Respiratory medicine
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Respiratory medicine · Mar 2007
Distance and oxygen desaturation in 6-min walk test predict prognosis in COPD patients.
The aim of the present study was to predict the prognosis of Chronic obstructive pulmonary disease (COPD) patients who underwent comprehensive pulmonary rehabilitation (PR). A total of 144 patients who performed PR between 1992 and 1999 was assessed. After PR, 67 patients underwent lung volume reduction surgery (LVRS). ⋯ Albumin level, PaCO(2), distance and DeltaSpO(2) were significant prognostic factors in univariate analysis. LVRS did not affect the prognosis. The multivariate analysis showed short distance and increase of DeltaSpO(2) as significant independent predictors of the risk of death. 6-min walk test was very useful for predicting the prognosis of the COPD patients.
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Respiratory medicine · Feb 2007
Randomized Controlled Trial Multicenter Study Comparative StudyRelative responsiveness of the Chronic Respiratory Questionnaire, St. Georges Respiratory Questionnaire and four other health-related quality of life instruments for patients with chronic lung disease.
Selection of heath-related quality of life (HRQL) instruments that are most responsive to changes in HRQL prevents investigators from drawing false-negative conclusions about the effectiveness of an intervention. The objective of this study was to compare the responsiveness of the Chronic Respiratory Questionnaire (CRQ), the St. Georges Respiratory Questionnaire (SGRQ) and four other HRQL instruments. ⋯ This study confirms that the CRQ and SGRQ are substantially more responsive than generic measures, and suggests particularly strong responsiveness for the self-administered CRQ.
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Respiratory medicine · Feb 2007
Randomized Controlled TrialInfluence of respiratory efforts on b2-agonist induced bronchodilation in mechanically ventilated COPD patients: a prospective clinical study.
Several in vitro studies have shown that at similar tidal volume (VT), bronchodilator delivery to target sites is significantly lower during controlled mechanical ventilation (CMV) than that during simulated spontaneous breathing. However, the influence of active respiratory efforts on the magnitude of b2-agonist induced bronchodilation in mechanically ventilated patients has not been examined. ⋯ Considering the use of propofol with its presumed bronchodilative properties as a shortcoming of our study, it is concluded that the magnitude of bronchodilation induced by salbutamol delivered by an MDI and a spacer device in mechanically ventilated COPD patients is not affected by the presence or absence of active respiratory efforts.
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Respiratory medicine · Feb 2007
Bronchoscopic diagnosis of pulmonary infiltrates in granulocytopenic patients with hematologic malignancies: BAL versus PSB and PBAL.
Treatment of patients with hematologic malignancies is often complicated by severe respiratory infections. Bronchoscopy is generally to be used as a diagnostic tool in order to find a causative pathogen. ⋯ Our results showed that modern bronchoscopic techniques such as PSB and PBAL did not yield better diagnostic results compared to BAL in granulocytopenic patients with hematologic malignancies and pulmonary infiltrates. In approximately half of the cases a presumptive diagnosis was made by bronchoscopic procedures.
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Respiratory medicine · Feb 2007
Case ReportsSubcutaneous emphysema secondary to pulmonary cavity in absence of pneumothorax or pneumomediastinum.
Subcutaneous emphysema is a common condition occurring after chest injury. It may also be observed in association with pneumothorax or pneumomediastinum as a result of pathological changes in the respiratory tract. Spontaneous subcutaneous emphysema in absence of pneumothorax or pneumomediastinum is rare. We report a case of spontaneous subcutaneous emphysema in isolation secondary to fibrocavitatory lesion in the chest along with review of the literature.