Respiratory care
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COPD will become the third leading cause of death by 2020. There are many situations in which spirometry, the primary tool for diagnosis of COPD, cannot be performed, and thus, the staging and status of these patients cannot be determined. To date, there is no known biochemical marker used for diagnosing COPD. This study aimed to explore the utility of biomarkers for diagnosis of COPD. ⋯ Biomarkers can be reliably utilized in the diagnosis of COPD. Of all the markers, SPD appears to be the most promising in smokers, whereas ferroxidase activity shows promise in nonsmokers. To rule out COPD, ferroxidase activity or glutathione peroxidase can be potentially useful, whereas to rule in COPD, ferroxidase activity and glutathione peroxidase appear to be the most promising combination in both nonsmoking and smoking subjects.
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The most important and difficult task when it comes to reducing tobacco-related morbidity and mortality is to convince smokers to quit and to maintain their abstinence. This study aimed to determine the smoking relapse rate and factors related to relapse in subjects who participated in a smoking cessation program and completed a 1-y follow-up in our center. ⋯ The relapse rate in a 1-y period was 51.4%. Similar to previous studies, alcohol intake presented a relapse risk. In subjects receiving drug treatment, planning support meetings more frequently and paying attention to adverse effects may increase the success of smoking cessation.
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Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as ≥4 h of use/night for ≥70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. ⋯ CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for ≥4 h/night for ≥70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.
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Readmission of mechanically ventilated patients to an ICU within 7 d reflects not only patient safety but also the quality of care of the ICU. This study aimed to investigate the risk and related factors for readmission to an ICU within 7 d in mechanically ventilated subjects. ⋯ The risk and related factors of a mechanically ventilated subject whose age is ≥ 17 y old being readmitted to the ICU within 7 d include subject characteristics, health status, hospital attributes, and the length of ICU stay. Therefore, higher risk subjects should receive attention and assessment before transfer or discharge from the ICU to prevent readmission.