Respirology : official journal of the Asian Pacific Society of Respirology
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The aim of this study was to summarize experiences of patients admitted to the intensive care unit (ICU) for an acute exacerbation of COPD and to identify factors associated with a poor outcome. ⋯ For patients with acute exacerbations of COPD in the ICU, serum total protein, a surrogate marker for nutrition, was significantly associated with hospital mortality.
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Randomized Controlled Trial Comparative Study Clinical Trial
Short- and long-term hospital and community exercise programmes for patients with chronic obstructive pulmonary disease.
Pulmonary rehabilitation in patients with COPD has been shown to be beneficial but the optimal setting is not known. In the present study, the efficacy of a short-term community-based exercise programme was compared with a standard hospital outpatient programme. Additionally, the usefulness of community or home programmes in maintaining improvements in the longer term was studied. ⋯ A 3-month community-based exercise programme for patients with COPD did not improve 6MWD. The long-term retention rates in the programmes were poor.
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The aim of the present study was to evaluate the effect of lung volume reduction surgery (LVRS), with an emphasis on improvement in activities of daily living (ADL), psychological state and health-related quality of life (HRQL), for 12 months in patients with severe emphysema. ⋯ Lung volume reduction surgery improves not only lung function and exercise performance but also ADL, HRQL and psychological state for at least 12 months.
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Randomized Controlled Trial Clinical Trial
Adverse effects of short-acting beta-agonists: potential impact when anti-inflammatory therapy is inadequate.
Short-acting beta-agonists (SABAs) are associated with reduced lung function and increased bronchial hyper-responsiveness. Earlier studies have failed to show that these changes are clinically important when SABAs are taken regularly in modest doses. However, some patients use SABAs to excess, especially with deteriorating asthma. Our aim was to establish whether adverse effects of SABAs are greater at higher than normal doses and after withdrawing inhaled corticosteroid (ICS) therapy. ⋯ Adverse changes in lung function with SABA appear to be greater with higher doses and increasing airway inflammation. This highlights the risks of excessive SABA use in patients who neglect ICS therapy and/or who rely on 'relievers'.
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Malignant pleural effusion is a common clinical problem. Evacuation of the pleural fluid and prevention of its reaccumulation are the main aims of management. Pleurodesis should be attempted early, although considerable practice variations exist in the way it is performed. ⋯ The association between talc and ARDS continues to be debated. Ambulatory small-bore pleural catheter drainage followed by intrapleural instillation of a pleurodesing agent is increasingly accepted as an alternative to conventional in-patient pleurodesis. Development of novel methods to control pleural fluid formation should be made a high priority in future pleural research.