Respiratory care
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Exercise capacity assessed by cardiopulmonary exercise testing is usually measured by peak oxygen consumption (VO2). However, not uncommonly, patients achieve a relatively higher work load (peak work) compared to their peak VO2. In these situations it is difficult to know which parameter to use in assessing exercise capacity. The purpose of this study was to determine whether there are distinguishing physiological characteristics of patients with discordance between percent-of-predicted peak work versus peak VO2, in order to understand how to use these measurements in interpreting exercise capacity. ⋯ The observation that there are distinguishing physiological features between those who have a higher peak work and those who have higher peak VO2 provides insight into the underlying processes determining maximal exercise capacity.
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Peripheral muscle dysfunction is a common finding in patients with COPD; however, the structural adaptation and functional impairment of the upper and lower limb muscles do not seem to be homogenous. We compared muscle fatigue and recovery time between 2 representative muscles: the middle deltoid and the quadriceps femoris. ⋯ Subjects with COPD had a higher fatigability of a representative upper limb muscle (middle deltoid) than a lower limb muscle (quadriceps femoris).
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Case Reports
Necrotizing Tracheitis secondary to Corynebacterium species presenting with Central Airway Obstruction.
Pseudomembranous necrotizing tracheitis is a rare cause of life-threatening central airway obstruction. Patients present with hoarseness, cough, dyspnea, wheezing, stridor, and occasionally with respiratory failure. ⋯ For patients with signs and symptoms of airway obstruction, a therapeutic rigid bronchoscopy with mechanical debridement is recommended. We present a rare case of necrotizing tracheitis secondary to Corynebacterium species, which caused life-threatening airway obstruction in an adult.
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Clinical Trial
IMPACT OF BRONCHODILATOR RESPONSIVENESS ON QUALITY OF LIFE AND EXERCISE CAPACITY IN PATIENTS WITH COPD.
Bronchial variability in COPD patients may be a phenotypic feature associated with clinical characteristics and differential treatment response. We analyzed whether symptoms, quality of life, and exercise capacity varied in COPD patients as a function of bronchodilator test results, and compared responses to an exercise program. ⋯ Compared to COPD subjects with negative reversibility, those with positive reversibility walked for shorter distances, and had shorter endurance times and worse quality of life, but the improvements after exercise training were similar.
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Smoking, depression, and anxiety increase the risk of death in patients with COPD, but the combined effect of these factors is unknown. We assessed the interactive effects of smoking, depression, and anxiety on mortality in patients with COPD. ⋯ Smoking, depression, and anxiety are associated with higher risk of death in patients with COPD. The risk of death, depression, and anxiety increases with increasing duration of smoking (years) and cigarette pack-years. Chinese Clinical Trials Registration ChiCTR-TRC-12001958.