Respirology : official journal of the Asian Pacific Society of Respirology
-
Cyclophosphamide is widely used in neoplastic and inflammatory diseases. Although several adverse events have been described with its use, acute and subacute interstitial pneumonitis leading to pulmonary fibrosis is rare and potentially fatal. This case report describes a 64-year-old man who, after the fifth chemotherapy cycle, developed a severe ARDS leading to pulmonary fibrosis in just 30 days.
-
Cardiovascular disease (CVD) contributes significantly to morbidity and mortality in COPD. There is a high prevalence of traditional risk factors in this patient group including smoking, sedentary behaviour and low socio-economic class. However, large studies have shown that airflow limitation is an independent risk factor for CVD. ⋯ In this article, we review the evidence for CVD in COPD. Next, we examine systemic factors present in COPD, and link these to the pathogenesis of atherosclerosis, including inflammation, oxidative stress and hypoxia. Finally, we review those studies that have investigated therapeutic interventions in COPD that may modify cardiovascular risk.
-
To assess the diagnostic performance of the amino-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in pleural fluid and serum for the identification of pleural effusions owing to heart failure, and to determine if these measurements allow better categorization of cardiac effusions that have been misclassified by Light's criteria, than do serum-pleural fluid albumin and protein gradients. ⋯ NT-proBNP is a useful marker for the diagnosis of pleural effusions from heart failure when measured in either serum or pleural fluid. At a cut-off of 1500 pg/mL, NT-proBNP is at least as accurate as the albumin gradient to correctly identify cardiac effusions misclassified as exudates by standard criteria, but at much higher cost.
-
Most asthmatics with mucus hypersecretion have difficulty in clearing their secretions so that mucus plugs and airway obstruction are commonly present. Inhaled mannitol facilitates clearance of mucus. This study investigated the changes in the physical properties of sputum in response to mannitol in asthmatics with chronic cough and sputum production. ⋯ Inhaled mannitol reduced the viscoelasticity, surface tension, contact angle and the solids content of sputum in asthmatics with chronic cough and sputum production, consistent with the osmotic effect of mannitol causing water efflux in the airway lumen.
-
The fifteen-count breathlessness score (15CBS) has been reported to quantify breathlessness; however, a ceiling effect limits its ability to discriminate between subjects with varying degrees of breathlessness. The aim of this study was to determine the reliability, sensitivity, specificity and validity of the thirty-count breathlessness score (30CBS) in adults with COPD. ⋯ While reliable, the 30CBS did not display sufficient discriminative ability to predict subjects with COPD though subjects requiring greater than two breaths may warrant further investigation. The 30CBS may be a useful indicator of physiological impairment, but was not significantly correlated with measures of breathlessness.