Respiratory medicine
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Respiratory medicine · Sep 2011
Randomized Controlled Trial Multicenter StudyEffect of fluticasone propionate/salmeterol on arterial stiffness in patients with COPD.
COPD is associated with increased arterial stiffness which may in part explain the cardiovascular morbidity observed in the disease. A causal relationship between arterial stiffness and cardiovascular events has not been established, though their strong association raises the possibility that therapies that reduce arterial stiffness may improve cardiovascular outcomes. Prior studies suggest that fluticasone propionate/salmeterol (FSC) may improve cardiovascular outcomes in COPD and we hypothesized that FSC would reduce arterial stiffness in these patients. ⋯ FSC does not reduce aPWV in all patients with moderate to severe COPD, but may have effects in those with elevated arterial stiffness. Additional studies are required to determine if aPWV could serve as a surrogate for cardiovascular events in COPD.
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Respiratory medicine · Sep 2011
Multicenter StudyEvaluating nocturnal oxygen desaturation in COPD--revised.
Although in patients with COPD, the approach to daytime hypoxemia using long-term oxygen therapy (LTOT) is established, the best approach to transient nocturnal desaturation varies among clinicians. An understanding of the prevalence of nocturnal desaturation in COPD, in the absence of other respiratory co-morbidities, is an important step towards its standardized management. ⋯ A significant proportion (38%) of patients with moderate-to-severe COPD who do not qualify for home oxygen therapy based on their daytime PaO(2) have nocturnal oxygen desaturation without evidence of sleep apnea. Home oximetry is an effective practical method for screening this population.
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Respiratory medicine · Sep 2011
Randomized Controlled TrialImproved respiratory system conductance following bronchodilator predicts reduced exertional dyspnoea.
In COPD, improvements in lung mechanics following bronchodilator, measured using the forced oscillation technique (FOT), are more sensitive than spirometry at detecting improvement in lung function following bronchodilator. The relationship between these improvements in lung mechanics and improvements in functional outcomes, such as exertional dyspnoea, following bronchodilator, in COPD is unknown. ⋯ Bronchodilator induced improvements in exertional dyspnoea in moderate to severe COPD are predicted by improvements in Grs, measured by FOT, independent of improvements in spirometry or hyperinflation. The findings suggest that FOT may be useful for measuring response to bronchodilator in COPD.
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Respiratory medicine · Sep 2011
Randomized Controlled TrialThe influence of Flutter®VRP1 components on mucus transport of patients with bronchiectasis.
The Flutter(®)VRP1 combines high frequency oscillation and positive expiratory pressure (PEP). ⋯ The use of the Flutter(®)VRP1 for four weeks is capable of altering the respiratory secretion transport properties, and this alteration is related to the high frequency oscillation component.
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Respiratory medicine · Sep 2011
Minimal (clinically) important differences for the Fatigue Assessment Scale in sarcoidosis.
The usefulness of any questionnaire in clinical management and research trials depends on its ability to indicate a likelihood of treatment success during follow-up. The Minimal Clinically Important Difference (MCID) reflects a clinically relevant change score. The aim of this study was to estimate the MCID for the Fatigue Assessment Scale (FAS) in patients with sarcoidosis. ⋯ Based on the anchor-based and distribution-based methods, the MCID is a 4-point difference on the FAS. This MCID can be used in the follow-up of fatigue (FAS) in clinical trials and in the management of individual sarcoidosis cases.