2681. The impact of anatomic manipulations on pharyngeal collapse: results from a computational model of the normal human upper airway.
Obstructive sleep apnea (OSA) is a common disease with important neurocognitive and cardiovascular sequelae. Existing therapies are unsatisfactory, leading investigators to seek alternative forms of anatomic manipulation to influence pharyngeal mechanics. We have developed a two-dimensional computational model of the normal human upper airway based on signal averaging of MRI. Using the finite element method, we can perform various anatomic perturbations on the structure in order to assess the impact of these manipulations on pharyngeal mechanics and collapse. By design, the normal sleeping upper airway model collapses at -13 cm H2O. This closing pressure becomes more negative (ie, less collapsible) when we perform mandibular advancement (-21 cm H2O), palatal resection (-18 cm H2O), or palatal stiffening (-17 cm H2O). Where clinical data are available in the literature, the results of our model correspond reasonably well. Furthermore, our model provides information regarding the site of obstruction and provides hypotheses for clinical studies that can be undertaken in the future (eg, combination therapies). We believe that, in the future, finite element modeling will provide a useful tool to help advance our understanding of OSA and its response to various therapies.
2683. Use of sedatives and neuromuscular blockers in a cohort of patients receiving mechanical ventilation.
作者: Alejandro Arroliga.;Fernando Frutos-Vivar.;Jesse Hall.;Andres Esteban.;Carlos Apezteguía.;Luis Soto.;Antonio Anzueto.; .
来源: Chest. 2005年128卷2期496-506页
To describe the use of sedatives and neuromuscular blocking agents (NMBs) and their impact in outcome in an international cohort of patients receiving mechanical ventilation.
2684. Adverse effects of ribavirin and outcome in severe acute respiratory syndrome: experience in two medical centers.
作者: Hsueh-Erh Chiou.;Ching-Lung Liu.;Mary Jeanne Buttrey.;Han-Pin Kuo.;Hui-Wen Liu.;Hsu-Tah Kuo.;Yen-Ta Lu.
来源: Chest. 2005年128卷1期263-72页
To assess the effect of ribavirin-induced anemia on the outcome of severe acute respiratory syndrome (SARS).
2685. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge.
作者: Lixin Xie.;Youning Liu.;Yueyong Xiao.;Qing Tian.;Baoxing Fan.;Hong Zhao.;Weijun Chen.
来源: Chest. 2005年127卷6期2119-24页
To follow-up on the changes in lung function and lung radiographic pictures of severe acute respiratory syndrome (SARS) patients discharged from Xiaotangshan Hospital in Beijing (by regularly receiving examination), and to analyze retrospectively the treatment strategy in these patients.
2686. Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapy.
作者: Mark S Aloia.;Michael Stanchina.;J Todd Arnedt.;Atul Malhotra.;Richard P Millman.
来源: Chest. 2005年127卷6期2085-93页
To compare adherence and clinical outcomes between flexible positive airway pressure (PAP) [C-Flex; Respironics; Murraysville, PA] and standard PAP therapy (ie, continuous positive airway pressure [CPAP]).
2687. Bone mineral density improvement after lung volume reduction surgery for severe emphysema.
作者: Tommaso Claudio Mineo.;Vincenzo Ambrogi.;Davide Mineo.;Andrea Fabbri.;Elisa Fabbrini.;Renato Massoud.
来源: Chest. 2005年127卷6期1960-6页
In patients with severe emphysema, bone mineral density (BMD) is reduced and the risk of osteoporosis is increased.
2688. Sentinel lymph node mapping of the pleural space.
作者: Cherie P Parungo.;Yolonda L Colson.;Sang-Wook Kim.;Sungjee Kim.;Lawrence H Cohn.;Moungi G Bawendi.;John V Frangioni.
来源: Chest. 2005年127卷5期1799-804页
Although the sentinel lymph node (SLN) concept has traditionally been applied to solid organs, we hypothesized that the pleural space might drain into a specific SLN group. The identification of such a nodal group could assist in the staging and treatment of pleural-based diseases, such as mesothelioma, or other lung cancers with visceral pleural invasion. The purpose of this study was to determine whether the pleural space has an SLN group.
