[Patient education in COPD during inpatient rehabilitation improves quality of life and morbidity].

Background: Pulmonary rehabilitation is recommended for the treatment of COPD in international guidelines. However, patient education as an important part of pulmonary rehabilitation has not been addressed sufficiently to show its benefit. The aim of this study was to find out whether education improves the effectiveness of rehabilitation with regard to quality of life (QoL) and morbidity in the year following rehabilitation.

Populations with explicit borders in space and time: concept, terminology, and estimation of characteristic parameters.

Biologists studying short-lived organisms have become aware of the need to recognize an explicit temporal extend of a population over a considerable time. In this article we outline the concept and the realm of populations with explicit spatial and temporary boundaries. We call such populations "temporally bounded populations".

A high-power laser-driven source of sub-nanosecond soft X-ray pulses for single-shot radiobiology experiments.

A large-scale, double-stream gas puff target has been illuminated by sub-kJ, near-infrared (NIR) focused laser pulses at the PALS facility (Prague Asterix Laser System) to produce high-energy pulses of soft X rays from hot, dense plasma. The double-puff arrangement ensures high gas density and conversion efficiency from NIR to X rays approaching that typical for solid targets. In addition, its major advantage over solid targets is that it is free of debris and has substantially suppressed charged-particle emission.

Prognostic value of mouth occlusion pressure in patients with chronic ventilatory failure.

Background: Mouth occlusion pressure measurement is widely used for assessment of respiratory muscle function, particularly in patients with respiratory failure. However, its predictive value for long-term survival remains largely unexplored.

Methods: In 464 patients with chronic hypercapnic respiratory failure (CHRF) due to various underlying disorders and receiving non-invasive ventilation (NIV), maximal inspiratory mouth pressure (PI(max)), mouth occlusion pressure at 100 ms during quiet breathing (P(0.

Impact of noninvasive home ventilation on long-term survival in chronic hypercapnic COPD: a prospective observational study.

Aims: The long-term benefit from noninvasive ventilation (NIV) in chronic hypercapnic chronic obstructive pulmonary disease (COPD) remains uncertain.

Methods: Within a prospective observational design, we compared the long-term survival of 140 patients with severe persistent hypercapnic COPD (FEV(1) 28.7 +/- 8.

Predictors of long-term survival in patients with restrictive thoracic disorders and chronic respiratory failure undergoing non-invasive home ventilation.

Background And Objectives: Non-invasive positive pressure ventilation (NPPV) is an established treatment in restrictive thoracic disorders (RTD) with chronic hypercapnic respiratory failure. The aim of this study was to identify predictors of long-term survival for patients on NPPV therapy.

Methods: In a 10-year retrospective cohort of patients with RTD and chronic hypercapnic respiratory failure, survival and the predictive value of nocturnal and daytime blood gases, lung function and laboratory data measured before initiation of NPPV were assessed.

Patient survival by Hsp70 membrane phenotype: association with different routes of metastasis.

Background: Heat shock proteins (HSPs) play important roles in tumor immunity. The authors prospectively investigated the correlation between the tumor-specific Hsp70 membrane expression as an independent clinicopathological marker and overall survival in tumor entities that differ in their route of metastasis.

Methods: Hsp70 membrane expression was examined by flow cytometry in 58 colon, 19 gastric, 54 lower rectal carcinoma, and 19 squamous cell carcinoma specimens and the corresponding normal tissues at time of first diagnosis.

Predictors of survival in COPD patients with chronic hypercapnic respiratory failure receiving noninvasive home ventilation.

Background: Patients with COPD and chronic hypercapnic respiratory failure (CHRF) are at high risk, and noninvasive ventilation at home is increasingly being used. Knowledge of prognostic parameters under these conditions is limited but may be clinically helpful and highlight the role of noninvasive ventilation.

Methods: In 188 patients with COPD (mean +/- SD FEV1, 31.

Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP).

Background: In the main analysis of the Canadian Continuous Positive Airway Pressure (CPAP) for Patients with Central Sleep Apnea (CSA) and Heart Failure Trial (CANPAP), CPAP had no effect on heart transplant-free survival; however, CPAP only reduced the mean apnea-hypopnea index to 19 events per hour of sleep, which remained above the trial inclusion threshold of 15. This stratified analysis of CANPAP tested the hypothesis that suppression of CSA below this threshold by CPAP would improve left ventricular ejection fraction and heart transplant-free survival.

Methods And Results: Of the 258 heart failure patients with CSA in CANPAP, 110 of the 130 randomized to the control group and 100 of the 128 randomized to CPAP had sleep studies 3 months later.

Patient and physician roles in end-of-life decision making.

This study is a cross-sectional descriptive survey of randomly selected primary care patients and physicians regarding patient, physician, and family roles in end-of-life decision making. The subjects included 329 adult outpatients and 272 practicing physicians. Physicians were more likely than patients to believe the patient alone was responsible for making end-of-life decisions.

NT-proBNP in chronic hypercapnic respiratory failure: a marker of disease severity, treatment effect and prognosis.

Background: Natriuretic peptides are considered as reliable indicators of left-heart failure (HF) and are useful for differential diagnosis of dyspnoea.

Aim: We evaluated the clinical significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic hypercapnic respiratory failure (CHRF).

Methods: In 60 patients with CHRF, plasma concentrations of NT-proBNP were assessed at baseline and after treatment including non-invasive ventilation (NIV).

Mortality and prognostic factors in patients with obesity-hypoventilation syndrome undergoing noninvasive ventilation.

