didgeridoo - Sleep-Disordered Breathing 51 obstructive...

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obstructive pulmonary disease (AECOPD) [1]. The patients were grouped according to blood glucose quartiles. The relative risk of death or long in-patient hospital stay was significantly increased among those patients whose glucose fell into the two higher quartiles compared with the lowest. Indeed, for each 1 mmol/L increase in blood glucose the absolute risk of adverse outcomes increased by 15%. In an accompanying editorial, deficiencies of the study are pointed out [2]. These include the possible complicating issues of concomitant corticosteroid administration, the disadvantages of a retrospective analysis relying entirely on clinical coding, and the fact that single measurements of maximal blood glucose values were used in the analysis. Nevertheless, evidence from the Baker et al. study indicates that tight control of blood glucose reduces mortality in a variety of patient populations, although there is considerable danger of hypoglycemia. A prospective study is now required to determine whether control of blood glucose can improve outcomes in patients with AECOPD. Short-burst oxygen therapy for COPD patients: a 6-month randomized, controlled study. Eaton T, Fergusson W, Kolbe J et al. University of Auckland, Auckland, New Zealand. Eur Respir J 2006;27:697–704. Editor’s note: Short burst oxygen therapy (SBOT) is defined as the intermittent use of oxygen for the relief of breathlessness before exercise or recovery following exercise. Several studies have suggested that SBOT provides little clinically meaningful benefit for patients with chronic obstructive pulmonary disease (COPD), although its use remains widespread. This interesting investigation aimed to determine whether SBOT improved health-related quality of life (QoL) or reduced acute healthcare utilization in patients discharged following an acute exacerbation of COPD. Patients were randomized to cylinder oxygen, cylinder air, or usual care following discharge. Participants were mainly elderly with high acute healthcare utilization, low forced expiratory volume in 1 s, significant dyspnea limiting their daily activity, and not hypoxemic at rest. Over the 6-month study period involving approx- imately 80 patients, no significant differences were found between the patient groups in terms of QoL scores except from the emotional domain of the chronic respiratory questionnaire. In addition, there were no significant differences in acute healthcare utilization although time to re-admission was greatest in the “usual care” group. Interestingly, cylinder use was initially high
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didgeridoo - Sleep-Disordered Breathing 51 obstructive...

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