Respiratory medicine
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Respiratory medicine · Nov 2007
Dissociation of lung function, dyspnea ratings and pulmonary extension in bronchiectasis.
Bronchiectasis is a heterogeneous disease in terms of its clinical and functional presentation. Some isolated parameters have been used to assess the severity of bronchiectasis or its response to treatment. A study was undertaken to evaluate whether lung function, dyspnea and extension of the disease are separate entities in the impact of bronchiectasis upon patients using factor analysis. Patients with bronchiectasis diagnosed by high-resolution computed tomography (HRCT) and airflow obstruction defined by FEV1/FVC<70% were included. Data were collected relating to clinical history, three different clinical ratings of dyspnea (Medical Research Council (MRC), Borg scale and Basal Dyspnea Index), the extent of bronchiectasis and functional variables. A total of 81 patients (mean age (SD): 69.5 (8.7)) years were included. The degree of dyspnea (MRC) was 1.9 (0.8). Mean FEV1 was 1301 ml (56.9% pred.). Four factors were found that accounted for 84.1% of the total data variance. Factor 1 (45.6% of the data variance) included the three measurements of dyspnea. Factor 2 (16% variance) comprised airflow obstruction parameters (FEV1, FEV1/FVC and PEF). Factor 3 (13.8% variance) included RV/TLC and RV (lung hyperinflation). Factor 4 (8.6% variance) included bronchiectasis extent. Dyspnea was more closely correlated with lung hyperinflation (r:0.33-0.54) than with airflow obstruction parameters (r:0.17-0.26). ⋯ Airflow obstruction, dyspnea, lung hyperinflation and the lung extent of the bronchiectasis are four independent entities in the impact of bronchiectasis upon patients.
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Respiratory medicine · Nov 2007
Assessment of the burden of caregiving for patients with chronic obstructive pulmonary disease.
To determine the effect of chronic obstructive pulmonary disease (COPD) on the quality of life of caregivers. ⋯ COPD causes a significant impact on the quality of life of caregivers. The two most important predictors of COPD burden are the relationship between caregivers and patients and caregiver MCS scores.
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Respiratory medicine · Oct 2007
Multicenter StudyEpidemiology of acute lung injury and acute respiratory distress syndrome in The Netherlands: a survey.
The characteristics, incidence and risk factors for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may depend on definitions and geography. ⋯ The effect of definitions of ALI/ARDS on mechanical ventilation in the Netherlands is small. Nevertheless, the incidence of ALI/ARDS may be higher than in other European countries but lower than in the USA, and the incidence of ALI by LIS may overestimate compared to that by NAECC. Aspiration, pneumonia, sepsis and chronic alcohol abuse are major risk factors, largely independent of definitions.
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Respiratory medicine · Oct 2007
Multicenter StudyOccupational exposure and severe pulmonary fibrosis.
External agents, especially metal and wood dust, are believed to be risk factors for development of idiopathic pulmonary fibrosis (IPF). The aim of this case-control study was to investigate which occupational exposure types are associated with development of severe pulmonary fibrosis (PF), and especially IPF. ⋯ Exposure for birch and hardwood dust may contribute to the risk for IPF in men.
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Respiratory medicine · Oct 2007
Diagnostic accuracy of bronchoalveolar lavage samples in immunosuppressed patients with suspected pneumonia: analysis of a protocol.
Fast and accurate etiologic diagnosis of pneumonia in immunocompromised patients is essential for a good outcome. Utility of bronchoalveolar lavage (BAL) samples has already been established, but studies about them are scarce and limited to few countries. We aimed to evaluate the accuracy of a diagnostic protocol, emphasizing on local epidemiology, rapidity, and yield of different techniques. ⋯ Systematical study of BAL samples has a high diagnostic yield in our immunocompromised patients with suspected pneumonia. As economical and epidemiological conditions of regions are different, it should be tried everywhere.