tailored interventions to improve guideline adherence.
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Respiratory medicine · Mar 2012
Randomized Controlled TrialEffect of cigarette smoking on cough reflex induced by TRPV1 and TRPA1 stimulations.
Recent studies have shown that neurogenic inflammation induced by cigarette smoke is inhibited by TRPA1 antagonist, but not by TRPV1 antagonist. Since cough reflex sensitivity is known to be modified by smoking status, we investigated the effects of cigarette smoking on TRPA1- and TRPV1-induced cough and urge-to-cough in healthy males. ⋯ The study suggests that smoking has a differential effect on cough responses between TRPV1 and TRPA1 stimulations.
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Respiratory medicine · Mar 2012
Development of the i-BODE: validation of the incremental shuttle walking test within the BODE index.
The BODE index has been shown to predict mortality in COPD. The index includes the 6 min walking test as the measure of exercise capacity. The incremental shuttle walking test (ISWT) is an alternative measure of exercise capacity which can be used to prescribe exercise and has been found to correlate well with peak VO2. The objective of the study was to evaluate the incorporation of the ISWT within the BODE index (named the i-BODE) to predict mortality in COPD. ⋯ We have found the i-BODE index to be an independent predictor of mortality in COPD, even when other strong predictors such as age and pack years are adjusted for. We conclude that the ISWT can be successfully substituted for the 6MWT as an alternative measure of exercise capacity within the BODE index.