Respiratory medicine
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Respiratory medicine · Apr 2006
Comparative StudyComparison of bronchoscopic diagnosis for peripheral pulmonary nodule under fluoroscopic guidance with CT guidance.
A new diagnostic procedure has been established for the selection of appropriate therapy for small lung lesions. We compared the sensitivity of real-time multi-slice computed tomography (MSCT) and X-ray television (TV) fluoroscopic guidance for performing bronchoscopy. ⋯ Real-time MSCT fluoroscopic guidance allows the bronchoscopist to accurately determine the location of the instruments in relation to the lesion in real time, thus helping to reduce the number of negative cases.
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Chronic Obstructive Pulmonary Disease (COPD) exacerbations are associated with viral infections. We wished to determine if respiratory viral infection of children in the community was associated with hospital admissions of patients with exacerbations of COPD. ⋯ When children are hospitalized with viral respiratory infection there is an associated rise in adult COPD admissions. This suggests exacerbations of COPD are associated with epidemics of respiratory viruses. When children are on school holidays there is a reduction in COPD admissions in the community. This provides further support for respiratory viruses in the pathogenesis of COPD exacerbations.
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Respiratory medicine · Mar 2006
Randomized Controlled Trial Multicenter StudyA new BAL fluid instillation and aspiration technique: a multicenter randomized study.
Bronchoalveolar lavage (BAL) is a widely used clinical and research tool even though certain steps in the procedure have not been standarized. One step that is subject to variation is the technique used to instill and recover BAL fluid. Our aim was to assess whether attaching a plastic tube between the syringe and the working channel of the flexible bronchoscope allowed recovery of more fluid in comparison with recovery using only a syringe, and whether tubing had a favorable impact on diagnostic yield and complications. ⋯ In the group with tubing, 8% more fluid was recovered. The difference was both statistically significant and clinically relevant given that 17.4% more diagnoses, 6.9% fewer complications, and 8.8% fewer technical failures were recorded. Based on these results, we recommend performing BAL using plastic tubing between the 50 mL syringe and the working channel of the flexible bronchoscope when carrying out manual instillation and suction.
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Respiratory medicine · Mar 2006
Changes in respiratory mechanics with increasing degrees of airway obstruction in COPD: detection by forced oscillation technique.
The Forced Oscillation Technique (FOT) is a method for non-invasively assessing respiratory mechanics during spontaneous breathing, demanding little cooperation. The aim of this study was to test the ability of FOT to describe the changes in respiratory mechanics in progressive COPD. The study was performed in a control group formed by 21 healthy subjects and 79 outpatients with COPD, which were classified by spirometry, according to the degree of airway obstruction, in mild, moderate and severe groups. ⋯ The results of this study demonstrated that the FOT is useful for detecting the respiratory mechanics modifications in COPD patients. The initial phases of airway obstruction in COPD can be described mainly by resistive parameters, while in more advanced phases, reactive parameters seem to be more useful. Since the FOT has the advantage of being a simple method, such a technique may give a significant clinical contribution, representing an alternative and/or complement to the evaluation of respiratory mechanics by means of forced expiration.
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Respiratory medicine · Feb 2006
ReviewEvidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews.
A range of physical therapies (including airway clearance and physical training) are used in cystic fibrosis (CF). The aim of this paper is to summarise the main findings from Cochrane systematic reviews that have considered the evidence for physical therapies in CF. ⋯ The Cochrane systematic reviews summarised in this paper provide some evidence to support the inclusion of physical therapies in the care-management plan of CF. They also provide information to steer the direction and focus of future research in this area.