Respiration; international review of thoracic diseases
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Measurements in absolute terms of the whole respiratory movement pattern (range, type, symmetry, rhythm and frequency of breathing movements) of healthy individuals are valuable for reference, when assessing patients with conditions affecting respiration. ⋯ As men and women have similar breathing movements during quiet breathing their reference values can be combined. On the other hand, separate reference values are needed for men and women for deep breathing.
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Multicenter Study Comparative Study
Gender and chronic obstructive pulmonary disease in high-risk smokers.
Data suggest that women are more susceptible to develop airway obstruction compared to men for the same number of cigarettes smoked. ⋯ Using the GOLD criteria, the prevalence of COPD in smokers was higher than previous reports. In this self-selected sample of high-risk smokers having the same smoking history, prevalence was lower in women than in men, suggesting a lower susceptibility for the development of airway obstruction.
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Over a 36-month study period, 10 nonconsecutive neuromuscular pediatric patients (6 infants, mean age 10.16 months, and 4 children, mean age 9.3 years) presenting with acute respiratory failure (ARF) were treated by noninvasive positive pressure ventilation (NPPV). All patients required immediate respiratory support and fulfilled our intubation criteria. ⋯ NPPV was a safe and effective first-line therapeutic approach in hypoxemic ARF children/infants with neuromuscular disease. It seems of importance to identify children with neuromuscular disorders who may be able to achieve residual ventilator-free breathing and to perform an NPPV trial avoiding tracheal intubation. Life-threatening respiratory distress and very young age should not preclude NPPV application in the PICU setting. The new helmet interface represents a promising tool for noninvasive ventilation in older children.
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Randomized Controlled Trial
Repeated pulmonary rehabilitation in severe and disabled COPD patients.
The optimal frequency of delivering a pulmonary rehabilitation program (PR) is not yet a well established issue. It is still unclear whether repeated PR at established intervals will result in effective maintenance or further improvement in the patient's health status. ⋯ In severe and disabled COPD, a more frequently repeated inpatient PR may lead to some additional physiological and clinical benefits over 1 year.
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Case Reports
Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids.
Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. ⋯ Postmortem lung histologic examination was consistent with amiodarone-induced pneumonitis. Since this complication is thought to be of immunological origin, we speculate that the sudden withdrawal of steroids was implicated in the development of the acute lung injury.