Comparison of the Diskus inhaler and the Handihaler regarding preference and ease of use.

Many chronic obstructive pulmonary disease (COPD) patients use their inhaler ineffectively and there is a trend towards increased inhaler resistance. We wanted to answer two questions: Is there a difference in preference and ease of use between Diskus (DK) and Handihaler (HH)? How acceptable are inhalation resistances? Sixty COPD patients, naive to DK and HH, but experienced in the use of other inhalers, had to read the instruction leaflet and demonstrate their inhalation technique. If errors were made, instruction was given and inhalation technique was checked again.

Ruling out clinically suspected pulmonary embolism by assessment of clinical probability and D-dimer levels: a management study.

D-dimer test combined with clinical probability assessment has been proposed as the first step in the diagnostic work-up of patients with suspected pulmonary embolism (PE). In a prospective management study we investigated the safety and efficiency of excluding PE by a normal D-dimer combined with a low or moderate clinical probability. Of the 202 study patients this combination ruled out PE in 64 (32%) patients.