Chronic respiratory disease
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Review Meta Analysis
Predictors of efficacy for endobronchial valves in bronchoscopic lung volume reduction: A meta-analysis.
Over the last several years, numerous trials have been carried out to check the efficacy of one-way valves in the management of advanced emphysema. While the design of the valves has not altered much, by selectively studying these valves in a select group of participants, such as those with and without intact fissures (FI+ and FI-), and by using different procedural techniques, our understanding of the valves has evolved. In this meta-analysis, we sought to study the effect of these factors on the efficacy of one-way valves. ⋯ In comparison, these results were superior to the FI- subgroup of participants. A separate analysis of the FI+ subgroup based on lobar occlusion versus nonlobar occlusion favored the former for superior efficacy. The preliminary findings of our meta-analysis confirm that one-way valves perform better in a select group of patients who show intact fissures on lung imaging pretreatment and in those who achieve lobar occlusion.
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Oxygen therapy is a common intervention in health care worldwide; yet, despite universal use, it is evident through poor practice that oxygen is often prescribed and administered injudiciously. It is proposed that possibly an influencing culture presides, whereby oxygen is often poorly understood and uncertainty regarding its use exists. It is unclear where the origins of this culture lie but exploring perceptions may enlighten the problem. ⋯ There appears uncertainty among patients regarding the purpose and benefits of oxygen therapy, though an underlying faith in health-care professionals is apparent. This faith seems to foster acceptance of a life-changing therapy, despite the impact, burden and incomplete understanding. There is a clear need for further research regarding these elusive perceptions in order to improve clinical practice in respect of oxygen.
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Functional status and quality of life are measures of the chronic obstructive pulmonary disease (COPD) patient's health status and can demonstrate the impact of the disease on the patient's ability to perform activities of daily living (ADLs). The Glittre-ADL test was developed to evaluate the functional status of COPD patients and their ability to perform activities of daily life. The objective of this study was to evaluate the cardiac, respiratory, and metabolic adjustments and reproducibility of the Glittre ADL test performed by COPD patients. ⋯ At the end of the test, patients reached 87.7% of the VO2 max, 81% of VE peak, and 88.5% of the HR peak obtained from an incremental maximal test on a treadmill. The Glittre ADL test is easy for COPD patients to perform and is a highly reproducible test in COPD patients with mild to severe stages of the disease. In addition, our results suggest that it is possible to demonstrate the patient's functional capacity with a single test of only three laps, making it faster and easier to apply and less stressful for some patients.