Respiratory medicine
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Respiratory medicine · May 2009
Impact of graft colonization with gram-negative bacteria after lung transplantation on the development of bronchiolitis obliterans syndrome in recipients with cystic fibrosis.
Bronchiolitis obliterans syndrome (BOS) represents the leading cause of late mortality after lung transplantation (LTx). Cystic fibrosis (CF) patients frequently show airway colonization with gram-negative bacteria (GNB) both before and after LTx. Graft colonization with GNB and its relevance towards BOS development were investigated in a CF population after LTx. ⋯ Persistent graft colonization with pseudomonads increases the prevalence of BOS after LTx in CF patients. A significant proportion of post-LTx CF patients demonstrates subsequent GNB eradication during later follow-up and this may have a protective role against development of BOS. Strategies to eradicate airway colonization or reduce bacterial load may prevent BOS in CF patients after LTx.
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Respiratory medicine · May 2009
Multicenter Study Comparative StudyCapsaicin cough sensitivity in smokers with and without airflow obstruction.
Cough is a frequent symptom of cigarette smokers that often precedes the development of airflow obstruction. We determined whether chronic cigarette smoking is associated with an increase in capsaicin cough response in the absence of cough. ⋯ We conclude that chronic cigarette smoking increases capsaicin cough reflex and that this remains so with the development of COPD.
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Respiratory medicine · May 2009
ReviewGlobal assessment of the COPD patient: time to look beyond FEV1?
COPD is a diverse disease entity with multiple dimensions that uniquely define the patient's performance, morbidity and mortality. FEV(1) is both the traditional metric used to define the progression of COPD as well as the strongest spirometric predictor of mortality in COPD patients. ⋯ Therefore, the global assessment of an affected patient should include different aspects of the consequences of this disorder, beyond the "gold-standard" assessment of airflow limitation. Quantification of the patient's dyspnea, body composition as expressed by BMI, simple measures of exercise capacity such as the 6MWD, assessment of comorbidities and identification of characteristics related to different phenotypes are features that may lead to more optimal management of such patients.
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Respiratory medicine · May 2009
Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients.
1) To determine whether severe exacerbation of COPD is a BODE index independent risk factor for death; 2) whether the combined application of exacerbations and BODE (e-BODE index), offers greater predictive capacity than BODE alone or can simplify the model, by replacing the exercise capacity (BODEx index). ⋯ Severe exacerbations of COPD imply an increased mortality risk that is independent of baseline severity of the disease as measured by the BODE index. The combined application of both parameters (e-BODE index) didn't improve the predictive capacity, but on replacing exacerbation with exercise capacity the multidimensional grading system is simplified without loss of predictive capacity.