Rev Port Pneumol
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To translate and culturally adapt the Living with Asthma Questionnaire (LWAQ) to the Portuguese language and to test its reliability and validity. ⋯ The Portuguese LWAQ exhibited suitable psychometric properties, in terms of internal consistency, reproducibility and construct validity.
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Case Reports
Flexible bronchoscopy during mechanical ventilation in the prone position to treat acute lung injury.
In patients with severe acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) the prone position has been shown to improve survival of patients who are severely hypoxemic with an arterial oxygen tension to inspiratory oxygen fraction ratio (PaO(2)/FiO(2))<100. In those patients tracheobronchial toilette is crucial in preventing or treating airways obstructed by secretions and deterioration of oxygenation. ⋯ Flexible bronchoscopy performed during prone mechanical ventilation in two cardiosurgical patients who developed ALI after complex surgery, proved feasible and safe and helped to avoid undesirable earlier cessation of prone mechanical ventilation. However decision making about bronchoscopy in severe hypoxia should be even more cautious than in the supine patient, as dangerous delay in resuscitation manoeuvres due to postponed switching the patient to the supine position should always be prevented.
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Excessive daytime sleepiness is a major symptom in obstructive sleep apnea syndrome (OSAS) and can be evaluated using both subjective and objective methods. The Epworth Sleepiness Scale (ESS) is a simple and validated questionnaire for assessing subjective daytime sleepiness in the context of sleep disorders. Although its subjective character may limit the accurate expression of daytime sleepiness, the clinical benefit of sequential ESS is clear and demonstrates how ESS scores evolve in individual patients and how these scores may relate to various parameters. ⋯ The mean baseline ESS score was 11.8, mean retrospective baseline ESS 15.4, with a mean difference of 3.55 (p<0.001 t-Test) and post-treatment ESS 7.3. There was no significant correlation between the difference in ESS score (baseline - retrospective baseline) with the average daily (hours) use of APAP, the apnea-hypopnea index (AHI), the minimal recorded SatO(2), disease duration, body mass index (BMI) and age. Our findings confirm that the severity of subjective sleepiness reported before treatment with positive airway pressure is often underestimated by patients with OSAS.