Thorax
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Randomized Controlled Trial Comparative Study Clinical Trial
Dose response study of ipratropium bromide aerosol on maximum exercise performance in stable patients with chronic obstructive pulmonary disease.
Although the bronchodilating effect of inhaled anticholinergics has been established in patients with chronic obstructive pulmonary disease (COPD), their effects on exercise capacity are still controversial. Previous studies have suggested that the standard dosage hardly affects exercise tolerance, whereas higher doses might elicit an improvement. The aim of the present study was to determine the dose of ipratropium bromide aerosol that improves exercise performance using progressive cycle ergometry in patients with stable COPD. ⋯ A dose of at least four times the standard dose of ipratropium bromide from an MDI with a spacer device was necessary to improve maximal cycle exercise capacity in patients with stable COPD. Although the data from cycle ergometry cannot be directly applied to exercise performed during day to day activities, it is conceivable that the recommended doses of ipratropium bromide do not elicit the optimal clinical benefits.
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A study was carried out to evaluate the potential place of spiral volumetric computed tomography (SVCT) in the diagnostic strategy for pulmonary embolism. ⋯ SVCT is a relatively noninvasive test for pulmonary embolism which is both sensitive and specific and which may serve as an alternative to ventilation scintigraphy and possibly to pulmonary angiography in the diagnostic strategy for pulmonary embolism.
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Peritoneal ventilation has been shown to be effective in achieving extrapulmonary oxygenation and carbon dioxide elimination in an animal model of severe adult respiratory distress syndrome (ARDS). Cisapride is a "prokinetic" agent (increases gastric emptying), that may increase the splanchnic circulation and thus favourably affect gas exchange in peritoneal ventilation. ⋯ Cisapride increases arterial oxygenation in rabbits with severe ARDS treated with peritoneal ventilation, probably due to its ability to increase splanchnic circulation. It should be considered as an adjuvant medication to peritoneal ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Measuring the systemic effects of inhaled beclomethasone: timed morning urine collections compared with 24 hour specimens.
Inhaled glucocorticoid therapy has systemic effects including hypothalamic-pituitary-adrenal (HPA) suppression. The optimal test for detecting these effects has not been defined. ⋯ UCC ratios are as sensitive as the more cumbersome 24 hour urinary free cortisol excretion, and more sensitive than single morning plasma cortisol measurements, in detecting the effects of inhaled beclomethasone on the HPA axis.
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Comparative Study
Significant differences in flow standardised breath sound spectra in patients with chronic obstructive pulmonary disease, stable asthma, and healthy lungs.
Spectral characteristics of breath sounds in asthma and chronic obstructive pulmonary disease (COPD) have not previously been compared, although the structural differences in these disorders might be reflected in breath sounds. ⋯ The observed differences in frequency content of breath sounds in patients with asthma and COPD may reflect altered sound generation or transmission due to structural changes of the bronchi and the surrounding lung tissue in these diseases. Spectral analysis of breath sounds may provide a new non-invasive method for differential diagnosis of obstructive pulmonary diseases.