Thorax
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Direct information on the health effects of air pollution in humans relies mainly on chamber studies and epidemiological studies. Although chamber studies have limitations they allow the acute effects of individual pollutants to be studied in well characterised subjects under controlled conditions. Most chamber studies have shown relatively small falls in lung function and relatively small increases in bronchial reactivity at the concentrations of ozone, SO2, and NO2 that occur even during high pollution episodes in the UK. ⋯ But did the smog episodes in Manchester in the 1950s or subsequent vehicle related pollution play a part and did they interact with the bronchial challenges he underwent over the years (estimated at 3000)? Air pollution is a product of the way that society chooses to live. Obtaining an accurate picture of the extent to which current levels of air pollution cause acute and chronic effects on health is important if sensible choices are to be made by individuals and society about the processes contributing to air pollution. It is also important for patients with or at risk of developing cardiorespiratory disease.
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A study was carried out to evaluate the potential place of spiral volumetric computed tomography (SVCT) in the diagnostic strategy for pulmonary embolism. ⋯ SVCT is a relatively noninvasive test for pulmonary embolism which is both sensitive and specific and which may serve as an alternative to ventilation scintigraphy and possibly to pulmonary angiography in the diagnostic strategy for pulmonary embolism.
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Peritoneal ventilation has been shown to be effective in achieving extrapulmonary oxygenation and carbon dioxide elimination in an animal model of severe adult respiratory distress syndrome (ARDS). Cisapride is a "prokinetic" agent (increases gastric emptying), that may increase the splanchnic circulation and thus favourably affect gas exchange in peritoneal ventilation. ⋯ Cisapride increases arterial oxygenation in rabbits with severe ARDS treated with peritoneal ventilation, probably due to its ability to increase splanchnic circulation. It should be considered as an adjuvant medication to peritoneal ventilation.
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Comparative Study
Significant differences in flow standardised breath sound spectra in patients with chronic obstructive pulmonary disease, stable asthma, and healthy lungs.
Spectral characteristics of breath sounds in asthma and chronic obstructive pulmonary disease (COPD) have not previously been compared, although the structural differences in these disorders might be reflected in breath sounds. ⋯ The observed differences in frequency content of breath sounds in patients with asthma and COPD may reflect altered sound generation or transmission due to structural changes of the bronchi and the surrounding lung tissue in these diseases. Spectral analysis of breath sounds may provide a new non-invasive method for differential diagnosis of obstructive pulmonary diseases.
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This study was carried out to establish a reliable bank of information on the spectral characteristics of chest wall breath sounds from healthy men and women, both non-smokers and smokers. ⋯ These data define the boundaries of normal chest wall breath sounds and may be used as reference for comparison with abnormal sounds.