Respiratory medicine
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Pulmonary hypertension (PH) is considered a clinically important feature of Obesity-Hypoventilation Syndrome (OHS). We aimed to determine prevalence, characteristics and severity of PH including associations with clinical outcomes after established non-invasive positive pressure ventilation (NPPV). ⋯ Mild to moderate PH is frequent in patients with OHS despite NPPV, mPAP being inversely related to NPPV adherence. PH is associated with impairments in daytime-sleepiness, WHO-FC, HRQL and physical functioning.
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Respiratory medicine · Dec 2013
Comparative StudyDifferential effects of smoking and COPD upon circulating myeloid derived suppressor cells.
Chronic obstructive pulmonary disease (COPD) is characterized by an enhanced and persistent innate and acquired immune response to tobacco smoking. Myeloid-derived suppressor cells (MDSCs) modulate T-cell responses by down-modulating the T cell receptor ζ chain (TCR ζ) through the catabolism of l-arginine. The effects of smoking on MDSCs and their potential participation in COPD immunopathogenesis have not been explored so far. ⋯ Smoking modulates circulating MDSCs. Their regulation appears altered in patients with COPD.
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Respiratory medicine · Dec 2013
Pulse wave amplitude reduction: a surrogate marker of micro-arousals associated with respiratory events occurring under non-invasive ventilation?
Respiratory events occurring under non-invasive ventilation (NIV) may produce sleep fragmentation. Alternatives to polysomnography (PSG) should be validated for providing simple monitoring tools for patients treated at home with NIV. ⋯ PWA reduction is a sensitive marker with a high PPV for the detection of EEG-MA associated with respiratory events during NREM sleep in stable OHS patients treated by NIV. In this situation, PWA could be used to improve scoring of hypopneas and allow an appropriate assessment of sleep fragmentation related to respiratory events.
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Respiratory medicine · Dec 2013
The recent multi-ethnic global lung initiative 2012 (GLI2012) reference values don't reflect contemporary adult's North African spirometry.
The applicability of the recent multi-ethnic reference equations derived by the ERS Global Lung Initiative (ERS/GLI) in interpreting spirometry data in North African adult subjects has not been studied. ⋯ The present study don't recommend the use of the recent ERS/GLI reference equations to interpret spirometry in North African adult population.
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Respiratory medicine · Dec 2013
Frequency of acute worsening events in fibrotic pulmonary sarcoidosis patients.
Patients with fibrotic sarcoidosis can develop worsening of pulmonary symptoms for various reasons. We studied acute worsening events defined as episodes treated with limited courses of either antibiotics and or increased corticosteroid doses which resolved within four weeks. The prevalence of acute worsening events in patients with fibrotic sarcoidosis was investigated. ⋯ Sixteen patients receiving anti-tumor necrosis factor antibodies reported a higher frequency of acute worsening events compared to those not receiving anti-tumor necrosis factor antibodies (p = 0.0297). There was no relationship between the number of acute worsening events and race, gender, smoking history, or FVC, FEV1, or FEV1/FVC ratio. We conclude that acute worsening events are frequent in patients with fibrotic sarcoidosis patients and are more common in patients with bronchiectasis and those receiving anti-tumor necrosis factor antibody therapies.