2689. Factors influencing in-hospital mortality in community-acquired pneumonia: a prospective study of patients not initially admitted to the ICU.
To determine the factors that predict in-hospital mortality among patients who require hospitalization for the treatment of community-acquired pneumonia (CAP).
2690. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion.
作者: Carolyn M Dresler.;Jemi Olak.;James E Herndon.;William G Richards.;Ernest Scalzetti.;Stewart B Fleishman.;Kemp H Kernstine.;Todd Demmy.;David M Jablons.;Leslie Kohman.;Thomas M Daniel.;George B Haasler.;David J Sugarbaker.; .; .; .; .
来源: Chest. 2005年127卷3期909-15页
To demonstrate the efficacy, safety, and appropriate mode of instillation of talc for sclerosis in treatment of malignant pleural effusions (MPEs).
2691. Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke: influence of stroke-specific impairments.
To identify the following in individuals with chronic stroke: (1) the relationship between the maximal oxygen consumption (Vo(2)max) during cycle ergometry and the distance covered in the 6-min walk test (6MWT), and (2) the stroke-specific impairments that are important determinants for the 6MWT distance.
2692. Length and clinical effectiveness of pulmonary rehabilitation in outpatients with chronic airway obstruction.
作者: Giuseppina Rossi.;Fabio Florini.;Micaela Romagnoli.;Tommasina Bellantone.;Sasa Lucic.;Daniela Lugli.;Enrico Clini.
来源: Chest. 2005年127卷1期105-9页
To assess the clinical effectiveness of pulmonary rehabilitation (PR) after 10 or 20 consecutive sessions in outpatients with chronic airway obstruction (CAO).
2694. Polycyclic aromatic hydrocarbons, environmental tobacco smoke, and respiratory symptoms in an inner-city birth cohort.
作者: Rachel L Miller.;Robin Garfinkel.;Megan Horton.;David Camann.;Frederica P Perera.;Robin M Whyatt.;Patrick L Kinney.
来源: Chest. 2004年126卷4期1071-8页
Several studies have found associations between diesel exposure, respiratory symptoms, and/or impaired pulmonary function. We hypothesized that prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH), important components of diesel exhaust and other combustion sources, may be associated with respiratory symptoms in young children. We also hypothesized that exposure to environmental tobacco smoke (ETS) may worsen symptoms beyond that observed to be associated with PAH alone.
2695. Effectiveness of noninvasive positive pressure ventilation in the treatment of acute respiratory failure in severe acute respiratory syndrome.
作者: Thomas M T Cheung.;Loretta Y C Yam.;Loletta K Y So.;Arthur C W Lau.;Edwin Poon.;Bernard M H Kong.;Raymond W H Yung.
来源: Chest. 2004年126卷3期845-50页
To study the effectiveness of noninvasive positive pressure ventilation (NIPPV) in the treatment of acute respiratory failure (ARF) in severe acute respiratory syndrome (SARS), and the associated infection risk.
2697. Clinical and laboratory features of severe acute respiratory syndrome vis-a-vis onset of fever.
作者: Ching-Lung Liu.;Yen-Ta Lu.;Meng-Jen Peng.;Pei-Jan Chen.;Rong-Luh Lin.;Chien-Liang Wu.;Hsu-Tah Kuo.
来源: Chest. 2004年126卷2期509-17页
Severe acute respiratory syndrome (SARS) is a rapidly progressive disease caused by a novel coronavirus (CoV) infection. However, the disease presentation is nonspecific. The aim of this study was to define clearly the presentation, clinical progression, and laboratory data in a group of patients who had SARS.
2700. Innovative approaches to lung volume reduction for emphysema.
作者: Matt Brenner.;Nevine Mikhail Hanna.;Reza Mina-Araghi.;Arthur F Gelb.;Robert J McKenna.;Henri Colt.
来源: Chest. 2004年126卷1期238-48页
The 10 years of resurgent interest in lung volume reduction surgery (LVRS) and recent National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative alternative ideas aimed at improving outcomes and reducing complications associated with current LVRS techniques. Concepts being actively investigated at this time include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices and valves, and bronchial bypass methods. These novel approaches are reaching the stage of clinical trials at this time. Theory, design issues, methods, potential advantages and limitations, and available results are presented. Extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms.
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