Respiration; international review of thoracic diseases
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Comparative Study Clinical Trial
Differences in response to pulmonary rehabilitation in idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease.
The benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) are well recognized. However, whether individuals with idiopathic pulmonary fibrosis (IPF) benefit is less clear. ⋯ Pulmonary rehabilitation in IPF produces only modest short-term gains in dyspnea, exercise capacity and ADL, but does not improve health status.
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Clinical Trial
Multidetector row computed tomography to assess changes in airways linked to asthma control.
In asthma, multidetector row computed tomography (MDCT) detects abnormalities that are related to disease severity, including increased bronchial wall thickness. However, whether these abnormalities could be related to asthma control has not been investigated yet. ⋯ MDCT is insensitive for demonstrating any decrease in bronchial wall thickness. This is mainly due to changes in bronchial caliber which may be linked to modifications of the elastic properties of the bronchopulmonary system under treatment.
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Flexible bronchoscopy can play an important role in the evaluation of an airway lumen during therapeutic bronchoscopic procedures. Despite its potential usefulness, however, evaluation with a standard-sized bronchoscope, which cannot pass completely through a severely stenosed airway, is often unsatisfactory. ⋯ The thin bronchoscope can be a useful tool for evaluating a severely stenosed airway during the stenting procedure.
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Increased risk of spontaneous pneumothorax has been described in patients with Marfan syndrome and has been attributed, in part, to the presence of apical blebs and bullae. ⋯ The frequency of blebs is relatively low in patients with Marfan syndrome but the risk of pneumothorax is significantly higher in those with radiologically detectable blebs or bullae. Chest CT scanning to identify blebs and bullae may allow risk stratification for pneumothorax in patients with Marfan syndrome.
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Irreversible airways obstruction in smokers is usually attributed to chronic obstructive pulmonary disease (COPD). We speculate that some of these are cases of asthma indistinguishable from COPD. ⋯ COPD, even in heavy smokers, includes cases of asthma. FEV1 fluctuation during 1 year is a novel concept which may distinguish irreversible asthma and COPD.