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A Noseda

Publications and source records attributed to A Noseda.

75 records · Page 5Linked to original sources

Resistive inspiratory muscle training and exercise performance in COPD patients. A comparative study with conventional breathing retraining.

Twenty patients with stable COPD (mean age 67.8 yr; mean FEV1 1.08 1), all limited by ventilation at maximum exercise, were randomly allocated after a four week control period, to an eight week programme of either inspiratory resistive training (IRT), with a P Flex device, or conventional breathing retraining (BR). Exercise performance was evaluated every four weeks, using a 12-min walking test, an incremental progressive exercise on a cycle ergometer and a cycle endurance test. Inspiratory muscle endurance was measured as the highest tolerated resistance for 10 min on a P Flex device. IRT produced a significant (p less than 0.05) increase in the highest tolerated resistance, but IRT and BR failed to improve lung function or exercise performance. The present study shows that in COPD patients with ventilatory limitation on exercise an IRT programme may fail to improve exercise performance, in spite of an efficient training effect on the endurance of the inspiratory muscles.

Aged↗

Inspiratory and expiratory lung pressure-volume curve in healthy males and females.

Quasistatic lung inspiratory and expiratory pressure-volume curves were obtained in 58 healthy nonsmoking males (mean age +/- SD: 42.8 +/- 15.1 years; range 22.70) and 56 healthy nonsmoking females (mean age +/- SD: 41.4 +/- 15.6 years; range: 21-76). Inspiratory and expiratory lung recoil pressures were measured at fixed percentages of TLC (100, 95, 90, 80, 70, 60 and 50%). In both sexes, inspiratory as well as expiratory lung recoil pressures were found to decrease linearly with aging (p less than 0.01 for all r values). There was no significant difference between males and females. At and above the 70% TLC level, the slopes of the age-related decreases in lung recoil were similar for the inspiratory and expiratory curves. At the 60% TLC level, the decrease in expiratory lung recoil was significantly (p less than 0.01) faster than the decrease in inspiratory lung recoil, presumably reflecting the influence of airway opening on the inspiratory pressure in older subjects. The shape of the expiratory PV curve described by the K index of the exponential model was similar in both sexes and changed with aging, K increasing significantly (p less than 0.01). By contrast, the shape of the inspiratory limb of the PV curve did not vary with aging. Consequently, the shape of the inspiratory PV curve cannot be predicted from the expiratory one and has to be measured directly.

Adult↗

[Induced expectoration or endoscopic samples in case of bronchopulmonary infection?].

The aim of this study was to compare induced sputum versus bronchoscopy in a non selected population. An induced sputum and a bronchoscopy with aspiration of secretions and bronchoalveolar lavage (BAL) were proposed to 30 patients with suspected lower respiratory tract infection, including 14 subjects with AIDS. Induced sputum failed in 3 patients, while endoscopy could not be performed (contra-indication, refusal or failure due to lack of cooperation) in 7 patients; a technical failure for BAL was observed in 3/23 cases. Contamination by oral germs was significantly less frequent with BAL (4/20) than with aspiration (15/23) or induced sputum (17/27). A relevant pathogen was cultured from induced sputum in 7/27 cases (3 mycobacteria, 4 usual pathogens) from aspiration in 3/23 cases (one mycobacterium, 2 usual pathogens) and from BAL in 4/20 cases (one mycobacterium, 3 usual pathogens). These results suggest that induced sputum is a promising method when difficulties in performing bronchoscopy are expected (severe respiratory insufficiency, psychiatric disease, lack of cooperation).

Bronchoalveolar Lavage Fluid↗