Respiratory medicine
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Respiratory medicine · Jan 2009
Comparative StudyInhaled corticosteroids and risk of lung cancer among COPD patients who quit smoking.
COPD is associated with an increased risk of lung cancer. We examined whether inhaled corticosteroids (ICS) used concomitantly with long-acting beta(2)-agonists (LABA) were associated with reduction in lung cancer risk in COPD patients. ⋯ Regular use of ICS, with and without LABA, may reduce the risk of lung cancer among former smokers with diagnosed COPD.
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Respiratory medicine · Jan 2009
CT scanning-based phenotypes vary with ADRB2 polymorphisms in chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that is characterized by varying degrees of involvement of airway and lung parenchyma. Although cigarette smoke is the major risk factor for COPD, the principal determining factors of involvement of the airway or lung parenchyma have not been clearly defined. Genetic variability in COPD patients might influence the varying degrees of involvement of airway and parenchyma. We therefore studied whether airway and parenchyma involvement might be associated with the ADRB2 genotype, which has been reported to be associated with COPD susceptibility and the bronchodilator response. ⋯ Gly16 variant in ADRB2 gene was associated with airway wall phenotypes measured using CT scanning in COPD patients.
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Respiratory medicine · Jan 2009
Comparative StudyImpact of noninvasive ventilation (NIV) trial for various types of acute respiratory failure in the emergency department; decreased mortality and use of the ICU.
Trial of noninvasive ventilation (NIV) in the emergency department (ED) for heterogeneous acute respiratory failure (ARF) has been optional and its clinical benefit unclear. ⋯ NIV-trial in the ED for all possible patients with ARF of pulmonary etiologies, excluding those with recurrent aspiration pneumonia, may reduce overall in-hospital mortality and ICU stays.
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Respiratory medicine · Jan 2009
Influenza vaccination among Canadians with chronic respiratory disease.
The purposes of this study were to estimate the prevalence of recent influenza vaccination, to identify sociodemographic risk factors and reasons for non-vaccination, and to examine the association between influenza vaccination and respiratory medication use, among individuals with asthma and COPD in Canada. ⋯ Recent self-reported influenza vaccination rates among individuals with asthma and COPD were relatively low. Influenza vaccination was not associated with decreased respiratory medication use among individuals with asthma and COPD, suggesting that vaccination may not help prevent exacerbations. More research is needed to fully clarify the role of influenza vaccination in chronic respiratory disease, particularly asthma, to justify policies of mass-immunization.
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Respiratory medicine · Dec 2008
Review Meta AnalysisInspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review.
The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. ⋯ Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD.