National Athletic Trainers' Association Position Statement: Management of Asthma in Athletes

PubMed Central

Miller, Michael G; Weiler, John M; Baker, Robert; Collins, James; D'Alonzo, Gilbert

2005-01-01

Objective: To present guidelines for the recognition, prophylaxis, and management of asthma that lead to improvement in the quality of care certified athletic trainers and other heath care providers can offer to athletes with asthma, especially exercise-induced asthma. Background: Many athletes have difficulty breathing during or after athletic events and practices. Although a wide variety of conditions can predispose an athlete to breathing difficulties, the most common cause is undiagnosed or uncontrolled asthma. At least 15% to 25% of athletes may have signs and symptoms suggestive of asthma, including exercise-induced asthma. Athletic trainers are in a unique position to recognize breathing difficulties caused by undiagnosed or uncontrolled asthma, particularly when asthma follows exercise. Once the diagnosis of asthma is made, the athletic trainer should play a pivotal role in supervising therapies to prevent and control asthma symptoms. It is also important for the athletic trainer to recognize when asthma is not the underlying cause for respiratory difficulties, so that the athlete can be evaluated and treated properly. Recommendations: The recommendations contained in this position statement describe a structured approach for the diagnosis and management of asthma in an exercising population. Athletic trainers should be educated to recognize asthma symptoms in order to identify patients who might benefit from better management and should understand the management of asthma, especially exercise-induced asthma, to participate as active members of the asthma care team. PMID:16284647

Toothpaste overdose

MedlinePlus

Poisonous ingredients include: Sodium fluoride Triclosan ... when swallowing a large amount of toothpaste containing fluoride: Convulsions Diarrhea Difficulty breathing Drooling Heart attack Salty ...

Legal Rights of Asbestos Exposure Victims. A Practical Legal Guide for People With Breathing and Other Medical Problems, Possibly Resulting from Exposure to Asbestos.

ERIC Educational Resources Information Center

Silberfeld, Roman M.; Hecht, Richard L.

This practical legal guide for people with breathing and other medical problems, possibly resulting from exposure to asbestos, provides 19 questions and detailed answers about Asbestosis and other diseases resulting from asbestos exposure. Included is information concerning symptoms, difficulty of diagnosis, necessity of a detailed…

JPRS Report, Soviet Union, Sociological Studies, No. 4, July-August 1987.

DTIC Science & Technology

1988-04-22

neuropsychological disorders, sexual dysfunction, psy- chosomatic illnesses (stomach ulcers, bronchial asthma, high blood pressure, neurodermatitis, and others...this—all of her friends and colleagues are unanimous in this belief!). "We children of the war did not suffer hunger and cold," she feverishly wrote

Burning Man

ERIC Educational Resources Information Center

Cech, Scott J.

2006-01-01

Former Baltimore cop and teacher Ed Burns isn't a masochist. The writer-producer for "The Wire," a critically applauded HBO series about life and death on the streets of Baltimore, is just feverishly trying to save public schools. He thinks American education is hopelessly screwed up, but that it's also the country's only hope. So it…

Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients.

PubMed

Gesualdo, Loreto; Cormio, Luigi; Stallone, Giovanni; Infante, Barbara; Di Palma, Anna Maria; Delli Carri, Paolo; Cignarelli, Mauro; Lamacchia, Olga; Iannaccone, Salvatore; Di Paolo, Salvatore; Morrone, Luigi; Aucella, Filippo; Carrieri, Giuseppe

2008-03-01

Percutaneous ultrasound (US)-guided renal biopsy is the gold standard in the evaluation of renal diseases, but some patients, such as the obese, may not be eligible for this procedure. Aim of this study was to determine the feasibility, efficacy and safety of US-guided percutaneous renal biopsy in supine antero-lateral position (SALP) in high-risk patients (BMI > 30 and/or respiratory difficulty), as well as to compare the overall outcome of SALP with that of traditional prone position (PP) in low-risk patients (BMI < or = 30/no respiratory difficulty). One hundred and ten consecutive patients scheduled for native kidney biopsy were recruited. Ninety low-risk patients were randomized following a permuted block randomization list to receive either US-guided renal biopsy in PP (Group 1) or SALP (Group 2), whereas 20 high-risk patients received US-guided renal biopsy in SALP (Group 3) and were our observational cohort study. Comfort compliance and breathing difficulty in each group were evaluated by the Visual Analogue Scale (VAS). Bleeding complications were evaluated through US renal scanning. Mean operating time was 7 min. Comfort compliance and breathing difficulty were significantly better for SALP in both low- and high-risk patients; there were no significant differences in pain after biopsy among the three groups. Bleeding complications were slightly higher in Group 1. Diagnostic yield was similar in all groups. SALP is reliable, minimally invasive, easy, highly successful, timesaving and almost free from severe side-effects. A better VAS score for breathing difficulty and comfort compliance characterizes this procedure, making it particularly suitable for obese patients.

Educators Flock to NPS amidst Concerns about Budget Cuts

ERIC Educational Resources Information Center

Emeagwali, N. Susan

2011-01-01

At a time of intense politicking on Capitol Hill as legislators work feverishly to cut federal spending, and amidst more threats to slash Perkins funding, career and technical education (CTE) professionals from around the country converged on Washington, D.C., to attend the Association for Career and Technical Education's National Policy Seminar…

Ask Dr. Sue: "Children and Fevers."

ERIC Educational Resources Information Center

Aronson, Susan S.

1989-01-01

Considers aspects of children's fevers. Answers questions concerning: (1) the temperature at which a fever is infectious; (2) the point at which a feverish child in care should be sent home; (3) the length of time a parent should wait before returning the child to day care; and (4) the way to take a child's temperature. (RJC)

Blockage of upper airway

MedlinePlus

... or fidgeting Bluish color to the skin ( cyanosis ) Changes in consciousness Choking Confusion Difficulty breathing , gasping for air, leading to panic Unconsciousness Wheezing , crowing, whistling, or other ...

Carcinoid Tumors

MedlinePlus

... feeling of warmth in your face and neck (skin flushing), chronic diarrhea, and difficulty breathing, among other signs and symptoms. Carcinoid heart disease. Carcinoid tumors may secrete hormones that can cause ...

A novel CT acquisition and analysis technique for breathing motion modeling

NASA Astrophysics Data System (ADS)

Low, Daniel A.; White, Benjamin M.; Lee, Percy P.; Thomas, David H.; Gaudio, Sergio; Jani, Shyam S.; Wu, Xiao; Lamb, James M.

2013-06-01

To report on a novel technique for providing artifact-free quantitative four-dimensional computed tomography (4DCT) image datasets for breathing motion modeling. Commercial clinical 4DCT methods have difficulty managing irregular breathing. The resulting images contain motion-induced artifacts that can distort structures and inaccurately characterize breathing motion. We have developed a novel scanning and analysis method for motion-correlated CT that utilizes standard repeated fast helical acquisitions, a simultaneous breathing surrogate measurement, deformable image registration, and a published breathing motion model. The motion model differs from the CT-measured motion by an average of 0.65 mm, indicating the precision of the motion model. The integral of the divergence of one of the motion model parameters is predicted to be a constant 1.11 and is found in this case to be 1.09, indicating the accuracy of the motion model. The proposed technique shows promise for providing motion-artifact free images at user-selected breathing phases, accurate Hounsfield units, and noise characteristics similar to non-4D CT techniques, at a patient dose similar to or less than current 4DCT techniques.

The English-Medium Fever in Pakistan: Analyzing Policy, Perceptions and Practices through Additive Bi/Multilingual Education Lens

ERIC Educational Resources Information Center

Manan, Syed Abdul; Dumanig, Francisco Perlas; David, Maya Khemlani

2017-01-01

This study analyses the crisis of English teaching in Pakistan. The study examines stakeholders' perceptions and classroom practices to identify theoretical fault lines and institutional/pedagogical challenges in the low-fee schools. We deem such research critical in the backdrop of public's heavy reliance and feverish pursuit of low-fee…

Bilateral paracoccidioidomycotic iliopsoas abscess associated with ileo-colonic lesion.

PubMed

Duani, Helena; Nunes, Vinícius Rodrigues Taranto; Assumpção, Anísio Borges; Saraiva, Isadora Sofia Borges; Rosa, Rodrigo Macedo; Neiva, Augusto Motta; Pedroso, Enio Roberto Pietra

2012-10-01

This case report shows the clinical development of a patient with systemic paracoccidioidomycosis presenting with lymphatic-intestinalmanifestation. The patient initially had a substantial clinical improvement but had a recrudescence after six months of sulfamethoxazoletrimethoprim oral treatment, with the emergence of feverish syndrome, lumbar pain, and intermittent claudication, characterizing a bilateral iliopsoas muscle abscess, necessitating clinicosurgical therapeutics.

Beyond the Call: Preserving Reflection in the Preparation of "Highly Qualified" Teachers

ERIC Educational Resources Information Center

Amobi, Funmi A.

2006-01-01

Many teacher education programs are working at a feverish pitch to ensure that their graduates are considered "highly qualified" in light of the No Child Left Behind (NCLB) legislation, which reduces teacher competency to proof of subject matter knowledge as demonstrated by passing a state test and completing requisite number of courses in the…

Know and Share the Facts about Flu Vaccination

ERIC Educational Resources Information Center

Grohskopf, Lisa

2012-01-01

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

Technology in Education: What Teachers Should Know

ERIC Educational Resources Information Center

De Bruyckere, Pedro; Kirschner, Paul A.; Hulshof, Casper D.

2016-01-01

Educators often have the feeling that they are finding it harder and harder to reach their students. That is why they are so feverishly interested in smartboards or learning platforms or anything new on the market that might help. Every new tool seems like a possible solution, although sometimes educators really don't know what the problem is or…

Tick paralysis

MedlinePlus

... after the tick is removed. Outlook (Prognosis) Full recovery is expected following the removal of the tick. Possible Complications Breathing difficulties can cause respiratory failure. When this happens, the body's organs do not ...

Methylergonovine

MedlinePlus

... uterus that can happen after childbirth or an abortion.This medication is sometimes prescribed for other uses; ... following symptoms, call your doctor immediately: seizures chest pain fast heartbeat difficulty breathing dizziness ringing in the ...

Orlistat

MedlinePlus

... you buy. When eating meat, poultry (chicken) or fish, eat only 2 or 3 ounces (55 or ... call your doctor immediately: hives rash itching difficulty breathing or swallowing severe or continuous stomach pain excessive ...

Angioedema

MedlinePlus

... cold or heat Foods (such as berries, shellfish, fish, nuts, eggs, and milk) Insect bites Medicines ( drug ... be painful. Other symptoms may include: Abdominal cramping Breathing difficulty Swollen eyes and mouth Swollen lining of ...

Soy Allergy

MedlinePlus

... most allergic responses, including a runny nose, itchy eyes, dry throat, rashes and hives, nausea, diarrhea, difficulty breathing, and anaphylactic shock. Food protein-induced enterocolitis syndrome (FPIES) A food allergen can also cause what's ...

Thioridazine overdose

MedlinePlus

... AND THROAT Blurred vision Drooling Dry mouth Nasal congestion Swallowing difficulties Ulcers in the mouth, on the ... urine tests Breathing support, including oxygen and a tube through the mouth into the lungs CT scan ( ...

Obinutuzumab Injection

MedlinePlus

... to treat follicular non-Hodgkin's lymphoma (NHL; a slow-growing blood cancer) in people who are starting ... hours after you receive obinutuzumab: dizziness, lightheadedness, fainting, fast heartbeat, chest pain, difficulty breathing, swelling of the ...

Chiari Malformation: Symptoms

MedlinePlus

... hands Fatigue Nausea Shortness of breath Blurred Vision Tinnitus Difficulty swallowing Leg weakness % 98 84 72 69 ... system) may not work properly, which may cause tinnitus (ringing in the ears), depth perception, running into ...

Chlordiazepoxide and Clidinium

MedlinePlus

... clidinium, you may experience withdrawal symptoms such as seizures, shaking, stomach cramps, muscle cramps, depression, vomiting, difficulty ... help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, ...

Atrial septal defect (ASD)

MedlinePlus

... any symptoms, or symptoms may not occur until middle age or later. Symptoms that do occur may begin at any time after birth through childhood. They can include: Difficulty breathing ( dyspnea ) Frequent respiratory ...

Signs and Symptoms

MedlinePlus

... have additional symptoms of low blood sugar (hypoglycemia), excessive acidity in the blood (metabolic acidosis) or neurological ... cardiomyopathy. In infants, common symptoms are difficulty breathing, excessive sweating (diaphoresis), poor appetite and failure to thrive. ...

Levomilnacipran

MedlinePlus

... by increasing the amount of serotonin and norepinephrine, natural substances in the brain that helps maintain mental ... swelling difficulty breathing or swallowing fever, sweating, confusion, ... the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

JPRS Report, East Europe

DTIC Science & Technology

1988-12-14

situation in the world healthier, particularly for the program to liquidate nuclear arms and other types of weapons of mass destruction. During the...make preparations for extensive discussions with the aim of radically reducing tactical nuclear weapons, armed forces, and conventional weap- ons...liquidat- ing two classes of nuclear arms as a historic step which will create preconditions for limiting the feverish arms race and for better

Enter the iPad (or Not?)

ERIC Educational Resources Information Center

Waters, John K.

2010-01-01

Few computing devices have sparked the burning gizmo lust ignited by the iPad. Apple's latest entry into the tablet PC market didn't generate much heat when it was first unveiled in January, but by April 3, the day of the official release, feverish customers were mobbing Apple stores. The company claims to have sold 300,000 iPads by midnight on…

Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study.

PubMed

Kuroishi, Rita Cristina Sadako; Garcia, Ricardo Basso; Valera, Fabiana Cardoso Pereira; Anselmo-Lima, Wilma Terezinha; Fukuda, Marisa Tomoe Hebihara

2015-01-01

Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing. Analytical cross-sectional study with control group conducted in a public university hospital. 42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills. Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76). Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.

Non-Invasive UWB Sensing of Astronauts' Breathing Activity

PubMed Central

Baldi, Marco; Cerri, Graziano; Chiaraluce, Franco; Eusebi, Lorenzo; Russo, Paola

2015-01-01

The use of a UWB system for sensing breathing activity of astronauts must account for many critical issues specific to the space environment. The aim of this paper is twofold. The first concerns the definition of design constraints about the pulse amplitude and waveform to transmit, as well as the immunity requirements of the receiver. The second issue concerns the assessment of the procedures and the characteristics of the algorithms to use for signal processing to retrieve the breathing frequency and respiration waveform. The algorithm has to work correctly in the presence of surrounding electromagnetic noise due to other sources in the environment. The highly reflecting walls increase the difficulty of the problem and the hostile scenario has to be accurately characterized. Examples of signal processing techniques able to recover breathing frequency in significant and realistic situations are shown and discussed. PMID:25558995

Chest tube insertion - series (image)

MedlinePlus

... cause the lung to collapse, such as: air leaks from the lung into the chest (pneumothorax) bleeding ... nursing staff will carefully check for possible air leaks, breathing difficulties, and need for additional oxygen. Frequent ...

Legionnaires' Disease

MedlinePlus

... and Treatment Cooling Towers, Evaporative Condensers, and Fluid Coolers Humidifiers and Misters Domestic Water Systems Domestic Hot- ... 105° F, or 39° to 41° C) Cough (dry at first, later producing phlegm) Difficulty in breathing ...

A Journey of Self-Discovery: An Intervention Involving Massage, Yoga and Relaxation for Children with Emotional and Behavioural Difficulties Attending Primary Schools

ERIC Educational Resources Information Center

Powell, Lesley; Gilchrist, Mollie; Stapley, Jacqueline

2008-01-01

This study reports on an intervention involving massage, yoga and relaxation delivered to young children with identified emotional and behavioural difficulties, and at risk of exclusion. Children (n = 126) were invited by the head teacher to participate in the Self-discovery Programme (involving massage, yoga, breath work and relaxation) with…

Learning about Alpha-1 Antitrypsin Deficiency (AATD)

MedlinePlus

... Tests Genomics and Health Disparities Genetic Discrimination Human Subjects Research Informed Consent for Genomics Research Intellectual Property ... the lungs are damaged. Symptoms of emphysema include difficulty breathing, a hacking cough and a barrel-shaped ...

Nicardipine

MedlinePlus

... fast heartbeat muscle cramps constipation heartburn increased sweating dry mouth If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: swelling of the face, eyes, lips, tongue, arms, or legs difficulty breathing or ...

Morphine Injection

MedlinePlus

... back or joint pain; widening of the pupils; irritability; anxiety; weakness; stomach cramps; difficulty falling asleep or staying asleep; nausea; loss of appetite; vomiting; diarrhea; fast breathing; or fast heartbeat. Your doctor will probably decrease your dose gradually.

Meperidine Injection

MedlinePlus

... back or joint pain; widening of the pupils; irritability; anxiety; weakness; stomach cramps; difficulty falling asleep or staying asleep; nausea; loss of appetite; vomiting; diarrhea; fast breathing; or fast heartbeat. Your doctor will probably decrease your dose gradually.

Rett Syndrome Fact Sheet

MedlinePlus

... management of symptoms — and supportive, requiring a multidisciplinary approach. Medication may be needed for breathing irregularities and motor difficulties, and anticonvulsant drugs may be used to control seizures. There should be regular monitoring for scoliosis ...

What You Should Know about Cerebral Aneurysms

MedlinePlus

... produce cerebrospinal fluid), difficulty breathing that requires a mechanical ventilator, and infection. Heart and lung problems may ... stay within the aneurysm and act as a mechanical barrier to blood flow, thus sealing it off. ...

Cariprazine

MedlinePlus

... severe muscle stiffness muscle weakness or aching blank facial expression difficulty swallowing or breathing tightness in the throat tongue that sticks out of the mouth rash itching hives swelling of the face, throat, tongue, lips, or eyes dark or cola- ...

Toilet bowl cleaners and deodorizers poisoning

MedlinePlus

... tongue STOMACH AND INTESTINES Blood in the stool Burns in the food pipe (esophagus) Severe abdominal pain ... swelling (which may also cause breathing difficulty) SKIN Burns Holes in the skin or tissues under the ...

Broken or dislocated jaw

MedlinePlus

... broken or dislocated jaw requires prompt medical attention. Emergency symptoms include difficulty breathing or heavy bleeding. ... safety equipment, such as a helmet when playing football, or using ... can prevent or minimize some injuries to the face or jaw.

Jewelry cleaners

MedlinePlus

... swelling (may also cause breathing difficulty) EYES, EARS, NOSE, AND THROAT Severe pain in the throat Severe pain or burning in the nose, eyes, ears, lips, or tongue Vision loss GASTROINTESTINAL SYSTEM ... pain (severe) Bloody stools Burns and possible holes of ...

Parathyroid gland removal

MedlinePlus

... nerves going to the muscles that move your vocal cords. You may have a hoarse or weaker voice which could be temporary or permanent. Difficulty breathing. This is very rare and almost always goes away several weeks or months after surgery.

Polio and Prevention

MedlinePlus

... polio More extensive paralysis, involving the trunk and muscles of the thorax and abdomen, can result in quadriplegia. In the most severe cases (bulbar polio), poliovirus attacks the nerve cells of the brain stem, reducing breathing capacity and causing difficulty in swallowing ...

Breathing difficulties - first aid

MedlinePlus

... walk around every few hours to avoid forming blood clots in your legs. While seated, do ankle circles ... lower your heels, toes, and knees to increase blood flow in your legs. Clots can break off and lodge in your lungs. ...

Piroxicam

MedlinePlus

Piroxicam comes as a capsule to take by mouth. It is usually taken once or twice a day. Take piroxicam at around the same time(s) ... a substance that is bloody or looks like coffee grounds difficulty breathing coma (loss of consciousness for ...

Hometown Hospitals: The Weakest Link? Bioterrorism Readiness in America’s Rural Hospitals

DTIC Science & Technology

2004-06-01

prophylaxis , and treatment. Eventually both public health and medical care systems were required to dispense antibiotics to an estimated 32,000...dispatched to the scene over 17 days in chaotic and feverish attempts to rescue and facilitate subsequent medical and surgical interventions to save...delivery of tertiary procedures for life-threatening diseases, hospitals face the quandary of terrorism preparedness and response with limited budgets

Evaluating the Importance of the Carotid Chemoreceptors in Controlling Breathing during Exercise in Man

PubMed Central

Parkes, M. J.

2013-01-01

Only the carotid chemoreceptors stimulate breathing during hypoxia in Man. They are also ideally located to warn if the brain's oxygen supply falls, or if hypercapnia occurs. Since their discovery ~80 years ago stimulation, ablation, and recording experiments still leave 3 substantial difficulties in establishing how important the carotid chemoreceptors are in controlling breathing during exercise in Man: (i) they are in the wrong location to measure metabolic rate (but are ideally located to measure any mismatch), (ii) they receive no known signal during exercise linking them with metabolic rate and no overt mismatch signals occur and (iii) their denervation in Man fails to prevent breathing matching metabolic rate in exercise. New research is needed to enable recording from carotid chemoreceptors in Man to establish whether there is any factor that rises with metabolic rate and greatly increases carotid chemoreceptor activity during exercise. Available evidence so far in Man indicates that carotid chemoreceptors are either one of two mechanisms that explain breathing matching metabolic rate or have no importance. We still lack key experimental evidence to distinguish between these two possibilities. PMID:24236297

Erythromycin and Sulfisoxazole

MedlinePlus

... dehydrogenase (G-6-PD) deficiency, yellowing of the skin or eyes, colitis, or stomach problems.tell your doctor if you ... rash If you experience any of the following symptoms, call your doctor immediately: severe skin rash itching hives difficulty breathing or swallowing wheezing ...

Croup and Your Young Child

MedlinePlus

... has extreme difficulty swallowing saliva Treating Croup with Medicine If your child has viral croup, your child's doctor or the ... your child's doctor may recommend allergy or reflux medicines to help your child's breathing. Antibiotics , which treat bacteria, are not helpful ...

Risk of Behavioral and Adaptive Functioning Difficulties in Youth with Previous and Current Sleep Disordered Breathing

PubMed Central

Perfect, Michelle M.; Archbold, Kristen; Goodwin, James L.; Levine-Donnerstein, Deborah; Quan, Stuart F.

2013-01-01

Objectives: To examine the rates of behavioral and adaptive functioning difficulties among youth who never had sleep disordered breathing (SDB), had remitted SDB, had incident SDB, or had persistent SDB; and to determine if there were increased odds of behavioral difficulties among youth with varying SDB histories relative to those who never had SDB. Methods: 263 youth had valid polysomnography and neurobehavioral data at two time points approximately 5 years apart from the prospective Tucson Children's Assessment of Sleep Apnea study. Primary outcomes were the Behavior Assessment Scale for Children-2nd Edition Parent Report Form (BASC-PRF) and Self-Report of Personality (SRP), and the Adaptive Behavior Assessment System-2nd Edition (ABAS-2). Results: Compared to those who never had SDB, individuals with persistent SDB had significant odds and met more cutoff scores on the BASC-2-PRF Externalizing Problems Composite (odds ratio [OR] 3.29; 8.92% vs. 35.3%), Behavioral Symptoms Index (OR 6.82; 7.4% vs. 35.3%) and Hyperactivity subscale (OR 6.82; 11.1% vs. 41.2%). Similarly, greater difficulties was seen for the group with persistent SDB (relative to never) on the ABAS-2 Social Domain (OR 3.39; 22% vs. 50%), and Communication (OR 4.26; 15% vs. 42.9%) and Self-Care subscales (OR = 2.97; 25.2% vs. 50%). Relative to youth who never had SDB, youth who developed SDB at Time 2 had compromised adaptive skills as evidenced by the BASC-2 PRF Adaptive Behavior Composite (OR 3.34; 15.6% vs. 38.1%) and the ABAS-2 General Adaptive Composite (OR 2.83; 20.5% vs. 42.1%). Conclusions: Youth with current SDB exhibited hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills. Citation: Perfect MM; Archbold K; Goodwin JL; Levine-Donnerstein D; Quan SF. Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing. SLEEP 2013;36(4):517-525. PMID:23543901

Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of "coherence" during biofeedback.

PubMed

Courtney, Rosalba; Cohen, Marc; van Dixhoorn, Jan

2011-01-01

Heart rate variability (HRV) biofeedback is a self-regulation strategy used to improve conditions including asthma, stress, hypertension, and chronic obstructive pulmonary disease. Respiratory muscle function affects hemodynamic influences on respiratory sinus arrhythmia (RSA), and HRV and HRV-biofeedback protocols often include slow abdominal breathing to achieve physiologically optimal patterns of HRV with power spectral distribution concentrated around the 0.1-Hz frequency and large amplitude. It is likely that optimal balanced breathing patterns and ability to entrain heart rhythms to breathing reflect physiological efficiency and resilience and that individuals with dysfunctional breathing patterns may have difficulty voluntarily modulating HRV and RSA. The relationship between breathing movement patterns and HRV, however, has not been investigated. This study examines how individuals' habitual breathing patterns correspond with their ability to optimize HRV and RSA. Breathing pattern was assessed using the Manual Assessment of Respiratory Motion (MARM) and the Hi Lo manual palpation techniques in 83 people with possible dysfunctional breathing before they attempted HRV biofeedback. Mean respiratory rate was also assessed. Subsequently, participants applied a brief 5-minute biofeedback protocol, involving breathing and positive emotional focus, to achieve HRV patterns proposed to reflect physiological "coherence" and entrainment of heart rhythm oscillations to other oscillating body systems. Thoracic-dominant breathing was associated with decreased coherence of HRV (r = -.463, P = .0001). Individuals with paradoxical breathing had the lowest HRV coherence (t(8) = 10.7, P = .001), and the negative relationship between coherence of HRV and extent of thoracic breathing was strongest in this group (r = -.768, P = .03). Dysfunctional breathing patterns are associated with decreased ability to achieve HRV patterns that reflect cardiorespiratory efficiency and autonomic nervous system balance. This suggests that dysfunctional breathing patterns are not only biomechanically inefficient but also reflect decreased physiological resilience. Breathing assessment using simple manual techniques such as the MARM and Hi Lo may be useful in HRV biofeedback to identify if poor responders require more emphasis on correction of dysfunctional breathing.

Flow experience and the mobilization of attentional resources.

PubMed

de Sampaio Barros, Marcelo Felipe; Araújo-Moreira, Fernando M; Trevelin, Luis Carlos; Radel, Rémi

2018-05-07

The present study attempts to better identify the neurophysiological changes occurring during flow experience and how this can be related to the mobilization of attentional resources. Self-reports of flow (using a flow feelings scale) and attention (using thought probes), autonomic activity (heart rate, heart rate variability, and breathing rate), and cerebral oxygenation (using near-infrared spectroscopy) in two regions of the frontoparietal attention network (right lateral frontal cortex and right inferior parietal lobe) were measured during the practice of two simple video games (Tetris and Pong) played at different difficulty conditions (easy, optimal, hard, or self-selected). Our results indicated that an optimal level of difficulty, compared with an easy or hard level of difficulty led to greater flow feelings and a higher concentration of oxygenated hemoglobin in the regions of the frontoparietal network. The self-selected, named autonomy condition did not lead to more flow feelings than the optimal condition; however, the autonomy condition led to greater sympathetic activity (reduced heart rate variability and greater breathing rate) and higher activation of the frontoparietal regions. Our study suggests that flow feelings are highly connected to the mobilization of attentional resources, and all the more in a condition that promotes individuals' choice and autonomy.

Risk of Neurological Insult in Competitive Deep Breath-Hold Diving.

PubMed

Tetzlaff, Kay; Schöppenthau, Holger; Schipke, Jochen D

2017-02-01

It has been widely believed that tissue nitrogen uptake from the lungs during breath-hold diving would be insufficient to cause decompression stress in humans. With competitive free diving, however, diving depths have been ever increasing over the past decades. A case is presented of a competitive free-diving athlete who suffered stroke-like symptoms after surfacing from his last dive of a series of 3 deep breath-hold dives. A literature and Web search was performed to screen for similar cases of subjects with serious neurological symptoms after deep breath-hold dives. A previously healthy 31-y-old athlete experienced right-sided motor weakness and difficulty speaking immediately after surfacing from a breathhold dive to a depth of 100 m. He had performed 2 preceding breath-hold dives to that depth with surface intervals of only 15 min. The presentation of symptoms and neuroimaging findings supported a clinical diagnosis of stroke. Three more cases of neurological insults were retrieved by literature and Web search; in all cases the athletes presented with stroke-like symptoms after single breath-hold dives of depths exceeding 100 m. Two of these cases only had a short delay to recompression treatment and completely recovered from the insult. This report highlights the possibility of neurological insult, eg, stroke, due to cerebral arterial gas embolism as a consequence of decompression stress after deep breath-hold dives. Thus, stroke as a clinical presentation of cerebral arterial gas embolism should be considered another risk of extreme breath-hold diving.

[The influence of breathing mode on the oral cavity].

PubMed

Surtel, Anna; Klepacz, Robert; Wysokińska-Miszczuk, Joanna

2015-12-01

Nose breathing is one of the key factors in the proper development and functioning of the oral cavity. The air passing through the nasal cavity is warmed and humidified while dust and other particulate matter is removed. It is also important as far as bone formation is concerned. The obstruction or congestions of the upper respiratory tract may negatively affect the correct and most optimal (nasal) respiratory tract. The switch from nasal to mouth breathing may lead to serious clinical consequences. Children with the clinical diagnosis of mouth breathing are usually pale, apathetic and they lack concentration and often get tired. Disorders resulting from hypoxy may also be the reason from sleep disturbances, such as frequent waking-up, nocturia, difficulties falling aslee. The main clinical manifestations of mouth breathing appear in the craniofacial structures. Mouth breathers frequently suffer from dental malocclusions and craniofacial bone abnormalities. Chronic muscle tension around the oral cavity could result in the widening of cranio-vertebral angle, posterior position of mandibula and narrow maxillary arch. Among dental alterations the most common are class II malocclusion (total or partial) with the protrusion of the anterior teeth, cross bite (unilateral or bilateral), anterior open bite and primary crowded teeth. Apart from malocclusion, chronic gingivitis, periodontitis, candida infections and halitosis are frequently present in mouth--breathing patients. © 2015 MEDPRESS.

Common cold - how to treat at home

MedlinePlus

... you have: Difficulty breathing Sudden chest pain or abdominal pain Sudden dizziness Acting strangely Severe vomiting that does not go away Also call your provider if: You start acting strangely Your symptoms get worse or do not improve after 7 to 10 days

Longitudinal Evaluation of Sleep-Disordered Breathing and Sleep Symptoms with Change in Quality of Life: The Sleep Heart Health Study (SHHS)

PubMed Central

Silva, Graciela E.; An, Ming-Wen; Goodwin, James L.; Shahar, Eyal; Redline, Susan; Resnick, Helaine; Baldwin, Carol M.; Quan, Stuart F.

2009-01-01

Study Objectives: Findings from population studies evaluating the progression and incidence of sleep disordered breathing have shown evidence of a longitudinal increase in the severity of sleep disordered breathing. The present study evaluates the association among changes in sleep disordered breathing, sleep symptoms, and quality of life over time. Design: Prospective cohort study. Data were from the Sleep Heart Health Study. Setting: Multicenter study. Participants: Three thousand seventy-eight subjects aged 40 years and older from the baseline and follow-up examination cycles were included. Measurements: The primary outcomes were changes in the Physical Component Summary and Mental Component Summary scales obtained from the Medical Outcomes Study Short-Form Health Survey. The primary exposure was change in the respiratory disturbance index obtained from unattended overnight polysomnograms performed approximately 5 years apart. Other covariates included measures of excessive daytime sleepiness and difficulty initiating and maintaining sleep. Results: Mean respiratory disturbance index increased from 8.1 ± 11 SD at baseline to 10.9 ± 14 (P < 0.0001) at follow-up. The mean Physical Component Summary and Mental Component Summary scores were 48.5 and 54.1 at baseline and 46.3 and 54.8 at follow-up. No associations between change in respiratory disturbance index and changes in Physical Component Summary or Mental Component Summary scores were seen. However, worsening of difficulty initiating and maintaining sleep and excessive daytime sleepiness were significantly associated with lower quality of life. Conclusions: A slight increase in severity of sleep disordered breathing was seen over 5 years; this was not associated with worsening of quality of life. However, subjective symptoms of quality of sleep and daytime sleepiness were associated with declining quality of life. Citation: Silva GE; An MW; Goodwin JL; Shahar E; Redline S; Resnick H; Baldwin CM; Quan SF. Longitudinal evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the Sleep Heart Health Study (SHHS). SLEEP 2009;32(8):1049-1057. PMID:19725256

Association between caregivers' knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries.

PubMed

Noordam, Aaltje Camielle; Sharkey, Alyssa B; Hinssen, Paddy; Dinant, GeertJan; Cals, Jochen W L

2017-02-02

Pneumonia is the main cause of child mortality world-wide and most of these deaths occur in sub-Saharan Africa (SSA). Treatment with effective antibiotics is crucial to prevent these deaths; nevertheless only 2 out of 5 children with symptoms of pneumonia are taken to an appropriate care provider in SSA. While various factors associated with care seeking have been identified, the relationship between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia is not well researched. Based on data from Multiple Indicator Cluster Surveys, we assessed the association between caregivers' knowledge of symptoms related to pneumonia - namely fast or difficulty breathing - and care seeking behaviour for these symptoms. We analysed data of 4,163 children with symptoms of pneumonia and their caregivers. A Chi-square tests and multivariable logistic regression was performed to assess the association between care seeking and knowledge of at least one symptom (i.e., fast or difficulty breathing). Across all 6 countries only around 30% of caregivers were aware of at least one of the two symptoms of pneumonia (i.e., fast or difficulty breathing). Our study shows that in the Democratic Republic of the Congo and Nigeria there was a positive association between knowledge and care seeking (P ≤ 0.01), even after adjusting for key variables (including wealth, residence, education). We found no association between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia in Central African Republic, Chad, Malawi, and Sierra Leone. These findings reveal an urgent need to increase community awareness of pneumonia symptoms, while simultaneously designing context specific strategies to address the fundamental challenges associated with timely care seeking.

Symptoms and impact of COPD assessed by an electronic diary in patients with moderate-to-severe COPD: psychometric results from the SHINE study.

PubMed

Kulich, Károly; Keininger, Dorothy L; Tiplady, Brian; Banerji, Donald

2015-01-01

Symptoms, particularly dyspnea, and activity limitation, have an impact on the health status and the ability to function normally in patients with chronic obstructive pulmonary disease (COPD). To develop an electronic patient diary (eDiary), qualitative patient interviews were conducted from 2009 to 2010 to identify relevant symptoms and degree of bother due to symptoms. The eDiary was completed by a subset of 209 patients with moderate-to-severe COPD in the 26-week QVA149 SHINE study. Two morning assessments (since awakening and since the last assessment) and one evening assessment were made each day. Assessments covered five symptoms ("shortness of breath," "phlegm/mucus," "chest tightness," "wheezing," and "coughing") and two impact items ("bothered by COPD" and "difficulty with activities") and were scored on a 10-point numeric scale. Patient compliance with the eDiary was 90.4% at baseline and 81.3% at week 26. Correlations between shortness of breath and impact items were >0.95. Regression analysis showed that shortness of breath was a highly significant (P<0.0001) predictor of impact items. Exploratory factor analysis gave a single factor comprising all eDiary items, including both symptoms and impact items. Shortness of breath, the total score (including five symptoms and two impact items), and the five-item symptom score from the eDiary performed well, with good consistency and reliability. The eDiary showed good sensitivity to change, with a 0.6 points reduction in the symptoms scores (on a 0-10 point scale) representing a meaningful change. The eDiary was found to be valid, reliable, and responsive. The high correlations obtained between "shortness of breath" and the ratings of "bother" and "difficulty with activities" confirmed the relevance of this symptom in patients with COPD. Future studies will be required to explore further psychometric properties and their ability to differentiate between COPD treatments.

Sleep-disordered breathing: a survey of otolaryngologic practice at military hospitals.

PubMed

Davidson, T M; Do, K L

2000-11-01

We conducted a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States to ascertain the nature and scope of their treatment of sleep-disordered breathing. Questionnaire responses indicated that head and neck surgeons in military hospitals have a strong interest in the management of patients with snoring and sleep apnea. Because of the difficulty in obtaining timely sleep test results and the low number of referrals from physicians who perform such testing, many otolaryngologists expressed a desire to be able to perform their own sleep testing.

Dragon Operations: Hostage Rescues in the Congo, 1964-1965 (Leavenworth Papers, Number 14)

DTIC Science & Technology

1988-01-01

lying in the street. 28 The corpse of Dr. Carlson 103 Off-loading medical supplies and food at Stanley.ville The paras’ assembly of the survivors was...attempted to care for the refugees- providing food , water, and shelter from rebel fire-Strobaugh and the · Belgians worked feverishly to get them safely...Georges Ledant, Colonel e.r. Belgian Army, interviews with the author, Ville Franche , France, 9 January 1986: Vandewalle interviews; and Janssens

Selumetinib Shrinks Tumors in Children with NF1

Cancer.gov

The investigational drug selumetinib shrank tumors in some children with a genetic syndrome called neurofibromatosis type 1 (NF1). As this Cancer Currents post explains, the drug also improved symptoms related to tumors known as neurofibromas, which can cause pain, difficulty breathing or walking, and disfigurement.

Heart Rates of Elite Synchronized Swimmers.

ERIC Educational Resources Information Center

Gemma, Karen Erickson; Wells, Christine L.

1987-01-01

Heart rates were recorded by radiotelemetry in ten elite and national-class synchronized swimmers as they performed competitive figures of high degrees of difficulty. The focus was on changes in heart rates and electrocardiogram patterns for each body position, especially those requiring facial immersion and breath-holding. (Author/MT)

Causes and differentials of childhood mortality in Iraq

PubMed Central

Awqati, Naira A; Ali, Mohamed M; Al-Ward, Nada J; Majeed, Faiza A; Salman, Khawla; Al-Alak, Mahdi; Al-Gasseer, Naeema

2009-01-01

Background Limited information is available in Iraq regarding the causes of under-five mortality. The vital registration system is deficient in its coverage, particularly from rural areas where access to health services is limited and most deaths occur at home, i.e. outside the health system, and hence the cause of death goes unreported. Knowledge of patterns and trends in causes of under-five mortality is essential for decision-makers in assessing programmatic needs, prioritizing interventions, and monitoring progress. The aim of this study was to identify causes of under-five children deaths using a simplified verbal autopsy questionnaire. The objective was to define the leading symptoms and cause of death among Iraqi children from all regions of Iraq during 1994–1999. Methods To determine the cause structure of child deaths, a simplified verbal autopsy questionnaire was used in interviews conducted in the Iraqi Child & Maternal Mortality Survey (ICMMS) 1999 national sample. All the mothers/caregivers of the deceased children were asked open-ended questions about the symptoms within the two weeks preceding death; they could mention more than one symptom. Results The leading cause of death among under-five children was found to be childhood illnesses in 81.2%, followed by sudden death in 8.9% and accidents in 3.3%. Among under-five children dying of illnesses, cough and difficulty in breathing were the main symptoms preceding death in 34.0%, followed by diarrhea in 24.4%. Among neonates the leading cause was cough/and or difficulty in breathing in 42.3%, followed by sudden death in 11.9%, congenital abnormalities in 10.3% and prematurity in 10.2%. Diarrhea was the leading cause of death among infants in 49.8%, followed by cough and/or difficulty in breathing in 26.6%. Among children 12–59 months diarrhea was the leading cause of death in 43.4%, followed by accidents, injuries, and poisoning in 19.3%, then cough/difficulty in breathing in 14.8%. Conclusion In Iraq Under-five child mortality is one of the highest in the Middle East region; deaths during the neonatal period accounted for more than half of under-five children deaths highlighting an urgent need to introduce health interventions to improve essential neonatal care. Priority needs to be given to the prevention, early and effective treatment of neonatal conditions, diarrheal diseases, acute respiratory infections, and accidents. This study points to the need for further standardized assessments of under-5 mortality in Iraq. PMID:19545410

Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

PubMed

Arden-Close, Emily; Yardley, Lucy; Kirby, Sarah; Thomas, Mike; Bruton, Anne

2017-10-05

Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. PATIENTS RECEPTIVE TO BREATHING RETRAINING: Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.

Genetics Home Reference: hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis

MedlinePlus

... which scar tissue forms in the lungs . Pulmonary fibrosis eventually causes difficulty breathing and can be life-threatening within ... Keavney B, Bézieau S, Mayosi BM. Mutations in FAM111B cause hereditary fibrosing ... myopathy, and pulmonary fibrosis. Am J Hum Genet. 2013 Dec 5;93( ...

Fluoroscopic evaluation of diaphragmatic motion reduction with a respiratory gated radiotherapy system.

PubMed

Mageras, G S; Yorke, E; Rosenzweig, K; Braban, L; Keatley, E; Ford, E; Leibel, S A; Ling, C C

2001-01-01

We report on initial patient studies to evaluate the performance of a commercial respiratory gating radiotherapy system. The system uses a breathing monitor, consisting of a video camera and passive infrared reflective markers placed on the patient's thorax, to synchronize radiation from a linear accelerator with the patient's breathing cycle. Six patients receiving treatment for lung cancer participated in a study of system characteristics during treatment simulation with fluoroscopy. Breathing synchronized fluoroscopy was performed initially without instruction, followed by fluoroscopy with recorded verbal instruction (i.e., when to inhale and exhale) with the tempo matched to the patient's normal breathing period. Patients tended to inhale more consistently when given instruction, as assessed by an external marker movement. This resulted in smaller variation in expiration and inspiration marker positions relative to total excursion, thereby permitting more precise gating tolerances at those parts of the breathing cycle. Breathing instruction also reduced the fraction of session times having irregular breathing as measured by the system software, thereby potentially increasing the accelerator duty factor and decreasing treatment times. Fluoroscopy studies showed external monitor movement to correlate well with that of the diaphragm in four patients, whereas time delays of up to 0.7 s in diaphragm movement were observed in two patients with impaired lung function. From fluoroscopic observations, average patient diaphragm excursion was reduced from 1.4 cm (range 0.7-2.1 cm) without gating and without breathing instruction, to 0.3 cm (range 0.2-0.5 cm) with instruction and with gating tolerances set for treatment at expiration for 25% of the breathing cycle. Patients expressed no difficulty with following instruction for the duration of a session. We conclude that the external monitor accurately predicts internal respiratory motion in most cases; however, it may be important to check with fluoroscopy for possible time delays in patients with impaired lung function. Furthermore, we observe that verbal instruction can improve breathing regularity, thus improving the performance of gated treatments with this system.

Protective Clothing as a Factor in the Dust Hazard of Potters

PubMed Central

Bloor, W. A.; Dinsdale, A.

1962-01-01

Investigations into the factors affecting dust concentrations in the breathing zone of pottery operatives have shown that cotton overalls constitute a serious source of dust. Attempts to overcome this difficulty by treatment of the material were not successful, so other types of materials were investigated. Terylene was found to have outstandingly desirable properties; types of “terylene” material and designs of clothing were defined. Factory tests showed that with this new protective clothing reductions of up to 65% in breathing zone dust concentrations were achieved. This type of clothing is now being officially recommended by the Joint Standing Committee for the Pottery Industry. Images PMID:13971816

14 CFR 382.23 - May carriers require a passenger with a disability to provide a medical certificate?

Code of Federal Regulations, 2012 CFR

2012-01-01

... flight. (2) For purposes of this paragraph, a medical certificate is a written statement from the... of this paragraph, a medical certificate is a written statement from the passenger's physician saying... (e.g., the passenger has apparent significant difficulty in breathing, appears to be in substantial...

14 CFR 382.23 - May carriers require a passenger with a disability to provide a medical certificate?

Code of Federal Regulations, 2014 CFR

2014-01-01

... flight. (2) For purposes of this paragraph, a medical certificate is a written statement from the... of this paragraph, a medical certificate is a written statement from the passenger's physician saying... (e.g., the passenger has apparent significant difficulty in breathing, appears to be in substantial...

14 CFR 382.23 - May carriers require a passenger with a disability to provide a medical certificate?

Code of Federal Regulations, 2013 CFR

2013-01-01

... flight. (2) For purposes of this paragraph, a medical certificate is a written statement from the... of this paragraph, a medical certificate is a written statement from the passenger's physician saying... (e.g., the passenger has apparent significant difficulty in breathing, appears to be in substantial...

78 FR 11210 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

..., which is the inability of the body to adequately process carbohydrates (sugars and starches) into energy... include difficulty breathing at birth, hypoglycemia (low blood sugar), and jaundice. Up to one-half of the..., which involves drinking a sweetened liquid containing 50 grams of sugar (glucose). A blood sample is...

Computer Series, 52: Scientific Exploration with a Microcomputer: Simulations for Nonscientists.

ERIC Educational Resources Information Center

Whisnant, David M.

1984-01-01

Describes two simulations, written for Apple II microcomputers, focusing on scientific methodology. The first is based on the tendency of colloidal iron in high concentrations to stick to fish gills and cause breathing difficulties. The second, modeled after the dioxin controversy, examines a hypothetical chemical thought to cause cancer. (JN)

Is passive smoking associated with sleep disturbance among pregnant women?

PubMed

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-09-01

Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. N/A. Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Passive smoking is independently associated with increased sleep disturbance during pregnancy.

Psychophysiological Responses to Repeated-Sprint Training in Normobaric Hypoxia and Normoxia.

PubMed

Brocherie, Franck; Millet, Grégoire P; Girard, Olivier

2017-01-01

To compare psychophysiological responses to 6 repeated-sprint sessions in normobaric hypoxia (RSH) and normoxia (RSN) in team-sport athletes during a 2-wk "live high-train low" training camp. While residing under normobaric hypoxia (≥14 h/d, FiO 2 14.5-14.2%), 23 lowland elite field hockey players performed, in addition to their usual training, 6 sessions (4 × 5 × 5-s maximal sprints, 25-s passive recovery, 5 min rest) under either RSH (FiO 2 ~14.5%) or RSN (FiO 2 21%). Sprint 1 and 5 times, physiological strain (heart rate [HR], arterial oxyhemoglobin saturation [SpO 2 ]), and perceptual responses (overall peripheral discomfort, difficulty breathing, and lower-limb discomfort) were monitored. During the 1st session, HR increased across sets (P < .001) independently of the conditions, while SpO 2 was globally lower (P < .001) for RSH (averaged value: 91.9% ± 1.2%) vs RSN (96.9% ± 0.6%). Thereafter, SpO 2 and HR remained similar across sessions for each condition. While 1st-sprint time remained similar, last-sprint time and fatigue index significantly decreased across sets (P < .01) and sessions (P < .05) but not between conditions. Ratings of overall perceived discomfort, difficulty breathing, and lower-limb discomfort were higher (P < .05) in RSH vs RSN at the 1st session. During subsequent sessions, values for overall perceived discomfort (time [P < .001] and condition [P < .05] effects), difficulty breathing (time effect; P < .001), and lower-limb discomfort (condition [P < .001] and interaction [P < .05] effects) decreased to a larger extent in RSH vs RSN. Despite higher hypoxia-induced physiological and perceptual strain during the 1st session, perceptual responses improved thereafter in RSH so as not to differ from RSN. This indicates an effective acclimation and tolerance to this innovative training.

Surgical treatment is effective in severe cases of exercise-induced laryngeal obstruction: A follow-up study.

PubMed

Norlander, Katarina; Johansson, Henrik; Jansson, Christer; Nordvall, Lennart; Nordang, Leif

2015-01-01

Surgery is an effective treatment in severe cases of supraglottic exercise-induced laryngeal obstruction (E-ILO). Conservatively treated subjects and subjects tested negative for E-ILO, who still experience breathing problems 1-3 years after diagnosis, tend to adjust their physical activity to a greater extent than surgically treated subjects. To investigate how symptoms and level of physical activity change over time in patients with E-ILO who have undergone surgery, patients with E-ILO treated conservatively and patients who tested negative for laryngeal obstruction at continuous laryngoscopy exercise-test (CLE-test). Patients referred for exercise-induced breathing difficulties answered questionnaires at diagnostic CLE-test and at follow-up. Questions regarded exercise-induced breathing problems, current physical activity level, and medical history of asthma and perennial allergy. Out of 84 invited subjects, 59 (70%) answered both questionnaires. Surgically treated subjects had less breathing problems at follow-up compared with conservatively treated subjects and subjects who tested negative (p < 0.001). None of the surgically treated subjects were less physically active or had changed sport due to exercise-induced dyspnoea, whereas 41.7% of the conservatively treated subjects had made such adjustments (p < 0.001).

View of Mission Control Center during the Apollo 13 emergency return

NASA Image and Video Library

1970-04-16

S70-35368 (16 April 1970) --- Overall view showing some of the feverish activity in the Mission Operations Control Room (MOCR) of the Mission Control Center (MCC) during the final 24 hours of the problem-plagued Apollo 13 mission. Here, flight controllers and several NASA/MSC officials confer at the flight director's console. When this picture was made, the Apollo 13 lunar landing had already been canceled, and the Apollo 13 crewmembers were in trans-Earth trajectory attempting to bring their crippled spacecraft back home.

Surgical correction of the snout suffocation syndrome.

PubMed

Keipper, V L; Chikes, P G

1990-04-01

Two nursing home patients with difficulty breathing because of occlusion of the mouth and nares by an involuntary snout reflex-like mannerism have previously been described. In both cases advanced dementia, edentia, and a downward-angled nasal base were present. Life-threatening hypoxia occurred intermittently in one case, and after becoming severe, was corrected by the surgical procedure described.

[Midface alterations in childhood as pathogenesis of obstructive sleep apnea syndrome].

PubMed

Rangel Chávez, José de Jesús; Espinosa Martínez, Cynthia; Medina Serpa, Aldo Uzziel

The onset of nasal breathing sets a genetically determined impulse to aerate the face cavities or paranasal sinuses, which in turn initiate its growth creating the useful trafficable space for air during the development of the midface. Considering the evidence that the upper airway obstruction has a primary role in the pathogenesis of respiratory sleep disorders, any condition that causes a permanent difficulty to the nasal airflow during breathing will cause hypo-development of the required amplitude in this airway, reducing the growth stimulation of the sinus cavities and altering the development of the midface as a whole. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Socio-Cultural Matrix of Raising a Child with Food Allergies: Experiences of a Migrant Mother

ERIC Educational Resources Information Center

Sanagavarapu, Prathyusha

2004-01-01

Children with life-threatening food allergies are increasing in number in Australia. A variety of foods such as dairy milk, peanut and tree nuts, fish and egg can cause severe allergic reactions in some children. The foods that cause allergies could trigger severe breathing difficulties (anaphylaxis) for these children and, if not treated…

[Psychological care of patients with head and neck cancer].

PubMed

Moya, Mélanie

2015-09-01

Treatments for head and neck cancers are generally complex and debilitating. Surgery, often mutilating, profoundly affects the relationship between oneself and others and causes verbal communication, breathing and swallowing difficulties. The functional and aesthetic sequelae are a constant reminder to the patient of the disease and make them conscious of their appearance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Clinical evaluation of a miniaturized desktop breath hydrogen analyzer.

PubMed

Duan, L P; Braden, B; Clement, T; Caspary, W F; Lembcke, B

1994-10-01

A small desktop electrochemical H2 analyzer (EC-60-Hydrogen monitor) was compared with a stationary electrochemical H2 monitor (GMI-exhaled Hydrogen monitor). The EC-60-H2 monitor shows a high degree of precision for repetitive (n = 10) measurements of standard hydrogen mixtures (CV 1-8%). The response time for completion of measurement is shorter than that of the GMI-exhaled H2 monitor (37 sec. vs 53 sec.; p < 0.0001), while reset times are almost identical (54 sec. vs 51 sec. n.s). In a clinical setting, breath H2-concentrations measured with the EC-60-H2 monitor and the GMI-exhaled H2 monitor were in excellent agreement with a linear correlation (Y = 1.12X + 1.022, r2 = 0.9617, n = 115). With increasing H2-concentrations the EC-60-H2 monitor required larger sample volumes for maintaining sufficient precision, and sample volumes greater than 200 ml were required with H2-concentrations > 30 ppm. For routine gastrointestinal function testing, the EC-60-H2 monitor is an satisfactory and reliable, easy to use and inexpensive desktop breath hydrogen analyzer, whereas in patients with difficulty in cooperating (children, people with severe pulmonary insufficiency), special care has to be applied to obtain sufficiently large breath samples.

Pilot Study on the Impact of Biogas as a Fuel Source on Respiratory Health of Women on Rural Kenyan Smallholder Dairy Farms

PubMed Central

Dohoo, Carolyn; Guernsey, Judith Read; Critchley, Kimberley; VanLeeuwen, John

2012-01-01

Biomass burning in indoor environments has been highlighted as a major cause of respiratory morbidity for women and children in low-income countries. Inexpensive technological innovations which reduce such exposures are needed. This study evaluated the impact of low tech compost digesters, which generate biogas for cooking, versus traditional fuel sources on the respiratory health of nonsmoking Kenyan farmwomen. Women from 31 farms with biogas digesters were compared to age-matched women from 31 biomass-reliant farms, in June 2010. Only 43% of the biogas group reported any breathing problems, compared to 71% in the referent group (P = 0.03). Referent women self-reported higher rates of shortness of breath (52% versus 30%), difficulty breathing (42% versus 23%), and chest pain while breathing (35% versus 17%) during the last 6 months (P = 0.09 to 0.12) compared to biogas women. Biogas women demonstrated slightly better spirometry results but differences were not statistically significant, likely due to limited latency between biogas digester installation and spirometry testing. Most biogas women reported improved personal respiratory health (87%) and improved children's health (72%) since biogas digester installation. These findings suggest that using biogas in cookhouses improves respiratory symptoms but long-term impacts on lung function are unclear. PMID:22969815

Active water management at the cathode of a planar air-breathing polymer electrolyte membrane fuel cell using an electroosmotic pump

NASA Astrophysics Data System (ADS)

Fabian, T.; O'Hayre, R.; Litster, S.; Prinz, F. B.; Santiago, J. G.

