Respiratory medicine
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Respiratory medicine · Apr 2015
Decision making among Veterans with incidental pulmonary nodules: a qualitative analysis.
Among patients undergoing lung cancer evaluation for newly diagnosed, incidental pulmonary nodules, it is important to evaluate the shared power and responsibility domain of patient-centered communication. We explored Veterans' perceptions of decision making with regards to an incidentally-detected pulmonary nodule. ⋯ Veterans in our study did not engage in shared decision making with their clinician. Some were satisfied with this approach although many would have preferred a shared approach. In order to reduce patient distress and improve satisfaction, clinicians may want to consider adopting a shared approach when making decisions about pulmonary nodule evaluation.
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Respiratory medicine · Apr 2015
Changes in fatigability following intense aerobic exercise training in patients with interstitial lung disease.
To determine if, in patients with interstitial lung disease (ILD), fatigue might be lessened after vigorous aerobic exercise. ⋯ After training, the decrease in fatigability appeared to result in increased 6MWD and was associated with physical activity. Since significant declines in 6MWD may be a marker for impending mortality in ILD, a better understanding of the etiological state of fatigue in patients with ILD and its reversal might provide fundamental insight into disease progression and even survival. [ClinicalTrials.gov identifier NCT00678821].
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Respiratory medicine · Apr 2015
Clinical findings and outcomes in patients with possible usual interstitial pneumonia.
Patients with possible usual interstitial pneumonia (UIP) constitute a substantial group, and their clinical characteristics and outcomes are not well defined. We compared the clinical characteristics and survival between patients with possible UIP and the UIP pattern. ⋯ Clinical characteristics and outcomes were similar in possible UIP and UIP patients, except for differences in DLCO. The UIP pattern itself did not affect survival.
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Respiratory medicine · Apr 2015
Fear of falling in people with chronic obstructive pulmonary disease.
Increased fear of falling (FOF) has been associated with impaired physical function, reduced physical activity and increased fall risk in older adults. Preliminary evidence suggests that individuals with chronic obstructive pulmonary disease (COPD) may have an increased FOF. This study aims to compare the level of FOF in people with COPD with healthy controls, and to determine the associations between FOF and measures of physical function, physical activity and fall risk in COPD. ⋯ People with COPD have a higher FOF compared to the healthy peers, which is related to lower quadriceps muscle strength, impaired balance, lower levels of physical activity and an increased fall risk.
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Respiratory medicine · Apr 2015
The effect of corticosteroids on quality of life in a sarcoidosis clinic: the results of a propensity analysis.
Both sarcoidosis and its treatment may worsen health related quality of life (HRQoL). We performed a propensity analysis of sarcoidosis-specific HRQoL patient reported outcome measures (PRO) to disentangle the effects of sarcoidosis and corticosteroid therapy on HRQoL in sarcoidosis outpatients. ⋯ Our cohort of sarcoidosis clinic patients who received ≤500 mg of prednisone in the previous year had an improved HRQoL compared to patients receiving >500 mg on the basis of two sarcoidosis-specific PROs after adjusting for severity of illness. These data support the need to measure HRQoL in sarcoidosis trials, and suggest that the search should continue for effective alternative medications to corticosteroids.