Respiratory medicine
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Respiratory medicine · Oct 2003
Randomized Controlled Trial Multicenter Study Clinical TrialSequential IV/PO moxifloxacin treatment of patients with severe community-acquired pneumonia.
IV/PO moxifloxacin was evaluated in the treatment of hospitalized patients with severe community-acquired pneumonia (CAP). ⋯ Sequential IV/PO moxifloxacin 400 mg QD is as safe and effective as other fluoroquinolones and a beta-lactam/macrolide combination for treating hospitalized patients with severe CAP.
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Respiratory medicine · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialComfort and pressure profiles of two auto-adjustable positive airway pressure devices: a technical report.
The purpose of this study was to compare comfort parameters and pressure profiles of the AutoSet (Resmed) and the SOMNOsmart (Weinmann), two auto-adjustable positive airway pressure (APAP) devices. ⋯ While the subjective tolerance of the two APAP machines was comparable, these devices were characterized by different pressure profiles. The pressure parameters of the AutoSet correlated better with Ppred than those of the SOMNOsmart.
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Respiratory medicine · Aug 2003
Endothelin-1 levels in the pathophysiology of chronic obstructive pulmonary disease and bronchial asthma.
Endothelin-1 (ET-1) has been implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). The ET-1 levels are elevated during exacerbations of asthma and COPD in bronchoalveolar lavage, serum, and sputum and fails with treatment of the exacerbations. Hypoxemia stimulates ET-1 secretion. ⋯ According to our results: (1) ET-1 levels were significantly higher in "desaturators" COPD patients than in "non-desaturators" COPD and in asthmatics; (2) ET-1 levels were significantly higher during the night than during the day in "desaturators" COPD patients; (3) the degree of desaturation correlated negatively with the ET-1 levels in "desaturators" COPD patients, both during daytime and nighttime. These findings are consistent with the hypothesis that ET-1 is implicated in the pathophysiology of asthma and COPD, especially if nocturnal, nonapneic, oxyhemoglobin desaturation exists.
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Respiratory medicine · Jul 2003
ReviewLong-term antibiotics in the management of non-CF bronchiectasis--do they improve outcome?
In addition to bacteria and inflammatory cells, the sputum of patients with bronchiectasis contains mediators that damage the airway epithelium and promote inflammatory change. The deleterious effects of these mediators, such as neutrophil elastase, reduce host defences and consequently perpetuate the propensity to recurrent infection. This 'vicious cycle' of infection and inflammation in bronchiectasis suggests that long-term antibiotic therapy might be beneficial in these patients by reducing microbial load and, in doing so, inhibit inflammation in the lung allowing tissue repair to occur. ⋯ This article will cite the studies reported for long-term antibiotic treatment in bronchiectasis and overall there seems to be benefits for patients with chronic sputum purulence. The evidence that supports the postulated pathological mechanisms will also be discussed. Important issues in clinical practice such as the usefulness of antibiotic sensitivities, the evolution of resistance patterns, and drug delivery will also be discussed.
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Respiratory medicine · Jul 2003
Bacterial infections in patients requiring admission for an acute exacerbation of COPD; a 1-year prospective study.
To investigate the frequency of respiratory bacterial infections in hospitalized patients, admitted with an acute exacerbation of chronic obstructive pulmonary disease (COPD), to identify the responsible pathogens by sputum culture and to assess patient characteristics in relation to sputum culture results. ⋯ Incidence of bacterial infection during acute exacerbations of COPD is about 50%. Patients with and without bacterial infection are not different in clinical characteristics or in outcome parameters. Patients with lower FEV1 have a higher incidence of bacterial infections, but there is no difference in the type of bacterial infection. In the future, the pathogenic role of bacterial infection in exacerbations of COPD should be further investigated, especially the role of bacterial infection in relation to local and systemic inflammation.