Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Short term effects of exercise training on exercise capacity and quality of life in patients with pulmonary arterial hypertension: protocol for a randomised controlled trial.

Short term effects of exercise training on exercise capacity and quality of life in patients with pulmonary arterial hypertension: protocol for a randomised controlled trial.

BMC Pulm Med. 2011 May 23;11(1):25

Authors: Ganderton L, Jenkins S, Gain K, Fowler R, Winship P, Lunt D, Gabbay E

ABSTRACT: BACKGROUND: Advances in the understanding and management of pulmonary arterial hypertension have enabled earlier diagnosis and improved prognosis. However, despite best available therapy, symptoms of exertional dyspnoea and fatigue are commonly reported and result in a reduced capacity to perform daily activities and impaired quality of life. Exercise training has demonstrated efficacy in individuals with other respiratory and cardiovascular diseases. Historically, however, exercise training has not been utilised as a form of therapy in pulmonary arterial hypertension due to the perceived risk of sudden cardiac death and the theoretical possibility that exercise would lead to worsening pulmonary vascular haemodynamics and deterioration in right heart function. Now, with the advances in pharmaceutical management, determining the safety and benefits of exercise training in this population has become more relevant. Only three studies of supervised exercise training in pulmonary arterial hypertension have been published. These studies demonstrated improvements in exercise capacity and quality of life, in the absence of adverse events or clinical deterioration. However, these studies have not utilised an outpatient-based, whole body exercise training program, the most common format for exercise programs within Australia. It is uncertain whether this form of training is beneficial and capable of producing sustained benefits in exercise capacity and quality of life in this population. Design/Methods: This randomised controlled trial will determine whether a 12 week, outpatient-based, supervised, whole body exercise training program, followed by a home-based exercise program, is safe and improves exercise capacity and quality of life in individuals with pulmonary arterial hypertension. This study aims to recruit 34 subjects who will be randomly allocated to the exercise group (supervised exercise training 3 times a week for 12 weeks, followed by 3 sessions per week of home exercise for 12 weeks) or the control group (usual medical care). Subjects will be assessed at baseline, 12 weeks and 24 weeks. DISCUSSION: This study will determine whether outpatient-based, whole body exercise training is beneficial and safe in individuals with pulmonary arterial hypertension. Additionally, this study will contribute to clinical practice guidelines for this patient population. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12609000502235).

PMID: 21600062 [PubMed - as supplied by publisher]

Respiratory disease registries in Spain: fundamentals and organization.

Respiratory disease registries in Spain: fundamentals and organization.

Arch Bronconeumol. 2011 May 20;

Authors: Lara B, Morales P, Blanco I, Vendrell M, Monreal M, Orriols R, Isidro I, Abú-Shams K, Escribano P, Villena V, Rodrigo T, García-Yuste M

This present paper describes the general characteristics, objectives and organizational aspects of the respiratory disease registries in Spain with the aim to report their activities and increase their diffusion. The document compiles information on the following registries: the Spanish Registry of Patients with Alpha-1 Antitrypsin Deficiency, Spanish Registry of Bronchiectasis, International Registry of Thromboembolic Disease, Spanish Registry of Occupational Diseases, Spanish Registry of Pulmonary Artery Hypertension, Registry of Pleural Mesothelioma, Spanish Registry of Tuberculosis and Spanish Multi-center Study of Neuroendocrine Pulmonary Tumors. Our paper provides information on each of the registries cited. Each registry has compiled specific clinical information providing data in real situations, and completes the results obtained from clinical assays. Said information has been published both in national as well as international publications and has lead to the creation of various guidelines. Therefore, the activities of the professionals involved in the registries have spread the knowledge about the diseases studied, promoting the exchange of information among workgroups.

PMID: 21601971 [PubMed - as supplied by publisher]

Why, when and how to propose noninvasive ventilation in cystic fibrosis?

Why, when and how to propose noninvasive ventilation in cystic fibrosis?

