J Formos Med Assoc
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Arterial blood gas (ABG) analysis is useful in evaluation of the clinical condition of critically ill patients; however, arterial puncture or insertion of an arterial catheter may cause many complications. This study evaluated whether pH, partial pressure of carbon dioxide (PCO2) and bicarbonate (HCO3-) values of venous blood gas (VBG) could accurately predict their ABG analogs for patients with acute respiratory failure treated by mechanical ventilation in an intensive care unit (ICU). ⋯ Venous blood gas can accurately predict the ABG values of pH, PCO2 and HCO3- for patients with acute respiratory failure being treated with mechanical ventilation.
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Case Reports
Acute aortic dissection associated with left ventricular dysfunction in a postpartum and normotensive young woman.
Aortic dissection is uncommon in young women and is associated with clinical conditions such as pregnancy and Marfan's syndrome. Owing to the low incidence, diagnosis of acute aortic dissection in young women might be missed or delayed in patients who have neither risk factors nor typical clinical manifestations. We report the case of a 28-year-old postpartum woman with aortic dissection. ⋯ Finally, computed tomography revealed acute aortic dissection after hemodynamic collapse occurred. This case suggests that acute aortic dissection can be associated with left ventricular dysfunction, and non-specific clinical symptoms in young, normotensive, and postpartum women. A high index of clinical suspicion and alertness are needed to identify this condition.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of effectiveness of pressure threshold and targeted resistance devices for inspiratory muscle training in patients with chronic obstructive pulmonary disease.
Previous studies have provided little information about the comparative efficacy of treatment with pressure threshold and targeted resistive inspiratory muscle training devices. This study compared the efficacy of these two types of inspiratory muscle training (IMT) devices on inspiratory muscle function, exercise capacity, and quality of life in patients with chronic obstructive pulmonary disease (COPD). ⋯ Targeted resistive IMT with a controlled training load has a similar efficacy to the more popularly used pressure threshold IMT and can be incorporated in the treatment of COPD patients. The targeted resistance device offers a less expensive and easily used treatment choice.
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Pneumatic tube transport has been reported to aggravate the error in partial pressure of oxygen (PO(2)) measurements caused by air bubbles. The aim of this study was to clarify the effect of manual and pneumatic tube methods of sample transportation and different amounts of air bubbles on arterial blood gas analysis. ⋯ Trapped air in the syringe should be expelled as thoroughly as possible, since the presence of only 1% air bubbles can result in aberrance in PO(2) measurement. Samples for blood gas analysis should be carried in ambient pressure to the laboratory because pneumatic tube delivery systems significantly aggravate the air bubble-related aberrance in PO(2) measurement.
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Precursor B-cell lymphoblastic lymphomas (B-LBLs) are rare and most often involve the skin in the head and neck region. Histologically, cutaneous B-LBLs may be confused with other small round-cell neoplasms. Moreover, half of B-LBL patients are negative for CD45 (leucocyte common antigen, LCA), a widely used marker for the diagnosis of lymphoma, and a significant portion express CD99, a marker for Ewing's sarcoma (ES) or primitive neuroectodermal tumor (PNET). ⋯ In retrospective analyses, tumor cells in the initial biopsy specimens of both patients were found to be reactive to terminal deoxynucleotidyl transferase (TdT), CD43 and CD10. Thus, the diagnosis of B-LBL was confirmed. These cases illustrate the possibility that primary cutaneous B-LBL may mimic ES or PNET immunophenotypically, and that correct diagnosis in doubtful cases may be facilitated by analysis using a complete panel of antibodies, particularly including TdT and CD43.