Respiratory medicine
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The 6-Minute Walk Test (6MWT) is a widely used measurement of functional exercise capacity in chronic lung disease. While exercise intolerance has been identified in patients with bronchiectasis, the clinical determinants of the 6MWT in this population have not been examined. The aim of this study was to 1) establish the relationship between the 6-Minute Walk Distance (6MWD), disease severity and Health-Related Quality of Life (HRQOL) and 2) identify predictors of exercise tolerance in adults with bronchiectasis. ⋯ Measures of HRQOL demonstrated a stronger association with the 6MWD compared to physiological measures of disease severity in patients with predominantly mild to moderate bronchiectasis.
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Respiratory medicine · May 2009
Inhaled colistin as monotherapy for multidrug-resistant gram (-) nosocomial pneumonia: a case series.
Reports of patients with polymyxin-only susceptible gram-negative nosocomial pneumonia treated with inhaled, but without concurrent intravenous, colistin are rare. ⋯ The experience from this case series and other relevant recent reports suggest that treatment of pneumonia due to polymyxin-only susceptible gram-negative bacilli with inhaled colistin (without concurrent systemic administration) deserves further careful investigation.
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Respiratory medicine · May 2009
Biomass smoke induced bronchial anthracofibrosis: presenting features and clinical course.
The presenting features and clinical course of biomass smoke induced bronchial anthracofibrosis (BAF) are not well known. ⋯ These findings suggest that biomass smoke induced BAF usually appears clinically as a form of obstructive airways disease. Since various pulmonary diseases, including tuberculosis, pneumonia, and malignancy, can be associated with BAF, thorough clinical evaluation and close follow-up of these patients are required.
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Respiratory medicine · Apr 2009
ReviewImproving mucociliary clearance in chronic obstructive pulmonary disease.
Patients with COPD usually experience mucus hypersecretion as a result of airway inflammation and response to noxious stimuli. These in turn lead to worsening airway resistance, impaired airflow, increased work of breathing, dyspnoea and exercise intolerance. ⋯ This review examines the current evidence base and best clinical practice in the area of airway clearance. Mechanical devices such as the flutter valves, positive end expiratory pressure and high frequency chest wall oscillation (HFCWO) may be able to provide the benefits of improved airway clearance in the patient's home potentially with reduced demands on healthcare resources.
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Respiratory medicine · Apr 2009
Multicenter StudySubacute and chronic hypersensitivity pneumonitis: histopathological patterns and survival.
In hypersensitivity pneumonitis (HP), survival can be predicted on the basis of the severity of fibrosis in surgical lung biopsy, but few data are available on the influence of clinical, functional, tomographic and histologic findings on prognosis. ⋯ A wide range of histological features are found in HP. Typical findings are seen in 45% of cases. Other common patterns are NSIP and centriacinar lesions. Survival is better in patients with NSIP and worse in those with older age, desaturation during exercise, and absence of mosaic pattern/air trapping on HRCT.