Respiratory medicine
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Respiratory medicine · Apr 2009
Genetic association analysis of COPD candidate genes with bronchodilator responsiveness.
Airflow limitation in COPD patients is not fully reversible. However, there may be large variability in bronchodilator responsiveness (BDR) among COPD patients, and familial aggregation of BDR suggests a genetic component. Therefore, we investigated the association between six candidate genes and BDR in subjects with severe COPD. ⋯ One SNP in EPHX1 (rs1009668, p=0.04) was significantly replicated in EOCOPD subjects. SNPs in SFTPB, TGFB1, and GSTP1 genes were not associated with BDR. In conclusion, a polymorphism of EPHX1 was associated with bronchodilator responsiveness phenotypes in subjects with severe COPD.
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Respiratory medicine · Apr 2009
Which tests may predict the need for noninvasive ventilation in children with neuromuscular disease?
Forced vital capacity (FVC) and maximal inspiratory pressure correlate with nocturnal hypoventilation in adults with neuromuscular disease, but children may not be able to perform these volitional tests. ⋯ Several lung function and respiratory muscle function tests are lower in children treated with NPPV as compared to children not treated with NPPV. A prospective hierarchical evaluation of these tests, according to their feasibility and invasiveness, may be helpful to identify children with neuromuscular disease at risk for nocturnal hypoventilation.
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Respiratory medicine · Apr 2009
Association between ischaemic heart disease and interstitial lung disease: a case-control study.
Idiopathic pulmonary fibrosis (IPF) is increasing in incidence. One of the authors noted that many of his patients with IPF were taking statins, and suspected an association. A case-control study was undertaken to investigate the association of statins with interstitial lung disease. ⋯ There was no statistically significant association between the use of statins and the diagnosis of interstitial lung disease. However there was a statistically significant association between ischaemic heart disease and the diagnosis of ILD.
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Respiratory medicine · Apr 2009
Randomized Controlled Trial Multicenter Study Comparative StudyEffects of arformoterol twice daily, tiotropium once daily, and their combination in patients with COPD.
Current guidelines support using in combination more than one class of long-acting bronchodilator for COPD patients whose symptoms are not controlled by mono-therapy. This 2-week, multi-center (34 sites), randomized, modified-blind, parallel group study evaluated the efficacy and safety of concomitant treatment with nebulized arformoterol (the formoterol(R,R)-isomer) BID and tiotropium DPI QD. ⋯ In this study, the combination of nebulized arformoterol 15microg BID plus tiotropium 18microg DPI QD was the most effective in improving pulmonary function and disease symptoms. Mono-therapy improvement with arformoterol or tiotropium was similar. All three treatments were well tolerated.
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Respiratory medicine · Apr 2009
Gas6 evaluation in patients with acute dyspnea due to suspected pulmonary embolism.
Gas6 protein is involved in pulmonary embolism (PE) and acute inflammation in animal models. ⋯ The data link Gas6 protein to infection/inflammation, but not to PE, in humans. Gas6 assay was useful in PE diagnosis, improving D-dimer accuracy particularly in LICP patients, and limiting false positives.