In a typical air-breathing fuel cell design, ambient air is supplied to the cathode by natural convection and dry hydrogen is supplied to a dead-ended anode. While this design is simple and attractive for portable low-power applications, the difficulty in implementing effective and robust water management presents disadvantages. In particular, excessive flooding of the open-cathode during long-term operation can lead to a dramatic reduction of fuel cell power. To overcome this limitation, we report here on a novel air-breathing fuel cell water management design based on a hydrophilic and electrically conductive wick in conjunction with an electroosmotic (EO) pump that actively pumps water out of the wick. Transient experiments demonstrate the ability of the EO-pump to "resuscitate" the fuel cell from catastrophic flooding events, while longer term galvanostatic measurements suggest that the design can completely eliminate cathode flooding using less than 2% of fuel cell power, and lead to stable operation with higher net power performance than a control design without EO-pump. This demonstrates that active EO-pump water management, which has previously only been demonstrated in forced-convection fuel cell systems, can also be applied effectively to miniaturized (<5 W) air-breathing fuel cell systems.

Disorders of Sleep and Ventilatory Control in Prader-Willi Syndrome

PubMed Central

Gillett, Emily S.; Perez, Iris A.

2016-01-01

Prader-Willi syndrome (PWS) is an imprinted genetic disorder conferred by loss of paternal gene expression from chromosome 15q11.2-q13. Individuals with PWS have impairments in ventilatory control and are predisposed toward sleep disordered breathing due to a combination of characteristic craniofacial features, obesity, hypotonia, and hypothalamic dysfunction. Children with PWS progress from failure to thrive during infancy to hyperphagia and morbid obesity during later childhood and onward. Similarly, the phenotype of sleep disordered breathing in PWS patients also evolves over time from predominantly central sleep apnea in infants to obstructive sleep apnea (OSA) in older children. Behavioral difficulties are common and may make establishing effective therapy with continuous positive airway pressure (CPAP) more challenging when OSA persists after adenotonsillectomy. Excessive daytime sleepiness (EDS) is also common in patients with PWS and may continue after OSA is effectively treated. We describe here the characteristic ventilatory control deficits, sleep disordered breathing, and excessive daytime sleepiness seen in individuals with PWS. We review respiratory issues that may contribute to sudden death events in PWS patients during sleep and wakefulness. We also discuss therapeutic options for treating sleep disordered breathing including adenotonsillectomy, weight loss, and CPAP. Lastly, we discuss the benefits and safety considerations related to growth hormone therapy. PMID:28933403

Disorders of Sleep and Ventilatory Control in Prader-Willi Syndrome.

PubMed

Gillett, Emily S; Perez, Iris A

2016-07-08

Prader-Willi syndrome (PWS) is an imprinted genetic disorder conferred by loss of paternal gene expression from chromosome 15q11.2-q13. Individuals with PWS have impairments in ventilatory control and are predisposed toward sleep disordered breathing due to a combination of characteristic craniofacial features, obesity, hypotonia, and hypothalamic dysfunction. Children with PWS progress from failure to thrive during infancy to hyperphagia and morbid obesity during later childhood and onward. Similarly, the phenotype of sleep disordered breathing in PWS patients also evolves over time from predominantly central sleep apnea in infants to obstructive sleep apnea (OSA) in older children. Behavioral difficulties are common and may make establishing effective therapy with continuous positive airway pressure (CPAP) more challenging when OSA persists after adenotonsillectomy. Excessive daytime sleepiness (EDS) is also common in patients with PWS and may continue after OSA is effectively treated. We describe here the characteristic ventilatory control deficits, sleep disordered breathing, and excessive daytime sleepiness seen in individuals with PWS. We review respiratory issues that may contribute to sudden death events in PWS patients during sleep and wakefulness. We also discuss therapeutic options for treating sleep disordered breathing including adenotonsillectomy, weight loss, and CPAP. Lastly, we discuss the benefits and safety considerations related to growth hormone therapy.

Using Wavelet Entropy to Demonstrate how Mindfulness Practice Increases Coordination between Irregular Cerebral and Cardiac Activities.

PubMed

Sik, Hin Hung; Gao, Junling; Fan, Jicong; Wu, Bonnie Wai Yan; Leung, Hang Kin; Hung, Yeung Sam

2017-05-10

In both the East and West, traditional teachings say that the mind and heart are somehow closely correlated, especially during spiritual practice. One difficulty in proving this objectively is that the natures of brain and heart activities are quite different. In this paper, we propose a methodology that uses wavelet entropy to measure the chaotic levels of both electroencephalogram (EEG) and electrocardiogram (ECG) data and show how this may be used to explore the potential coordination between the mind and heart under different experimental conditions. Furthermore, Statistical Parametric Mapping (SPM) was used to identify the brain regions in which the EEG wavelet entropy was the most affected by the experimental conditions. As an illustration, the EEG and ECG were recorded under two different conditions (normal rest and mindful breathing) at the beginning of an 8-week standard Mindfulness-based Stress Reduction (MBSR) training course (pretest) and after the course (posttest). Using the proposed method, the results consistently showed that the wavelet entropy of the brain EEG decreased during the MBSR mindful breathing state as compared to that during the closed-eye resting state. Similarly, a lower wavelet entropy of heartrate was found during MBSR mindful breathing. However, no difference in wavelet entropy during MBSR mindful breathing was found between the pretest and posttest. No correlation was observed between the entropy of brain waves and the entropy of heartrate during normal rest in all participants, whereas a significant correlation was observed during MBSR mindful breathing. Additionally, the most well-correlated brain regions were located in the central areas of the brain. This study provides a methodology for the establishment of evidence that mindfulness practice (i.e., mindful breathing) may increase the coordination between mind and heart activities.

Using Wavelet Entropy to Demonstrate how Mindfulness Practice Increases Coordination between Irregular Cerebral and Cardiac Activities

PubMed Central

Sik, Hin Hung; Gao, Junling; Fan, Jicong; Wu, Bonnie Wai Yan; Leung, Hang Kin; Hung, Yeung Sam

2017-01-01

In both the East and West, traditional teachings say that the mind and heart are somehow closely correlated, especially during spiritual practice. One difficulty in proving this objectively is that the natures of brain and heart activities are quite different. In this paper, we propose a methodology that uses wavelet entropy to measure the chaotic levels of both electroencephalogram (EEG) and electrocardiogram (ECG) data and show how this may be used to explore the potential coordination between the mind and heart under different experimental conditions. Furthermore, Statistical Parametric Mapping (SPM) was used to identify the brain regions in which the EEG wavelet entropy was the most affected by the experimental conditions. As an illustration, the EEG and ECG were recorded under two different conditions (normal rest and mindful breathing) at the beginning of an 8-week standard Mindfulness-based Stress Reduction (MBSR) training course (pretest) and after the course (posttest). Using the proposed method, the results consistently showed that the wavelet entropy of the brain EEG decreased during the MBSR mindful breathing state as compared to that during the closed-eye resting state. Similarly, a lower wavelet entropy of heartrate was found during MBSR mindful breathing. However, no difference in wavelet entropy during MBSR mindful breathing was found between the pretest and posttest. No correlation was observed between the entropy of brain waves and the entropy of heartrate during normal rest in all participants, whereas a significant correlation was observed during MBSR mindful breathing. Additionally, the most well-correlated brain regions were located in the central areas of the brain. This study provides a methodology for the establishment of evidence that mindfulness practice (i.e., mindful breathing) may increase the coordination between mind and heart activities. PMID:28518101

Atmospheric Light Detection and Ranging (LiDAR) Coupled With Point Measurement Air Quality Samplers to Measure Fine Particulate Matter (PM) Emissions From Agricultural Operations: The Los Banos CA Fall 2007 Tillage Campaign.

EPA Science Inventory

Airborne particles, especially fine particulate matter 2.5 micrometers (μm) or less in aerodynamic diameter (PM2.5), are microscopic solids or liquid droplets that can cause serious health problems, including increased respiratory symptoms such as coughing or difficulty breathing...

Adult onset Still's disease accompanied by acute respiratory distress syndrome: A case report.

PubMed

Xi, Xiao-Tu; Wang, Mao-Jie; Huang, Run-Yue; Ding, Bang-Han

2016-09-01

Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by rash, leukocytosis, fever and arthralgia/arthritis. The most common pulmonary manifestations associated with AOSD are pulmonary infiltrates and pleural effusion. The present study describes a 40-year-old male with AOSD who developed fever, sore throat and shortness of breath. Difficulty breathing promptly developed, and the patient was diagnosed with acute respiratory distress syndrome (ARDS). The patient did not respond to antibiotics, including imipenem, vancomycin, fluconazole, moxifloxacin, penicillin, doxycycline and meropenem, but was sensitive to glucocorticoid treatment, including methylprednisolone sodium succinate. ARDS accompanied by AOSD has been rarely reported in the literature. In conclusion, in a patient with ARDS who does not respond to antibiotic treatment, the involvement of AOSD should be considered.

Ammonia as a respiratory gas in water and air-breathing fishes.

PubMed

Randall, David J; Ip, Yuen K

2006-11-01

Ammonia is produced in the liver and excreted as NH(3) by diffusion across the gills. Elevated ammonia results in an increase in gill ventilation, perhaps via stimulation of gill oxygen chemo-receptors. Acidification of the water around the fish by carbon dioxide and acid excretion enhances ammonia excretion and constitutes "environmental ammonia detoxification". Fish have difficulties in excreting ammonia in alkaline water or high concentrations of environmental ammonia, or when out of water. The mudskipper, Periphthalmodon schlosseri, is capable of active NH(4)(+) transport, maintaining low internal levels of ammonia. To prevent a back flux of NH(3), these air-breathing fish can increase gill acid excretion and reduce the membrane NH(3) permeability by modifying the phospholipid and cholesterol compositions of their skin. Several air-breathing fish species can excrete ammonia into air through NH(3) volatilization. Some fish detoxify ammonia to glutamine or urea. The brains of some fish can tolerate much higher levels of ammonia than other animals. Studies of these fish may offer insights into the nature of ammonia toxicity in general.

Middle-aged and mobility-limited: prevalence of disability and symptom attributions in a national survey.

PubMed

Gardener, Elizabeth A; Huppert, Felicia A; Guralnik, Jack M; Melzer, David

2006-10-01

Lower limb mobility disabilities are well understood in older people, but the causes in middle age have attracted little attention. To estimate the prevalence of mobility disabilities among noninstitutionalized adults in England and to compare the disabling symptoms reported by middle-aged and older people. Cross-sectional data from the 2002 English Longitudinal Study of Ageing (ELSA). Mobility disability was identified by level of reported difficulty walking a quarter mile. Eleven thousand two hundred sixteen respondents aged 50 years and older living in private households in 2002. The prevalence of difficulty walking a quarter mile increases sharply with age, but even in the middle-aged (50 to 64 years age-group) 18% (95% confidence interval [CI]: 16% to 19%) of men and 19% (95% CI: 17% to 20%) of women reported some degree of difficulty. Of the 16 main symptoms reported as causing mobility disability in middle age, 2 dominated: pain in the leg or the foot (43%; 95% CI: 40% to 46%) and shortness of breath/dyspnea (21%; 95% CI: 18% to 23%). Fatigue or tiredness, and stability problems were cited by only 5% and 6%, respectively. These proportions were slightly different from those in the 65 to 79-year age group: 40%, 23%, 6%, and 8%, respectively. Mobility (walking) disabilities in the middle-aged are relatively common. The symptoms reported as causes in this age group differ little from those reported by older groups, and are dominated by lower limb pain and shortness of breath. More clinical attention paid to disabling symptoms may lead to disability reductions in later life.

Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep.

PubMed

Calhoun, Susan L; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Mayes, Susan D; Tsaoussoglou, Marina; Basta, Maria; Bixler, Edward O

2011-04-01

We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e.g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent. Cross-sectional Population -based. 508 school-aged children from the general population. N/A. Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS. It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.

Sickness behavior in feverish children is independent of the severity of fever. An observational, multicenter study.

PubMed

Corrard, François; Copin, Christian; Wollner, Alain; Elbez, Annie; Derkx, Véronique; Bechet, Stéphane; Levy, Corinne; Boucherat, Michel; Cohen, Robert

2017-01-01

Behavioral changes in a febrile child are usually considered to stem from the fever. We studied sickness behavior (SB) in terms of its clinical components and its relation to fever. This observational, multicenter study included children aged 6 months to 3 years who were either febrile (fever ≥12 hours, ≥ 39°C and ≥38°C at inclusion) or non-febrile and well. The child had to have been awake for the 2 hours preceding the consultation and cared for by the parent who brought him/her to the doctor. SB was evaluated according to 6 parameters over this 2-hour period: time spent playing, distance covered, time spent seeking comfort, time spent whining or crying, time spent in a state of irritation or of anger, most distorted facial expression. Two parameters were assessed for the 24-hour period preceding the consultation: time spent sleeping and appetite. The parent reported the degree of change in these parameters compared with the usual situation, using rating scales. 200 febrile children (most with nonspecific upper respiratory infections) and 200 non-febrile children were included. The mean values of the 8 parameters differed significantly (p<0.001) between the 2 groups and were independent of the height of fever at inclusion in the febrile children. In the study conditions, paracetamol failed to improve SB when the child was still feverish. The 8 parameters suggested that SB and fever are two independent manifestations that are activated simultaneously during an infection. This independence is in harmony with recommendations to treat the discomfort of SB and not the fever.

Assessing the appropriateness of information on childhood fever in thermometer package leaflets: a systematic audit of thermometers available in the UK.

PubMed

Hernandez, Jose; Nicholson, Brian D; Thompson, Matthew

2015-06-01

Thermometers are found in most parents' homes, but little is known about the quality and accuracy of the information they provide, nor its consistency with current guidelines for managing fever. To compare information included with commonly available thermometers with National Institute for Health and Care Excellence (NICE) guidance for management of feverish illness in children. Systematic thermometer sampling from UK retailers between February 2013 and May 2013. Information was extracted from device packaging and leaflets on details and type of thermometer, instructions for use, normal ranges, and fever thresholds cited. This was compared with key parental recommendations from the 2013 NICE guidance on feverish illness in children. Associations were explored between cost of device and level of information. There were 123 thermometers identified (ranging from £0.99 to £69.99), none of which made explicit reference to NICE guidance. Most (n = 81, 65.9%) recommended use at a body site consistent with NICE guidance, but only 17 (13.8%) defined fever using the correct threshold (≥38.0°C), and few (n = 12, 9.8%) included advice on fever management, of which four suggested actions not advised by NICE. There was no association between thermometer cost and provision of information consistent with NICE guidance. Parents and caregivers have access to a large number of thermometers, yet they lack evidence-based information about fever detection and management, and in some cases contain misleading information. This represents a missed opportunity to disseminate best practices from guidelines for management of fever in children, and thermometer manufacturers are urged to include information consistent with current guidance. © British Journal of General Practice 2015.

Urinary cotinine and breath carbon monoxide levels among bar and restaurant employees in ankara.

PubMed

Caman, Ozge Karadag; Erguder, Berrin I; Ozcebe, Hilal; Bilir, Nazmi

2013-08-01

Hospitality sector employees constitute one of the key groups with respect to their secondhand tobacco smoke exposure at work. This study aimed to detect urinary cotinine and breath carbon monoxide (CO) levels among bar and restaurant employees in Ankara, as well as the employees' opinions on the new antitobacco law, changes in smoking behavior, and subjective health status before and after the law entered into force. This before-after study was conducted in 19 premises, with the participation of 65 employees before implementation and 81 employees 3 months after implementation of the new antitobacco law in the hospitality sector. Data in both phases were collected through face-to-face surveys, breath CO measurements, and urinary cotinine analysis. Descriptive statistics were used to summarize data, whereas chi-square test, paired and unpaired t tests, and analysis of variance were used to compare groups. Most of the restaurant and bar employees were male and below 35 years old. Before-after comparison showed that health complaints of the hospitality sector employees such as watering and itching in the eyes, difficulty in breathing, and cough (p < .001), as well as breath CO (p < .001) and urinary cotinine levels (p < .001) decreased significantly 3 months after implementation of the law. Among the smoking employees, mean number of cigarettes smoked was also found to decrease (p = .012). Majority of the employees (83.8%) were found to support the smoking ban in enclosed public places. Results of this study provide solid evidence on the positive health effects of smoke-free laws and employees' support for smoke-free workplaces.

American River Watershed Investigation, California. Volume 3. Appendix M

DTIC Science & Technology

1991-12-01

curing of the concrete and for general construction. The water used in concrete mixes must be free from injurious materials. Water from the American River...in achieving the desired bond strength between lifts. Water is needed for curing and to maintain freshness of lift joints. Lift surfaces should be kept...dizziness, throat pain, breathing difficulty and coughing . The health effects caused by combined concentrations of certain sulfur oxides and ozone

Respiratory difficulties and breathing disorders in achondroplasia.

PubMed

Afsharpaiman, S; Saburi, A; Waters, Karen A

2013-12-01

Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Multimedia based health information to parents in a pediatric acute ward: a randomized controlled trial.

PubMed

Botngård, Anja; Skranes, Lars P; Skranes, Jon; Døllner, Henrik

2013-12-01

To determine whether multimedia based health information presented to parents of children with breathing difficulties in a pediatric acute ward, is more effective than verbal information, to reduce parental anxiety and increase satisfaction. This randomized controlled trial was conducted in a pediatric acute ward in Norway, from January to March 2011. Parents were randomly assigned to a multimedia intervention (n=53), or verbal health information (n=48). Primary outcome measure was parental anxiety, and secondary outcome measures were parental satisfaction with nursing care and health information. Parental anxiety decreased from arrival to discharge within both groups. At discharge the anxiety levels in the intervention group were no lower than in the control group. There was no difference in satisfaction with nursing care between the groups, but parents in the intervention group reported higher satisfaction with the health information given in the acute ward (p=.005). Multimedia based health information did not reduce anxiety more than verbal information, among parents to children with breathing difficulties. However, after discharge the parents were more satisfied with the multimedia approach. More research is needed to recommend the use of multimedia based information as a routine to parents in pediatric emergency care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Adherence to Integrated Management of Childhood Illnesses Guideline in Treating South Sudanese Children with Cough or Difficulty in Breathing

PubMed Central

Anyigu, Stanley; Ndungutse, David

2017-01-01

Background Pneumonia substantially kills children aged 2–59 months in South Sudan. However, information on health workers adherence to Integrated Management of Childhood Illnesses (IMCI) guideline in treating children with cough/difficulty in breathing remains scarce. This study assessed factors associated with adherence to IMCI guideline in Aweil East County, South Sudan. Methods This cross-sectional study involved 232 health workers from 36 health facilities. Data collected using structured questionnaire and checklist was double-entered in EpiData and analyzed with STATA at 5% significance level using logistic regression. Results Respondents mean age was 32.41 ± 7.0 years, 154 (66.4%) were males, 104 (44.8%) reached secondary education, and 190 (81.9%) had certificate. 23 (9.9%, 95% CI: 6.4–14.5) adhered to IMCI guideline. Holding diploma (adjusted odds ratio (AOR) = 6.97; 95% Confidence Interval (CI): 1.82–26.67; P = 0.005), shorter time to follow guideline steps (AOR = 12.0; 95% CI: 2.73–61.66; P < 0.001), and nondifficult use (AOR = 27.7; 95% CI: 5.40–142.25; P < 0.001) were associated with adherence. Conclusion Adherence was low. Academic qualifications, guideline complexity, and availability of IMCI drugs were associated factors. PMID:29075300

Exploring the Waveform Characteristics of Tidal Breathing Carbon Dioxide, Measured Using the N-Tidal C Device in Different Breathing Conditions (The General Breathing Record Study): Protocol for an Observational, Longitudinal Study

PubMed Central

Rupani, Hitasha; Kalra, Paul R; Adeniji, Kayode; Quint, Matthew; De Vos, Ruth; Begum, Selina; Mottershaw, Mark; Fogg, Carole; Jones, Thomas L; Lanning, Eleanor; Bassett, Paul; Chauhan, Anoop J

2018-01-01

Background In an increasingly comorbid population, there are significant challenges to diagnosing the cause of breathlessness, and once diagnosed, considerable difficulty in detecting deterioration early enough to provide effective intervention. The burden of the breathless patient on the health care economy is substantial, with asthma, chronic heart failure, and pneumonia affecting over 6 million people in the United Kingdom alone. Furthermore, these patients often have more than one contributory factor to their breathlessness symptoms, with conditions such as dysfunctional breathing pattern disorders—an under-recognized component. Current methods of diagnosing and monitoring breathless conditions can be extensive and difficult to perform. As a consequence, home monitoring is poorly complied with. In contrast, capnography (the measurement of tidal breath carbon dioxide) is performed during normal breathing. There is a need for a simple, easy-to-use, personal device that can aid in the diagnosis and monitoring of respiratory and cardiac causes of breathlessness. Objective The aim of this study was to explore the use of a new, handheld capnometer (called the N-Tidal C) in different conditions that cause breathlessness. We will study whether the tidal breath carbon dioxide (TBCO2) waveform, as measured by the N-Tidal C, has different characteristics in a range of respiratory and cardiac conditions. Methods We will perform a longitudinal, observational study of the TBCO2 waveform (capnogram) as measured by the N-Tidal C capnometer. Participants with a confirmed diagnosis of asthma, breathing pattern disorders, chronic heart failure, motor neurone disease, pneumonia, as well as volunteers with no history of lung disease will be asked to provide twice daily, 75-second TBCO2 collection via the N-Tidal C device for 6 months duration. The collated capnograms will be correlated with the underlying diagnosis and disease state (stable or exacerbation) to determine if there are different TBCO2 characteristics that can distinguish different respiratory and cardiac causes of breathlessness. Results This study’s recruitment is ongoing. It is anticipated that the results will be available in late 2018. Conclusions The General Breathing Record Study will provide an evaluation of the use of capnography as a diagnostic and home-monitoring tool for various diseases. Registered Report Identifier RR1-10.2196/9767 PMID:29798833

Insomnia and sleep apnea in midlife women: prevalence and consequences to health and functioning

PubMed Central

Kline, Christopher E.; Nowakowski, Sara

2015-01-01

Sleep disturbance is common during the menopausal transition, with numerous downstream consequences to health and functioning, including reduced quality of life, impaired mental health, and increased physical health morbidity. Insomnia affects approximately 50% of midlife women and is characterized by nocturnal symptoms of difficulties initiating or maintaining sleep (or both) and daytime symptoms that impair occupational, social, or other components of functioning. In addition, approximately 20% of midlife women develop sleep-disordered breathing during the menopausal transition. This commentary summarizes the prevalence, risk factors, and treatment options for each of these sleep disorders in midlife women, with specific focus on first-line treatments for insomnia (cognitive behavioral therapy for insomnia) and sleep-disordered breathing (continuous positive airway pressure) and unique considerations for treating sleep disorders in midlife women. Future directions are also discussed. PMID:26097736

Endotracheal intubation - A life saving procedure, still potential hazardous to upper airway: A case report.

PubMed

Afreen, Mahrukh; Ansari, Murtaza Ahsan

2015-12-01

Endotracheal intubation plays a key role in the management of upper airway obstruction in emergency situations. It is non-invasive and easily learned technique by medical professionals as compared to other more skilled, surgical procedures, e.g., tracheostomy and cricothyrotomies etc. But prolonged intubation may result in numerous complications, most notorious being tracheoesophageal fistula and narrowing of subglottic area. We report a profile of a patient who had been diagnosed as case of Guillian-Barre Syndrome, had difficulty in breathing due to paralysis of respiratory muscles. The patient was admitted in Medical Intensive Care Unit (MICU) for 40 days and was kept on artificial breathing through endotracheal intubation, which remained in place for 19 days. Later tracheostomy was performed. Patient ultimately developed severe subglottic stenosis and became dependent on tracheostomy tube.

YOCAS©® Yoga Reduces Self-reported Memory Difficulty in Cancer Survivors in a Nationwide Randomized Clinical Trial: Investigating Relationships Between Memory and Sleep.

PubMed

Janelsins, Michelle C; Peppone, Luke J; Heckler, Charles E; Kesler, Shelli R; Sprod, Lisa K; Atkins, James; Melnik, Marianne; Kamen, Charles; Giguere, Jeffrey; Messino, Michael J; Mohile, Supriya G; Mustian, Karen M

2016-09-01

Background Interventions are needed to alleviate memory difficulty in cancer survivors. We previously showed in a phase III randomized clinical trial that YOCAS©® yoga-a program that consists of breathing exercises, postures, and meditation-significantly improved sleep quality in cancer survivors. This study assessed the effects of YOCAS©® on memory and identified relationships between memory and sleep. Survivors were randomized to standard care (SC) or SC with YOCAS©® . 328 participants who provided data on the memory difficulty item of the MD Anderson Symptom Inventory are included. Sleep quality was measured using the Pittsburgh Sleep Quality Index. General linear modeling (GLM) determined the group effect of YOCAS©® on memory difficulty compared with SC. GLM also determined moderation of baseline memory difficulty on postintervention sleep and vice versa. Path modeling assessed the mediating effects of changes in memory difficulty on YOCAS©® changes in sleep and vice versa. YOCAS©® significantly reduced memory difficulty at postintervention compared with SC (mean change: yoga=-0.60; SC=-0.16; P<.05). Baseline memory difficulty did not moderate the effects of postintervention sleep quality in YOCAS©® compared with SC. Baseline sleep quality did moderate the effects of postintervention memory difficulty in YOCAS©® compared with SC (P<.05). Changes in sleep quality was a significant mediator of reduced memory difficulty in YOCAS©® compared with SC (P<.05); however, changes in memory difficulty did not significantly mediate improved sleep quality in YOCAS©® compared with SC. In this large nationwide trial, YOCAS©® yoga significantly reduced patient-reported memory difficulty in cancer survivors. © The Author(s) 2015.

Malignant anterior uveal melanoma with diffuse metastasis in a dog.

PubMed

Minami, T; Patnaik, A K

1992-12-15

Enucleation was performed in 10-year-old sexually intact female mixed-breed German Shepherd Dog. Histologic examination revealed that the dog had an uveal amelanotic melanoma of the eye. The tumor consisted of anaplastic cells with a high mitotic index, indicating malignancy. On examination 3 months after enucleation, the dog had difficulty breathing and nasal discharge. Radiography revealed pulmonary metastasis. The dog was euthanatized. Necropsy revealed diffuse metastasis involving various organs.

A pilot feasibility study of neurofeedback for children with autism.

PubMed

Steiner, Naomi J; Frenette, Elizabeth; Hynes, Caitlin; Pisarik, Elizabeth; Tomasetti, Kathryn; Perrin, Ellen C; Rene, Kirsten

2014-06-01

Neurofeedback (NFB) is an emerging treatment for children with autism spectrum disorder (ASD). This pilot study examined the feasibility of NFB for children with ASD. Ten children ages 7-12 with high functioning ASD and attention difficulties received a NFB attention training intervention. A standardized checklist captured feasibility, including focus during exercises and academic tasks, as well as off-task behaviors. Active behaviors and vocalizations were the most frequent off-task behaviors. Positive reinforcement and breaks including calm breathing exercises were the most common supports. Low motivation was associated with higher feasibility challenges, yet parental involvement and accommodations were helpful. This pilot study shows that it is feasible to conduct NFB sessions with children with high functioning autism and attention difficulties.

Performance of the 13C-urea breath test for the diagnosis of H. pylori infection using a substrate synthesized in Brazil: A preliminary study.

PubMed

Coelho, Luiz Gonzaga; Sant'Ana, Carlos Roberto; Oliveira, Ricardo Brandt de; Cezar, Raíra César E; Araujo, Aline Cordeiro Campos de; Silva, Raisa Cristina Teodoro da; Trindade, Osmar Reni; Coelho, Maria Clara; Ferrioli, Eduardo; Bendassolli, José Albertino

2018-06-07

The 13C-urea breath test is the main non-invasive test for the diagnosis of Helicobacter pylori infection. The availability of this test throughout the country is limited, mainly due to the difficulty in obtaining the labeled isotope from abroad. Recently, researchers from the Nuclear Energy Center in Agriculture at the University of São Paulo (CENA/USP) succeeded in synthesizing 13C-enriched urea for Helicobacter pylori diagnosis. The aim of the study was to compare the performance of the 13C-urea breath test using 13C-urea acquired abroad with that of a test using 13C-urea synthesized in Brazil. Sixty-four dyspeptic patients participated in the study (24 men and 40 women). Initially, the patients performed the 13C-urea breath test using the imported substrate (Euriso-Top, France). Seven to fourteen days later, all the patients repeated the test using the Brazilian substrate. The samples from both examinations were processed in an infrared isotope analyzer (IRIS, Wagner Analisen Technik, Germany), and all delta over baseline (DOB) [%] values above four were considered positive results. Twenty-seven patients (42%) exhibited negative results for Helicobacter pylori infection, and thirty-seven patients (58%) exhibited positive results when tested using the foreign substrate (gold standard). There was a 100% concordance regarding the presence or absence of infection when the gold standard results were compared with those obtained using the Brazilian substrate. Similar performance in the diagnosis of Helicobacter pylori infection was demonstrated when using the 13C-urea breath test with the Brazilian 13C-urea substrate and the test with the substrate produced abroad. This validation represents an important step toward increasing the availability of the 13C-urea breath test throughout the country, which will have a positive influence on the management of Helicobacter pylori infection.

Middle-Aged and Mobility-Limited: Prevalence of Disability and Symptom Attributions in a National Survey

PubMed Central

Gardener, Elizabeth A; Huppert, Felicia A; Guralnik, Jack M; Melzer, David

2006-01-01

BACKGROUND Lower limb mobility disabilities are well understood in older people, but the causes in middle age have attracted little attention. OBJECTIVES To estimate the prevalence of mobility disabilities among noninstitutionalized adults in England and to compare the disabling symptoms reported by middle-aged and older people. DESIGN Cross-sectional data from the 2002 English Longitudinal Study of Ageing (ELSA). Mobility disability was identified by level of reported difficulty walking a quarter mile. PARTICIPANTS Eleven thousand two hundred sixteen respondents aged 50 years and older living in private households in 2002. RESULTS The prevalence of difficulty walking a quarter mile increases sharply with age, but even in the middle-aged (50 to 64 years age-group) 18% (95% confidence interval [CI]: 16% to 19%) of men and 19% (95% CI: 17% to 20%) of women reported some degree of difficulty. Of the 16 main symptoms reported as causing mobility disability in middle age, 2 dominated: pain in the leg or the foot (43%; 95% CI: 40% to 46%) and shortness of breath/dyspnea (21%; 95% CI: 18% to 23%). Fatigue or tiredness, and stability problems were cited by only 5% and 6%, respectively. These proportions were slightly different from those in the 65 to 79-year age group: 40%, 23%, 6%, and 8%, respectively. CONCLUSIONS Mobility (walking) disabilities in the middle-aged are relatively common. The symptoms reported as causes in this age group differ little from those reported by older groups, and are dominated by lower limb pain and shortness of breath. More clinical attention paid to disabling symptoms may lead to disability reductions in later life. PMID:16970558

Biomass Cooking Fuels and Health Outcomes for Women in Malawi

PubMed Central

Das, Ipsita; Jagger, Pamela; Yeatts, Karin

2016-01-01

In sub-Saharan Africa, biomass fuels account for approximately 90% of household energy consumption. Limited evidence exists on the association between different biomass fuels and health outcomes. We report results from a cross-sectional sample of 655 households in Malawi. We calculated odds ratios between hypothesized determinants of household air pollution (HAP) exposure (fuel, stove type, and cooking location) and five categories of health outcomes (cardiopulmonary, respiratory, neurologic, eye health, and burns). Reliance on high- or low-quality firewood or crop residue (vs. charcoal) was associated with significantly higher odds of shortness of breath, difficulty breathing, chest pains, night phlegm, forgetfulness, dizziness, and dry irritated eyes. Use of high-quality firewood was associated with significantly lower odds of persistent phlegm. Cooks in rural areas (vs. urban areas) had significantly higher odds of experiencing shortness of breath, persistent cough, and phlegm, but significantly lower odds of phlegm, forgetfulness, and burns. With deforestation and population pressures increasing reliance on low-quality biomass fuels, prevalence of HAP-related cardiopulmonary and neurologic symptoms will likely increase among cooks. Short- to medium-term strategies are needed to secure access to high-quality biomass fuels given limited potential for scalable transitions to modern energy. PMID:27800583

Biomass Cooking Fuels and Health Outcomes for Women in Malawi.

PubMed

Das, Ipsita; Jagger, Pamela; Yeatts, Karin

2017-03-01

In sub-Saharan Africa, biomass fuels account for approximately 90% of household energy consumption. Limited evidence exists on the association between different biomass fuels and health outcomes. We report results from a cross-sectional sample of 655 households in Malawi. We calculated odds ratios between hypothesized determinants of household air pollution (HAP) exposure (fuel, stove type, and cooking location) and five categories of health outcomes (cardiopulmonary, respiratory, neurologic, eye health, and burns). Reliance on high- or low-quality firewood or crop residue (vs. charcoal) was associated with significantly higher odds of shortness of breath, difficulty breathing, chest pains, night phlegm, forgetfulness, dizziness, and dry irritated eyes. Use of high-quality firewood was associated with significantly lower odds of persistent phlegm. Cooks in rural areas (vs. urban areas) had significantly higher odds of experiencing shortness of breath, persistent cough, and phlegm, but significantly lower odds of phlegm, forgetfulness, and burns. With deforestation and population pressures increasing reliance on low-quality biomass fuels, prevalence of HAP-related cardiopulmonary and neurologic symptoms will likely increase among cooks. Short- to medium-term strategies are needed to secure access to high-quality biomass fuels given limited potential for scalable transitions to modern energy.

A breath fungal secondary metabolite signature to diagnose invasive aspergillosis.

PubMed

Koo, Sophia; Thomas, Horatio R; Daniels, S David; Lynch, Robert C; Fortier, Sean M; Shea, Margaret M; Rearden, Preshious; Comolli, James C; Baden, Lindsey R; Marty, Francisco M

2014-12-15

Invasive aspergillosis (IA) remains a leading cause of mortality in immunocompromised patients, in part due to the difficulty of diagnosing this infection. Using thermal desorption-gas chromatography/mass spectrometry, we characterized the in vitro volatile metabolite profile of Aspergillus fumigatus, the most common cause of IA, and other pathogenic aspergilli. We prospectively collected breath samples from patients with suspected invasive fungal pneumonia from 2011 to 2013, and assessed whether we could discriminate patients with proven or probable IA from patients without aspergillosis, as determined by European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions, by direct detection of fungal volatile metabolites in these breath samples. The monoterpenes camphene, α- and β-pinene, and limonene, and the sesquiterpene compounds α- and β-trans-bergamotene were distinctive volatile metabolites of A. fumigatus in vitro, distinguishing it from other pathogenic aspergilli. Of 64 patients with suspected invasive fungal pneumonia based on host risk factors, clinical symptoms, and radiologic findings, 34 were diagnosed with IA, whereas 30 were ultimately diagnosed with other causes of pneumonia, including other invasive mycoses. Detection of α-trans-bergamotene, β-trans-bergamotene, a β-vatirenene-like sesquiterpene, or trans-geranylacetone identified IA patients with 94% sensitivity (95% confidence interval [CI], 81%-98%) and 93% specificity (95% CI, 79%-98%). In patients with suspected fungal pneumonia, an Aspergillus secondary metabolite signature in breath can identify individuals with IA. These results provide proof-of-concept that direct detection of exogenous fungal metabolites in breath can be used as a novel, noninvasive, pathogen-specific approach to identifying the precise microbial cause of pneumonia. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Influence of the breathing pattern on the learning process: a systematic review of literature.

PubMed

Ribeiro, Genef Caroline Andrade; Dos Santos, Isadora Diniz; Santos, Ana Claudia Nascimento; Paranhos, Luiz Renato; César, Carla Patrícia Hernandez Alves Ribeiro

2016-01-01

Mouth breathing leads to negative consequences on quality of life, especially in school-age children. To determine whether the breathing pattern influences children's learning process. This systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) instructions, with no restrictions regarding the year of publication and language, created based on the clinical question formulation according to the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) strategy: "Is the mouth-breathing child more likely to have learning disabilities when compared to nasal breathers?" in the SciELO, PubMed, LILACS, and Scopus electronic databases. Google Scholar was used to search the gray literature. The keywords "learning," "mouth breathing," and their equivalent terms in Portuguese were used in an integrated manner. The studies included in the review were observational, conducted with schoolchildren aged 7-11 years. Afterwards, the studies were evaluated regarding their methodological quality. The research was performed by two eligible reviewers. A total of 357 records were obtained, of which 43 records were duplicate. After applying the eligibility criteria, ten articles were included in the research scope. Half of the studies used a control group and otorhinolaryngological assessment, whereas a minority used validated (20%) and sample calculation protocols (10%). The evaluation procedures were varied. Overall, 80% of the articles showed a higher incidence of learning disabilities among mouth breathers. This systematic review has shown that mouth breathers are more likely to have learning difficulties than nasal breathers. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Breathe Easy at Home

PubMed Central

Rosofsky, Anna; Reid, Margaret; Sandel, Megan; Zielenbach, Molly; Murphy, Johnna; Scammell, Madeleine K.

2016-01-01

The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians (n = 10) who referred patients, and focus groups with inspectors from the ISD (n = 9) and a variety of stakeholders (n = 13), to gain insight into program function and implementation. Clinician interviews revealed inconsistencies in enrollment approaches, dissatisfaction with the web-based system, and patient follow-up difficulties. Inspectors identified barriers to working effectively with residents and landlords, and the stakeholder focus group highlighted successes of an unusual institutional collaboration. Interviews and focus groups identified strong and personal rapport between clinicians, inspectors, and patients as key to program retention, and that participating families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes. PMID:28462348

Development of a space activity suit

NASA Technical Reports Server (NTRS)

Annis, J. F.; Webb, P.

1971-01-01

The development of a series of prototype space activity suit (SAS) assemblies is discussed. The SAS is a new type of pressure suit designed especially for extravehicular activity. It consists of a set of carefully tailored elastic fabric garments which have been engineered to supply sufficient counterpressure to the body to permit subjects to breath O2 at pressures up to 200 mm Hg without circulatory difficulty. A closed, positive pressure breathing system (PPBS) and a full bubble helmet were also developed to complete the system. The ultimate goal of the SAS is to improve the range of activity and decrease the energy cost of work associated with wearing conventional gas filled pressure suits. Results are presented from both laboratory (1 atmosphere) and altitude chamber tests with subjects wearing various SAS assemblies. In laboratory tests lasting up to three hours, the SAS was worn while subjects breathed O2 at pressures up to 170 mm Hg without developing physiological problems. The only physiological symptoms apparent were a moderate tachycardia related to breathing pressures above 130 mm Hg, and a small collection of edema fluid in the hands. Both problems were considered to be related to areas of under-pressurization by the garments. These problems, it is suggested, can ultimately be corrected by the development of new elastic fabrics and tailoring techniques. Energy cost of activity, and mobility and dexterity of subjects in the SAS, were found to be superior to those in comparable tests on subjects in full pressure suits.

Sleep, chronic pain, and opioid risk for apnea.

PubMed

Marshansky, Serguei; Mayer, Pierre; Rizzo, Dorrie; Baltzan, Marc; Denis, Ronald; Lavigne, Gilles J

2017-07-19

Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain). Pain and sleep management strategies should be personalized to reflect the patient's history and ongoing complaints. Understanding the pain-sleep interaction requires assessments of: i) sleep quality, ii) potential contributions to fatigue, mood, and/or wake time functioning; iii) potential concomitant sleep-disordered breathing (SDB); and more importantly; iv) opioid use, as central apnea may occur in at-risk patients. Treatments include sleep hygiene advice, cognitive behavioral therapy, physical therapy, breathing devices (continuous positive airway pressure - CPAP, or oral appliance) and medications (sleep facilitators, e.g., zolpidem; or antidepressants, e.g., trazodone, duloxetine, or neuroleptics, e.g., pregabalin). In the presence of opioid-exacerbated SDB, if the dose cannot be reduced and normal breathing restored, servo-ventilation is a promising avenue that nevertheless requires close medical supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

Introduction of a compressed air breathing apparatus for the offshore oil and gas industry.

PubMed

Brooks, Chris J; MacDonald, Conor V; Carroll, Joel; Gibbs, Peter N G

2010-07-01

When a helicopter ditches the majority of crew and passengers have to make an underwater escape. Some may not be able to hold their breath and will drown. For at least 15 yr, military aircrew have been trained to use a scuba system. In the offshore oil and gas industry, there has been more caution about introducing a compressed air system and a rebreather system has been introduced as an alternative. Recently, Canadian industry and authorities approved the introduction of Helicopter Underwater Emergency Breathing Apparatus (HUEBA) training using compressed air. This communication reports the training of the first 1000 personnel. Training was introduced in both Nova Scotia and Newfoundland concurrently by the same group of instructors. Trainees filled out a questionnaire concerning their perceived ratings of the ease or difficulty of classroom training and the practical use of the HUEBA. Ninety-eight percent of trainees found the classroom and in-water training to be "good/very good". Trainees found it to be "easy/very easy" to clear the HUEBA and breathe underwater in 84% and 64% of cases, respectively. Divers reported a greater ease in learning all the practical uses of the HUEBA except application of the nose clip. There were problems with the nose clip fitting incorrectly, and interference of the survival suit hood with the regulator, which subsequently have been resolved. When carefully applied, the introduction of the HUEBA into training for offshore oil and gas industry helicopter crew and passengers can be safely conducted.

Exploring the Waveform Characteristics of Tidal Breathing Carbon Dioxide, Measured Using the N-Tidal C Device in Different Breathing Conditions (The General Breathing Record Study): Protocol for an Observational, Longitudinal Study.

PubMed

Neville, Daniel M; Rupani, Hitasha; Kalra, Paul R; Adeniji, Kayode; Quint, Matthew; De Vos, Ruth; Begum, Selina; Mottershaw, Mark; Fogg, Carole; Jones, Thomas L; Lanning, Eleanor; Bassett, Paul; Chauhan, Anoop J

2018-05-24

In an increasingly comorbid population, there are significant challenges to diagnosing the cause of breathlessness, and once diagnosed, considerable difficulty in detecting deterioration early enough to provide effective intervention. The burden of the breathless patient on the health care economy is substantial, with asthma, chronic heart failure, and pneumonia affecting over 6 million people in the United Kingdom alone. Furthermore, these patients often have more than one contributory factor to their breathlessness symptoms, with conditions such as dysfunctional breathing pattern disorders-an under-recognized component. Current methods of diagnosing and monitoring breathless conditions can be extensive and difficult to perform. As a consequence, home monitoring is poorly complied with. In contrast, capnography (the measurement of tidal breath carbon dioxide) is performed during normal breathing. There is a need for a simple, easy-to-use, personal device that can aid in the diagnosis and monitoring of respiratory and cardiac causes of breathlessness. The aim of this study was to explore the use of a new, handheld capnometer (called the N-Tidal C) in different conditions that cause breathlessness. We will study whether the tidal breath carbon dioxide (TBCO 2 ) waveform, as measured by the N-Tidal C, has different characteristics in a range of respiratory and cardiac conditions. We will perform a longitudinal, observational study of the TBCO 2 waveform (capnogram) as measured by the N-Tidal C capnometer. Participants with a confirmed diagnosis of asthma, breathing pattern disorders, chronic heart failure, motor neurone disease, pneumonia, as well as volunteers with no history of lung disease will be asked to provide twice daily, 75-second TBCO 2 collection via the N-Tidal C device for 6 months duration. The collated capnograms will be correlated with the underlying diagnosis and disease state (stable or exacerbation) to determine if there are different TBCO 2 characteristics that can distinguish different respiratory and cardiac causes of breathlessness. This study's recruitment is ongoing. It is anticipated that the results will be available in late 2018. The General Breathing Record Study will provide an evaluation of the use of capnography as a diagnostic and home-monitoring tool for various diseases. RR1-10.2196/9767. ©Daniel M Neville, Hitasha Rupani, Paul R Kalra, Kayode Adeniji, Matthew Quint, Ruth De Vos, Selina Begum, Mark Mottershaw, Carole Fogg, Thomas L Jones, Eleanor Lanning, Paul Bassett, Anoop J Chauhan. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.05.2018.

Effectiveness and fabrication of mouthguards.

PubMed

Maeda, Yoshinobu; Kumamoto, David; Yagi, Kazutomo; Ikebe, Kazunori

2009-12-01

Although mouthguards have been suggested as a means for preventing dental traumatic injuries, there are still some controversies over some aspects such as effectiveness in preventing concussions, material selections, method for fabrication, design, side effects and so on. The purpose of this literature review was to clarify differences in opinions with supporting evidence on these issues and find the best guidelines for promoting usage and providing mouthguards with better protective capability and fewer side effects such as difficulty in breathing and speaking.

Is Passive Smoking Associated With Sleep Disturbance Among Pregnant Women?

PubMed Central

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-01-01

Study Objective: Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Design: Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Setting: Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. Participants: 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. Intervention: N/A. Measurements and Results: Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Conclusion: Passive smoking is independently associated with increased sleep disturbance during pregnancy. Citation: Ohida T; Kaneita Y; Osaki Y; Harano S; Tanihata T; Takemura S; Wada K; Kanda H; Hayashi K; Uchiyama M. Is passive smoking associated with sleep disturbance among pregnant women? SLEEP 2007;30(9):1155-1161. PMID:17910387

Sleep problems in Dravet syndrome: a modifiable comorbidity.

PubMed

Licheni, Shane H; Mcmahon, Jacinta M; Schneider, Amy L; Davey, Margot J; Scheffer, Ingrid E

2018-02-01

Many children with severe developmental and epileptic encephalopathies experience significant sleep disturbance, causing major disruption to the family's quality of life. We aimed to determine the frequency and nature of sleep problems in individuals with Dravet syndrome. The Sleep Disturbance Scale for Children and a seizure questionnaire were distributed to the parents/guardians of 96 patients with Dravet syndrome. Sixteen patients had two nights of home oximetry. Fifty-seven out of 96 questionnaires were completed. Forty-three out of 57 (75%) individuals had sleep problems. Twenty-five out of 57 (44%) individuals had an abnormal total sleep score, with difficulty initiating and maintaining sleep (22 out of 57, 39%), sleep-wake transition disorders (20 out of 57, 35%), and sleep breathing disorders (19 out of 57, 33%). Twenty-two out of 57 (39%) individuals took medication to assist sleep, predominantly melatonin (n=14). Thirty out of 57 (53%) recently had nocturnal seizures. Overnight oximetry showed 14 out of 16 (88%) had a higher oxygen desaturation index (>3%), and six out of 16 (38%) had higher mean pulse rates than normative values. Home oximetry was normal or inconclusive in all patients. Seventy-five per cent of individuals with Dravet syndrome had sleep problems, highlighting the importance of routinely assessing sleep and initiating appropriate behavioural and pharmacological interventions to improve the patient and family's quality of life. A high oxygen desaturation index and mean pulse rates on pulse oximetry may reflect unrecognized nocturnal seizures. More than 70% of patients with Dravet syndrome have sleep problems. Difficulty initiating and maintaining sleep was most common, particularly in those older than 20 years. Second most common were sleep-wake transition disorders, affecting more than 50% of those younger than 5 years. Sleep breathing disorders were a frequent problem across all age groups. Oximetry was not diagnostic of sleep-disordered breathing or obvious seizures. © 2017 Mac Keith Press.

The Association Between Sleep Disordered Breathing, Academic Grades, and Cognitive and Behavioral Functioning Among Overweight Subjects During Middle to Late Childhood

PubMed Central

Beebe, Dean W.; Ris, M. Douglas; Kramer, Megan E.; Long, Elizabeth; Amin, Raouf

2010-01-01

Study Objectives: (1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. Design: Cross-sectional correlative study. Setting: Office/hospital, plus reported functioning at home and at school. Participants: 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). Measurements: Inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. Results: The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. Conclusions: SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school. Citation: Beebe DW; Ris MD; Kramer ME; Long E; Amin R. The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood. SLEEP 2010;33(11):1447-1456. PMID:21102986

The role of the dental surgeon in an integrated care pathway for the treatment of breathing difficulties.

PubMed

McDonald, J P

2005-04-09

We live in a professional environment in which the role of the dental surgeon is changing more rapidly than perhaps ever before. The concept of team working towards more efficient and focused delivery of care to our patients is one of the major developments, both within the practice environment through professionals complementary to dentistry, and indeed through medical and surgical colleagues in dealing with some of the wider aspects of holistic healthcare.

Extracorporeal Membrane Oxygenation in a Patient With Refractory Acute Respiratory Distress Syndrome Secondary to Toxic Epidermal Necrolysis.

DTIC Science & Technology

2014-12-01

she had complained of a sore throat, some difficulty in breathing, and chest pain. Two weeks earlier, she had started lamotrigine for depression. On...Despite escalating ventilator support for 7 days with airway pressure release ventilation, high levels of fraction of inspired oxygen (FiO2), and, later...out of clinical necessity, heavy sedation and paralytics, her saturations remained low (70–80%), with mean airway pressures in the mid-30s and a ris

Green and Blue Spaces and Behavioral Development in Barcelona Schoolchildren: The BREATHE Project

PubMed Central

Amoly, Elmira; Forns, Joan; López-Vicente, Mónica; Basagaña, Xavier; Julvez, Jordi; Alvarez-Pedrerol, Mar; Nieuwenhuijsen, Mark J.; Sunyer, Jordi

2014-01-01

Background: Green spaces have been associated with improved mental health in children; however, available epidemiological evidence on their impact on child behavioral development is scarce. Objectives: We investigated the impact of contact with green spaces and blue spaces (beaches) on indicators of behavioral development and symptoms of attention deficit/hyperactivity disorder (ADHD) in schoolchildren. Methods: This study was based on a sample of 2,111 schoolchildren (7–10 years of age) from 36 schools in Barcelona in 2012. We obtained data on time spent in green spaces and beaches and Strengths and Difficulties Questionnaires (SDQ) from parents, and ADHD/DSM-IV questionnaires from teachers. Surrounding greenness was abstracted as the average Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, and 500 m around each home address. Proximity to green spaces was defined as living within 300 m of a major green space (≥ 0.05 km2). We applied quasi-Poisson mixed-effects models (with school random effect) to separately estimate associations between indicators of contact with green spaces and SDQ and ADHD total and subscale scores. Results: We generally estimated beneficial associations between behavioral indicators and longer time spent in green spaces and beaches, and with residential surrounding greenness. Specifically, we found statistically significant inverse associations between green space playing time and SDQ total difficulties, emotional symptoms, and peer relationship problems; between residential surrounding greenness and SDQ total difficulties and hyperactivity/inattention and ADHD/DSM-IV total and inattention scores; and between annual beach attendance and SDQ total difficulties, peer relationship problems, and prosocial behavior. For proximity to major green spaces, the results were not conclusive. Conclusion: Our findings support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren. Citation: Amoly E, Dadvand P, Forns J, López-Vicente M, Basagaña X, Julvez J, Alvarez-Pedrerol M, Nieuwenhuijsen MJ, Sunyer J. 2014. Green and blue spaces and behavioral development in Barcelona schoolchildren: the BREATHE Project. Environ Health Perspect 122:1351–1358; http://dx.doi.org/10.1289/ehp.1408215 PMID:25204008

Improvement of plastic optical fiber microphone based on moisture pattern sensing in devoiced breath

NASA Astrophysics Data System (ADS)

Taki, Tomohito; Honma, Satoshi; Morisawa, Masayuki; Muto, Shinzo

2008-03-01

Conversation is the most practical and common form in communication. However, people with a verbal handicap feel a difficulty to produce words due to variations in vocal chords. This research leads to develop a new devoiced microphone system based on distinguishes between the moisture patterns for each devoiced breaths, using a plastic optical fiber (POF) moisture sensor. In the experiment, five POF-type moisture sensors with fast response were fabricated by coating swell polymer with a slightly larger refractive index than that of fiber core and were set in front of mouth. When these sensors are exposed into humid air produced by devoiced breath, refractive index in cladding layer decreases by swelling and then the POF sensor heads change to guided type. Based on the above operation principle, the output light intensities from the five sensors set in front of mouth change each other. Using above mentioned output light intensity patterns, discernment of devoiced vowels in Japanese (a,i,u,e,o) was tried by means of DynamicProgramming-Matching (DP-matching) method. As the result, distinction rate over 90% was obtained to Japanese devoiced vowels. Therefore, using this system and a voice synthesizer, development of new microphone for the person with a functional disorder in the vocal chords seems to be possible.

Characteristics of the swallowing sounds recorded in the ear, nose and on trachea.

PubMed

Sarraf-Shirazi, Samaneh; Baril, Jonathan-F; Moussavi, Zahra

2012-08-01

The various malfunctions and difficulties of the swallowing mechanism necessitate various diagnostic techniques to address those problems. Swallowing sounds recorded from the trachea have been suggested as a noninvasive method of swallowing assessment. However, acquiring signals from the trachea can be difficult for those with loose skin. The objective of this pilot study was to explore the viability of using the ear and nose as alternative recording locations for recording swallowing sounds. We recorded the swallowing and breathing sounds of five healthy young individuals from the ear, nose and trachea, simultaneously. We computed time-frequency features and compared them for the different locations of recording. The features included the peak and the maximum frequencies of the power spectrum density, average power at different frequency bands and the wavelet coefficients. The average power calculated over the 4 octave bands between 150 and 2,400 Hz showed a consistent trend with less than 20 dB difference for the breath sounds of all the recording locations. Thus, analyzing breath sounds recorded from the ear and nose for the purpose of aspiration detection would give similar results to those from tracheal recordings; thus, ear and nose recording may be a viable alternative when tracheal recording is not possible.

Modeling Periodic Impulsive Effects on Online TV Series Diffusion.

