Chest
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Comparative Study
Diagnostics of spontaneous cough in childhood asthma: results of continuous tracheal sound recording in the homes of children.
Spontaneous cough is a symptom with diffuse diagnostic significance for childhood asthma. Information on the interrelations between presence/frequency of cough and other symptoms of asthma are not available to the physician. Tracheal sounds were continuously recorded in the homes of 60 children with and 30 without asthma, at 72 and 24 h, respectively. ⋯ Three children did not cough during exacerbations. Persistent, isolated cough was observed in two children. It was concluded that spontaneous cough is modestly predictive of asthmatic exacerbations, but not of a diagnosis of asthma or severity of asthma.
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To investigate the ability of patients with COPD to reproduce an exercise intensity accurately on the treadmill using dyspnea ratings obtained during incremental exercise on the cycle ergometer (cross-modal exercise prescription). ⋯ Patients with COPD can use dyspnea ratings from an incremental cycle ergometry test to regulate exercise on the treadmill without systematic bias at an intensity of 80% of peak VO2, but exceed the desired VO2 when using the dyspnea rating at an intensity of 50% of peak VO2.
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The treatment of small cell lung cancer (SCLC) has evolved significantly over the past 3 decades. Single-agent and combination chemotherapies given with radiotherapy have greatly improved response rates and median survival. Combination regimens such as cisplatin/etoposide, carboplatin/etoposide, ifosfamide/carboplatin/etoposide, cyclophosphamide/doxorubicin/vincristine, and etoposide/ifosfamide/cisplatin have all achieved good response rates. ⋯ New agents showing good preliminary single-agent activity in untreated SCLC include paclitaxel, vinorelbine, gemcitabine, topotecan, and teniposide. Results obtained with single-agent docetaxel and CPT-11 are thus far inconclusive. Studies evaluating response and survival rates of these new agents in combination with agents of known activity are underway.
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Comparative Study
Salbutamol delivery from a hydrofluoroalkane pressurized metered-dose inhaler in pediatric ventilator circuits: an in vitro study.
The aim of our study was to determine the in vitro delivery of salbutamol from a pressurized metered-dose inhaler (pMDI) containing hydrofluoroalkane (HFA) propellant through various delivery devices to four models of a pediatric lung. ⋯ Salbutamol from an HFA pMDI is delivered efficiently through inline holding chambers with reduced static in pediatric ventilator settings. A large holding chamber has no advantage over a small holding chamber. In addition, salbutamol delivery is more efficient through a holding chamber than through a nonchamber device.
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To assess the utilization of venous thromboembolism (VTE) prophylaxis in a medical-surgical ICU. ⋯ Eighty-six percent of the medical-surgical patients included in this study received VTE prophylaxis. The utilization of VTE prophylaxis described in this study is higher compared to previously published data. The nature of physician coverage in our medical-surgical ICU (closed unit), consistent practice patterns of a designated ICU staff, and a continuing medical education program involving VTE prophylaxis are the factors believed to be responsible for these results.