American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 1994
Patterns of cigarette consumption and cotinine levels among African American women smokers.
Cigarette smoking intensifies a number of serious health problems, including lung cancer, hypertension, low birth weight, and infant mortality, that disproportionately affect black Americans. Cotinine, a major nicotine metabolite, is one indicator of smoke exposure. It has been reported that black women have higher mean cotinine levels than white women. ⋯ Average cotinine/cigarette values were higher in black women compared with previous reports for Mexican American women smokers. No comparable values are available for white women. Additional study is needed to begin to explain variations in levels of cotinine, as well as perceived nicotine dependence among black women.
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Am. J. Respir. Crit. Care Med. · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation.
Several modalities of ventilatory support have been proposed to gradually withdraw patients from mechanical ventilation, but their respective effects on the outcome of weaning from mechanical ventilation are not known. We conducted a randomized trial in three intensive care units in mechanically ventilated patients who met standard weaning criteria. Those who could not sustain 2 h of spontaneous breathing were randomly assigned to be weaned with T-piece trials, with synchronized intermittent mandatory ventilation (SIMV), or with pressure support ventilation (PSV). ⋯ The three groups were comparable in terms of etiology of disease or characteristics at entry in the study. When all causes for weaning failure were considered, a lower number of failures was found with PSV than with the other two modes, with the difference just reaching the level of significance (23% for PSV, 43% for T piece, 42% for SIMV; p = 0.05). After excluding patients whose weaning was terminated for complications unrelated to the weaning process, the difference became highly significant (8% for PSV versus 33% and 39%, p < 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
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Am. J. Respir. Crit. Care Med. · Oct 1994
Comparative StudyPreoperative risk evaluation for lung cancer resection: predicted postoperative product as a predictor of surgical mortality.
We assessed the capacity to predict surgical mortality, complications, and functional loss by using the results of resting and exercise respiratory function. Measurements were made before and 4 mo after lung resection in 54 consecutive patients with bronchogenic carcinoma. Predicted postoperative (ppo) FEV1 and DLCO were derived using quantitative lung perfusion scans when baseline FEV1 was < 55% predicted, and by proportional loss of pulmonary segments (total = 19 segments) when FEV1 was > 55% predicted. ⋯ For surgical mortality: (1) the predicted postoperative product (PPP) of ppo FEV1% x ppo DLCO%; (2) ppo DLCO%; (3) ppo FEV1%, and (4) RV, FRC, and SaO2 on the maximal step exercise test. For respiratory complications: body mass index (BMI) (for patients undergoing lobectomy or wedge resection only). For cardiac complications: (1) age; (2) SaO2 at baseline and on the maximal step exercise test; (3) PaO2; (4) PaCO2; and (5) minute ventilation at maximal exercise.(ABSTRACT TRUNCATED AT 250 WORDS)