Articles: function.
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Am. J. Respir. Crit. Care Med. · Dec 2013
Short-Term Exposure to Air Pollution and Lung Function in the Framingham Heart Study.
Short-term exposure to ambient air pollution has been associated with lower lung function. Few studies have examined whether these associations are detectable at relatively low levels of pollution within current U.S. Environmental Protection Agency (EPA) standards. ⋯ Short-term exposure to PM2.5, NO2, and O3 within current EPA standards was associated with lower lung function in this cohort of adults.
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Observational Study
Re-admission to Level 2 unit after hip-fracture surgery - Risk factors, reasons and outcome.
Hip fractures are common geriatric fractures with increasing incidence. Treatment of these fractures is still associated with high rates of complications and poor outcome. Data concerning unexpected re-admission to a Level 2 unit after an initial inconspicuous postoperative course are limited. We aimed to identify causes and associated risk factors for admission as well as impact of re-admission on acute care and short-term outcome. ⋯ Unexpected admission to the Level 2 unit in the post-surgical period is a frequent phenomenon in geriatric hip-fracture patients. Males and femoral neck fracture patients seem to be especially endangered. Although the majority of reasons for admissions were not immediately life-threatening illnesses, they had a substantial negative impact on patients' outcome. This emphasises the importance of careful handling of this frail patient population.
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We present 2 cases of patients with septic shock and discuss changes in B-type natriuretic peptide (BNP) levels. While previous increases in BNP in septic shock were attributed to the accompanying myocardial depression, recent work claims that high levels of BNP in sepsis are related to an alteration in the BNP clearance pathway. We postulate from these cases that increased BNP should not automatically be associated with cardiac dysfunction and may assist in an early, difficult diagnosis of septic shock.
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Comparative Study Clinical Trial
Two-Year Follow-up in Patients Treated With Emphysematous Lung Sealant for Advanced Emphysema.
Endoscopic lung volume-reduction therapy for emphysema has been associated with therapeutic responses smaller in magnitude and less durable than surgical volume reduction (LVRS). Bronchoscopic emphysematous lung sealant (ELS) therapy has been shown to produce improvements in pulmonary function similar to surgery at 1 year. This case series summarizes safety and efficacy data of all patients from the initial ELS study out to 2 years. ⋯ An exponential model fit to FEV₁ data at 6, 12, 18, and 24 months predicted improvements from a baseline of > 5% out to 4.1 years, similar to what has been reported following surgery. This report confirms long-term safety and efficacy following ELS therapy in advanced emphysema. Studies in a larger cohort are needed to define the role of ELS therapy in the treatment algorithm of patients with this condition.