Articles: chronic.
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There is increasing interest in the use of telemedicine to assist in the management of chronic diseases. Telemedicine possibilities for patients with COPD include medical consultations, in-home patient monitoring, and remote rehabilitation. Teleconsultations have been used successfully, saving time and travel costs for patients with only a few subsequently requiring face-to-face visits. ⋯ Given the health-care costs and commitment involved in telemonitoring, well-designed longer-term multicenter studies with appropriate follow-up are required prior to its more widespread application. Emerging evidence from preliminary trials of telerehabilitation for the pulmonary patient is encouraging. It may represent a useful tool for increasing access and building capacity, especially in remote areas.
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Clinical Trial
Young "healthy" smokers have functional and inflammatory changes in the nasal and the lower airways.
Smoking is responsible for most COPD. Although people with COPD often have concomitant nasal disease, there are few studies that report physiologic or inflammatory changes in the upper airways in young asymptomatic smokers. We investigated physiologic and inflammatory changes in the nasal and lower airways of young smokers and if these changes were related to smoking history. ⋯ Young adult smokers have functional and inflammatory changes in the nasal and lower airways and these correlate with smoking history. However, in these young smokers, smoking history was not associated with pulmonary function decline, probably because it is unlikely that spirometry detects early physiologic changes in the airways.
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The Short Physical Performance Battery (SPPB) is commonly used in gerontology, but its determinants have not been previously evaluated in COPD. In particular, it is unknown whether pulmonary aspects of COPD would limit the value of SPPB as an assessment tool of lower limb function. ⋯ The SPPB is a valid and simple assessment tool that may detect a phenotype with functional impairment, loss of muscle mass, and structural muscle abnormality in stable patients with COPD.
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The aim of the present study was to elucidate whether occupational exposure to vapors, gases, dusts, and fumes increases the mortality risk of COPD, especially among never smokers. ⋯ Occupational exposure to airborne pollution increases the mortality risk for COPD, especially among never smokers.
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Reduced pulmonary arterial compliance (Ca) is a marker of poor prognosis in idiopathic pulmonary arterial hypertension. We tested the hypothesis that pulmonary arterial Ca could be a predictor of outcome in patients with chronic heart failure (CHF). ⋯ Pulmonary arterial Ca is a strong prognostic indicator in patients with CHF with sLVD. Most importantly, its prognostic role is retained in patients with normal pulmonary vascular resistance.