PubMed

Fu, Peihua; Zhu, Anding; Fang, Qiwen; Wang, Xi

Online broadcasting substantially affects the production, distribution, and profit of TV series. In addition, online word-of-mouth significantly affects the diffusion of TV series. Because on-demand streaming rates are the most important factor that influences the earnings of online video suppliers, streaming statistics and forecasting trends are valuable. In this paper, we investigate the effects of periodic impulsive stimulation and pre-launch promotion on on-demand streaming dynamics. We consider imbalanced audience feverish distribution using an impulsive susceptible-infected-removed(SIR)-like model. In addition, we perform a correlation analysis of online buzz volume based on Baidu Index data. We propose a PI-SIR model to evolve audience dynamics and translate them into on-demand streaming fluctuations, which can be observed and comprehended by online video suppliers. Six South Korean TV series datasets are used to test the model. We develop a coarse-to-fine two-step fitting scheme to estimate the model parameters, first by fitting inter-period accumulation and then by fitting inner-period feverish distribution. We find that audience members display similar viewing habits. That is, they seek new episodes every update day but fade away. This outcome means that impulsive intensity plays a crucial role in on-demand streaming diffusion. In addition, the initial audience size and online buzz are significant factors. On-demand streaming fluctuation is highly correlated with online buzz fluctuation. To stimulate audience attention and interpersonal diffusion, it is worthwhile to invest in promotion near update days. Strong pre-launch promotion is also a good marketing tool to improve overall performance. It is not advisable for online video providers to promote several popular TV series on the same update day. Inter-period accumulation is a feasible forecasting tool to predict the future trend of the on-demand streaming amount. The buzz in public social communities also represents a highly correlated analysis tool to evaluate the advertising value of TV series.

Modeling Periodic Impulsive Effects on Online TV Series Diffusion

PubMed Central

Fang, Qiwen; Wang, Xi

2016-01-01

Background Online broadcasting substantially affects the production, distribution, and profit of TV series. In addition, online word-of-mouth significantly affects the diffusion of TV series. Because on-demand streaming rates are the most important factor that influences the earnings of online video suppliers, streaming statistics and forecasting trends are valuable. In this paper, we investigate the effects of periodic impulsive stimulation and pre-launch promotion on on-demand streaming dynamics. We consider imbalanced audience feverish distribution using an impulsive susceptible-infected-removed(SIR)-like model. In addition, we perform a correlation analysis of online buzz volume based on Baidu Index data. Methods We propose a PI-SIR model to evolve audience dynamics and translate them into on-demand streaming fluctuations, which can be observed and comprehended by online video suppliers. Six South Korean TV series datasets are used to test the model. We develop a coarse-to-fine two-step fitting scheme to estimate the model parameters, first by fitting inter-period accumulation and then by fitting inner-period feverish distribution. Results We find that audience members display similar viewing habits. That is, they seek new episodes every update day but fade away. This outcome means that impulsive intensity plays a crucial role in on-demand streaming diffusion. In addition, the initial audience size and online buzz are significant factors. On-demand streaming fluctuation is highly correlated with online buzz fluctuation. Conclusion To stimulate audience attention and interpersonal diffusion, it is worthwhile to invest in promotion near update days. Strong pre-launch promotion is also a good marketing tool to improve overall performance. It is not advisable for online video providers to promote several popular TV series on the same update day. Inter-period accumulation is a feasible forecasting tool to predict the future trend of the on-demand streaming amount. The buzz in public social communities also represents a highly correlated analysis tool to evaluate the advertising value of TV series. PMID:27669520

Pharyngeal swallowing phase and chronic cough

PubMed Central

Drozdz, Daniela Rejane Constantino; Costa, Cintia Conceição; Jesus, Paulo Roberto de Oliveira; Trindade, Mateus Silva; Weiss, Guilherme; Neto, Abdias Baptista M.; da Silva, Ana Maria T.; Mancopes, Renata

2012-01-01

Summary Introduction: The act of swallowing depends on a complex and dynamic process which uses common structures to the act of breathing; respiratory problems can cause swallowing difficulties. Aim: To assess the swallowing pharyngeal phase in patients with chronic cough. Method: Retrospective study with 15 patients of both genders, patients with chronic cough and risk factors for aspiration defined by the pneumologic diagnosis. The patients were submitted to anamnesis on complaints related to swallowing, chewing and breathing, or related to food and to videofluoroscopic examination. Results: It was observed that 33.3% had normal and functional swallowing, being the last one of most prevalence. The mild dysphagia was observed in 20% of the patients, the mild to moderate dysphagia in 6.7% of them. In relation to the Rosenbek scale, 73.3% of patients presented degree 1, 6.7% presented degrees 2 and 3, and 13.3% presented degree 8. The most found pathology was the chronic cough with 40%, followed by asthma with 20%; 69.2% of patients presented stasis and of these, five used protection maneuvers, of these, seven were effective and only three were used in the presence of stasis. The most used maneuver was the multiple swallowing, being effective in 100%. Conclusion: There are peculiarities in the patients' swallowing with chronic cough that, although not presenting complaints relating to swallowing, it presents an important aspiration risk due to the presence of changes in breathing pattern that can intervene in the coordination between breathing and swallowing, which is essential to protect the lower airway. PMID:25991980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beaudry, J.; Bergman, A.; British Columbia Cancer Agency - Vancouver Centre, Vancouver, BC

Lung tumours move due to respiratory motion. This is managed during planning by acquiring a 4DCT and capturing the excursion of the GTV (gross tumour volume) throughout the breathing cycle within an IGTV (Internal Gross Tumour Volume) contour. Patients undergo a verification cone-beam CT (CBCT) scan immediately prior to treatment. 3D reconstructed images do not consider tumour motion, resulting in image artefacts, such as blurring. This may lead to difficulty in identifying the tumour on reconstructed images. It would be valuable to create a 4DCBCT reconstruction of the tumour motion to confirm that does indeed remain within the planned IGTV.more » CBCT projections of a Quasar Respiratory Motion Phantom are acquired in Treatment mode (half-fan scan) on a Varian TrueBeam accelerator. This phantom contains a mobile, low-density lung insert with an embedded 3cm diameter tumour object. It is programmed to create a 15s periodic, 2cm (sup/inf) displacement. A Varian Real-time Position Management (RPM) tracking-box is placed on the phantom breathing platform. Breathing phase information is automatically integrated into the projection image files. Using in-house Matlab programs and RTK (Reconstruction Tool Kit) open-source toolboxes, the projections are re-binned into 10 phases and a 4DCBCT scan reconstructed. The planning IGTV is registered to the 4DCBCT and the tumour excursion is verified to remain within the planned contour. This technique successfully reconstructs 4DCBCT images using clinical modes for a breathing phantom. UBC-BCCA ethics approval has been obtained to perform 4DCBCT reconstructions on lung patients (REB#H12-00192). Clinical images will be accrued starting April 2014.« less

Clinical Symptoms and Adverse Effects Associated With Energy Drink Consumption in Adolescents.

PubMed

Bashir, Dalia; Reed-Schrader, Essie; Olympia, Robert P; Brady, Jodi; Rivera, Ruby; Serra, Theresa; Weber, Christopher

2016-11-01

The aims of the study were to determine the prevalence of energy drink consumption by adolescents, to identify associated clinical symptoms and adverse effects, and to gain an understanding to the motivation behind its consumption. A prospective, questionnaire-based study was conducted at 2 emergency departments from June 2011 to June 2013. The questionnaire was distributed to a convenience sample of adolescents aged 12 to 18 years. Stratification was performed on the basis of frequency of consumption: frequent consumption (at least once a month) and infrequent consumption (less frequent than once a month). Data analysis was performed on 612 completed questionnaires. Two hundred two responders (33%) were considered frequent energy drink consumers. Frequent consumers were more likely to be involved in high-risk behaviors and more likely to consume other caffeinated drinks. In the previous 6 months, frequent energy drink consumers were more likely to report headache (76%), anger (47%), and increased urination (24%) and were more likely to require medical evaluation for headache (41%) and difficulty breathing (22%). Frequent energy drink consumers were more likely to believe that energy drinks "help me do better in school" (12%), "help me do better in sports" (35%), "are just for fun" (46%), "help me stay up at night" (67%), and "make me concentrate/focus better" (34%). Clarifying common misconceptions associated with energy drink consumption, especially in high-risk adolescents and frequent energy drink consumers, may decrease the frequency of symptoms experienced by adolescents, such as headache and difficulty breathing, requiring medical evaluation.

Outcomes after tongue-lip adhesion or mandibular distraction osteogenesis in infants with Pierre Robin sequence and severe airway obstruction.

PubMed

Papoff, P; Guelfi, G; Cicchetti, R; Caresta, E; Cozzi, D A; Moretti, C; Midulla, F; Miano, S; Cerasaro, C; Cascone, P

2013-11-01

The objective was to review and compare outcomes after tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) in infants with severe breathing difficulties related to Pierre Robin sequence (PRS). A single-centre retrospective (2002-2012) study was carried out; 18 infants with severe breathing difficulties related to PRS resistant to conservative treatment, who underwent TLA or MDO to correct airway obstruction, were enrolled. The primary outcome measures were successful weaning from respiratory support and resumption of full oral feeding. Nine underwent TLA and nine MDO. Eight of the nine infants who underwent MDO and all those treated with TLA were successfully weaned from respiratory support. After discharge, residual respiratory distress was diagnosed more commonly after TLA than after MDO (6/9 vs 1/9, P=0.050). Infants resumed oral feeding sooner after MDO than after TLA (mean days after surgery to full oral feeds 44±24 vs 217±134, P<0.003). The length of hospital stay was longer for infants treated with MDO than for those treated with TLA. The rate of complications was similar. Infants with severe airway obstruction related to PRS can benefit safely from either TLA or MDO. Although MDO lengthens the time to discharge, this option stabilizes airway patency of infants with PRS more efficiently and achieves full oral feeding more rapidly than TLA. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Gene editing as a promising approach for respiratory diseases.

PubMed

Bai, Yichun; Liu, Yang; Su, Zhenlei; Ma, Yana; Ren, Chonghua; Zhao, Runzhen; Ji, Hong-Long

2018-03-01

Respiratory diseases, which are leading causes of mortality and morbidity in the world, are dysfunctions of the nasopharynx, the trachea, the bronchus, the lung and the pleural cavity. Symptoms of chronic respiratory diseases, such as cough, sneezing and difficulty breathing, may seriously affect the productivity, sleep quality and physical and mental well-being of patients, and patients with acute respiratory diseases may have difficulty breathing, anoxia and even life-threatening respiratory failure. Respiratory diseases are generally heterogeneous, with multifaceted causes including smoking, ageing, air pollution, infection and gene mutations. Clinically, a single pulmonary disease can exhibit more than one phenotype or coexist with multiple organ disorders. To correct abnormal function or repair injured respiratory tissues, one of the most promising techniques is to correct mutated genes by gene editing, as some gene mutations have been clearly demonstrated to be associated with genetic or heterogeneous respiratory diseases. Zinc finger nucleases (ZFN), transcription activator-like effector nucleases (TALEN) and clustered regulatory interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) systems are three innovative gene editing technologies developed recently. In this short review, we have summarised the structure and operating principles of the ZFNs, TALENs and CRISPR/Cas9 systems and their preclinical and clinical applications in respiratory diseases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association between Symptoms of Sleep-Disordered Breathing and Speech in Children with Craniofacial Malformations

PubMed Central

Moraleda-Cibrián, Marta; Berger, Mary; Edwards, Sean P.; Kasten, Steven J.; Buchman, Steven R.; O'Brien, Louise M.

2014-01-01

Study Objective: Sleep-disordered breathing (SDB) and speech difficulties are common problems in children with craniofacial malformations (CFM). The present study was designed to investigate whether resonance issues identified during speech assessment are associated with parental report of SDB symptoms in children with CFM. Methods: Children aged 2-18 years with congenital CFM attending at the Craniofacial Anomalies Program from March 2007 to April 2011 were screened for SDB symptoms using the Sleep-Related Breathing Disturbance Scale of the Pediatric Sleep Questionnaire. Speech evaluation, based on the Pittsburgh Weighted Speech Scale score, was the tool used to investigate velopharyngeal dysfunction (VPD) based on speech perceptual assessment. Results: A total of 488 children with congenital CFM were included. Overall 81% were Caucasian and 24% were overweight/obese. Twenty-four percent of children screened positive for SDB and 35% had VPD. Children with VPD were no more likely to screen positive for SDB than children without VPD (26% vs. 23%, p = 0.38). However, children with previous sphincter pharyngoplasty (SP) were more likely to have hyponasality (51% vs. 12%, p = 0.0001) and reduced or absent nasal emission (33% vs. 16%, p = 0.008). In a logistic regression, the adjusted odds ratio for SDB for those with hyponasality was 2.10 (95%CI 1.21-3.61, p = 0.008) and for those with reduced or absent nasal emission was 1.75 (95%CI 1.06-2.88, p = 0.028). Conclusion: Symptoms of sleep disordered breathing are common in children with craniofacial malformations especially if they have undergone sphincter pharyngoplasty; many of these children can be identified by measures of resonance on routine speech evaluation. Citation: Moraleda-Cibrián M, Berger M, Edwards SP, Kasten SJ, Buchman SR, O'Brien LM. Association between symptoms of sleep-disordered breathing and speech in children with craniofacial malformations. J Clin Sleep Med 2014;10(6):671-676. PMID:24932148

What I did on my summer vacation

NASA Astrophysics Data System (ADS)

Hotinski, Roberta

Imagine learning on Monday morning that you had to write an article on an area of science you knew little about. Now imagine that the article had to be finished by Thursday morning, in print by Friday, and scrutinized by millions on the following Monday morning. If you felt a rush of adrenaline reading that scenario, then you have a sense of my fellowship experience this summer. Instead of scaling mountains or feverishly experimenting in the lab, I explored a strange new frontier: the world of science journalism. I spent ten weeks immersed in the tumult and fervor of a news organization, and now have a new appreciation for the art of science communication as well as a new sympathy for science writers that would benefit any researcher.

Bordetella pertussis infection in children with severe pneumonia, Philippines, 2012-2015.

PubMed

Sadiasa, Alexander; Saito-Obata, Mariko; Dapat, Clyde

2017-02-15

A case-comparison study was conducted based on an observational study of severe pneumonia among hospitalized children in the Philippines. The children, from 8days to 13years old and hospitalized with clinical diagnosis of severe or very severe pneumonia from August 2012 to February 2015, were recruited. Nasopharyngeal swabs were collected from 1152 cases and B. pertussis were detected from 34 cases by PCR. Pertussis-positive cases were more likely to have no fever, more than one week of coughing and breathing difficulty, decreased breathing sounds, and central cyanosis than pertussis- negative cases. The percentage of underweight was significantly higher in pertussis-positive cases than pertussis-negative cases. Pertussis-positive cases showed remarkably higher fatality rate than pertussis-negative cases. All of the fatal cases among pertussis-positive cases were less than 6months old. More attention should be given to protect young infants from pertussis. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Association between oral malodour and psychological characteristics in subjects with neurotic tendencies complaining of halitosis.

PubMed

Suzuki, Nao; Yoneda, Masahiro; Naito, Toru; Inamitsu, Tetsuaki; Yamada, Kazuhiko; Okada, Ichizo; Hatano, Yuko; Iwamoto, Tomoyuki; Masuo, Yosuke; Fuijimoto, Akie; Hirofuji, Takao

2011-04-01

  To assess the psychosomatically subjective symptoms of subjects with neurotic tendencies complaining of halitosis.   Breath malodour was measured in 368 patients using organoleptic test and gas chromatography. Neurotic tendency and subjective symptoms were assessed using the Cornell Medical Index (CMI).   Of the 79 subjects who met the criteria for neurotic tendencies according to CMI scores, 58 (73.4%) had oral malodour, whereas 21 (26.6%) did not. Coated tongue, periodontal pocket, and daily drinking were significantly more common in subjects with oral malodour. On the CMI questionnaire, subjects with no oral malodour more frequently responded 'yes' to questions about fatigue and psychological problems in their families. Additionally, many answered that they had perceived their own bad breath.   Difficulties experienced by subjects with neurotic tendencies and oral malodour may manifest primarily in oral conditions, whereas those experienced by individuals with neurotic tendencies and no oral malodour may manifest primarily in psychosomatic symptoms. © 2011 FDI World Dental Federation.

Breathe Easy at Home: A Qualitative Evaluation of a Pediatric Asthma Intervention.

PubMed

Rosofsky, Anna; Reid, Margaret; Sandel, Megan; Zielenbach, Molly; Murphy, Johnna; Scammell, Madeleine K

2016-01-01

The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians ( n = 10) who referred patients, and focus groups with inspectors from the ISD ( n = 9) and a variety of stakeholders ( n = 13), to gain insight into program function and implementation. Clinician interviews revealed inconsistencies in enrollment approaches, dissatisfaction with the web-based system, and patient follow-up difficulties. Inspectors identified barriers to working effectively with residents and landlords, and the stakeholder focus group highlighted successes of an unusual institutional collaboration. Interviews and focus groups identified strong and personal rapport between clinicians, inspectors, and patients as key to program retention, and that participating families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes.

System controls challenges of hypersonic combined-cycle engine powered vehicles

NASA Technical Reports Server (NTRS)

Morrison, Russell H.; Ianculescu, George D.

1992-01-01

Hypersonic aircraft with air-breathing engines have been described as the most complex and challenging air/space vehicle designs ever attempted. This is particularly true for aircraft designed to accelerate to orbital velocities. The propulsion system for the National Aerospace Plane will be an active factor in maintaining the aircraft on course. Typically addressed are the difficulties with the aerodynamic vehicle design and development, materials limitations and propulsion performance. The propulsion control system requires equal materials limitations and propulsion performance. The propulsion control system requires equal concern. Far more important than merely a subset of propulsion performance, the propulsion control system resides at the crossroads of trajectory optimization, engine static performance, and vehicle-engine configuration optimization. To date, solutions at these crossroads are multidisciplinary and generally lag behind the broader performance issues. Just how daunting these demands will be is suggested. A somewhat simplified treatment of the behavioral characteristics of hypersonic aircraft and the issues associated with their air-breathing propulsion control system design are presented.

Unexplained apnoea and loss of consciousness during sub arachnoid block for caesarean section.

PubMed

Acharya, S P; Marhatta, M N; Amatya, R

2009-01-01

Sub arachnoid block (SAB) is often perceived safe by many anesthesiologists and other faculties but is also not completely safe choice especially in pregnant females, as the incidence of complications and local anaesthetic agent toxicity is high in these groups of patients. Here we present four such cases out of the seventeen patients over a period of six months, who developed apnea and transient loss of consciousness after spinal anesthesia for lower segment caesarean section. Typically all these patients after spinal anesthesia developed difficulty in breathing, became apnoea and had loss of consciousness for about a minute or two. The apnea was relieved with bag and mask ventilation following which the patient regained consciousness and start breathing normally. The rest of the procedure was uneventful. We presented these cases with aim of sharing similar experiences, and to aware about the possibility of such events as these events do occur frequently but case reports and literatures are unavailable.

Airway compromise in infectious mononucleosis: a case report

PubMed Central

Kakani, Sravan

2009-01-01

A 25-year-old Caucasian man had difficulty swallowing and shortness of breath during an episode of infectious mononucleosis. His tonsils were “kissing” and erythematous but no superimposed infection with a streptococcal organism was identified. His symptoms improved rapidly upon administration of intravenous steroids. This case demonstrates a rare and short-term complication that is well described in young adults with infectious mononucleosis. Physicians should routinely counsel their patients with infectious mononucleosis to be aware of potentially life-threatening airway obstruction in addition to splenic rupture and meningitis. PMID:19918540

Airway compromise in infectious mononucleosis: a case report.

PubMed

Kakani, Sravan

2009-08-13

A 25-year-old Caucasian man had difficulty swallowing and shortness of breath during an episode of infectious mononucleosis. His tonsils were "kissing" and erythematous but no superimposed infection with a streptococcal organism was identified. His symptoms improved rapidly upon administration of intravenous steroids. This case demonstrates a rare and short-term complication that is well described in young adults with infectious mononucleosis. Physicians should routinely counsel their patients with infectious mononucleosis to be aware of potentially life-threatening airway obstruction in addition to splenic rupture and meningitis.

School Nurses on the Front Lines of Medicine: Connecting the Dots: SCRIPTS for Success in the Evaluation of Pediatric Rashes.

PubMed

Olympia, Robert P

2017-05-01

Although skin rashes may not necessarily prompt a visit to the school nurse's office, a rash associated with other systemic symptoms, such as fever, headache, difficulty swallowing or breathing, weakness, or abdominal pain, may cause a child to visit your office. This article describes the initial assessment and management of skin rashes in children and adolescents and delineates reasons that may prompt the school nurse to transfer a student with a rash to a local emergency department.

Association between symptoms of sleep-disordered breathing and speech in children with craniofacial malformations.

PubMed

Moraleda-Cibrián, Marta; Berger, Mary; Edwards, Sean P; Kasten, Steven J; Buchman, Steven R; O'Brien, Louise M

2014-06-15

Sleep-disordered breathing (SDB) and speech difficulties are common problems in children with craniofacial malformations (CFM). The present study was designed to investigate whether resonance issues identified during speech assessment are associated with parental report of SDB symptoms in children with CFM. Children aged 2-18 years with congenital CFM attending at the Craniofacial Anomalies Program from March 2007 to April 2011 were screened for SDB symptoms using the Sleep-Related Breathing Disturbance Scale of the Pediatric Sleep Questionnaire. Speech evaluation, based on the Pittsburgh Weighted Speech Scale score, was the tool used to investigate velopharyngeal dysfunction (VPD) based on speech perceptual assessment. A total of 488 children with congenital CFM were included. Overall 81% were Caucasian and 24% were overweight/obese. Twenty-four percent of children screened positive for SDB and 35% had VPD. Children with VPD were no more likely to screen positive for SDB than children without VPD (26% vs. 23%, p = 0.38). However, children with previous sphincter pharyngoplasty (SP) were more likely to have hyponasality (51% vs. 12%, p = 0.0001) and reduced or absent nasal emission (33% vs. 16%, p = 0.008). In a logistic regression, the adjusted odds ratio for SDB for those with hyponasality was 2.10 (95%CI 1.21-3.61, p = 0.008) and for those with reduced or absent nasal emission was 1.75 (95%CI 1.06-2.88, p = 0.028). Symptoms of sleep disordered breathing are common in children with craniofacial malformations especially if they have undergone sphincter pharyngoplasty; many of these children can be identified by measures of resonance on routine speech evaluation.

Breaking wind to survive: fishes that breathe air with their gut.

PubMed

Nelson, J A

2014-03-01

Several taxonomically disparate groups of fishes have evolved the ability to extract oxygen from the air with elements of their gut. Despite perceived difficulties with balancing digestive and respiratory function, gut air breathing (GAB) has evolved multiple times in fishes and several GAB families are among the most successful fish families in terms of species numbers. When gut segments evolve into an air-breathing organ (ABO), there is generally a specialized region for exchange of gases where the gut wall has diminished, vascularization has increased, capillaries have penetrated into the luminal epithelium and surfactant is produced. This specialized region is generally separated from digestive portions of the gut by sphincters. GAB fishes tend to be facultative air breathers that use air breathing to supplement aquatic respiration in hypoxic waters. Some hindgut breathers may be continuous, but not obligate air breathers (obligate air breathers drown if denied access to air). Gut ABOs are generally used only for oxygen uptake; CO₂ elimination seems to occur via the gills and skin in all GAB fishes studied. Aerial ventilation in GAB fishes is driven primarily by oxygen partial pressure of the water (PO₂) and possibly also by metabolic demand. The effect of aerial ventilation on branchial ventilation and the cardiovascular system is complex and generalizations across taxa or ABO type are not currently possible. Blood from GAB fishes generally has a low blood oxygen partial pressure that half saturates haemoglobin (p50) with a very low erythrocytic nucleoside triphosphate concentration [NTP]. GAB behaviour in nature depends on the social and ecological context of the animal as well as on physiological factors. © 2014 The Fisheries Society of the British Isles.

[Symptoms, effects on quality of life, judgement and expectations of treatment in active ankylosing spondylitis: the patient's view].

PubMed

Falkenbach, A; Curda, B

2001-10-01

Symptoms, Effects on Quality of Life, Judgement and Expectations of Treatment in Active Ankylosing Spondylitis: The Patient's View.In ankylosing spondylitis uncertainty prevails among rheumatologists on how to define and measure activity. In the present study the patient's view of activity was evaluated. What does active ankylosing spondylitis mean for the patient? In a standardized interview the patient was asked to describe, from his own experience, what active ankylosing spondylitis means, what bothers him most, what helps most, and what he expects from therapy. For the patient, active ankylosing spondylitis means pain (99 responses), mobility restriction (19), muscle tension (10), inability to stay supine (6), restriction in chest mobility (5) and dyspnea (5). Fatigue was mentioned by two patients. In active states patients are mainly bothered by pain (77), mobility restriction (55), consequences for social life (20) and work (18), disturbed sleep (17) and difficult breathing (16). Drugs (84) and physical activity (42) were judged the best treatments during active ankylosing spondylitis. It was no surprise that pain and mobility restriction were cited most often by the patients. Breathing difficulties were cited rather often, whereas fatigue seems not to play an important role for most patients. The results suggest that modern rheumatology may have underestimated the relevance of difficult breathing and paid too much attention to fatigue.

The patient inflating valve in anaesthesia and resuscitation breathing systems.

PubMed

Fenton, P M; Bell, G

2013-03-01

Patient inflating valves combined with self-inflating bags are known to all anaesthetists as resuscitation devices and are familiar as components of draw-over anaesthesia systems. Their variants are also commonplace in transfer and home ventilators. However, the many variations in structure and function have led to difficulties in their optimal use, definition and classification. After reviewing the relevant literature, we defined a patient inflating valve as a one-way valve that closes an exit port to enable lung inflation, also permitting exhalation and spontaneous breathing, the actions being automatic. We present a new classification based on the mechanism of valve opening/closure; namely elastic recoil of a flexible flap/diaphragm, sliding spindle opened by a spring/magnet or a hollow balloon collapsed by external pressure. The evolution of these valves has been driven by the difficulties documented in critical incidents, which we have used along with information from modern International Organization for Standardization standards to identify 13 ideal properties, the top six of which are non-jamming, automatic, no bypass effect, no rebreathing or air entry at patient end, low resistance, robust and easy to service. The Ambu and the Laerdal valves have remained popular due to their simplicity and reliability. Two new alternatives, the Fenton and Diamedica valves, offer the benefits of location away from the patient while retaining a small functional dead space. They also offer the potential for greater use of hybrid continuous flow/draw-over systems that can operate close to atmospheric pressure. The reliable application of positive end-expiratory pressure/continuous positive airway pressure remains a challenge.

Normotensive cardiomyopathy and malignant hypertension in phaeochromocytoma

PubMed Central

Shapiro, L. M.; Trethowan, N.; Singh, S. P.

1982-01-01

A patient with two different presentations of phaeochromocytoma is described. She initially presented with normal blood pressure and heart failure following a prolonged feverish prodrome. A provisional diagnosis of myocarditis or early congestive cardiomyopathy was made and she improved with digoxin and diuretics. Eighteen months later, after a period of normotension free from heart failure, she developed malignant hypertension with recurrence of heart failure. A phaeochromocytoma was surgically removed, with return to normal of blood pressure and cardiac status. It would seem that the initial presentation of the phaeochromocytoma was a catecholamine-induced myocarditis without hypertension and this resolved with the subsequent development of malignant hypertension. The possible mechanisms responsible for this are discussed and it is concluded that phaeochromocytoma should be considered in patients who have heart failure and persistent features of myocarditis. PMID:7100023

Nuclear proliferation: Will the Soviet Union's collapse spawn a new arms race

DOE Office of Scientific and Technical Information (OSTI.GOV)

Griffin, R.D.

Almost 30 years ago, in the midst of the US-Soviet arms race, President John F. Kennedy warned of the danger of nuclear proliferation. Ironically, now that the Cold War is over, the prospect has become a reality. The collapse of the Soviet Union may have calmed fears of a nuclear Armageddon, but it has aroused new concerns about the spread of nuclear weapons. More than a dozen nations either have or are feverishly trying to develop nuclear arsenals, including Third World nations riven by religious and territorial disputes. If the world fails to contain the spread of nuclear-weapons technology, themore » balance of power that kept relative peace during the four decades of the Cold War may be displaced by a balance of terror.« less

Monitoring of hemodynamic changes induced in the healthy breast through inspired gas stimuli with MR-guided diffuse optical imaging

PubMed Central

Carpenter, C. M.; Rakow-Penner, R.; Jiang, S.; Pogue, B. W.; Glover, G. H.; Paulsen, K. D.

2010-01-01

Purpose: The modulation of tissue hemodynamics has important clinical value in medicine for both tumor diagnosis and therapy. As an oncological tool, increasing tissue oxygenation via modulation of inspired gas has been proposed as a method to improve cancer therapy and determine radiation sensitivity. As a radiological tool, inducing changes in tissue total hemoglobin may provide a means to detect and characterize malignant tumors by providing information about tissue vascular function. The ability to change and measure tissue hemoglobin and oxygenation concentrations in the healthy breast during administration of three different types of modulated gas stimuli (oxygen∕carbogen, air∕carbogen, and air∕oxygen) was investigated. Methods: Subjects breathed combinations of gases which were modulated in time. MR-guided diffuse optical tomography measured total hemoglobin and oxygen saturation in the breast every 30 s during the 16 min breathing stimulus. Metrics of maximum correlation and phase lag were calculated by cross correlating the measured hemodynamics with the stimulus. These results were compared to an air∕air control to determine the hemodynamic changes compared to the baseline physiology. Results: This study demonstrated that a gas stimulus consisting of alternating oxygen∕carbogen induced the largest and most robust hemodynamic response in healthy breast parenchyma relative to the changes that occurred during the breathing of room air. This stimulus caused increases in total hemoglobin and oxygen saturation during the carbogen phase of gas inhalation, and decreases during the oxygen phase. These findings are consistent with the theory that oxygen acts as a vasoconstrictor, while carbogen acts as a vasodilator. However, difficulties in inducing a consistent change in tissue hemoglobin and oxygenation were observed because of variability in intersubject physiology, especially during the air∕oxygen or air∕carbogen modulated breathing protocols. Conclusions: MR-guided diffuse optical imaging is a unique tool that can measure tissue hemodynamics in the breast during modulated breathing. This technique may have utility in determining the therapeutic potential of pretreatment tissue oxygenation or in investigating vascular function. Future gas modulation studies in the breast should use a combination of oxygen and carbogen as the functional stimulus. Additionally, control measures of subject physiology during air breathing are critical for robust measurements. PMID:20443485

Congenital Atresia of Wharton’s Duct

PubMed Central

Hseu, Anne; Anne, Premchand

2016-01-01

This is a case report of a three-month-old male who presented to clinic with a cystic lesion under the tongue. On clinical examination, a cystic lesion was observed in the, floor-of-mouth. The patient was referred to Paediatric Otorhinolaryngology service for further management. The differential diagnoses for floor-of-mouth lesions should be reviewed with primary focus on the Wharton’s duct atresia and its management. It is crucial to recognize submandibular duct atresia in the primary Paediatric clinic in order to expedite management of lesion before complications arise including infection, enlargement of cyst, and feeding and breathing difficulties. PMID:27042492

Rheumatoid Arthritis Complicated by Pseudochylothorax Without Pleural Thickening: A Diagnostic Challenge for Clinicians.

PubMed

Agrawal, Anand; Chandermani; Madaan, Himanshu; Yadav, Sarita

2016-01-01

A 60-year-old female who was known to have rheumatoid arthritis for the preceding two-and-half years presented with difficulty in breathing associated with chest pain over the right hemithorax of two months duration. She was found to have a right-sided mild to moderate pleural effusion; there was no evidence of pleural thickening. The pleural fluid was pale yellow in appearance and diagnostic work-up confirmed it to be a pseudochylous pleural effusion. The present case highlights the rare occurrence of pseudochylothorax without pleural thickening as a complication of rheumatoid arthritis.

Beliefs and practices regarding childhood fever among parents: a cross-sectional study from Palestine

PubMed Central

2013-01-01

Background Fever is an extremely common occurrence in paediatric patients and the most common cause for a child to be taken to the doctor. The literature indicates that parents have too many misconceptions and conflicting information about fever management. The aim of this study was to identify parents’ beliefs and practices regarding childhood fever management. Methods We conducted a cross-sectional survey among parents whose children were enrolled and presented for health care at primary health care clinics in the Nablus region of Palestine. Data were collected using structured questionnaire interviews with parents. The questionnaire consisted of ‘yes/no’ responses and multiple-response questions. Descriptive statistics were used. Results Overall, 402 parents were interviewed. All parents believed that fever could cause at least one harmful effect if left untreated. The harmful effects most frequently reported by parents were brain damage (38.1%), dehydration (15.7%), and other organs damage such as liver and kidney damage (14.2%). The study showed that 65.4% of parents would recognise fever by only touching the child, 31.6% would measure the temperature and 3.0% would assess temperature by touching and measuring the child. Antipyretic was preferred to be used by 34.8% of parents, while 49.8% stated that they preferred cold sponges, and 3.2% stated that they preferred homeopathic methods to treat fever. The most common factors influencing frequency of medication administration included physician’s instruction (61.7%), the degree of elevated temperature (14.9%) and instructions on the medication leaflet (13.7%). Of the participant parents, 53.2% believed antipyretics used to reduce fever were harmful. Parents reported the most harmful outcomes from these antipyretics to be allergic reactions (20.9%), effects on the stomach (16.9%), kidney damage (16.2%) and overdose (11.4%). Conclusions Parents were anxious when dealing with a feverish child, which resulted in incorrect or inappropriate practices. Parents require reliable evidence-based information about the care of feverish children. These results indicate a need to develop and evaluate educational programs in our setting that will provide parents with education on fever and fever management. PMID:23622106

Design, Development and Testing of Airplanes for Mars Exploration

NASA Technical Reports Server (NTRS)

Hall, David W.

2004-01-01

The opportunity for a piggyback mission to Mars aboard an Ariane 5 rocket in the early spring of 1999 set off feverish design activity at several NASA centers. This report describes the contract work done by faculty, students, and consultants at the California Polytechnic State University in San Luis Obispo California (Cal poly/SLO) to support the NASA/Ames design, construction and test efforts to develop a simple and robust Mars Flyer configuration capable of performing a practical science mission on Mars. The first sections will address the conceptual design of a workable Mars Flyer configuration which started in the spring and summer of 1999. The following sections will focus on construction and flight test of two full-scale vehicles. The final section will reflect on the overall effort and make recommendations for future work.

Kikuchi-Fujimoto disease: an unusual association with acute renal failure.

PubMed

Silva, Amanda Feliciano da; Focaccia, Roberto; Oliveira, Allan Constantino de; Sementilli, Angelo; Reis, Gelvana Flávio Barreto

2010-01-01

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis of unknown etiopathogenesis, is a self-limited disease which frequently appears as feverish lymphadenomegaly, thus creating the need for differential diagnosis with lymphoma, systemic lupus erythematosus (SLE), infectious mononucleosis, cat-scratch disease, and toxoplasmosis with lymphonodal impairment. However, there are cases in which it may evolve with complications such as aseptic meningitis, cerebellar ataxia, and aseptic myocarditis. We are presenting a case of a 24-year-old man who had an initial picture of arthralgia, evening fever and adenomegaly. Kikuchi disease was diagnosed through lymph node biopsy with immunohistochemistry and evolves with severe systemic manifestations, such as pericarditis with cardiac tamponade, pneumonitis, hepatitis, and acute kidney failure - the latter has not been reported in literature yet. There was significant improvement of the clinical picture with prednisone.

The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood.

PubMed

Beebe, Dean W; Ris, M Douglas; Kramer, Megan E; Long, Elizabeth; Amin, Raouf

2010-11-01

(1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. cross-sectional correlative study. Office/hospital, plus reported functioning at home and at school. 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school.

Factors affecting health seeking behavior for common childhood illnesses in Yemen

PubMed Central

Webair, Hana Hasan; Bin-Gouth, Abdulla Salim

2013-01-01

Introduction Appropriate medical care seeking could prevent a significant number of child deaths and complications due to ill health. This study aims to determine factors affecting health seeking behavior (HSB) for childhood illnesses, thereby improving child survival. Methods A cross sectional study was carried out from January 11 to April 2, 2012. A total of 212 caretakers of children under the age of 5 years participated. Caretakers who visited the vaccination unit in the Shehair Health Center during the study period and had a child with a history of diarrhea, fever, cough, and/or difficulty of breathing during the last 14 days were included. The data were collected by interviewing caretakers and the answers were reported in pretested structured questionnaires. Results Medical care was sought for about half of the sick children (n=109, 51.42%). Seeking medical care was frequently initiated for illnesses that did not improve or worsened. The major reasons for not seeking medical care were “illness was mild” (n=40, 38.83%) and “illness is not for medical treatment” (n=32, 31.07%). The caretakers sought medical care significantly more when they had a higher level of school education (POR [prevalence odds ratio] 5.85, 95% CI [confidence interval]: 2.34–14.61), when the illness was perceived as severe (POR 5.39, 95% CI: 2.81–10.33), and when the child had difficulty of breathing (POR 2.93, 95% CI: 1.10–7.80). Conclusion For the preventable childhood illnesses with existing interventions, appropriate HSB prevalence is low. Symptom type, caretakers’ education, and perception of illness severity are the predictors of HSB. Educational improvement of the mothers, introduction of community based integrated management of childhood illness, and in-depth research are imperative to improve mothers’ HSB. PMID:24187490

Design and Control of a Mechatronic Tracheostomy Tube for Automated Tracheal Suctioning.

PubMed

Do, Thanh Nho; Seah, Tian En Timothy; Phee, Soo Jay

2016-06-01

Mechanical ventilation is required to aid patients with breathing difficulty to breathe more comfortably. A tracheostomy tube inserted through an opening in the patient neck into the trachea is connected to a ventilator for suctioning. Currently, nurses spend millions of person-hours yearly to perform this task. To save significant person-hours, an automated mechatronic tracheostomy system is needed. This system allows for relieving nurses and other carers from the millions of person-hours spent yearly on tracheal suctioning. In addition, it will result in huge healthcare cost savings. We introduce a novel mechatronic tracheostomy system including the development of a long suction catheter, automatic suctioning mechanisms, and relevant control approaches to perform tracheal suctioning automatically. To stop the catheter at a desired position, two approaches are introduced: 1) Based on the known travel length of the catheter tip; 2) Based on a new sensing device integrated at the catheter tip. It is known that backlash nonlinearity between the suction catheter and its conduit as well as in the gear system of the actuator are unavoidable. They cause difficulties to control the exact position of the catheter tip. For the former case, we develop an approximate model of backlash and a direct inverse scheme to enhance the system performances. The scheme does not require any complex inversions of the backlash model and allows easy implementations. For the latter case, a new sensing device integrated into the suction catheter tip is developed and backlash compensation controls are avoided. Automated suctioning validations are successfully carried out on the proposed experimental system. Comparisons and discussions are also introduced. The results demonstrate a significant contribution and potential benefits to the mechanical ventilation areas.

Patients' awareness of symptoms of dysphagia.

PubMed

Boczko, Faerella

2006-11-01

To assess geriatric patients' assessment of their clinical symptoms of dysphagia by means of a customized dysphagia screening tool and the usefulness of this assessment to health care professionals. The screening tool was distributed to an appropriate cohort and the entries correlated with results of standard speech-language pathology clinical assessments. A large long-term care/subacute rehabilitation facility. There were 199 new admissions screened. The patients included 74 (37.2%) males and 125 (60.8%) females. Patients' ages ranged from 50 to 98 with the mean age of 79.9 years. The screening tool used requires yes/no patient responses to 9 clinical indicators of dysphagia: difficulty keeping liquids in the mouth; coughing after drinking; shortness of breath while drinking; voice change after drinking; coughing after eating; shortness of breath after eating; food getting stuck in the mouth/throat when eating; voice change after eating; difficulty with saliva. After completing the questionnaire, the speech-language pathologist then conducted a standard bedside swallowing examination using the same 9 indicators. The findings suggest that although patients are less discriminating than clinicians in recognizing swallowing problems, the screening tool as a generalized indicator of potential for dysphagia is consistent and reliable. Individual items should not be used as indicators of dysphagia, but as a whole, the screening tool completed by patients is a reliable indicator of potential for dysphagia. Patients' awareness of their own swallowing impairment represents an important aspect of functional recovery. The findings of the study indicate that when patients self-identify a swallowing problem, the speech-language pathologist also identifies the existence of a problem, although not the same problem identified by the patient, with the same intensity or with the same manifestation.

Dental status, oral prosthesis and chewing ability in an adult and elderly population in southern Brazil.

PubMed

Baumgarten, Alexandre; Schmidt, Jeanne Gabriele; Rech, Rafaela Soares; Hilgert, Juliana Balbinot; Goulart, Bárbara Niegia Garcia de

2017-11-01

The objective of this study was to explore the factors associated with inadequate chewing in an adult and elderly population of a city in the southern region of Brazil. This was a cross-sectional study based on a population home-based inquiry (DCH-POP) in southern Brazil. Individuals were interviewed by trained interviewers to create a standardized procedure. In a pilot study, the Questionnaire of Human Communication Disorders (DCH-POP) was created and validated to identify self-reported speech and language, swallowing and hearing disorders. The outcome was dichotomized into either having adequate chewing or not, as assessed by a series of questions about chewing ability. Analyses of absolute and relative frequencies were measured according to the studied variables. A Poisson regression was applied at a significance level of 5%. A total of 1,246 people were interviewed. Inadequate chewing was found in 52 (5.6%) individuals, with a higher prevalence in the elderly (11.8%) than in adults (5.2%). In the final model, the following factors were associated with inadequate chewing: being 61 years of age or older (prevalence ratio or PR=9.03; 95% CI: 1.20-67.91), loss of teeth and use of unadjusted prosthesis (PR=3.50; 95% CI: 1.54-7.95), preference for foods of soft consistency (PR=9.34; 95% CI:4.66-8.70) and difficulty in nasal breathing (PR=2.82; 95% CI: 1.31-6.06). Age, oral health status through dental prosthesis, preference for foods of soft consistency and difficulty breathing through the nose were factors associated with chewing inability in adults and the elderly.

A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus.

PubMed

Rasmussen, E R; Schnack, D T; Ravn, A T

2018-06-01

To investigate the epidemiology of globus pharyngeus in adult patients presenting to the otolaryngologist's office. Also, the predictors of persisting symptoms, prevalence of anxiety and the effect of clinical assessment were analysed. This was a prospective cohort study. Follow-up was carried out using a postal questionnaire. One otolaryngologists' office comprising three medical doctors. A total of 122 consecutive globus patients presenting to one otolaryngology office in a 1-year period. Globus incidence, gender and age distribution, predictors of persisting symptoms and the patient's health-related concerns. 3.8% of first-time visits were regarding globus. The mean age was 48 years [range 20-88 years], and a female predominance was found (ratio 1.49). Eighty-four per cent experienced anxiety, mainly due to fear of cancer. The most common pathological findings were reflux (15.6%) and post-infectious inflammation (10.6%). 21.4% of questionnaire responders reported full remission of their symptoms. Three predictors regarding symptom persistence were identified: male gender (OR 1.52), smoking (OR 3.4) and difficulties in breathing (OR 8.7). Patients with concomitant foreign body sensation were less likely to have persisting symptoms (OR 0.42). No cases of malignant disease were encountered. 94.7% was reassured by the office visit. The incidence of globus is 3.8% in the otolaryngologist's office. Female gender and concomitant foreign body sensation were predictive for presenting to the clinic even if symptom remission had occurred. Male gender, smoking and self-perceived breathing difficulties were predictive for persisting symptoms. Globus is an anxiety-causing symptom, but reassurance is provided by clinical examination by the otolaryngologist. © 2018 John Wiley & Sons Ltd.

Recurrent zoonotic transmission of Nipah virus into humans, Bangladesh, 2001-2007.

PubMed

Luby, Stephen P; Hossain, M Jahangir; Gurley, Emily S; Ahmed, Be Nazir; Banu, Shakila; Khan, Salah Uddin; Homaira, Nusrat; Rota, Paul A; Rollin, Pierre E; Comer, James A; Kenah, Eben; Ksiazek, Thomas G; Rahman, Mahmudur

2009-08-01

Human Nipah outbreaks recur in a specific region and time of year in Bangladesh. Fruit bats are the reservoir host for Nipah virus. We identified 23 introductions of Nipah virus into human populations in central and northwestern Bangladesh from 2001 through 2007. Ten introductions affected multiple persons (median 10). Illness onset occurred from December through May but not every year. We identified 122 cases of human Nipah infection. The mean age of case-patients was 27 years; 87 (71%) died. In 62 (51%) Nipah virus-infected patients, illness developed 5-15 days after close contact with another Nipah case-patient. Nine (7%) Nipah case-patients transmitted virus to others. Nipah case-patients who had difficulty breathing were more likely than those without respiratory difficulty to transmit Nipah (12% vs. 0%, p = 0.03). Although a small minority of infected patients transmit Nipah virus, more than half of identified cases result from person-to-person transmission. Interventions to prevent virus transmission from bats to humans and from person to person are needed.

The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study.

PubMed

Scott, J Anthony G; Wonodi, Chizoba; Moïsi, Jennifer C; Deloria-Knoll, Maria; DeLuca, Andrea N; Karron, Ruth A; Bhat, Niranjan; Murdoch, David R; Crawley, Jane; Levine, Orin S; O'Brien, Katherine L; Feikin, Daniel R

2012-04-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1-59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing.

The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

PubMed Central

Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O’Brien, Katherine L.; Feikin, Daniel R.

2012-01-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing. PMID:22403224

Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts.

PubMed

Del Valle-Mendoza, Juana; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; Del Valle-Vargas, Cristina; Cieza-Mora, Erico; Martins-Luna, Johanna; Aquino-Ortega, Ronald; Silva-Vásquez, Andrea; Bazán-Mayra, Jorge; Weilg, Pablo

2018-05-18

Describe the prevalence of Bordetella pertussis via PCR in children under 5 years old hospitalized as probable cases of pertussis and report the most common clinical features among them. A positive PCR result for B. pertussis was observed in 20.5% of our samples (18/88), one-third of them were from infants between 2 and 3 months old. The most common symptoms were paroxysms of coughing (88.9%), difficulty breathing (72.2%), cyanosis (77.8%) and fever (50%). The mother was the most common symptomatic carrier (27.8%), followed by uncles/aunts (22.2%) among children with pertussis.

Diagnosing vocal cord dysfunction in young athletes.

PubMed

Rhodes, Rea Kae

2008-12-01

To provide an overview of the pathophysiology, steps in making a diagnosis, differential diagnosis, and treatment methods for vocal cord dysfunction (VCD) in young athletes. Review of published literature about VCD and exercise-induced asthma (EIA) and a case study. The clinical presentation of VCD is often confusing. A young athlete who is having difficulty "catching his breath" may have more than EIA. Young athletes who have been previously diagnosed with EIA may actually have VCD. The ability to correctly differentiate VCD from other causes of respiratory distress can lead to accurate interventions, save precious time in an acute situation, and promote long-term control of this condition.

A Case of Pulmonary Mycobacterium kansasii Disease Complicated with Tension Pneumothorax.

PubMed

Boo, Ki Yung; Lee, Jong Hoo

2015-10-01

Pneumothorax is an extremely rare complication of non-tuberculous mycobacterial infection. A 52-year-old man presenting with difficulty breathing and chest pain was admitted to our hospital. A right-sided pneumothorax was observed on chest radiography and chest computed tomography showed multiple cavitating and non-cavitating nodules with consolidation in the upper to middle lung zones bilaterally. Serial sputum cultures were positive for Mycobacterium kansasii, and he was diagnosed with pulmonary M. kansasii disease complicated by tension pneumothorax. After initiation of treatment including decortications and pleurodesis, the patient made a full recovery. We herein describe this patient's course in detail and review the current relevant literature.

Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion

PubMed Central

Nath, Proggananda; Harada, Michiyo; Sarkar, Santana; Selim, Shahjada; Maude, Richard J; Noiri, Eisei; Faiz, Abul

2014-01-01

Liposomal amphotericin-B (AmBisome) is now becoming first choice for the treatment of visceral leishmaniasis (kala-azar) patients due to high efficacy and less toxicity. The reported incidence of hypersensitivity reactions to liposomal amphotericin-B (AmBisome), especially during therapy, is very rare. We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision. PMID:25139411

Postoperative airway findings after maxillomandibular advancement for obstructive sleep apnea syndrome.

PubMed

Li, K K; Riley, R W; Powell, N B; Zonato, A; Troell, R; Guilleminault, C

2000-02-01

To evaluate the upper airway characteristics in the early postoperative period after maxilomandibular advancement for obstructive sleep apnea syndrome. Nasopharyngolaryngoscopy was performed before and 48 hours after surgery on 70 consecutive patients who underwent maxillomandibular advancement for obstructive sleep apnea syndrome. The preoperative and the postoperative evaluations were performed by the same examiner for consistency. Mild to moderate lateral pharyngeal wall edema was identified in 70 consecutive patients. Fourteen patients (20%) had edema as well as ecchymosis involving the pyriform sinus and aryepiglottic fold. Four of these patients (6%) were also noted to have hypopharyngeal hematoma involving the pyriform sinus, aryepiglottic fold, arytenoid, and false vocal cord that partially obstructed the airway. These four patients were closely monitored for 1 to 2 additional days for possible expanding hematoma leading to airway compromise. None of these patients were found to have airway difficulty, and the minimum oxygen saturation was more than 90% throughout the hospitalization. All four patients were discharged uneventfully, and the hematoma resolved completely within 10 days. Although postoperative edema was expected after maxillomandibular advancement, hypopharyngeal hematoma was unexpected. Although none of our patients had evidence of airway difficulty, the possibility of an expanding hypopharyngeal hematoma should be considered in patients complaining of breathing difficulty after maxillomandibular advancement surgery.

Development of a miniaturized diffusive sampler for true breathing-zone sampling and thermal desorption gas chromatographic analysis.

PubMed

Lindahl, Roger; Levin, Jan-Olof; Sundgren, Margit

2009-07-01

Exposure measurements should be performed as close as possible to the nose and mouth for a more correct assessment of exposure. User-friendly sampling equipment, with a minimum of handling before, during and after measurement, should not affect ordinary work. In diffusive (passive) sampling, no extra equipment as sampling pumps is needed, making the measurements more acceptable to the user. The diffusive samplers are normally attached on a shoulder, on a breast-pocket or on the lapel. There are, however, difficulties if true breathing-zone sampling is to be performed, since available diffusive samplers normally cannot be arranged close to the nose/mouth. The purpose of this work was to study the performance of a miniaturized tube type diffusive sampler attached to a headset for true breathing-zone sampling. The basis for this miniaturization was the Perkin Elmer ATD tube. Both the size of the tube and the amount of adsorbent was decreased for the miniaturized sampler. A special tube holder to be used with a headset was designed for the mini tube. The mini tube is thermally desorbed inside a standard PE tube. The new sampler was evaluated for the determination of styrene, both in laboratory experiments and in field measurements. As reference method, diffusive sampling with standard Perkin Elmer tubes, thermal desorption and gas chromatographic (GC) analysis was used. The sampling rate was determined to 0.356 mL min(-1) (CV 9.6%) and was not significantly affected by concentration, sampling time or relative humidity.

[Disturbed respiratory cycle accompanying hypoxic-ischemic encephalopathy].

PubMed

Saito, Yoshiaki; Masuko, Kaori; Kaneko, Kaori; Saito, Kazuyo; Chikumaru, Yuri; Iwamoto, Hiroko; Matsui, Akira; Kimura, Seiji

2005-09-01

We report the case of a 2-year-old boy who experienced total asphyxia at 4 months of age, and suffered abnormalities at specific phases of the respiratory cycle. The patient was bedridden due to severe tetraplegia and showed little response to external stimuli. He has been tube-fed since the initial asphyxia and a tracheotomy was performed after recurrent hypoxic episodes as a result of the respiratory dysfunction. Upon examination, his respiratory pattern was characterized by arrest during the inspiratory phase with a possible over-riding secondary inspiration. The respiratory pause at the inspiratory phase was markedly prolonged during an episode of pulmonary infection, resulting in recurrent cyanosis that necessitated artificial ventilation. The "second" inspiration typically occurred during the mid- or late-inspiratory phases, with this pattern often shown to be variable after epileptic seizures. The characteristic breathing of this patient suggested that difficulty in forming a normal respiratory cycle, other than during periods of hypoventilation or apnoea, could be a significant respiratory dysfunction following asphyxiation. Strategies for the management of such patients should be carefully designed after close observation of breathing patterns within the respiratory cycle, and with consideration for the influence of epileptic seizures and other inputs from somatic afferents.

A Novel Remote Rehabilitation System with the Fusion of Noninvasive Wearable Device and Motion Sensing for Pulmonary Patients.

PubMed

Tey, Chuang-Kit; An, Jinyoung; Chung, Wan-Young

2017-01-01

Chronic obstructive pulmonary disease is a type of lung disease caused by chronically poor airflow that makes breathing difficult. As a chronic illness, it typically worsens over time. Therefore, pulmonary rehabilitation exercises and patient management for extensive periods of time are required. This paper presents a remote rehabilitation system for a multimodal sensors-based application for patients who have chronic breathing difficulties. The process involves the fusion of sensory data-captured motion data by stereo-camera and photoplethysmogram signal by a wearable PPG sensor-that are the input variables of a detection and evaluation framework. In addition, we incorporated a set of rehabilitation exercises specific for pulmonary patients into the system by fusing sensory data. Simultaneously, the system also features medical functions that accommodate the needs of medical professionals and those which ease the use of the application for patients, including exercises for tracking progress, patient performance, exercise assignments, and exercise guidance. Finally, the results indicate the accurate determination of pulmonary exercises from the fusion of sensory data. This remote rehabilitation system provides a comfortable and cost-effective option in the healthcare rehabilitation system.

[Herpetic encephalitis: a clinical case].

PubMed

Dryhant, L P; Sereda, V H; Kushpiĭ, O V; Tkachenko, V V; Kravchuk, N A; Inhula, N I; Sizina, A V; Sachko, Iu Iu; Andrusenko, A S; Tytenko, Iu I; Babirad, A M

2012-01-01

An example of diagnostics and treatment of patient is in-process made with herpetic encephalitis. It is well-proven in researches, that a herpetic encephalitis is 11.5% among sharp encephalitises. Morbidity is sporadic, some researchers specify on an increase its spring. An infection can be passed tiny and pin a way. Seasonal vibrations are not incident to the herpetic encephalitis. Two peaks of morbidity are on 5-30 years and age more senior 50 years. More than in 95% cases the virus of simple herpes of type serves as an exciter of herpetic encephalitis 1. A characteristic triad of herpetic encephalitis is the sharp feverish beginning, development of cramps of dzheksonovskogo type and violation of consciousness, developing usually after a brief respirator infection. Sometimes sudden development of cramps and loss of consciousness is preceded a fever. Example of such development of disease is made an in our work.

