Respirology : official journal of the Asian Pacific Society of Respirology
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Randomized Controlled Trial
Pleural fluid interleukin-8 and C-reactive protein for discriminating complicated non-purulent from uncomplicated parapneumonic effusions.
This study was designed to test the hypothesis that measurement of IL-8 and CRP in pleural fluid could improve the identification of patients with non-purulent parapneumonic effusions that ultimately require chest tube drainage. ⋯ Pleural fluid IL-8 is an accurate marker for the identification of non-purulent CPPE.
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Randomized Controlled Trial
Mucociliary clearance in patients with chronic asthma: effects of beta agonists.
Chronic asthma is characterized by airway inflammation, mucus hypersecretion and impaired mucociliary clearance (MCC). We investigated baseline MCC and the acute effect of terbutaline in chronic asthmatics with sputum production while on long-term treatment with salmeterol in combination with inhaled corticosteroids (ICS). ⋯ MCC was impaired in most of these asthmatics with persistent airway obstruction and sputum production, despite regular treatment with ICS and salmeterol. In addition, there was little or no stimulation of MCC acutely after terbutaline in most of these asthmatics.
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Randomized Controlled Trial Clinical Trial
Adverse effects associated with influenza vaccination in patients with COPD: a randomized controlled study.
The aim of this study was to assess the frequency and type of adverse reactions following influenza vaccination and its effects on lung function, dyspnoeic symptoms, exercise capacity, and clinical acute respiratory illness (ARI) in patients with COPD, and the relationship of these adverse effects to the degree of airflow obstruction. ⋯ Influenza vaccination is associated with minimal local adverse reactions in patients with COPD. Vaccination does not cause systemic adverse reactions, induce clinical exacerbations or adversely affect lung function, dyspnoeic symptoms and exercise capacity in patients with COPD, regardless of the severity of airflow obstruction.
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Randomized Controlled Trial Comparative Study Clinical Trial
Short- and long-term hospital and community exercise programmes for patients with chronic obstructive pulmonary disease.
Pulmonary rehabilitation in patients with COPD has been shown to be beneficial but the optimal setting is not known. In the present study, the efficacy of a short-term community-based exercise programme was compared with a standard hospital outpatient programme. Additionally, the usefulness of community or home programmes in maintaining improvements in the longer term was studied. ⋯ A 3-month community-based exercise programme for patients with COPD did not improve 6MWD. The long-term retention rates in the programmes were poor.
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Randomized Controlled Trial Clinical Trial
Adverse effects of short-acting beta-agonists: potential impact when anti-inflammatory therapy is inadequate.
Short-acting beta-agonists (SABAs) are associated with reduced lung function and increased bronchial hyper-responsiveness. Earlier studies have failed to show that these changes are clinically important when SABAs are taken regularly in modest doses. However, some patients use SABAs to excess, especially with deteriorating asthma. Our aim was to establish whether adverse effects of SABAs are greater at higher than normal doses and after withdrawing inhaled corticosteroid (ICS) therapy. ⋯ Adverse changes in lung function with SABA appear to be greater with higher doses and increasing airway inflammation. This highlights the risks of excessive SABA use in patients who neglect ICS therapy and/or who rely on 'relievers'.