Objectives: The incidence of obesity-hypoventilation syndrome (OHS) has greatly increased over time, but data on long-term outcome are limited. We investigated survival and prognostic factors in these patients undergoing noninvasive positive pressure ventilation (NPPV).

Design: Retrospective descriptive analysis of patients with OHS and NPPV up to 10 years.

Nutritional depletion and its relationship to respiratory impairment in patients with chronic respiratory failure due to COPD or restrictive thoracic diseases.

Objective: While malnutrition, especially fat-free mass index (FFMI), is a predictor for mortality in chronic obstructive pulmonary disease (COPD), less information on prevalence and mechanisms is available in patients with chronic respiratory failure (CRF) due to restrictive thoracic diseases (RTD).

Design And Setting: Cross-sectional study of patients consecutively admitted to an in-patient primary pulmonary centre.

Subjects: One hundred and thirty-two patients (30% RTD; 70% COPD) with CRF and intermittent non-invasive positive pressure ventilation.

Effectiveness of iterative algorithms in recovering phase in the presence of noise.

Inversion of coherent X-ray diffraction patterns allows the imaging of three-dimensional density distributions. The recovery of such shapes often requires application of iterative algorithms, such as Fienup's error reduction or hybrid input/output. Since the measurement of such a pattern records the intensity in reciprocal space, any errors due to noise will probably not have a straightforward impact on the final real-space result.

Non-invasive positive pressure ventilation improves lung volumes in the obesity hypoventilation syndrome.

Background: Our objective was to study the long-term effects of non-invasive positive pressure ventilation (NPPV) on lung function and gas exchange in patients with the obesity hypoventilation syndrome (OHS).

Design: Prospective observational study in OHS patients performing NPPV over a period of 24 months.

Results: We studied 35 clinically stable OHS patients with a mean body mass index (BMI) 45.

Respiratory muscle training in restrictive thoracic disease: a randomized controlled trial.

Objective: To investigate the effects of respiratory muscle training (RMT) in patients with restrictive thoracic disorders and intermittent noninvasive positive-pressure ventilation (NPPV).

Design: Prospective randomized controlled trial.

Setting: Home-based RMT, with assessment in a primary care pulmonary center.

The Caring Connections Project: Providing palliative care to Medicaid patients with advanced cancer.

Palliative care, with its focus on symptom management, patient-centered goals, preparation for life's end, and preservation of quality of life in the face of advancing illness, is a rapidly advancing component of mainstream American medicine. Yet, access to palliative care is often lacking in the community setting and may be further hindered by the presence of healthcare disparities that impact the poor. This article presents a unique approach to assuring the availability of palliative care to Medicaid patients receiving case management services.

Optical and X-ray emission spectroscopy of high-power laser-induced dielectric breakdown in molecular gases and their mixtures.

Large-scale plasma was created in molecular gases (CO, CO2, N2, H2O) and their mixtures by high-power laser-induced dielectric breakdown (LIDB). Compositions of the mixtures used are those suggested for the early earth's atmosphere of neutral and/or mildly reducing character. Time-integrated optical spectra emitted from the laser spark have been measured and analyzed.

Molecular mechanisms of insulin resistance and associated diseases.

Insulin resistance is a state in which higher than normal concentrations of insulin are required for normal response. The most common underlying cause is central obesity, although primary insulin resistance in normal-weight individuals is also possible. Excess abdominal adipose tissue has been shown to release increased amounts of free fatty acids which directly affect insulin signalling, diminish glucose uptake in muscle, drive exaggerated triglyceride synthesis and induce gluconeogenesis in the liver.

Smoking and cancer-related gene expression in bronchial epithelium and non-small-cell lung cancers.

Tobacco smoking is the leading cause of lung cancer worldwide. Gene expression in surgically resected and microdissected samples of non-small-cell lung cancers (18 squamous cell carcinomas and nine adenocarcinomas), matched normal bronchial epithelium, and peripheral lung tissue from both smokers (n = 22) and non-smokers (n = 5) was studied using the Affymetrix U133A array. A subset of 15 differentially regulated genes was validated by real-time PCR or immunohistochemistry.

[The role of vitamin D in the treatment of osteoporosis in the elderly].

During the last 5 years several randomized, prospective, placebo-controlled clinical trials have documented that a supplementation with vitamin D (400-1,200 IU per day) together with calcium (800-1,500 mg per day) may reduce the risk of falls and fall-related fractures in the elderly. This is especially the case in elderly women >or= 65 years of age with a serum 25-hydroxy-vitamin-D(3) level < 50 nmol/l. Based on the results of a recently published meta-analysis involving more than 10,000 participants, the grade of evidence according to the Oxford Centre of Evidence-based Medicine is Ia with respect to the primary prevention of falls in the elderly population.

Three-dimensional mapping of a deformation field inside a nanocrystal.

Coherent X-ray diffraction imaging is a rapidly advancing form of microscopy: diffraction patterns, measured using the latest third-generation synchrotron radiation sources, can be inverted to obtain full three-dimensional images of the interior density within nanocrystals. Diffraction from an ideal crystal lattice results in an identical copy of this continuous diffraction pattern at every Bragg peak. This symmetry is broken by the presence of strain fields, which arise from the epitaxial contact forces that are inevitable whenever nanocrystals are prepared on a substrate.

Hugoniot data of plastic foams obtained from laser-driven shocks.

In this paper we present Hugoniot data for plastic foams obtained with laser-driven shocks. Relative equation-of-state data for foams were obtained using Al as a reference material. The diagnostics consisted in the detection of shock breakout from double layer Al/foam targets.