Confirmed viral meningitis with normal CSF findings.

PubMed

Dawood, Naghum; Desjobert, Edouard; Lumley, Janine; Webster, Daniel; Jacobs, Michael

2014-07-17

An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a trip to Peru. At presentation, she had clinical signs of meningism. On admission, blood tests showed a mild lymphopenia, with a normal C reactive protein and white cell count. Chest X-ray and CT of the head were normal. Cerebrospinal fluid (CSF) microscopy was normal. CSF protein and glucose were in the normal range. MRI of the head and cerebral angiography were also normal. Subsequent molecular testing of CSF detected enterovirus RNA by reverse transcriptase PCR. The patient's clinical syndrome correlated with her virological diagnosis and no other cause of her symptoms was found. Her symptoms were self-limiting and improved with supportive management. This case illustrates an important example of viral central nervous system infection presenting clinically as meningitis but with normal CSF microscopy. 2014 BMJ Publishing Group Ltd.

[Laryngeal mask].

PubMed

Villaverde Rozados, María José; Mos Reguera, M Esther; González Argibay, M Concepción; Sixto Gato, Sandra; Radío, Beatriz Alfonso; Fernández Díaz, María José

2003-11-01

A laryngeal mask is a very useful instrument to use both in easy as well as difficult handling situations related to the air tract. This mask is placed in the pharynx and it permits a patient to breathe in different modes, either spontaneously or mechanically. Different models are available; some even facilitate the tracheal intubation through the mask. The authors highlight that this type of mask does not protect nor isolate the air tract. As advantages, the authors point out its easy installation; thus, it is an alternative when an air tract presents difficulties; therefore, it is necessary that all personnel who have to deal with the air tract be aware of this mask and know how to handle it.

Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion.

PubMed

Nath, Proggananda; Basher, Ariful; Harada, Michiyo; Sarkar, Santana; Selim, Shahjada; Maude, Richard J; Noiri, Eisei; Faiz, Abul

2014-10-01

Liposomal amphotericin-B (AmBisome) is now becoming first choice for the treatment of visceral leishmaniasis (kala-azar) patients due to high efficacy and less toxicity. The reported incidence of hypersensitivity reactions to liposomal amphotericin-B (AmBisome), especially during therapy, is very rare. We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

[Difficulties with diagnosis of fibromyalgia: case report].

PubMed

Atarowska, Magdalena; Samborski, Włodzimierz

2006-01-01

We present a case of a 33-year-old woman with nonspecific systemic symptoms (fatigue, weakness), widespread pains, sleep disorders, morning stiffness, accompanied by symptoms from the autonomic nervous system (chest pain, digestive tract disorders, hyperesthesia of the skin, dizziness, paresthesia with a feeling of coldness in hands and feet, excessive sweating, breath problems, palpitations). The diagnostic process was difficult and it took a long time to establish the diagnosis partly because of problems in cooperating with this patient. During several years, the woman was hospitalized at several specialist departments, underwent many consultations, laboratory tests, and imaging studies. Finally, fibromyalgia was diagnosed. Treatment was implemented with good results improving the quality of life of this patient.

Sleep Medicine Care Under One Roof: A Proposed Model for Integrating Dentistry and Medicine

PubMed Central

Sharma, Sunil; Essick, Greg; Schwartz, David; Aronsky, Amy J.

2013-01-01

Integrating oral appliance therapy into the delivery of care for sleeprelated breathing disorders has been a challenge for dental and medical professionals alike. We review the difficulties that have been faced and propose a multidisciplinary care delivery model that integrates dental sleep medicine and sleep medicine under the same roof with educational and research components. The model promises to offer distinct advantages to improved patient care, continuity of treatment, and the central coordination of clinical and insurance-related benefits. Citation: Sharma S; Essick G; Schwartz D; Aronsky AJ. Sleep medicine care under one roof: a proposed model for integrating dentistry and medicine. J Clin Sleep Med 2013;9(8):827-833. PMID:23946715

Recurrent Zoonotic Transmission of Nipah Virus into Humans, Bangladesh, 2001–2007

PubMed Central

Hossain, M. Jahangir; Gurley, Emily S.; Ahmed, Be-Nazir; Banu, Shakila; Khan, Salah Uddin; Homaira, Nusrat; Rota, Paul A.; Rollin, Pierre E.; Comer, James A.; Kenah, Eben; Ksiazek, Thomas G.; Rahman, Mahmudur

2009-01-01

Human Nipah outbreaks recur in a specific region and time of year in Bangladesh. Fruit bats are the reservoir host for Nipah virus. We identified 23 introductions of Nipah virus into human populations in central and northwestern Bangladesh from 2001 through 2007. Ten introductions affected multiple persons (median 10). Illness onset occurred from December through May but not every year. We identified 122 cases of human Nipah infection. The mean age of case-patients was 27 years; 87 (71%) died. In 62 (51%) Nipah virus–infected patients, illness developed 5–15 days after close contact with another Nipah case-patient. Nine (7%) Nipah case-patients transmitted virus to others. Nipah case-patients who had difficulty breathing were more likely than those without respiratory difficulty to transmit Nipah (12% vs. 0%, p = 0.03). Although a small minority of infected patients transmit Nipah virus, more than half of identified cases result from person-to-person transmission. Interventions to prevent virus transmission from bats to humans and from person to person are needed. PMID:19751584

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

PubMed Central

de Zambotti, Massimiliano; Colrain, Ian M; Bei, Bei

2018-01-01

A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years. PMID:29445307

Challenges experienced during rehabilitation after traumatic multiple rib fractures: a qualitative study.

PubMed

Claydon, Jacqueline; Maniatopoulos, Gregory; Robinson, Lisa; Fearon, Paul

2017-08-02

People with multiple rib fractures rarely receive rehabilitation aimed specifically at their chest wall injuries. This research explores patient perceptions of rehabilitation and recovery. A qualitative study exploring how a purposive sample of 15 people with traumatic multiple rib fractures at a Major Trauma Centre in the United Kingdom make sense of their recovery. Data collected during one-to-one interviews 4 to 9 months after injury. Transcripts analysed using Interpretative Phenomenological Analysis. Struggling with breathing and pain: Difficulties with breathing and pain were initially so severe ?it takes your breath away? and people felt scared they may not survive. These symptoms gradually improved but feeling "out of puff" often persisted. Life on hold: Healing was considered a natural process which people couldn't influence, creating frustration whilst waiting for injuries to heal. Many believed they would never fully recover and accepted limitations. Lucky to be alive: All participants expressed a sense of feeling lucky to be alive. The seriousness of injury prompted a change in attitude to make the most of life. Rib fractures can be painful, but also frightening. A rehabilitation intervention promoting pain management, normalises trauma and restores physical activity may improve recovery. Implications for Rehabilitation Patients identified challenges with rehabilitation throughout the entire recovery journey, and their rehabilitation needs evolved with time. People find it difficult to regain pre-injury fitness even after their fractures heal and pain subsides. A belief there is nothing that can be done to help rib fractures contributed to people lowering their expectations of achieving a full recovery and developing a sense of "making do". Rehabilitation and patient education after traumatic multiple rib fractures should focus on improving pain management, respiratory fitness and emotional well-being.

Anaerobic threshold assessment through the ventilatory method during roller-ski skating testing: right or wrong?

PubMed

Fabre, Nicolas; Bortolan, Lorenzo; Pellegrini, Barbara; Zerbini, Livio; Mourot, Laurent; Schena, Federico

2012-02-01

This study aimed at questioning the validity of the ventilatory method to determine the anaerobic threshold (respiratory compensation point [RCP]) during an incremental roller-ski skating test to exhaustion. Nine elite crosscountry skiers were evaluated. The skiers carried out an incremental roller-ski test on a treadmill with the V2 skating technique. Ventilatory parameters were continuously collected breath by breath, thanks to a portable gas exchange measurement system. Poling signal was obtained using instrumented ski poles. For each stage, ventilatory and poling signals were synchronized and averaged. The poor coefficient of interobserver reliability for the time at RCP confirmed the great difficulty felt by the 3 blinded reviewers for the RCP determination. Moreover, the reviewer agreed with the impossibility of determining RCP in 4 of the 9 skiers. There was no significant difference between breathing frequency (Bf) and poling frequency (Pf) during the last 8 stages. However, it seems that the differences observed during the first stages arose from the use of either a strictly 1:1 or a 1:2 Bf to Pf ratio when the exercise intensity was still moderate. So, even if there were significant differences between the frequencies, the Bf was strictly subordinate to the Pf during the entire test. In the same way, the normalized tidal volume and peak poling forces curves were superposable. These findings showed that when the upper body is mainly involved in the propulsion, the determinants of the ventilation are strictly dependent on the poling pattern during an incremental test to exhaustion. Thus, during roller-ski skating, the determination of RCP must be used cautiously because too much depending on mechanical factors.

[Comparative study of respiratory mechanisms between professional lyrical singers and beginners].

PubMed

Lassalle, A; Grini, M N; Amy de la Bretèque, B; Ouaknine, M; Giovanni, A

2002-01-01

The apprenticeship for classical singing requires years of training due to its complexity. This training is directed at the different levels of the vocal apparatus: the source of energy or air flow (lungs), the vibrator (vocal cords) and the resonators (bucco-pharyngeal cavity). For this study we have concentrated on the first level, that is, respiration. When a greater demand of vocal activity is required respiration becomes more sustained and more complex; this is when difficulties may be observed. Singers overcome these difficulties through different strategies according to their level of vocal training. Our study compared respiratory strategies used by professional singers and singing students (first year conservatoire students) during singing tasks; none of the subjects had any history of vocal pathology. Electromyographic analysis of muscle activity was registered for the rectus abdominals muscle, external oblique muscle and transverse muscle with surface electrodes. Kinetic analysis was used to measure thoracic cage displacement: pressure sensitive belts were placed around the pubis, the epigastric region and thorax. The subjects were asked to perform two vocal tasks: vocalization of a sustained "i" and singing of an extract of a vaccaï. Results were compared between the 7 professional singers and the 6 singing students. They allowed us to confirm the existence of distinct respiratory strategies according to the level of vocal training, as described in literature. Professional singers inhibited the activity of their rectus abdominals muscles during singing and used mostly their external oblique and transverse muscles, thus, sustaining an expanded ribcage and a longer expiratory breath. Singing students, on the other hand, worked intensively all the abdominal muscles leading to a collapse of the ribcage. Management of air was more difficult and breath was shorter. Future studies will consider a larger population sample in order to define quantitative parameters that might allow a significant differentiation of respiratory strategies between professional singers and singing students.

Survival analysis for respiratory failure in patients with food-borne botulism.

PubMed

Witoonpanich, Rawiphan; Vichayanrat, Ekawat; Tantisiriwit, Kanit; Wongtanate, Manas; Sucharitchan, Niwatchai; Oranrigsupak, Petchdee; Chuesuwan, Aphinya; Nakarawat, Weeraworn; Tima, Ariya; Suwatcharangkoon, Sureerat; Ingsathit, Atiporn; Rattanasiri, Sasivimol; Wananukul, Winai

2010-03-01

Botulism is a rare presynaptic neuromuscular junction disorder caused by potent toxins produced by the anaerobic, spore-forming, Gram-positive bacterium Clostridium botulinum. Food-borne botulism is caused by the ingestion of foods contaminated with botulinum toxin. In March 2006, there was a large outbreak of food-borne botulism associated with the ingestion of home-canned bamboo shoots in Thailand. The survival analyses for respiratory failure in these patients were studied and are reported here. A prospective observational cohort study was conducted on this outbreak. The primary outcome of interest was the time to respiratory failure. The secondary outcome was the time to weaning off ventilator. The prognostic factors associated with respiratory failure and weaning off ventilator are presented. A total of 91 in-patients with baseline clinical characteristics were included. Most cases first presented with gastrointestinal symptoms followed by neurological symptoms, the most striking of which being difficulty in swallowing. Common clinical features included ptosis, ophthalmoplegia, proximal muscle weakness, pupillary abnormality, and respiratory failure. Forty-two patients developed respiratory failure requiring mechanical ventilation and the median duration on ventilator was 14 days. The median length of hospital stay for all patients was 13.5 days. Difficulty in breathing, moderate to severe ptosis, and dilated and fixed pupils were associated with respiratory failure. Among patients who were on ventilators, a short incubation period and pupillary abnormality were associated with a longer period of mechanical ventilation. All patients had antitoxin injection and there was no mortality in this outbreak. The history of difficult breathing and the findings of moderate to severe ptosis and pupillary abnormality were associated with severe illness and respiratory failure. A long incubation time was associated with a better prognosis. Although botulism is a potentially fatal disease, there was no mortality in this outbreak. All patients had antitoxin injection and good intensive care that resulted in good clinical outcomes.

Influence of different types of mouthguards on strength and performance of collegiate athletes: a controlled-randomized trial.

PubMed

Duddy, Fergus A; Weissman, Jake; Lee, Rich A; Paranjpe, Avina; Johnson, James D; Cohenca, Nestor

2012-08-01

Prevention of traumatic dental injuries relies on the identification of etiologic factors and the use of protective devices during contact sports. Mouthguards are considered to be an effective and cost-efficient device aimed at buffering the impacts or blows that might otherwise cause moderate to severe dental and maxillofacial injuries. Interestingly, besides their role in preventing injury, some authors claim that mouthguards can enhance athletic performance. Thus, the purpose of this controlled randomized trial was to evaluate and compare the effect of two different types of mouthguards on the athletic performance and strength of collegiate athletes. Eighteen college athletes ranging from 19 to 23 years participated in this study. Devices tested in this study included an over-the-counter boil-and-bite mouthguard (O-Flow™ Max Under Armour®) (UA) and a custom-made mouthguard (CM). Physical tests were carefully selected by the head athletic trainer and aimed at evaluating the strength and performance. The following sequence was carried out on each test day: (i) 3-stroke maximum power ergometer test, (ii) 1-min ergometer test, and (iii) a 1600-m run. A random assignment was developed to test all three experimental groups on each test day. Following the tests, each athlete completed a brief anonymous survey aimed at evaluating the athletes' overall satisfaction with each type of mouthguard. Custom-made mouthguards had no detrimental effect on athletic strength and performance and were reported by the athletes as being comfortable and not causing difficulty in breathing. In contrast, boil-and-bite mouthguards did not perform as well and were reported as being uncomfortable and causing breathing difficulties. Based on the results of this study, the use of custom-made mouthguards should be encouraged in contact sports as a protective measure, without concern for any negative effect on the athletic performance of the athletes. © 2012 John Wiley & Sons A/S.

Voluntary control of breathing does not alter vagal modulation of heart rate

NASA Technical Reports Server (NTRS)

Patwardhan, A. R.; Evans, J. M.; Bruce, E. N.; Eckberg, D. L.; Knapp, C. F.

1995-01-01

Variations in respiratory pattern influence the heart rate spectrum. It has been suggested, hence, that metronomic respiration should be used to correctly assess vagal modulation of heart rate by using spectral analysis. On the other hand, breathing to a metronome has been reported to increase heart rate spectral power in the high- or respiratory frequency region; this finding has led to the suggestion that metronomic respiration enhances vagal tone or alters vagal modulation of heart rate. To investigate whether metronomic breathing complicates the interpretation of heart rate spectra by altering vagal modulation, we recorded the electrocardiogram and respiration from eight volunteers during three breathing trials of 10 min each: 1) spontaneous breathing (mean rate of 14.4 breaths/min); 2) breathing to a metronome at the rate of 15, 18, and 21 breaths/min for 2, 6, and 2 min, respectively; and 3) breathing to a metronome at the rate of 18 breaths/min for 10 min. Data were also collected from eight volunteers who breathed spontaneously for 20 min and breathed metronomically at each subject's mean spontaneous breathing frequency for 20 min. Results from the three 10-min breathing trials showed that heart rate power in the respiratory frequency region was smaller during metronomic breathing than during spontaneous breathing. This decrease could be explained fully by the higher breathing frequencies used during trials 2 and 3 of metronomic breathing. When the subjects breathed metronomically at each subject's mean breathing frequency, the heart rate powers during metronomic breathing were similar to those during spontaneous breathing. Our results suggest that vagal modulation of heart rate is not altered and vagal tone is not enhanced during metronomic breathing.

Pulmonary function in workers exposed to diesel exhausts: the effect of control measures.

PubMed

Ulfvarson, U; Alexandersson, R; Dahlqvist, M; Ekholm, U; Bergström, B

1991-01-01

To assess the protective effect of exhausts pipe filters or respirators on pulmonary function, 15 workers in a tunnel construction site, truck and loading machine drivers, rock workers, and others were studied. The total and respirable dust, combustible matter in respirable dust, carbon monoxide, nitrogen monoxide and nitrogen dioxide were measured for each subject during entire work shifts. The effect of the exposure on the lung function variables was measured by dynamic spirometry, carbon monoxide single breath technique, and nitrogen single breath wash-out. The exhaust pipe filtering had a protective effect, directly discernible in the drivers on vital capacity and FEV1.0 and for the whole group on FEV% and TLco. The dust respirators had no effect, probably because of the difficulties in correctly using personal protection under the circumstances in the tunnel. In the absence of a true exposure assessment, control measures for diesel exhausts can be tested by medical effect studies. Catalytic particle filters of diesel exhausts are one method of rendering the emissions less irritant, although they will not remove irritant gases. An indicator of diesel exhaust exposure should include the particle fraction of the diesel exhausts, but a discrimination between different sources of organic dust must be possible.

Airborne Dust in Space Vehicles and Habitats

NASA Technical Reports Server (NTRS)

James, John

2006-01-01

Airborne dust, suspended inside a space vehicle or in future celestial habitats, can present a serious threat to crew health if it is not controlled. During the Apollo missions to the moon, lunar dust brought inside the capsule caused eye irritation and breathing difficulty to the crew when they launched from the moon and re-acquired "microgravity." During Shuttle flights reactive and toxic dusts such as lithium hydroxide have created a risk to crew health, and fine particles from combustion events can be especially worrisome. Under nominal spaceflight conditions, airborne dusts and particles tend to be larger than on earth because of the absence of gravity settling. Aboard the ISS, dusts are effectively managed by HEPA filters, although floating dust in newly-arrived modules can be a nuisance. Future missions to the moon and to Mars will present additional challenges because of the possibility that external dust will enter the breathing atmosphere of the habitat and reach the crew's respiratory system. Testing with simulated lunar and Martian dust has shown that these materials are toxic when placed into the lungs of test animals. Defining and evaluating the physical and chemical properties of Martian dusts through robotic missions will challenge our ability to prepare better dust simulants and to determine the risk to crew health from exposure to such dusts.

Comminuted Laryngeal Fracture Following Blunt Trauma: A Need for Strict Legislation on Roads!

PubMed

Jain, Shraddha; Singh, Pragya; Gupta, Minal; Kamble, Bhavna; Phatak, Suresh S

2017-01-01

Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding. He presented with breathing difficulty, change in voice, surgical emphysema, and pneumomediastinum, but without any skin changes over the neck. His airway could be restored due to early tracheostomy and open reduction with internal fixation with sutures along with laryngeal stenting. He has no significant swallowing or breathing problem and reasonably good voice 6 months after surgery. This case highlights the need for strict legislation on roads in India and the importance of high level of suspicion for laryngeal fracture in acute trauma patient. Early identification and timely internal fixation not only restore the airway but also improve long-term voice and airway outcomes.

Relaxant effect of superimposed length oscillation on sensitized airway smooth muscle.

PubMed

Jo-Avila, Miguel; Al-Jumaily, Ahmed M; Lu, Jun

2015-03-01

Asthma is associated with reductions in the airway lumen and breathing difficulties that are attributed to airway smooth muscles (ASM) hyperconstriction. Pharmaceutical bronchodilators such as salbutamol and isoproterenol are normally used to alleviate this constriction. Deep inspirations and tidal oscillations (TO) have also been reported to relax ASM in healthy airways with less response in asthmatics. Little information is available on the effect of other forms of oscillation on asthmatic airways. This study investigates the effect of length oscillations (LO), with amplitude 1 and 1.5% in the frequency range 5-20 Hz superimposed on breathing equivalent LO, on contracted ASM dissected from sensitized mice. These mice are believed to show some symptoms such as airway hyperreactivity similar to those associated with asthma in humans. In the frequency range used in this work, this study shows an increase in ASM relaxation of an average of 10% for 1.5% amplitude when compared with TO, ISO, or the combination of both. No similar finding is observed with 1% amplitude. This suggests that superimposed length oscillation acting over the interaction of myosin and actin during contraction may lead to temporal rearrangement and disturbance of the cross-bridge process in asthmatic airways. Copyright © 2015 the American Physiological Society.

Biological effects of 2,4-pentadiene-1-ol.

PubMed

Benesová, O; Sprincl, L; Ulbrich, K; Obereigner, B; Drobník, J; Kálal, J; Kopecek

1977-07-01

The biological effects of 2,4-pentadiene-1-ol (CH2 = CH--CH = CH--CH2--OH) the starting monomer in the preparation of a biocompatible polymer were studied. The experiments in rats revealed both a high local (oedema, necrosis) and systemic toxicity. Within 5-10 min after dermal application of 0.2 ml the compound evoked intensive hyperaemia of acral parts (ears, snout, paws) and induced severe breathing difficulties which led to death in half of the animals after a single administration. The most evident macroscopic and microscopic pathologic changes were found in the place of application and in the lungs (haemorrhage in alveolae). Both clinical and histological findings indicated that the toxicity is due to an increased permeability of capillaries.

Anesthetic Management in Pediatric Patient for Percutaneous Endoscopic Gastrostomy with Mitochondrial Myopathy: Leigh Syndrome

PubMed Central

Kiliç, Ebru Tarikçi; Gerenli, Nelgin; Akdemir, Mehmet Salim; Tastan, Necmi Onur; Atag, Egemen

2018-01-01

Leigh syndrome (LS) is a rare disease mainly affecting the central nervous system due to the abnormalities of mitochondrial energy generation and seen in early childhood with progressive loss of movement, mental abilities, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Anesthesia and surgery exacerbate the risks of aspiration, wheezing, and breathing difficulties. Tracheal irritability can be stimulated with the efforts of intubation. We report the anesthetic management of a rare case of an 11-year-old boy with a severe form of LS for percutaneous endoscopic gastrostomy insertion. The patient was closely monitored during the procedure and the postoperative period. Carefully chosen anesthetic agents, good pain control, and close monitoring are essential. PMID:29628597

TR-BREATH: Time-Reversal Breathing Rate Estimation and Detection.

PubMed

Chen, Chen; Han, Yi; Chen, Yan; Lai, Hung-Quoc; Zhang, Feng; Wang, Beibei; Liu, K J Ray

2018-03-01

In this paper, we introduce TR-BREATH, a time-reversal (TR)-based contact-free breathing monitoring system. It is capable of breathing detection and multiperson breathing rate estimation within a short period of time using off-the-shelf WiFi devices. The proposed system exploits the channel state information (CSI) to capture the miniature variations in the environment caused by breathing. To magnify the CSI variations, TR-BREATH projects CSIs into the TR resonating strength (TRRS) feature space and analyzes the TRRS by the Root-MUSIC and affinity propagation algorithms. Extensive experiment results indoor demonstrate a perfect detection rate of breathing. With only 10 s of measurement, a mean accuracy of can be obtained for single-person breathing rate estimation under the non-line-of-sight (NLOS) scenario. Furthermore, it achieves a mean accuracy of in breathing rate estimation for a dozen people under the line-of-sight scenario and a mean accuracy of in breathing rate estimation of nine people under the NLOS scenario, both with 63 s of measurement. Moreover, TR-BREATH can estimate the number of people with an error around 1. We also demonstrate that TR-BREATH is robust against packet loss and motions. With the prevailing of WiFi, TR-BREATH can be applied for in-home and real-time breathing monitoring.

Syllable-related breathing in infants in the second year of life.

PubMed

Parham, Douglas F; Buder, Eugene H; Oller, D Kimbrough; Boliek, Carol A

2011-08-01

This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection protocol was used to identify analyzable breath cycles. Syllables were categorized on the basis of consensus coding. Inspiratory and expiratory durations, excursions, and slopes were calculated for the 3 breath cycle types and were normalized using mean tidal breath measures. Tidal breathing cycles were significantly different from syllable-related cycles on all breathing measures. There were no significant differences between unarticulated syllable cycles and canonical syllable cycles, even after controlling for utterance duration and sound pressure level. Infants in the 2nd year of life exhibit clear differences between tidal breathing and speech-related breathing, but categorically distinct breath support for syllable types with varying articulatory demands was not evident in the present findings. Speech development introduces increasingly complex utterances, so older infants may produce detectable articulation-related adaptations of breathing kinematics. For younger infants, breath support may vary systematically among utterance types, due more to phonatory variations than to articulatory demands.

Syllable-Related Breathing in Infants in the Second Year of Life

PubMed Central

Parham, Douglas F.; Buder, Eugene H.; Oller, D. Kimbrough; Boliek, Carol A.

2010-01-01

Purpose This study explored whether breathing behaviors of infants within the second year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Method Vocalizations and breathing kinematics of nine infants between 53 and 90 weeks of age were recorded. A strict selection protocol was used to identify analyzable breath cycles. Syllables were categorized based on consensus coding. Inspiratory and expiratory durations, excursions, and slopes were calculated for the three breath cycle types and normalized using mean tidal breath measures. Results Tidal breathing cycles were significantly different from syllable-related cycles on all breathing measures. There were no significant differences between unarticulated syllable cycles and canonical syllable cycles, even after controlling for utterance duration and sound pressure level. Conclusions Infants in the second year of life exhibit clear differences between tidal breathing and speech-related breathing, but categorically distinct breath support for syllable types with varying articulatory demands was not evident in the current findings. Speech development introduces increasingly complex utterances, so older infants may produce detectable articulation-related adaptations of breathing kinematics. For younger infants, breath support may vary systematically among utterance types, due more to phonatory variations than to articulatory demands. PMID:21173390

Changes in the oral health-related quality of life 24 h following insertion of fixed orthodontic appliances.

PubMed

Mansor, Noorhanizar; Saub, Roslan; Othman, Siti Adibah

2012-10-01

The objective of this study was to assess changes in the oral health-related quality of life (OHRQoL) among patients wearing fixed orthodontic appliances 24 h after insertion. Sixty patients aged between 14 and 24 years (29 males and 31 females; mean age, 17.8 years; SD 3.1 years) were recruited from the Postgraduate Clinic, Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya. The oral health-related quality of life (OHRQoL) was measured before treatment and 24 h after insertion of the orthodontic appliance. The instrument used to measure OHRQoL was a modified self-administered short version of Malaysian Oral Health Impact Profile (OHIP-16[M]) questionnaire. The higher the score, the poorer is the OHRQoL. Overall score of OHRQoL increased significantly 24 h after insertion (mean 43.5±10.9) as compared to before insertion (mean 34.1±9.2) (P<0.001). Significant changes were found for the following items: Difficulties in chewing, bad breath, difficulties in pronunciation, discomfort in eating, ulcer, pain, avoidances of eating certain foods, difficulties in cleaning, embarrassment, avoid smiling, disturbed sleep, concentration affected, difficulty carrying out daily activities, and lack of self-confidence (P<0.05). Significant changes were also found in the mean difference of OHRQoL for gender (P<0.001). OHRQoL was found to deteriorate 24 h after insertion of fixed orthodontic appliances in almost all domains, with significant changes in gender. This information can be used as "informed consent", which might increase patient's compliance as they are aware of what to expect from initial orthodontic treatment.

Free-breathing quantification of hepatic fat in healthy children and children with nonalcoholic fatty liver disease using a multi-echo 3-D stack-of-radial MRI technique.

PubMed

Armstrong, Tess; Ly, Karrie V; Murthy, Smruthi; Ghahremani, Shahnaz; Kim, Grace Hyun J; Calkins, Kara L; Wu, Holden H

2018-05-04

In adults, noninvasive chemical shift encoded Cartesian magnetic resonance imaging (MRI) and single-voxel magnetic resonance (MR) spectroscopy (SVS) accurately quantify hepatic steatosis but require breath-holding. In children, especially young and sick children, breath-holding is often limited or not feasible. Sedation can facilitate breath-holding but is highly undesirable. For these reasons, there is a need to develop free-breathing MRI technology that accurately quantifies steatosis in all children. This study aimed to compare non-sedated free-breathing multi-echo 3-D stack-of-radial (radial) MRI versus standard breath-holding MRI and SVS techniques in a group of children for fat quantification with respect to image quality, accuracy and repeatability. Healthy children (n=10, median age [±interquartile range]: 10.9 [±3.3] years) and overweight children with nonalcoholic fatty liver disease (NAFLD) (n=9, median age: 15.2 [±3.2] years) were imaged at 3 Tesla using free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS. Acquisitions were performed twice to assess repeatability (within-subject mean difference, MD within ). Images and hepatic proton-density fat fraction (PDFF) maps were scored for image quality. Free-breathing and breath-holding PDFF were compared using linear regression (correlation coefficient, r and concordance correlation coefficient, ρ c ) and Bland-Altman analysis (mean difference). P<0.05 was considered significant. In patients with NAFLD, free-breathing radial MRI demonstrated significantly less motion artifacts compared to breath-holding Cartesian (P<0.05). Free-breathing radial PDFF demonstrated a linear relationship (P<0.001) versus breath-holding SVS PDFF and breath-holding Cartesian PDFF with r=0.996 and ρ c =0.994, and r=0.997 and ρ c =0.995, respectively. The mean difference in PDFF between free-breathing radial MRI, breath-holding Cartesian MRI and breath-holding SVS was <0.7%. Repeated free-breathing radial MRI had MD within =0.25% for PDFF. In this pediatric study, non-sedated free-breathing radial MRI provided accurate and repeatable hepatic PDFF measurements and improved image quality, compared to standard breath-holding MR techniques.

[Microorganisms of the order Rickettsiales in taiga tick (Ixodes persulcatus Sch.) from the Pre-Ural region].

PubMed

Nefedova, V V; Korenberg, E I; Kovalevskiĭ, Iu V; Gorelova, N B; Vorob'eva, N N

2008-01-01

The PCR and sequence analysis revealed DNA Ehrlichia muris, Anaplasma phagocytophilum, and Rickettsia spp. in the I. persulcatus ticks and blood samples from a patients with acute febrile illness occurring after a tick bite, registered in the seasonal peak of the tick activity of one of the highly endemic areas of Russia (Perm region). These data confirmed the validity a diagnosis of HME and HGA, which were made earlier on the basis of the clinical-serologic survey. In 10.0% of the tested taiga ticks were detected DNA of two and more agents in various combinations i.e. E. muris and Rickettsia spp, A. phagocytophilum and Rickettsia spp., and E. muris, A. phagocytophilum and Rickettsia spp. DNA of a R. helvetica was detected in I. persulcatus tick and blood tick-bitten patient with febrile episodes. Probably that R. helvetica can be etiological agent in some part of cases with the serologically unconfirmed diagnoses of acute feverish diseases developing after tick bite.

Success requires seizing opportunities.

PubMed

Melum, M M

1987-01-01

The well-trained group of professionals had worked hard at the business they knew well. Their efforts had paid off--they were highly respected for their quality; their business grew; they had a close, trusting relationship with their customers; and they had the satisfaction of running their business as they alone knew to be best. As they looked ahead, they saw the personal security of a bright, safe future, of more of the same success. Then, slowly at first but building steadily to a feverish pace, their business and their lives were uprooted and torn apart in an all-encompassing economic and social earthquake. Now, with a force the professionals could hardly believe, let alone keep track of, the very definition of their business was changing, the trusting relationship with customers began to break down as massive numbers of new and different competitors vied for their business, many new players began to control how they ran their business, and security vanished into a confusion of competition, entrepreneurship, and risk.

Dynamic phosphorylation of Ebola virus VP30 in NP-induced inclusion bodies.

PubMed

Lier, Clemens; Becker, Stephan; Biedenkopf, Nadine

2017-12-01

Zaire Ebolavirus (EBOV) causes a severe feverish disease with high case fatality rates. Transcription of EBOV is dependent on the activity of the nucleocapsid protein VP30 which represents an essential viral transcription factor. Activity of VP30 is regulated via phosphorylation at six N-terminal serine residues. Recent data demonstrated that dynamic phosphorylation and dephosphorylation of serine residue 29 is essential for transcriptional support activity of VP30. To analyze the spatio/temporal dynamics of VP30 phosphorylation, we generated a peptide antibody recognizing specifically VP30 phosphorylated at serine 29. Using this antibody we could demonstrate that (i) the majority of VP30 molecules in EBOV-infected cells is dephosphorylated at the crucial position serine 29, (ii) both, VP30 phosphorylation and dephosphorylation take place in viral inclusion bodies that are induced by the nucleoprotein NP and (iii) NP influences the phosphorylation state of VP30. Copyright © 2017 Elsevier Inc. All rights reserved.

Breathing efficiency during inspiratory threshold loading in patients with chronic obstructive pulmonary disease.

PubMed

Baarends, E M; Schols, A M; Nusmeier, C M; van der Grinten, C P; Wouters, E F

1998-05-01

Patients with chronic obstructive pulmonary disease (COPD) demonstrate an increased oxygen cost of breathing. It is as yet unclear whether this is related to a decreased breathing efficiency. The aim of the present study was to compare breathing efficiency in 16 patients with COPD (11 men, five women) and 16 healthy elderly subjects (seven men, nine women), and to investigate a possible relationship between breathing efficiency and resting energy expenditure (REE). REE was measured using a ventilated hood system. Breathing efficiency was assessed by measuring oxygen consumption (V'O2), mean inspiratory mouth pressure (MIP) and flow during breathing at rest and subsequently during breathing against an inspiratory threshold (40% of maximal inspiratory pressure). During loaded breathing there was a significant increase in V'O2, MIP, and external work of breathing compared with unloaded breathing in both groups. As intended, ventilation did not increase significantly during the breathing efficiency test in the patients with COPD. The breathing efficiency (median, range) of the patients with COPD was similar (3.7%, 1.4-8.7%) to that of the healthy elderly subjects (3.2%, 1.7-8.3%). Breathing efficiency was not correlated with REE in either group. In the present study, in which dynamic hyperinflation was probably prevented, no difference in breathing efficiency was found between healthy elderly subjects and COPD patients when breathing against an external inspiratory threshold. Furthermore, breathing efficiency was not related to REE in both groups.

Dosimetric comparison of moderate deep inspiration breath-hold and free-breathing intensity-modulated radiotherapy for left-sided breast cancer.

PubMed

Chi, F; Wu, S; Zhou, J; Li, F; Sun, J; Lin, Q; Lin, H; Guan, X; He, Z

2015-05-01

This study determined the dosimetric comparison of moderate deep inspiration breath-hold using active breathing control and free-breathing intensity-modulated radiotherapy (IMRT) after breast-conserving surgery for left-sided breast cancer. Thirty-one patients were enrolled. One free breathe and two moderate deep inspiration breath-hold images were obtained. A field-in-field-IMRT free-breathing plan and two field-in-field-IMRT moderate deep inspiration breath-holding plans were compared in the dosimetry to target volume coverage of the glandular breast tissue and organs at risks for each patient. The breath-holding time under moderate deep inspiration extended significantly after breathing training (P<0.05). There was no significant difference between the free-breathing and moderate deep inspiration breath-holding in the target volume coverage. The volume of the ipsilateral lung in the free-breathing technique were significantly smaller than the moderate deep inspiration breath-holding techniques (P<0.05); however, there was no significant difference between the two moderate deep inspiration breath-holding plans. There were no significant differences in target volume coverage between the three plans for the field-in-field-IMRT (all P>0.05). The dose to ipsilateral lung, coronary artery and heart in the field-in-field-IMRT were significantly lower for the free-breathing plan than for the two moderate deep inspiration breath-holding plans (all P<0.05); however, there was no significant difference between the two moderate deep inspiration breath-holding plans. The whole-breast field-in-field-IMRT under moderate deep inspiration breath-hold with active breathing control after breast-conserving surgery in left-sided breast cancer can reduce the irradiation volume and dose to organs at risks. There are no significant differences between various moderate deep inspiration breath-holding states in the dosimetry of irradiation to the field-in-field-IMRT target volume coverage and organs at risks. Copyright © 2015 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Recovery of Percent Vital Capacity by Breathing Training in Patients With Panic Disorder and Impaired Diaphragmatic Breathing.

PubMed

Yamada, Tatsuji; Inoue, Akiomi; Mafune, Kosuke; Hiro, Hisanori; Nagata, Shoji

2017-09-01

Slow diaphragmatic breathing is one of the therapeutic methods used in behavioral therapy for panic disorder. In practice, we have noticed that some of these patients could not perform diaphragmatic breathing and their percent vital capacity was initially reduced but could be recovered through breathing training. We conducted a comparative study with healthy controls to investigate the relationship between diaphragmatic breathing ability and percent vital capacity in patients with panic disorder. Our findings suggest that percent vital capacity in patients with impaired diaphragmatic breathing was significantly reduced compared with those with normal diaphragmatic breathing and that diaphragmatic breathing could be restored by breathing training. Percent vital capacity of the healthy controls was equivalent to that of the patients who had completed breathing training. This article provides preliminary findings regarding reduced vital capacity in relation to abnormal respiratory movements found in patients with panic disorder, potentially offering alternative perspectives for verifying the significance of breathing training for panic disorder.

Prevalence and Losses in Quality-Adjusted Life Years of Child Health Conditions: A Burden of Disease Analysis.

PubMed

Craig, Benjamin M; Hartman, John D; Owens, Michelle A; Brown, Derek S

2016-04-01

To estimate the prevalence and losses in quality-adjusted life years (QALYs) associated with 20 child health conditions. Using data from the 2009-2010 National Survey of Children with Special Health Care Needs, preference weights were applied to 14 functional difficulties to summarize the quality of life burden of 20 health conditions. Among the 14 functional difficulties, "a little trouble with breathing" had the highest prevalence (37.1 %), but amounted to a loss of just 0.16 QALYs from the perspective of US adults. Though less prevalent, "a lot of behavioral problems" and "chronic pain" were associated with the greatest losses (1.86 and 3.43 QALYs). Among the 20 conditions, allergies and asthma were the most prevalent but were associated with the least burden. Muscular dystrophy and cerebral palsy were among the least prevalent and most burdensome. Furthermore, a scatterplot shows the association between condition prevalence and burden. In child health, condition prevalence is negatively associated with quality of life burden from the perspective of US adults. Both should be considered carefully when evaluating the appropriate role for public health prevention and interventions.

Relationship between Dysphagia and Exacerbations in Chronic Obstructive Pulmonary Disease: A Literature Review

PubMed Central

Steidl, Eduardo; Ribeiro, Carla Simone; Gonçalves, Bruna Franciele; Fernandes, Natália; Antunes, Vívian; Mancopes, Renata

2014-01-01

Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease. PMID:25992155

The role of arterial chemoreceptors in the breath-by-breath augmentation of inspiratory effort in rabbits during airway occlusion or elastic loading.

PubMed

Callanan, D; Read, D J

1974-08-01

1. The breath-by-breath augmentation of inspiratory effort in the five breaths following airway occlusion or elastic loading was assessed in anaesthetized rabbits from changes of airway pressure, diaphragm e.m.g. and lung volume.2. When the airway was occluded in animals breathing air, arterial O(2) tension fell by 20 mmHg and CO(2) tension rose by 7 mmHg within the time of the first five loaded breaths.3. Inhalation of 100% O(2) or carotid denervation markedly reduced the breath-by-breath progression but had little or no effect on the responses at the first loaded breath.4. These results indicate that the breath-by-breath augmentation of inspiratory effort following addition of a load is mainly due to asphyxial stimulation of the carotid bodies, rather than to the gradual emergence of a powerful load-compensating reflex originating in the chest-wall, as postulated by some workers.5. The small residual progression seen in animals breathing 100% O(2) or following carotid denervation was not eliminated (a) by combining these procedures or (b) by addition of gas to the lungs to prevent the progressive lung deflation which occurred during airway occlusion.6. Bilateral vagotomy, when combined with carotid denervation, abolished the residual breath-by-breath progression of inspiratory effort.

Outcome of breath tests in adult patients with suspected small intestinal bacterial overgrowth

PubMed Central

Mattsson, Johanna; Minaya, Maria Teresa; Monegro, Milka; Lebwohl, Benjamin; Lewis, Suzanne K.; Green, Peter HR; Stenberg, Reidun

2017-01-01

Aim: The aim was to investigate breath test outcomes in patients with suspected SIBO and indicative symptoms of SIBO, diagnosed by breath testing. Background: Breath testing is used to detect small intestinal bacterial overgrowth (SIBO) by measuring hydrogen and methane produced by intestinal bacteria. Methods: This retrospective cross sectional study included 311 patients with gastrointestinal symptoms who underwent the breath test for evaluation of SIBO at Celiac Disease Center at Columbia University, New York, in 2014-2015. The patients were divided into two groups based on the physician’s choice: lactulose breath test group (72%) and glucose breath test group (28%). Among them, 38% had a history of celiac disease or non-celiac gluten sensitivity. Results: In total, 46% had a positive breath test: 18% were positive for methane, 24 % positive for hydrogen and 4% positive for both gases (p=0.014). Also, 50% had a positive lactulose breath result and 37% had a positive glucose breath result (p=0.036). The most common symptom for performing the breath test was bloating and the only clinical symptom that significantly showed a positive glucose breath test was increased gas (p=0.028). Conclusion: Lactulose breath test was more often positive than glucose breath test. Positivity for hydrogen was more common than methane. Bloating was the most frequently perceived symptom of the patients undergoing the breath test but the only statistically significant clinical symptom for a positive glucose breath test was increased gas. Furthermore, the results showed that there was no significant association between positive breath test result and gender, age, non-celiac gluten sensitivity or celiac disease. PMID:29118931

Sensing the effects of mouth breathing by using 3-tesla MRI

NASA Astrophysics Data System (ADS)

Park, Chan-A.; Kang, Chang-Ki

2017-06-01

We investigated the effects of mouth breathing and typical nasal breathing on brain function by using blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI). The study had two parts: the first test was a simple contrast between mouth and nasal breathing, and the second test involved combined breathing modes, e.g., mouth inspiration and nasal expiration. Eleven healthy participants performed the combined breathing task while undergoing 3T fMRI. In the group-level analysis, contrast images acquired by using an individual participantlevel analysis were processed using the one-sample t test. We also conducted a region-of-interest analysis comparing signal intensity changes between the breathing modes; the region was selected using an automated anatomical labeling map. The results demonstrated that the BOLD signal in the hippocampus and brainstem was significantly decreased in mouth breathing relative to nasal breathing. On the other hand, both the precentral and postcentral gyri showed activation that was more significant in mouth breathing compared to nasal breathing. This study suggests that the BOLD activity patterns between mouth and nasal breathing may be induced differently, especially in the hippocampus, which could provide clues to explain the effects on brain cognitive function due to mouth breathing.

Application of LaserBreath-001 for breath acetone measurement in subjects with diabetes mellitus

NASA Astrophysics Data System (ADS)

Wang, Zhennan; Sun, Meixiu; Chen, Zhuying; Zhao, Xiaomeng; Li, Yingxin; Wang, Chuji

2016-11-01

Breath acetone is a promising biomarker of diabetes mellitus. With an integrated standalone, on-site cavity ringdown breath acetone analyzer, LaserBreath-001, we tested breath samples from 23 type 1 diabetic (T1D) patients, 312 type 2 diabetic (T2D) patients, 52 healthy subjects. In the cross-sectional studies, the obtained breath acetone concentrations were higher in the diabetic subjects compared with those in the control group. No correlation between breath acetone and simultaneous BG was observed in the T1D, T2D, and healthy subjects. A moderate positive correlation between the mean individual breath acetone concentrations and the mean individual BG levels was observed in the 20 T1D patients without ketoacidosis. In a longitudinal study, the breath acetone concentrations in a T1D patient with ketoacidosis decreased significantly and remained stable during the 5-day hospitalization. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone concentrations, fast (<1 min) and on site breath acetone measurement can be used for diabetic screening and management under a specifically controlled condition.

Apnea of Prematurity (For Parents)

MedlinePlus

... large bursts of breath followed by periods of shallow breathing or stopped breathing. Apnea of prematurity usually ... seconds and is followed by several fast and shallow breaths. Periodic breathing doesn't cause a change ...

How to breathe when you are short of breath

MedlinePlus

... pursed lip breathing; Hypoxia - pursed lip breathing; Chronic respiratory failure - pursed lip breathing ... et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

Controlled breathing protocols probe human autonomic cardiovascular rhythms

NASA Technical Reports Server (NTRS)

Cooke, W. H.; Cox, J. F.; Diedrich, A. M.; Taylor, J. A.; Beightol, L. A.; Ames, J. E. 4th; Hoag, J. B.; Seidel, H.; Eckberg, D. L.

1998-01-01

The purpose of this study was to determine how breathing protocols requiring varying degrees of control affect cardiovascular dynamics. We measured inspiratory volume, end-tidal CO2, R-R interval, and arterial pressure spectral power in 10 volunteers who followed the following 5 breathing protocols: 1) uncontrolled breathing for 5 min; 2) stepwise frequency breathing (at 0.3, 0.25, 0.2, 0.15, 0.1, and 0.05 Hz for 2 min each); 3) stepwise frequency breathing as above, but with prescribed tidal volumes; 4) random-frequency breathing (approximately 0.5-0.05 Hz) for 6 min; and 5) fixed-frequency breathing (0.25 Hz) for 5 min. During stepwise breathing, R-R interval and arterial pressure spectral power increased as breathing frequency decreased. Control of inspired volume reduced R-R interval spectral power during 0.1 Hz breathing (P < 0.05). Stepwise and random-breathing protocols yielded comparable coherence and transfer functions between respiration and R-R intervals and systolic pressure and R-R intervals. Random- and fixed-frequency breathing reduced end-tidal CO2 modestly (P < 0.05). Our data suggest that stringent tidal volume control attenuates low-frequency R-R interval oscillations and that fixed- and random-rate breathing may decrease CO2 chemoreceptor stimulation. We conclude that autonomic rhythms measured during different breathing protocols have much in common but that a stepwise protocol without stringent control of inspired volume may allow for the most efficient assessment of short-term respiratory-mediated autonomic oscillations.

42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing... the container. (d) Compressed breathing gas contained valves or a separate charging system or adapter...

42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing... the container. (d) Compressed breathing gas contained valves or a separate charging system or adapter...

42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing... the container. (d) Compressed breathing gas contained valves or a separate charging system or adapter...

42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing... the container. (d) Compressed breathing gas contained valves or a separate charging system or adapter...

42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing... the container. (d) Compressed breathing gas contained valves or a separate charging system or adapter...

Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command.

PubMed

Gutzeit, Andreas; Matoori, Simon; Froehlich, Johannes M; von Weymarn, Constantin; Reischauer, Carolin; Kolokythas, Orpheus; Goyen, Matthias; Hergan, Klaus; Meissnitzer, Matthias; Forstner, Rosemarie; Soyka, Jan D; Doert, Aleksis; Koh, Dow-Mu

2016-08-01

To investigate whether a trained group of technicians using a modified breathing command during gadoxetate-enhanced liver MRI reduces respiratory motion artefacts compared to non-trained technicians using a traditional breathing command. The gadoxetate-enhanced liver MR images of 30 patients acquired using the traditional breathing command and the subsequent 30 patients after training the technicians to use a modified breathing command were analyzed. A subgroup of patients (n = 8) underwent scans both by trained and untrained technicians. Images obtained using the traditional and modified breathing command were compared for the presence of breathing artefacts [respiratory artefact-based image quality scores from 1 (best) to 5 (non-diagnostic)]. There was a highly significant improvement in the arterial phase image quality scores in patients using the modified breathing command compared to the traditional one (P < 0.001). The percentage of patients with severe and extensive breathing artefacts in the arterial phase decreased from 33.3 % to 6.7 % after introducing the modified breathing command (P = 0.021). In the subgroup that underwent MRI using both breathing commands, arterial phase image quality improved significantly (P = 0.008) using the modified breathing command. Training technicians to use a modified breathing command significantly improved arterial phase image quality of gadoxetate-enhanced liver MRI. • A modified breathing command reduced respiratory artefacts on arterial-phase gadoxetate-enhanced MRI (P < 0.001). • The modified command decreased severe and extensive arterial-phase breathing artefacts (P = 0.021). • Training technicians to use a modified breathing command improved arterial-phase images.

A Gaussian method to improve work-of-breathing calculations.

PubMed

Petrini, M F; Evans, J N; Wall, M A; Norman, J R

1995-01-01

The work of breathing is a calculated index of pulmonary function in ventilated patients that may be useful in deciding when to wean and when to extubate. However, the accuracy of the calculated work of breathing of the patient (WOBp) can suffer from artifacts introduced by coughing, swallowing, and other non-breathing maneuvers. The WOBp in this case will include not only the usual work of inspiration, but also the work of performing these non-breathing maneuvers. The authors developed a method to objectively eliminate the calculated work of these movements from the work of breathing, based on fitting to a Gaussian curve the variable P, which is obtained from the difference between the esophageal pressure change and the airway pressure change during each breath. In spontaneously breathing adults the normal breaths fit the Gaussian curve, while breaths that contain non-breathing maneuvers do not. In this Gaussian breath-elimination method (GM), breaths that are two standard deviations from that mean obtained by the fit are eliminated. For normally breathing control adult subjects, GM had little effect on WOBp, reducing it from 0.49 to 0.47 J/L (n = 8), while there was a 40% reduction in the coefficient of variation. Non-breathing maneuvers were simulated by coughing, which increased WOBp to 0.88 (n = 6); with the GM correction, WOBp was 0.50 J/L, a value not significantly different from that of normal breathing. Occlusion also increased WOBp to 0.60 J/L, but GM-corrected WOBp was 0.51 J/L, a normal value. As predicted, doubling the respiratory rate did not change the WOBp before or after the GM correction.(ABSTRACT TRUNCATED AT 250 WORDS)

Intracyclic velocity variation and arm coordination assessment in swimmers with Down syndrome.

PubMed

Marques-Aleixo, Inês; Querido, Ana; Figueiredo, Pedro; Vilas-Boas, João Paulo; Corredeira, Rui; Daly, Daniel; Fernandes, Ricardo J

2013-01-01

This study examined the differences in intracycle velocity variation and arm coordination in front crawl in swimmers with Down syndrome in three breathing conditions. International swimmers with Down syndrome (N = 16) performed 3 × 20 m front crawl at 50 m race speed: without breathing, breathing to the preferred side, and breathing to the nonpreferred side. A two dimensional video movement analysis was performed using the APASystem. Breathing conditions were compared using Repeated Measures ANOVA. Swimming velocity was higher without breathing and intracyclic velocity variation was higher while breathing. Swimmers tended to a catch up arm coordination mode for both breathing conditions and a superposition mode when not breathing. These data reflect arm coordination compromising swimming performance, particularly when comparing with non disabled swimmers in literature. The physical and perhaps cognitive impairment associated with Down syndrome may result in a disadvantage in both propulsion and drag, more evident when breathing.

Sleep patterns and sleep disturbances across pregnancy.

PubMed

Mindell, Jodi A; Cook, Rae Ann; Nikolovski, Janeta

2015-04-01

This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy. A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI). Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%). Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

Rib kinematics during lung ventilation in the American alligator (Alligator mississippiensis): an XROMM analysis

PubMed Central

Moritz, Sabine; Codd, Jonathan; Sellers, William I.

2017-01-01

ABSTRACT The current hypothesis regarding the mechanics of breathing in crocodylians is that the double-headed ribs, with both a capitulum and tuberculum, rotate about a constrained axis passing through the two articulations; moreover, this axis shifts in the caudal thoracic ribs, as the vertebral parapophysis moves from the centrum to the transverse process. Additionally, the ventral ribcage in crocodylians is thought to possess additional degrees of freedom through mobile intermediate ribs. In this study, X-ray reconstruction of moving morphology (XROMM) was used to quantify rib rotation during breathing in American alligators. Whilst costovertebral joint anatomy predicted overall patterns of motion across the ribcage (decreased bucket handle motion and increased calliper motion), there were significant deviations: anatomical axes overestimated pump handle motion and, generally, ribs in vivo rotate about all three body axes more equally than predicted. The intermediate ribs are mobile, with a high degree of rotation measured about the dorsal intracostal joints, especially in the more caudal ribs. Motion of the sternal ribs became increasingly complex caudally, owing to a combination of the movements of the vertebral and intermediate segments. As the crocodylian ribcage is sometimes used as a model for the ancestral archosaur, these results have important implications for how rib motion is reconstructed in fossil taxa, and illustrate the difficulties in reconstructing rib movement based on osteology alone. PMID:28855323

Methodologies for Verification and Validation of Space Launch System (SLS) Structural Dynamic Models

NASA Technical Reports Server (NTRS)

Coppolino, Robert N.

2018-01-01

Responses to challenges associated with verification and validation (V&V) of Space Launch System (SLS) structural dynamics models are presented in this paper. Four methodologies addressing specific requirements for V&V are discussed. (1) Residual Mode Augmentation (RMA), which has gained acceptance by various principals in the NASA community, defines efficient and accurate FEM modal sensitivity models that are useful in test-analysis correlation and reconciliation and parametric uncertainty studies. (2) Modified Guyan Reduction (MGR) and Harmonic Reduction (HR, introduced in 1976), developed to remedy difficulties encountered with the widely used Classical Guyan Reduction (CGR) method, are presented. MGR and HR are particularly relevant for estimation of "body dominant" target modes of shell-type SLS assemblies that have numerous "body", "breathing" and local component constituents. Realities associated with configuration features and "imperfections" cause "body" and "breathing" mode characteristics to mix resulting in a lack of clarity in the understanding and correlation of FEM- and test-derived modal data. (3) Mode Consolidation (MC) is a newly introduced procedure designed to effectively "de-feature" FEM and experimental modes of detailed structural shell assemblies for unambiguous estimation of "body" dominant target modes. Finally, (4) Experimental Mode Verification (EMV) is a procedure that addresses ambiguities associated with experimental modal analysis of complex structural systems. Specifically, EMV directly separates well-defined modal data from spurious and poorly excited modal data employing newly introduced graphical and coherence metrics.

