Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology.

Long-term mechanical ventilation is a well-established treatment for chronic hypercapnic respiratory failure (CHRF). It is aimed at improving CHRF-related symptoms, health-related quality of life, survival, and decreasing hospital admissions. In Switzerland, long-term mechanical ventilation has been increasingly used since the 1980s in hospital and home care settings.

Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss Respiratory Society.

The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements are based on the available literature, on other national guidelines and, in particular, on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report.

[Pulmonary rehabilitation - a modern and patient-centred treatment approach in COPD].

Physical exercise is highly effective to improve exercise capacity and quality of life of patients with COPD and to reduce the risk for hospital admissions in patients with exacerbations.The combination of physical exercise,patient education and pharmacotherapy,as typically performed during pulmonary rehabilitation, has become the modern disease management for COPD patients. Unfortunately, there is still a lack of evidence on effective treatments to increase levels of physical activity.

Acute respiratory health effects of urban air pollutants in adults with different patterns of underlying respiratory disease.

Objective: Whether underlying chronic respiratory diseases are susceptible factors for symptomatic episodes, which lead to primary-level care, in association with air pollutant exposures is unknown. We evaluated and compared association lag structures between daily ambient levels of nitrogen dioxide (NO(2)) and total suspended particulates (TSP) and respiratory symptom-related doctor visits in adults with different patterns of underlying chronic respiratory disease.

Methods: In a time-stratified case-crossover analysis nested within a diary panel study, 459 Swiss adult participants with asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and healthy participants recorded occurrence of respiratory-symptom related doctor visits (n = 1,048) in one to six four-week intervals over two years.

Accuracy of the piko-1 pocket spirometer.

Background: Good asthma control is the main goal of long-term asthma treatment. According to the Global Initiative for Asthma (GINA) guidelines (www.ginasthma.

Early versus late pulmonary rehabilitation in chronic obstructive pulmonary disease patients with acute exacerbations: a randomized trial.

Background: Around the world, the timing of referral of chronic obstructive pulmonary disease (COPD) patients for pulmonary rehabilitation differs from immediately after exacerbation (early) to later on when patients are in a stable state (late). There are no trials comparing the different time points of referral for pulmonary rehabilitation.

Objectives: Our aim was to compare the effects of early and late pulmonary rehabilitation on exacerbation rates and health-related quality of life (HRQOL) in COPD patients with exacerbations.

A single dose of Sildenafil does not enhance FeNO: a randomised, cross-over and placebo-controlled study.

Monitoring of asthma control can be performed with different means including measurement of the concentration of nitric oxide (NO) in exhaled air. Due to its action on the NO-metabolism; we hypothesized that the intake of Sildenafil might augment and falsify the NO-values in exhaled air of subjects taking the drug to treat erectile dysfunction. This randomised, placebo-controlled cross-over study including 10 male non-asthmatic volunteers taking a single dose of 50 mg Sildenafil did not confirm this assumption in non-asthmatic subjects.

Recruitment barriers in a randomized controlled trial from the physicians' perspective: a postal survey.

Background: The feasibility of randomized trials often depends on successful patient recruitment. Although numerous recruitment barriers have been identified it is unclear which of them complicate recruitment most. Also, most surveys have focused on the patients' perspective of recruitment barriers whereas the perspective of recruiting physicians has received less attention.

Improvements in PM10 exposure and reduced rates of respiratory symptoms in a cohort of Swiss adults (SAPALDIA).

Rationale: Reductions in mortality following improvements in air quality were documented by several studies, and our group found, in an earlier analysis, that decreasing particulate levels attenuate lung function decline in adults.

Objectives: We investigated whether decreases in particulates with an aerodynamic diameter of less than 10 microm (PM10) were associated with lower rates of reporting respiratory symptoms (i.e.

[How is your asthma today?--A case report considering different parameters of asthma control].

Any anti-asthmatic therapy aims to control the disease activity. The amount of medication necessary to maintain asthma control over a longer period may vary. In the course of a long-term treatment, achievement of asthma control has regularly to be assessed.

Pulmonary rehabilitation in Switzerland.

Pulmonary rehabilitation is a form of therapy for patients with chronic lung disease that is evidence based, which ameliorates performance and endurance of the patient and improves quality of life significantly. Pulmonary rehabilitation also diminishes the amount of hospitalisations and the duration of stay in hospitals. It can improve capacity of work and diminishes the absenteeism.

Short-term variation in air pollution and in average lung function among never-smokers. The Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA).

The present analysis was directed at investigating associations between short-term variations in air pollutant levels (NO2, total suspended particulates [TSP], O3) and cross-sectional lung function (FVC, FEV1, and forced expiratory flow at 25% to 75% of FVC [FEF25-75]) within a random sample of 3,912 adult never-smokers from eight areas of Switzerland (i.e., participants in the Swiss Study on Air Pollution and Lung Diseases in Adults [SAPALDIA] cross-sectional study, 1991).

[Nasal CPAP therapy in obstructive sleep apnea syndrome: patient compliance].

We aimed in 186 patients with obstructive sleep apnoea, consecutively treated with nasal CPAP between January 1990 and December 1997, to evaluate compliance with nCPAP therapy and to explore factors influencing compliance. At 3 to 6 months (K1), 1 to 2 years (K2) and more than 3 years (K3) patients were reexamined regarding clinical conditions, the mean time of nCPAP usage per night, nCPAP pressure, and body mass index (BMI). The regularly conducted controls consisted of checking mask fitting, polygraphy with automatic pressure titration and once, mostly at K1, polysomnography.

Occupational exposure to inhalative irritants and methacholine responsiveness.

Objectives: Occupational exposures to inhalative irritants have been associated with an increased reporting of respiratory symptoms in previous studies. Methacholine responsiveness represents a continuous measure of airway responsiveness. As such, it may be less subject to recall bias and more sensitive to detecting effects of occupational exposure on airways.

[Predictive value of nocturnal pulse oximetry in sleep apnea screening].

The monitoring of overnight oxygen saturation is widely used for sleep apnoea screening. The point of this screening has been questioned as a wide range of sensitivity has been reported in the literature. In a prospective study 70 subjects presenting with a possible sleep apnoea-hypopnoea syndrome had overnight oximetry followed by polysomnography 2 to 4 months later.

[Tuberculosis in Switzerland--a millenium problem?].

In Switzerland a family physician sees a case of tuberculosis only every 4-6 years. While tuberculosis does not seem to be a major medical challenge in western countries, it is a real problem in the developing world. Nevertheless, special situations do arise in the western hemisphere where the standard therapy needs to be changed.

Peak flow variability in the SAPALDIA study and its validity in screening for asthma-related conditions. The SPALDIA Team.

We used 3-wk peak expiratory flow (PEF) measurements (twice daily) made in the diary study of the population-based Swiss Study on Air Pollution and Lung Disease in Adults to describe PEF-variability (PEF(var)) (amplitude as a percent of the mean, PEF [i.e., difference between morning and evening values divided by the mean]) in the study population and in five subgroups (physician-diagnosed asthma; current asthma, or physician-diagnosed asthma plus asthma attacks and/or medication; history of wheezing without a cold; hyperreactive; and nonsymptomatic).