Thorax
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Multicenter Study
Isolated nocturnal desaturation in COPD: prevalence and impact on quality of life and sleep.
The clinical impact of nocturnal desaturation on health related quality of life (HRQL) and sleep in chronic obstructive pulmonary disease (COPD) has been little studied. The aim of this study was to evaluate the prevalence and clinical impact of nocturnal desaturation in a typical outpatient population with COPD. ⋯ Significant nocturnal desaturation was common in patients with COPD with resting saturations of less than 95%, but was estimated to have a prevalence of less than 5% in the whole outpatient population. Nocturnal desaturation was not associated with impairment of HRQL, sleep quality or daytime function.
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While acute lung injury (ALI) is among the most serious postoperative pulmonary complications, its incidence, risk factors and outcome have not been prospectively studied. ⋯ ALI is the most common cause of postoperative respiratory failure and is associated with markedly lower postoperative survival. Intraoperative tidal volume was not associated with an increased risk for early postoperative ALI.
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Randomized Controlled Trial Multicenter Study
Breathing exercises for asthma: a randomised controlled trial.
The effect of breathing modification techniques on asthma symptoms and objective disease control is uncertain. ⋯ Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication.
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Effect of breastfeeding duration on lung function at age 10 years: a prospective birth cohort study.
The protective effects of breastfeeding on early life respiratory infections are established, but there have been conflicting reports on protection from asthma in late childhood. The association of breastfeeding duration and lung function was assessed in 10-year-old children. ⋯ Breastfeeding for at least 4 months enhances lung volume in children. The effect on airflow appears to be mediated by lung volume changes. Future studies need to elucidate the mechanisms that drive this phenomenon.
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Chronic obstructive pulmonary disease (COPD) is characterised by the presence of airflow limitation caused by loss of lung elasticity and/or airway narrowing. The pathological hallmark of loss of lung elasticity is emphysema, and airway wall remodelling contributes to the airway narrowing. Using CT, these lesions can be assessed by measuring low attenuation areas (LAA) and airway wall thickness/luminal area, respectively. As previously reported, COPD can be divided into airway dominant, emphysema dominant and mixed phenotypes using CT. In this study, it is postulated that a patient's physique may be associated with the relative contribution of these lesions to airflow obstruction. ⋯ A low BMI is associated with the presence of emphysema, but not with airway wall thickening, in male smokers who have COPD. These results support the concept of different COPD phenotypes and suggest that there may be different systemic manifestations of these phenotypes.