Respiratory medicine
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Respiratory medicine · Jul 2008
Impact of extravascular lung water index on outcomes of severe sepsis patients in a medical intensive care unit.
This study was designated to investigate whether extravascular lung water index (EVLI) is an independent predictor for mortality outcome in patients with severe sepsis. ⋯ This investigation suggested that EVLI was an independent predictor for in-hospital survival in medical ICU patients with severe sepsis. Measurement of EVLI may be used for risk stratification among those patients.
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Respiratory medicine · Jul 2008
Intrapleural minocycline following simple aspiration for initial treatment of primary spontaneous pneumothorax.
The optimal initial management of primary spontaneous pneumothorax (PSP) remains controversial. This study was to evaluate the safety and efficacy of intrapleural minocycline following aspiration for initial treatment of PSP. ⋯ Although associated with immediate chest pain, intrapleural minocycline following simple aspiration is a simple, safe and convenient initial treatment for PSP that may reduce the rates of ipsilateral recurrence.
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Respiratory medicine · Jun 2008
ReviewIt's about time--directing our attention toward modifying the course of COPD.
The course of COPD has traditionally been equated with an accelerated decline in the forced expiratory volume in one second (FEVi) over time in patients with COPD, compared to healthy individuals. However, other important clinical outcomes associated with COPD also worsen over time and should also be considered in conceptualizing the course of COPD. These include health status, breathlessness related to activities of daily living, exercise capacity, the frequency of exacerbations, and peripheral muscle weakness. ⋯ As novel therapeutic agents become available that may alter the underlying pathology of COPD, additional markers and outcomes of disease progression will be needed to provide a more comprehensive assessment. There has been increasing interest in predicting and assessing mortality as it is the final outcome of disease progression. In this review we have considered three approaches toward modifying the course of COPD: smoking cessation, reduction in lung hyperinflation through medical and surgical approaches, and long-term pharmacotherapy.
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Respiratory medicine · Jun 2008
ReviewInhaled corticosteroids during pregnancy: a review of methodologic issues.
There is evidence in the literature that inhaled corticosteroids (ICSs) are safe for pregnant women with asthma and their infants. Although this is useful information about ICS use during pregnancy, some articles must be viewed cautiously because of lack of power and adjustment for potentially important confounding variables. ⋯ While there currently is some degree of evidence to support the safety of ICS use during pregnancy, this review highlights the limited statistical power of several studies published in this area.
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Respiratory medicine · Jun 2008
Randomized Controlled TrialAntioxidant effect of zinc picolinate in patients with chronic obstructive pulmonary disease.
An imbalance between oxidative stress and antioxidant capacity is thought to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, studies in regard to stable COPD patients and effect of zinc supplementation are lacking. We investigated the effects of zinc picolinate supplementation on the oxidant stress, and pulmonary function tests (PFTs) of patients with stable COPD. ⋯ In conclusion, the results indicate that zinc supplementation may have favorable effects on oxidant-antioxidant balance in patients with COPD. The lack of an effect on PFT may be due to the short duration of the supplementation. Longer duration of zinc supplementation may be necessary to see clinical benefit.