Respiratory medicine
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Respiratory medicine · Nov 2003
Randomized Controlled Trial Clinical TrialTopical tetracaine prior to arterial puncture: a randomized, placebo-controlled clinical trial.
The objective of this randomized, double-blind, placebo-controlled clinical trial was to determine whether a topical anesthetic agent (tetracaine) provides effective local analgesia prior to radial arterial puncture. Tetracaine or placebo gel was applied 45 min prior to arterial puncture to patients who were referred for elective arterial blood gas. The primary outcome was the patient's perception of pain associated with the procedure as measured by a visual analog scale. ⋯ Mean time from the first skin puncture to successful procurement of 1 ml of arterial blood was 70 +/- 103s in the tetracaine group and 49 +/- 48s in the placebo group (P = 0.40). Difficulty of arterial puncture as assessed by the respiratory therapist performing the test was identical for the two groups (P = 0.86). We conclude that tetracaine gel did not decrease patient's perception of pain associated with arterial puncture, nor did its use facilitate the ABG procedure.
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Respiratory medicine · Nov 2003
Comparative StudyLung function in patients with chronic airflow obstruction due to tuberculous destroyed lung.
Lung function in cases of chronic airflow obstruction (CAO) due to tuberculous destroyed lung, which is still common in Korea, has not been objectively investigated. We evaluated lung functions and postbronchodilator responses in 21 CAO patients with a forced expiratory volume in 1 s (FEV1) of 30-65% of the predicted value, and compared some of these results with those of age-, sex- and FEV1% predicted-matched patients with chronic obstructive pulmonary disease (COPD). In addition, we analyzed the lung functions of CAO patients with respect to wheezing. ⋯ Among the CAO patients, patients with wheezing showed lower forced expiratory flow 25%-75% (FEF(25-75%)) (P < 0.05) and higher airway resistance than those without wheezing (P < 0.05). CAO patients with wheezing were more responsive to bronchodilator than those without wheezing. Although the pathophysiology of CAO differs from that of COPD, bronchodilator therapy could be useful for treating CAO, especially in cases presenting with wheezing.
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Respiratory medicine · Nov 2003
Social deprivation and hospital admission for respiratory infection: an ecological study.
To examine the relationship between social deprivation and risk of hospital admission for respiratory infection. ⋯ Respiratory infection is associated with social inequalities in all age-groups, particularly in children. Prevention of respiratory infection could make an important contribution to reducing health inequalities.
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Lung injury in ventilated lungs may occur due to local or systemic disease and is usually caused by or accompanied by inflammatory processes. Recently, acidification of exhaled breath condensate pH (EBC-pH) has been suggested as marker of inflammation in airway disease. We investigated pH, ammonia, Lactate, pCO2, HCO3-, IL-6 and IL-8 in EBC of 35 ventilated patients (AECC-classification: ARDS: 15, ALI: 12, no lung injury: 8). ⋯ Among factors potentially contributing to pH of EBC, EBC-lactate and EBC-NH4+ were found to correlate with EBC-pH. Inflammation-induced disturbances of regulatory mechanisms, such as glutaminase systems may result in EBC acidification. EBC-pH is suggested to represent a marker of acute lung injury caused by or accompanied by pulmonary inflammation.