Abstract:
:The mechanisms for exercise intolerance in chronic obstructive pulmonary disease are complex and multifaceted. Although ventilatory limitation caused by abnormal pulmonary function is a major contributor to this phenomenon, other factors may play an important role in limiting exercise. These other factors include depressed cardiac function, respiratory and peripheral muscle weakness, nutritional imbalances, and psychologic factors. The assessment of the pulmonary patient who complains of decreased functional status must include examination and consideration of all these variables. Only by addressing and treating the combination of these variables as they present in an individual patient will clinicians have the potential to impact that individual's functional status and quality of life.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Nici Ldoi
10.1016/s0272-5231(05)70178-7subject
Has Abstractpub_date
2000-12-01 00:00:00pages
693-704issue
4eissn
0272-5231issn
1557-8216pii
S0272-5231(05)70178-7journal_volume
21pub_type
杂志文章,评审abstract::Recognition and management of agitation, delirium, and pain are key areas. Reduced use of sedatives is an important measure that must be coupled with increased patient engagement, mobilization, and exercise. Use of low tidal volumes and low mean airway pressures during mechanical ventilation is helpful. A key hemodyna...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.01.006
更新日期:2016-06-01 00:00:00
abstract::This article concentrates on those factors that are particularly important for performing and interpreting lung function tests in children. Specifically, technical considerations such as equipment, personnel, test performance, and bronchoprovocation procedures are discussed. Changes in lung function with growth and ap...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::Rheumatoid arthritis (RA) is commonly associated with pulmonary disease that can affect any anatomic compartment of the thorax. The most common intrathoracic manifestations of RA include interstitial lung disease, airway disease, pleural disease, rheumatoid nodules, and drug-induced toxicity. Patients with RA with tho...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.05.003
更新日期:2019-09-01 00:00:00
abstract::Patients with MAC-PD and pre-existing lung disease are a distinct group from the more common and recently recognized group of predominantly middle- to older-aged women without pre-existing lung disease. Those with pre-existing disease are expected to have more sputum positivity and slower conversion of sputum with tre...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(02)00022-9
更新日期:2002-09-01 00:00:00
abstract::Because of physiologic changes associated with aging and the development of chronic illness, the elderly will continue to be at risk for catastrophic illnesses including adult respiratory distress syndrome (ARDS). Current management of elderly patients with ARDS is only supportive and focused on avoiding complications...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::Occupational and environmental exposures contribute to the development and progression of most lung diseases, yet their impact is greatly under-recognized in clinical practice. Clinicians caring for patients with respiratory diseases should maintain a high index of suspicion for occupational and environmental contribu...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2020.08.019
更新日期:2020-12-01 00:00:00
abstract::In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all sit...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::The specialty has the knowledge and technology to change the outcome of lung cancer. Lung cancer, diagnosed in early stages, is as curable as all other cancers. Sputum cytology is the initial step in diagnosing roentgenographically occult lung cancer. Sputum cytology is complementary to CT scanning. Sputum cytology id...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(03)00060-1
更新日期:2002-03-01 00:00:00
abstract::Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU. This pre-existing cognitive ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(03)00092-3
更新日期:2003-12-01 00:00:00
abstract::Despite complete resection of what seems to be all evident tumor, one third to three quarters of patients with stages I and II NSCLC ultimately succumb to this neoplasm. Patients who are cured of an original NSCLC or small cell cancer remain at risk for a new primary lung cancer. Although the importance of lifelong su...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(03)00067-4
更新日期:2002-03-01 00:00:00
abstract::Cough is a complex physiologic event that protects the lungs from mechanical, chemical, and thermal injury. It is a normal reflex and therefore helps humans to adapt to an ever-changing environment. Cough can also be a pathologic reflex in that it may be an important and often the only sign of serious disease, may sig...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-06-01 00:00:00
abstract::Lung cancer remains the most common fatal malignancy, so even modest therapeutic advances are potentially beneficial to large numbers of patients. For patients with regional nodal metastases identified at thoracotomy, adjuvant chemotherapy may be of benefit and additional clinical trials are in progress. Locally advan...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::The pathogenic importance of cytomegalovirus (CMV) infection in AIDS-associated pneumonitis is controversial. Uncertainty regarding the significance of CMV isolation from pulmonary secretions of AIDS patients results in part from the difficulty in distinguishing CMV infection from CMV disease and from the high frequen...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Given that poor asthma management leads to such devastating rates of morbidity and mortality in this country, efforts must be made to increase the knowledge, skills, and behaviors of persons with asthma. The suggestions and recommendations provided here represent a blend of academic opinion and practical advice on met...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-01 00:00:00
