Respiratory medicine
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Respiratory medicine · Oct 2007
Multicenter StudyEpidemiology of acute lung injury and acute respiratory distress syndrome in The Netherlands: a survey.
The characteristics, incidence and risk factors for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may depend on definitions and geography. ⋯ The effect of definitions of ALI/ARDS on mechanical ventilation in the Netherlands is small. Nevertheless, the incidence of ALI/ARDS may be higher than in other European countries but lower than in the USA, and the incidence of ALI by LIS may overestimate compared to that by NAECC. Aspiration, pneumonia, sepsis and chronic alcohol abuse are major risk factors, largely independent of definitions.
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Respiratory medicine · Oct 2007
Multicenter StudyOccupational exposure and severe pulmonary fibrosis.
External agents, especially metal and wood dust, are believed to be risk factors for development of idiopathic pulmonary fibrosis (IPF). The aim of this case-control study was to investigate which occupational exposure types are associated with development of severe pulmonary fibrosis (PF), and especially IPF. ⋯ Exposure for birch and hardwood dust may contribute to the risk for IPF in men.
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Respiratory medicine · Sep 2007
Multicenter StudyEmpiric treatment in hospitalized community-acquired pneumonia. Impact on mortality, length of stay and re-admission.
To evaluate adherence to guidelines when choosing an empirical treatment and its impact upon the prognosis of community-acquired pneumonia (CAP). ⋯ A high adherence to CAP treatment guidelines was found, though with considerable variability in the empirical antibiotic treatment among hospitals. Non-adherent other regimens were associated with greater mortality. Beta-lactam monotherapy was associated with an increased re-admission rate.
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Respiratory medicine · Sep 2007
Multicenter StudyIncreased occurrence of respiratory symptoms is associated with indoor climate risk indicators - a cross-sectional study in a Swedish population.
A basic assumption was that exposure to the indoor environment would increase the manifestation of respiratory symptoms in predisposed individuals. The aim was to investigate the proportion of perceived respiratory symptoms attributed to specific environmental exposures, and associations related to indoor climate risk indicators, i.e. occurrence of damp or mould, insufficient ventilation and condensation on windows. ⋯ The high frequency of respiratory symptoms among asthmatics increased when occurrences of risk indicators were reported. Similarly, increased symptoms were found for healthy indicating that indoor climate risk indicators may affect both healthy and unhealthy individuals.
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Respiratory medicine · Sep 2007
Multicenter StudyProgression parameters for emphysema: a clinical investigation.
In patients with airflow limitation caused by cigarette smoking, lung density measured by computed tomography is strongly correlated with quantitative pathology scores of emphysema, but the ability of lung densitometry to detect progression of emphysema is disputed. We assessed the sensitivity of lung densitometry as a parameter of disease progression of emphysema in comparison to FEV(1) and gas transfer. At study baseline and after 30 months we measured computed tomography (CT)-derived lung density, spirometry and carbon monoxide diffusion coefficient in 144 patients with chronic obstructive pulmonary disease (COPD) in five different centers. ⋯ Signal-to-noise ratio (mean change divided by standard error of the change) for the detection of annual change was 3.2 for lung densitometry, but 1.3 for both FEV(1) and gas diffusion. We conclude that detection of progression of emphysema was found to be 2.5-fold more sensitive using lung densitometry than by using currently recommended lung function parameters. Our results support CT scan as an efficacious test for novel drugs for emphysema.