Chest
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Randomized Controlled Trial Comparative Study
Optimizing the 6-min walk test as a measure of exercise capacity in COPD.
It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min walk distance if an additional walk were to be performed. ⋯ Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD.
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Randomized Controlled Trial Multicenter Study
Oral treprostinil for the treatment of pulmonary arterial hypertension in patients on background endothelin receptor antagonist and/or phosphodiesterase type 5 inhibitor therapy (the FREEDOM-C study): a randomized controlled trial.
Infused and inhaled treprostinil are effective for treatment of pulmonary arterial hypertension (PAH), although their administration routes have limitations. This study assessed the efficacy and safety of bid oral sustained-release treprostinil in the treatment of PAH with a concomitant endothelin receptor antagonist (ERA) and/or phosphodiesterase type 5 inhibitor. ⋯ The primary end point of improvement in 6MWD at week 16 did not achieve significance. This study enhanced understanding of oral treprostinil titration and dosing, which has set the stage for additional studies.
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Comparative Study
Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease.
Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex; however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellulare lung disease. ⋯ Patients with M intracellulare lung disease exhibited a more severe presentation and had a worse prognosis than patients with M avium lung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.
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Respiratory frequency increases during exacerbations of COPD (ECOPD). We hypothesized that this increase can be detected at home before ECOPD hospitalization. ⋯ Respiratory frequency can be monitored daily at home in patients with COPD receiving domiciliary oxygen therapy. In these patients, breathing rate increases significantly days before they require hospitalization because of ECOPD. This may offer a window of opportunity for early intervention.
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Comparative Study
Is sleep apnea a winter disease?: meteorologic and sleep laboratory evidence collected over 1 decade.
The severity of obstructive sleep apnea increases by influence of conditions that are more frequent in winter. The hypothesis that the apnea-hypopnea index (AHI) of different patients undergoing polysomnography may be seasonally affected was tested. ⋯ More sleep-disordered breathing events were recorded in winter than in other seasons. Cosinor analysis uncovered a significant seasonal pattern in the AHI of different patients undergoing polysomnography, independent of sex, age, BMI, neck circumference, and relative air humidity. This finding suggests that obstructive sleep apnea severity may be associated with other seasonal epidemiologic phenomena.