Respiratory medicine
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Respiratory medicine · Apr 2010
Randomized Controlled TrialThe clinical utility of long-term humidification therapy in chronic airway disease.
Persistent airway inflammation with mucus retention in patients with chronic airway disorders such as COPD and bronchiectasis may lead to frequent exacerbations, reduced lung function and poor quality of life. This study investigates if long-term humidification therapy with high flow fully humidified air at 37 degrees C through nasal cannulae can improve these clinical outcomes in this group of patients. ⋯ Long-term humidification therapy significantly reduced exacerbation days, increased time to first exacerbation, improved lung function and quality of life in patients with COPD and bronchiectasis. Clinical trial registered with www.actr.org.au; Number ACTRN2605000623695.
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Respiratory medicine · Apr 2010
Community-acquired pneumonia and nursing home-acquired pneumonia in the very elderly patients.
The rapid increase in the elderly population is leading to a corresponding increase in the number of people requiring medical care. To date no comparative study between community-acquired pneumonia (CAP) and nursing home-acquired pneumonia (NHAP) has been reported in the very elderly non-intubated patients. The present study was undertaken to compare the clinical characteristics and microbial etiology between CAP and NHAP in elderly patients >/=85-years old. ⋯ Physical activity, nutrition status and dehydration were significant prognostic factors of pneumonia among all patients. In-hospital mortality was significantly higher in NHAP than in CAP after adjusting for age and sex. This study demonstrated that the etiology and clinical outcome differ between CAP and NHAP patients in the very elderly non-intubated population.
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Respiratory medicine · Mar 2010
Review Meta AnalysisFrequency, prevention, outcome and treatment of ventilator-associated tracheobronchitis: systematic review and meta-analysis.
To clarify issues regarding the frequency, prevention, outcome, and treatment of patients with ventilator-associated tracheobronchitis (VAT), which is a lower respiratory tract infection involving the tracheobronchial tree, while sparing the lung parenchyma. ⋯ Approximately one tenth of mechanically ventilated patients suffer from VAT. Antimicrobial treatment of patients with VAT may protect against the development of subsequent ventilator-associated pneumonia and improve weaning outcome.
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Respiratory medicine · Mar 2010
Multicenter StudyGenetic variability in the severity and outcome of community-acquired pneumonia.
Several studies have investigated single nucleotide polymorphisms (SNP) in candidate genes associated with susceptibility, severity or outcome in patients with community-acquired pneumonia (CAP) with conflicting results. ⋯ Our study does not support a role for the controversial studied polymorphisms of the TNF, LTA, IL6 and IL1RN genes in the susceptibility or outcome of CAP. A protective role of heterozygosity for the functionally relevant TNFRSF1B+676 polymorphism in the outcome of CAP was observed.
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Respiratory medicine · Mar 2010
Randomized Controlled TrialCombining triple therapy and pulmonary rehabilitation in patients with advanced COPD: a pilot study.
The synergistic interactions between pharmacotherapy and pulmonary rehabilitation has been provided, but it remains to be established whether this may also apply to more severe patients. ⋯ Our study clearly indicates that there is an advantage in combining pulmonary rehabilitation with an aggressive drug therapy in more severe patients.