Pneumonologia i alergologia polska
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Pneumonol Alergol Pol · Jan 2011
[Usefulness of selected tests in the diagnosis of exercise induced bronchoconstriction].
Indirect airway challenge tests are commonly used in the diagnosis of exercise-induced bronchoconstriction (EIB), defined as a post-exercise decrease in FEV(1) ≥ 10%. The aim of this study was to evaluate the diagnostic value of bronchial hyperreactivity tests in the diagnosis of EIB. ⋯ Symptoms suggestive of EIB do not have acceptable sensitivity and specifity for the diagnosis of exercise-induced bronchoconstriction. The most useful measure to diagnose EIB is a combination of typical symptoms of EIB with positive challenge to AMP.
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Pneumonol Alergol Pol · Jan 2011
[Restrictive pattern in spirometry: does FEV(1)/FVC need to be increased?].
Spirometry is an excellent tool in diagnosis of airway obstruction, but is less reliable in restrictive diseases. Diagnosis of lung restriction on the ground of reduced forced vital capacity (FVC) is saddled with a lot of mistakes. According to American Thoracic Society/European Respiratory Society (ATS/ERS) 2005 guidelines restrictive pattern in spirometry consists of a reduction in vital capacity and increase in forced expiratory volume in 1 second/vital capacity (FEV(1)/VC) 〉 85-90%. However, to our knowledge, this recommendation has not been validated. The aim of the study was to check how inclusion of an increased FEV(1)/FVC as a mandatory condition affects value of spirometry in detection of restrictive ventilatory defect. ⋯ Dual condition of reduced FVC and increased FEV(1)/FVC greatly diminishes sensitivity of the test, and hampers diagnosis of restrictive ventilatory defect in spirometry, especially in mild and moderate stages.
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Pneumonol Alergol Pol · Jan 2011
[Mortality and comorbidity in hospitalized chronic obstructive pulmonary disease patients].
Chronic obstructive pulmonary disease (COPD) is a fourth cause of death in USA and is expected to be the third cause of death by year 2020. It is believed that some diseases like cardiovascular diseases, osteoporosis, cachexia, anaemia are systemic consequences of COPD. Some data show that the co-morbidities are more frequent in severe COPD patients than in control groups and are associated with the serious health outcomes. It is debated whether extra pulmonary comorbidities or pulmonary complications are the main reason of death in COPD. The aim of the study was to analyze the mortality and comorbidity in COPD patients who died during hospitalization in the Department of Pneumonology and Allergology in WMU from 2004 to 2008. ⋯ 1. The most frequent reasons of death were related to respiratory system: COPD exacerbation, pneumonia and lung cancer. 2. The most frequent diseases coexisting with COPD were cardiovascular disease, respiratory insufficiency and diabetes mellitus.
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Pneumonol Alergol Pol · Jan 2011
[The role of non-invasive ventilation in the treatment of chronic obstructive pulmonary disease].
Non-invasive ventilation (NIV) is one of the most important developments in pulmonology over the past 15 years. Physiologic effect of NIV is the same as that of invasive ventilation and consists of unloading respiratory muscles and improving oxygenation. Nevertheless avoidance of ominous complications of intubation gives important advantages of NIV over invasive ventilation. ⋯ The role of NIV in the treatment of COPD patients in stable state is less evident. However, there are several theoretical reasons and clinical evidences to use NIV in home setting in patients with severe hypercapnia and symptoms of hypoventilation, in individuals who failed long-term oxygen therapy (LTOT) treatment and in subjects with recurrent exacerbations. Moreover, NIV in acute and chronic setting was recognized as cost-effective treatment.