Chest
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Comparative Study
Identification of smokers susceptible to development of chronic airflow limitation: a 13-year follow-up.
Cigarette smoking is the cardinal cause of COPD, but only a relatively small percentage of smokers have development of clinically overt disease. ⋯ Middle-aged smokers are at no evident risk of functional deterioration if their FEV1/VC ratio is normal. This is so even if results of small airways tests are abnormal. A decreased FEV1/VC ratio has no serious implications in itself. Only an associated high N2 slope adds the necessary information to predict a low FEV1. Present data suggest that a subgroup of smokers in their 50s, characterized by a low FEV1/VC ratio and a high N2 slope, are probably the susceptible smokers at high risk for development of COPD.
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Comparative Study
Utility of transbronchial biopsy in patients with acute respiratory failure: a postmortem study.
To determine the diagnostic yield of histologic specimens obtained by postmortem transbronchial biopsy (TBB) in patients with acute respiratory failure requiring mechanical ventilation. ⋯ These findings suggest poor overall agreement between standard postmortem histologic examination and TBB specimens. Although not performed in a clinical setting, this postmortem investigation suggests that TBB may be of limited value in mechanically ventilated patients with acute respiratory failure because of its low sensitivity.
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Comparative Study
Pulmonary Wegener's granulomatosis: correlation between high-resolution CT findings and clinical scoring of disease activity.
To evaluate the usefulness of high-resolution CT (HRCT) for monitoring pulmonary disease activity in Wegener's granulomatosis (WG). ⋯ HRCT may be a useful adjunct to clinical scoring of pulmonary disease activity in patients with WG and suspected lung involvement.
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Noise levels in the hospital setting are exceedingly high, especially in the ICU environment. We set out to determine what caused the noises producing sound peaks > or = 80 A-weighted decibels (dBA) in our ICU settings, and attempted to reduce the number of sound peaks > or = 80 dBA through a behavior modification program. ⋯ We conclude that many of the noises causing sound peaks > or =80 dBA are amenable to behavior modification and that it is possible to reduce the noise levels in an ICU setting significantly through a program of behavior modification.
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Comparative Study
The new onset of atrial arrhythmias following major noncardiothoracic surgery is associated with increased mortality.
To examine the incidence and consequences of atrial arrhythmias in surgical ICU patients following major noncardiac, nonthoracic surgery. ⋯ Patients admitted to a surgical ICU after noncardiothoracic surgery with a history of or who developed new atrial arrhythmias had greater mortality and longer ICU stays than patients without arrhythmias. The incidence of new-onset arrhythmias was lower than reported after cardiac and thoracic surgery, but higher than in the general population. Atrial arrhythmias were not the cause of death and appear to be markers of increased mortality and morbidity.