Category Archives: Pulmonary Function : Part 2

Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India: Statistical Analysis

Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India: Statistical AnalysisStatistical analyses were performed using a statistical software package (SPSS for Windows, version 10.0; SPSS Inc; Chicago IL). Descriptive frequencies were expressed using the mean (SD) and the median (range and interquartile range [IQR]). Differences between the means of continuous variables were compared using the Mann-Whitney U test, and those of categoric variables were compared with the x2 test. Levels of significance were expressed as p values and odds ratios (ORs) [95% confidence intervals (CIs)]. link
Stepwise multivariable logistic regression analysis was performed to study the effect of the type of ARDS on RICU mortality. Initially, the variables (ie, age, gender, etiology [ALI/ ARDSp vs ALI/ARDSexp], Pplat values, PEEP levels, SOFA scores, and ASOFA scores) were analyzed using univariate analysis to derive a crude OR. The variables that were found to be significant (ie, p < 0.1) on univariate analysis were then entered in a multivariate logistic regression model to derive the adjusted OR and CIs.
Continue reading

Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India: Materials and Methods

This was a retrospective study conducted in the RICU of the Postgraduate Institute of Medical Education and Research between January 2001 and June 2005. All data in the RICU are entered prospectively into a computer program that is specifically designed for this purpose, with a continuous process of monitoring its completeness and correcting entries. Data are registered on RICU admission and every 24 h thereafter, using the lowest daily values for all variables of interest. Day 0 is defined as the interval from the time of RICU admission to 8:00 am on the next day; data from this time period are used to calculate the RICU admission sequential organ failure assessment (SOFA) scores. All remaining days are calendar days from 8:00 am to 8:00 am the following day. An informed consent form was obtained from all patients or their relatives as per the RICU protocol. The study was cleared by the institutional ethics committee. there
Continue reading

Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North India

Etiology and Outcomes of Pulmonary and Extrapulmonary Acute Lung Injury/ARDS in a Respiratory ICU in North IndiaAcute lung injury (ALI) and ARDS are characterized by refractory hypoxemia that develops secondary to high-permeability pulmonary edema. These syndromes can occur even without primary damage to the lung parenchyma, and thus they are now more often being classified as ALI/ARDS resulting from pulmonary causes (ALI/ARDSp) or extrapulmonary causes (ALI/ARDSexp) according to the mechanism of lung insult. Lung injuries of different origins may have possible differences in pathophysiology, lung morphology, radiology, respiratory mechanics, and response to different management strategies. Also, this distinction between a direct etiology of lung injury (ie, ALI/ARDSp) and an indirect etiology of lung injury (ie, ALI/ARDSexp) is gaining more attention as a means of better comprehending the pathophysiology of ARDS and possibly for modifying ventilatory management.

Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Conclusions

It is, of course, possible that our negative findings are only due to the methodology. Discordance between perceived and recorded snoring has been reported. The results may differ depending on the population studied. Whether a single-night recording of snoring is adequate remains unknown as the repeatability of these measurements is also unknown. Furthermore, how much nasal resistance should be reduced to show a possible effect on snoring also is not clear.
In addition to relieving symptoms of nasal stuffiness, the treatment of nasal obstruction has been shown to decrease the needed pressure levels in nasal continuous positive airway pressure therapy, and it may increase adherence to the treatment.

Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Recommendation

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: RecommendationVariable treatment outcomes can be hypothesized to reflect differences in other obstructive sites. Strifes and coworkers reported better outcomes after nasal surgery in patients with normal cephalometry in 14 patients who were matched for SDB and BMI. In six of seven patients with a wide ph1-ph2 and a short H/MP as criteria for normal cephalometry findings, the AHI returned to < 10 and the number of arousals decreased. In the group of patients with abnormal cephalometry findings, none of the patients were cured by nasal surgery. In consecutive patients taken from our waiting list of patients for nasal surgery, these results could not be confirmed. www.canadian-familypharmacy.com

Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Symptoms

Hoffstein and coworkers did not find differences in the mean or highest sound intensity across the sleep stages in heavy snorers. However, Nakano and coworkers reported increased snoring time and intensity during slow-wave sleep, when compared to REM sleep in apneic snorers. In the present study, the snoring intensity index was also found to be significantly higher during NREM sleep than during REM sleep in both sleep studies. Snoring seems more prevalent and more intense during stages 2 to 4 of NREM sleep. Since REM sleep is more prevalent in the early morning and sleep onset is followed by stages of NREM sleep, increased intensity of snoring during NREM sleep may have social implications. further

Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Treatment

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: TreatmentObjective snoring measurement has been performed earlier in one surgical study and in some studies using nasal dilators, nasal decongestants or topical corticosteroids.’’ Some studies have reported the degree of nasal obstruction before and after treatment by objective nasal measurement. Patient samples in nonsurgical studies have varied from subjects without nasal symptoms or signs of nasal pathology to unselected snorers and those with abnormal rhinoscopy findings. www.canadian-familypharmacy.com

Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Discussion

Table 2 shows preoperative and postoperative PSG data in the overall patient group, and in the subgroups with surgical improvement and no improvement of nasal patency. There were no statistical differences in preoperative breathing or sleep parameters between the subgroups (Table 2). REM sleep increased after the operation in the overall patient group and in the subgroup with surgical improvement (p < 0.05 for both). The change in REM sleep time was not correlated to the change in snoring time. BMI did not change between the sleep studies. ESS score remained unchanged in the overall patient group.
Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Results

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: ResultsDifferences between the subgroups were evaluated using the Mann-Whitney U test. Comparisons of snoring intensity between REM sleep and NREM sleep, between supine and nonsupine sleep position, and between preoperative and postoperative measurements were analyzed using the Wilcoxon matched-pair test. A Pearson correlation analysis was used to evaluate the relationship between the change in REM sleep time and the change in snoring time.
The computations were performed using a commercial statistical package (Statistica, version 5.1; Statsoft Inc; Tulsa, OK). A p value of < 0.05 was considered to indicate statistical significance.
Continue reading

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: PSG

Snoring was detected as previously described with a microphone attached to the subject’s throat, and the analog signal was transferred to the monitor screen. Another microphone was attached to the ceiling, 2 m from the patient’s head, to record sounds on a videotape.
During the calibration process, the subjects were asked to imitate snoring as loud as they could while lying supine before the start of the recording. The maximal snoring signal during calibration was given a value of 100 on an arbitrary scale from 0 to 100. With a snoring signal of 50, no snoring was heard on the videotape. A snoring event was scored visually if the signal was at least 50% of the calibration signal. A snoring episode included at least one snoring event and terminated when no snoring event was detected for two breathing cycles. The time spent in snoring episodes was divided by total sleeping time to give the figure for snoring time.
Continue reading

Pages: Prev 1 2 3 4 5 6 7 8 9 10 ... 21 22 23 Next