Chest
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Randomized Controlled Trial Multicenter Study
Effect of fluticasone propionate/salmeterol on lung hyperinflation and exercise endurance in COPD.
To examine the effect of fluticasone propionate, 250 microg/salmeterol, 50 microg combination (FSC 250/50) twice daily on lung hyperinflation and associated measures of exercise performance in patients with COPD. ⋯ We conclude that FSC 250/50 decreases lung hyperinflation at rest and during exercise with an associated increase in exercise endurance time when compared with placebo.
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Meta Analysis
How frequently is venous thromboembolism in heparin-treated patients associated with heparin-induced thrombocytopenia?
Patients receiving heparin for thromboprophylaxis or treatment may have new or recurrent venous thromboembolism (VTE) if immune-mediated heparin-induced thrombocytopenia (HIT) occurs or for other reasons, eg, if anticoagulation fails. We estimated from the literature how frequently a patient presenting with VTE during or following heparin therapy has HIT-associated VTE. ⋯ VTE is associated with HIT infrequently (< 1%) in LMWH-treated patients, yet often (approximately one in eight cases) in unfractionated heparin-treated patients. Physicians should suspect the possibility of HIT if VTE develops during or soon after unfractionated heparin use; if thrombocytopenia is present, alternative anticoagulation should be used until HIT is excluded.
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Multicenter Study Comparative Study
Technical and functional assessment of 10 office spirometers: A multicenter comparative study.
To investigate the technical properties and user friendliness of 10 office spirometers devoted for use in general practice, and to compare the results with standard diagnostic spirometers. ⋯ The global quality and user friendliness of several office spirometers make them acceptable for the detection of COPD, although differences between the laboratory and some of the office spirometers values suggest that the misclassification rates may be increased when using some models of office spirometers.
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Randomized Controlled Trial
Effect of treatment with nasal continuous positive airway pressure on ventilatory response to hypoxia and hypercapnia in patients with sleep apnea syndrome.
The increase in peripheral chemoreflex sensitivity in patients with obstructive sleep apnea (OSA) is associated with activation of autonomic nervous system and hemodynamic responses. Nasal CPAP (nCPAP) is an effective treatment for OSA, but little is known on its effect on chemoreflex sensitivity. ⋯ The ventilatory response to hypoxia is reduced during regular treatment, but not after short-term treatment, with nCPAP. Readjusted peripheral oxygen chemosensitivity during nCPAP treatment may be a side effect of both reduced sympathetic activity and increased baroreflex activity, or a possible continuous positive airway pressure-related mechanism leading to a reduced activation of autonomic nervous system per se.
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Multicenter Study Comparative Study
Comparison of sarcoidosis phenotypes among affected African-American siblings.
To test the hypothesis that sibling pairs, who share genes and environmental exposures, might have similar phenotypic expressions of sarcoidosis beyond what would be expected by chance alone. ⋯ The phenotypic features and clinical outcomes of sarcoidosis in sibling pairs show minimal concordance, with the possible exception that the presence of ocular or liver involvement in the first sibling with a diagnosis of sarcoidosis makes involvement of these organs more likely in other affected siblings.