The clinical course and prognosis were studied in patients with chronic pulmonary emphysema with special reference to clinical features and pulmonary hemodynamics. In 78 patients, right heart catheterization was performed. The period of the follow-up was 4.4 years on an average.The results obtained suggest that pulmonary hemodynamics, especially pulmonary artery mean pressure, is an important factor in predicting the prognosis of chronic pulmonary emphysema. It was most significant that many patients with pulmonary hypertension showed poor prognosis. Furthermore, in the presence of the pulmonary hypertension some abnormalities of pulmonary ventilatory, respiratory and circulatory functions had additional prognostic values.HE advance of the pulmonary function tests has contributed much to clarifying the clinico-physiological feature of chronic pulmonary emphysema. However, there are still some discrepancies between clinical diagnosis of this disease and post-mortem findings, so that it is difficult to grasp the actual aspects of the disease.In this presentation, pulmonary hemodynamics in patients with chronic pulmonary emphysema were investigated, and pulmonary circulatory disturbance was found to be a more significant factor in evaluating the severity and in predicting the prognosis of the disease than the values of ventilatory and respiratory function tests.
MATERIALS AND METHODSThe subjects in this study were 103 patients with chronic pulmonary emphysema, 81 males and 22 females, aged 34 to 77 (54 cases of over 60 years of age, 38 cases of 45 to 60, and 11 cases of below 45). The clinical diagnosis was made according to clinical manifestations, spirometric studies and/or other additional laboratory findings.
Objective:To analyze and reveal the contents of medical questionnaires distributed to nationwide general practice outpatients prior to their initial medical consultations.Method:An observational study was conducted, based on questionnaire format. Sample questionnaires were collected from 85 hospitals registered with the Japan Primary Care Association.Results:No standard format was found among the samples. A4 size forms(210 mm×297 mm)averaging 19.7 questions were in the majority, accounting for 68%. The distribution frequency of questionnaires reported by research cooperation centers listed 28 items(31.8%)concerning medical history, 19 items(21.6%)related to lifestyle, and 7 items(8.0%)referring to social and reproductive status.
Conclusion:This research assessed the qualitative value of medical questionnaires used in General PracticeClinics in Japan. The results indicate the nature of the medical information required by physicians prior to medical consultation.
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