abstract::A number of different imaging modalities can be used in the assessment of pleural disease. Although ultrasound has been the more traditional method, CT has found increasing utility for the assessment of the empyema and loculated pleural fluid collections prior to drainage and the evaluation of benign and malignant ple...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70076-9
更新日期:1998-06-01 00:00:00
abstract::As recently as the 1992 Report of the American Thoracic Society Workshop on Lung Transplantation, no QOL facts were given and no knowledge gaps related to QOL outcomes were cited. Even at the present time, the information in that area is based on a relatively small set of preliminary reports. Current information indic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70387-7
更新日期:1997-06-01 00:00:00
abstract::With the increasing threat of pandemic influenza and catastrophic bioterrorism, it is important for intensive care providers to be prepared to meet the challenge of large-scale airborne epidemics causing mass casualty respiratory failure. The severe acute respiratory syndrome outbreak exposed the vulnerability of heal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2008.01.001
更新日期:2008-06-01 00:00:00
abstract::Stents are used for palliation of symptoms of central airway obstruction caused by either malignant or benign conditions. Stents may be applied for maintaining airway patency after dilatation of postinflammatory and infectious strictures, for airway dehiscence after lung transplantation, and for the management of trac...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2009.08.002
更新日期:2010-03-01 00:00:00
abstract::Each year, a vast number of individuals are infected with the endemic fungi. An expanding population, along with further land development in endemic areas, will likely continue to place individuals at risk for exposure to these organisms. A high index of suspicion may be required to diagnose histoplasmosis, blastomyco...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70232-x
更新日期:1999-09-01 00:00:00
abstract::The authors' data show a higher rate of pleural and meningeal involvement among extrapulmonary TB cases than expected by previous works. Special attention should be given to tuberculous meningitis cases among all extrapulmonary TB cases because of its high mortality rate. The most common extrapulmonary involvement is ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:10.1016/s0272-5231(02)00002-3
更新日期:2002-06-01 00:00:00
abstract::The heart and lungs are intimately linked. Hence, impaired function of one organ may lead to changes in the other. Accordingly, heart failure is associated with airway obstruction, loss of lung volume, impaired gas exchange, and abnormal ventilatory control. Cardiopulmonary exercise testing is an excellent tool for ev...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.02.010
更新日期:2019-06-01 00:00:00
abstract::From our studies, it is clear that diaphragm muscle neuromotor control is responsive to alterations in innervation and activation. These adaptations to altered use appear to be most pronounced among fast-twitch motor units composed of type II muscle fibers. Because the plasticity involves diminished contractile streng...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::Chronic thromboembolic pulmonary hypertension is one of the few forms of pulmonary hypertension that is surgically curable. It is likely underdiagnosed and must be considered in every patient presenting with pulmonary hypertension to avoid missing the opportunity to cure these patients. This article discusses the epid...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2010.07.006
更新日期:2010-12-01 00:00:00
abstract::Pulmonary embolism remains a leading cause of morbidity and mortality in the United States. However, with improved recognition and diagnosis, the risk of death diminishes. The diagnosis depends on the clinician's suspicion. Pulmonary emboli are categorized into low, intermediate, or high risk based on the scoring scal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2018.04.013
更新日期:2018-09-01 00:00:00
abstract::Computed tomography has acquired an increasingly central role in the evaluation of asbestos-exposed individuals. The advantages of increased contrast resolution and axial image display have extended our ability to interrogate areas of the pulmonary parenchyma and pleura that are inadequately seen on chest radiographs....
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
abstract::In summary, the evaluation of the tired patient requires an awareness of the various meanings of tiredness. Furthermore, it is important to differentiate normal sleepiness that is a product of circadian rhythm variation in vigilance from pathologic sleepiness. Sleepiness that results from faulty habits, e.g., altered ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.12.009
更新日期:2017-06-01 00:00:00
abstract::Rapidly growing mycobacteria (RGM) include a diverse group of species. We address the treatment of the most commonly isolated RGM-M abscessus complex, M fortuitum, and M chelonae. The M abscessus complex is composed of 3 closely related species: M abscessus senso stricto (hereafter M abscessus), M massiliense, and M b...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2014.10.004
更新日期:2015-03-01 00:00:00
abstract::CT is a useful tool for identification of small airways diseases, and it can be used to classify these entities into inflammatory and constrictive bronchiolitis. Inflammatory forms of bronchiolitis include cellular bronchiolitis (usually caused by infection or aspiration), respiratory bronchiolitis, panbronchiolitis, ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2007.11.008
更新日期:2008-03-01 00:00:00
abstract::It has been proposed that invasive carcinoma of the bronchus develops through a transition from preinvasive lesions to overt malignancy. Newer diagnostic technologies have provided a more sensitive way to diagnose preinvasive lesions and a better understanding of the prevalence of such lesions. The natural history of ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2011.08.008
更新日期:2011-12-01 00:00:00