Articles: function.
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Because anesthetic machines have become more complex and more expensive, they have become less suitable for use in the many isolated hospitals in the poorest countries in the world. In these situations, they are frequently unable to function at all because of interruptions in the supply of oxygen or electricity and the absence of skilled technicians for maintenance and servicing. Despite these disadvantages, these machines are still delivered in large numbers, thereby expending precious resources without any benefit to patients. ⋯ Additional economies are achieved by completely eliminating spillage of oxygen from the breathing system and by recycling the driving gas into the breathing system to increase the Fraction of Inspired Oxygen (FIO2) at no extra cost. Savings also are accrued when using the drawover breathing system as the need for nitrous oxide, compressed air, and soda lime are eliminated. The Glostavent enables the administration of safe anesthesia to be continued when standard machines are unable to function and can do so with minimal harm to the environment.
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Controlled Clinical Trial
Effects of weight loss on airway responsiveness in obese asthmatics: Does weight loss lead to reversibility of asthma?
The growing epidemics of obesity and asthma are major public health concerns. Although asthma-obesity links are widely studied, the effects of weight loss on asthma severity measured by airway hyperresponsiveness (AHR) have received limited attention. The main study objective was to examine whether weight reduction reduces asthma severity in obese adults with asthma. ⋯ Weight loss in obese adults with asthma can improve asthma severity, AHR, asthma control, lung function, and quality of life. These findings support the need to actively pursue healthy weight-loss measures in this population.
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Randomized Controlled Trial Comparative Study
Impact of epidural analgesia on quality of life and pain in advanced cancer patients.
Patients with advanced cancer often experience chronic postoperative pain and poor quality of life. The objective of this study was to determine if epidural self-controlled analgesia reduced the incidence of chronic pain and improved the quality of life when compared with intravenous self-controlled analgesia. A total of 50 patients diagnosed with advanced cancer who received analgesia treatment were randomly divided into two groups, epidural self-controlled analgesia group (EA group, n = 26) and intravenous self-controlled analgesia group (IA group, n = 24). ⋯ The VAS in the EA group was significantly lower than that in the IA group (p < .05), and the Karnofsky score in the EA group was significantly higher than that in the IA group (p < .05). Moreover, patients treated with EA felt more satisfied and experienced fewer complications than those with IA (p < .05). The epidural self-controlled analgesia may greatly improve the quality of life and relieve the pain in patients with advanced cancer.
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Occupational asthma (OA) and work-exacerbated asthma (WEA), collectively known as work-related asthma (WRA), have been recognized as the most prevalent work-related lung diseases in the industrialized world. OA is asthma caused by workplace conditions, and is subdivided into sensitizer-induced (allergic) OA and irritant-induced (nonallergic) OA. WEA is asthma that is made worse, but was not initially caused, by workplace conditions. ⋯ If possible, diagnostic assessment should also include objective evidence with functional and immunologic testing. Treatment and prevention of onset or worsening of WRA can be highly effective and typically include both optimal medical management (generally the same as for non-WRA) and, importantly, avoidance of sensitizer or irritant exposures that caused or exacerbate the asthma. In most cases of OA, prognosis is better with cessation rather than reduction of exposure, and this may require substantial changes in the workplace environment or change of job or even profession.
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Hypoxic pulmonary vasoconstriction (HPV) is critically important in regionally heterogeneous lung diseases by directing blood toward better-oxygenated lung units, yet the molecular mechanism of HPV remains unknown. Transient receptor potential (TRP) channels are a large cation channel family that has been implicated in HPV, specifically in the pulmonary artery smooth muscle cell (PASMC) Ca and contractile response to hypoxia. In this study, the authors probed the role of the TRP family member, TRPV4, in HPV. ⋯ TRPV4 plays a critical role in HPV, potentially via cooperation with TRPC6.