Chest
-
Comparative Study
Measurements of PEEP-induced changes in lung volume: evaluation of a laser monitor.
To evaluate a newly developed laser monitor in the measurement of positive end-expiratory pressure (PEEP)-induced changes in end-expiratory lung volume (EELV) in spontaneously breathing subjects. ⋯ The laser monitor is sufficiently accurate for measuring PEEP-induced changes in EELV during spontaneous breathing in healthy adult subjects. Monitors incorporating multiple laser sensors may have considerable clinical promise.
-
To determine if renal dose dopamine (3 microg/kg/min) alters the heart rate (HR) by itself, or if a dopamine infusion alters the HR response to bolus doses of the beta-adrenergic agonist isoproterenol in healthy human subjects. ⋯ In healthy human subjects, infusion of 3 microg/kg/min of dopamine does not significantly increase the HR when combined with beta-adrenergic stimulation using isoproterenol, suggesting neither an additive nor antagonistic interaction between the two drugs. While our study did not demonstrate an increase in HR in healthy subjects, the risk of increasing the chronotropic response to beta-adrenergic inotropic medications with "renal dose" dopamine in critically ill patients needs to be investigated. The frequency of nausea during dopamine infusion also may influence consideration of using dopamine to augment splanchnic blood flow and renal function in conscious patients.
-
Clinically apparent involvement of the nervous system occurs in a relatively small number of patients with sarcoidosis. The diagnosis of neurosarcoidosis is often difficult and particularly so in patients who lack either pulmonary or systemic manifestations of sarcoidosis. Furthermore, clinical features of neurosarcoidosis are extremely variable. ⋯ Although corticosteroids are the mainstay of therapy, in this series, 12 patients received chloroquine or hydroxychloroquine. Prognosis of chronic neurosarcoidosis is poor. Six (18%) of 37 patients died of complications related to sarcoidosis.
-
To elucidate whether atherosclerotic aortic plaque detected by transesophageal echocardiography can be a clinically useful marker for coronary artery disease in the elderly. ⋯ In elderly patients, atherosclerotic aortic plaque detected by transesophageal echocardiography is not useful in predicting significant coronary artery disease. It is useful only in a relatively younger population.
-
To identify lifestyle, anthropometric, biochemical, and clinical characteristics associated with pulmonary function in elderly men. ⋯ Cigarette smoking, respiratory symptoms and disease, and several cardiovascular risk factors were independently associated with pulmonary function in elderly Japanese-American men. In most cases, inadequate control for smoking does not appear to account for these associations. Results suggest that a number of factors that are correlates of FEV1 and FVC in younger age groups are also associated with pulmonary function beyond the age of 70 years.