Articles: function.
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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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Autonomic function tests require standardised test conditions. We compared testing under non-standardised and standardised conditions and investigated the agreement between heart and pulse rate variability in 30 subjects with diabetes mellitus. Deep breathing, Valsalva manoeuvre and quick standing tests showed non-standardised reproducibility intraclass correlations (95% CI) of 0.96 (0.82-0.99), 0.96 (0.81-0.99) and 0.75 (-0.98 to 0.94), respectively. ⋯ Reproducibility under standardised conditions was comparable. The mean difference (95% limits of agreement) between heart and pulse rate variability was 0.99 (0.80-1.22) for very low frequency, 1.03 (0.88-1.21) for low frequency and 1.35 (0.84-2.16) for high frequency, with a Spearman's correlation coefficient of 1.00, 0.99 and 0.98, respectively. We demonstrated a high agreement between heart and pulse rate variability and acceptable reproducibility with most autonomic function tests, heart and pulse rate variability.
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The aim of this study was to investigate cardiac function and haemodynamic indices using transthoracic echocardiography in women with severe pre-eclampsia who had already received treatment interventions. Fifteen women with treated severe pre-eclampsia were studied using transthoracic echocardiography. Mean (SD) cardiac output in women with treated disease was 5690 (1708) ml.min(-1). ⋯ Left ventricular mass was increased at 182.0 (44.4) g. There was large variability in haemodynamics in women with treated severe pre-eclampsia. Transthoracic echocardiography is acceptable and applicable and enables quantification of cardiac function in women with severe pre-eclampsia.
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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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Critical care medicine · May 2014
ReviewRehabilitation Interventions for Postintensive Care Syndrome: A Systematic Review.
An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. ⋯ Interventions which have substantial effects in post-ICU patients are rare. Positive effects were seen for ICU-diary interventions for posttraumatic stress disorder. More interventions for the growing number of ICU survivors are needed.