Respiratory medicine
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Respiratory medicine · Jul 2007
Induced sputum as a tool for early detection of airway inflammation in connective diseases-related lung involvement.
Induced sputum (IS) sampling is a safe and validated approach to study bronchial inflammation in chronic obstructive lung diseases. Although promising results have also been reported in various diffuse interstitial lung disorders, the potential use of IS in the assessment of connective tissue diseases (CTD)-related lung involvement has not yet been investigated. ⋯ This is the first study investigating the inflammatory cell pattern in IS from CTD patients with early clinical evidence of lung involvement. Future studies are needed to determine whether the assessment of airway inflammation adds significant information that may result in a relevant improvement of disease management.
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Respiratory medicine · Jul 2007
Patterns of chest wall kinematics during volitional pursed-lip breathing in COPD at rest.
Analysis of chest wall kinematics can contribute to identifying the reasons why some patients benefit from pursed-lip breathing (PLB). ⋯ OEP helps identifying the reason why patients with COPD may benefit from PLB at rest.
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Bronchiectasis has a number of causes. Their prevalence is not well documented. The aim of this study was to identify aetiology in a population of patients referred to a specialist clinic with symptoms suggestive of bronchiectasis, to determine the proportion of patients in whom knowing the aetiology altered management. In addition we wished to describe in detail those patients who remained idiopathic to facilitate future studies of this group; and establish the diagnosis in those without bronchiectasis. ⋯ Full investigation of problematic cases should occur in a specialist centre because results affect management in a third of cases.
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Respiratory medicine · Jun 2007
Non-invasive positive pressure ventilation improves lung volumes in the obesity hypoventilation syndrome.
Our objective was to study the long-term effects of non-invasive positive pressure ventilation (NPPV) on lung function and gas exchange in patients with the obesity hypoventilation syndrome (OHS). ⋯ Long-term domiciliary NPPV normalizes hypercapnia and markedly improves hypoxemia as well as polycythemia in OHS patients. In addition, NPPV leads to a significant reduction in restrictive ventilatory disturbance, predominantly by increasing ERV. Application of high inspiratory pressures and good adherence to therapy are presumed to be the basis for the beneficial effects of NPPV in OHS.
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Respiratory medicine · Jun 2007
Non-invasive home mechanical ventilation: effectiveness and efficiency of an outpatient initiation protocol compared with the standard in-hospital model.
To compare the effectiveness and efficiency of an initiation protocol for non-invasive home mechanical ventilation (NIHMV) carried out at a pulmonary outpatient clinic with the standard in-hospital model. ⋯ (1) Outpatient initiation is an effective and efficient alternative to the traditional in-hospital method for NIHMV. (2) The outpatient protocol represents a substantial saving for the financier.