Chest
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Comparative Study
Emphysema in silica- and asbestos-exposed workers seeking compensation. A CT scan study.
It has been established that coal pneumoconiosis and confluent silicosis are associated with emphysematous changes in the lungs. In the present study, we addressed the concept of emphysema in simple silicosis and asbestosis and in workers exposed to these minerals without the pneumoconiosis. The study was done on 207 consecutive workers evaluated for possible pneumoconiosis at Québec Workman Compensation Board, who had a radiographic reading of pneumoconiosis in the category 0 or 1 of the ILO scale, and in 5 control subjects. ⋯ We conclude that, in our population, there was a significant excess of CT scan emphysema, associated with lung dysfunction, in those with pneumoconioses and in smokers with silica exposure. In the absence of smoking, it took a patient with pneumoconiosis to have emphysema. These changes contributed to the lung function impairment of these subjects with ILO category 0 or 1 pneumoconioses.
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In a rodent model of cardiac arrest and resuscitation in which the inspired gas mixture was enriched with oxygen, resuscitability and survival were unaffected by positive pressure ventilation. In the present study, in a larger animal model, tidal volumes generated during precordial compression and with spontaneous gasping were quantitated. ⋯ Positive pressure mechanical ventilation did not improve resuscitability or postresuscitation outcome in this porcine model of cardiac arrest.
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To obtain spirometry and maximal respiratory pressure (MRP) reference values for elderly persons. ⋯ Spirometry and MRP reference values used for elderly patients should come from population studies using similar techniques and with large numbers of subjects over age 65 years.
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Comparative Study
Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children.
To determine whether primary snoring (PS) could be distinguished from childhood obstructive sleep apnea syndrome (OSAS) by clinical history. ⋯ We conclude that PS in children cannot be reliably distinguished from OSAS by clinical history alone.
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Comparative Study
COPD in the elderly. A reversible cause of functional impairment.
To determine the frequency of referral of patients age 69 years and older to the pulmonary function laboratory at a tertiary-care hospital for airflow limitation studies; to determine the point prevalence of a significant reversible component in patients with COPD as an age-related function; and to determine the proportion of patients who were prescribed bronchodilators following a pulmonary function test (PFT) demonstrating significant reversibility. ⋯ Responses to inhaled bronchodilators occur at all ages. Older patients showed greater reversibility as the degree of obstruction increased, while a smoking history reduced the likelihood of a bronchodilator response. COPD in the elderly may differ from the traditional form of the disease.