Respiratory care
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A pneumatic tube system (PTS) is a cost-effective, rapid transport modality that utilizes induced pressure changes. We evaluated the clinical importance of 2 transport modalities, human courier and PTS, for blood gas specimens. ⋯ The difference in the PO2 and PaCO2 of paired (walked vs tubed) arterial and venous blood gas specimens demonstrated a slight bias. PaCO2 values demonstrated the greatest bias, however not clinically important. Thus, PTS transport does not impact clinical interpretations of blood gas values.
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E-cigarettes are a diverse set of devices that are designed for pulmonary delivery of nicotine through an aerosol, usually consisting of propylene glycol, nicotine, and flavorings. The devices heat the nicotine solution using a battery-powered circuit and deliver the resulting vapor into the proximal airways and lung. ⋯ Pending regulation by the FDA will enforce limited disclosures on the industry but will not directly impact safety or efficacy. Meanwhile, respiratory health practitioners will need to tailor their discussions with patients, taking into account the broad range of existing effective smoking cessation techniques, including pharmaceutical nicotine replacement therapy.
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Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease associated with poor prognosis and limited effective treatment options. Reliable predictors of outcome in daily clinical practice are needed to determine high-risk patients for urgent lung transplantation referral. This study aimed to identify practical prognostic predictors of mortality using cardiopulmonary exercise testing (CPET) in IPF subjects. ⋯ This study provides simple, practical, and novel cut-off points for CPET as predictors of prognosis to identify high-risk IPF subjects. Impairment in exercise capacity and abnormal ventilatory responses during CPET were associated with poorer survival in IPF subjects. The findings suggest considering the use of CPET for IPF risk stratification and prediction of prognosis. (ClinicalTrials.gov registration NCT01499745.).
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Asymmetric dimethylarginine and ischemia-modified albumin are new biomarkers that are used for evaluation of ischemia and oxidative stress. The present study aimed to investigate whether serum levels of asymmetric dimethylarginine and ischemia-modified albumin are altered in subjects with obstructive sleep apnea (OSA). ⋯ Ischemia-modified albumin and asymmetric dimethylarginine were significantly higher in subjects with OSA. Furthermore, ischemia-modified albumin was independently associated with severity of OSA defined by AHI and severity of oxygen desaturation.