Based on this preliminary information, the

National judicial treatment of emphysema (net) was the first multicenter clinical trial designed to determine the role of safety and efficacy of bilateral >> << in the treatment of emphysema. Inmate in 2002, supported by the National Heart, Lung, and Blood Institute (NHLBI), Centers for Medicare and Medicaid Services (CMMS), as well as Agency of Health Research and Quality (AHRQ). Emphysema is a chronic lung disease, which is a major cause of death and disability in the U.S. LVRS If you find useful, the secondary objective will be to develop criteria for identifying patients who may benefit from the procedure. In patients with emphysema, the walls between the tiny air sacs in the lungs are damaged. While healthy lungs expand with each inhalation and exhalation with each collapse, lungs damaged by emphysema gradually lose their elasticity and become more flexible and expanded, as has a rubber band. Respiratory tract, usually open lung elastic traction and become floppy and collapse on expiration. As a result, patients with emphysema were more difficult to move air in and out of lungs. LVRS reduces lung. The theories that underlie the operation is that the reduction in lung size will pull open the airways and allow respiratory muscles to return to more normal and comfortable position, making breathing easier. LVRS has been proposed as a new method of treatment that can improve the quality of life for people with end-stage emphysema, but many questions regarding the procedure answered. For example: >> << What are the benefits and risks compared with good medical therapy? How long any benefits last time? Is surgery benefit some patients more than others? These are questions that doctors and patients had to answer before they can make informed, rational decisions about the transaction. NHLBI National Institutes of Health held a NETT provide definitive answers to these important questions. CMMS, which oversees Medicare program and co-NETT, used data from a study to determine Medicare reimbursement should provide LVRS. NETT results led to an ad that Medicare will soon cover the procedure. First to get this coverage, patients must undergo LVRS in one of 17 medical centers participating in the NETT. LVRS was first used to treat emphysema in 1950. Although some patients seemed to improve after surgery, high mortality and morbidity associated with LVRS prevent its widespread use. In the early 1990s, some doctors began to use the procedure again. Early reported successes led to its rapid spread, despite the lack of data on long-term benefits, risks and costs. To study the safety and efficacy of LVRS, NHLBI held a workshop of experts in the treatment of emphysema in 1995. Workshop participants reviewed existing data and unanimously agreed that a systematic evaluation of the selection criteria of patients and long-term results should be done before surgery was widely practiced. Independent assessment carried out for LVRS CMMS concluded that current data on the risks and benefits of LVRS were too flimsy to justify unrestricted Medicare reimbursement for surgery. However, since some patients appeared to use the procedure, Center for Health Technology AHRQ, which is evaluated, advised CMMS, that trial evaluating the effectiveness of surgery is important. As a result, NHLBI and CMMS announced in April 1996 that they will conduct research LVRS, to evaluate the safety and effectiveness of the current best available medical care and in combination with LVRS. In late 1996, the participating clinical centers and coordinating center were announced. Patient selection for entry into the study began in autumn 1997. Completed in 2002, the study found that patients with upper lobe emphysema had better lung function and exercise tolerance after LVRS, than after medical (non-surgical) treatment. For patients with upper lobe emphysema and poor exercise tolerance, survival was better after LVRS than after treatment. Since the centers were chosen, NETT investigators and CMMS continue to examine data on the effectiveness of LVRS, but they found insufficient data on the following too many patients to make definitive conclusions. From 1741 LVRS cases performed at NETT centers to the study, researchers found that only 25% had sufficient data to determine the outcome. With information missing 75% of patients is not possible to draw conclusions about the results, the more that patients are better after surgery, most likely return to the worse these patients. While Medicare is a complete data on 711 patients who underwent LVRS between October 1995 and January 1996, the data sharply contrast with those in the literature, which reported success in some cases and low mortality. Medicare data show that 26% of patients died of January 1997, 40% were re-hospitalized (average 2. A hospitalization and 30 days in hospital), and 16% to long-term lasix generic side effects inpatient treatment. Due to the lack of control group, however, is not known whether these results can be attributed to the operation or the natural history of underlying disease. The process is intended to include about 4500 patients, and take up to five years. The process may be terminated prematurely if any of the quarterly review of data shows a clear risk or benefit for one of the treatments. People who are interested in participating in the trial should ask your doctor to send their case histories, radiographs and results of spirometry and ECG tests in NETT center of their choice. Based on this preliminary information, the Center will determine the further investigation is warranted. If so, then the patient will be asked to undergo assessment to determine whether he or she meets the criteria and provide baseline data. After enrollment in the study, patient consent will be completed six to 10 weeks of rehabilitation, where they will receive medications and oxygen as required and participate in the program of exercises and breathing techniques. It is now most famous for the treatment of emphysema. Upon successful completion of the rehabilitation program, patients will be randomized consent or continue this treatment or have a light reduction of operations in addition to further medical care. For this process, the operation will be performed on both lungs, or through the pipe through the chest wall (two-way video-assisted thorascopy) or cut in the center of the sternum (sternotomy on average). In centers with experience and methods, patients receiving operations will be randomly assigned to one of surgical methods. Participants must be NETT diagnosed emphysema, which significantly reduces their ability to function. They must meet certain lung function and CT requirements and be approved for operation by a cardiologist, pulmonologist and thoracic surgeon. However, they can not participate if they have:

People who want to participate should ask your doctor to refer them to the NETT center of their choice. For more information on the location of specific centers, go to the list of participating centers. Medicare beneficiaries enrolled in NETT will cover all the services an integral part of the study, which is allowed under the law Medicare. The cost is usually not covered by medical assistance, such as the cost of oral medications will be responsible for a patient or possibly additional insurance the patient may have. Patients may be responsible for deductibles and payments need medical care and other insurers. Private insurance companies are also participating in the NETT, that people are interested in participating in the study should check with their insurers about coverage of services. Please click on name to view resume. You will need

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