A. Di Paco

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Papers by A. Di Paco

The patients with severe chronic obstructive pulmonary disease and chronic respiratory insufficiency

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2007

Caring for patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III... more Caring for patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure is difficult independent of whether the target is survival or quality of life (QOL). The role of inhaled drug therapy in this specific set of very severe COPD patients has not previously been assessed. The only drug able to prolong survival in these patients is long term oxygen therapy, whereas there is little evidence to indicate long-term domiciliary mechanical ventilation in the routine management of stable hypercapnic patients. Supplemental oxygen during exercise reduces exercise breathlessness and improves exercise capacity of the hypoxaemic patient. Pulmonary rehabilitation including nutritional supplementation is a significant component of therapy, even in these severe patients. Relief of dyspnoea with drugs such as morphine should not be denied to severely disabled patients who share poor QOL with cancer patients. Non-invasive ventilation ...

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Difficult to wean patients after cardiac and thoracic surgery: Outcome results of a regional weaning center

by A. Di Paco and Stefano Mazzoleni

A sequential school based smoke prevention program in secondary school adolescents

The hazardous health effects of smoking and second-hand smoke are well known and have been confir... more The hazardous health effects of smoking and second-hand smoke are well known and have been confirmed in several studies. We wondered whether a school based programme involving media models such as those represented by famous soccer players and TV characters, was effective in prevention of smoking habit in secondary school adolescents. Since October 2006 to May 2007 an anonymous survey was submitted to 1382 secondary schools pupils. After completing the questionnaire all students of 42 out of 70 classes selected by the school principals underwent a prevention programme consisting of 1 hour lecture on smoke healthy hazard with educational material (slides, video, leaflets). Furthermore each pupil was given card games with significant pictures. Since October 2007 to May 2008 and Since October 2008 to May 2009 pupils underwent a 1 hour interactive lesson on smoke related health hazards respectively. On December 2007 pupils in study attended a theatre event with show business characters ...

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Ventilatory response to exercise of elite soccer players

by A. Di Paco and Stefano Mazzoleni

Multidisciplinary Respiratory Medicine, 2014

Background: The purpose of this study was to evaluate the role of ventilatory parameters in maxim... more Background: The purpose of this study was to evaluate the role of ventilatory parameters in maximal exercise performance in elite soccer players. Methods: From September 2009 to December 2012, 90 elite soccer players underwent evaluation of lung function test and ergospirometry by means of an incremental symptom-limited treadmill test. Results were analyzed according to i) maximal exercise velocity performed (Hi-M: high-performers, >18.65 km/h; Lo-M: low-performers, <18.65 km/h) and ii) usual role in the team. Results: Hi-M showed higher peak minute ventilation ( _ V E peak : 158.3 ± 19.5 vs 148.0 ± 18.54 L/min, p = 0.0203), and forced expiratory volume at first second (5.28 ± 0.50 vs 4.89 ± 0.52 liters, p < 0.001) than Lo-M, independently of playing role. Moreover, a significant correlation between peak oxygen uptake and _ V E (r = 0.57, p < 0.001) was found. Conclusions: Ventilatory response plays a role in the assessment of exercise capacity in elite soccer players.

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Strategies to improve breathlessness and exercise tolerance in chronic obstructive pulmonary disease

Respiratory Medicine: COPD Update, 2006

Breathlessness often limits patients with chronic obstructive pulmonary disease (COPD) in their a... more Breathlessness often limits patients with chronic obstructive pulmonary disease (COPD) in their activities. Many of the therapeutic interventions currently available relieve dyspnoea by addressing a combination of different mechanisms, namely (i) reduction of ventilatory demand, (ii) reduction of ventilatory impedance and (iii) improvement in ventilatory muscle function.

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Efficacia della riabilitazione respiratoria intensiva in soggetti post-acuti provenienti da reparti di pneumologia e medicina interna

by F. Mezzasalma, A. Di Paco, and A. Zito