Novel strategy of stents in thyroid mass: a case series report of managing severely dyspneic patients.

PubMed

Bhandari, Adheesh; Wang, Ying-Hao; Lv, Shi-Xu; Xia, Er-Jie; Wang, Ou-Chen

2017-01-01

Tracheal and bronchial stenosis is a life-threatening condition causing difficulty in breathing and even severe respiratory distress. The silicone tracheobronchial stents were placed using the rigid bronchoscopy into the trachea of severe dyspneic patients and they exhibited symptomatic improvement as well as a rise in the saturation of oxygen. The bronchial stents were applicable to many extensive malignant airway stenosis patients, such as those with esophageal cancer, lung cancer, and laryngeal cancer. But the effectiveness of bronchial stents for thyroid cancer is not certain. Here, we report 3 emergency patients with a thyroid mass referred to our hospital because of grade 4 dyspnea according to the American Thoracic Society shortness of breath guidelines. The main clinical symptoms were severe dyspnea and stridor. The radiographic examination and tomographic examination showed the narrowing and displacement of the trachea. To the best of our knowledge, ideal airway management for the massive thyroid mass was considered to be temporary tracheobronchial stent placement pre-operation. In our study, we applied the tracheobronchial stent to massive thyroid mass patients with dyspnea and aimed to not only improve preoperative airway obstruction but also to protect the potential airway collapse from post-operative tracheomalacia following extubation. We found that application of tracheobronchial stents may provide a new strategy to dyspneic patients with huge thyroid mass.

Novel strategy of stents in thyroid mass: a case series report of managing severely dyspneic patients

PubMed Central

Lv, Shi-xu; Xia, Er-jie; Wang, Ou-Chen

2017-01-01

Background Tracheal and bronchial stenosis is a life-threatening condition causing difficulty in breathing and even severe respiratory distress. The silicone tracheobronchial stents were placed using the rigid bronchoscopy into the trachea of severe dyspneic patients and they exhibited symptomatic improvement as well as a rise in the saturation of oxygen. The bronchial stents were applicable to many extensive malignant airway stenosis patients, such as those with esophageal cancer, lung cancer, and laryngeal cancer. But the effectiveness of bronchial stents for thyroid cancer is not certain. Case presentation Here, we report 3 emergency patients with a thyroid mass referred to our hospital because of grade 4 dyspnea according to the American Thoracic Society shortness of breath guidelines. The main clinical symptoms were severe dyspnea and stridor. The radiographic examination and tomographic examination showed the narrowing and displacement of the trachea. To the best of our knowledge, ideal airway management for the massive thyroid mass was considered to be temporary tracheobronchial stent placement pre-operation. Conclusion In our study, we applied the tracheobronchial stent to massive thyroid mass patients with dyspnea and aimed to not only improve preoperative airway obstruction but also to protect the potential airway collapse from post-operative tracheomalacia following extubation. We found that application of tracheobronchial stents may provide a new strategy to dyspneic patients with huge thyroid mass. PMID:29081662

Ultrasonic nebulization platforms for pulmonary drug delivery.

PubMed

Yeo, Leslie Y; Friend, James R; McIntosh, Michelle P; Meeusen, Els N T; Morton, David A V

2010-06-01

Since the 1950s, ultrasonic nebulizers have played an important role in pulmonary drug delivery. As the process in which aerosol droplets are generated is independent and does not require breath-actuation, ultrasonic nebulizers, in principle, offer the potential for instantaneously fine-tuning the dose administered to the specific requirements of a patient, taking into account the patient's breathing pattern, physiological profile and disease state. Nevertheless, owing to the difficulties and limitations associated with conventional designs and technologies, ultrasonic nebulizers have never been widely adopted, and have in recent years been in a state of decline. An overview is provided on the advances in new miniature ultrasonic nebulization platforms in which large increases in lung dose efficiency have been reported. In addition to a discussion of the underlying mechanisms governing ultrasonic nebulization, in which there appears to be widely differing views, the advantages and shortcomings of conventional ultrasonic nebulization technology are reviewed and advanced state-of-the-art technologies that have been developed recently are discussed. Recent advances in ultrasonic nebulization technology demonstrate significant potential for the development of smart, portable inhalation therapy platforms for the future. Nevertheless, there remain considerable challenges that need to be addressed before such personalized delivery systems can be realized. These have to be addressed across the spectrum from fundamental physics through to in vivo device testing and dealing with the relevant regulatory framework.

Sleep-disordered breathing in patients with myelomeningocele.

PubMed

Patel, Daxa M; Rocque, Brandon G; Hopson, Betsy; Arynchyna, Anastasia; Bishop, E Ralee'; Lozano, David; Blount, Jeffrey P

2015-07-01

OBJECT A paucity of literature examines sleep apnea in patients with myelomeningocele, Chiari malformation Type II (CM-II), and related hydrocephalus. Even less is known about the effect of hydrocephalus treatment or CM-II decompression on sleep hygiene. This study is an exploratory analysis of sleep-disordered breathing in patients with myelomeningocele and the effects of neurosurgical treatments, in particular CM-II decompression and hydrocephalus management, on sleep organization. METHODS The authors performed a retrospective review of all patients seen in their multidisciplinary spina bifida clinic (approximately 435 patients with myelomeningocele) to evaluate polysomnographs obtained between March 1999 and July 2013. They analyzed symptoms prompting evaluation, results, and recommended interventions by using descriptive statistics. They also conducted a subset analysis of 9 children who had undergone polysomnography both before and after neurosurgical intervention. RESULTS Fifty-two patients had polysomnographs available for review. Sleep apnea was diagnosed in 81% of these patients. The most common presenting symptom was "breathing difficulties" (18 cases [43%]). Mild sleep apnea was present in 26 cases (50%), moderate in 10 (19%), and severe in 6 (12%). Among the 42 patients with abnormal sleep architecture, 30 had predominantly obstructive apneas and 12 had predominantly central apneas. The most common pulmonology-recommended intervention was adjustment of peripheral oxygen supplementation (24 cases [57%]), followed by initiation of peripheral oxygen (10 cases [24%]). In a subset analysis of 9 patients who had sleep studies before and after neurosurgical intervention, there was a trend toward a decrease in the mean number of respiratory events (from 34.8 to 15.9, p = 0.098), obstructive events (from 14.7 to 13.9, p = 0.85), and central events (from 20.1 to 2.25, p = 0.15) and in the apnea-hypopnea index (from 5.05 to 2.03, p = 0.038, not significant when corrected for multiple measures). CONCLUSIONS A large proportion of patients with myelomeningocele who had undergone polysomnography showed evidence of disordered sleep on an initial study. Furthermore, 31% of patients had moderate or severe obstructive sleep apnea. Myelomeningocele patients with an abnormal sleep structure who had undergone nonoperative treatment with peripheral oxygen supplementation showed improvement in the apnea-hypopnea index. Results in this study suggested that polysomnography in patients with myelomeningocele may present an opportunity to detect and classify sleep apnea, identify low-risk interventions, and prevent future implications of sleep-disordered breathing.

Breath-collection device for delayed breath-alcohol analysis

DOT National Transportation Integrated Search

1980-12-01

The report includes the details of a study to develop, evaluate, and validate a breath collection device (BCD) for delayed breath-alcohol analysis. Primary applications of the BCD include collection of breath-alcohol samples for field surveys or for ...

A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving.

PubMed

Meule, Adrian; Kübler, Andrea

2017-03-01

Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

Optimising diffusion-weighted MR imaging for demonstrating pancreatic cancer: a comparison of respiratory-triggered, free-breathing and breath-hold techniques.

PubMed

Kartalis, Nikolaos; Loizou, Louiza; Edsborg, Nick; Segersvärd, Ralf; Albiin, Nils

2012-10-01

To compare respiratory-triggered, free-breathing, and breath-hold DWI techniques regarding (1) image quality, and (2) signal intensity (SI) and ADC measurements in pancreatic ductal adenocarcinoma (PDAC). Fifteen patients with histopathologically proven PDAC underwent DWI prospectively at 1.5 T (b = 0, 50, 300, 600 and 1,000 s/mm(2)) with the three techniques. Two radiologists, independently and blindly, assigned total image quality scores [sum of rating diffusion images (lesion detection, anatomy, presence of artefacts) and ADC maps (lesion characterisation, overall image quality)] per technique and ranked them. The lesion SI, signal-to-noise ratio, mean ADC and coefficient of variation (CV) were compared. Total image quality scores for respiratory-triggered, free-breathing and breath-hold techniques were 17.9, 16.5 and 17.1 respectively (respiratory-triggered was significantly higher than free-breathing but not breath-hold). The respiratory-triggered technique had a significantly higher ranking. Lesion SI on all b-values and signal-to-noise ratio on b300 and b600 were significantly higher for the respiratory-triggered technique. For respiratory-triggered, free-breathing and breath-hold techniques the mean ADCs were 1.201, 1.132 and 1.253 × 10(-3) mm(2)/s, and mean CVs were 8.9, 10.8 and 14.1 % respectively (respiratory-triggered and free-breathing techniques had a significantly lower mean CV than the breath-hold technique). In both analyses, respiratory-triggered DWI showed superiority and seems the optimal DWI technique for demonstrating PDAC. • Diffusion-weighted magnetic resonance imaging is increasingly used to detect pancreatic cancer • Images are acquired using various breathing techniques and multiple b-values • Breathing techniques used: respiratory-triggering, free-breathing and breath-hold • Respiratory-triggering seems the optimal breathing technique for demonstrating pancreatic cancer.

Control of gill ventilation and air-breathing in the bowfin amia calva

PubMed

Hedrick; Jones

1999-01-01

The purpose of this study was to investigate the roles of branchial and gas bladder reflex pathways in the control of gill ventilation and air-breathing in the bowfin Amia calva. We have previously determined that bowfin use two distinct air-breathing mechanisms to ventilate the gas bladder: type I air breaths are characterized by exhalation followed by inhalation, are stimulated by aquatic or aerial hypoxia and appear to regulate O2 gas exchange; type II air breaths are characterized by inhalation alone and possibly regulate gas bladder volume and buoyancy. In the present study, we test the hypotheses (1) that gill ventilation and type I air breaths are controlled by O2-sensitive chemoreceptors located in the branchial region, and (2) that type II air breaths are controlled by gas bladder mechanosensitive stretch receptors. Hypothesis 1 was tested by examining the effects of partial or complete branchial denervation of cranial nerves IX and X to the gill arches on gill ventilation frequency (fg) and the proportion of type I air breaths during normoxia and hypoxia; hypothesis II was tested by gas bladder inflation and deflation. Following complete bilateral branchial denervation, fg did not differ from that of sham-operated control fish; in addition, fg was not significantly affected by aquatic hypoxia in sham-operated or denervated fish. In sham-operated fish, aquatic hypoxia significantly increased overall air-breathing frequency (fab) and the percentage of type I breaths. In fish with complete IX-X branchial denervation, fab was also significantly increased during aquatic hypoxia, but there were equal percentages of type I and type II air breaths. Branchial denervation did not affect the frequency of type I air breaths during aquatic hypoxia. Gas bladder deflation via an indwelling catheter resulted in type II breaths almost exclusively; furthermore, fab was significantly correlated with the volume removed from the gas bladder, suggesting a volume-regulating function for type II air breaths. These results indicate that chronic (3-4 weeks) branchial denervation does not significantly affect fg or type I air-breathing responses to aquatic hypoxia. Because type I air-breathing responses to aquatic hypoxia persist after IX-X cranial nerve denervation, O2-sensitive chemoreceptors that regulate air-breathing may be carried in other afferent pathways, such as the pseudobranch. Gas bladder deflation reflexly stimulates type II breaths, suggesting that gas bladder volume-sensitive stretch receptors control this particular air-breathing mechanism. It is likely that type II air breaths function to regulate buoyancy when gas bladder volume declines during the inter-breath interval.

Vented versus unvented chest seals for treatment of pneumothorax and prevention of tension pneumothorax in a swine model.

PubMed

Kheirabadi, Bijan S; Terrazas, Irasema B; Koller, Alexandra; Allen, Paul B; Klemcke, Harold G; Convertino, Victor A; Dubick, Michael A; Gerhardt, Robert T; Blackbourne, Lorne H

2013-07-01

Unvented chest seals (CSs) are currently recommended for the management of penetrating thoracic injuries in the battlefield. Since no supporting data exist, we compared the efficacy of a preferred unvented with that of a vented CS in a novel swine model of pneumothorax (PTx). An open chest wound was created in the left thorax of spontaneously air-breathing anesthetized pigs (n = 8). A CS was applied over the injury, then tension PTx was induced by incremental air injections (0.2 L) into the pleural cavity via a cannula that was also used to measure intrapleural pressure (IP). Both CS were tested on each pig in series. Tidal volume (V(T)), respiratory rate, IP, heart rate, mean arterial pressure, cardiac output, central venous pressure, pulmonary arterial pressure, venous and peripheral oxygen saturations (SvO2, SpO2) were recorded. Tension PTx was defined as a mean IP equal to or greater than +1 mm Hg plus significant (20-30%) deviation in baseline levels of the previously mentioned parameters and confirmed by chest x-ray study. PaO2 and PaCo2 were also measured. PTx produced immediate breathing difficulty and significant rises in IP and pulmonary arterial pressure and falls in V(T), SpO2, and SvO2. Both CSs returned these parameters to near baseline within 5 minutes of application. After vented CS was applied, serial air injections up to 2 L resulted in no significant change in the previously mentioned parameters. After unvented CS application, progressive deterioration of all respiratory parameters and onset of tension PTx were observed in all subjects after approximately 1.4-L air injection. Both vented and unvented CSs provided immediate improvements in breathing and blood oxygenation in our model of penetrating thoracic trauma. However, in the presence of ongoing intrapleural air accumulation, the unvented CS led to tension PTx, hypoxemia, and possible respiratory arrest, while the vented CS prevented these outcomes.

[57-year-old female patient in early retirement with underweight and chronic-relapsing diarrhoea].

PubMed

Allgayer, H; Mainos, D; Dietrich, C F

2007-02-01

Underweight as a consequence of chronic diarrhoea may lead to fatigue, tiredness and impaired physical performance, especially when the underlying cause has not been evaluated. In spite of algorithms as a help in the differential diagnosis, an individual approach with critical consideration of diet history, laboratory data and imaging procedures is necessary. Additional difficulties may arise when the history of food intolerance is inconsistent and technical findings including endoscopy are inconclusive. We report on a 57-year-old female patient with underweight, chronic intermittent diarrhoea and cramp-like abdominal pain for more than 10 years following pelvic irradiation due to Hodgkin's disease of the ovary. A systematic diagnostic approach was not undertaken until very recently due to the deterioration of her clinical conditions pointing to jejunal malabsorption. In spite of the absence of a specific history of milk/milk product intolerance a lactose H (2)-breath test was performed showing lactase deficiency with lactose intolerance. The rapid improvement of all her symptoms after a lactose-poor diet had been started supported this diagnosis. Possible reasons for the long time period which had elapsed until the diagnosis was established and the discrepancy of the H (2)-breath test results with the absence of a clear-cut history for milk/milk product intolerance are discussed in terms of the importance of a structured history-taking with regard to nutrition and diet habits. In addition, potential explanations for radiation-induced functional damage in the absence of morphological abnormalities are provided. Based on the experience of this case and considerations regarding the consequences of radiation-induced jejunal damage, we recommend that a lactose-H (2) breath test be routinely included in the diagnostic work-up of patients with unclear chronic diarrhoea even if there is no defined history of milk/milk product intolerance.

Calculation of Supersonic Combustion Using Implicit Schemes

NASA Technical Reports Server (NTRS)

Yoon, Seokkwan; Kwak, Dochan (Technical Monitor)

2003-01-01

One of the technology goals of NASA for advanced space transportation is to develop highly efficient propulsion systems to reduce the cost of payload for space missions. Developments of rockets for the second generation Reusable Launch Vehicle (RLV) in the past several years have been focused on low-cost versions of conventional engines. However, recent changes in the Integrated Space Transportation Program to build a crew transportation vehicle to extend the life of the Space Shuttle fleet might suggest that air-breathing rockets could reemerge as a possible propulsion system for the third generation RLV to replace the Space Shuttle after 2015. The weight of the oxygen tank exceeds thirty percent of the total weight of the Space Shuttle at launch while the payload is only one percent of the total weight. The air-breathing rocket propulsion systems, which consume oxygen in the air, offer clear advantages by making vehicles lighter and more efficient. Experience in the National Aerospace Plane Program in the late 1980s indicates that scramjet engines can achieve high specific impulse for low hypersonic vehicle speeds. Whether taking a form of Rocket Based Combined Cycle (RBCC) or Turbine Based Combined Cycle (TBCC), the scramjet is an essential mode of operation for air-breathing rockets. It is well known that fuel-air mixing and rapid combustion are of crucial importance for the success of scramjet engines since the spreading rate of the supersonic mixing layer decreases as the Mach number increases. A factored form of the Gauss-Seidel relaxation method has been widely used in hypersonic flow research since its first application to non-equilibrium flows. However, difficulties in stability and convergence have been encountered when there is strong interaction between fluid motion and chemical reaction, such as multiple fuel injection problems. The present paper reports the results from investigation of the effect of modifications to the original algorithm on the performance for multiple injectors.

Assessing Asthma Symptoms in Adolescents and Adults: Qualitative Research Supporting Development of the Asthma Daily Symptom Diary.

PubMed

Gater, Adam; Nelsen, Linda; Fleming, Sarah; Lundy, J Jason; Bonner, Nicola; Hall, Rebecca; Marshall, Chris; Staunton, Hannah; Krishnan, Jerry A; Stoloff, Stuart; Schatz, Michael; Haughney, John

2016-06-01

Despite the widespread availability of patient-reported asthma questionnaires, instruments developed in accordance with present regulatory expectations are lacking. To address this gap, the Patient-Reported Outcome (PRO) Consortium's Asthma Working Group has developed a patient-reported asthma daily symptom diary (ADSD) for use in clinical research to assess outcomes and support medical product labeling claims in adults and adolescents with asthma. To summarize the qualitative research conducted to inform the initial development of the ADSD and to provide evidence for content validity of the instrument in accordance with the Food and Drug Administration's PRO Guidance. Research informing the initial development and confirming the content validity of the ADSD is summarized. This comprised a review of published qualitative research, semi-structured concept elicitation interviews (n = 55), and cognitive interviews (n = 65) with a diverse and representative sample of adults and adolescents with a clinician-confirmed diagnosis of asthma in the United States to understand the asthma symptom experience and to assess the relevance and understanding of the newly developed ADSD. From the qualitative literature review and concept elicitation interviews, eight core asthma symptoms emerged. These were broadly categorized as breathing symptoms (difficulty breathing, shortness of breath, and wheezing), chest symptoms (chest tightness, chest pain, and pressure/weight on chest), and cough symptoms (cough and the presence of mucus/phlegm). Conceptual saturation was achieved and differences in the experience of participants according to socio-demographic or clinical characteristics were not observed. Subsequent testing of the ADSD confirmed participant relevance and understanding. The ADSD is a new patient-reported asthma symptom diary developed in accordance with the Food and Drug Administration's PRO Guidance. Evidence to date supports the content validity of the instrument. Item performance, reliability, and construct validity will be assessed in future quantitative research. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Timing of the breath analyzer: does it make a difference?

PubMed

Cherpitel, C J

1993-09-01

The purpose of this article is to examine in an emergency room (ER) population the concordance of self-reports of no alcohol consumption prior to injury with breath-analyzer readings in two groups: (1) those patients from whom reports were obtained after they were breath analyzed compared to (2) patients from whom reports were obtained prior to obtaining the breath-analyzer reading. Data were collected on a probability sample of patients attending three health maintenance organization ERs. Among those sampled were 159 patients admitted for initial treatment of an injury, who were breath analyzed within 6 hours of the event and reported no drinking following the event that lead to injury. Of these, 119 were breath analyzed prior to the interview, and none who reported not drinking were positive on the breath analyzer, while of the 37 breath analyzed after the interview, only one was positive who had reported not drinking. Obtaining the breath-analyzer reading following the interview was not found to affect the rate of refusal to provide a breath-analyzer reading; however, it was found to adversely affect obtaining the breath-analyzer reading for other reasons. The data suggest that the concordance of negative self-reports of consumption with breath-analyzer readings remains high in ER populations regardless of when the breath-analyzer reading is obtained; however, it appears best to obtain the reading prior to interviewing the patient for reasons explained below.

Practice It: Deep Conscious Breathing Exercise

Cancer.gov

No time to sit and breathe? No problem; take your breathing practice with you! Deep conscious breathing can also be done with the eyes open wherever you happen to be—simply pause and take two to three full deep breaths (inhale deeply and exhale completely).

SU-E-T-326: The Oxygen Saturation (SO2) and Breath-Holding Time Variation Applied Active Breathing Control (ABC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gong, G; Yin, Y

Purpose: To study the oxygen saturation (SO2) and breath-holding time variation applied active breathing control (ABC) in radiotherapy of tumor. Methods: 24 volunteers were involved in our trials, and they all did breath-holding motion assisted by ELEKTA Active Breathing Coordinator 2.0 for 10 times respectively. And the patient monitor was used to observe the oxygen saturation (SO2) variation. The variation of SO2, and length of breath-holding time and the time for recovering to the initial value of SO2 were recorded and analyzed. Results: (1) The volunteers were divided into two groups according to the SO2 variation in breath-holding: A group,more » 14 cases whose SO2 reduction were more than 2% (initial value was 97% to 99%, while termination value was 91% to 96%); B group, 10 cases were less than 2% in breath-holding without inhaling oxygen. (2) The interfraction breath holding time varied from 8 to 20s for A group compared to the first breath-holding time, and for B group varied from 4 to 14s. (3) The breathing holding time of B group prolonged mean 8s, compared to A group. (4) The time for restoring to the initial value of SO2 was from 10s to 30s. And the breath-holding time shortened obviously for patients whose SO2 did not recover to normal. Conclusion: It is very obvious that the SO2 reduction in breath-holding associated with ABC for partial people. It is necessary to check the SO2 variation in breath training, and enough time should be given to recover SO2.« less

Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults.

PubMed

Jones, Mandy; Harvey, Alex; Marston, Louise; O'Connell, Neil E

2013-05-31

Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply and/or too rapidly (hyperventilation) or erratic breathing interspersed with breath-holding or sighing (DB). DB/HVS can result in significant patient morbidity and an array of symptoms including breathlessness, chest tightness, dizziness, tremor and paraesthesia. DB/HVS has an estimated prevalence of 9.5% in the general adult population, however, there is little consensus regarding the most effective management of this patient group. (1) To determine whether breathing exercises in patients with DB/HVS have beneficial effects as measured by quality of life indices (2) To determine whether there are any adverse effects of breathing exercises in patients with DB/HVS SEARCH METHODS: We identified trials for consideration using both electronic and manual search strategies. We searched CENTRAL, MEDLINE, EMBASE, and four other databases. The latest search was in February 2013. We planned to include randomised, quasi-randomised or cluster randomised controlled trials (RCTs) in which breathing exercises, or a combined intervention including breathing exercises as a key component, were compared with either no treatment or another therapy that did not include breathing exercises in patients with DB/HVS. Observational studies, case studies and studies utilising a cross-over design were not eligible for inclusion.We considered any type of breathing exercise for inclusion in this review, such as breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathing modification, yawn/sigh suppression. Programs where exercises were either supervised or unsupervised were eligible as were relaxation techniques and acute-episode management, as long as it was clear that breathing exercises were a key component of the intervention.We excluded any intervention without breathing exercises or where breathing exercises were not key to the intervention. Two review authors independently checked search results for eligible studies, assessed all studies that appeared to meet the selection criteria and extracted data. We used standard procedures recommended by The Cochrane Collaboration. We included a single RCT assessed at unclear risk of bias, which compared relaxation therapy (n = 15) versus relaxation therapy and breathing exercises (n = 15) and a no therapy control group (n = 15).Quality of life was not an outcome measure in this RCT, and no numerical data or statistical analysis were presented in this paper. A significant reduction in the frequency and severity of hyperventilation attacks in the breathing exercise group compared with the control group was reported. In addition, a significant difference in frequency and severity of hyperventilation attacks between the breathing and relaxation group was reported. However, no information could be extracted from the paper regarding the size of the treatment effects. The results of this systematic review are unable to inform clinical practice, based on the inclusion of only one small, poorly reported RCT. There is no credible evidence regarding the effectiveness of breathing exercises for the clinical symptoms of DB/HVS. It is currently unknown whether these interventions offer any added value in this patient group or whether specific types of breathing exercise demonstrate superiority over others. Given that breathing exercises are frequently used to treat DB/HVS, there is an urgent need for further well designed clinical trials in this area. Future trials should conform to the CONSORT statement for standards of reporting and use appropriate, validated outcome measures. Trial reports should also ensure full disclosure of data for all important clinical outcomes.

The effect of breath freshener strips on two types of breath alcohol testing instruments.

PubMed

Moore, Ronald L; Guillen, Jennifer

2004-07-01

The potential for breath freshener strips to interfere with the accuracy of a breath alcohol test was studied. Twelve varieties of breath freshener strips from five manufacturers were examined. Breath tests were conducted using the infrared based BAC DataMaster or the fuel cell based Alco-Sensor IV-XL, 30 and 150 seconds after placing a breath strip on the tongue. No effect was observed using the Alco-Sensor system. Some of the strips gave a small reading at 30 seconds (less than or equal to 0.010 g/210 L apparent alcohol) using the DataMaster. Readings on the DataMaster returned to zero by the 150 second test. A proper pre-test observation and deprivation period should prevent any interference from breath freshener strips on breath alcohol testing.

42 CFR 84.70 - Self-contained breathing apparatus; description.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Self-contained breathing apparatus; description. 84...-Contained Breathing Apparatus § 84.70 Self-contained breathing apparatus; description. (a) Self-contained breathing apparatus, including all completely assembled, portable, self-contained devices designed for use...

42 CFR 84.70 - Self-contained breathing apparatus; description.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Self-contained breathing apparatus; description. 84...-Contained Breathing Apparatus § 84.70 Self-contained breathing apparatus; description. (a) Self-contained breathing apparatus, including all completely assembled, portable, self-contained devices designed for use...

Standardization of exhaled breath condensate (EBC) collection using a feedback regulated breathing pattern

EPA Science Inventory

Collection of exhaled breath condensate (EBC) fluid by cooling of expired breath is a potentially valuable approach for the detection of biomarkers associated with disease or exposure to xenobiotics. EBC is generally collected using unregulated breathing patterns, perceived to el...

Breath Analysis in Disease Diagnosis: Methodological Considerations and Applications

PubMed Central

Lourenço, Célia; Turner, Claire

2014-01-01

Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. “Breath fingerprinting”, indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles. PMID:24957037

Breath analysis in disease diagnosis: methodological considerations and applications.

PubMed

Lourenço, Célia; Turner, Claire

2014-06-20

Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. "Breath fingerprinting", indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles.

Calculating rhythmicity of infant breathing using wavelets

NASA Astrophysics Data System (ADS)

Macey, Katherine E.; Page, Wyatt H.; Harper, Ronald M.; Macey, Paul M.; Ford, Rodney P. K.

2000-12-01

Breathing signals are one set of physiological data that may provide information regarding the mechanisms that cause SIDS. Isolated breathing pauses have been implicated in fatal events. Other features of interest include slow amplitude modulation of the breathing signal, a phenomenon whose origin is unclear, and periodic breathing. The latter describes a repetitive series of apnea, and may be considered an extreme manifestation of amplitude modulation with successive cessations of breathing. Rhythmicity is defined to assess the impact of amplitude modulation on breathing signals and describes the extent to which frequency components remain constant for the duration of the signal. The wavelet transform was used to identify sections of constant frequency components within signals. Rhythmicity can be evaluated for all the frequency components in a signal, for individual frequencies. The rhythmicity of eight breathing epochs from sleeping infants at high and low risk for SIDS was calculated. Initial results show breathing from infants at high risk for SIDS exhibits greater rhythmicity of modulating frequencies than breathing from low risk infants.

Abdominal organ motion during inhalation and exhalation breath-holds: pancreatic motion at different lung volumes compared.

PubMed

Lens, Eelco; Gurney-Champion, Oliver J; Tekelenburg, Daniël R; van Kesteren, Zdenko; Parkes, Michael J; van Tienhoven, Geertjan; Nederveen, Aart J; van der Horst, Astrid; Bel, Arjan

2016-11-01

Contrary to what is commonly assumed, organs continue to move during breath-holding. We investigated the influence of lung volume on motion magnitude during breath-holding and changes in velocity over the duration of breath-holding. Sixteen healthy subjects performed 60-second inhalation breath-holds in room-air, with lung volumes of ∼100% and ∼70% of the inspiratory capacity, and exhalation breath-holds, with lung volumes of ∼30% and ∼0% of the inspiratory capacity. During breath-holding, we obtained dynamic single-slice magnetic-resonance images with a time-resolution of 0.6s. We used 2-dimensional image correlation to obtain the diaphragmatic and pancreatic velocity and displacement during breath-holding. Organ velocity was largest in the inferior-superior direction and was greatest during the first 10s of breath-holding, with diaphragm velocities of 0.41mm/s, 0.29mm/s, 0.16mm/s and 0.15mm/s during BH 100% , BH 70% , BH 30% and BH 0% , respectively. Organ motion magnitudes were larger during inhalation breath-holds (diaphragm moved 9.8 and 9.0mm during BH 100% and BH 70% , respectively) than during exhalation breath-holds (5.6 and 4.3mm during BH 30% and BH 0% , respectively). Using exhalation breath-holds rather than inhalation breath-holds and delaying irradiation until after the first 10s of breath-holding may be advantageous for irradiation of abdominal tumors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A sigh of relief or a sigh to relieve: The psychological and physiological relief effect of deep breaths.

PubMed

Vlemincx, Elke; Van Diest, Ilse; Van den Bergh, Omer

2016-10-15

Both animal and human research have revealed important associations between sighs and relief. Previously we argued to conceive of sighs as resetters which temporarily induce relief. The present study aimed to investigate the psychological and physiological relief effect of sighs by instructed deep breaths and spontaneous sighs compared to a control breathing maneuver. Participants completed three blocks of 40 trials during which uncertainty cues were followed by either safety cues followed by a positive picture, or danger cues followed by a negative picture. One block was presented without breathing instructions, two subsequent blocks with breathing instructions. During the presentation of the safety and danger cues, an instruction was given to either 'take a deep breath' or 'postpone the next inhalation for 2 s (breath hold). Continuously, participants rated relief and Frontalis electromyography was recorded. Trait anxiety sensitivity was assessed by the Anxiety Sensitivity Index. Self-reported relief and physiological tension were compared 5s before and after instructed deep breaths and breath holds, and before and after spontaneous deep breaths and breath holds in the respective blocks. Results show that self-reported relief following an instructed deep breath was higher than before. Physiological tension decreased following a spontaneous sigh in high anxiety sensitive persons and following a spontaneous breath hold in low anxiety sensitive persons. These results are the first to show that a deep breath relieves and, in anxiety sensitive persons, reduces physiological tension. These findings support the hypothesis that sighs are psychological and physiological resetters. Copyright © 2016 Elsevier Inc. All rights reserved.

News from the Breath Analysis Summit 2011.

PubMed

Corradi, Massimo; Mutti, Antonio

2012-06-01

This special section highlights some of the important work presented at the Breath Analysis Summit 2011, which was held in Parma (Italy) from 11 to 14 September 2011. The meeting, which was jointly organized by the International Association for Breath Research and the University of Parma, was attended by more than 250 delegates from 33 countries, and offered 34 invited lectures and 64 unsolicited scientific contributions. The summit was organized to provide a forum to scientists, engineers and clinicians to present their latest findings and to meet industry executives and entrepreneurs to discuss key trends, future directions and technologies available for breath analysis. A major focus was on nitric oxide, exhaled breath condensate, electronic nose, mass spectrometry and newer sensor technologies. Medical applications ranged from asthma and other respiratory diseases to gastrointestinal disease, occupational diseases, critical care and cancer. Most people identify breath tests with breathalysers used by police to estimate ethanol concentration in blood. However, breath testing has far more sophisticated applications. Breath analysis is rapidly evolving as a new frontier in medical testing for disease states in the lung and beyond. Every individual has a breath fingerprint-or 'breathprint'-that can provide useful information about his or her state of health. This breathprint comprises the many thousands of molecules that are expelled with each breath we exhale. Breath research in the past few years has uncovered the scientific and molecular basis for such clinical observations. Relying on mass spectrometry, we have been able to identify many such unique substances in exhaled breath, including gases, such as nitric oxide (NO) and carbon monoxide (CO), and a wide array of volatile organic compounds. Exhaled breath also carries aerosolized droplets that can be collected as an exhaled breath condensate that contains endogenously produced non-volatile compounds. Breath analysis is now used to diagnose and monitor asthma, check for transplant organ rejection, detect lung cancer and test for Helicobacter pyloriinfection-and the list is growing. A major milestone in the scientific study of breath was marked in the 1970s when Linus Pauling demonstrated that there is more to exhaled breath than the classic gases of nitrogen, oxygen, carbon dioxide and water vapour-a lot more. Based on the gas-liquid partition chromatography analysis, Pauling reported the presence of 250 substances in exhaled breath. We now have the technology to test for any and all of these components. The field of breath analysis has made considerable advances in the 21st century and the utility of breath analysis in health care is advancing quickly. The science is rapidly expanding, the technology is improving and several new applications have been developed or are under commercial development. Breath analysis may rely on both direct (on line) and indirect (off line) reading methods: in the on-line method, breath analysis is immediately available, whereas the use of indirect methods generally involves collecting and trapping the breath sample and subsequently transferring it to an analytical instrument for analysis. Various kinds of breath samples have been used in biological monitoring, including mixed expired air and end expired air: end exhaled air represents the alveolar air concentration and mixed exhaled air represents the gas mixture coming from the dead space of the bronchial tree and the alveolar gas-exchange space. Exhaled breath analysis is an area where the modern day advances in technology and engineering meet the ever expanding need in medicine for more sensitive, specific and non-invasive tests which makes this area a major front in the interface between medicine and engineering. A major breakthrough over the past decade has been the increase in breath-based tests approved by the US Food and Drug Administration (FDA). Devices measuring common breath gases (oxygen, nitrogen, water vapour and CO(2)) in patient respiratory monitoring have served as a platform for technological growth in clinical breath-testing applications. A few exhaled breath tests have demonstrated clinical utility and are in widespread use, and several FDA-approved devices are available. These widely used exhaled breath tests include detection of blood alcohol concentration and exhaled CO(2). Other clinical applications of exhaled breath analysis include testing for H. pylori infection, lactose intolerance, heart transplant rejection and, more recently, monitoring of airway inflammation by means of exhaled NO. Examination of exhaled breath has the potential to change the existing routine approaches in human medicine. The rapidly developing new analytical and computer technologies along with novel, unorthodox ideas are prerequisites for future advances in this field. Scientists who participated in the Breath Analysis Summit 2011 were invited to submit a full length paper to the Journal of Breath Research and this issue includes eight articles which describe the different applications of breath analysis. We thank all the authors for their valuable contribution and we trust that this collection will provide useful information and an update to this rapidly evolving field, giving an example of integration among scientists who address the same topic-breath analysis-from different and complementary perspectives, from basic to clinical research.

46 CFR 197.456 - Breathing supply hoses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Breathing supply hoses. 197.456 Section 197.456 Shipping....456 Breathing supply hoses. (a) The diving supervisor shall insure that— (1) Each breathing supply....5 times its maximum working pressure; (2) Each breathing supply hose assembly, prior to being placed...

46 CFR 78.47-27 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Markings for Fire and Emergency Equipment, Etc. § 78.47-27 Self-contained breathing apparatus. Lockers or spaces containing self-contained breathing apparatus shall be marked “SELF-CONTAINED BREATHING APPARATUS... 46 Shipping 3 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 78.47-27 Section 78...

42 CFR 84.71 - Self-contained breathing apparatus; required components.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Self-contained breathing apparatus; required...-Contained Breathing Apparatus § 84.71 Self-contained breathing apparatus; required components. (a) Each self-contained breathing apparatus described in § 84.70 shall, where its design requires, contain the following...

42 CFR 84.71 - Self-contained breathing apparatus; required components.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Self-contained breathing apparatus; required...-Contained Breathing Apparatus § 84.71 Self-contained breathing apparatus; required components. (a) Each self-contained breathing apparatus described in § 84.70 shall, where its design requires, contain the following...

46 CFR 78.47-27 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Markings for Fire and Emergency Equipment, Etc. § 78.47-27 Self-contained breathing apparatus. Lockers or spaces containing self-contained breathing apparatus shall be marked “SELF-CONTAINED BREATHING APPARATUS... 46 Shipping 3 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 78.47-27 Section 78...

Technologies for Clinical Diagnosis Using Expired Human Breath Analysis

PubMed Central

Mathew, Thalakkotur Lazar; Pownraj, Prabhahari; Abdulla, Sukhananazerin; Pullithadathil, Biji

2015-01-01

This review elucidates the technologies in the field of exhaled breath analysis. Exhaled breath gas analysis offers an inexpensive, noninvasive and rapid method for detecting a large number of compounds under various conditions for health and disease states. There are various techniques to analyze some exhaled breath gases, including spectrometry, gas chromatography and spectroscopy. This review places emphasis on some of the critical biomarkers present in exhaled human breath, and its related effects. Additionally, various medical monitoring techniques used for breath analysis have been discussed. It also includes the current scenario of breath analysis with nanotechnology-oriented techniques. PMID:26854142

Quantitative Analysis of Periodic Breathing and Very Long Apnea in Preterm Infants

NASA Astrophysics Data System (ADS)

Mohr, Mary A.

Electronic signals from bedside monitors in University of Virginia's Neonatal Intensive Care Unit (NICU) are routinely collected and stored. The overall goal of our research is predictive monitoring: we seek patterns in signals that give early warning of impending pathology. This work focuses on apnea (pauses in regular respiration), and on periodic breathing (regular cycles of breathing and apnea). Our examination of apnea events revealed a disturbing number of cases in which the cessation of breathing lasted at least 60 seconds. These observations were validated, clinical correlations of these events were identified, and a theory was developed that partially explains how they occur. Periodic breathing in neonates is a normal developmental phenomenon. It arises when there is instability in the respiratory control system. A mathematical model of periodic breathing was developed to analyze the stability of the control system in infants. Periodic breathing has long been thought to be benign, however, exaggerated durations of periodic breathing may be an indicator of pathology. Characterization of periodic breathing has previously been limited to short monitoring times in small numbers of infants. An automated system for measurement and characterization of periodic breathing was developed and applied to 5 years of data from the NICU. The amount of periodic breathing that infants had was found to increase with gestational age (up to 32 weeks). Also, times of excessive periodic breathing were recorded and clinical correlations were sought. A significant increase in periodic breathing in the 24 hours before diagnosis of necrotizing enterocolitis was found.

Physiological response of rats to delivery of helium and xenon: implications for hyperpolarized noble gas imaging

NASA Technical Reports Server (NTRS)

Ramirez, M. P.; Sigaloff, K. C.; Kubatina, L. V.; Donahue, M. A.; Venkatesh, A. K.; Albert, M. S.; ALbert, M. S. (Principal Investigator)

2000-01-01

The physiological effects of various hyperpolarized helium and xenon MRI-compatible breathing protocols were investigated in 17 Sprague-Dawley rats, by continuous monitoring of blood oxygen saturation, heart rate, EKG, temperature and endotracheal pressure. The protocols included alternating breaths of pure noble gas and oxygen, continuous breaths of pure noble gas, breath-holds of pure noble gas for varying durations, and helium breath-holds preceded by two helium rinses. Alternate-breath protocols up to 128 breaths caused a decrease in oxygen saturation level of less than 5% for either helium or xenon, whereas 16 continuous-breaths caused a 31.5% +/- 2.3% decrease in oxygen saturation for helium and a 30.7% +/- 1. 3% decrease for xenon. Breath-hold protocols up to 25 s did not cause the oxygen saturation to fall below 90% for either of the noble gases. Oxygen saturation values below 90% are considered pathological. At 30 s of breath-hold, the blood oxygen saturation dropped precipitously to 82% +/- 0.6% for helium, and to 76.5% +/- 7. 4% for xenon. Breath-holds longer than 10 s preceded by pre-rinses caused oxygen saturation to drop below 90%. These findings demonstrate the need for standardized noble gas inhalation procedures that have been carefully tested, and for continuous physiological monitoring to ensure the safety of the subject. We find short breath-hold and alternate-breath protocols to be safe procedures for use in hyperpolarized noble gas MRI experiments. Copyright 2000 John Wiley & Sons, Ltd.

Asthma and Pneumonia among Children Less Than Five Years with Acute Respiratory Symptoms in Mulago Hospital, Uganda: Evidence of Under-Diagnosis of Asthma

PubMed Central

Nantanda, Rebecca; Tumwine, James K.; Ndeezi, Grace; Ostergaard, Marianne S.

2013-01-01

Background Pneumonia is considered the major cause of mortality among children with acute respiratory disease in low-income countries but may be over-diagnosed at the cost of under-diagnosing asthma. We report the magnitude of asthma and pneumonia among “under-fives” with cough and difficulty breathing, based on stringent clinical criteria. We also describe the treatment for children with acute respiratory symptoms in Mulago Hospital. Methods We enrolled 614 children aged 2–59 months with cough and difficulty breathing. Interviews, physical examination, blood and radiological investigations were done. We defined asthma according to Global Initiative for Asthma guidelines. Pneumonia was defined according to World Health Organization guidelines, which were modified by including fever and white cell count, C-reactive protein, blood culture and chest x-ray. Children with asthma or bronchiolitis were collectively referred to as “asthma syndrome” due to challenges of differentiating the two conditions in young children. Three pediatricians reviewed each participant’s case report post hoc and made a diagnosis according to the study criteria. Results Of the 614 children, 41.2% (95% CI: 37.3–45.2) had asthma syndrome, 27.2% (95% CI: 23.7–30.9) had bacterial pneumonia, 26.5% (95% CI: 23.1–30.2) had viral pneumonia, while 5.1% (95% CI: 3.5–7.1) had other diagnoses including tuberculosis. Only 9.5% of the children with asthma syndrome had been previously diagnosed as asthma. Of the 253 children with asthma syndrome, 95.3% (95% CI: 91.9–97.5) had a prescription for antibiotics, 87.7% (95% CI: 83.1–91.5) for bronchodilators and 43.1% (95% CI: 36.9–49.4) for steroids. Conclusion Although reports indicate that acute respiratory symptoms in children are predominantly due to pneumonia, asthma syndrome contributes a significant proportion. Antibiotics are used irrationally due to misdiagnosis of asthma as pneumonia. There is need for better diagnostic tools for childhood asthma and pneumonia in Uganda. PMID:24312321

A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST).

PubMed

Ames, Nancy J; Powers, John H; Ranucci, Alexandra; Gartrell, Kyungsook; Yang, Li; VanRaden, Mark; Leidy, Nancy Kline; Wallen, Gwenyth R

2017-04-27

Although body temperature is one of four key vital signs routinely monitored and treated in clinical practice, relatively little is known about the symptoms associated with febrile states. The purpose of this study was to assess the validity, reliability and feasibility of the Fever Assessment Tool (FAST) in an acute care research setting. Qualitative: To assess content validity and finalize the FAST instrument, 12 adults from an inpatient medical-surgical unit at the National Institutes of Health (NIH) Clinical Center participated in cognitive interviews within approximately 12 h of a febrile state (tympanic temperature ≥ 38° Celsius). Quantitative: To test reliability, validity and feasibility, 56 new adult inpatients completed the 21-item FAST. The cognitive interviews clarified and validated the content of the final 21-item FAST. Fifty-six patients completed the FAST from two to 133 times during routine vital sign assessment, yielding 1,699 temperature time points. Thirty-four percent of the patients (N = 19) experienced fever at one or more time points, with a total of 125 febrile time points. Kuder-Richardson 20 (KR-20) reliability of the FAST was 0.70. Four nonspecific symptom categories, Tired or Run-Down (12), Sleepy (13), Weak or Lacking Energy (11), and Thirsty (9) were among the most frequently reported symptoms in all participants. Using Generalized Estimating Equations (GEE), the odds of reporting eight symptoms, Warm (4), Sweating (5), Thirsty (9), General Body Aches (10), Weak or Lacking Energy (11), Tired or Run Down (12) and Difficulty Breathing (17), were increased when patients had a fever (Fever Now), compared to the two other subgroups-patients who had a fever, but not at that particular time point, (Fever Not Now) and patients who never had a fever (Fever Never). Many, but not all, of the comparisons were significant in both groups. Results suggest the FAST is reliable, valid and easy to administer. In addition to symptoms usually associated with fever (e.g. feeling warm), symptoms such as Difficulty Breathing (17) were identified with fever. Further study in a larger, more diverse patient population is warranted. Clinical Trials Number: NCT01287143 (January 2011).

Tramadol for premature ejaculation: a systematic review and meta-analysis.

PubMed

Martyn-St James, Marrissa; Cooper, Katy; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

2015-01-30

Tramadol is a centrally acting analgesic prescribed off-label for the treatment of premature ejaculation (PE). However, tramadol may cause addiction and difficulty in breathing and the beneficial effect of tramadol in PE is yet not supported by a high level of evidence. The purpose of this study was to systematically review the evidence from randomised controlled trials (RCT) for tramadol in the management of PE. We searched bibliographic databases including MEDLINE to August 2014 for RCTs. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of RCTs was assessed. Between-group differences in IELT and other outcomes were pooled across RCTs in a meta-analysis. Statistical and clinical between-trial heterogeneity was assessed. A total of eight RCTs that evaluated tramadol against a comparator were included. The majority of RCTs were of unclear methodological quality due to limited reporting. Pooled evidence (four RCTs, 721 participants), suggests that tramadol is significantly more effective than placebo at increasing IELT over eight to 12 weeks (p = 0.0007). However, a high level of statistical heterogeneity is evident (I-squared = 74%). Single RCT evidence indicates that tramadol is significantly more effective than paroxetine taken on-demand, sildenafil, lidocaine gel, or behavioural therapy on IELT in men with PE. Tramadol is associated with significantly more adverse events including: erectile dysfunction, constipation, nausea, headache, somnolence, dry mouth, dizziness, pruritus, and vomiting, than placebo or behavioural therapy over eight to 12 weeks of treatment. However, addiction problems or breathing difficulties reported by patients for PE is not assessed in the current evidence base. Tramadol appears effective in the treatment of PE. However, these findings should be interpreted with caution given the observed levels of between-trial heterogeneity and the reporting quality of the available evidence. The variability across placebo-controlled trials in terms of the tramadol dose evaluated and the treatment duration does not permit any assessment of a safe and effective minimum daily dose. The long-term effects and side effects, including addiction potential, for men with PE have not been evaluated in the current evidence base. The review is registered on PROSPERO 2013: CRD42013005289 .

Fatal sepsis and systemic inflammatory response syndrome after off-label prasugrel: a case report.

PubMed

Serebruany, Victor L; Kipshidze, Nodar; Pershukov, Igor V; Kuliczkowski, Wiktor; Carnes, Judy; Atar, Dan

2014-01-01

Aggressive dual antiplatelet therapy is associated not only with more bleeding, impaired wound healing, and potentially more solid cancer rates but it also causes higher infection risks including sepsis, and systemic inflammatory response syndrome (SIRS). This may be especially true considering the alarming off-label use of prasugrel. A 65-year-old white male patient with a history of myocardial infarction treated with percutaneous coronary intervention and implantation of 2 bare metal stents, was treated with off-label clopidogrel for 4 years, including a double daily dose (150 mg) for the initial 13 months. Still on clopidogrel, the patient was hospitalized with suspected pneumonia. A diagnostic cardiac catheterization revealed a 60%-70% blockage of the mid left anterior descending, but there was no need for coronary intervention. At discharge, clopidogrel 75 mg/d was switched over to off-label prasugrel 10 mg/d on top of aspirin (81 mg/d). On day 3 after prasugrel was given, a football-sized bruise appeared on the patient's lower right abdomen, but computed tomography results were unremarkable. On day 6 after administration of prasugrel, the patient became dizzy, disoriented, confused, experienced difficulty breathing, severe headache, weakness, intensive petechial rash covering the entire body, and breathing difficulty requiring ventilation. Within 24 hours, the patient was unable to correctly identify his age; his eyes were pale in color to almost colorless and when hearing a sound he would turn his entire head toward the sound and he appeared to be blind. His lungs, liver, and kidneys began to show signs of failure over the next 5-9 days. Sixteen days after the administration of the first prasugrel dose, the patient died of sepsis complicated with SIRS. Aggressive off-label use of clopidogrel (double dose for 13 months, and >4 years overall duration), followed by off-label switchover to the highest daily dose (10 mg) prasugrel may trigger sepsis and fatal SIRS. The mechanism responsible for such harmful association is probably indirect, and involves the weakening of platelet-neutrophil-endothelial crosstalk necessary to combat infections, and/or keep inflammation from spreading.

The role of point of care ultrasound in prehospital critical care: a systematic review.

PubMed

Bøtker, Morten Thingemann; Jacobsen, Lars; Rudolph, Søren Steemann; Knudsen, Lars

2018-06-26

In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasibility of prehospital POCUS, changes in patient management induced by POCUS and education of providers. This systematic review aimed to assess these three topics by including studies examining all kinds of prehospital patients undergoing all kinds of prehospital POCUS examinations and studies examining any kind of POCUS education in prehospital critical care providers. By a systematic literature search in MEDLINE, EMBASE, and Cochrane databases, we identified and screened titles and abstracts of 3264 studies published from 2012 to 2017. Of these, 65 studies were read in full-text for assessment of eligibility and 27 studies were ultimately included and assessed for quality by SIGN-50 checklists. No studies compared patient outcome with and without prehospital POCUS. Four studies of acceptable quality demonstrated feasibility and changes in patient management in trauma. Two studies of acceptable quality demonstrated feasibility and changes in patient management in breathing difficulties. Four studies of acceptable quality demonstrated feasibility, outcome prediction and changes in patient management in cardiac arrest, but also that POCUS may prolong pauses in compressions. Two studies of acceptable quality demonstrated that short (few hours) teaching sessions are sufficient for obtaining simple interpretation skills, but not image acquisition skills. Three studies of acceptable quality demonstrated that longer one- or two-day courses including hands-on training are sufficient for learning simple, but not advanced, image acquisition skills. Three studies of acceptable quality demonstrated that systematic educational programs including supervised examinations are sufficient for learning advanced image acquisition skills in healthy volunteers, but that more than 50 clinical examinations are required for expertise in a clinical setting. Prehospital POCUS is feasible and changes patient management in trauma, breathing difficulties and cardiac arrest, but it is unknown if this improves outcome. Expertise in POCUS requires extensive training by a combination of theory, hands-on training and a substantial amount of clinical examinations - a large part of these needs to be supervised.

Changes in respiratory activity induced by mastication during oral breathing in humans.

PubMed

Daimon, Shigeru; Yamaguchi, Kazunori

2014-06-01

We examined the effect of oral breathing on respiratory movements, including the number of respirations and the movement of the thoracic wall at rest and while chewing gum. Forty normal nose breathers were selected by detecting expiratory airflow from the mouth using a CO2 sensor. Chest measurements were recorded using a Piezo respiratory belt transducer, and electromyographic (EMG) activity of the masseter and trapezius muscles were recorded at rest and while chewing gum during nasal or oral breathing. Oral breathing was introduced by completely occluding the nostrils with a nose clip. During oral breathing, the respiration rate was significantly lower while chewing gum than while at rest (P < 0.05). While chewing gum, the respiration rate was significantly lower during oral breathing than during nasal breathing (P < 0.05). During oral breathing, thoracic movement was significantly higher while chewing gum than while at rest (P < 0.05). Thoracic movement was significantly greater during oral breathing than during nasal breathing (P < 0.05). The trapezius muscle exhibited significant EMG activity when chewing gum during oral breathing. The activity of the trapezius muscle coincided with increased movement of the thoracic wall. Chewing food while breathing through the mouth interferes with and decreases the respiratory cycle and promotes unusual respiratory movement of the thoracic wall, which is directed by the activity of accessory muscles of respiration. Copyright © 2014 the American Physiological Society.

Syllable-Related Breathing in Infants in the Second Year of Life

ERIC Educational Resources Information Center

Parham, Douglas F.; Buder, Eugene H.; Oller, D. Kimbrough; Boliek, Carol A.

2011-01-01

Purpose: This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Method: Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection…

21 CFR 862.3050 - Breath-alcohol test system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breath-alcohol test system. 862.3050 Section 862....3050 Breath-alcohol test system. (a) Identification. A breath-alcohol test system is a device intened to measure alcohol in the human breath. Measurements obtained by this device are used in the...

21 CFR 862.3050 - Breath-alcohol test system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breath-alcohol test system. 862.3050 Section 862....3050 Breath-alcohol test system. (a) Identification. A breath-alcohol test system is a device intened to measure alcohol in the human breath. Measurements obtained by this device are used in the...

Optimal technique for deep breathing exercises after cardiac surgery.

PubMed

Westerdahl, E

2015-06-01

Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breathing exercises have been implemented as a major component of postoperative care. A variety of deep breathing maneuvres are recommended to the spontaneously breathing patient to reduce atelectasis and to improve lung function in the early postoperative period. Different breathing exercises are recommended in different parts of the world, and there is no consensus about the most effective breathing technique after cardiac surgery. Arbitrary instructions are given, and recommendations on performance and duration vary between hospitals. Deep breathing exercises are a major part of this therapy, but scientific evidence for the efficacy has been lacking until recently, and there is a lack of trials describing how postoperative breathing exercises actually should be performed. The purpose of this review is to provide a brief overview of postoperative breathing exercises for patients undergoing cardiac surgery via sternotomy, and to discuss and suggest an optimal technique for the performance of deep breathing exercises.

