Respiration; international review of thoracic diseases
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In patients with severe chronic obstructive pulmonary disease (COPD), pursed-lips breathing (PLB) improves the pulmonary gas exchange and hyperinflation measured by electro-optic coupling. The response to PLB in inspiratory lung function tests is not known. ⋯ Improved IC after PLB indicates less hyperinflation in patients with severe COPD; there was no effect on parameters of flow.
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Multicenter Study Comparative Study
U.K. National COPD Resources and Outcomes Project 2008: patients with chronic obstructive pulmonary disease exacerbations who present with radiological pneumonia have worse outcome compared to those with non-pneumonic chronic obstructive pulmonary disease exacerbations.
Limited comparative data exist on the outcomes of patients presenting with chronic obstructive pulmonary disease (COPD) exacerbations with or without radiological pneumonia. ⋯ Patients who present with radiological pneumonia have worse outcomes compared to those admitted without pneumonia in exacerbation of COPD.
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This report summarizes initial tests of an emphysematous lung synthetic polymer sealant (ELS) designed to reduce lung volume in patients with advanced emphysema. ⋯ ELS therapy shows promise for treating patients with advanced heterogeneous emphysema. Additional studies to assess responses in a larger cohort with a longer follow-up are warranted.
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Endothelial dysfunction has recently been demonstrated in obstructive sleep apnea (OSA), but the underlying mechanisms are not entirely understood. Oxidative stress is a typical feature of OSA. ⋯ This study strongly suggests that microvascular endothelial function is affected by OSA predominantly through increased oxidative stress, and treatment of OSA may improve endothelial function mainly by reducing oxidative stress. The role of oxidative stress-induced endothelial dysfunction as a potential promoter of atherosclerosis and an increased cardiovascular risk in patients with OSA should be investigated in further controlled studies.
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Long-term adherence to positive airway pressure (PAP) treatment is essential in patients with obstructive sleep apnea syndrome (OSAS). ⋯ PAP treatment adherence has to be optimized in OSAS patients. When initiating PAP therapy, clinicians have to focus on those patients at risk for discontinuing treatment. Education sessions and closer follow-up are possible strategies to improve treatment adherence and to avoid treatment discontinuation.