Articles: chronic.
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Randomized Controlled Trial
A Randomized Controlled Trial of ACE-inhibition for Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease.
Skeletal muscle impairment is a recognized complication of COPD, predicting mortality in severe disease. Increasing evidence implicates the renin-angiotensin system in control of muscle phenotype. We hypothesized that angiotensin-converting enzyme (ACE) inhibition would improve quadriceps function and exercise performance in COPD. ⋯ This randomized controlled trial found that ACE inhibition, using fosinopril for 3 months, did not improve quadriceps function or exercise performance in patients with COPD with quadriceps weakness.
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Chronic pain impairs the quality of life for millions of individuals and therefore presents a serious ongoing challenge to clinicians and researchers. Debilitating chronic pain syndromes cost the US economy more than $600 billion per year. This article provides an overview of the epidemiology, clinical presentation, and treatment outcomes for craniofacial, spinal, and peripheral neurologic pain syndromes. Although the authors recognize that the diagnosis and treatment of the chronic forms of neuropathic pain syndromes represent a clinical challenge, there is an urgent need for standardized classification systems, improved epidemiologic data, and reliable treatment outcomes data.
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Multicenter Study Clinical Trial
Chinese Waterpipe Smoking and the Risk of Chronic Obstructive Pulmonary Disease.
Studies show that the incidence of COPD has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality. Chinese water-pipe tobacco smoking (commonly referred to as water-pipe smoking), which is thought to be less harmful under the assumption that no charcoal is used and water filters tobacco smoke, is popular in China. We investigated whether Chinese water-pipe use and exposure are associated with the risk of COPD. ⋯ Chinese water-pipe smoking significantly increases the risk of COPD, including the risk to women who are exposed to the water-pipe smoke.
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Curr Opin Crit Care · Oct 2014
Review Historical ArticleA history of outcome prediction in the ICU.
There are few first-hand accounts that describe the history of outcome prediction in critical care. This review summarizes the authors' personal perspectives about the development and evolution of Acute Physiology and Chronic Health Evaluation over the past 35 years. ⋯ There is increasing evidence that superior accuracy in outcome prediction requires complex modeling with detailed adjustment for diagnosis and physiologic abnormalities. Thus, an automated electronic system is recommended for gathering data and generating predictions. Support, either public or private, is required to assist users and to update and improve models. Current outcome prediction models have increasingly focused on benchmarks for resource use, a trend that seems likely to increase in the future.