Respiratory medicine
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Respiratory medicine · Mar 2009
Comparative StudyRecurrent exacerbations affect FEV(1) decline in adult patients with cystic fibrosis.
Obstructive lung disease is the major cause of morbidity and mortality in cystic fibrosis (CF). To identify risk factors contributing to FEV(1) decline in CF patients, we carried out a retrospective analysis of clinical and pulmonary function data in a population of CF patients followed up for 5 years and studied the correlation between clinical data and FEV(1) decline. Fifty-one adult CF patients were studied. ⋯ Both the number of exacerbations/year and the number of i.v. antibiotic courses/year were strongly related to the FEV(1) decline. Patients with airway infection or with diabetes had significantly lower FEV(1) values during the study as compared with non-infected patients or patients without diabetes; however, both the presence of airway infection or diabetes did not affect the FEV(1) decline. These results suggest that the aggressive treatment of disease exacerbations is crucial for delaying lung function decline in CF.
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Respiratory medicine · Mar 2009
Randomized Controlled TrialThe role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine.
Oxidative stress has a proven role in pathophysiology of acute respiratory distress syndrome. The antioxidant drugs, especially N-acetylcysteine (NAC) have been used for years to overcome oxidative stress effects in patients. ⋯ The results indicated that NAC improved oxygenation (increase in PaO(2)/FiO(2)) and decreased mortality rate in treated patients compared to control group (p<0.05). Evaluation of three isoforms of glutathione-S-transferase (GST M1, P1 and T1), in these patients have showed an association between GST M1 null, and GST M1 and T1 double null polymorphisms with increased mortality in control group, suggesting antioxidant therapy critical for this group of patients.
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Respiratory medicine · Mar 2009
Multicenter StudyPrediction of risk of COPD exacerbations by the BODE index.
This study assesses the power of the BODE index, a multidimensional grading system that predicts mortality, to predict subsequent exacerbations in patients with COPD. ⋯ The BODE index is a better predictor of the number and severity of exacerbations in COPD than FEV(1) alone.
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Respiratory medicine · Mar 2009
Cold temperature and low humidity are associated with increased occurrence of respiratory tract infections.
The association between cold exposure and acute respiratory tract infections (RTIs) has remained unclear. The study examined whether the development of RTIs is potentiated by cold exposure and lowered humidity in a northern population. ⋯ Cold temperature and low humidity were associated with increased occurrence of RTIs, and a decrease in temperature and humidity preceded the onset of the infections.
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Respiratory medicine · Mar 2009
Risk assessment of pneumothorax and pulmonary haemorrhage complicating percutaneous co-axial cutting needle lung biopsy.
The primary aim of this study was to evaluate the ability of radiologists to accurately estimate pneumothorax and pulmonary haemorrhage during percutaneous co-axial cutting needle CT-guided lung biopsy. ⋯ Radiologists differ markedly in the estimation of pneumothorax risk for a patient undergoing co-axial lung biopsy. Identifying individual patients developing pneumothorax was only possible when risk was estimated at > or =50%. Pulmonary haemorrhage was uncommon and difficult to predict accurately.