Biomedical subjects

Y Lacasse

Publications and source records attributed to Y Lacasse.

57 records · Page 4Linked to original sources

PubMedDate not supplied

Randomized trial of paroxetine in end-stage COPD.

BACKGROUND: Although the underlying pathology is initially confined to the lungs, the associated emotional responses to chronic obstructive pulmonary disease (COPD) contribute greatly to the resulting morbidity. The objective of this study was to examine the effect of an antidepressant drug on disease-specific quality of life in patients with end-stage COPD who present significant depressive symptoms. METHODS: We conducted a 12-week, randomized double-blind placebo-controlled trial of Paroxetine in which quality of life measured by the Chronic Respiratory Questionnaire (CRQ), an evaluative COPD-specific quality-of-life questionnaire, was the primary outcome. RESULTS: 23 patients were randomized and 15 completed the trial (8 on Paroxetine; 7 on placebo). In the per-protocol analysis, we observed statistically and clinically significant improvements favoring the active treatment in 2 of the 4 domains of the CRQ: emotional function (adjusted mean difference: 1.1; 95% confidence interval [CI]: 0.0 - 2.2) and mastery (difference: 1.1; CI: 0.4 - 1.8). Dyspnea and fatigue improved, but to an extent that did not reach statistical significance. In the intention-to-treat analysis, none of the differences in CRQ scores was significant. Paroxetine was not associated to any worsening of respiratory symptoms. CONCLUSIONS: The results of this small randomized trial indicated that patients with end-stage COPD may benefit from antidepressant drug therapy when significant depressive symptoms are present. This study underlined the difficulties in conducting experimental studies in frail and elderly patients with COPD.

Aged↗

PubMedDate not supplied

Pulmonary rehabilitation programs in Canada: national survey.

OBJECTIVE: To characterize pulmonary rehabilitation (PR) programs in terms of their type, size, duration, patient population, content and staffing. DESIGN: Surveys were sent to members of the Rehabilitation Committee of the Canadian Thoracic Society, as well as any program identified by members of the Canadian Physiotherapy Cardio-Respiratory Society, by provincial lung associations or by the respondents. PARTICIPANTS: Of 51 surveys sent, responses were received from 44 facilities (86% response rate). In-patient or out-patient pulmonary rehabilitation programs were offered by 36 facilities. RESULTS: Most programs (97%) admitted out-patients, and 22% had an in-patient capability. Out-patient programs enrolled 13 patients (median 11; range five to 48) at a given time for a duration of 8.3 weeks (range two to 26). In-patient programs enrolled nine patients at a given time (range two to 26) for 4.6 weeks (range one to eight). Programs included patients with chronic obstructive pulmonary disorder (100%), restrictive disease (93%), asthma (82%), adults with cystic fibrosis (46%), patients pre- or postlung transplantation (45%) and patients receiving mechanical ventilatory support (18%). Breathing retraining, education and upper extremity training were incorporated in more than 90% of all programs. Only one-third of programs offered smoking cessation as part of the rehabilitation. Education sessions on medications and inhaler usage were included in most programs, but sexuality was addressed in only half the programs. CONCLUSIONS: This first comprehensive national survey of PR programs in Canada shows that there are similarities in the format, content and staffing of PR programs. Programs are only able to service a small percentage of patients with chronic respiratory conditions.

Adult↗

PubMedDate not supplied

[Sudden death in leukemic patients treated with doxorubicin].

Cardiotoxicity of the anthracycline antineoplastic drugs is well known, especially the chronic effects, manifested mainly as congestive heart failure. Fewer reports have been published about the acute cardiotoxicity of these medications, and risk factors associated with their use. Two cases of malignant arrhythmias leading to sudden death associated with severe hypokalemia are reported. These cases suggest a synergistic effect between anthracyclines and electrolyte disorders resulting in the acute cardiotoxicity of these drugs. The administration of these antineoplastic drugs should include regular and systematic control of serum electrolytes and correction of hypokalemia during treatment.

Daunorubicin↗