Toward Anatomical Simulation for Breath Training in Mind/Body Medicine

NASA Astrophysics Data System (ADS)

Sanders, Benjamin; Dilorenzo, Paul; Zordan, Victor; Bakal, Donald

The use of breath in healing is poorly understood by patients and professionals alike. Dysfunctional breathing is a characteristic of many unexplained symptoms and mind/body medical professionals seek methods for breath training to alleviate such problems. Our approach is to re-purpose and evolve a recently developed anatomically inspired respiration simulation which was created for synthesizing motion in entertainment for the use of visualization in breath training. In mind/body medicine, problems are often created from patients being advised to breathe according to some standard based on pace or volume. However, a breathing pattern that is comfortable and effortless for one person may not have the same benefits for the next person. The breathing rhythm which is most effortless for each person needs to be dynamically identified. To this end, in this chapter, we employ optimization to modify a generic model of respiration to fit the breath patterns of specific individuals. In practice, the corresponding visualization which is specific to individual patients could be used to train proper breath behavior, both by showing specific (abnormal) practice and recommended modification(s).

Is breath acetone a biomarker of diabetes? A historical review on breath acetone measurements.

PubMed

Wang, Zhennan; Wang, Chuji

2013-09-01

Since the ancient discovery of the 'sweet odor' in human breath gas, pursuits of the breath analysis-based disease diagnostics have never stopped. Actually, the 'smell' of the breath, as one of three key disease diagnostic techniques, has been used in Eastern-Medicine for more than three thousand years. With advancement of measuring technologies in sensitivity and selectivity, more specific breath gas species have been identified and established as a biomarker of a particular disease. Acetone is one of the breath gases and its concentration in exhaled breath can now be determined with high accuracy using various techniques and methods. With the worldwide prevalence of diabetes that is typically diagnosed through blood testing, human desire to achieve non-blood based diabetic diagnostics and monitoring has never been quenched. Questions, such as is breath acetone a biomarker of diabetes and how is the breath acetone related to the blood glucose (BG) level (the golden criterion currently used in clinic for diabetes diagnostic, monitoring, and management), remain to be answered. A majority of current research efforts in breath acetone measurements and its technology developments focus on addressing the first question. The effort to tackle the second question has begun recently. The earliest breath acetone measurement in clearly defined diabetic patients was reported more than 60 years ago. For more than a half-century, as reviewed in this paper, there have been more than 41 independent studies of breath acetone using various techniques and methods, and more than 3211 human subjects, including 1581 healthy people, 242 Type 1 diabetic patients, 384 Type 2 diabetic patients, 174 unspecified diabetic patients, and 830 non-diabetic patients or healthy subjects who are under various physiological conditions, have been used in the studies. The results of the breath acetone measurements collected in this review support that many conditions might cause changes to breath acetone concentrations; however, the results from the six independent studies using clearly-defined Type 1 and Type 2 diabetic patients unanimously support that an elevated mean breath acetone concentration exists in Type 1 diabetes. Note that there is some overlap between the ranges of breath acetone concentration in individual T1D patients and healthy subjects; this reminds one to be careful when using an acetone breath test on T1D diagnostics. Comparatively, it is too early to draw a general conclusion on the relationship between a breath acetone level and a BG level from the very limited data in the literature.

Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension.

PubMed

Li, Changjun; Chang, Qinghua; Zhang, Jia; Chai, Wenshu

2018-05-01

This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P < .05), and shifted respiratory peak toward left (P < .05). Compared to 16 breaths/minute, traditional spectral analysis showed increased LF power and LF/HF ratio, decreased HF power of HRV at 8 breaths per minute (P < .05). As breathing rate decreased, corrected spectral analysis showed increased HF power, decreased LF power, LF/HF ratio of HRV (P < .05). Compared to controls, resting baroreflex sensitivity decreased in hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ± 6.39 to 78.93 ± 5.04 ms/mm Hg, P < .05) and controls (from 88.49 ± 6.01 to 112.91 ± 7.29 ms/mm Hg, P < .05).Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.

Simultaneous Measurement of Breathing and Heartbeat using Airborne Ultrasound in a Standing Position

NASA Astrophysics Data System (ADS)

Hoshiba, Kotaro; Hirata, Shinnosuke; Hachiya, Hiroyuki

We have been studied about non-contact measurement of respiration and heart rates. In previous papers, the measurement system of small velocity using the M-sequence-modulated signal and phase difference of reflected signals from the target has been proposed. In this paper, we describe measurement of breathing and heartbeat in a standing position using the proposed method. Body-surface velocities by breathing and heartbeat could be observed respectively when the volunteer was breathing and holding the breath. In addition, measured velocity of breathing volunteer includes the component by heartbeat. It is considered that it has possibility to measure breathing and heartbeat concurrently.

49 CFR 40.277 - Are alcohol tests other than saliva or breath permitted under these regulations?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Are alcohol tests other than saliva or breath... Testing § 40.277 Are alcohol tests other than saliva or breath permitted under these regulations? No.... Only saliva or breath for screening tests and breath for confirmation tests using approved devices are...

49 CFR 40.277 - Are alcohol tests other than saliva or breath permitted under these regulations?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Are alcohol tests other than saliva or breath... Testing § 40.277 Are alcohol tests other than saliva or breath permitted under these regulations? No.... Only saliva or breath for screening tests and breath for confirmation tests using approved devices are...

Deep breathing after surgery

MedlinePlus

... and taking big breaths can be uncomfortable. A device called an incentive spirometer can help you take deep breaths correctly. If you do not have this device, you can still practice deep breathing on your ...

Breathing simulator of workers for respirator performance test.

PubMed

Yuasa, Hisashi; Kumita, Mikio; Honda, Takeshi; Kimura, Kazushi; Nozaki, Kosuke; Emi, Hitoshi; Otani, Yoshio

2015-01-01

Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker's respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns.

Whole-heart magnetic resonance coronary angiography with multiple breath-holds and automatic breathing-level tracking

NASA Astrophysics Data System (ADS)

Kuhara, Shigehide; Ninomiya, Ayako; Okada, Tomohisa; Kanao, Shotaro; Kamae, Toshikazu; Togashi, Kaori

2010-05-01

Whole-heart (WH) magnetic resonance coronary angiography (MRCA) studies are usually performed during free breathing while monitoring the position of the diaphragm with real-time motion correction. However, this results in a long scan time and the patient's breathing pattern may change, causing the study to be aborted. Alternatively, WH MRCA can be performed with multiple breath-holds (mBH). However, one problem in the mBH method is that patients cannot hold their breath at the same position every time, leading to image degradation. We have developed a new WH MRCA imaging method that employs both the mBH method and automatic breathing-level tracking to permit automatic tracking of the changes in breathing or breath-hold levels. Evaluation of its effects on WH MRCA image quality showed that this method can provide high-quality images within a shorter scan time. This proposed method is expected to be very useful in clinical WH MRCA studies.

Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles.

PubMed

Celhay, Isabel; Cordova, Rosa; Miralles, Rodolfo; Meza, Francisco; Erices, Pia; Barrientos, Camilo; Valenzuela, Saúl

2015-04-01

To compare electromyographic (EMG) activity in young-adult subjects with different breathing types. This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word 'Mississippi'; (3) swallowing saliva; and (4) forced deep breathing. Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test). Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.

Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study.

PubMed

Sano, Masahiro; Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

2013-12-04

Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient's habitual breathing route than a patient interview.

Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study

PubMed Central

Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

2013-01-01

Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient’s habitual breathing route than a patient interview. PMID:24169579

Override of spontaneous respiratory pattern generator reduces cardiovascular parasympathetic influence

NASA Technical Reports Server (NTRS)

Patwardhan, A. R.; Vallurupalli, S.; Evans, J. M.; Bruce, E. N.; Knapp, C. F.

1995-01-01

We investigated the effects of voluntary control of breathing on autonomic function in cardiovascular regulation. Variability in heart rate was compared between 5 min of spontaneous and controlled breathing. During controlled breathing, for 5 min, subjects voluntarily reproduced their own spontaneous breathing pattern (both rate and volume on a breath-by-breath basis). With the use of this experimental design, we could unmask the effects of voluntary override of the spontaneous respiratory pattern generator on autonomic function in cardiovascular regulation without the confounding effects of altered respiratory pattern. Results from 10 subjects showed that during voluntary control of breathing, mean values of heart rate and blood pressure increased, whereas fractal and spectral powers in heart rate in the respiratory frequency region decreased. End-tidal PCO2 was similar during spontaneous and controlled breathing. These results indicate that the act of voluntary control of breathing decreases the influence of the vagal component, which is the principal parasympathetic influence in cardiovascular regulation.

Hydrogen breath test in schoolchildren.

PubMed Central

Douwes, A C; Schaap, C; van der Klei-van Moorsel, J M

1985-01-01

The frequency of negative hydrogen breath tests due to colonic bacterial flora which are unable to produce hydrogen was determined after oral lactulose challenge in 98 healthy Dutch schoolchildren. There was a negative result in 9.2%. The probability of a false normal lactose breath test (1:77) was calculated from these results together with those from a separate group of children with lactose malabsorption (also determined by hydrogen breath test). A study of siblings and mothers of subjects with a negative breath test did not show familial clustering of this condition. Faecal incubation tests with various sugars showed an increase in breath hydrogen greater than 100 parts per million in those with a positive breath test while subjects with a negative breath test also had a negative faecal incubation test. The frequency of a false negative hydrogen breath test was higher than previously reported, but this does not affect the superiority of this method of testing over the conventional blood glucose determination. PMID:4004310

New breathing functions for the transverse breathing crack of the cracked rotor system: Approach for critical and subcritical harmonic analysis

NASA Astrophysics Data System (ADS)

Al-Shudeifat, Mohammad A.; Butcher, Eric A.

2011-01-01

The actual breathing mechanism of the transverse breathing crack in the cracked rotor system that appears due to the shaft weight is addressed here. As a result, the correct time-varying area moments of inertia for the cracked element cross-section during shaft rotation are also determined. Hence, two new breathing functions are identified to represent the actual breathing effect on the cracked element stiffness matrix. The new breathing functions are used in formulating the time-varying finite element stiffness matrix of the cracked element. The finite element equations of motion are then formulated for the cracked rotor system and solved via harmonic balance method for response, whirl orbits and the shift in the critical and subcritical speeds. The analytical results of this approach are compared with some previously published results obtained using approximate formulas for the breathing mechanism. The comparison shows that the previously used breathing function is a weak model for the breathing mechanism in the cracked rotor even for small crack depths. The new breathing functions give more accurate results for the dynamic behavior of the cracked rotor system for a wide range of the crack depths. The current approach is found to be efficient for crack detection since the critical and subcritical shaft speeds, the unique vibration signature in the neighborhood of the subcritical speeds and the sensitivity to the unbalance force direction all together can be utilized to detect the breathing crack before further damage occurs.

Speech disorders in neurofibromatosis type 1: a sample survey.

PubMed

Cosyns, Marjan; Vandeweghe, Lies; Mortier, Geert; Janssens, Sandra; Van Borsel, John

2010-01-01

Neurofibromatosis type 1 (NF1) is an autosomal-dominant neurocutaneous disorder with an estimated prevalence of two to three cases per 10,000 population. While the physical characteristics have been well documented, speech disorders have not been fully characterized in NF1 patients. This study serves as a pilot to identify key issues in the speech of NF1 patients. In particular, the aim is to explore further the occurrence and nature of problems associated with speech as perceived by the patients themselves. A questionnaire was sent to 149 patients with NF1 registered at the Department of Genetics, Ghent University Hospital. The questionnaire inquired about articulation, hearing, breathing, voice, resonance and fluency. Sixty individuals ranging in age from 4.5 to 61.3 years returned completed questionnaires and these served as the database for the study. The results of this sample survey were compared with data of the normal population. About two-thirds of participants experienced at least one speech or speech-related problem of any type. Compared with the normal population, the NF1 group indicated more articulation difficulties, hearing impairment, abnormalities in loudness, and stuttering. The results indicate that speech difficulties are an area of interest in the NF1 population. Further research to elucidate these findings is needed.

Cholinergic urticaria with anaphylaxis: hazardous duty of a deployed US marine.

PubMed

Handfield, Kent S; Dolan, Christopher K; Kaplan, Michael

2015-04-01

Cholinergic urticaria (CU) is triggered by a rise in body temperature and can be complicated by bronchial hyperresponsiveness and anaphylaxis. It primarily affects young adults who actively engage in strenuous exercise, such as servicemen and servicewomen. If the patient reports a history of wheezing or difficulty breathing with urticaria, a water challenge test in a warm bath can be performed to confirm the presence of anaphylaxis. The test should be conducted in an environment in which the patient's airway can be secured and epinephrine can be administered if necessary. Nonsedating antihistamines commonly are used to treat CU, but few other treatments have been thoroughly evaluated for cases that are refractory to antihistamines. We present the case of a 27-year-old US Marine with CU and anaphylaxis confirmed by a water challenge test in a warm bath.

[Iodine 131 joint radio frequency ablation treatment for child with hyperthyroidism goiter: one case report].

PubMed

Chen, Yonghua; Liang, Li; Fang, Yanlan; Wang, Chunlin; Li, Linfa; Jiang, Tian'an

2017-01-25

A 12-year-old girl presented with a history of cervical mass, and one week of throat discomfort and dyspnea. Five years ago, the patient was diagnosed as Hashimoto's thyroiditis and hyperthyroidism; she received antithyroid drug treatment, but the result was not satisfactory. B-ultrasonic showed that the size of thyroid gland was 8.1 cm×3.2 cm in the left and 8.2 cm×4.8 cm in the right. After iodine 131 combined with radiofrequency ablation (RFA) treatment, throat discomfort and recumbent breathing difficulties disappeared, and B-ultrasonic showed that the size of thyroid reduced to 2.3 cm×1.7 cm (left) and 2.8 cm×2.0 cm (right). No recurrence was observed during the two and a half years of follow-up.

Salt-losing nephropathy in hypothyroidism.

PubMed

Bautista, Aileen Azul; Duya, Jose Eduardo De Leon; Sandoval, Mark Anthony Santiago

2014-05-21

A 35-year-old man presented with recurrent lower extremity weakness associated with polyuria later progressing to generalised weakness with difficulty in breathing. The patient was hypotensive and dry, with normal thyroid and chest examination, weak lower extremity and carpopedal spasm. Workup revealed hypokalaemia, hyponatraemia, hypocalcaemia, hypomagnesaemia, hypochloraemia and hypophosphataemia. Arterial blood gas showed respiratory alkalosis with good oxygenation. Twenty-four-hour urine collection showed normal volume with electrolyte wasting. Thyroid function test revealed overt hypothyroidism with negative antithyroid peroxidase. The patient was well after treatment with levothyroxine, volume and electrolyte replacement and was discharged. Thyroid hormones are related to the expression of the Na-K-ATPase, Na-Pi cotransporter, Mg-ATPase and Na-Ca exchanger pumps in the renal tubules. Sodium, potassium, phosphate, calcium, magnesium and water losses result from decreased expression of these pumps. 2014 BMJ Publishing Group Ltd.

Laryngeal kaposiform hemangioendothelioma: case report and literature review.

PubMed

Kim, Dong Wook; Chung, Jin Haeng; Ahn, Soon Hyun; Kwon, Tack-Kyun

2010-04-01

The kaposiform hemangioendothelioma (KHE) is an uncommon vascular neoplasm of borderline or intermediate malignant potential in which involvement of the head and neck region is rare. A 5-year-old girl was admitted to the emergency room with abrupt massive hemoptysis. Transoral laryngoscopy revealed a round, reddish mass with active bleeding on the anterior portion of the left vocal fold region. Since re-hemoptysis and large amount of aspiration caused breathing difficulties for the patient, suspension exam was performed under general anesthesia. Mass excision and thorough bleeding control was performed with laser assisted laryngo-micro system. Postoperatively, there was no further bleeding. The pathologic diagnosis of the tumor was KHE. To the best of our knowledge, this is the first report of a KHE in the larynx presenting as recurrent hemoptysis in childhood. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Comprehensive care of amyotrophic lateral sclerosis patients: a care model.

PubMed

Güell, Maria Rosa; Antón, Antonio; Rojas-García, Ricardo; Puy, Carmen; Pradas, Jesus

2013-12-01

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that presents with muscle weakness, causing progressive difficulty in movement, communication, eating and ultimately, breathing, creating a growing dependence on family members and other carers. The ideal way to address the problems associated with the disease, and the decisions that must be taken, is through multidisciplinary teams. The key objectives of these teams are to optimise medical care, facilitate communication between team members, and thus to improve the quality of care. In our centre, we have extensive experience in the care of patients with ALS through an interdisciplinary team whose aim is to ensure proper patient care from the hospital to the home setting. In this article, we describe the components of the team, their roles and our way of working. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

KSC-02pd1298

NASA Image and Video Library

2002-09-12

KENNEDY SPACE CENTER, FLA. -- Andy Fish, an SRB retrieval diver and diver medical technician with United Space Alliance, is in the spotlight for helping rescue a diver in distress off Cape Canaveral Sept. 11. Fish and others were on a certification exercise on board Freedom Star, one of the Shuttle Rocket Booster retrieval ships, manned by USA workers. The ship was near the location of a lobster diving boat that radioed the U.S. Coast Guard for help when one of the divers experienced difficulty breathing on his return to the surface. Hearing the call for help, the captain of the Freedom Star offered to help. Fish had experience with distressed divers. He stayed with the diver in the recompression chamber aboard the Freedom Star until the ship reached Port Canaveral where a KSC Occupational Health doctor waited. The diver was stabilized and taken to Florida Hospital. .

KSC-02pd1300

NASA Image and Video Library

2002-09-11

KENNEDY SPACE CENTER, FLA. -- United Space Alliance workers on board the Freedom Star, one of the Shuttle Rocket Booster retrieval ships, check the controls on the recompression chamber at right. The ship and its dive team, including a diver medical technician, Andy Fish, were instrumental in rescuing a lobster diver in distress off Cape Canaveral Sept. 11. The ship was on a certification exercise and near the location of a lobster diving boat that radioed the U.S. Coast Guard for help when one of the divers experienced difficulty breathing on his return to the surface. Hearing the call for help, the captain of the Freedom Star offered to help. Fish stayed with the diver in the recompression chamber aboard the Freedom Star until the ship reached Port Canaveral where a KSC Occupational Health doctor waited. The diver was stabilized and taken to Florida Hospital.

Sleep-wake disturbances after traumatic brain injury.

PubMed

Ouellet, Marie-Christine; Beaulieu-Bonneau, Simon; Morin, Charles M

2015-07-01

Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia. Sleep-wake disturbances can have a major effect on functional outcomes and on the recovery process after TBI. These negative effects can exacerbate other common sequelae of TBI-such as fatigue, pain, cognitive impairments, and psychological disorders (eg, depression and anxiety). Sleep-wake disturbances associated with TBI warrant treatment. Although evidence specific to patients with TBI is still scarce, cognitive-behavioural therapy and medication could prove helpful to alleviate sleep-wake disturbances in patients with a TBI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ammonia and ethylene biomarkers in the respiration of the people with schizophrenia using photoacoustic spectroscopy

NASA Astrophysics Data System (ADS)

Popa, Cristina; Petrus, Mioara; Bratu, Ana Maria

2015-05-01

Oxidative stress has become an exciting area of schizophrenia (SCZ) research, and provides ample opportunities and hope for a better understanding of its pathophysiology, which may lead to new treatment strategies. The first objective of the present study was to analyze the oxidative stress markers in breath samples of patients with SCZ before and after the treatment with Levomepromazine. The second objective was to analyze the deficiency of amino acids marker in breath samples of patients with SCZ before and after the treatment. Exhaled breath was collected from 15 SCZ patients and 19 healthy controls; subsequently, CO2 laser photoacoustic spectroscopy was used to assess the exhaled breath compounds of the study subjects. One of the main breath biomarkers of the oxidative stress is ethylene, while one of the main breath biomarkers of the amino acids deficiency is ammonia. The breath biomarkers in the exhalation of SCZ patients exhibited significant differences from the breath biomarkers in the exhalation of healthy controls. Analysis of breath ethylene and breath ammonia provides a related model of SCZ exhalation that could represent an effective and convenient screening method for this intellectual disability.

Sports-related lung injury during breath-hold diving.

PubMed

Mijacika, Tanja; Dujic, Zeljko

2016-12-01

The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage. Copyright ©ERS 2016.

U.S. Congress playing budgetary endgame

NASA Astrophysics Data System (ADS)

Carlowicz, Mike

With fiscal year 1997 (FY '97) set to begin on October 1, the U.S. Congress was poised to fund most American science programs and agencies at or above the levels of funding appropriated in the tumultuous FY '96. Seeking to avert a drawn-out budget debate during an election year, congressional leaders were working feverishly in the last week of September to write appropriations bills that would be acceptable—though not necessarily satisfying—to both Congress and the Clinton Administration.On September 24, the U.S. House of Representatives and the Senate approved the conference report of H.R. 3666, the appropriations bill that provides funding for the departments of Veterans Affairs, Housing and Urban Development, and the Independent Agencies. The conference report of this VA-HUD bill provides $84.7 billion in spending for the affected agencies, including NASA, the Environmental Protection Agency (EPA), and the National Science Foundation (NSF). The conference report was weighted heavily toward the preferences of the Senate, where moderates and pragmatists were stressing compromise and pushing for appropriations bills that President Clinton would be likely to sign.

[Efficiency and specificity of the KAT-test for rapid diagnosis of falciparum malaria].

PubMed

Cong, Le Dinh; Sergiev, V P; Rabinovich, S A; Nhah, Doan Hanh; Huong, Nguyen Van; Morozov, E N; Kukina, I V; Thinh, Ta Thi; Maksakovskaia, E V; Dao, Le Minh; Chalyĭ, V F; To, Dang Thi; Fandeev, V A; Hoa, Ngo Viet; Due, Nguyen Thi

2002-01-01

A new rapid KAT Quick Malaria test for the diagnosis of falciparum malaria, which is based on the detection of a monoclonal antibody-antigen complex of malaria parasites, has been worked out by the KAT Medical CC in South Africa. The efficiency and specificity of the KAT test were compared with those of the microscopic method and with the ICT test for rapid diagnosis of P. falciparum and P. vivax. The polymerase chain reaction was used as a control test. Testing for malaria was performed on 98 blood samples from feverish patients in Vietnam and Tadjikistan and among the persons who had returned to Moscow from endemic regions. The efficiency of the KAT test for falciparum-malaria was found to be 100% versus 90.5% with ICT. The absence of cross-reactions with P. vivax and the presence of pseudopositive results of the KAT test for fever cases of non-malaria origin indicate its high specificity. There was no correlation between the rate of test line colouring and the level of parasitemia. The KAT test yielded positive results only when gametocytes were found in blood specimens.

[Pyelonephritis with massive renal tissue necrosis in child with urinary tract malformation--a case report].

PubMed

Pawlak-Bratkowska, Monika; Finke, Daria; Olejniczak, Dariusz; Midel, Anna; Tkaczyk, Marcin

2009-04-01

The aim of the case report is presentation of unusual and heavy clinical course of pyelonephritis with renal tissue necrosis in a child with urinary tract malformation. Nine month old girl was admitted to hospital in heavy clinical status due to pyelonephritis--urosepsis. It was complicated by acute renal insufficiency. Patient was treated by broad-spectrum antibiotics and parenteral nutrition. She was feverish for 14 days. Computed tomography done in order to exclude abdominal abscess showed massive renal tissue necrosis of on both sides. Antibiotic treatment was successful after 6 weeks. Urological evaluation revealed bilateral vesico-ureteral refluxes grade IV. Scintigraphy showed multiple scars. Patient was treated Deflux injections (twice). We noted 5 urinary tract recurrences despite antibiotic profilaxis. GFR of 75 ml/min/1.73 m2 was estimated at age of 16 m. Immunodeficiency or malignancy as background of clinical course were excluded. The case we describe presents severe clinical course of pyelonephritis due to complex urinary tract malformation that is to be considered despite based on modern publications "sparing" strategies of diagnosis and profilaxis in urinary tract malformations.

Exhaled breath temperature in children: reproducibility and influencing factors.

PubMed

Vermeulen, S; Barreto, M; La Penna, F; Prete, A; Martella, S; Biagiarelli, F; Villa, M P

2014-09-01

This study will investigate the reproducibility and influencing factors of exhaled breath temperature measured with the tidal breathing technique in asthmatic patients and healthy children. Exhaled breath temperature, fractional exhaled nitric oxide, and spirometry were assessed in 124 children (63 healthy and 61 asthmatic), aged 11.2 ± 2.5 year, M/F 73/51. A modified version of the American Thoracic Society questionnaire on the child's present and past respiratory history was obtained from parents. Parents were also asked to provide detailed information on their child's medication use during the previous 4 weeks. Ear temperature, ambient temperature, and relative-ambient humidity were also recorded. Exhaled breath temperature measurements were highly reproducible; the second measurement was higher than the first measurement, consistent with a test-retest situation. In 13 subjects, between-session within-day reproducibility of exhaled breath temperature was still high. Exhaled breath temperature increased with age and relative-ambient humidity. Exhaled breath temperature was comparable in healthy and asthmatic children; when adjusted for potential confounders (i.e. ambient conditions and subject characteristics), thermal values of asthmatic patients exceeded those of the healthy children by 1.1 °C. Normalized exhaled breath temperature, by subtracting ambient temperature, was lower in asthmatic patients treated with inhaled corticosteroids than in those who were corticosteroid-naive. Measurements of exhaled breath temperature are highly reproducible, yet influenced by several factors. Corrected values, i.e. normalized exhaled breath temperature, could help us to assess the effect of therapy with inhaled corticosteroids. More studies are needed to improve the usefulness of the exhaled breath temperature measured with the tidal breathing technique in children.

Comparison of spontaneous vs. metronome-guided breathing on assessment of vagal modulation using RR variability.

PubMed

Bloomfield, D M; Magnano, A; Bigger, J T; Rivadeneira, H; Parides, M; Steinman, R C

2001-03-01

R-R interval variability (RR variability) is increasingly being used as an index of autonomic activity. High-frequency (HF) power reflects vagal modulation of the sinus node. Since vagal modulation occurs at the respiratory frequency, some investigators have suggested that HF power cannot be interpreted unless the breathing rate is controlled. We hypothesized that HF power during spontaneous breathing would not differ significantly from HF power during metronome-guided breathing. We measured HF power during spontaneous breathing in 20 healthy subjects and 19 patients with heart disease. Each subject's spontaneous breathing rate was determined, and the calculation of HF power was repeated with a metronome set to his or her average spontaneous breathing rate. There was no significant difference between the logarithm of HF power measured during spontaneous and metronome-guided breathing [4.88 +/- 0.29 vs. 5.29 +/- 0.30 ln(ms(2)), P = 0.32] in the group as a whole and when patients and healthy subjects were examined separately. We did observe a small (9.9%) decrease in HF power with increasing metronome-guided breathing rates (from 9 to 20 breaths/min). These data indicate that HF power during spontaneous and metronome-guided breathing differs at most by very small amounts. This variability is several logarithmic units less than the wide discrepancies observed between healthy subjects and cardiac patients with a heterogeneous group of cardiovascular disorders. In addition, HF power is relatively constant across the range of typical breathing rates. These data indicate that there is no need to control breathing rate to interpret HF power when RR variability (and specifically HF power) is used to identify high-risk cardiac patients.

Guiding curve based on the normal breathing as monitored by thermocouple for regular breathing.

PubMed

Lim, Sangwook; Park, Sung Ho; Ahn, Seung Do; Suh, Yelin; Shin, Seong Soo; Lee, Sang-wook; Kim, Jong Hoon; Choi, Eun Kyoung; Yi, Byong Yong; Kwon, Soo Il; Kim, Sookil; Jeung, Tae Sig

2007-11-01

Adapting radiation fields to a moving target requires information continuously on the location of internal target by detecting it directly or indirectly. The aim of this study is to make the breathing regular effectively with minimizing stress to the patient. A system for regulating patient's breath consists of a respiratory monitoring mask (ReMM), a thermocouple module, a screen, inner earphones, and a personal computer. A ReMM with thermocouple was developed previously to measure the patient's respiration. A software was written in LabView 7.0 (National Instruments, TX), which acquires respiration signal and displays its pattern. Two curves are displayed on the screen: One is a curve indicating the patient's current breathing pattern; the other is a guiding curve, which is iterated with one period of the patient's normal breathing curve. The guiding curves were acquired for each volunteer before they breathed with guidance. Ten volunteers participated in this study to evaluate this system. A cycle of the representative guiding curve was acquired by monitoring each volunteer's free breathing with ReMM and was then generated iteratively. The regularity was compared between a free breath curve and a guided breath curve by measuring standard deviations of amplitudes and periods of two groups of breathing. When the breathing was guided, the standard deviation of amplitudes and periods on average were reduced from 0.0029 to 0.00139 (arbitrary units) and from 0.359 s to 0.202 s, respectively. And the correlation coefficients between breathing curves and guiding curves were greater than 0.99 for all volunteers. The regularity was improved statistically when the guiding curve was used.

Transcriptomic Analysis of Compromise Between Air-Breathing and Nutrient Uptake of Posterior Intestine in Loach (Misgurnus anguillicaudatus), an Air-Breathing Fish.

PubMed

Huang, Songqian; Cao, Xiaojuan; Tian, Xianchang

2016-08-01

Dojo loach (Misgurnus anguillicaudatus) is an air-breathing fish species by using its posterior intestine to breathe on water surface. So far, the molecular mechanism about accessory air-breathing in fish is seldom addressed. Five cDNA libraries were constructed here for loach posterior intestines form T01 (the initial stage group), T02 (mid-stage of normal group), T03 (end stage of normal group), T04 (mid-stage of air-breathing inhibited group), and T05 (the end stage of air-breathing inhibited group) and subjected to perform RNA-seq to compare their transcriptomic profilings. A total of 92,962 unigenes were assembled, while 37,905 (40.77 %) unigenes were successfully annotated. 2298, 1091, and 3275 differentially expressed genes (fn1, ACE, EGFR, Pxdn, SDF, HIF, VEGF, SLC2A1, SLC5A8 etc.) were observed in T04/T02, T05/T03, and T05/T04, respectively. Expression levels of many genes associated with air-breathing and nutrient uptake varied significantly between normal and intestinal air-breathing inhibited group. Intraepithelial capillaries in posterior intestines of loaches from T05 were broken, while red blood cells were enriched at the surface of intestinal epithelial lining with 241 ± 39 cells per millimeter. There were periodic acid-schiff (PAS)-positive epithelial mucous cells in posterior intestines from both normal and air-breathing inhibited groups. Results obtained here suggested an overlap of air-breathing and nutrient uptake function of posterior intestine in loach. Intestinal air-breathing inhibition in loach would influence the posterior intestine's nutrient uptake ability and endothelial capillary structure stability. This study will contribute to our understanding on the molecular regulatory mechanisms of intestinal air-breathing in loach.

An Acute Bout of a Controlled Breathing Frequency Lowers Sympathetic Neural Outflow but not Blood Pressure in Healthy Normotensive Subjects

PubMed Central

MCCLAIN, SHANNON L.; BROOKS, ALEXA M.; JARVIS, SARA S.

2017-01-01

Controlled or paced breathing is often used as a stress reduction technique but the impact on blood pressure (BP) and sympathetic outflow have not been consistently reported. The purpose of this study was to determine whether a controlled breathing (12 breaths/min, CB) rate would be similar to an individual’s spontaneous breathing (SB) rate. Secondly, would a CB rate of 12 breaths/min alter heart rate (HR), BP, and indices of muscle sympathetic nerve activity (MSNA). Twenty-one subjects (10 women, 11 men) performed two trials: SB, where the subject chose a comfortable breathing rate; and CB, where the subject breathed at a pace of 12 breaths/min. Each trial was 6 min during which respiratory waveforms, HR, BP (systolic, SBP; diastolic, DBP), and MSNA were recorded. During CB, the 6 min average breathing frequency (14±4 vs 12±1 breaths/min, P<0.05 for SB and CB, respectively), MSNA burst frequency (18±12 vs 14±10 bursts/min, P<0.01) and MSNA burst incidence (28±19 vs 21± 6 bursts/100 heart beats, P<0.01) were significantly lower than during SB. HR (66±9 vs 67±9 beats/min, P<0.05) was higher during CB. SBP (120±13 vs 121±15 mmHg, P=0.741), DBP (56±8 vs 57±9 mmHg, P=0.768), and MSNA total activity (166±94 vs 145±102 a.u./min, P=0.145) were not different between the breathing conditions. In conclusion, an acute reduction in breathing frequency such as that observed during CB elicited a decrease in indices of MSNA (burst frequency and incidence) with no change in BP. PMID:28344733

Changes in cardiac output during swimming and aquatic hypoxia in the air-breathing Pacific tarpon.

PubMed

Clark, T D; Seymour, R S; Christian, K; Wells, R M G; Baldwin, J; Farrell, A P

2007-11-01

Pacific tarpon (Megalops cyprinoides) use a modified gas bladder as an air-breathing organ (ABO). We examined changes in cardiac output (V(b)) associated with increases in air-breathing that accompany exercise and aquatic hypoxia. Juvenile (0.49 kg) and adult (1.21 kg) tarpon were allowed to recover in a swim flume at 27 degrees C after being instrumented with a Doppler flow probe around the ventral aorta to monitor V(b) and with a fibre-optic oxygen sensor in the ABO to monitor air-breathing frequency. Under normoxic conditions and in both juveniles and adults, routine air-breathing frequency was 0.03 breaths min(-1) and V(b) was about 15 mL min(-1) kg(-1). Normoxic exercise (swimming at about 1.1 body lengths s(-1)) increased air-breathing frequency by 8-fold in both groups (reaching 0.23 breaths min(-1)) and increased V(b) by 3-fold for juveniles and 2-fold for adults. Hypoxic exposure (2 kPa O2) at rest increased air-breathing frequency 19-fold (to around 0.53 breaths min(-1)) in both groups, and while V(b) again increased 3-fold in resting juvenile fish, V(b) was unchanged in resting adult fish. Exercise in hypoxia increased air-breathing frequency 35-fold (to 0.95 breaths min(-1)) in comparison with resting normoxic fish. While juvenile fish increased V(b) nearly 2-fold with exercise in hypoxia, adult fish maintained the same V(b) irrespective of exercise state and became agitated in comparison. These results imply that air-breathing during exercise and hypoxia can benefit oxygen delivery, but to differing degrees in juvenile and adult tarpon. We discuss this difference in the context of myocardial oxygen supply.

Role of the superior pharyngeal constrictor muscle in forced breathing in dogs.

PubMed

Yaman, Z; Kogo, M; Senoo, H; Iida, S; Ishii, S; Matsuya, T

2000-03-01

Respiratory-related electromyographic (EMG) activity of the superior pharyngeal constrictor (SPC) muscle was analyzed during the early stage of forced breathing. Four adult dogs anesthetized with sodium pentobarbital were used. In the first part of the study, oral and nasal breathing tubes were placed into the respective cavities, and a tracheotomy tube was placed in the second part of the study. Two conditions, the presence (oral-nasal tube breathing) and absence (tracheotomy breathing) of airflow in the upper airway, were achieved in each dog. Following quiet breathing, animals were connected to a closed breathing system, first by an oral-nasal tube and then by a tracheotomy tube. We proposed to induce a forced breathing condition mechanically by using this system for 1 minute. We increased resistance to airflow during forced breathing by means of connecting tubes and a bag. Our aim was not to produce chemical drive but to produce a forced respiration by increasing the resistance to airflow. Tidal volume, breathing frequency, minute volume, chest wall movement, and EMG activity of the SPC muscle were measured and analyzed. During quiet breathing through an oral-nasal or tracheotomy tube, low-amplitude EMG activity of the SPC muscle corresponding to the expiratory cycle of the respiration was observed. In both study conditions, phasic expiratory EMG activity increased immediately after the advent of the breathing from the closed system. Tidal volumes and frequencies also increased rapidly during forced breathing. An increase in the resistance to airflow increased the activity of the SPC muscle. This augmented respiratory activity probably assists the patency of the upper airway. The augmented respiratory activity was independent of the local reflex pathways. Respiratory-related activity of the SPC muscle may help dilate and stiffen the pharyngeal airway, promoting airway patency.

An Acute Bout of a Controlled Breathing Frequency Lowers Sympathetic Neural Outflow but not Blood Pressure in Healthy Normotensive Subjects.

PubMed

McClain, Shannon L; Brooks, Alexa M; Jarvis, Sara S

2017-01-01

Controlled or paced breathing is often used as a stress reduction technique but the impact on blood pressure (BP) and sympathetic outflow have not been consistently reported. The purpose of this study was to determine whether a controlled breathing (12 breaths/min, CB) rate would be similar to an individual's spontaneous breathing (SB) rate. Secondly, would a CB rate of 12 breaths/min alter heart rate (HR), BP, and indices of muscle sympathetic nerve activity (MSNA). Twenty-one subjects (10 women, 11 men) performed two trials: SB, where the subject chose a comfortable breathing rate; and CB, where the subject breathed at a pace of 12 breaths/min. Each trial was 6 min during which respiratory waveforms, HR, BP (systolic, SBP; diastolic, DBP), and MSNA were recorded. During CB, the 6 min average breathing frequency (14±4 vs 12±1 breaths/min, P <0.05 for SB and CB, respectively), MSNA burst frequency (18±12 vs 14±10 bursts/min, P <0.01) and MSNA burst incidence (28±19 vs 21± 6 bursts/100 heart beats, P <0.01) were significantly lower than during SB. HR (66±9 vs 67±9 beats/min, P <0.05) was higher during CB. SBP (120±13 vs 121±15 mmHg, P =0.741), DBP (56±8 vs 57±9 mmHg, P =0.768), and MSNA total activity (166±94 vs 145±102 a.u./min, P =0.145) were not different between the breathing conditions. In conclusion, an acute reduction in breathing frequency such as that observed during CB elicited a decrease in indices of MSNA (burst frequency and incidence) with no change in BP.

A probability-based multi-cycle sorting method for 4D-MRI: A simulation study.

PubMed

Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

2016-12-01

To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients' breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors' preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management.

Work of Breathing into Snow in the Presence versus Absence of an Artificial Air Pocket Affects Hypoxia and Hypercapnia of a Victim Covered with Avalanche Snow: A Randomized Double Blind Crossover Study.

PubMed

Roubík, Karel; Sieger, Ladislav; Sykora, Karel

2015-01-01

Presence of an air pocket and its size play an important role in survival of victims buried in the avalanche snow. Even small air pockets facilitate breathing. We hypothesize that the size of the air pocket significantly affects the airflow resistance and work of breathing. The aims of the study are (1) to investigate the effect of the presence of an air pocket on gas exchange and work of breathing in subjects breathing into the simulated avalanche snow and (2) to test whether it is possible to breathe with no air pocket. The prospective interventional double-blinded study involved 12 male volunteers, from which 10 completed the whole protocol. Each volunteer underwent two phases of the experiment in a random order: phase "AP"--breathing into the snow with a one-liter air pocket, and phase "NP"--breathing into the snow with no air pocket. Physiological parameters, fractions of oxygen and carbon dioxide in the airways and work of breathing expressed as pressure-time product were recorded continuously. The main finding of the study is that it is possible to breath in the avalanche snow even with no air pocket (0 L volume), but breathing under this condition is associated with significantly increased work of breathing. The significant differences were initially observed for end-tidal values of the respiratory gases (EtO2 and EtCO2) and peripheral oxygen saturation (SpO2) between AP and NP phases, whereas significant differences in inspiratory fractions occurred much later (for FIO2) or never (for FICO2). The limiting factor in no air pocket conditions is excessive increase in work of breathing that induces increase in metabolism accompanied by higher oxygen consumption and carbon dioxide production. The presence of even a small air pocket reduces significantly the work of breathing.

Ventilation is unstable during drowsiness before sleep onset.

PubMed

Thomson, Stuart; Morrell, Mary J; Cordingley, Jeremy J; Semple, Stephen J

2005-11-01

Ventilation is unstable during drowsiness before sleep onset. We have studied the effects of transitory changes in cerebral state during drowsiness on breath duration and lung volume in eight healthy subjects in the absence of changes in airway resistance and fluctuations of ventilation and CO2 tension, characteristic of the onset of non-rapid eye movement sleep. A volume-cycled ventilator in the assist control mode was used to maintain CO2 tension close to that when awake. Changes in cerebral state were determined by the EEG on a breath-by-breath basis and classified as alpha or theta breaths. Breath duration and the pause in gas flow between the end of expiratory airflow and the next breath were computed for two alpha breaths which preceded a theta breath and for the theta breath itself. The group mean (SD) results for this alpha-to-theta transition was associated with a prolongation in breath duration from 5.2 (SD 1.3) to 13.0 s (SD 2.1) and expiratory pause from 0.7 (SD 0.4) to 7.5 s (SD 2.2). Because the changes in arterial CO2 tension (PaCO2) are unknown during the theta breaths, we made in two subjects a continuous record of PaCO2 in the radial artery. PaCO2 remained constant from the alpha breaths through to the expiratory period of the theta breath by which time the duration of breath was already prolonged, representing an immediate and altered ventilatory response to the prevailing PaCO2. In the eight subjects, the CO2 tension awake was 39.6 Torr (SD 2.3) and on assisted ventilation 38.0 Torr (1.4). We conclude that the ventilatory instability recorded in the present experiments is due to the apneic threshold for CO2 being at or just below that when awake.

SU-E-J-178: A Normalization Method Can Remove Discrepancy in Ventilation Function Due to Different Breathing Patterns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qu, H; Yu, N; Stephans, K

2014-06-01

Purpose: To develop a normalization method to remove discrepancy in ventilation function due to different breathing patterns. Methods: Twenty five early stage non-small cell lung cancer patients were included in this study. For each patient, a ten phase 4D-CT and the voluntarily maximum inhale and exhale CTs were acquired clinically and retrospectively used for this study. For each patient, two ventilation maps were calculated from voxel-to-voxel CT density variations from two phases of the quiet breathing and two phases of the extreme breathing. For the quiet breathing, 0% (inhale) and 50% (exhale) phases from 4D-CT were used. An in-house toolmore » was developed to calculate and display the ventilation maps. To enable normalization, the whole lung of each patient was evenly divided into three parts in the longitude direction at a coronal image with a maximum lung cross section. The ratio of cumulated ventilation from the top one-third region to the middle one-third region of the lung was calculated for each breathing pattern. Pearson's correlation coefficient was calculated on the ratios of the two breathing patterns for the group. Results: For each patient, the ventilation map from the quiet breathing was different from that of the extreme breathing. When the cumulative ventilation was normalized to the middle one-third of the lung region for each patient, the normalized ventilation functions from the two breathing patterns were consistent. For this group of patients, the correlation coefficient of the normalized ventilations for the two breathing patterns was 0.76 (p < 0.01), indicating a strong correlation in the ventilation function measured from the two breathing patterns. Conclusion: For each patient, the ventilation map is dependent of the breathing pattern. Using a regional normalization method, the discrepancy in ventilation function induced by the different breathing patterns thus different tidal volumes can be removed.« less

MO-FG-BRA-02: A Feasibility Study of Integrating Breathing Audio Signal with Surface Surrogates for Respiratory Motion Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lei, Y; Zhu, X; Zheng, D

Purpose: Tracking the surrogate placed on patient skin surface sometimes leads to problematic signals for certain patients, such as shallow breathers. This in turn impairs the 4D CT image quality and dosimetric accuracy. In this pilot study, we explored the feasibility of monitoring human breathing motion by integrating breathing sound signal with surface surrogates. Methods: The breathing sound signals were acquired though a microphone attached adjacently to volunteer’s nostrils, and breathing curve were analyzed using a low pass filter. Simultaneously, the Real-time Position Management™ (RPM) system from Varian were employed on a volunteer to monitor respiratory motion including both shallowmore » and deep breath modes. The similar experiment was performed by using Calypso system, and three beacons taped on volunteer abdominal region to capture breath motion. The period of each breathing curves were calculated with autocorrelation functions. The coherence and consistency between breathing signals using different acquisition methods were examined. Results: Clear breathing patterns were revealed by the sound signal which was coherent with the signal obtained from both the RPM system and Calypso system. For shallow breathing, the periods of breathing cycle were 3.00±0.19 sec (sound) and 3.00±0.21 sec (RPM); For deep breathing, the periods were 3.49± 0.11 sec (sound) and 3.49±0.12 sec (RPM). Compared with 4.54±0.66 sec period recorded by the calypso system, the sound measured 4.64±0.54 sec. The additional signal from sound could be supplement to the surface monitoring, and provide new parameters to model the hysteresis lung motion. Conclusion: Our preliminary study shows that the breathing sound signal can provide a comparable way as the RPM system to evaluate the respiratory motion. It’s instantaneous and robust characteristics facilitate it possibly to be a either independently or as auxiliary methods to manage respiratory motion in radiotherapy.« less

Oxygen and carbon dioxide sensitivity of ventilation in amphibious crabs, Cardisoma guanhumi, breathing air and water.

PubMed

Gannon, Andrew T; Henry, Raymond P

2004-05-01

Amphibious crabs, Cardisoma guanhumi, were acclimated to breathing either air or water and exposed to altered levels of oxygen and/or carbon dioxide in the medium. Hypercapnia (22, 36 and 73 torr CO(2)) stimulated a significant hypercapnic ventilatory response (HCVR) in both groups of crabs, with a much greater effect on scaphognathite frequency (Deltaf(SC)=+700%) in air-breathing crabs than water-breathing crabs (Deltaf(SC)=+100%). In contrast, hyperoxia induced significant hypoventilation in both sets of crabs. However, simultaneous hyperoxia and hypercapnia triggered a greater than 10-fold increase in f(SC) in air-breathing crabs but no change in water-breathing crabs. For water-breathing crabs hypoxia simultaneous with hypercapnia triggered the same response as hypoxia alone-bradycardia (-50%), and a significant increase in f(SC) at moderate exposures but not at the more extreme levels. The response of air-breathing crabs to hypoxia concurrent with hypercapnia was proportionally closer to the response to hypercapnia alone than to hypoxia. Thus, C. guanhumi were more sensitive to ambient CO(2) than O(2) when breathing air, characteristic of fully terrestrial species, and more sensitive to ambient O(2) when breathing water, characteristic of fully aquatic species. C. guanhumi possesses both an O(2)- and a CO(2)-based ventilatory drive whether breathing air or water, but the relative importance switches when the respiratory medium is altered.

Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial.

PubMed

Pettersson, Henrik; Faager, Gun; Westerdahl, Elisabeth

2015-09-01

Breathing exercises after cardiac surgery are often performed in a sitting position. It is unknown whether oxygenation would be better in the standing position. The aim of this study was to evaluate oxygenation and subjective breathing ability during sitting vs standing performance of deep breathing exercises on the second day after cardiac surgery. Patients undergoing coronary artery bypass grafting (n = 189) were randomized to sitting (controls) or standing. Both groups performed 3 × 10 deep breaths with a positive expiratory pressure device. Peripheral oxygen saturation was measured before, directly after, and 15 min after the intervention. Subjective breathing ability, blood pressure, heart rate, and pain were assessed. Oxygenation improved significantly in the standing group compared with controls directly after the breathing exercises (p < 0.001) and after 15 min rest (p = 0.027). The standing group reported better deep breathing ability compared with controls (p = 0.004). A slightly increased heart rate was found in the standing group (p = 0.047). After cardiac surgery, breathing exercises with positive expiratory pressure, performed in a standing position, significantly improved oxygenation and subjective breathing ability compared with sitting performance. Performance of breathing exercises in the standing position is feasible and could be a valuable treatment for patients with postoperative hypoxaemia.

Dental arch dimensional changes after adenotonsillectomy in prepubertal children.

PubMed

Petraccone Caixeta, Anna Cristina; Andrade, Ildeu; Bahia Junqueira Pereira, Tatiana; Franco, Letícia Paiva; Becker, Helena Maria Gonçalves; Souki, Bernardo Quiroga

2014-04-01

The purposes of this study were to investigate the dental arch changes after adenotonsillectomies in prepubertal children and to compare the dental arch dimensions of mouth-breathing and nasal-breathing children. The sample included 49 prepubertal severely obstructed mouth-breathing children and 46 prepubertal nasal-breathing children. Twenty-four of the 49 mouth-breathing children had an adenotonsillectomy and composed the adenotonsillectomy subgroup. The 25 children in whom the mouth-breathing pattern was unchanged during the 1-year study period composed the control subgroup. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. After airway clearance, the adenotonsillectomy group showed a significant maxillary transverse width gain compared with the control subgroup. The control subgroup showed a significant deepening of the palatal height when compared with the adenotonsillectomy subgroup after 1 year. The adenotonsillectomy subgroup had a significantly different pattern of arch development compared with the untreated controls. After adenotonsillectomy, the mouth-breathing children showed greater maxillary transverse development than did the controls. The palatal vault deepened in the untreated children. The mouth-breathing children showed a deeper palatal vault, a larger mandibular width, and a larger mandibular arch length in comparison with the nasal-breathing children. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Analysis of Exhaled Breath for Disease Detection

NASA Astrophysics Data System (ADS)

Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

2014-06-01

Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

Effects of breathing frequency and flow rate on the total inward leakage of an elastomeric half-mask donned on an advanced manikin headform.

PubMed

He, Xinjian; Grinshpun, Sergey A; Reponen, Tiina; McKay, Roy; Bergman, Michael S; Zhuang, Ziqing

2014-03-01

The objective of this study was to investigate the effects of breathing frequency and flow rate on the total inward leakage (TIL) of an elastomeric half-mask donned on an advanced manikin headform and challenged with combustion aerosols. An elastomeric half-mask respirator equipped with P100 filters was donned on an advanced manikin headform covered with life-like soft skin and challenged with aerosols originated by burning three materials: wood, paper, and plastic (polyethylene). TIL was determined as the ratio of aerosol concentrations inside (C in) and outside (C out) of the respirator (C in/C out) measured with a nanoparticle spectrometer operating in the particle size range of 20-200nm. The testing was performed under three cyclic breathing flows [mean inspiratory flow (MIF) of 30, 55, and 85 l/min] and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). A completely randomized factorial study design was chosen with four replicates for each combination of breathing flow rate and frequency. Particle size, MIF, and combustion material had significant (P < 0.001) effects on TIL regardless of breathing frequency. Increasing breathing flow decreased TIL. Testing with plastic aerosol produced higher mean TIL values than wood and paper aerosols. The effect of the breathing frequency was complex. When analyzed using all combustion aerosols and MIFs (pooled data), breathing frequency did not significantly (P = 0.08) affect TIL. However, once the data were stratified according to combustion aerosol and MIF, the effect of breathing frequency became significant (P < 0.05) for all MIFs challenged with wood and paper combustion aerosols, and for MIF = 30 l/min only when challenged with plastic combustion aerosol. The effect of breathing frequency on TIL is less significant than the effects of combustion aerosol and breathing flow rate for the tested elastomeric half-mask respirator. The greatest TIL occurred when challenged with plastic aerosol at 30 l/min and at a breathing frequency of 30 breaths/min.

A fully integrated standalone portable cavity ringdown breath acetone analyzer.

PubMed

Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

2015-09-01

Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

A fully integrated standalone portable cavity ringdown breath acetone analyzer

NASA Astrophysics Data System (ADS)

Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

2015-09-01

Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

Human breath metabolomics using an optimized noninvasive exhaled breath condensate sampler

PubMed Central

Zamuruyev, Konstantin O.; Aksenov, Alexander A.; Pasamontes, Alberto; Brown, Joshua F.; Pettit, Dayna R.; Foutouhi, Soraya; Weimer, Bart C.; Schivo, Michael; Kenyon, Nicholas J.; Delplanque, Jean-Pierre; Davis, Cristina E.

2017-01-01

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017). PMID:28004639

Comparative transcriptome analysis between aquatic and aerial breathing organs of Channa argus to reveal the genetic basis underlying bimodal respiration.

PubMed

Jiang, Yanliang; Feng, Shuaisheng; Xu, Jian; Zhang, Songhao; Li, Shangqi; Sun, Xiaoqing; Xu, Peng

2016-10-01

Aerial breathing in fish was an important adaption for successful survival in hypoxic water. All aerial breathing fish are bimodal breathers. It is intriguing that they can obtain oxygen from both air and water. However, the genetic basis underlying bimodal breathing has not been extensively studied. In this study, we performed next-generation sequencing on a bimodal breathing fish, the Northern snakehead, Channa argus, and generated a transcriptome profiling of C. argus. A total of 53,591 microsatellites and 26,378 SNPs were identified and classified. A Ka/Ks analysis of the unigenes indicated that 63 genes were under strong positive selection. Furthermore, the transcriptomes from the aquatic breathing organ (gill) and the aerial breathing organ (suprabranchial chamber) were sequenced and compared, and the results showed 1,966 genes up-regulated in the gill and 2,727 genes up-regulated in the suprabranchial chamber. A gene pathway analysis concluded that four functional categories were significant, of which angiogenesis and elastic fibre formation were up-regulated in the suprabranchial chamber, indicating that the aerial breathing organ may be more efficient for gas exchange due to its highly vascularized and elastic structure. In contrast, ion uptake and transport and acid-base balance were up-regulated in the gill, indicating that the aquatic breathing organ functions in ion homeostasis and acid-base balance, in addition to breathing. Understanding the genetic mechanism underlying bimodal breathing will shed light on the initiation and importance of aerial breathing in the evolution of vertebrates. Copyright © 2016 Elsevier B.V. All rights reserved.

Human breath metabolomics using an optimized non-invasive exhaled breath condensate sampler.

PubMed

Zamuruyev, Konstantin O; Aksenov, Alexander A; Pasamontes, Alberto; Brown, Joshua F; Pettit, Dayna R; Foutouhi, Soraya; Weimer, Bart C; Schivo, Michael; Kenyon, Nicholas J; Delplanque, Jean-Pierre; Davis, Cristina E

2016-12-22

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube ™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017).

Benzene levels in ambient air and breath of smokers and nonsmokers in urban and pristine environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wester, R.C.; Maibach, H.I.; Gruenke, L.D.

