Economic efficiency of light volume reduction ...

Easy volume reduction operation involves removing the diseased part of lung emphysema, which probably allows nondiseased parts function more efficiently buy lasix generic online. The National Emphysema Treatment Trial, 1218 patients with emphysema were randomized for lung volume reduction surgery or treatment. In 2001, researchers reported unacceptably high mortality in the subgroup of 70 surgical treatment of patients with very low FEV

20% good) and several other high-risk characteristics (). Now, the conclusions for the entire cohort have been published. Mortality was significantly higher in the surgical group than medical group within 90 days (7. 9% to 1. 3%), but 26% in both groups after the average period of observation was 29 months. In the post analysis of specific subgroups of patients with predominantly upper lobe emphysema and low baseline physical activity had significantly lower mortality in the operation compared with drug therapy (19% vs. 34%). In contrast, patients with predominantly upper lobe without disease and high physical activity was significantly higher mortality in the operation compared with drug therapy (25% vs. 13%). For other combinations of spreading disease and exercise tolerance, mortality did not differ from surgical and medical treatment. At 24 months, significantly higher proportion of surgical patients than medical patients experienced improved exercise tolerance (15% vs. 3%) and health-related quality of life (33% vs. 9%). Comment: It is easy, the volume reduction surgery benefit? This process gave no "one size fits all" answer. As previously reported, the procedure is contraindicated in high-risk subgroup, but some other subgroups experienced lower mortality and improve symptoms for about 2 years of observation. Because these conclusions are partly based on analysis after the fact, journalists require additional studies. Finally, according to the companion article, additional cost-effectiveness of this procedure an average of 3 years U.S. $ 190.000 per quality adjusted life year experience.

Allan S. Brett, MD

Posted in Journal Watch therapeutic June 3, 2003

Member emphysema Treatment Trial Research Group. Randomized studies comparing lung volume reduction operations with drug therapy of severe emphysema. N Engl J Med 2003 May 22, 348:2059-73. National Emphysema Treatment Trial Research Group. Economic efficiency of light volume reduction surgery for patients with severe emphysema. N Engl J Med 2003 May 22, 348:2092-102. Drazhen M. Epstein and AM. Management of surgery for emphysema. N Engl J Med 2003 May 22, 348:2134-6. .

Bone mineral density (ipc) of the hip joint, lumbar ...

Study population was performed to compare different definitions of lasix purchase peak bone mass, and take appropriate T-scores for different skeletal sites cohort of 70-year old woman for the study of prevalence.

Bone mineral density (BMD) of the hip joint, lumbar spine, forearm and was measured by dual X-ray densitometry (Hologic 4500) in 296 women aged 16-31 years and 210 women aged 70 years. Peak bone mass occurs in women aged 20 years in the proximal femur and in 28 and 31 years in the spine and forearm, respectively. Level BMD circumcision were compared with vehicle specific cutoff values ​​for different sites. As our group of 70-year-old women, the prevalence >> << the total hip was 9-25%, depending on peak bone mass T score of 2. 5 was based. Prevalence in the spine was 28-33% and 45-67% in the forearm. at least one of the three measurement sites were recorded in 49-72% of the sample. Our results show that using the T-criterion for determining results

in a very different prevalence in this population depending on public authorities and skeletal sites chosen for measurement. .

Smoking facts show that cigarette smoke

There are three main causes of emphysema. Smoking facts show that cigarette smoke is the first in the list. Genetic deficiencies of enzymes and certain professional

harmful and can lead to emphysema and the presence of these conditions increases

harmful effects of smoking cigarettes. Look at any list that causes emphysema and you'll see smoking are listed in the top. Cigarette smoking accounts for more than 80% of all cases of emphysema. Changes that occur in the lungs with repeated inhalation of hot smoke is one of the

The most significant harmful effects of smoking on the body. Over time, damaged airways so

significant accumulation of mucus, which becomes visible and can even lead to obstruction. Hyperinflation in tiny air sacs in the lungs lasix furosemide side effects >> << and damage lung tissue itself makes it difficult for carbon dioxide filled air from the lungs. Eventually your body becomes chronically miss oxygen. .