Chest
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Comparative Study
Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy.
To assess the performance of two prognostic models in predicting short-term mortality in patients with pulmonary embolism (PE). ⋯ The PESI quantified the prognosis of patients with PE better than the Geneva score. This study demonstrated that PESI can select patients with very low adverse event rates during the initial days of acute PE therapy and assist in selecting patients for treatment in the outpatient setting.
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Controlled Clinical Trial
Right ventricular diastolic dysfunction and the acute effects of sildenafil in pulmonary hypertension patients.
This study investigated whether right ventricular (RV) diastolic function is impaired in pulmonary hypertension (PH) patients, and whether it is related to RV mass and afterload. In addition, the effects of an acute reduction of RV afterload by the oral intake of sildenafil were studied. Finally, we assessed whether diastolic function is related to cardiac parameters of disease severity. ⋯ In PH patients, RV diastolic dysfunction is related to RV mass and afterload. RV diastolic function improves by reducing afterload. The correlations between diastolic function and prognostic parameters showed that diastolic function is most impaired in patients with severe disease.
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Clinical Trial
The significance and outcome of continuous positive airway pressure-related central sleep apnea during split-night sleep studies.
To determine whether central sleep apnea (CSA) occurring during continuous positive airway pressure (CPAP) titration in patients with obstructive sleep apnea (OSA) reflects subclinical congestive heart failure (CHF), and whether these events will improve with CPAP therapy. ⋯ CSA events occurring during CPAP titration are transient and self-limited. They may be precipitated by the sleep fragmentation associated with initial CPAP titration and are not associated with an increased prevalence of occult CHF compared to OSA patients without CPAP-related CSA.
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Untreated pulmonary arteriovenous malformations (PAVMs) can present with life-threatening complications. Agitated saline solution transthoracic contrast echocardiography (TTCE) has been recommended as the screening test of choice for PAVMs in hereditary hemorrhagic telangiectasia (HHT). A TTCE grading system has been proposed but not validated. The aim of this study was to determine the positive predictive value (PPV) of TTCE grades for the presence of PAVMs on CT. ⋯ Increased shunt grade predicts increased probability of PAVMs and may be used to guide decisions in the screening algorithm for PAVMs.
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Comparative Study
Verbal descriptors of dyspnea in patients with COPD at different intensity levels of dyspnea.
Verbal descriptors of dyspnea are important in understanding the underlying mechanisms, but little is known about the language of dyspnea in COPD. We examined the language of dyspnea in COPD at different intensity levels of dyspnea. ⋯ Verbal descriptors of dyspnea in COPD are related to the intensity level of dyspnea. The clusters heavy/fast breathing and work/effort seem to be particularly sensitive descriptors of dyspnea during exercise in COPD.