Chest
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To analyze the physiologic effects and tolerance of mechanical insufflation-exsufflation (MI-E) by means of mechanical cough assistance (Cough Assist; JH Emerson Company; Cambridge, MA) for children with neuromuscular disease. ⋯ Our results confirm the good tolerance and physiologic short-term benefit of the MI-E in children with neuromuscular disease who were in a stable state.
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Little is known about the determinants of airway hyperresponsiveness (AHR) among children with asthma in Hispanic America. ⋯ Our results suggest that paternal asthma and environmental exposure to mold/mildew are strong determinants of AHR in Costa Rican children with asthma. FEV(1)/FVC ratio may be a useful measure of AHR (a marker of asthma severity) among Costa Ricans and other Hispanic Americans for whom reference values for FEV(1) are not currently available.
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The aim of this prospective observational study was to evaluate the utility of derived dead space indexes to predict survival in mechanically ventilated patients with acute lung injury (ALI) and ARDS. ⋯ Noninvasive measures of Vae/Vt at ICU admission and after 48 h of mechanical ventilation, associated with Pao(2)/Fio(2) ratio provided useful information on outcome in critically ill patients with ALI.
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To investigate the relationship between tuberculin skin responses and the development of adult asthma, rhinitis, and atopy. ⋯ There is no relationship between history of tuberculosis infection, tuberculin responses, and development of adult bronchial asthma, allergic rhinitis, and atopy. Our study suggests that the protection provided by intradermal BCG vaccination in infants to prevent atopic diseases may be limited in early childhood, when a substantial memory of cellular immune modulation still exists.
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The fractional concentration of exhaled nitric oxide (Feno) is a useful indicator of airway inflammation in children and adults with asthma. ⋯ Feno concentrations in healthy school-aged children appeared to be affected by race, and, to a lesser extent, by age and height. These factors should be taken into consideration when interpreting clinical results.