Thorax
-
Randomized Controlled Trial Comparative Study Clinical Trial
Measuring the systemic effects of inhaled beclomethasone: timed morning urine collections compared with 24 hour specimens.
Inhaled glucocorticoid therapy has systemic effects including hypothalamic-pituitary-adrenal (HPA) suppression. The optimal test for detecting these effects has not been defined. ⋯ UCC ratios are as sensitive as the more cumbersome 24 hour urinary free cortisol excretion, and more sensitive than single morning plasma cortisol measurements, in detecting the effects of inhaled beclomethasone on the HPA axis.
-
Comparative Study
Significant differences in flow standardised breath sound spectra in patients with chronic obstructive pulmonary disease, stable asthma, and healthy lungs.
Spectral characteristics of breath sounds in asthma and chronic obstructive pulmonary disease (COPD) have not previously been compared, although the structural differences in these disorders might be reflected in breath sounds. ⋯ The observed differences in frequency content of breath sounds in patients with asthma and COPD may reflect altered sound generation or transmission due to structural changes of the bronchi and the surrounding lung tissue in these diseases. Spectral analysis of breath sounds may provide a new non-invasive method for differential diagnosis of obstructive pulmonary diseases.
-
A case is described of fulminant community-acquired pneumococcal pneumonia in a 16 year old girl with no previous history of respiratory disease or any predisposing factors. She required extracorporeal membrane oxygenation (ECMO) until the diagnosis could be made and appropriate antibiotic therapy established.
-
Ultrasound allows observation of the thickness of the diaphragm in the zone of apposition in vivo during relaxation and maximum inspiratory efforts. ⋯ Ultrasound provides a non-invasive assessment of diaphragm thickness with change of lung volume and during the PImax manoeuvre which should prove useful in assessing diaphragm mass and contraction in respiratory and muscle disease.