Benzene levels in human breath and in ambient air were compared in the urban area of San Francisco (SF) and in a more remote coastal pristine setting of Stinson Beach, Calif. (SB). Benzene analysis was done by gas chromatography-mass spectroscopy (GC-MS). Ambient benzene levels were sevenfold higher in SF (2.6 +/- 1.3 ppb, n = 25) than SB (0.38 +/- 0.39 ppb, n = 21). In SF, benzene in smokers' breath (6.8 +/- 3.0 ppb) was greater than in nonsmokers' breath (2.5 +/- 0.8 ppb) and smokers' ambient air (3.3 +/- 0.8 ppb). In SB the same pattern was observed:more » benzene in smokers' breath was higher than in nonsmokers' breath and ambient air. Benzene in SF nonsmokers' breath was greater than in SB nonsmokers' breath. Marijuana-only smokers had benzene breath levels between those of smokers and nonsmokers. There was little correlation between benzene in breath and number of cigarettes smoked, or with other benzene exposures such as diet. Of special interest was the finding that benzene in breath of SF nonsmokers (2.5 +/- 0.8 ppb) was greater than that in nonsmokers ambient air (1.4 +/- 0.1 ppb). The same was true in SB, where benzene in nonsmokers breath was greater than ambient air (1.8 +/- 0.2 ppb versus 1.0 +/- 0.1 ppb on d 1 and 1.3 +/- 0.3 ppb versus 0.23 +/- 0.18 ppb on d 2). This suggests an additional source of benzene other than outdoor ambient air.« less

Study of the detectability of controlled substances on breath

DOT National Transportation Integrated Search

1975-07-01

The University of Missouri used high pressure liquid chromatography plus mass spectrometry for a quantitative analysis of marijuana metabolites in blood and breath. A breath collector was developed for road-side sampling of human breath and subsequen...

[Reliability study on the infrared spectrometry for measuring the delta over baseline for breath 13C].

PubMed

Wang, Min; Wang, Zhiling; Gou, Lingyan; Zhang, Yuhui; Yang, Xiaoguang; Sha, Lei; Li, Min

2013-03-01

To assess the validity and reliability of the infrared spectrometry for measuring the delta over baseline for breath 13C. Twenty-four healthy adults were selected, including twelve males and twelve females. 13C-Leucine was used as tracer in stable isotope metabolic experiments. One baseline breath was collected before the tracer protocol began. Other breath samples were collected at 60, 120, 180, 195, 210, 225, 240, 255, 270 and 300 min post-tracer challenge. The delta over baseline for breath 13C was measured by the infrared spectrometry and Heliview 13C breath analyzer. No significant differences were found between the infrared spectrometry and Heliview 13C breath analyzer in measuring the delta over baseline for breath 13C. The F value and p value of two-way ANOVA were 0.29 and 0.5874 respectively. The t and p value of consistency test were 0.48 and 0.6346 respectively. The 13C infrared spectrometry can reliably measure the delta over baseline for breath 13C.

Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients.

PubMed

Krishnan, Sanduru Thamarai; Devadhasan, Jasmine Pramila; Kim, Sanghyo

2017-01-01

The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies.

Breathing simulator of workers for respirator performance test

PubMed Central

YUASA, Hisashi; KUMITA, Mikio; HONDA, Takeshi; KIMURA, Kazushi; NOZAKI, Kosuke; EMI, Hitoshi; OTANI, Yoshio

2014-01-01

Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker’s respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns. PMID:25382381

Breath in the technoscientific imaginary

PubMed Central

Rose, Arthur

2016-01-01

Breath has a realist function in most artistic media. It serves to remind the reader, the viewer or the spectator of the exigencies of the body. In science fiction (SF) literature and films, breath is often a plot device for human encounters with otherness, either with alien peoples, who may not breathe oxygen, or environments, where there may not be oxygen to breathe. But while there is a technoscientific quality to breath in SF, especially in its attention to physiological systems, concentrating on the technoscientific threatens to occlude other, more affective aspects raised by the literature. In order to supplement the tendency to read SF as a succession of technoscientific accounts of bodily experience, this paper recalls how SF texts draw attention to the affective, non-scientific qualities of breath, both as a metonym for life and as a metaphor for anticipation. Through an engagement with diverse examples from SF literature and films, this article considers the tension between technoscientific and affective responses to breath in order to demonstrate breath's co-determinacy in SF's blending of scientific and artistic discourses. PMID:27542677

Breathing and sense of self: visuo-respiratory conflicts alter body self-consciousness.

PubMed

Adler, Dan; Herbelin, Bruno; Similowski, Thomas; Blanke, Olaf

2014-11-01

Bodily self-consciousness depends on the processing of interoceptive and exteroceptive signals. It can be disrupted by inducing signal conflicts. Breathing, at the crossroad between interoception and exteroception, should contribute to bodily self-consciousness. We induced visuo-respiratory conflicts in 17 subjects presented with a virtual body or a parallelepidedal object flashing synchronously or asynchronously with their breathing. A questionnaire detected illusory changes in bodily self-consciousness and breathing agency (the feeling of sensing one's breathing command). Changes in self-location were tested by measuring reaction time during mental ball drop (MBD). Synchronous illumination changed the perceived location of breathing (body: p=0.008 vs. asynchronous; object: p=0.013). It resulted in a significant change in breathing agency, but no changes in self-identification. This was corroborated by prolonged MBD reaction time (body: +0.045s, 95%CI [0.013; 0.08], p=0.007). We conclude that breathing modulates bodily self-consciousness. We also conclude that one can induce the irruption of unattended breathing into consciousness without modifying respiratory mechanics or gas exchange. Copyright © 2014 Elsevier B.V. All rights reserved.

Control of Breathing During Mechanical Ventilation: Who Is the Boss?

PubMed Central

Williams, Kathleen; Hinojosa-Kurtzberg, Marina; Parthasarathy, Sairam

2011-01-01

Over the past decade, concepts of control of breathing have increasingly moved from being theoretical concepts to “real world” applied science. The purpose of this review is to examine the basics of control of breathing, discuss the bidirectional relationship between control of breathing and mechanical ventilation, and critically assess the application of this knowledge at the patient’s bedside. The principles of control of breathing remain under-represented in the training curriculum of respiratory therapists and pulmonologists, whereas the day-to-day bedside application of the principles of control of breathing continues to suffer from a lack of outcomes-based research in the intensive care unit. In contrast, the bedside application of the principles of control of breathing to ambulatory subjects with sleep-disordered breathing has out-stripped that in critically ill patients. The evolution of newer technologies, faster real-time computing abilities, and miniaturization of ventilator technology can bring the concepts of control of breathing to the bedside and benefit the critically ill patient. However, market forces, lack of scientific data, lack of research funding, and regulatory obstacles need to be surmounted. PMID:21333174

Are questionnaires reliable in diagnosing sleep-disordered breathing in university students?

PubMed

Migacz, E; Wichniak, A; Kukwa, W

2017-11-01

This study aimed to screen young adults for sleep-disordered breathing, and compare those with high and low risk for sleep-disordered breathing. A survey based on the Berlin questionnaire was completed by 330 university students, and the results were used to divide them into sleep-disordered breathing positive and sleep-disordered breathing negative groups. A representative group was selected from each cohort (positive group, n = 16; negative group, n = 21), and assessed with sleep study, ENT examination, the Nose Obstruction Symptom Evaluation scale, and the Epworth Sleepiness Scale. Sleep-disordered breathing prevalence was 11.2 per cent in the questionnaire and 24 per cent according to the sleep study. The sleep-disordered breathing positive and negative groups significantly differed in terms of coexisting sleep-disordered breathing symptoms. There were no significant differences between the positive and negative groups with regard to sleep study parameters (apnoea/hypopnoea index, respiratory disturbance index, oxygen desaturation index, snoring intensity) and the Epworth Sleepiness Scale. Subjective and objective diagnostic tools revealed that sleep-disordered breathing is a common problem among young adults.

A cross-sectional study of breath acetone based on diabetic metabolic disorders.

PubMed

Li, Wenwen; Liu, Yong; Lu, Xiaoyong; Huang, Yanping; Liu, Yu; Cheng, Shouquan; Duan, Yixiang

2015-02-26

Breath acetone is a known biomarker for diabetes mellitus in breath analysis. In this work, a cross-sectional study of breath acetone based on clinical metabolic disorders of type 2 diabetes mellitus (T2DM) was carried out. Breath acetone concentrations of 113 T2DM patients and 56 apparently healthy individuals were measured at a single time point. Concentrations varied from 0.22 to 9.41 ppmv (mean 1.75 ppmv) for T2DM, which were significantly higher than those for normal controls (ranged from 0.32 to 1.96 ppmv, mean 0.72 ppmv, p = 0.008). Observations in our work revealed that breath acetone concentrations elevated to different degrees, along with the abnormality of blood glucose, glycated hemoglobin (HbA1c), triglyceride and cholesterol. Breath acetone showed obviously positive correlations with blood ketone and urine ketone. Possible metabolic relations between breath acetone and diabetic disorders were also discussed. This work aimed at giving an overall assessment of breath acetone from the perspective of clinical parameters for type 2 diabetes.

Detection of pulmonary metastases with pathological correlation: effect of breathing on the accuracy of spiral CT.

PubMed

Coakley, F V; Cohen, M D; Waters, D J; Davis, M M; Karmazyn, B; Gonin, R; Hanna, M P

1997-07-01

CT of the chest for suspected pulmonary metastases in adults is generally performed using a breath-hold technique. The results may not be applicable to young children in whom breath-holding may be impossible. Determine the effect of breathing on the accuracy of pulmonary metastasis detection by spiral CT (SCT). Prior to euthanasia four anesthetized dogs with metastatic osteosarcoma underwent SCT with a collimation of 5 mm and a pitch of 2, during both induced breath-hold and normal quiet breathing. Images were reconstructed as contiguous 5-mm slices. Macroscopically evident metastases were noted at postmortem. Hard-copy SCT images were reviewed by ten radiologists, each of whom circled all suspected metastases. SCT images were compared with postmortem results to determine true and false positives. The pathologist identified 132 macroscopically evident pulmonary metastases. For metastasis detection, there was no significant difference between breath-hold SCT and breathing SCT. In our animal model, SCT can be performed during normal resting breathing without significant loss of accuracy in the detection of pulmonary metastases.

Emptying patterns of the lung studied by multiple-breath N2 washout

NASA Technical Reports Server (NTRS)

Lewis, S. M.

1978-01-01

Changes in the nitrogen concentration seen during the single-breath nitrogen washout reflect changes in relative flow (ventilation) from units with differing ventilation/volume ratios. The multiple-breath washout provides sufficient data on ventilation for units with varying ventilation/volume ratios to be plotted as a function of the volume expired. Flow from the dead space may also be determined. In young normals the emptying patterns are narrow and unimodal throughout the alveolar plateau with little or no flow from the dead space at the end of the breath. Older normals show more flow from the dead space, particularly toward the end of the breath, and some show a high ventilation/volume ratio mode early in the breath. Patients with obstructive lung disease have a high flow from the dead space which is present throughout the breath. A well ventilated mode at the end of the breath is seen in some obstructed subjects. Patients with cystic fibrosis showed a poorly ventilated mode appearing at the end of the breath as well as a very high dead space.

The impact of breathing rate on the cardiac autonomic dynamics among children with cerebral palsy compared to typically developed controls.

PubMed

Amichai, Taly; Eylon, Sharon; Berger, Itai; Katz-Leurer, Michal

2018-02-06

To describe the immediate effect of breathing rate on heart rate (HR) and heart rate variability (HRV) in children with cerebral palsy (CP) and a control group of typically developed (TD) age and gender-matched children. Twenty children with CP at gross motor function classification system levels I-III and 20 TD children aged 6-11 participated in the study. HR was monitored at rest and during paced breathing with biofeedback. Respiratory measures were assessed by KoKo spirometry. Children with CP have lower spirometry and HRV values at rest compared to TD children. The mean reduction of breathing rate during paced breathing among children with CP was significantly smaller. Nonetheless, while practicing paced breathing, both groups reduced their breathing rate and increased their HRV. The results of the current work present the immediate effect of paced breathing on HRV parameters in CP and TD children. Further studies are needed to investigate the effect of long-term treatment focusing on paced breathing for children with CP.

Respiratory Symptoms, Sleep, and Quality of Life in Patients With Advanced Lung Cancer.

PubMed

Lou, Vivian W Q; Chen, Elaine J; Jian, Hong; Zhou, Zhen; Zhu, Jingfen; Li, Guohong; He, Yaping

2017-02-01

Maintenance of quality of life and symptom management are important in lung cancer therapy. To the author's knowledge, the interplay of respiratory symptoms and sleep disturbance in affecting quality of life in advanced lung cancer remains unexamined. The study was designed to examine the relationships among respiratory symptoms, sleep disturbance, and quality of life in patients with advanced lung cancer. A total of 128 patients with advanced lung cancer (from chest oncology inpatient-units in Shanghai, China) participated in the study. They completed two questionnaires: the Functional Assessment of Cancer Therapy-Lung and the Pittsburgh Sleep Quality Index. Symptomatic breathing difficulty, coughing, shortness of breath, and tightness in the chest were reported in 78.1%, 70.3%, 60.9%, and 60.2% of the patients, respectively. Sleep disturbance affected 62.5% of the patients. The patients with severe respiratory symptoms were more likely to be poor sleepers and to have a lower quality of life. After the covariates were controlled for, regression analysis showed that respiratory symptoms and sleep disturbance were significant indicators of quality of life. In addition, some of the effect of the respiratory symptoms on quality of life was mediated by sleep disturbance. Respiratory symptoms and sleep disturbance were common in the advanced lung cancer patients and had a negative impact on their quality of life; sleep disturbance may mediate the relationship between respiratory symptoms and quality of life. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Physiological scoring: an aid to emergency medical services transport decisions?

PubMed

Challen, Kirsty; Walter, Darren

2010-01-01

Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoring<2 was admitted or received stabilizing treatment. Despite significant over-triage, this system could have diverted 79 patients safely from the emergency department to alternative, unscheduled, care providers.

The effect of humidified heated breathing circuit on core body temperature in perioperative hypothermia during thyroid surgery.

PubMed

Park, Hue Jung; Moon, Ho Sik; Moon, Se Ho; Do Jeong, Hyeon; Jeon, Young Jae; Do Han, Keung; Koh, Hyun Jung

2017-01-01

Purpose: During general anesthesia, human body easily reaches a hypothermic state, which is mainly caused by heat redistribution. Most studies suggested that humidified heated breathing circuits (HHBC) have little influence on maintenance of the core temperature during early phase of anesthesia. This study was aimed at examining heat preservation effect with HHBC in case of undergoing surgery with less exposure of surgical fields and short surgical duration. Methods: Patients aged 19 to 70 yr - old, ASA-PS I or II who were scheduled for elective thyroidectomy were assigned and divided to the group using HHBC (G1) and the group using conventional circuit (G2) by random allocation. During operation, core, skin, and room temperatures were measured every 5minutes by specific thermometer. Results: G1 was decreased by a lesser extent than G2 in core temperature, apparently higher at 30 and 60 minutes after induction. Skin and room temperatures showed no differences between the two groups (p>0.05). Consequently, we confirmed HHBC efficiently prevented a decrease in core temperature during early period in small operation which has difficulty in preparing warming devices or environments were not usually considered. Conclusions: This study showed that HHBC influences heat redistribution in early period of operation and can lessen the magnitude of the decrease in core body temperature. Therefore, it can be applied efficiently for other active warming devices in mild hypothermia.

Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer.

PubMed

Sun, Meixiu; Chen, Zhuying; Gong, Zhiyong; Zhao, Xiaomeng; Jiang, Chenyu; Yuan, Yuan; Wang, Zhennang; Li, Yingxin; Wang, Chuji

2015-02-01

Over 90% of diabetic patients have Type 2 diabetes. Although an elevated mean breath acetone concentration has been found to exist in Type 1 diabetes (T1D), information on breath acetone in Type 2 diabetes (T2D) has yet to be obtained. In this study, we first used gas chromatography-mass spectrometry (GC-MS) to validate a ringdown breath-acetone analyzer based on the cavity-ringdown-spectroscopy technique, through comparing breath acetone concentrations in the range 0.5-2.5 ppm measured using both methods. The linear fitting of R = 0.99 suggests that the acetone concentrations obtained using both methods are consistent with a largest standard deviation of ±0.4 ppm in the lowest concentration of the range. Next, 620 breath samples from 149 T2D patients and 42 healthy subjects were collected and tested using the breath analyzer. Four breath samples were taken from each subject under each of four different conditions: fasting, 2 h post-breakfast, 2 h post-lunch, and 2 h post-dinner. Simultaneous blood glucose levels were also measured using a standard diabetic-management blood-glucose meter. For the 149 T2D subjects, their exhaled breath acetone concentrations ranged from 0.1 to 19.8 ppm; four different ranges of breath acetone concentration, 0.1-19.8, 0.1-7.1, 0.1-6.3, and 0.1-9.5 ppm, were obtained for the subjects under the four different conditions, respectively. For the 42 healthy subjects, their breath acetone concentration ranged from 0.1 to 2.6 ppm; four different ranges of breath acetone concentration, 0.3-2.6, 0.1-2.6, 0.1-1.7, and 0.3-1.6 ppm, were obtained for the four different conditions. The mean breath acetone concentration of the 149 T2D subjects was determined to be 1.5 ± 1.5 ppm, which was 1.5 times that of 1.0 ± 0.6 ppm for the 42 healthy subjects. No correlation was found between the breath acetone concentration and the blood glucose level of the T2D subjects and the healthy volunteers. This study using a relatively large number of subjects provides new data regarding breath acetone in diabetes (T1D and T2D) and suggests that an elevated mean breath acetone concentration also exists in T2D.

A visual stethoscope to detect the position of the tracheal tube.

PubMed

Kato, Hiromi; Suzuki, Akira; Nakajima, Yoshiki; Makino, Hiroshi; Sanjo, Yoshimitsu; Nakai, Takayoshi; Shiraishi, Yoshito; Katoh, Takasumi; Sato, Shigehito

2009-12-01

Advancing a tracheal tube into the bronchus produces unilateral breath sounds. We created a Visual Stethoscope that allows real-time fast Fourier transformation of the sound signal and 3-dimensional (frequency-amplitude-time) color rendering of the results on a personal computer with simultaneous processing of 2 individual sound signals. The aim of this study was to evaluate whether the Visual Stethoscope can detect bronchial intubation in comparison with auscultation. After induction of general anesthesia, the trachea was intubated with a tracheal tube. The distance from the incisors to the carina was measured using a fiberoptic bronchoscope. While the anesthesiologist advanced the tracheal tube from the trachea to the bronchus, another anesthesiologist auscultated breath sounds to detect changes of the breath sounds and/or disappearance of bilateral breath sounds for every 1 cm that the tracheal tube was advanced. Two precordial stethoscopes placed at the left and right sides of the chest were used to record breath sounds simultaneously. Subsequently, at a later date, we randomly entered the recorded breath sounds into the Visual Stethoscope. The same anesthesiologist observed the visualized breath sounds on the personal computer screen processed by the Visual Stethoscope to examine changes of breath sounds and/or disappearance of bilateral breath sound. We compared the decision made based on auscultation with that made based on the results of the visualized breath sounds using the Visual Stethoscope. Thirty patients were enrolled in the study. When irregular breath sounds were auscultated, the tip of the tracheal tube was located at 0.6 +/- 1.2 cm on the bronchial side of the carina. Using the Visual Stethoscope, when there were any changes of the shape of the visualized breath sound, the tube was located at 0.4 +/- 0.8 cm on the tracheal side of the carina (P < 0.01). When unilateral breath sounds were auscultated, the tube was located at 2.6 +/- 1.2 cm on the bronchial side of the carina. The tube was also located at 2.3 +/- 1.0 cm on the bronchial side of the carina when a unilateral shape of visualized breath sounds was obtained using the Visual Stethoscope (not significant). During advancement of the tracheal tube, alterations of the shape of the visualized breath sounds using the Visual Stethoscope appeared before the changes of the breath sounds were detected by auscultation. Bilateral breath sounds disappeared when the tip of the tracheal tube was advanced beyond the carina in both groups.

A dual mode breath sampler for the collection of the end-tidal and dead space fractions.

PubMed

Salvo, P; Ferrari, C; Persia, R; Ghimenti, S; Lomonaco, T; Bellagambi, F; Di Francesco, F

2015-06-01

This work presents a breath sampler prototype automatically collecting end-tidal (single and multiple breaths) or dead space air fractions (multiple breaths). This result is achieved by real time measurements of the CO2 partial pressure and airflow during the expiratory and inspiratory phases. Suitable algorithms, used to control a solenoid valve, guarantee that a Nalophan(®) bag is filled with the selected breath fraction even if the subject under test hyperventilates. The breath sampler has low pressure drop (<0.5 kPa) and uses inert or disposable components to avoid bacteriological risk for the patients and contamination of the breath samples. A fully customisable software interface allows a real time control of the hardware and software status. The performances of the breath sampler were evaluated by comparing (a) the CO2 partial pressure calculated during the sampling with the CO2 pressure measured off-line within the Nalophan(®) bag; (b) the concentrations of four selected volatile organic compounds in dead space, end-tidal and mixed breath fractions. Results showed negligible deviations between calculated and off-line CO2 pressure values and the distributions of the selected compounds into dead space, end-tidal and mixed breath fractions were in agreement with their chemical-physical properties. Copyright © 2015. Published by Elsevier Ltd.

The effect of mouth breathing on chewing efficiency.

PubMed

Nagaiwa, Miho; Gunjigake, Kaori; Yamaguchi, Kazunori

2016-03-01

To examine the effect of mouth breathing on chewing efficiency by evaluating masticatory variables. Ten adult nasal breathers with normal occlusion and no temporomandibular dysfunction were selected. Subjects were instructed to bite the chewing gum on the habitual side. While breathing through the mouth and nose, the glucide elution from the chewing gum, number of chewing strokes, duration of chewing, and electromyography (EMG) activity of the masseter muscle were evaluated as variables of masticatory efficiency. The durations required for the chewing of 30, 60, 90, 120, 180, and 250 strokes were significantly (P < .05) longer while breathing through the mouth. There was no significant difference in the glucide elution rate (%) for each chewing stroke between nose and mouth breathings. The glucide elution rates for 1- and 3-minute chewing were significantly (P < .05) lower while breathing through the mouth. However, there was no significant difference in the glucide elution rate for 5-minute chewing between nose and mouth breathings. While chewing for 1, 3, and 5 minutes, the chewing stroke and EMG activity of the masseter muscle were significantly (P < .05) lower during mouth breathing. It takes a longer amount of time to complete chewing to obtain higher masticatory efficiency when breathing through the mouth. Therefore, mouth breathing will decrease the masticatory efficiency if the duration of chewing is restricted in everyday life.

Chemical sensors for breath gas analysis: the latest developments at the Breath Analysis Summit 2013.

PubMed

Tisch, Ulrike; Haick, Hossam

2014-06-01

Profiling the body chemistry by means of volatile organic compounds (VOCs) in the breath opens exciting new avenues in medical diagnostics. Gas sensors could provide ideal platforms for realizing portable, hand-held breath testing devices in the near future. This review summarizes the latest developments and applications in the field of chemical sensors for diagnostic breath testing that were presented at the Breath Analysis Summit 2013 in Wallerfangen, Germany. Considerable progress has been made towards clinically applicable breath testing devices, especially by utilizing chemo-sensitive nanomaterials. Examples of several specialized breath testing applications are presented that are either based on stand-alone nanomaterial-based sensors being highly sensitive and specific to individual breath compounds over others, or on combinations of several highly specific sensors, or on experimental nanomaterial-based sensors arrays. Other interesting approaches include the adaption of a commercially available MOx-based sensor array to indirect breath testing applications, using a sample pre-concentration method, and the development of compact integrated GC-sensor systems. The recent trend towards device integration has led to the development of fully integrated prototypes of point-of-care devices. We describe and compare the performance of several prototypes that are based on different sensing technologies and evaluate their potential as low-cost and readily available next-generation medical devices.

Breath acidification in adolescent runners exposed to atmospheric pollution: A prospective, repeated measures observational study

PubMed Central

Ferdinands, Jill M; Crawford, Carol A Gotway; Greenwald, Roby; Van Sickle, David; Hunter, Eric; Teague, W Gerald

2008-01-01

Background Vigorous outdoors exercise during an episode of air pollution might cause airway inflammation. The purpose of this study was to examine the effects of vigorous outdoor exercise during peak smog season on breath pH, a biomarker of airway inflammation, in adolescent athletes. Methods We measured breath pH both pre- and post-exercise on ten days during peak smog season in 16 high school athletes engaged in daily long-distance running in a downwind suburb of Atlanta. The association of post-exercise breath pH with ambient ozone and particulate matter concentrations was tested with linear regression. Results We collected 144 pre-exercise and 146 post-exercise breath samples from 16 runners (mean age 14.9 years, 56% male). Median pre-exercise breath pH was 7.58 (interquartile range: 6.90 to 7.86) and did not change significantly after exercise. We observed no significant association between ambient ozone or particulate matter and post-exercise breath pH. However both pre- and post-exercise breath pH were strikingly low in these athletes when compared to a control sample of 14 relatively sedentary healthy adults and to published values of breath pH in healthy subjects. Conclusion Although we did not observe an acute effect of air pollution exposure during exercise on breath pH, breath pH was surprisingly low in this sample of otherwise healthy long-distance runners. We speculate that repetitive vigorous exercise may induce airway acidification. PMID:18328105

Bronchial intubation could be detected by the visual stethoscope techniques in pediatric patients.

PubMed

Kimura, Tetsuro; Suzuki, Akira; Mimuro, Soichiro; Makino, Hiroshi; Sato, Shigehito

2012-12-01

We created a system that allows the visualization of breath sounds (visual stethoscope). We compared the visual stethoscope technique with auscultation for the detection of bronchial intubation in pediatric patients. In the auscultation group, an anesthesiologist advanced the tracheal tube, while another anesthesiologist auscultated bilateral breath sounds to detect the change and/or disappearance of unilateral breath sounds. In the visualization group, the stethoscope was used to detect changes in breath sounds and/or disappearance of unilateral breath sounds. The distance from the edge of the mouth to the carina was measured using a fiberoptic bronchoscope. Forty pediatric patients were enrolled in the study. At the point at which irregular breath sounds were auscultated, the tracheal tube was located at 0.5 ± 0.8 cm on the bronchial side from the carina. When a detectable change of shape of the visualized breath sound was observed, the tracheal tube was located 0.1 ± 1.2 cm on the bronchial side (not significant). At the point at which unilateral breath sounds were auscultated or a unilateral shape of the visualized breath sound was observed, the tracheal tube was 1.5 ± 0.8 or 1.2 ± 1.0 cm on the bronchial side, respectively (not significant). The visual stethoscope allowed to display the left and the right lung sound simultaneously and detected changes of breath sounds and unilateral breath sound as a tracheal tube was advanced. © 2012 Blackwell Publishing Ltd.

13C-methacetin and 13C-galactose breath tests can assess restricted liver function even in early stages of primary biliary cirrhosis.

PubMed

Holtmeier, Julia; Leuschner, Maria; Schneider, Arne; Leuschner, Ulrich; Caspary, Wolfgang F; Braden, Barbara

2006-11-01

The 13C-methacetin breath test quantitatively evaluates cytochrome P450-dependent liver function. The 13C-galactose breath test non-invasively measures the galactose oxidation capacity of the liver. The aim of this study was to find out whether these breath tests are sensitive parameters also in non-cirrhotic patients with primary biliary cirrhosis. Nineteen patients with early-stage primary biliary cirrhosis (no cirrhotic alterations in the liver biopsy, Ludwig stage I-III) and 20 healthy controls underwent the 13C-methacetin and 13C-galactose breath tests. Patients with primary biliary cirrhosis metabolized less 13C-methacetin than controls (cumulative recovery within 30 min 7.5+/-2.4% versus 14.0+/-2.6%; p < 0.001). When a cut-off > 9.8% was used for the cumulative recovery after 30 min, the methacetin breath test reached 84.2% sensitivity and 95.0 specificity. In the 13C-galactose breath test, the percentage recovery at 60 min in patients was 3.1+/-1.3%/h, and 6.3+/-1.1%/h in controls (p < 0.001). Using a cut-off > 4.7%/h, the galactose breath test reached 89.5% sensitivity and 95.0 specificity. In non-cirrhotic, early-stage, primary biliary cirrhosis the 13C-methacetin breath test and the 13C-galactose breath test reliably indicate decreased liver function. The 13C-galactose breath test can also predict the histological score.

The importance of a normal breathing pattern for an effective abdominal-hollowing maneuver in healthy people: an experimental study.

PubMed

Ha, Sung-min; Kwon, Oh-yun; Kim, Su-jung; Choung, Sung-dae

2014-02-01

A normal breathing pattern while performing the abdominal-hollowing (AH) maneuver or spinal-stabilization exercise is essential for the success of rehabilitation programs and exercises. In previous studies, subjects were given standardized instructions to control the influence of respiration during the AH maneuver. However, the effect of breathing pattern on abdominal-muscle thickness during the AH maneuver has not been investigated. To compare abdominal-muscle thickness in subjects performing the AH maneuver under normal and abnormal breathing-pattern conditions and to investigate the effect of breathing pattern on the preferential contraction ratio (PCR) of the transverse abdominis. Comparative, repeated-measures experimental study. University research laboratory. 16 healthy subjects (8 male, 8 female) from a university population. A real-time ultrasound scanner was used to measure abdominal-muscle thickness during normal and abnormal breathing patterns. A paired t test was used to assess the effect of breathing pattern on abdominal-muscle thickness and PCR. Muscle thickness in the transverse abdominis and internal oblique muscles was significantly greater under the normal breathing pattern than under the abnormal pattern (P < .05). The PCR of the transverse abdominis was significantly higher under the normal breathing pattern compared with the abnormal pattern (P < .05). The results indicate that a normal breathing pattern is essential for performance of an effective AH maneuver. Thus, clinicians should ensure that patients adopt a normal breathing pattern before performing the AH maneuver and monitor transverse abdominis activation during the maneuver.

Application of drug testing using exhaled breath for compliance monitoring of drug addicts in treatment.

PubMed

Carlsson, Sten; Olsson, Robert; Lindkvist, Irene; Beck, Olof

2015-04-01

Exhaled breath has recently been identified as a possible matrix for drug testing. This study explored the potential of this new method for compliance monitoring of patients being treated for dependence disorders. Outpatients in treatment programs were recruited for this study. Urine was collected as part of clinical routine and a breath sample was collected in parallel together with a questionnaire about their views of the testing procedure. Urine was analyzed for amphetamines, benzodiazepines, cannabis, cocaine, buprenorphine, methadone and opiates using CEDIA immunochemical screening and mass spectrometry confirmation. The exhaled breath was collected using the SensAbues device and analyzed by mass spectrometry for amphetamine, methamphetamine, diazepam, oxazepam, tetrahydrocannabinol, cocaine, benzoylecgonine, buprenorphine, methadone, morphine, codeine and 6-acetylmorphine. A total of 122 cases with parallel urine and breath samples were collected; 34 of these were negative both in urine and breath. Out of 88 cases with positive urine samples 51 (58%) were also positive in breath. Among the patients on methadone treatment, all were positive for methadone in urine and 83% were positive in breath. Among patients in treatment with buprenorphine, 92% were positive in urine and among those 80% were also positive in breath. The questionnaire response documented that in general, patients accepted drug testing well and that the breath sampling procedure was preferred. Compliance testing for the intake of prescribed and unprescribed drugs among patients in treatment for dependence disorders using the exhaled breath sampling technique is a viable method and deserves future attention.

Effect of waveforms of inspired gas tension on the respiratory oscillations of carotid body discharge.

PubMed

Kumar, P; Nye, P C; Torrance, R W

1991-07-01

The responses of carotid body chemoreceptor discharge to repeated ramps (20- to 60-s forcing cycle durations) of inspired gas tensions were studied in spontaneously breathing and in artificially ventilated pentobarbitone-anesthetized cats. In all animals the mean intensity of chemoreceptor discharge followed the frequency of the forcing cycle, and superimposed on this were oscillations at the frequency of ventilation (breath-by-breath oscillations). The amplitude of the breath-by-breath oscillations in discharge was often large, and it waxed and waned with the forcing cycle. It was greatest when the mean level of discharge was falling and smallest near the peak of mean discharge. No qualitative differences were observed between PO2-alone forcing in constant normocapnia and PCO2-alone forcing in constant hypoxia. The variation in the amplitudes of breath-by-breath oscillations was shown to be due primarily to variations in the amplitudes of the downslope component of the discharge oscillation. Variations in the upslope component of individual oscillations were small. The factors responsible for the breath-by-breath oscillations are discussed, and it is concluded that the shape of the waveform of arterial gas tensions that stimulate the peripheral chemoreceptors departs markedly from that of a line joining end-tidal gas tensions. This causes breath-by-breath oscillations of discharge to be very large after an "off" stimulus. Reflex studies involving the forcing of respiratory gases should therefore include consideration of these effects.

3D Late Gadolinium Enhancement in a Single Prolonged Breath-hold using Supplemental Oxygenation and Hyperventilation

PubMed Central

Roujol, Sébastien; Basha, Tamer A.; Akçakaya, Mehmet; Foppa, Murilo; Chan, Raymond H.; Kissinger, Kraig V.; Goddu, Beth; Berg, Sophie; Manning, Warren J.; Nezafat, Reza

2013-01-01

Purpose: To evaluate the feasibility of 3D single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. Methods: Breath-hold metrics (breath-hold duration, diaphragmatic/LV position drift, and maximum variation of RR interval) without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (FOV=320×320×100 mm3, resolution=1.6×1.6×5.0 mm3, acceleration rate of 4) and a free breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semi-quantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. Results: Supplemental oxygenation and hyperventilation increased the breath-hold duration (35±11 s to 58±21 s, p<0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both p>0.01). LGE images were of similar quality when compared to free breathing acquisitions but with reduced total scan time (85±22 s to 35±6 s, p<0.001). Conclusions: Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV. PMID:24186772

BreathDx - molecular analysis of exhaled breath as a diagnostic test for ventilator-associated pneumonia: protocol for a European multicentre observational study.

PubMed

van Oort, Pouline M P; Nijsen, Tamara; Weda, Hans; Knobel, Hugo; Dark, Paul; Felton, Timothy; Rattray, Nicholas J W; Lawal, Oluwasola; Ahmed, Waqar; Portsmouth, Craig; Sterk, Peter J; Schultz, Marcus J; Zakharkina, Tetyana; Artigas, Antonio; Povoa, Pedro; Martin-Loeches, Ignacio; Fowler, Stephen J; Bos, Lieuwe D J

2017-01-03

The diagnosis of ventilator-associated pneumonia (VAP) remains time-consuming and costly, the clinical tools lack specificity and a bedside test to exclude infection in suspected patients is unavailable. Breath contains hundreds to thousands of volatile organic compounds (VOCs) that result from host and microbial metabolism as well as the environment. The present study aims to use breath VOC analysis to develop a model that can discriminate between patients who have positive cultures and who have negative cultures with a high sensitivity. The Molecular Analysis of Exhaled Breath as Diagnostic Test for Ventilator-Associated Pneumonia (BreathDx) study is a multicentre observational study. Breath and bronchial lavage samples will be collected from 100 and 53 intubated and ventilated patients suspected of VAP. Breath will be analysed using Thermal Desorption - Gas Chromatography - Mass Spectrometry (TD-GC-MS). The primary endpoint is the accuracy of cross-validated prediction for positive respiratory cultures in patients that are suspected of VAP, with a sensitivity of at least 99% (high negative predictive value). To our knowledge, BreathDx is the first study powered to investigate whether molecular analysis of breath can be used to classify suspected VAP patients with and without positive microbiological cultures with 99% sensitivity. UKCRN ID number 19086, registered May 2015; as well as registration at www.trialregister.nl under the acronym 'BreathDx' with trial ID number NTR 6114 (retrospectively registered on 28 October 2016).

A probability-based multi-cycle sorting method for 4D-MRI: A simulation study

PubMed Central

Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

2016-01-01

Purpose: To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Methods: Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients’ breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Results: Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. Conclusions: In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors’ preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management. PMID:27908178

Results of the first semi-annual qualification testing of devices to measure breath alcohol

DOT National Transportation Integrated Search

1975-01-01

Eight evidential breath testers were performance tested according to the Standard for Devices to Measure Breath Alcohol Federal Register, Vol 38, No. 212, November 5, 1973. In addition, a prototype breath tester not commercially available was tested....

77 FR 37862 - Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

...; NIOSH-258] Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance... open-circuit self-contained breathing apparatus (OC- SCBA) remaining service-life indicators... ``Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance...

Halitosis

MedlinePlus

... can also affect your breath. Common examples of foods and beverages that may cause bad breath include onions, garlic, ... and vegetables every day. Eat less meat. Avoid foods that cause you to have bad breath. Also try to avoid alcoholic beverages, which often cause bad breath. Avoid using tobacco ...

Breathing metabolic simulator

NASA Technical Reports Server (NTRS)

Bartlett, R. G.; Hendricks, C. M.; Morison, W. B.

1972-01-01

The development of a breathing metabolic simulator (BMS) is reported. This BMS simulates all of the breathing and metabolic parameters required for complete evaluation and test of life support and resuscitation equipment. It is also useful for calibrating and validating mechanical and gaseous pulmonary function test procedures. Breathing rate, breathing depth, breath velocity contour, oxygen uptake, and carbon dioxide release are all variable over wide ranges simulating conditions from sleep to hard work with respiratory exchange ratios covering the range from hypoventilation. In addition, all of these parameters are remotely controllable to facilitate use of the device in hostile or remote environments. The exhaled breath is also maintained at body temperature and a high humidity. The simulation is accurate to the extent of having a variable functional residual capacity independent of other parameters.

Prolonged dry apnoea: effects on brain activity and physiological functions in breath-hold divers and non-divers.

PubMed

Ratmanova, Patricia; Semenyuk, Roxana; Popov, Daniil; Kuznetsov, Sergey; Zelenkova, Irina; Napalkov, Dmitry; Vinogradova, Olga

2016-07-01

The aim of the study was to investigate the effects of voluntary breath-holding on brain activity and physiological functions. We hypothesised that prolonged apnoea would trigger cerebral hypoxia, resulting in a decrease of brain performance; and the apnoea's effects would be more pronounced in breath-hold divers. Trained breath-hold divers and non-divers performed maximal dry breath-holdings. Lung volume, alveolar partial pressures of O2 and CO2, attention and anxiety levels were estimated. Heart rate, blood pressure, arterial blood oxygenation, brain tissue oxygenation, EEG, and DC potential were monitored continuously during breath-holding. There were a few significant changes in electrical brain activity caused by prolonged apnoea. Brain tissue oxygenation index and DC potential were relatively stable up to the end of the apnoea in breath-hold divers and non-divers. We also did not observe any decrease of attention level or speed of processing immediately after breath-holding. Interestingly, trained breath-hold divers had some peculiarities in EEG activity at resting state (before any breath-holding): non-spindled, sharpened alpha rhythm; slowed-down alpha with the frequency nearer to the theta band; and untypical spatial pattern of alpha activity. Our findings contradicted the primary hypothesis. Apnoea up to 5 min does not lead to notable cerebral hypoxia or a decrease of brain performance in either breath-hold divers or non-divers. It seems to be the result of the compensatory mechanisms similar to the diving response aimed at centralising blood circulation and reducing peripheral O2 uptake. Adaptive changes during apnoea are much more prominent in trained breath-hold divers.

Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis - a randomized controlled trial.

PubMed

Westerdahl, Elisabeth; Wittrin, Anna; Kånåhols, Margareta; Gunnarsson, Martin; Nilsagård, Ylva

2016-11-01

Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials. To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes. Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH 2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period. Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups. Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained. © 2015 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

Comparison of the heart and breathing rate of acutely ill medical patients recorded by nursing staff with those measured over 5 min by a piezoelectric belt and ECG monitor at the time of admission to hospital.

PubMed

Kellett, John; Li, Min; Rasool, Shahzeb; Green, Geoffrey C; Seely, Andrew

2011-11-01

Heart and breathing rates are predictors of disease severity and of a poor outcome. However, few reports have compared their machine measurements with traditional manual methods. A small rural Irish hospital. The heart and breathing rates of 377 acutely ill medical patients (mean age 68.3 SD 16.8 years) recorded by nursing staff at the time of admission to hospital was compared with those measured over 5 min by a piezoelectric belt and ECG monitor (the BT16 acquisition system). The mean breathing rate measured by the nursing staff (20.9 SD 4.8 breaths per min) and that measured by the BT16 piezoelectric belt (19.9 SD 4.5 breaths per min) were significantly different (p 0.004), as were the nurse and BT16 measured heart rates (85.4 SD 21.3 vs. 81.2 SD 18.7, p 0.004), and the correlation coefficient between the two methods of breathing and heart rate measurement were low. Nurse measured breathing rate measurements were clustered around rates of 18, 20 and 22 breaths per min. Unlike those obtained by nurses, BT16 measured heart and breathing rates were shown by logistic regression to be independent predictors of in-hospital mortality. There is a poor correlation between breathing and heart rates measured by traditional methods and those obtained by the BT16 device. BT16 derived breathing and heart rates, but not those measured manually, were independent predictors of in-hospital mortality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Effects of breathing exercises on breathing patterns in obese and non-obese subjects.

PubMed

Olsén, M F; Lönroth, H; Bake, B

1999-05-01

Chest physiotherapy in connection with abdominal surgery includes different deep-breathing exercises to prevent post-operative pulmonary complications. The therapy is effective in preventing pulmonary complications, especially in high-risk patients such as obese persons. The mechanisms behind the effect is unclear, but part of the effect may be explained by the changes in breathing patterns. The aim of this study was therefore to describe and to analyse the breathing patterns in obese and non-obese subjects during three different breathing techniques frequently used in the treatment of post-operative patients. Twenty-one severely obese [body mass index (BMI) > 40] and 21 non-obese (BMI 19-25) subjects were studied. All persons denied having any lung disease and were non-smokers. The breathing techniques investigated were: deep breaths without any resistance (DB), positive expiratory pressure (PEP) with an airway resistance of approximately +15 cmH2O (1.5 kPa) during expiration, inspiratory resistance positive expiratory pressure (IR-PEP) with a pressure of approximately -10 cmH2O (-1.0 kPa) during inspiration. Expiratory resistance as for PEP. Volume against time was monitored while the subjects were sitting in a body plethysmograph. Variables for volume and flow during the breathing cycle were determined. Tidal volume and alveolar ventilation were highest during DB, and peak inspiratory volume was significantly higher than during PEP and IR-PEP in the group of obese subjects. The breathing cycles were prolonged in all techniques but were most prolonged in PEP and IR-PEP. The functional residual capacity (FRC) was significantly lower during DB than during PEP and IR-PEP in the group of obese subjects. FRC as determined within 2 min of finishing each breathing technique was identical to before the breathing manoeuvres.

Autonomic control of post-air-breathing tachycardia in Clarias gariepinus (Teleostei: Clariidae).

PubMed

Teixeira, Mariana Teodoro; Armelin, Vinicius Araújo; Abe, Augusto Shinya; Rantin, Francisco Tadeu; Florindo, Luiz Henrique

2015-08-01

The African catfish (Clarias gariepinus) is a teleost with bimodal respiration that utilizes a paired suprabranchial chamber located in the gill cavity as an air-breathing organ. Like all air-breathing fishes studied to date, the African catfish exhibits pronounced changes in heart rate (f H) that are associated with air-breathing events. We acquired f H, gill-breathing frequency (f G) and air-breathing frequency (f AB) in situations that require or do not require air breathing (during normoxia and hypoxia), and we assessed the autonomic control of post-air-breathing tachycardia using an infusion of the β-adrenergic antagonist propranolol and the muscarinic cholinergic antagonist atropine. During normoxia, C. gariepinus presented low f AB (1.85 ± 0.73 AB h(-1)) and a constant f G (43.16 ± 1.74 breaths min(-1)). During non-critical hypoxia (PO2 = 60 mmHg), f AB in the African catfish increased to 5.42 ± 1.19 AB h(-1) and f G decreased to 39.12 ± 1.58 breaths min(-1). During critical hypoxia (PO2 = 20 mmHg), f AB increased to 7.4 ± 1.39 AB h(-1) and f G decreased to 34.97 ± 1.78 breaths min(-1). These results were expected for a facultative air breather. Each air breath (AB) was followed by a brief but significant tachycardia, which in the critical hypoxia trials, reached a maximum of 143 % of the pre-AB f H values of untreated animals. Pharmacological blockade allowed the calculation of cardiac autonomic tones, which showed that post-AB tachycardia is predominantly regulated by the parasympathetic subdivision of the autonomic nervous system.

Dosimetric Considerations in Respiratory-Gated Deep Inspiration Breath-Hold for Left Breast Irradiation.

PubMed

Walston, Steve; Quick, Allison M; Kuhn, Karla; Rong, Yi

2017-02-01

To present our clinical workflow of incorporating AlignRT for left breast deep inspiration breath-hold treatments and the dosimetric considerations with the deep inspiration breath-hold protocol. Patients with stage I to III left-sided breast cancer who underwent lumpectomy or mastectomy were considered candidates for deep inspiration breath-hold technique for their external beam radiation therapy. Treatment plans were created on both free-breathing and deep inspiration breath-hold computed tomography for each patient to determine whether deep inspiration breath-hold was beneficial based on dosimetric comparison. The AlignRT system was used for patient setup and monitoring. Dosimetric measurements and their correlation with chest wall excursion and increase in left lung volume were studied for free-breathing and deep inspiration breath-hold plans. Deep inspiration breath-hold plans had significantly increased chest wall excursion when compared with free breathing. This change in geometry resulted in reduced mean and maximum heart dose but did not impact lung V 20 or mean dose. The correlation between chest wall excursion and absolute reduction in heart or lung dose was found to be nonsignificant, but correlation between left lung volume and heart dose showed a linear association. It was also identified that higher levels of chest wall excursion may paradoxically increase heart or lung dose. Reduction in heart dose can be achieved for many left-sided breast and chest wall patients using deep inspiration breath-hold. Chest wall excursion as well as left lung volume did not correlate with reduction in heart dose, and it remains to be determined what metric will provide the most optimal and reliable dosimetric advantage.

SU-E-J-158: Audiovisual Biofeedback Reduces Image Artefacts in 4DCT: A Digital Phantom Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pollock, S; Kipritidis, J; Lee, D

2015-06-15

Purpose: Irregular breathing motion has a deleterious impact on 4DCT image quality. The breathing guidance system: audiovisual biofeedback (AVB) is designed to improve breathing regularity, however, its impact on 4DCT image quality has yet to be quantified. The purpose of this study was to quantify the impact of AVB on thoracic 4DCT image quality by utilizing the digital eXtended Cardiac Torso (XCAT) phantom driven by lung tumor motion patterns. Methods: 2D tumor motion obtained from 4 lung cancer patients under two breathing conditions (i) without breathing guidance (free breathing), and (ii) with guidance (AVB). There were two breathing sessions, yieldingmore » 8 tumor motion traces. This tumor motion was synchronized with the XCAT phantom to simulate 4DCT acquisitions under two acquisition modes: (1) cine mode, and (2) prospective respiratory-gated mode. Motion regularity was quantified by the root mean square error (RMSE) of displacement. The number of artefacts was visually assessed for each 4DCT and summed up for each breathing condition. Inter-session anatomic reproducibility was quantified by the mean absolute difference (MAD) between the Session 1 4DCT and Session 2 4DCT. Results: AVB improved tumor motion regularity by 30%. In cine mode, the number of artefacts was reduced from 61 in free breathing to 40 with AVB, in addition to AVB reducing the MAD by 34%. In gated mode, the number of artefacts was reduced from 63 in free breathing to 51 with AVB, in addition to AVB reducing the MAD by 23%. Conclusion: This was the first study to compare the impact of breathing guidance on 4DCT image quality compared to free breathing, with AVB reducing the amount of artefacts present in 4DCT images in addition to improving inter-session anatomic reproducibility. Results thus far suggest that breathing guidance interventions could have implications for improving radiotherapy treatment planning and interfraction reproducibility.« less

78 FR 52563 - Certain Sleep-Disordered Breathing Treatment Systems and Components Thereof; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-890] Certain Sleep-Disordered Breathing... certain sleep- disordered breathing treatment systems and components thereof by reason of infringement of... after importation of certain sleep- disordered breathing treatment systems and components thereof that...

VOLATILE ORGANIC COMPOUNDS AS BREATH BIOMARKERS FOR ACTIVE AND PASSIVE SMOKING

EPA Science Inventory

Real-time breath measurement technology was used to investigate the suitability of some volatile organic compounds (VOCs) to serve as breath biomarkers for active and passive smoking and to measure actual exposures and resulting breath concentrations for persons exposed to toba...

75 FR 61386 - Emergency Escape Breathing Apparatus Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

...-0044, Notice No. 1] RIN 2130-AC14 Emergency Escape Breathing Apparatus Standards AGENCY: Federal... breathing apparatus (EEBA) to the members of the train crew and certain other employees while they are... EEBA--emergency escape breathing apparatus FRA--Federal Railroad Administration FRSA--the former...

The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn's disease.

PubMed

Mishkin, Daniel; Boston, Francis M; Blank, David; Yalovsky, Morty; Mishkin, Seymour

2002-03-01

The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohn's disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohn's disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohn's disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohn's disease.

Breathing Maneuvers as a Vasoactive Stimulus for Detecting Inducible Myocardial Ischemia – An Experimental Cardiovascular Magnetic Resonance Study

PubMed Central

Fischer, Kady; Guensch, Dominik P; Shie, Nancy; Lebel, Julie; Friedrich, Matthias G

2016-01-01

Background Breathing maneuvers can elicit a similar vascular response as vasodilatory agents like adenosine; yet, their potential diagnostic utility in the presence of coronary artery stenosis is unknown. The objective of the study is to investigate if breathing maneuvers can non-invasively detect inducible ischemia in an experimental animal model when the myocardium is imaged with oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR). Methods and Findings In 11 anesthetised swine with experimentally induced significant stenosis (fractional flow reserve <0.75) of the left anterior descending coronary artery (LAD) and 9 control animals, OS-CMR at 3T was performed during two different breathing maneuvers, a long breath-hold; and a combined maneuver of 60s of hyperventilation followed by a long breath-hold. The resulting change of myocardial oxygenation was compared to the invasive measurements of coronary blood flow, blood gases, and oxygen extraction. In control animals, all breathing maneuvers could significantly alter coronary blood flow as hyperventilation decreased coronary blood flow by 34±23%. A long breath-hold alone led to an increase of 97±88%, while the increase was 346±327% (p<0.001), when the long breath-hold was performed after hyperventilation. In stenosis animals, the coronary blood flow response was attenuated after both hyperventilation and the following breath-hold. This was matched by the observed oxygenation response as breath-holds following hyperventilation consistently yielded a significant difference in the signal of the MRI images between the perfusion territory of the stenosis LAD and remote myocardium. There was no difference between the coronary territories during the other breathing maneuvers or in the control group at any point. Conclusion In an experimental animal model, the response to a combined breathing maneuver of hyperventilation with subsequent breath-holding is blunted in myocardium subject to significant coronary artery stenosis. This maneuver may allow for detecting severe coronary artery stenosis and have a significant clinical potential as a non-pharmacological method for diagnostic testing in patients with suspected coronary artery disease. PMID:27741282

Crackle pitch and rate do not vary significantly during a single automated-auscultation session in patients with pneumonia, congestive heart failure, or interstitial pulmonary fibrosis.

PubMed

Vyshedskiy, Andrey; Ishikawa, Sadamu; Murphy, Raymond L H

2011-06-01

To determine the variability of crackle pitch and crackle rate during a single automated-auscultation session with a computerized 16-channel lung-sound analyzer. Forty-nine patients with pneumonia, 52 with congestive heart failure (CHF), and 18 with interstitial pulmonary fibrosis (IPF) performed breathing maneuvers in the following sequence: normal breathing, deep breathing, cough several times; deep breathing, vital-capacity maneuver, and deep breathing. From the auscultation recordings we measured the crackle pitch and crackle rate. Crackle pitch variability, expressed as a percentage of the average crackle pitch, was small in all patients and in all maneuvers: pneumonia 11%, CHF 11%, pulmonary fibrosis 7%. Crackle rate variability was also small: pneumonia 31%, CHF 32%, IPF 24%. Compared to the first deep-breathing maneuver (100%), the average crackle pitch did not significantly change following coughing (pneumonia 100%, CHF 103%, IPF 100%), the vital-capacity maneuver (pneumonia 100%, CHF 92%, IPF 104%), or during quiet breathing (pneumonia 97%, CHF 100%, IPF 104%). Similarly, the average crackle rate did not change significantly following coughing (pneumonia 105%, CHF 110%, IPF 90%) or the vital-capacity maneuver (pneumonia 102%, CHF 101%, IPF 99%). However, during normal breathing the crackle rate was significantly lower in the patients with pneumonia (74%, P < .001) and significantly higher in the patients with IPF (147%, P < .05) than it was during deep breathing. In patients with CHF the average crackle rate during normal breathing was not significantly different from that during the first deep-breathing maneuver (108%). Crackle pitch and rate were surprisingly stable in all 3 conditions. Neither crackle pitch nor crackle rate changed significantly from breath to breath or from one deep-breathing maneuver to another, even when the maneuvers were separated by cough or the vital-capacity maneuver. The observation that crackle rate is a reproducible measurement during one automated-auscultation session suggests that crackle rate can be used to follow the course of cardiopulmonary illnesses such as pneumonia, IPF, and CHF.

The autonomic control and functional significance of the changes in heart rate associated with air breathing in the jeju, Hoplerythrinus unitaeniatus.

PubMed

McKenzie, D J; Campbell, H A; Taylor, E W; Micheli, M; Rantin, F T; Abe, A S

2007-12-01

The jeju is a teleost fish with bimodal respiration that utilizes a modified swim bladder as an air-breathing organ (ABO). Like all air-breathing fish studied to date, jeju exhibit pronounced changes in heart rate (fH) during air-breathing events, and it is believed that these may facilitate oxygen uptake (MO2) from the ABO. The current study employed power spectral analysis (PSA) of fH patterns, coupled with instantaneous respirometry, to investigate the autonomic control of these phenomena and their functional significance for the efficacy of air breathing. The jeju obtained less than 5% of total MO2 (MtO2) from air breathing in normoxia at 26 degrees C, and PSA of beat-to-beat variability in fH revealed a pattern similar to that of unimodal water-breathing fish. In deep aquatic hypoxia (water PO2)=1 kPa) the jeju increased the frequency of air breathing (fAB) tenfold and maintained MtO2 unchanged from normoxia. This was associated with a significant increase in heart rate variability (HRV), each air breath (AB) being preceded by a brief bradycardia and then followed by a brief tachycardia. These fH changes are qualitatively similar to those associated with breathing in unimodal air-breathing vertebrates. Within 20 heartbeats after the AB, however, a beat-to-beat variability in fH typical of water-breathing fish was re-established. Pharmacological blockade revealed that both adrenergic and cholinergic tone increased simultaneously prior to each AB, and then decreased after it. However, modulation of inhibitory cholinergic tone was responsible for the major proportion of HRV, including the precise beat-to-beat modulation of fH around each AB. Pharmacological blockade of all variations in fH associated with air breathing in deep hypoxia did not, however, have a significant effect upon fAB or the regulation of MtO2. Thus, the functional significance of the profound HRV during air breathing remains a mystery.

