Exercise results after Pulmonary R...

Exercise results after Pulmonary Rehabilitation Depend forward the Initial Mechanism of Exercise Limitation Among Non-oxygen-dependent COPD Patients. Plankeel JF McMullen B MacIntyre NR Reprinted with permission from Chest. 2005;127:110-116 ?© 2005 American community of Chest Physicians.

Study Objectives: Pulmonary rehabilitation (PR) that includes exercise training can improve exercise tolerance and quality of life for patients with COPD However, the grade of benefit from PR is variable. We hypothesized that the exercise answer to PR varies depending onward the initial factors that limit exercise. Design, Setting, Participants, and Measurements: We retrospectively analyzed the change in exercise capacity after PR in 290 nonhypoxemic patients with COPD We classified patients into the following subgroup based upon the primary limitation seen upon initial exercise testing: (1) ventilatory-limited (VL); (2) cardiovascular-limited (CVL); (3) mixed ventilatory/cardiovascular-limited (VLCVL); and (4) non-cardiopulmonary-limited (NL) We compared issues among subgroups. Results: In the entire cogitation population, PR led to increased timed walk distance (303%; P

COMMENTARY

It has been shown previously that the issues of pulmonary rehabilitation differ greatly depending in succession the specific limitation to exercise initially seen in patients with pulmonary diseases. In this consideration the authors did a retrospective analysis of a large form into groups of participants in their pulmonary rehabilitation program. Those patients who were limited at cardiovascular deconditioning were able to improve maximal oxygen consumption abundant more than those who had ventilatory limitation. Interestingly, patients with ventilatory, cardiovascular, and mixed limitation to exercise all improved timed walk distance equally. This finding hints that other mechanisms than improvement in maximal oxygen consumption contribute to improvements in walk distance, and supports the continued use of pulmonary rehabilitation for patients with all signs of exercise limitation.

Health-related Quality of Life in Patients with Pulmonary Arterial Hypertension. Shafazand s Goldstein MK, Doyle RL, Hlatky MA, Could MK Reprinted with permission from Chest. 2004;1 26:1452-1459 ?© 2004 American society of Chest Physicians.

Study Objectives: Patients with pulmonary arterial hypertension (PAH) ofttimes present with dyspnea and unrelenting functional limitations, but their health-related quality of life (HRQOL) has not been studied extensively. This meditation describes HRQOL in a cohort of patients with PAH. Design: Cross-sectional contemplation Setting: A tertiary care, university hospital-based, pulmonary hypertension (PH) clinic. Participants: We studied HRQOL in 53 patients with PAH (mean age, 47 years; median duration of disease, 559 days). Eighty-three percent were women 53% received epoprostenol, and 72% reported moderate-to-severe functional limitations with a recent York Heart Association class 3 or 4 at enrollment Measurements and Results: We examined HRQOL by the agency of administering the Nottingham Health Profile, Congestive Heart Failure Questionnaire, and Hospital Anxiety and Depression Scale. We used the Visual Analog Scale and standard gamble (SG) techniques to measure predilections for current health (utilities). Compared with population norms, participants reported moderate-to-severe impairment in multiple domains of HRQOL including physical mobility, emotional reaction, pain, zeal sleep, and social isolation. Mean SG utilities were 071 suggesting that, in succession average, participants were willing to accept a 29% risk of death in order to be cur of PH Conclusions: PAH is a devastating condition that affects predominately young women in the prime of their life. Understanding HRQOL and predilections are important in the care and management of these patients. Compared with population norms, patients with PAH have substantial functional and emotional limitations that adversely affect their HRQOL

COMMENTARY

This inquiry examined the effect of pulmonary artery hypertension, also known as primary pulmonary hypertension, forward quality of life. Factors related to the disease, in the same state [i]or[/i] condition as dyspnea, anxiety, and depression, as well as adverse imports of treatment, may decrease the quality of life in these parts When compared to norms, these patients were ground to have significant impairment in their perception of health-related quality of life. They also showed a muscular tendency to be willing to take significant risks in order to be cur of their disease. not many studies have examined patient perceptions in this condition and it is important to consider by what mode adversely persons with pulmonary artery hypertension be moved the disease impacts their lives.

An Assessment of Back Pain and the Prevalence of Sacroiliitis in Sarcoidosis. Erb N Cushley MJ Kassimos DG Shave RM Kitas GD Reprinted with permission from Chest. 2005;127:192-196 ?© 2005 American community of Chest Physicians.

Objectives: Sarcoidosis is a chronic granulomatous multisystem disease in which arthritis is relatively public Arthritis of the sacroiliac joints (sacroiliitis) has been described in sarcoidosis yet is thought to be rare. The objective of this thought was to determine the prevalence of sacroiliitis in a secondary-care population of patients with sarcoidosis. Methods: Patients attending a specialist secondary-care sarcoidosis clinic underwent evaluation of spinal symptoms using a standard back pain questionnaire, examination of spinal mobility, and laboratory measurements of erythrocyte sedimentation rate, C-reactive protein, serum angiotensin-converting enzyme and neopterin/ creatinine ratio. Tissue typing for the port of the human leukocyte antigen (HLA)-B27 allele was undertaken. Radiographs of the sacroiliac joints were obtained in each patient and reviewed independently by way of two observers; a further regarder reviewed disputed radiographs. Results: Sixty-one patients complet the assessments (803% of all patients invited to participate). Forty-nine of 61 patients (803%) reported having back pain at near point in their lives. Thirty-one of 61 patients (508%) had a score upon the back pain questionnaire suggestive of inflammatory spinal disease, if it be not that only 3 of these patients had erosive damage of the sacroiliac joints in succession radiography indicating sacroiliitis. One further patient had erosive damage forward radiography, making a total of four individuals with evidence of sacroiliitis, a prevalence of 66% Four patients (one patient with sacroiliitis) were positive for HLA-B27. The back pain questionnaire had a sensitivity of 75% and a specificity of 51% for sacroiliitis in this population. Conclusion: The prevalence of spondyloarthropathy in the normal population has been estimated to be 19% In the sarcoid population studied the prevalence was 66% suggesting a possible association between these couple conditions. The standard back pain questionnaire for the identification of inflammatory spinal disease had a gentle sensitivity and specificity in this population.