Minerva Anestesiol. 2011 May 20;

Authors: Fauroux B

Cystic fibrosis (CF) lung disease is characterized by progressive airflow obstruction, due to mucus plugging and inflammation within the bronchial walls, and destruction of the lung parenchyma secondary to bronchiectasis. These alterations result in an increase of the work of breathing, leading to alveolar hypoventilation predominantly during sleep, exercise and acute respiratory exacerbations. Noninvasive positive pressure ventilation (NPPV) has been shown to unload the respiratory muscles in patients with CF, which increases alveolar ventilation and improves gas exchange. NPPV has been shown to reduce oxygen desaturation during sleep, exercise and chest physiotherapy and may facilitate the recovery of a severe hypercapnic respiratory exacerbation. Several ventilatory modes may be used in cystic fibrosis patients but the most physiological mode is pressure support. However, validated criteria to start NPPV as well as data on long term outcome, notably in terms of improved survival and quality of life, are lacking and should be assessed in the future.

PMID: 21602746 [PubMed - as supplied by publisher]

Survey of non-invasive ventilation practices: a snapshot of Italian practice.

Survey of non-invasive ventilation practices: a snapshot of Italian practice.

Minerva Anestesiol. 2011 May 20;

Authors: Crimi C, Noto A, Princi P, Nava S

BACKGROUND: In Italy, NIV began to be employed in the late 1980s. Because it was adopted earlier than in Italy than in other countries, the pattern and rate of utilization of NIV may be different. We aim to determine factors that may influence Italian physicians' preferences towards NIV use, with a particular emphasis on the primary specialty of these physicians and the type of hospital in which they work. METHODS:We re-examined the data from our European survey conducted in 2008 and focused our analysis on the Italian subsets of respondents to explore factors that influence physicians' perceptions of their NIV practices in four scenarios: acute hypercapnic respiratory failure (AHRF), cardiogenic pulmonary edema (CPE), de novo respiratory failure, and weaning/post-extubation failure (W/PE). RESULTS: On average, NIV was equally applied in university and community hospitals (P>0.05) and its utilization rate was higher for pulmonologists (62% reported >20% of patients treated with NIV a year) vs. intensivists (17%) and others (21%) (P<0.05). A greater use of NIV was related to a smaller number of unit beds in de novo respiratory failure (56% vs. 40%) and a larger amount of unit beds in AHRF (16% vs. 7%) (P<0.05). Dedicated NIV platforms and ICU ventilators with NIV modules were the preferred machines in AHRF (P<0.05), while a greater utilization of ICU ventilators with NIV modules was observed in de novo respiratory failure. In all the scenarios, a facial mask was predominantly used (P<0.05), with the helmet rated as the second preferred choice in CPE. CONCLUSION: Overall, Italian physicians perceived that NIV represents an essential tool when dealing with acute episodes of respiratory failure, irrespective of the type of hospital in which they worked.

PMID: 21602754 [PubMed - as supplied by publisher]

EP4 receptor as a new target for bronchodilator therapy.

EP4 receptor as a new target for bronchodilator therapy.

Thorax. 2011 May 23;

Authors: Buckley J, Birrell MA, Maher SA, Nials AT, Clarke DL, Belvisi MG

Background Asthma and chronic obstructive pulmonary disease are airway inflammatory diseases characterised by airflow obstruction. Currently approved bronchodilators such as long-acting β(2) adrenoceptor agonists are the mainstay treatments but often fail to relieve symptoms of chronic obstructive pulmonary disease and severe asthma and safety concerns have been raised over long-term use. The aim of the study was to identify the receptor involved in prostaglandin E(2) (PGE(2))-induced relaxation in guinea pig, murine, monkey, rat and human airways in vitro. Methods Using an extensive range of pharmacological tools, the relaxant potential of PGE(2) and selective agonists for the EP(1-4) receptors in the presence and absence of selective antagonists in guinea pig, murine, monkey, rat and human isolated airways was investigated. Results In agreement with previous studies, it was found that the EP(2) receptor mediates PGE(2)-induced relaxation of guinea pig, murine and monkey trachea and that the EP(4) receptor mediates PGE(2)-induced relaxation of the rat trachea. These data have been confirmed in murine airways from EP(2) receptor-deficient mice (Ptger2). In contrast to previous publications, a role for the EP(4) receptor in relaxant responses in human airways in vitro was found. Relaxant activity of AH13205 (EP(2) agonist) was also demonstrated in guinea pig but not human airway tissue, which may explain its failure in clinical studies. Conclusion Identification of the receptor mediating PGE(2)-induced relaxation represents a key step in developing a novel bronchodilator therapy. These data explain the lack of bronchodilator activity observed with selective EP(2) receptor agonists in clinical studies.

PMID: 21606476 [PubMed - as supplied by publisher]

Search

Search