Abstract:
:Chronic obstructive pulmonary disease (COPD) affects 6% of the general population and is the fourth-leading cause of death in the United States with severe and very severe disease accounting for 15% and 3% of physician diagnoses of COPD. Guidelines make few recommendations regarding providing the provision of care for the most severe stages of disease, namely Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure. The effectiveness of inhaled drug therapy in very severe patients has not been assessed yet. Health care systems in many countries include public funding of long-term oxygen therapy for eligible candidates. Currently, there is little evidence for the use of mechanical ventilatory support in the routine management of hypercapnic patients. Pulmonary rehabilitation should be considered as a significant component of therapy, even in the most severe patients. Although Lung Volume Reduction Surgery has been shown to improve mortality, exercise capacity, and quality of life in selected patients, this modality is associated with significant morbidity and an early mortality rate in the most severe patients. Despite significant progress over the past 25 years, both short- and long-term outcomes remain significantly inferior for lung transplantation relative to other "solid" organ recipients. Nutritional assessment and management is an important therapeutic option in patients with chronic respiratory diseases. Morphine may significantly reduce dyspnoea and does not significantly accelerate death. No consistent improvement in dyspnoea over placebo has been shown with anxiolytics. Supplemental oxygen during exercise reduces exertional breathlessness and improves exercise tolerance of the hypoxaemic patient. Non-invasive ventilation has been used as a palliative treatment to reduce dyspnoea. Hypoxaemic COPD patients, on long-term oxygen therapy, may show reduced health-related quality of life, cognitive function, and depression. Only a small proportion of patients with severe COPD discuss end-of-life issues with their physicians.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Ambrosino N,Simonds Adoi
10.1016/j.rmed.2007.02.011subject
Has Abstractpub_date
2007-08-01 00:00:00pages
1613-24issue
8eissn
0954-6111issn
1532-3064pii
S0954-6111(07)00084-4journal_volume
101pub_type
杂志文章,评审abstract:BACKGROUND:Neuromuscular electrical stimulation (NMES) improves muscle performance and exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. In contrast, no study has assessed the effect of NMES on dynamic hyperinflation (DH) in COPD. This study investigated the effect of short-term, high-frequen...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2013.12.013
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Natriuretic peptides are considered as reliable indicators of left-heart failure (HF) and are useful for differential diagnosis of dyspnoea. AIM:We evaluated the clinical significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic hypercapnic respiratory failure (CHRF). ME...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.04.001
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Exercise induced asthma may symptomatically be difficult to differentiate from exercise related obstruction in the upper airways, sometimes leading to diagnostic confusion and inappropriate treatment. Larynx accounts for a significant fraction of total airway resistance, but its role as a limiting factor for...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2009.05.024
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:GINA guideline recommends stepping down treatment of asthma patients where control is achieved. The aim of this analysis was to estimate the costs and health outcomes associated with step down of controlled patients on high dose fluticasone/salmeterol (FP/S 1000/100 μg daily) to either medium dose FP/S (500/...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2013.07.010
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Aspirin desensitization (AD) is an effective and safe therapeutic option for patients with nonsteroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD). The mechanisms driving its beneficial effects remain poorly understood. OBJECTIVE:To investigate the effect of long-term AD on cli...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2019.04.021
更新日期:2019-06-01 00:00:00
abstract::This manuscript offers an approach to the treatment of pulmonary sarcoidosis based on current available information. The treatment of pulmonary sarcoidosis is not mandatory as the disease may be self-limiting and therapy is often associated with significant drug side effects. The decision to treat rests predominantly ...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2012.01.013
更新日期:2012-10-01 00:00:00
abstract::Subjects with chronic obstructive airways disease may have difficulty with the roadside alcolmeter. Twenty-six subjects with a FEV1/FVC less than 60% were asked to use an alcolmeter simulator. Only ten were able to produce the necessary flow rate of 28 l min-1 for a minimum of 2.7 s, two could produce the same total v...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0954-6111(08)80093-5
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Treatment with an inhaled corticosteroid (ICS) and long-acting bronchodilator is recommended for severe/very severe chronic obstructive pulmonary disease (COPD) patients with repeated exacerbations. This randomized, double-blind, double-dummy, parallel-group, 12-month multicenter study evaluated the effect o...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2011.07.020
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Decreased lung function has health impacts beyond diagnosable lung disease. It is therefore important to understand the factors that may influence even small changes in lung function including obesity, physical fitness and physical activity. The aim of this study was to determine the anthropometric measure m...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2017.08.030
更新日期:2017-10-01 00:00:00
abstract:AIM:To assess the effect of intrapleural urokinase, vis-à-vis simple pleural drainage, on residual pleural thickening in a series of patients suffering from loculated tuberculous pleural effusion. PATIENTS AND METHOD:Twenty-nine patients (21 males and 8 females) with loculated pleural effusion were studied. These pati...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2006.02.010
更新日期:2006-11-01 00:00:00
abstract::Mechanical ventilation (MV) in chronic situations is commonly used, either delivered invasively or by means of non-invasive interfaces, to control hypoventilation in patients with chest wall, neuromuscular or obstructive lung diseases (either in adulthood or childhood). The global prevalence of ventilator-assisted ind...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2003.11.008
更新日期:2004-05-01 00:00:00
abstract::Current asthma management guidelines state that where a patient is receiving a low to moderate dose of inhaled corticosteroids and is still experiencing symptoms the dose of corticosteroid should be increased and, if necessary, a long-acting bronchodilator should be added. Many studies have now shown that the addition...
