Respiratory medicine
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Respiratory medicine · Jun 2012
The prevalence of chronic obstructive pulmonary disease in Maastricht, the Netherlands.
Chronic obstructive pulmonary disease (COPD) is an increasing public health problem worldwide. Although epidemiologic data on COPD are important to raise awareness of the burden of disease, there are no actual spirometry-based data on the prevalence of COPD in the Netherlands. ⋯ Almost one quarter of the Maastricht population aged ≥ 40 years had COPD. Considering the ageing population and still an important smoking prevalence, this burden is bound to increase and imposes great demands to public health care and society in the Netherlands.
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Respiratory medicine · Jun 2012
ReviewEndemic mycoses: overlooked causes of community acquired pneumonia.
The endemic mycoses are important but often overlooked causes for community acquired pneumonia. Delays in recognition, diagnosis and proper treatment often lead to disastrous outcomes. ⋯ In this review we discuss the three major endemic mycoses in North America that present as community acquired pneumonias; Coccidioidomycosis, Histoplasmosis and Blastomycosis. We discuss their epidemiology, clinical presentations, methods of diagnosis and current treatment strategies.
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Respiratory medicine · Jun 2012
Meta AnalysisEfficacy and safety of convex probe EBUS-TBNA in sarcoidosis: a systematic review and meta-analysis.
Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for diagnosis of mediastinal lymphadenopathy. Although most studies have reported the utility of EBUS-TBNA in malignancy, its use has been extended to benign conditions including sarcoidosis. Herein, we perform a systematic review and meta-analysis of studies reporting the diagnostic yield and safety of EBUS-TBNA in sarcoidosis. ⋯ EBUS-TBNA is a safe and efficacious procedure in the diagnosis of sarcoidosis, and should be routinely employed wherever available.
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Respiratory medicine · Jun 2012
Multicenter StudyReal-life effectiveness of extrafine beclometasone dipropionate/formoterol in adults with persistent asthma according to smoking status.
The efficacy and safety of extrafine beclomethasone dipropionate 100 μg/formoterol 6 μg (BDP/F HFA) pressurized metered dose inhaler (pMDI) in patients with moderate-to-severe persistent asthma, has been demonstrated in randomised controlled trials (RCTs). The aim of this prospective observational study was to assess real-life effectiveness in terms of asthma control in smoking (most of the time excluded from RCTs) and non-smoking asthmatics. ⋯ This prospective cohort study demonstrates the real-life effectiveness and safety of BDP/F HFA in adult asthma patients, including smokers, in normal clinical practice.
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Respiratory medicine · Jun 2012
The value of exhaled nitric oxide to identify asthma in smoking patients with asthma-like symptoms.
The fraction of nitric oxide in exhaled air (FeNO) is used in asthma diagnosis and management. Smoking reduces FeNO and 20-35% of asthmatics are smoking. However no guidelines exist on the diagnostic value of FeNO in smokers. Therefore we assessed the value of FeNO to diagnose asthma in a population of subjects with asthma-like symptoms and different smoking habits. ⋯ FeNO could differentiate asthmatic subjects from non-asthmatic subjects with asthma-like symptoms equally well in both never- and current smokers within a random population sample. The FeNO cut-off levels needed in order to achieve high sensitivity or specificity were lower in current smokers.