Respiratory medicine
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Respiratory medicine · Sep 2012
Multicenter Study Clinical TrialIdentifying patients at risk of late recovery (≥ 8 days) from acute exacerbation of chronic bronchitis and COPD.
To identify factors associated with late recovery (≥ 8 days from exacerbation start) in patients with acute exacerbations of chronic bronchitis/COPD (AECB/AECOPD). ⋯ In a large cohort of patients, all treated with the same antibiotic for an exacerbation of chronic bronchitis or COPD, the main factors associated with late recovery (≥ 8 days) were: older age, history of frequent exacerbations, current exacerbation type of Anthonisen I/II, history of prior hospitalizations and cardiac comorbid conditions.
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Respiratory medicine · Sep 2012
Copeptin in the assessment of acute lung injury and cardiogenic pulmonary edema.
Copeptin has been studied as an excellent predictor of outcome in a variety of diseases, its value is even superior to that of B-type natriuretic peptide (BNP) in heart failure, but little is known about its characteristics in acute respiratory distress syndrome (ARDS)/acute lung injury (ALI). We sought to assess the diagnostic and prognostic value of copeptin together with N-terminal pro-BNP (NT-proBNP) in patients with ARDS/ALI or cardiogenic pulmonary edema (CPE). ⋯ Copeptin of >40.11 pmol/L had a high specificity for the diagnosis of ARDS/ALI in patients presenting with ARDS/ALI or CPE. Compared to NT-proBNP, copeptin was a stronger prognostic marker for short-term mortality.
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Respiratory medicine · Sep 2012
Poor prediction of potentially drug-resistant pathogens using current criteria of health care-associated pneumonia.
Health care-associated pneumonia (HCAP) includes a broad range of patients having frequent or chronic contact with health care systems. However, the relationship between current defining criteria for HCAP and the risk of potentially drug-resistant (PDR) pathogens is controversial. ⋯ The current HCAP criteria are poor predictors of PDR pathogens and all patients with HCAP should not be empirically treated for these pathogens. To avoid excessive antibiotic use, individual risk stratification approaches should be considered.
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Respiratory medicine · Sep 2012
Clinical TrialA pilot study of an Internet walking program and pedometer in COPD.
Higher levels of physical activity are associated with better functional status, fewer hospital admissions, and lower mortality. In this pilot study, we examined the feasibility and safety of a novel program that combines a pedometer with a website to increase walking. ⋯ The use of a website and pedometer was feasible and safe, and persons increased their daily walking.
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Respiratory medicine · Sep 2012
Overlap syndrome: additive effects of COPD on the cardiovascular damages in patients with OSA.
The chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been recently much focused as independent risks for cardiovascular disease. Furthermore, the complication of both has a worse prognosis compared with patients with only one of these diseases. However, the details of the underlying mechanisms of this worsened prognosis have not been clear. ⋯ However, parameters of nocturnal hypoxemia and serum CRP levels were similar between both groups. Thus, the overlap of COPD in patients with OSA augments increase in arterial stiffness without the exaggeration of nocturnal hypoxemia and inflammation. Even so, this augmentation may partially contribute to the increased cardiovascular risk in the overlap syndrome.