Archive for the 'Pulmonary function' Category

31 Mar

DRG Payment for Long-term Ventilator Patients— Revisited

Nearly a year ago, we analyzed the cost and payment of long-term ventilator-dependent Medicare patients and concluded that a financial bias against such patients existed in the Diagnostic Related Groups (DRG) system. We analyzed 95 long-term ventilator-dependent Medicare patients, defined as those who received three or more days of continuous ventilator treatment and spent no […]

17 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Conclusion

Findings relating to TG vary widely in different studies. According to Kelemen et al2 the TG was 0.042 ± 0.005 s, while according to Ross et al it was 0.2 s and according to Yanaghihara et al, 0.09 to 0.34 s. Our findings confirm this substantial variation. In addition, there seems to be a positive […]

16 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Discussion

The groups for the present study were selected with the purpose of studying patients with different pathophysiologic basis of cough: asthma with variable bronchial obstruction, bronchitis with expectoration or infection or both, TBCS with pathologic bronchial dynamics, and FPD with reorganization of the pulmonary tissue. Since the patients were breathing through a mouthpiece, we recorded […]

15 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Asthmatic patients

Occasionally, an expiration was interrupted by cough, without immediately preceding inspiration, an average 1,713 ± 859 ms after the start of expiration. We therefore termed them end-expiratory coughs (Fig 6). The incidence of end-expiratory cough in the patient groups is represented in Table 2. Asthmatic patients had the highest percentage of end-expiratory coughs of all […]

14 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Results

An average of 12.4 ± 6.2 (mean ± SD) coughs (range, 4 to 27) were recorded from each patient. Typically, a cough reflex comprised deep inspiration followed by glottic closure, glottic opening and rapid expiratory flow (CPEF) (Fig 2). However, one cough could include several opening and closing phases without intermittent inspirations. The sounds always […]

13 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Methods

Methods The recording of cough was performed in an acoustically isolated chamber with the patient sitting. Breathing air was conducted through a pneumotachograph (Fleisch) and the nose was shut. Sounds of spontaneous cough were recorded from the sternal manubrium with a condenser microphone (B&K 4134) mounted in a plastic piece attached to the skin with […]

12 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases: Patients and Methods

In the five patients with acute bronchitis, symptoms had lasted from one to four weeks before the recording. One patient also had rheumatoid arthritis and another patient arterial hypertension. The findings of dynamic spirometry were normal in four patients but showed moderately diminished vital capacity in one. Bronchoscopic studies were not performed. The chest x-ray […]

11 Nov

Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases

Cough is one of the most common symptoms of pulmonary disease. Its properties are not, however, clinically consistent from one disease to another. Few objective studies have been published on the acoustic or dynamic patterns of cough; most studies deal with intensity analysis or tussiphonography of voluntary cough. One study has analyzed the spectral contents […]

03 Mar

FK 506 ‘Rescue’ Immunosuppression for Obliterative Bronchiolitis After Lung Transplantation: Conclusion

Alternative immunosuppressive strategies for OB may significantly increase the risk for infections and contribute to the escalating medical costs after transplantation. In a recent retrospective study of 15 patients with OB who received antilymphocyte globulin, Kesten et al reported stabilization of FE in 50% of patients during the ensuing 3-month interval. Although we did not […]

01 Mar

FK 506 ‘Rescue’ Immunosuppression for Obliterative Bronchiolitis After Lung Transplantation: Discussion

Long-term survival after LT has been limited by the development of OB with a variously reported incidence between 10 and 70%. Although augmented immunosuppression may result in transient stabilization of allograft function, infectious complications may be increased. Data derived from orthotopic liver transplantation have suggested a decreased incidence as well as potential stabilization of CR […]

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