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Chronic Pulmonary Disease (chronic + pulmonary_disease)
Selected AbstractsLymphocyte Response in Subjects with Chronic Pulmonary Disease Colonized by Pneumocystis jiroveciiTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 2003JOSE M VARELA No abstract is available for this article. [source] Giant Right Atrium in an AdultECHOCARDIOGRAPHY, Issue 10 2008Vignendra Ariyarajah M.D. Massive right atrial (RA) enlargement is certainly more common in children than in adults, owing to rare congenital anomalies. Indeed, the largest description of such chamber enlargement was noted in a child, where the RA volume was reported to be 900 ml. We now report one of the largest descriptions of the RA in an adult, in absence of tricuspid stenosis and other common adult associations of RA abnormality, such as chronic pulmonary disease, severe mitral valvular pathology with pulmonary hypertension, and pulmonary embolism or infarct. The RA volume was estimated to be well over 500 ml and was notably disproportionate to that of the left atrium and either ventricle. [source] Cardiovascular Disease Is Associated with Greater Incident Dehydroepiandrosterone Sulfate Decline in the Oldest Old: The Cardiovascular Health Study All Stars StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Jason L. Sanders BA OBJECTIVES: To describe cross-sectional and longitudinal associations with dehydroepiandrosterone sulfate (DHEAS) and change in DHEAS with age. DESIGN: Longitudinal cohort study. SETTING: Pittsburgh, Pennsylvania. PARTICIPANTS: Cardiovascular Health Study All Stars study participants assessed in 2005/06 (N=989, mean age 85.2, 63.5% women, 16.5% African American). MEASUREMENTS: Health characteristics were assessed in 2005/06 according to DHEAS level, mean DHEAS and DHEAS change across age categories were tested, and linear and logistic regression was used to identify factors present in 1996/97 associated with continuous and categorical DHEAS change. RESULTS: Mean ± standard deviation DHEAS was 0.555 ± 0.414 ,g/mL in 1996/97 and 0.482 ± 0.449 ,g/mL in 2005/06 for women and 0.845 ± 0.520 ,g/mL in 1996/97 and 0.658 ± 0.516 ,g/mL in 2005/06 for men. In 2005/06, DHEAS was lower in women and subjects with cardiovascular disease (CVD) and chronic pulmonary disease and higher for African Americans and subjects with hypertension and high cholesterol. Mean DHEAS change was greater in men (,0.200 ,g/mL) than in women (,0.078 ,g/mL) (P<.001). Each 1-year increase in age attenuated the effect of male sex by 0.01 ,g/mL (P=.009), abolishing the sex difference in DHEAS change by age 79. Presence of CVD before the study period was associated with greater absolute DHEAS change (,=,0.04 ,g/mL, P=.04) and with the fourth quartile of DHEAS change versus the first to third quartiles (odds ratio=1.46, 95% confidence interval=1.03,2.05). CONCLUSION: DHEAS change continues into very old age, is not homogenous, is affected by sex, and is associated with prevalent CVD. Future studies should investigate factors that might accelerate DHEAS decline. [source] The effect of a pulmonary rehabilitation programme on older patients with chronic pulmonary diseaseJOURNAL OF CLINICAL NURSING, Issue 1 2008Kim Ae Kyung RN Aim., The aim of this study was to answer the question: is there an effect on the respiratory capacity and activity tolerance of older patients with chronic obstructive pulmonary disease who participate in a pulmonary rehabilitation programme? Background., Pulmonary rehabilitation is now an integral part of chronic obstructive pulmonary disease management. Evidence supports the positive effects of breath training and exercising training on quality of life, exercise tolerance and improved physical condition of individual with chronic obstructive pulmonary disease. Limited empirical documentation exists to support the effectiveness of a nurse managed rehabilitation programme for older patients with chronic obstructive pulmonary disease. The study was done to evaluate the effects of pulmonary rehabilitation provided by nurses on the pulmonary function, gas exchange and exercise tolerance in older patients with chronic obstructive pulmonary disease. Design., A one group pre-test,post-test design was used to evaluate the effects of a pulmonary rehabilitation programme. Method., The sample consisted of 20 patients with chronic obstructive pulmonary disease who participated in a pulmonary rehabilitation programme including breathing exercises, upper-limb exercises and inspiratory muscle training. Results., The findings indicated improvement in exercise performance and a decrease in dyspnea after participation in the pulmonary rehabilitation programme. Relevance to clinical practice., The clinical nurse can make a significant impact on the illness trajectory and quality of life for patients with chronic obstructive pulmonary disease. The nurse has a critical role in helping patient with