Thorax
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Paediatricians rely on cough descriptors to direct them to the level of investigations needed for a child presenting with chronic cough, yet there is a lack of published data to support this approach. A study was undertaken to evaluate (1) whether historical cough pointers can predict which children have a specific cause for their cough and (2) the usefulness of chest radiography and spirometry as standard investigations in children with chronic cough. ⋯ The most useful clinical marker in predicting specific cough is the presence of a daily moist cough. Both chest examination and chest radiographic abnormalities are also useful in predicting whether children have a specific cause of their cough.
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Despite a decline in incidence of Pneumocystis jirovecii pneumonia (PCP), severe PCP continues to be a common cause of admission to the intensive care unit (ICU) where mortality remains high. A study was undertaken to examine the outcome from intensive care for patients with PCP and to identify prognostic factors. ⋯ Observed improved outcomes from severe PCP for patients admitted to the ICU occurred in the absence of intervention with HAART and probably reflect general improvements in ICU management of respiratory failure and ARDS rather than improvements in the management of PCP.
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To study motor activation patterns of voluntary and reflex cough adjusted for cough flow rates. ⋯ Functional organisation of motor activity differs between voluntary and reflex cough. Voluntary cough is characterised by sequential activation whereas reflex cough is associated with early and simultaneous activation of expiratory and accessory muscles.
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Randomized Controlled Trial
Combined physiological effects of bronchodilators and hyperoxia on exertional dyspnoea in normoxic COPD.
Studies examining the physiological interactions of oxygen (O(2)) and bronchodilators (BD) during exercise in chronic obstructive pulmonary disease (COPD) should provide new insights into mechanisms of exercise intolerance. We examined the effects of O(2) and BD, alone and in combination, on dyspnoea, ventilation (e), breathing pattern, operating lung volumes, and exercise endurance. ⋯ By combining the benefits of BD (reduced hyperinflation) and O(2) (reduced ventilatory drive), additive effects on exercise endurance were observed in patients with normoxic COPD.