Respiratory medicine
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Respiratory medicine · Sep 2013
Multicenter Study Controlled Clinical TrialNoninvasive ventilation for acute respiratory distress in children with central nervous system disorders.
Acute respiratory distress (ARD) is a relatively frequent occurrence in patients suffering from central nervous system disorders (CNSD) and moderate to severe mental retardation. Whenever conventional therapy is little effective, noninvasive mechanical ventilation (NIV) is the additional treatment in patients with diseases of the peripheral nervous system. However, NIV is traditionally little employed in the acute phase in patients suffering from CNSD. In the latter, either conventional therapy is maintained or invasive mechanical ventilation is instituted if the patient's condition worsens severely. To challenge the traditional view, we conducted the study to prove that NIV is both applicable and effective in the treatment of ARD also in children with moderate to severe mental retardation. ⋯ NIV is both applicable and beneficial in stabilizing blood gases, respiratory and cardiovascular parameters also in children with CNSD. Moreover its use shortens the hospital stay.
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Respiratory medicine · Jul 2013
Multicenter StudyImpaired chronotropic response to 6-min walk test and reduced survival in interstitial lung disease.
Reduced chronotropic response to maximal exercise has been associated with poor survival in people without respiratory disease. The contribution of chronotropic response to exercise limitation and survival in interstitial lung disease (ILD) is not well defined. This study investigated the relationships between chronotropic response during 6-min walk test, exercise capacity and survival in ILD. ⋯ Impaired chronotropic response to 6-min walk test is associated with reduced 6MWD and reduced survival in ILD, independent of physical fitness and pulmonary hypertension. Investigation of the mechanisms underlying attenuated HR response to exercise in ILD is warranted.
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Respiratory medicine · Jun 2013
Randomized Controlled Trial Multicenter Study Comparative StudySafety and efficacy of the once-daily anticholinergic BEA2180 compared with tiotropium in patients with COPD.
To determine the safety and efficacy of BEA2180, an anticholinergic agent in patients with chronic obstructive pulmonary disease (COPD). ⋯ All study doses of BEA2180 improved lung function, reduced symptoms and exacerbations, and improved health status in COPD; all treatments were well tolerated. Clinical trial identifier: NCT00528996.
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Respiratory medicine · Jun 2013
Multicenter StudyResting and ADL-induced dynamic hyperinflation explain physical inactivity in COPD better than FEV1.
Physical activity and health status deteriorate early in the course of chronic obstructive pulmonary disease (COPD). This can only partially be explained by the degree of airflow limitation. Changes in (resting and dynamic) lung volumes are known to be associated with functional impairments and thus might influence physical activity level. The aim of the present cross-sectional study was to explore the contribution of dynamic hyperinflation during daily life activities (ADL) in the decline in physical activity. ⋯ The presence of resting hyperinflation and occurrence of dynamic hyperinflation during ADL contribute to reduced physical activity levels in patients with COPD, independently of the degree of airflow limitation.
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Respiratory medicine · May 2013
Randomized Controlled Trial Multicenter StudyRandomised, double-blind, placebo-controlled trial of EPs 7630 in adults with COPD.
Preventing and managing exacerbations is one major component in COPD treatment. We investigated whether EPs 7630, a herbal drug preparation from the roots of Pelargonium sidoides, could prolong time to acute exacerbation in patients with COPD stage II/III. ⋯ The results demonstrate a statistically significant and clinically relevant superiority of add-on therapy with EPs 7630 over placebo and a good long-term tolerability in the treatment of moderate to severe COPD. EPs 7630 prolonged time to exacerbations and reduced exacerbation frequency and antibiotic use. Trial Registration No.: ISRCTN01681733.