chronic obstructive pulmonary disease learn to cope, adjust and adapt to life with a chronic illness. Active nurse involvement with a patient in a pulmonary rehabilitation programme can assist in the identification of factors that motivate the patient, help in establishing realistic out comes expectations and provide patient teaching opportunities. The nurse can assist the patient to develop skills of self-awareness regarding particular symptoms, self-monitoring and health status change identification. [source] Clinical prediction rule to diagnose post-infectious bronchiolitis obliterans in childrenPEDIATRIC PULMONOLOGY, Issue 11 2009Alejandro J. Colom Abstract Rationale Infant pulmonary function testing has a great value in the diagnosis of post-infectious bronchiolitis obliterans (BOs), because of characteristic patterns of severe and fixed airway obstruction. Unfortunately, infant pulmonary function testing is not available in most pediatric pulmonary centers. Objective To develop and validate a clinical prediction rule (BO-Score) to diagnose children under 2 years of age with BOs, using multiple objectively measured parameters readily available in most medical centers. Methods Study subjects, children under 2 years old with a chronic pulmonary disease assisted at R. Gutierrez Children's Hospital of Buenos Aires. Patients were randomly divided into a derivation (66%) and a validation (34%) set. ROC analyses and multivariable logistic regression included significant clinical, radiological, and laboratory predictors. The main outcome measure was a diagnosis of BOs. The performance of the BO-Score was tested on the validation set. Results Hundred twenty-five patients were included, 83 in the derivation set and 42 in the validation set. The BO-Score (area under ROC curve,=,0.96; 95% CI, 0.9,1.0%) was developed by assigning points to the following variables: typical clinical history (four points), adenovirus infection (three points), and high-resolution computed tomography with mosaic perfusion (four points). A Score ,7 predicted the diagnosis of BOs with a specificity of 100% (95% CI, 79,100%) and a sensitivity of 67% (95% CI, 47,80%). Conclusions The BO-Score is a simple-to-use clinical prediction rule, based on variables that are readily available. A BO-Score of 7 or more predicts a diagnosis of post-infectious BOs with high accuracy. Pediatr Pulmonol. 2009; 44:1065,1069. ©2009 Wiley-Liss, Inc. [source] Age and comorbidity impact surgical therapy in older bladder carcinoma patients,,CANCER, Issue 8 2005A population-based study Abstract BACKGROUND Bladder carcinoma often occurs in older patients who also may have other comorbid conditions that could influence the administration of surgical therapy. The current study was conducted to describe the distribution of comorbid conditions in patients with bladder carcinoma and ascertain whether these conditions, as grouped by the American Society of Anesthesiologists physical status classification, affected the choice of surgical therapy. METHODS The authors examined six population-based cancer registries from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program in 1992. A total of 820 individuals age 55 years and older was found. A random sample of newly diagnosed bladder carcinoma patients were stratified according to registry, age group (ages 55,64 yrs, ages 65,74 yrs, and age 75 yrs and older), and gender. Data regarding comorbid conditions were abstracted from the medical records and merged with routinely collected cancer registry data. The main outcome measures were the prevalence and distribution of comorbid conditions, American Society of Anesthesiologists physical status classification, and the receipt of cystectomy in patients with muscle invasion. RESULTS Hypertension, chronic pulmonary disease, arthritis, and heart disease were found to affect at least 15% of the study population. Approximately 38% of patients were current or former smokers. Greater than 90% of patients with superficial disease were treated with transurethral resection alone. Among those patients with muscle invasion, only 55% of those ages 55,59 years underwent cystectomy; this percentage dropped to 4% in patients age 85 years and older. Among patients with an American Society of Anesthesiologists physical status classification of 0,2, the cystectomy rate ranged from 53% in those ages 55,59 years to 9% in those age 85 years and older. CONCLUSIONS There were no significant treatment differences noted with regard to age among patients with superficial disease. Among those patients with muscle invasion, those age 75 years and older were less likely to undergo radical cystectomy (14%) compared with patients ages 55,64 years (48%) and those ages 65,74 years (43%). Patient age may contribute to treatment decisions in patients with muscle-invasive disease, even when comorbidity is taken into account. Cancer 2005. © 2005 American Cancer Society. [source] | ||||||||||