Posted in Pulmonary Function | 25/01/2015
Pulmonary function in patients with cystic fibrosis is characterized primarily by airflow obstruction and hyperinflation of static pulmonary volumes. Elevation in the ratio of residual volume to total lung capacity (RV/TLC) correlates with severity of disease. The TLC calculated from body plethysmographic measurements of thoracic gas volume is usually normal or elevated.’ The TLC by gas dilution techniques (helium dilution of nitrogen washout) may be lower than by plethysmography because of noncommunicating gas volume. Nevertheless, some patients with cystic fibrosis have restricted pulmonary function with reduction in TLC even when measured by body plethysmography. This has been reported occasionally and is thought to represent a severe stage of disease. Here We conducted this study (1) to better characterize the clinical, radiographic, and pulmonary functional features of restricted patients compared to a matched control group of nonrestricted patients with cystic fibrosis; and (2) to elevate possible mechanisms of restriction.
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Posted in Health | 24/01/2015
A significant number are unable to stand for measurement of vertical height as part of pulmonary function testing. This is especially true for amputees, stroke victims, and spinal cord injured patients. We did not compare spirometric results in sitting and standing positions. Pierson et al made such a comparison in 235 men and women. These investigators found values obtained in the standing position to be greater than in the sitting position. The differences were statistically significant but small for the forced vital capacity (FVC) (0.04 ±0.01 L; p<0.01) and the forced expiratory volume in one second (FEVX) (0.02 ±0.01 L; p<0.05). They found no significant differences for the mean forced expiratory flow over the middle half of the FVC (FEF25-75%) (0.03 ±0.02 L) and the FEV/FVC ratio expressed as a percentage (FEV1/FVC%) (0.1 ±0.2 percent). Townsend tested 90 middle-aged men using a crossover sequence and found significantly larger values for…
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Posted in Health | 20/01/2015
The data on height were first analyzed as the H/S ratio. The data for one man and two women were rejected because their ratios were greater than 3.8 standard deviations from the mean. The man and one woman had sitting heights within 1 SD of the sample means but were the shortest man and woman for standing height. This could indicate incomplete development of long bones. The remaining womans standing height was within 1 SD of the sample mean, but the sitting height was abnormally large. This would most likely result from an error in transcription. The statistics on physical characteristics were calculated for the remaining 103 men and 93 women and are summarized in Table 1.
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Posted in Health | 19/01/2015
Predicting the normal values of pulmonary function for an individual to be compared with the individuals performance on a test is an important part of the process of pulmonary evaluation. The consensus among pulmonologists is that the most reliable predictors of pulmonary function are the individuals sex, age, and standing height. Prediction equations using these factors have been developed independently by different investigators; however, our patient population includes amputees, spinal cord injuries, and others who are unable or incapable of standing upright, for whom the generally available prediction equations do not apply.
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Posted in Cardiopulmonary Bypass | 17/01/2015
Rabinovitch et al concluded from their studies that the right side of the heart should not be neglected to achieve optimal myocardial protection during cardiac operations. High-grade RCA lesions can prevent the cold cardioplegia solution from reaching the right ventricular myocardium at a sufficient rate. Moreover, the right heart is not as well submerged as the left ventricle in the pericardial cold saline solution bath used for supplementary topical cooling due to its ventral location. Therefore, the right ventricle seems to be the most vulnerable aspect of an ischemic heart. Therefore, overall right ventricular dysfunction after CPB is not determined by the loading conditions alone. Local myocardial and septal involvement is suspected to be an important determinant of right ventricular function as well. xalatan generic
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Posted in Cardiopulmonary Bypass | 16/01/2015
We have chosen PEEP of 15 cmH20 because Metzler et al found that only high levels of PEEP elevating pulmonary vascular resistance limit myocardial performance of the right ventricle resulting in a significant reduction of CO. PEEP was found to be associated with a large decrease in left and right ventricular end-diastolic volumes. Right ventricular volume and performance, however, have been difficult to obtain because of the functional anatomy and complex geometry The correlation between the new thermodilution technique used in this study for estimation of RVEF and other methods such as first pass technique or equilibrium gated techniques is significant. Traditionally monitored hemodynamic parameters such as RAP or RVP, however, have failed to be representative for right ventricular function. RVEDR too, shows considerable individual variations and does not have a close relationship to ejection fraction or clinical evidence of right heart decompensation. zaditor eye drops
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Posted in Cardiopulmonary Bypass | 15/01/2015
In the past, the right ventricle has received less attention than the physically more dominant left ventricle. A tendency to overlook the right ventricle as an important part of the circulatory system has been reinforced by some previous studies in which the right ventricle has been considered a nonfunctional, passive conduit for accepting venous blood and transfusing it through the pulmonary system. Later studies have yielded a more complete picture stressing continuous interplay between the right and left ventricles due to the anatomic relationship of the two sides of the heart. The right ventricle constitutes the pump that conveys hydraulic energy to the blood passing from the low-pressure venous reservoir to the medium-high pressure reservoir of the pulmonary arterial blood and is ensuring delivery of the preload required to subserve left ventricular output. http://www.cheap-asthma-inhalers.com/
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