Thorax
-
A biologically plausible link between gastro-oesophageal reflux (GOR), aspiration, and lung allograft dysfunction has been suggested, but there is no systematic evidence indicating the presence of gastric contents in the lung. We have tested the hypothesis that pepsin, as a marker of aspiration, is detectable in bronchoalveolar lavage (BAL) fluid of allograft recipients who had not reported symptoms of GOR. ⋯ These data demonstrate lung epithelial lining fluid concentrations of pepsin in lung allograft recipients which are much higher than blood reference levels, with no detectable pepsin in controls. This provides direct evidence of gastric aspiration, which is potentially injurious to the allograft.
-
Multicenter Study
Implications of reversibility testing on prevalence and risk factors for chronic obstructive pulmonary disease: a community study.
The Global Initiative for Obstructive Lung Disease (GOLD) has defined chronic obstructive pulmonary disease (COPD) as a post-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) of <0.7. In the first general population based study to apply post-bronchodilator values, the prevalence and predictors of GOLD defined COPD were assessed and the implications of beta2 agonist reversibility testing examined. ⋯ These results indicate that community programmes on prevention of COPD should focus on anti-smoking, nutritional aspects, and socioeconomic conditions. The effect of beta2 reversibility testing on prevalence estimates of COPD was substantial.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Randomised crossover study of pressure and volume non-invasive ventilation in chest wall deformity.
Non-invasive ventilation is an established treatment for chronic respiratory failure due to chest wall deformity. There are few data available to inform the choice between volume and pressure ventilators. The aim of this study was to compare pressure and volume targeted ventilation in terms of diurnal arterial blood gas tensions, lung volumes, hypercapnic ventilatory responses, sleep quality, and effect on daytime function and health status when ventilators were carefully set to provide the same minute ventilation. ⋯ These data suggest that pressure and volume ventilation are equivalent in terms of the effect on nocturnal and daytime physiology, and resulting daytime function and health status.
-
Review Meta Analysis
Association of birth weight with adult lung function: findings from the British Women's Heart and Health Study and a meta-analysis.
The aim of this study was to examine the associations between birth weight and lung function in a cohort of women aged 60-79 years and to combine these results with those from other published studies in a systematic review and meta-analysis. ⋯ There is a modest positive association between birth weight and lung function which indicates that intrauterine factors might have a role in lung development.
-
Randomized Controlled Trial Clinical Trial
Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnoea.
Obstructive sleep apnoea (OSA) elicits a number of cardiovascular perturbations that could lead acutely or chronically to increased ventricular ectopy in patients with heart failure (HF). We tested the hypothesis that treatment of OSA with continuous positive airway pressure (CPAP) in patients with HF would reduce the frequency of ventricular premature beats (VPBs) during sleep in association with reduced sympathetic nervous system activity. ⋯ In patients with HF, treatment of co-existing OSA by CPAP reduces the frequency of VPBs during sleep. These data suggest that reductions in VPBs and other ventricular arrhythmias through treatment of OSA might improve the prognosis in patients with HF.