Respiratory medicine
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Respiratory medicine · Jun 2007
Lung function testing in the elderly--can we still use FEV1/FVC<70% as a criterion of COPD?
Chronic obstructive pulmonary disease (COPD) can be diagnosed when the FEV(1)/FVC ratio is below 70%, according to global initiative for chronic obstructive lung disease (GOLD). COPD is known as a disease which is frequently under-diagnosed. However, there is a risk of over diagnosis when this diagnostic threshold is applied among the elderly. ⋯ Adjustments of the GOLD criteria for diagnosing COPD are needed, and FEV(1)/FVC ratios down to 65% should be regarded as normal when aged 70 years and older.
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Respiratory medicine · Jun 2007
Outcome of non-invasive domiciliary ventilation in elderly patients.
To analyze the short- and long-term effects of domiciliary non-invasive ventilation (NIV) in the elderly. ⋯ NIV is an effective treatment in the elderly. It improves arterial blood gases and nocturnal desaturations, decreases hospital admissions and is associated with long survival. So advanced age should not be considered as an exclusion criteria to prescribe NIV.
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Bronchiectasis has a number of causes. Their prevalence is not well documented. The aim of this study was to identify aetiology in a population of patients referred to a specialist clinic with symptoms suggestive of bronchiectasis, to determine the proportion of patients in whom knowing the aetiology altered management. In addition we wished to describe in detail those patients who remained idiopathic to facilitate future studies of this group; and establish the diagnosis in those without bronchiectasis. ⋯ Full investigation of problematic cases should occur in a specialist centre because results affect management in a third of cases.