Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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In this study, the presence of microalbuminuria in patients with chronic obstructive pulmonary disease (COPD) in whom no proteinuria was determined by conventional methods, has been studied taking into account the possible relationship between microalbuminuria and respiratory parameters and their predictive role on mortality. ⋯ In a quite large number of patients with COPD in whom no proteinuria were determined by conventional methods, especially at the time of exacerbation, microalbuminuria could be seen. Microalbuminuria was related with hypoxemia but has no predictive role on mortality.
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Monaldi Arch Chest Dis · Sep 2003
Review Practice Guideline Guideline[Guidelines for psychology activities in cardiologic rehabilitation and prevention].
The purpose of these guidelines is to provide specific recommendations in regard to psychological activities in cardiac rehabilitation (CR). Based on scientific evidence and clinical experience, the present guidelines are targeted for psychologists working in the field of cardiac rehabilitation and for the core component of CR, as well as for the health care providers, insurers, policy makers and consumers. In the introduction, the framework of Italian cardiac rehabilitation and psychology as well as the methodology used are defined, in accordance with the recommendations of the National Guidelines Programme of the Italian Health Ministry. ⋯ Section three describes the psychological characterization and the specificity of psychological interventions in different cardiac patients populations: patients with ischemic heart disease, patients after cardiac surgery, patients with chronic heart failure, patients after heart transplantation, patients with chronic peripheral artery disease, patients with pace-maker or implantable cardioverter defibrillator, high risk patients for cardiovascular disease, over 75 years of age and finally end-stage cardiac patients. The last section describes the processes of programme evaluation, audit and patient feedback as the main instruments recommended for continuous improvement of quality of psychological care in cardiac rehabilitation. The appendices contain a flow-chart describing the course of psychological interventions, a summary of recommendations for each cardiac condition and a glossary.
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Monaldi Arch Chest Dis · Jul 2003
ReviewImpact of sleep on ventilation and gas exchange in chronic lung disease.
Sleep has many effects on breathing, all potentially adverse, ranging from the respiratory centre to the lower airways and chest wall. The overall effect is to diminish ventilation with consequent hypoxaemia and hypercapnia. ⋯ Patients with obstructive airway disease are particularly adversely affected during sleep with hypoventilation and reduced tidal volume, whereas patients with interstitial disease maintain overall ventilation although respiratory frequency falls. Sleep-related effects are most pronounced in rapid-eye-movement (REM) sleep and can have significant cardiovascular consequences including sleep-related cardiac arrhythmias and pulmonary hypertension and can also predispose to nocturnal death, particularly during acute exacerbations.
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Monaldi Arch Chest Dis · Apr 2003
The role of prophylactic brain irradiation in small cell lung cancer treatment.
To review the effectiveness and safety of prophylactic cranial irradiation (PCI) in patients with small-cell lung cancer (SCLC). ⋯ PCI improves both overall and disease free survival and decreases the risk for brain relapse in SCLC patients in complete remission. PCI should be applied early, and useful and safe doses may be 30-36 GY in 2-3 Gy fractions, though future studies may further illuminate the optimal dose, fractionation and timing.