ObjectiveThe purpose of this study was to evaluate the clinical/functional aspects and
quality of life of chronic obstructive pulmonary disease patients who were
discharged after an intensive care unit admission for acute respiratory
failure.MethodsThis prospective study included chronic obstructive pulmonary disease
patients who were admitted to two intensive care units between December of
2010 and August of 2011 and evaluated over three visits after discharge.
Thirty patients were included, and 20 patients completed the three-month
follow up.ResultsThere was a significant improvement in the following: forced expiratory flow
in one second (L) (1.1/1.4/1.4; p = 0.019), six-minute walk test (m) (-
/232.8 /272.6; p = 0.04), BODE score (7.5/5.0/3.8; p = 0.001), cognition
measured by the Mini Mental State Examination (21/23.5/23.5; p = 0.008) and
quality of life measured by the total Saint George Respiratory Questionnaire
score (63.3/56.8/51, p = 0.02). The mean difference in the total score was
12.3 (between visits 1 and three). Important clinical differences were
observed for the symptom score (18.8), activities score (5.2) and impact
score (14.3). The majority of participants (80%) reported they would be
willing to undergo a new intensive care unit admission.ConclusionDespite the disease severity, there was a significant clinical, functional
and quality of life improvement at the end of the third month. Most patients
would be willing to undergo a new intensive care unit admission.
A 25-year-old female presented, reporting back pain and intermittent fever for 3 months. At the time, she was at the end of the third trimester of pregnancy; therefore, an imaging examination could not be carried out.
Auscultation of breathing sounds is a common practice since the antiquity. In 1819, Laënnec invented the stethoscope and published the first work on pulmonary disorders and their associated sounds. Since then, the auscultation was incorporated into medicine. The first electronic device to record and analyze physiological sounds was built in 1955, being followed by many other developments. In 2000, a task force of the European Respiratory Society established guidelines for computerized respiratory sound analysis (CORSA). Our work describes a low cost microcomputerized system, based on the CORSA guidelines, developed to acquire and record breathing sounds as well as respiratory flow waveforms. It consists of a four channel micro-controlled device that can simultaneously record sounds from three different sources and flow waveform. These signals are transmitted to a microcomputer running dedicated software that shows the waveforms on the screen and stores them into the hard disk. The developed device was tested in patients with heart failure, idiopathic pulmonary fibrosis, pneumonia and asthma. Examples of the registered signals and results of a qualitative assessment of the developed system are presented.
A395 21.91%, p< 0.01), compared to those without a PD diagnosis. The PD cohort also incurred significantly higher skilled nursing facility ($6,458 vs. $5,182, p= 0.03), DME ($344 vs. $206, p< 0.01) and pharmacy costs ($6,025 vs. $4,998, p< 0.0001) compared to the comparison cohort. ConClusions: Study results suggest that patients diagnosed with PD incurred significantly higher costs and had higher resource utilization than those without a PD diagnosis.
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