Respiratory medicine
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Respiratory medicine · Nov 2016
Comparative StudyClinical usefulness of end-tidal CO2 profiles during incremental exercise in patients with chronic thromboembolic pulmonary hypertension.
Great ventilation to carbon dioxide output (ΔV˙E/ΔV˙CO2) and reduced end-tidal partial pressures for CO2 (PetCO2) during incremental exercise are hallmarks of chronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). However, CTEPH is more likely to involve proximal arteries, which may lead to poorer right ventricle-pulmonary vascular coupling and worse gas exchange abnormalities. Therefore, abnormal PetCO2 profiles during exercise may be more prominent in patients with CTEPH and could be helpful to indicate disease severity. ⋯ Compared to patients with IPAH, patients with CTEPH present more impaired gas exchange during exercise, and PetCO2 abnormalities may be used to identify more clinically and hemodynamically severe cases.
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Respiratory medicine · Oct 2016
Clinical features and natural history of interstitial pneumonia with autoimmune features: A single center experience.
To describe the clinical phenotype and natural history of a cohort of patients with interstitial pneumonia with autoimmune features (IPAF). ⋯ In this single center study, patients with IPAF were predominately non-smoking women with high-resolution computed tomography scans that suggested NSIP. Their pulmonary physiology was stable, and during limited follow-up, no deaths were observed. Prospective and multi-center studies are needed to better inform our understanding of IPAF.
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Respiratory medicine · Oct 2016
Randomized Controlled Trial Clinical TrialRandomised, double-blind, placebo-controlled, cross-over single dose study of the bronchodilator duration of action of combination fluticasone furoate/vilanterol inhaler in adult asthma.
Fluticasone furoate (FF)/vilanterol (VI) is a once-daily maintenance treatment for asthma and chronic obstructive pulmonary disease. The duration of bronchodilation beyond 24 h has not been determined previously. ⋯ A single dose of FF/VI 100/25 mcg showed evidence of a 72-h bronchodilator duration of action in adults with asthma.
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Respiratory medicine · Oct 2016
Clinical characteristics in patients with asymmetric idiopathic pulmonary fibrosis.
A group of patients with idiopathic pulmonary fibrosis (IPF) presents with disease affecting one lung markedly more than the other. At this time, it is unclear how this population differs from those who present with more symmetric disease. We sought to explain the characteristics of the asymmetric group and how their disease progresses. ⋯ Patients with asymmetric IPF resemble patients in the general IPF population but may have a lower overall survival rate. Further systemic factors may be studied to identify reasons for disease asymmetry and clinical decline in this population.
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Respiratory medicine · Oct 2016
The relationship of body habitus and respiratory function in Duchenne muscular dystrophy.
The multidisciplinary care of Duchenne muscular dystrophy (DMD) incorporates management of nutrition and the respiratory system, however the effect of body habitus on respiratory function in DMD is poorly understood. The present study examined the impact of nutritional status on respiratory function in DMD to guide further treatment strategies. ⋯ The present study reinforces the importance of weight management in DMD, showing that a higher weight profile and lower adiposity have better respiratory outcomes. Furthermore, attention to body position with airway clearance techniques will maximize their effectiveness.