Respiratory medicine
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Respiratory medicine · May 2012
Randomized Controlled Trial Comparative StudyA double blind randomized cross over trial comparing rate of decortication and efficacy of intrapleural instillation of alteplase vs placebo in patients with empyemas and complicated parapneumonic effusions.
A double blind randomized cross over trial to compare the rate of decortication, safety and efficacy of intrapleural instillation of Alteplase vs. Placebo in empyema and complicated parapneumonic effusions (CPE). ⋯ Intrapleural instillation of Alteplase is significantly more effective than Placebo in patients with empyema and PPE (95% vs.12%). This study demonstrates it is safe and efficacious with minimal adverse reactions.
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Respiratory medicine · May 2012
ReviewDual therapy in IPAH and SSc-PAH. A qualitative systematic review.
Use of endothelin receptor antagonists (ERA), phosphodiesterase type-5 (PDE-5) inhibitors and prostaglandin analogues has resulted in improved outcomes in idiopathic pulmonary arterial hypertension (IPAH) and systemic sclerosis-associated PAH (SSc-PAH) patients. However, patients often deteriorate on monotherapy. The objective of this study is to evaluate the effect of dual therapy on outcomes in IPAH and SSc-PAH. ⋯ The evidence suggests a beneficial effect of dual therapy in IPAH and SSc-PAH, particularly those who are deteriorating on monotherapy. Research should focus on subsets of patients to identify the optimal timing and combination of dual therapy.
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Respiratory medicine · May 2012
Controlled Clinical TrialEffect of bariatric surgery on airway response and lung function in obese subjects with asthma.
Obesity is a risk factor for self-reported asthma and makes asthma management more difficult. The effects of bariatric surgery on asthma in severely obese subjects remain to be documented. ⋯ Airway responsiveness, lung volumes and asthma severity/control markedly improved with weight loss following bariatric surgery in severely obese patients.
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Respiratory medicine · May 2012
Electromagnetic navigation bronchoscopy (ENB): Increasing diagnostic yield.
To determine factors associated with diagnostic yield of ENB. ⋯ Diagnostic yield increased with experience but was independent from the size of the lesion, the localisation in the lungs, and lung function. The diagnostic yield of ENB can be as high as for CT-guided transthoracic biopsies but carries a significantly lower complication rate.
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Respiratory medicine · May 2012
A better response in exercise capacity after pulmonary rehabilitation in more severe COPD patients.
Pulmonary rehabilitation (PR) has positive effects on exercise capacity in Chronic Obstructive Pulmonary Disease (COPD). However, not all COPD patients benefit from PR to the same extent. We investigated whether there is a patient profile, which is associated with the improvement in endurance exercise capacity. ⋯ Single variables from lung function or exercise testing at baseline have limited predictive value for response to exercise training. However, patients with worse disease status (i.e. a combination of lower FEV(1), more hyperinflation, lower exercise capacity and worse quadriceps force) improve more in endurance exercise capacity.