Chest
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Randomized Controlled Trial Multicenter Study
Alendronate once weekly for the prevention and treatment of bone loss in Canadian adult cystic fibrosis patients (CFOS trial).
Patients with cystic fibrosis (CF) are at risk for early bone loss, and demonstrate increased risks for vertebral fractures and kyphosis. A multicenter, randomized, controlled trial was conducted to assess the efficacy, tolerability, and safety of therapy with oral alendronate (FOSAMAX; Merck; Whitehouse Station, NJ) in adults with CF and low bone mass. ⋯ Alendronate therapy was well tolerated and produced a significantly greater increase in BMD over 12 months compared with placebo.
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Randomized Controlled Trial
Rapid effect of inhaled ciclesonide in asthma: a randomized, placebo-controlled study.
Ciclesonide is a novel inhaled corticosteroid for the treatment of asthma, and it is important to measure the onset of effect of this therapy on airway hyperresponsiveness (AHR), exhaled nitric oxide (NO), and levels of eosinophils in induced sputum. ⋯ A single dose of ciclesonide decreased AHR to AMP and exhaled NO within 3 h, while FEV, improved at 3 days and 7 days.
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Randomized Controlled Trial Multicenter Study
Sitaxsentan for the treatment of pulmonary arterial hypertension: a 1-year, prospective, open-label observation of outcome and survival.
Despite advances in the management of pulmonary arterial hypertension (PAH), the mortality rate remains excessive. Long-term efficacy evaluations are needed to guide therapeutic management. The purpose of this study is to present 1-year observational data with two endothelin antagonists, sitaxsentan and bosentan, in a prospective, open-label study. ⋯ At 1 year, sitaxsentan therapy appears safe and efficacious for patients with PAH; reductions in mortality and the risk for clinical worsening events provide support for durability of efficacy.
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Randomized Controlled Trial
Patterns of domestic activity and ambulatory oxygen usage in COPD.
The aim of this study was to examine patterns of domestic activity and ambulatory oxygen usage in patients with COPD in their domestic environment. ⋯ In the short term, ambulatory oxygen therapy is not associated with improvements in physical activity, HRQL, or time spent away from home. However, the use of cylinder oxygen increased over the 8 weeks compared to cylinder air. Patients need time to learn how to use oxygen, and ambulatory oxygen appears to enhance activities rather than increase them.
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Randomized Controlled Trial
Differences in the response to methacholine between the tidal breathing and dosimeter methods: influence of the dose of bronchoconstrictor agent delivered to the mouth.
It has been postulated that differences in provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) values between the dosimeter method and tidal breathing method might be due to differences in the dose of agonist delivered to the mouth. The aim of the present study was to determine the influence of the dose of aerosol delivered to the mouth on differences in the response obtained with each challenge method. ⋯ The tidal breathing method produces PC20 values significantly lower than a modified dosimeter method, which delivers the same volume of aerosol. These results suggest that the discordant PC20 values obtained with the two methods are not due to differences in the dose of agonist delivered to the mouth.