journal_title:Respiratory medicine
pub_type: 杂志文章,meta分析
doi:10.1053/rmed.2001.1140
更新日期:2001-08-01 00:00:00
abstract::Induced sputum and bronchoalveolar lavage (BAL) are widely used for retrieving cells and soluble materials for studies of airway inflammation. Centrifuged cell samples are suitable for immunochemical identification of cellular products. The aim was to determine the optimal fixation procedure to detect intracellular an...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.2002.1373
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Systemic inflammation is associated with impaired lung function in healthy adults as well as in patients with lung disease. The mechanism for this association is unknown and it is unclear if systemic inflammation leads to impaired lung function or if poor lung function leads to inflammation. We explored the ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2015.12.007
更新日期:2016-02-01 00:00:00
abstract::Total lung capacity was measured in 16 workers with pulmonary asbestosis using four standard methods: body plethysmography, radiographic lung area, helium dilution by multiple breath and by single breath (alveolar volume). All men had irregular opacities of ILO profusion category 2/1 or greater and four had pleural pl...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/0954-6111(93)90138-p
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Although athletes have a high prevalence of airway hyperresponsiveness (AHR) and asthma, little is known about possible gender differences in regard to these features. We looked at the comparative prevalence of AHR, physician-diagnosed asthma and respiratory symptoms during exercise in female (F) and male (M...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2008.09.023
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Data on the effects of long-term treatment with azithromycin (AZM) on inflammatory markers in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa are scarce. So far there is no pharmacokinetic and clinical data on once-weekly dosage of AZM in CF patients. METHODS:In a randomised double...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2008.03.009
更新日期:2008-11-01 00:00:00
abstract:AIM:To describe how patients with COPD, heart failure, dementia and cancer differ in frequency and timing of referral to palliative care services. METHODS:We performed a population-based study with the Sentinel Network of General Practitioners in Belgium. Of 2405 registered deaths respectively 5%, 4% and 28% were iden...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2013.06.003
更新日期:2013-11-01 00:00:00
abstract::Previous studies have shown that chronic hypoxia leads to changes in skeletal muscle structure (fibre size and type) and activities of several bioenergetic enzymes. Whether this occurs also in conditions characterised by intermittent hypoxia, such as the obstructive sleep apnoea syndrome (OSAS), is unknown. To explore...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(03)00034-9
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:This study evaluated the tolerability and efficacy of inhaled AZD4818, a CCR1 antagonist, in patients with COPD. METHODS:This double-blind, placebo-controlled study (NCT00629239) randomised patients with moderate to severe COPD to AZD4818 300mug or placebo twice daily via Turbuhaler((R)) for 4 weeks. Safety,...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2010.04.010
更新日期:2010-09-01 00:00:00
abstract::Pleural fluid analysis was performed in patients with idiopathic spontaneous pneumothorax. The objective of the study was to define the cell differentiation, and part of the cytokine profile, in relation to the duration of pneumothorax. In the 23 consecutive patients (19 men, mean age 34.2 years, 17 smokers), pleural ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(99)90022-7
更新日期:1999-04-01 00:00:00
abstract::The aim of the present investigation was to evaluate the predictive value of a symptom-limited exercise test in predicting postoperative morbidity and mortality in patients submitted to pneumonectomy. The study was conducted in 150 patients (mean age, 57.1). Forty-four patients (29.3%) had postoperative complications....
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2003.07.004
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:No consensus exists on the exact treatment of pneumothorax (PTX). Some guidelines are proposing manual aspiration (MA) to be preferred over tube thoracostomy (TT) in uncomplicated primary spontaneous pneumothorax (PSP). However, only a few studies reported a direct comparison of both methods. Our aim was to ...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2012.08.005
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Reduction in 30-day readmission rate after chronic obstructive pulmonary disease (COPD)-related hospitalization is a national objective. However, little is known about trends in readmission rates in recent years, particularly in priority populations defined by the Agency for Healthcare Research and Quality (...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2017.07.058
更新日期:2017-09-01 00:00:00
abstract::Patients with COPD are at risk for other comorbid diseases, like heart failure, coronary heart disease, and depression. However, little is known about COPD phenotypes and prevalence of sub-clinical renal failure. 433 COPD patients and 233 subjects without COPD, from Western Norway, age 40-75, GOLD stage II-IV, were ex...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2011.10.004
更新日期:2012-03-01 00:00:00
abstract::Patients with immune deficiencies can present with variable clinical phenotypes. This often translates into a significant delay in their diagnosis, and resultant patient morbidity. This review summarises the most common types of immunodeficiency disorders, primary and secondary, along with their key features. It provi...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.106100
更新日期:2020-09-01 00:00:00
abstract::The objective of this study was to evaluate the effect of lateral body position on gas exchange in patients with unilateral pleural effusion, with special reference to the influence of effusion volume. Thirty consecutive patients with unilateral pleural effusion, without evidence of parenchymal pulmonary involvement, ...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0954-6111(95)90091-8
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To investigate the usefulness of a self-reported respiratory health transition question over 10 years through reliability, ability to capture long-term asthma trajectory and predictive ability. SETTINGS:In two 20-year cohorts (Asthma-E3N, n = 16,371, 61-88 years; EGEA, n = 1254, 27-82 years), perceived 10-ye...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2014.11.010
更新日期:2015-02-01 00:00:00
abstract::To determine if shortcomings in asthma management in the Accident and Emergency (A & E) department identified in a previous (1983) study (Reed et al. Thorax 1985; 40: 897-902) had been corrected, we retrospectively reviewed the case records of patients attending with asthma between December 1987 and November 1988. The...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(06)80180-0
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Previous research indicates a high prevalence of untreated anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). The current study examined the effect of cognitive behavioral therapy (CBT) in groups for co-morbid, clinically significant anxiety and depression in COPD outpatien...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2010.02.020
更新日期:2010-07-01 00:00:00