Cross-correlation of heartbeat and respiration rhythms

NASA Astrophysics Data System (ADS)

Capurro, A.; Malta, C. P.; Diambra, L.; Contreras, P.; Migliaro, E. R.

2005-10-01

The cross-correlation function between respiration and heart beat interval series shows that during metronomized breathing the heart beat follows the respiration more closely than during spontaneous breathing. We reproduced the heart beat interval modulations during metronomized breathing using a biophysical model of the sinoatrial node excited by an input signal formed by the recorded respiration. In the case of spontaneous breathing, a good agreement with the experimental data was obtained only by using an input signal formed by the sum of the recorded respiration and a realization of correlated noise. Metronomized breathing refers to the situation where a subject breathes following the rhythm of a metronome.

Breathing spiral waves in the chlorine dioxide-iodine-malonic acid reaction-diffusion system.

PubMed

Berenstein, Igal; Muñuzuri, Alberto P; Yang, Lingfa; Dolnik, Milos; Zhabotinsky, Anatol M; Epstein, Irving R

2008-08-01

Breathing spiral waves are observed in the oscillatory chlorine dioxide-iodine-malonic acid reaction-diffusion system. The breathing develops within established patterns of multiple spiral waves after the concentration of polyvinyl alcohol in the feeding chamber of a continuously fed, unstirred reactor is increased. The breathing period is determined by the period of bulk oscillations in the feeding chamber. Similar behavior is obtained in the Lengyel-Epstein model of this system, where small amplitude parametric forcing of spiral waves near the spiral wave frequency leads to the formation of breathing spiral waves in which the period of breathing is equal to the period of forcing.

Human sinus arrhythmia as an index of vagal cardiac outflow

NASA Technical Reports Server (NTRS)

Eckberg, D. L.

1983-01-01

The human central vagal mechanisms were investigated by measuring the intervals between heartbeats during controlled breathing (at breathing intervals of 2.5-10 s and nominal tidal volumes of 1000 and 1500 ml) in six young men and women. It was found that as the breathing interval increased, the longest heart periods became longer, the shortest heart periods became shorter, and the peak-valley P-P intervals increased asymptotically. Peak-valley intervals also increased in proportion to tidal volume, although this influence was small. The phase angles between heart period changes and respiration were found to vary as linear functions of breathing interval. Heart period shortening began in inspiration at short breathing intervals and in expiration at long breathing intervals, while heart period lengthening began in early expiration at all breathing intervals studied. It is concluded that a close relationship exists between variations of respiratory depth and interval and the quantity, periodicity, and timing of vagal cardiac outflow in conscious humans. The results indicate that at usual breathing rates, phasic respiration-related changes of vagal motoneuron activity begin in expiration, progress slowly, and are incompletely expressed at fast breathing ratges.

An acetone breath analyzer using cavity ringdown spectroscopy: an initial test with human subjects under various situations

NASA Astrophysics Data System (ADS)

Wang, Chuji; Surampudi, Anand B.

2008-10-01

We have developed a portable breath acetone analyzer using cavity ringdown spectroscopy (CRDS). The instrument was initially tested by measuring the absorbance of breath gases at a single wavelength (266 nm) from 32 human subjects under various conditions. A background subtraction method, implemented to obtain absorbance differences, from which an upper limit of breath acetone concentration was obtained, is described. The upper limits of breath acetone concentration in the four Type 1 diabetes (T1D) subjects, tested after a 14 h overnight fast, range from 0.80 to 3.97 parts per million by volume (ppmv), higher than the mean acetone concentration (0.49 ppmv) in non-diabetic healthy breath reported in the literature. The preliminary results show that the instrument can tell distinctive differences between the breath from individuals who are healthy and those with T1D. On-line monitoring of breath gases in healthy people post-exercise, post-meals and post-alcohol-consumption was also conducted. This exploratory study demonstrates the first CRDS-based acetone breath analyzer and its potential application for point-of-care, non-invasive, diabetic monitoring.

Evaluation of the agreement of tidal breathing parameters measured simultaneously using pneumotachography and structured light plethysmography.

PubMed

Motamedi-Fakhr, Shayan; Iles, Richard; Barney, Anna; de Boer, Willem; Conlon, Jenny; Khalid, Amna; Wilson, Rachel C

2017-02-01

Structured light plethysmography (SLP) is a noncontact, noninvasive, respiratory measurement technique, which uses a structured pattern of light and two cameras to track displacement of the thoraco-abdominal wall during tidal breathing. The primary objective of this study was to examine agreement between tidal breathing parameters measured simultaneously for 45 sec using pneumotachography and SLP in a group of 20 participants with a range of respiratory patterns ("primary cohort"). To examine repeatability of the agreement, an additional 21 healthy subjects ("repeatability cohort") were measured twice during resting breathing and once during increased respiratory rate (RR). Breath-by-breath and averaged RR, inspiratory time (tI), expiratory time (tE), total breath time (tTot), tI/tE, tI/tTot, and IE50 (inspiratory to expiratory flow measured at 50% of tidal volume) were calculated. Bland-Altman plots were used to assess the agreement. In the primary cohort, breath-by-breath agreement for RR was ±1.44 breaths per minute (brpm). tI, tE, and tTot agreed to ±0.22, ±0.29, and ±0.32 sec, respectively, and tI/tE, tI/tTot, and IE50/IE50 SLP to ±0.16, ±0.05, and ±0.55, respectively. When averaged, agreement for RR was ±0.19 brpm. tI, tE, and tTot were within ±0.16, ±0.16, and ±0.07 sec, respectively, and tI/tE, tI/tTot, and IE50 were within ±0.09, ±0.03, and ±0.25, respectively. A comparison of resting breathing demonstrated that breath-by-breath and averaged agreements for all seven parameters were repeatable ( P  > 0.05). With increased RR, agreement improved for tI, tE, and tTot ( P  ≤ 0.01), did not differ for tI/tE, tI/tTot, and IE50 ( P  > 0.05) and reduced for breath-by-breath ( P  < 0.05) but not averaged RR ( P  > 0.05). © 2017 PneumaCare Limited. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rubinstein, A; Kingsley, C; Melancon, A

Purpose: To evaluate the use of post-irradiation changes in respiratory rate and CBCT-based morphology as predictors of survival in mice. Methods: C57L/J mice underwent whole-thorax irradiation with a Co-60 beam to four different doses [0Gy (n=3), 9Gy (n=5), 11Gy (n=7), and 13Gy (n=5)] in order to induce varying levels of pneumonitis. Respiratory rate measurements, breath-hold CBCTs, and free-breathing CBCTs were acquired pre-irradiation and at six time points between two and seven months post-irradiation. For respiratory rate measurements, we developed a novel computer-vision-based technique. We recorded mice sleeping in standard laboratory cages with a 30 fps, 1080p webcam (Logitech C920). Wemore » calculated respiratory rate using corner detection and optical flow to track cyclical motion in the fur in the recorded video. Breath-hold and free-breathing CBCTs were acquired on the X-RAD225Cx system. For breathhold imaging, the mice were intubated and their breath was held at full-inhale for 20 seconds. Healthy lung tissue was delineated in the scans using auto-threshold contouring (0–0.7 g/cm{sup 3}). The volume of healthy lung was measured in each of the scans. Next, lung density was measured in a 6-mm{sup 2} ROI in a fixed anatomic location in each of the scans. Results: Day-to-day variability in respiratory rate with our technique was 13%. All metrics except for breath-hold lung volume were correlated with survival: lung density on free-breathing (r=−0.7482,p<0.01) and breath-hold images (r=−0.5864,p<0.01), free-breathing lung volume (r=0.7179,p<0.01), and respiratory rate (r= 0.6953,p<0.01). Lung density on free-breathing scans was correlated with respiratory rate (r=0.7142,p<0.01) and lung density on breath-hold scans (r=0.5543,p<0.01). One significant practical hurdle in the CBCT measurements was that at least one lobe of the lung was collapsed in 36% of free-breathing scans and 45% of breath-hold scans. Conclusion: Lung density and lung volume on free-breathing CBCTs and respiratory rate outperform breath-hold CBCT measurements as indicators for survival from radiation-induced pneumonitis. This work was partially funded by Elekta.« less

46 CFR 154.1852 - Air breathing equipment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Air breathing equipment. 154.1852 Section 154.1852... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1852 Air breathing equipment. (a) The master shall ensure that a licensed officer inspects the compressed air breathing...

46 CFR 154.1852 - Air breathing equipment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Air breathing equipment. 154.1852 Section 154.1852... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1852 Air breathing equipment. (a) The master shall ensure that a licensed officer inspects the compressed air breathing...

46 CFR 154.1852 - Air breathing equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Air breathing equipment. 154.1852 Section 154.1852... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1852 Air breathing equipment. (a) The master shall ensure that a licensed officer inspects the compressed air breathing...

46 CFR 154.1852 - Air breathing equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Air breathing equipment. 154.1852 Section 154.1852... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Operations § 154.1852 Air breathing equipment. (a) The master shall ensure that a licensed officer inspects the compressed air breathing...

21 CFR 868.2375 - Breathing frequency monitor.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breathing frequency monitor. 868.2375 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Monitoring Devices § 868.2375 Breathing frequency monitor. (a) Identification. A breathing (ventilatory) frequency monitor is a device intended to measure or monitor a patient...

46 CFR 108.635 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.635 Self-contained breathing apparatus. Each locker or space containing self-contained breathing apparatus must be marked: “SELF CONTAINED... 46 Shipping 4 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 108.635 Section 108...

78 FR 2618 - Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... 0920-AA38 Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance Requirements... requirements for self-contained breathing apparatus (SCBA) remaining service-life indicators or warning devices... self-contained breathing apparatus (SCBA) used in the fire service, and a firefighters' union. A...

46 CFR 108.635 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.635 Self-contained breathing apparatus. Each locker or space containing self-contained breathing apparatus must be marked: “SELF CONTAINED... 46 Shipping 4 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 108.635 Section 108...

Effects of microgravity on tissue perfusion and the efficacy of astronaut denitrogenation for EVA

NASA Technical Reports Server (NTRS)

Gerth, Wayne A.; Vann, Richard D.; Leatherman, Nelson E.; Feezor, Michael D.

1987-01-01

A potentially flight-applicable, breath-by-breath method for measuring N2 elimination from human subjects breathing 100 percent O2 for 2-3 hr periods has been developed. The present report describes this development with particular emphasis on required methodological accuracy and its achievement in view of certain properties of mass spectrometer performance. A method for the breath-by-breath analysis of errors in measured N2 elimination profiles is also described.

Breathing and Relaxation

MedlinePlus

... Programs Health Information Doctors & Departments Clinical Research & Science Education & Training Home Health Insights Stress & Relaxation Breathing and Relaxation Breathing and Relaxation Make ...

[Periodic oscillating respiration outside of comatous stages].

PubMed

Jammes, Y; Delpierre, S; Zwirn, P; Nicoli, M M

1977-04-01

A periodic oscillating breathing was observed in 11 subjects during study of their pulmonary function. All these patients were male and more than 50 years old. A cardiovascular disease was clinically evident in eight of them. Arterial hypoxemia was found in five subjects and a light hypocapnia in three. Analysis of oscillating rhythms first, revealed unexistence of ventilatory pauses between periods of deep breaths in some subjects and secondly, showed existence of permanent or discontinuous periodic rhythms. Breath by breath changes in ventilation were essentially induced by oscillations in tidal volume. Discontinuous oscillating breathing appeared after forced maximal inspiration and this periodic rhythm was frequently associated with sights. This periodic breathing began or persisted under progressive hypoxia but disappeared under normobaric hyperoxia. These data are discussed in terms of changes in the ventilatory control system and in central regulation of breathing patterns.

Paced respiration with end-expiration technique offers superior BOLD signal repeatability for breath-hold studies.

PubMed

Scouten, A; Schwarzbauer, C

2008-11-01

As a simple, non-invasive method of blood oxygenation level-dependent (BOLD) signal calibration, the breath-hold task offers considerable potential for the quantification of neuronal activity from functional magnetic resonance imaging (fMRI) measurements. With an aim to improve the precision of this calibration method, the impact of respiratory rate control on the BOLD signal achieved with the breath-hold task was investigated. In addition to self-paced breathing, three different computer-paced breathing rates were imposed during the periods between end-expiration breath-hold blocks. The resulting BOLD signal timecourses and statistical activation maps were compared in eleven healthy human subjects. Results indicate that computer-paced respiration produces a larger peak BOLD signal increase with breath-hold than self-paced breathing, in addition to lower variability between trials. This is due to the more significant post-breath-hold signal undershoot present in self-paced runs, a characteristic which confounds the definition of baseline and is difficult to accurately model. Interestingly, the specific respiratory rate imposed between breath-hold periods generally does not have a statistically significant impact on the BOLD signal change. This result can be explained by previous reports of humans adjusting their inhalation depth to compensate for changes in rate, with the end-goal of maintaining homeostatic ventilation. The advantage of using end-expiration relative to end-inspiration breath-hold is apparent in view of the high repeatability of the BOLD signal in the present study, which does not suffer from the previously reported high variability associated with uncontrolled inspiration depth when using the end-inspiration technique.

Effect of hypobaric air, oxygen, heliox (50:50), or heliox (80:20) breathing on air bubbles in adipose tissue.

PubMed

Hyldegaard, O; Madsen, J

2007-09-01

The fate of bubbles formed in tissues during decompression to altitude after diving or due to accidental loss of cabin pressure during flight has only been indirectly inferred from theoretical modeling and clinical observations with noninvasive bubble-measuring techniques of intravascular bubbles. In this report we visually followed the in vivo resolution of micro-air bubbles injected into adipose tissue of anesthetized rats decompressed from 101.3 kPa to and held at 71 kPa corresponding to approximately 2.750 m above sea level, while the rats breathed air, oxygen, heliox (50:50), or heliox (80:20). During air breathing, bubbles initially grew for 30-80 min, after which they remained stable or began to shrink slowly. Oxygen breathing caused an initial growth of all bubbles for 15-85 min, after which they shrank until they disappeared from view. Bubble growth was significantly greater during breathing of oxygen compared with air and heliox breathing mixtures. During heliox (50:50) breathing, bubbles initially grew for 5-30 min, from which point they shrank until they disappeared from view. After a shift to heliox (80:20) breathing, some bubbles grew slightly for 20-30 min, then shrank until they disappeared from view. Bubble disappearance was significantly faster during breathing of oxygen and heliox mixtures compared with air. In conclusion, the present results show that oxygen breathing at 71 kPa promotes bubble growth in lipid tissue, and it is possible that breathing of heliox may be beneficial in treating decompression sickness during flight.

Effects of Diaphragmatic Breathing Patterns on Balance: A Preliminary Clinical Trial.

PubMed

Stephens, Rylee J; Haas, Mitchell; Moore, William L; Emmil, Jordan R; Sipress, Jayson A; Williams, Alex

The purpose of this study was to determine the feasibility of performing a larger study to determine if training in diaphragmatic breathing influences static and dynamic balance. A group of 13 healthy persons (8 men, 5 women), who were staff, faculty, or students at the University of Western States participated in an 8-week breathing and balance study using an uncontrolled clinical trial design. Participants were given a series of breathing exercises to perform weekly in the clinic and at home. Balance and breathing were assessed at the weekly clinic sessions. Breathing was evaluated with Liebenson's breathing assessment, static balance with the Modified Balance Error Scoring System, and dynamic balance with OptoGait's March in Place protocol. Improvement was noted in mean diaphragmatic breathing scores (1.3 to 2.6, P < .001), number of single-leg stance balance errors (7.1 to 3.8, P = .001), and tandem stance balance errors (3.2 to 0.9, P = .039). A decreasing error rate in single-leg stance was associated with improvement in breathing score within participants over the 8 weeks of the study (-1.4 errors/unit breathing score change, P < .001). Tandem stance performance did not reach statistical significance (-0.5 error/unit change, P = .118). Dynamic balance was insensitive to balance change, being error free for all participants throughout the study. This proof-of-concept study indicated that promotion of a costal-diaphragmatic breathing pattern may be associated with improvement in balance and suggests that a study of this phenomenon using an experimental design is feasible. Copyright © 2017. Published by Elsevier Inc.

Off-line breath acetone analysis in critical illness.

PubMed

Sturney, S C; Storer, M K; Shaw, G M; Shaw, D E; Epton, M J

2013-09-01

Analysis of breath acetone could be useful in the Intensive Care Unit (ICU) setting to monitor evidence of starvation and metabolic stress. The aims of this study were to examine the relationship between acetone concentrations in breath and blood in critical illness, to explore any changes in breath acetone concentration over time and correlate these with clinical features. Consecutive patients, ventilated on controlled modes in a mixed ICU, with stress hyperglycaemia requiring insulin therapy and/or new pulmonary infiltrates on chest radiograph were recruited. Once daily, triplicate end-tidal breath samples were collected and analysed off-line by selected ion flow tube mass spectrometry (SIFT-MS). Thirty-two patients were recruited (20 males), median age 61.5 years (range 26-85 years). The median breath acetone concentration of all samples was 853 ppb (range 162-11 375 ppb) collected over a median of 3 days (range 1-8). There was a trend towards a reduction in breath acetone concentration over time. Relationships were seen between breath acetone and arterial acetone (rs = 0.64, p < 0.0001) and arterial beta-hydroxybutyrate (rs = 0.52, p < 0.0001) concentrations. Changes in breath acetone concentration over time corresponded to changes in arterial acetone concentration. Some patients remained ketotic despite insulin therapy and normal arterial glucose concentrations. This is the first study to look at breath acetone concentration in ICU patients for up to 8 days. Breath acetone concentration may be used as a surrogate for arterial acetone concentration, which may in future have a role in the modulation of insulin and feeding in critical illness.

Effects of forced deep breathing on blood flow velocity in the femoral vein: Developing a new physical prophylaxis for deep vein thrombosis in patients with plaster cast immobilization of the lower limb.

PubMed

Nakanishi, Keisuke; Takahira, Naonobu; Sakamoto, Miki; Yamaoka-Tojo, Minako; Katagiri, Masato; Kitagawa, Jun

2018-02-01

Patients with plaster cast immobilization of the lower limb have an estimated symptomatic venous thromboembolism rate of 5.5%. However, there is currently no practical physical prophylaxis for deep-vein thrombosis (DVT). The objective of this study was to examine the effects of forced deep breathing on peak blood velocity in the superficial femoral vein (PBVFV), which is a surrogate measure of the efficacy of thromboprophylaxis against DVT, in patients with plaster cast immobilization of the lower limb. Nine young males and 18 elderly males were recruited. We immobilized the right lower limb of each subject with a plaster splint and measured PBVFV during forced deep breathing in supine and sitting positions. In all subjects, PBVFV during forced deep breathing in both positions was significantly higher than at rest. There was no significant difference in the PBVFV change ratio for three breathing rates in the sitting position for the young subjects (15breaths/min: 415%, 5breaths/min: 475%, 3breaths/min: 483%), whereas that for the elderly subjects at 3breaths/min (449%) was significantly higher than that at 15breaths/min (284%). Forced deep breathing significantly increased PBVFV in patients with plaster cast immobilization of the lower limb in both supine and sitting positions. Testing the efficacy and adherence in clinical contexts, and following up with the incidence rate of DVT in future studies, is necessary for the development of a new physical prophylaxis for DVT. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Assessment of influence of breath holding and hyperventilation on human postural stability with spectral analysis of stabilographic signal].

PubMed

Malakhov, M V; Makarenkova, E A; Mel'nikov, A A; Vikulov, A D

2014-01-01

The influence of breath holding and voluntary hyperventilation on the classic stabilometric parameters and the frequency characteristic of stabilographic signal were studied. We measured the stabilometric parameters on the force platform ("Ritm", Russia) on the healthy volunteers (n = 107) during quiet breath, voluntary hyperventilation (20 seconds) and maximal inspiratory breath holding (20 seconds). Respiratory frequency, respiratory amplitude and ventilation were estimated with strain gauge. We found that antero-posterior and medio-lateral sway amplitude and velocity as well as sway surface at breath-holding and at quiet breathing were the same, so breath holding didn't influence the postural stability. However the spectral parameters shifted to the high frequency range due to alteration of the respiratory muscles contractions during breath-holding versus quiet breath. Voluntary hyperventilation caused significant increase of all stabilographic indices that implied an impairment of postural stability, which was due to the increase of respiration frequency and amplitude. We also found that the spectral indices moved toward the high-frequency range with more pronounced degree of this shift versus breath holding. Besides, amplitudes of spectral peaks also increased. Perhaps such change of spectral indices was due to distortion of proprioceptive information because of increased excitability of nerve fibers during hyperventilation. Maximal inspiration breath holding causes strain of the postural control mechanisms that is reflected as elevation of postural sway frequency with no postural stability changes. Hyperventilation leads to the most prominent strain of balance function and decrease of steadiness that is manifested as increase of center of pressure oscillations amplitude and frequency.

3D late gadolinium enhancement in a single prolonged breath-hold using supplemental oxygenation and hyperventilation.

PubMed

Roujol, Sébastien; Basha, Tamer A; Akçakaya, Mehmet; Foppa, Murilo; Chan, Raymond H; Kissinger, Kraig V; Goddu, Beth; Berg, Sophie; Manning, Warren J; Nezafat, Reza

2014-09-01

To evaluate the feasibility of three-dimensional (3D) single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. Breath-hold metrics [breath-hold duration, diaphragmatic/LV position drift, and maximum variation of R wave to R wave (RR) interval] without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real-time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (field of view = 320 × 320 × 100 mm(3) , resolution = 1.6 × 1.6 × 5.0 mm(3) , acceleration rate of 4) and a free-breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semiquantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. Supplemental oxygenation and hyperventilation increased the breath-hold duration (35 ± 11 s to 58 ± 21 s; P < 0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both P > 0.01). LGE images were of similar quality when compared with free-breathing acquisitions, but with reduced total scan time (85 ± 22 s to 35 ± 6 s; P < 0.001). Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV. Copyright © 2013 Wiley Periodicals, Inc.

Stridor

MedlinePlus

Breathing sounds - abnormal; Extrathoracic airway obstruction; Wheezing - stridor ... questions: Is the abnormal breathing a high-pitched sound? Did the breathing problem start suddenly? Could the ...

77 FR 35747 - Highway Safety Programs; Conforming Products List of Evidential Breath Alcohol Measurement Devices

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

...-0061] Highway Safety Programs; Conforming Products List of Evidential Breath Alcohol Measurement... Evidential Breath Alcohol Measurement Devices dated, September 17, 1993 (58 FR 48705). DATES: Effective Date... Safety Administration (NHTSA) published the Standards for Devices to Measure Breath Alcohol (38 FR 30459...

21 CFR 868.5240 - Anesthesia breathing circuit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to a...

21 CFR 868.5240 - Anesthesia breathing circuit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to a...

21 CFR 868.2375 - Breathing frequency monitor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breathing frequency monitor. 868.2375 Section 868.2375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Monitoring Devices § 868.2375 Breathing frequency monitor. (a) Identification. A breathing (ventilatory)...

Breathwork as a Therapeutic Modality: An Overview for Counselors

ERIC Educational Resources Information Center

Young, J. Scott; Cashwell, Craig S.; Giordano, Amanda L.

2010-01-01

Using the breath as a vehicle for accessing psychological material is a topic rarely discussed in the counseling literature, despite the use of conscious engagement with the breath by many spiritual traditions for the purpose of personal transformation. This article describes 3 types of conscious breathing (circular breathing, conscious connected…

46 CFR 197.340 - Breathing gas supply.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Breathing gas supply. 197.340 Section 197.340 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.340 Breathing gas supply. (a) A primary breathing gas supply for surface-supplied diving must be sufficient to support the following for the...

46 CFR 197.340 - Breathing gas supply.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Breathing gas supply. 197.340 Section 197.340 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.340 Breathing gas supply. (a) A primary breathing gas supply for surface-supplied diving must be sufficient to support the following for the...

46 CFR 197.340 - Breathing gas supply.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Breathing gas supply. 197.340 Section 197.340 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.340 Breathing gas supply. (a) A primary breathing gas supply for surface-supplied diving must be sufficient to support the following for the...

46 CFR 197.340 - Breathing gas supply.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Breathing gas supply. 197.340 Section 197.340 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.340 Breathing gas supply. (a) A primary breathing gas supply for surface-supplied diving must be sufficient to support the following for the...

Oral Breathing Challenge in Participants with Vocal Attrition

ERIC Educational Resources Information Center

Sivasankar, Mahalakshmi; Fisher, Kimberly V.

2003-01-01

Vocal folds undergo osmotic challenge by mouth breathing during singing, exercising, and loud speaking. Just 15 min of obligatory oral breathing, to dry the vocal folds, increases phonation threshold pressure (P[subscript th]) and expiratory vocal effort in healthy speakers (M. Sivasankar & K. Fisher, 2002). We questioned whether oral breathing is…

46 CFR 195.30-15 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 195.30-15 Section... VESSELS VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Protection From Refrigerants § 195.30-15 Self-contained breathing apparatus. (a) Each vessel must have a self-contained breathing apparatus for...

46 CFR 167.45-60 - Emergency breathing apparatus and flame safety lamps.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Emergency breathing apparatus and flame safety lamps... Emergency breathing apparatus and flame safety lamps. Each nautical-school ship must be equipped with the following devices: (a) Two pressure-demand, open circuit, self-contained breathing apparatus, approved by...

46 CFR 195.30-15 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 195.30-15 Section... VESSELS VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Protection From Refrigerants § 195.30-15 Self-contained breathing apparatus. (a) Each vessel must have a self-contained breathing apparatus for...

46 CFR 108.703 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DESIGN AND EQUIPMENT Miscellaneous Equipment § 108.703 Self-contained breathing apparatus. (a) Each unit must be equipped with a self-contained breathing apparatus described in § 108.497(a) to use as... 46 Shipping 4 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 108.703 Section 108...

46 CFR 96.30-15 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 96.30-15 Section 96... VESSELS VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Protection From Refrigerants § 96.30-15 Self-contained breathing apparatus. (a) Each vessel must have a self-contained breathing apparatus for...

46 CFR 97.37-20 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 97.37-20 Section 97... VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-20 Self-contained breathing apparatus. (a) Lockers or spaces containing self-contained breathing apparatus shall be marked “SELF...

46 CFR 169.736 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 169.736 Section 169... VESSELS Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.736 Self-contained breathing apparatus. Each locker or space containing self-contained breathing apparatus must be marked “SELF-CONTAINED...

46 CFR 167.45-60 - Emergency breathing apparatus and flame safety lamps.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency breathing apparatus and flame safety lamps... Emergency breathing apparatus and flame safety lamps. Each nautical-school ship must be equipped with the following devices: (a) Two pressure-demand, open circuit, self-contained breathing apparatus, approved by...

46 CFR 108.703 - Self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DESIGN AND EQUIPMENT Miscellaneous Equipment § 108.703 Self-contained breathing apparatus. (a) Each unit must be equipped with a self-contained breathing apparatus described in § 108.497(a) to use as... 46 Shipping 4 2010-10-01 2010-10-01 false Self-contained breathing apparatus. 108.703 Section 108...

46 CFR 96.30-15 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 96.30-15 Section 96... VESSELS VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Protection From Refrigerants § 96.30-15 Self-contained breathing apparatus. (a) Each vessel must have a self-contained breathing apparatus for...

46 CFR 169.736 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 169.736 Section 169... VESSELS Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.736 Self-contained breathing apparatus. Each locker or space containing self-contained breathing apparatus must be marked “SELF-CONTAINED...

46 CFR 97.37-20 - Self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Self-contained breathing apparatus. 97.37-20 Section 97... VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-20 Self-contained breathing apparatus. (a) Lockers or spaces containing self-contained breathing apparatus shall be marked “SELF...

Functional Analysis and Intervention for Breath Holding.

ERIC Educational Resources Information Center

Kern, Lee; And Others

1995-01-01

A functional analysis of breath-holding episodes in a 7-year-old girl with severe mental retardation and Cornelia-de-Lange syndrome indicated that breath holding served an operant function, primarily to gain access to attention. Use of extinction, scheduled attention, and a picture card communication system decreased breath holding. (Author/SW)

21 CFR 868.5240 - Anesthesia breathing circuit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to a...

Development of a South African integrated syndromic respiratory disease guideline for primary care.

PubMed

English, René G; Bateman, Eric D; Zwarenstein, Merrick F; Fairall, Lara R; Bheekie, Angeni; Bachmann, Max O; Majara, Bosielo; Ottmani, Salah-Eddine; Scherpbier, Robert W

2008-09-01

The Practical Approach to Lung Health in South Africa (PALSA) initiative aimed to develop an integrated symptom- and sign-based (syndromic) respiratory disease guideline for nurse care practitioners working in primary care in a developing country. A multidisciplinary team developed the guideline after reviewing local barriers to respiratory health care provision, relevant health care policies, existing respiratory guidelines, and literature. Guideline drafts were evaluated by means of focus group discussions. Existing evidence-based guideline development methodologies were tailored for development of the guideline. A locally-applicable guideline based on syndromic diagnostic algorithms was developed for the management of patients 15 years and older who presented to primary care facilities with cough or difficulty breathing. PALSA has developed a guideline that integrates and presents diagnostic and management recommendations for priority respiratory diseases in adults using a symptom- and sign-based algorithmic guideline for nurses in developing countries.

Chest wall reconstruction using iliac bone allografts and muscle flaps.

PubMed

Garcia-Tutor, Emilio; Yeste, Luis; Murillo, Julio; Aubá, Cristina; Sanjulian, Mikel; Torre, Wenceslao

2004-01-01

Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue.

Ventilator caregiver education through the use of high-fidelity pediatric simulators: a pilot study.

PubMed

Tofil, Nancy M; Rutledge, Chrystal; Zinkan, J Lynn; Youngblood, Amber Q; Stone, Julie; Peterson, Dawn Taylor; Slayton, Donna; Makris, Chris; Magruder, Terri; White, Marjorie Lee

2013-11-01

Introduction. Home ventilator programs (HVP) have been developed to train parents of critically ill children. Simulators are used in health care, but not often for parents. We added simulation to our HVP and assessed parents' response. Methods. In July 2008, the HVP at Children's of Alabama added simulation to parent training. Debriefing was provided after the training session to reinforce correct skills and critical thinking. Follow-up surveys were completed after training. Results. Fifteen families participated. All parents were confident in changing tracheostomies, knowing signs of breathing difficulties, and responding to alarms. 71% strongly agree that simulation resulted in feeling better prepared to care for their child. 86% felt simulation improved their confidence in taking care of their child. Conclusion. Simulators provide a crucial transition between learned skills and application. This novel use of simulation-based education improves parents' confidence in emergencies and may lead to shortened training resulting in cost savings.

Role of Endoscopic Gastroplasty Techniques in the Management of Obesity.

PubMed

Jung, Yunho

2017-01-01

Health and wellness represent a major global concern. Trends such as a lack of exercise and excessive consumption of calories are major causes of the rapid increase in obesity worldwide. Obesity should be controlled because it can result in other illnesses, such as diabetes, high blood pressure, high cholesterol, coronary artery disease, stroke, breathing disorders, or cancer. However, many people have difficulty in managing obesity through exercise, dietary control, behavioral modifications, and drug therapy. Bariatric surgery is not commonly used due to a variety of complications, even though it has been demonstrated to produce reliable results with respect to adequate weight loss when performed using an open or a laparoscopic approach. Endoscopic bariatric procedures are emerging techniques that are less invasive and safer compared with current surgical approaches. However, the evaluation of endoluminal procedures is limited by the small number of studies and their short-term follow-up.

Heat-related symptoms in sugarcane harvesters.

PubMed

Crowe, Jennifer; Nilsson, Maria; Kjellstrom, Tord; Wesseling, Catharina

2015-05-01

Exposure to heat stress is a documented risk for Central American sugarcane harvesters. However, little is known about heat-related illness in this population. This study examined the frequency of heat-related health effects among harvesters (n = 106) exposed to occupational heat stress compared to non-harvesters (n = 63). Chi-square test and gamma statistic were used to evaluate differences in self-reported symptoms and trends over heat exposure categories. Heat and dehydration symptoms (headache, tachycardia, muscle cramps, fever, nausea, difficulty breathing, dizziness, swelling of hands/feet, and dysuria) were experienced at least once per week significantly more frequently among harvesters. Percentages of workers reporting heat and dehydration symptoms increased in accordance with increasing heat exposure categories. A large percentage of harvesters are experiencing heat illness throughout the harvest demonstrating an urgent need for improved workplace practices, particularly in light of climate change and the epidemic of chronic kidney disease prevalent in this population. © 2015 Wiley Periodicals, Inc.

National Advisory Committee on Immunization (NACI). Supplementary statement MMR vaccine and anaphylactic hypersensitivity to egg or egg-related antigens.

PubMed

1996-07-15

The fourth edition of the Canadian Immunization Guide (1993) recommends that "persons who have a history of anaphylactic hypersensitivity to hens' eggs (urticaria, swelling of the mouth and throat, difficulty in breathing or hypotension) should not be given measles vaccine except under special precautions." The precautions outlined include skin testing with diluted vaccine and graded challenge vaccination if the skin test is positive. Results of several recent studies have questioned such a cautious approach. NACI has reviewed all available data and revised its guidelines accordingly. The following revised guidelines are a major departure from the previously published recommendations. They will appear in the next edition of the Canadian Immunization Guide. A measles-rubella combination vaccine (Mo-Ru Viraten Berna TM) recently licensed in Canada contains no avian proteins and therefore can be used without regard to egg allergy.

KSC-02pd1299

NASA Image and Video Library

2002-09-11

KENNEDY SPACE CENTER, FLA. - On board the Freedom Star, one of the Shuttle Rocket Booster retrieval ships, workers with United Space Alliance help finalize the rescue of a lobster diver in distress after their return to port Sept. 11. The ship was on a certification exercise and near the location of a lobster diving boat that radioed the U.S. Coast Guard for help when one of the divers experienced difficulty breathing on his return to the surface. Hearing the call for help, the captain of the Freedom Star offered to help. On board the ship was a dive team, including a diver medical technician, Andy Fish, who are trained to assist in case of a dive accident during a retrieval mission. Fish stayed with the diver in the recompression chamber aboard the Freedom Star until the ship reached Port Canaveral where a KSC Occupational Health doctor waited. The diver was stabilized and taken to Florida Hospital.

KSC-02pd1302

NASA Image and Video Library

2002-09-11

KENNEDY SPACE CENTER, FLA. -- An Air Care team from Orlando take a distressed lobster diver to the helicopter to take him to Florida Hospital. The diver was picked up by the Freedom Star, one of the Shuttle Rocket Booster retrieval ships, on a certification exercise and near the location of a lobster diving boat that radioed the U.S. Coast Guard for help when one of the divers experienced difficulty breathing on his return to the surface. Hearing the call for help, the captain of the Freedom Star offered to help. The ship had a dive team on board, including a diver medical technician, Andy Fish, as well as a hyperbaric chamber. Fish stayed with the diver in the recompression chamber aboard the Freedom Star until the ship reached Port Canaveral where a KSC Occupational Health doctor waited. The diver was stabilized and then taken to Florida Hospital.

KSC-02pd1301

NASA Image and Video Library

2002-09-11

KENNEDY SPACE CENTER, FLA. - United Space Alliance workers on board the Freedom Star, one of the Shuttle Rocket Booster retrieval ships, release a distressed lobster diver to an Air Care Team from Orlando for transfer to a hospital. The ship and its dive team, including a diver medical technician, Andy Fish, were instrumental in rescuing the diver off Cape Canaveral Sept. 11. The ship was on a certification exercise and near the location of a lobster diving boat that radioed the U.S. Coast Guard for help when one of the divers experienced difficulty breathing on his return to the surface. Hearing the call for help, the captain of the Freedom Star offered to help. Fish stayed with the diver in the recompression chamber aboard the Freedom Star until the ship reached Port Canaveral where a KSC Occupational Health doctor waited. The diver was stabilized and then taken to Florida Hospital.

[A paclitaxel-resistant case of recurrent breast cancer responded to combination therapy of capecitabine and trastuzumab].

PubMed

Marutaka, Masahito; Suguri, Takayasu; Miyake, Mikio; Yoshimura, Kouichi

2005-12-01

The patient was a 72-year-old female. Under the supervision of her former doctor, this patient had an operation and adjuvant chemotherapy for progressive breast cancer. During the following period, local recurrence of breast cancer and pulmonary lymphopathia developed. Although medication with paclitaxel was attempted, the focus was resistant to this treatment, and metastasis to the brain was also observed. Due to the dyscrasia above, the patient had difficulty breathing and became bedridden. Subsequently, combination treatment of capecitabine and trastuzumab was attempted. As a result,metastasis in the brain and pulmonary lymphopathia were improved. The patient recovered enough to be discharged at one time. However, his condition took a turn for the worse after the interruption of the combination treatment by a side effect. In conclusion, the combination treatment of capecitabine and trastuzumab is thought to be effective for non-responders to paclitaxel.

Sleep Disorders in Patients with Bronchial Asthma

PubMed Central

Cukic, Vesna; Lovre, Vladimir; Dragisic, Dejan

2011-01-01

Respiratory disturbances during sleep are recognized as extremely common disorders with important clinical consequences. Breathing disorders during sleep can result in broad range of clinical manifestations, the most prevalent of which are unrefreshing sleep, daytime sleepiness and fatigue, and cognitive impairmant. There is also evidence that respiratory-related sleep disturbances can contribute to several common cardiovascular and metabolic disorders, including systemic hypertension, cardiac dysfunction, and insulin-resistance. Correlations are found between asthma-related symptoms and sleep disturbances. Difficulties inducing sleep, sleep fragmentation on polysomnography, early morning awakenings and daytime sleepiness are more common in asthmatics compared with subjects without asthma. The “morning deep” in asthma is relevant for the characterization of asthma severity, and impact drugs’ choices. Sleep and night control of asthma could be relevant to evaluate disease’s control. Appropriate asthma control recovering is guarantor for better sleep quality in these patients and less clinical consequences of respiratory disturbances during sleep. PMID:23678304

Severe facial swelling in a pregnant woman after using hair dye.

PubMed

van Genderen, Michel E; Carels, Ginette; Lonnee, Edward R; Dees, Adriaan

2014-03-31

A 33-year-old Caucasian pregnant woman (26 weeks' gestation) presented to the emergency department. She had a 2-day history of severe itching of the scalp and steadily worsening swelling of the face over the previous 12 h, which had extended to the neck. She had no difficulty breathing. The itching and swelling had developed 3 days after she had used hair dye. The patient had no history of allergic responses to hair dye or black henna tattoos. A diagnosis of type IV delayed hypersensitivity reaction was made. Permanent hair dyes are the most frequently used professional hair dyes and are most commonly based on paraphenylenediamine (PPD) or related chemicals. PPD is known to be one of the most potent allergens which cause allergic contact dermatitis. After treatment with intravenous antihistamines and steroids, the facial swelling reduced and the patient had completely recovered by the following day.

Virological Sampling of Inaccessible Wildlife with Drones.

PubMed

Geoghegan, Jemma L; Pirotta, Vanessa; Harvey, Erin; Smith, Alastair; Buchmann, Jan P; Ostrowski, Martin; Eden, John-Sebastian; Harcourt, Robert; Holmes, Edward C

2018-06-02

There is growing interest in characterizing the viromes of diverse mammalian species, particularly in the context of disease emergence. However, little is known about virome diversity in aquatic mammals, in part due to difficulties in sampling. We characterized the virome of the exhaled breath (or blow) of the Eastern Australian humpback whale ( Megaptera novaeangliae ). To achieve an unbiased survey of virome diversity, a meta-transcriptomic analysis was performed on 19 pooled whale blow samples collected via a purpose-built Unmanned Aerial Vehicle (UAV, or drone) approximately 3 km off the coast of Sydney, Australia during the 2017 winter annual northward migration from Antarctica to northern Australia. To our knowledge, this is the first time that UAVs have been used to sample viruses. Despite the relatively small number of animals surveyed in this initial study, we identified six novel virus species from five viral families. This work demonstrates the potential of UAVs in studies of virus disease, diversity, and evolution.

Piezosurgery an Asset in Treatment of Pierre Robin Sequence.

PubMed

Singh, Divya; Gadre, Pushkar; Gadre, Kiran; Ramanojam, Shandilya

2017-03-01

Pierre Robin sequence (formerly a syndrome) is named after the French stomatologist who, in 1923 and 1934, described the problems associated with micrognathia in newborn. It comprises mandibular micrognathia, U-shaped cleft palate, and glossoptosis. The typical symptoms are hypoxaemia, noisy breathing, snoring, stridor, cyanosis, bradycardia, feeding difficulties, and failure to thrive. Distraction osteogenesis has recently been considered as a surgical option for early intervention to lengthen the mandible and relieve respiratory problems. Piezosurgery offers a modality to make precise bone cuts preserving vital structures, minimizing the invasiveness of the surgical procedure, and offering bloodless field. We present case of 1-year-old male malnourished child with Pierre Robin sequence and tracheostomy in situ since day 11 of his birth. The staged treatment plan involving mandibular lengthening in which mandibular osteotomies were performed with the piezoelectric scalpel followed by decannulation of tracheostomy, which has been described in detail in this article.

Metastatic renal cell carcinoma in the nasopharynx.

PubMed

Atar, Yavuz; Topaloglu, Ilhan; Ozcan, Deniz

2013-01-01

Metastatic renal cell carcinoma of the nasopharynx, nasal cavity, and paranasal sinuses can be misdiagnosed as primary malignant or benign diseases. A 33-year-old male attended our outpatient clinic complaining of difficulty breathing through the nose, bloody nasal discharge, postnasal drop, snoring, and discharge of phlegm. Endoscopic nasopharyngeal examination showed a vascularized nasopharyngeal mass. Under general anesthesia, multiple punch biopsies were taken from the nasopharynx. Pathologically, the tumor cells had clear cytoplasm and were arranged in a trabecular pattern lined by a layer of endothelial cells. After the initial pathological examination, the pathologist requested more information about the patient's clinical status. A careful history revealed that the patient had undergone left a nephrectomy for a kidney mass diagnosed as renal cell carcinoma 3 years earlier. Subsequently, nasopharyngeal metastatic renal cell carcinoma was diagnosed by immunohistochemical staining with CD10 and vimentin. Radiotherapy was recommended for treatment.

[Nicergoline-induced Prinzmetal angina. "Heartache" instead of headache].

PubMed

Tomcsányi, János; Vecsey, Tibor; Tátrai, Tihamér

2004-01-04

A 56 year old woman was admitted to our hospital with crescendo chest pain in the last ten days. Her past history included hypertension treated by 100 mg metoprolol for more than ten years and right carotid endarterectomy. She complained headache and a treatment of 20 mg nicergoline (ergoline derivate) daily was started. Her chest pains started always one hour after the nicergoline intake. The chest pain was accompanied by breathing difficulties and sweating of 5 min duration at first but the next days it lasted longer and longer. Next morning following her admission, one hour after the nicergoline administration she had severe chest pain again. The ECG showed ST-segment elevation in inferior leads resolved after nitroglycerin administration. The angiogram revealed normal coronary artery. Nicergoline was stopped. The patient was treated with felodipine and remains free of symptoms. Nicergoline was good for head but worse for heart in this case.

Noise Reduction in Breath Sound Files Using Wavelet Transform Based Filter

NASA Astrophysics Data System (ADS)

Syahputra, M. F.; Situmeang, S. I. G.; Rahmat, R. F.; Budiarto, R.

2017-04-01

The development of science and technology in the field of healthcare increasingly provides convenience in diagnosing respiratory system problem. Recording the breath sounds is one example of these developments. Breath sounds are recorded using a digital stethoscope, and then stored in a file with sound format. This breath sounds will be analyzed by health practitioners to diagnose the symptoms of disease or illness. However, the breath sounds is not free from interference signals. Therefore, noise filter or signal interference reduction system is required so that breath sounds component which contains information signal can be clarified. In this study, we designed a filter called a wavelet transform based filter. The filter that is designed in this study is using Daubechies wavelet with four wavelet transform coefficients. Based on the testing of the ten types of breath sounds data, the data is obtained in the largest SNRdB bronchial for 74.3685 decibels.

49 CFR 219.206 - FRA access to breath test results.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

49 CFR 219.206 - FRA access to breath test results.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

49 CFR 219.206 - FRA access to breath test results.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

49 CFR 219.206 - FRA access to breath test results.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

49 CFR 219.206 - FRA access to breath test results.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false FRA access to breath test results. 219.206 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.206 FRA access to breath test results. Documentation of breath test results must be made available...

Experimental Analysis of Dampened Breathing Mode Oscillation on Hall Thruster Performance

DTIC Science & Technology

2013-03-01

38 4.5 Analysis of Discharge RMS Effect on Breathing Mode Amplitude...20 xii EXPERIMENTAL ANALYSIS OF DAMPENED BREATHING MODE OSCILLATION ON HALL EFFECT THRUSTER...the large error in the data presented above prevents many conclusions from being drawn. 4.5 Analysis of Discharge RMS Effect on Breathing Mode

30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape from...

46 CFR 196.37-20 - Self-contained breathing apparatus and gas masks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Self-contained breathing apparatus and gas masks. 196.37... RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-20 Self-contained breathing apparatus and gas masks. (a) Lockers or spaces containing self-contained breathing apparatus shall...

46 CFR 196.37-20 - Self-contained breathing apparatus and gas masks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Self-contained breathing apparatus and gas masks. 196.37... RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-20 Self-contained breathing apparatus and gas masks. (a) Lockers or spaces containing self-contained breathing apparatus shall...

46 CFR 28.205 - Fireman's outfits and self-contained breathing apparatus.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Fireman's outfits and self-contained breathing apparatus... the Aleutian Trade § 28.205 Fireman's outfits and self-contained breathing apparatus. (a) Each vessel... equipped with at least two self-contained breathing apparatuses. (c) A fireman's outfit must consist of one...

30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape from...

46 CFR 28.205 - Fireman's outfits and self-contained breathing apparatus.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Fireman's outfits and self-contained breathing apparatus... the Aleutian Trade § 28.205 Fireman's outfits and self-contained breathing apparatus. (a) Each vessel... equipped with at least two self-contained breathing apparatuses. (c) A fireman's outfit must consist of one...

Drinking influences exhaled breath condensate acidity.

PubMed

Kullmann, Tamás; Barta, Imre; Antus, Balázs; Horváth, Ildikó

2008-01-01

Exhaled breath condensate analysis is a developing method for investigating airway pathology. Impact of food and drink on breath condensate composition has not been systematically addressed. The aim of the study was to follow exhaled breath condensate pH after drinking an acidic and a neutral beverage. Breath condensate, capillary blood, and urine of 12 healthy volunteers were collected before and after drinking either 1 l of coke or 1 l of mineral water. The pH of each sample was determined with a blood gas analyzer. The mean difference between the pH of two breath condensate samples collected within 15 min before drinking was 0.13+/-0.03. Condensate pH decreased significantly from 6.29+/-0.02 to 6.24+/-0.02 (p<0.03) after drinking coke and from 6.37+/-0.03 to 6.22+/-0.04 (p<0.003) after drinking water. Drinking coke induced significant changes in blood and urine pH as well. Drinking influences exhaled breath condensate composition and may contribute to the variability of exhaled breath condensate pH.

Qualitative assessment of contrast-enhanced magnetic resonance angiography using breath-hold and non-breath-hold techniques in the portal venous system

NASA Astrophysics Data System (ADS)

Goo, Eun-Hoe; Kim, Sun-Ju; Dong, Kyung-Rae; Kim, Kwang-Choul; Chung, Woon-Kwan

2016-09-01

The purpose of this study is to evaluate the image quality in delineation of the portal venous systems with two different methods, breath-hold and non-breath-hold by using the 3D FLASH sequence. We used a 1.5 T system to obtain magnetic resonance(MR)images. Arterial and portal phase 3D FLASH images were obtained with breath-hold after a bolus injection of GD-DOTA. The detection of PVS on the MR angiograms was classified into three grades. First, the angiograms of the breath-hold method showed well the portal vein, the splenic vein and the superior mesenteric vein systems in 13 of 15 patients (86%) and the inferior mesenteric vein system in 6 of 15 patients (40%), Second, MR angiograms of the non-breath-hold method demonstrated the PVS and the SMV in 12 of 15 patients (80%) and the IMV in 5 of 15 patients (33%). Our study showed contrast-enhanced 3D FLASH MR angiography, together with the breath-hold technique, may provide reliable and accurate information on the portal venous system.

Influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathing pattern in laryngectomized individuals.

PubMed

Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Sinaasappel, Michiel; Hilgers, Frans J M

2010-08-01

The aim of this study was to determine the influence of breathing resistance of heat and moisture exchangers (HMEs) on endotracheal climate and breathing pattern. Endotracheal temperature and humidity and tidal volumes were measured in 11 laryngectomized patients with a regularly used HME with "standard" breathing resistance (Provox Normal HME; R-HME), a low breathing-resistance HME (Provox HiFlow HME; L-HME), and without HME. Both R-HME and L-HME increased end-inspiratory humidity (+5.8 and 4.7 mgH(2)O/L, respectively), decreased end-inspiratory temperature (-1.6 and -1.0 degrees C, respectively), and prolonged the exhalation breath length to approximately 0.5 seconds. The R-HME significantly enlarged tidal volumes (0.07 L; p < .05). Both HMEs significantly improve tracheal climate. The R-HME has better moistening properties and a small but significant positive effect on tidal volume. Therefore, if the higher resistance is tolerated, the R-HME is the preferred pulmonary rehabilitation device. The L-HME is indicated if lower breathing resistance is required. 2009 Wiley Periodicals, Inc. Head Neck, 2010.

Neurophysiological study on the effect of various short durations of deep breathing: A randomized controlled trial.

PubMed

Cheng, Kok Suen; Han, Ray P S; Lee, Poh Foong

2018-02-01

The study aims to study the effects of short duration deep breathing on the EEG power with topography based on parallel group randomized controlled trial design which was lacking in prior reports. 50 participants were split into 4 groups: control (CONT), deep breathing (DB) for 5 (DB5), 7 (DB7), and 9 (DB9) minutes. EEG recordings were obtained during baseline, deep breathing session, after deep breathing, and a follow-up session after 7 days of consecutive practice. Frontal theta power of DB5 and DB9 was significantly larger than that of CONT after the deep breathing session (p = 0.027 and p = 0.006, respectively) and the profound finding showed that the theta topography obtained a central-focused distribution for DB7 and DB9. The result obtained was consistent with previous literature, albeit for certain deep breathing durations only, indicating a possible linkage between the deep breathing duration and the neurophysiology of the brain. Copyright © 2017 Elsevier B.V. All rights reserved.

Applications of external cavity diode laser-based technique to noninvasive clinical diagnosis using expired breath ammonia analysis: chronic kidney disease, epilepsy

NASA Astrophysics Data System (ADS)

Bayrakli, Ismail; Turkmen, Aysenur; Akman, Hatice; Sezer, M. Tugrul; Kutluhan, Suleyman

2016-08-01

An external cavity laser (ECL)-based off-axis cavity-enhanced absorption spectroscopy was applied to noninvasive clinical diagnosis using expired breath ammonia analysis: (1) the correlation between breath ammonia levels and blood parameters related to chronic kidney disease (CKD) was investigated and (2) the relationship between breath ammonia levels and blood concentrations of valproic acid (VAP) was studied. The concentrations of breath ammonia in 15 healthy volunteers, 10 epilepsy patients (before and after taking VAP), and 27 patients with different stages of CKD were examined. The range of breath ammonia levels was 120 to 530 ppb for healthy subjects and 710 to 10,400 ppb for patients with CKD. There was a statistically significant positive correlation between breath ammonia concentrations and urea, blood urea nitrogen, creatinine, or estimated glomerular filtration rate in 27 patients. It was demonstrated that taking VAP gave rise to increasing breath ammonia levels. A statistically significant difference was found between the levels of exhaled ammonia (NH3) in healthy subjects and in patients with epilepsy before and after taking VAP. The results suggest that our breath ammonia measurement system has great potential as an easy, noninvasive, real-time, and continuous monitor of the clinical parameters related to epilepsy and CKD.

Noninvasive detection of lung cancer using exhaled breath

PubMed Central

Fu, Xiao-An; Li, Mingxiao; Knipp, Ralph J; Nantz, Michael H; Bousamra, Michael

2014-01-01

Early detection of lung cancer is a key factor for increasing the survival rates of lung cancer patients. The analysis of exhaled breath is promising as a noninvasive diagnostic tool for diagnosis of lung cancer. We demonstrate the quantitative analysis of carbonyl volatile organic compounds (VOCs) and identification of lung cancer VOC markers in exhaled breath using unique silicon microreactor technology. The microreactor consists of thousands of micropillars coated with an ammonium aminooxy salt for capture of carbonyl VOCs in exhaled breath by means of oximation reactions. Captured aminooxy-VOC adducts are analyzed by nanoelectrospray Fourier transform-ion cyclotron resonance (FT-ICR) mass spectrometry (MS). The concentrations of 2-butanone, 2-hydroxyacetaldehyde, 3-hydroxy-2-butanone, and 4-hydroxyhexenal (4-HHE) in the exhaled breath of lung cancer patients (n = 97) were significantly higher than in the exhaled breath of healthy smoker and nonsmoker controls (n = 88) and patients with benign pulmonary nodules (n = 32). The concentration of 2-butanone in exhaled breath of patients (n = 51) with stages II though IV non–small cell lung cancer (NSCLC) was significantly higher than in exhaled breath of patients with stage I (n = 34). The carbonyl VOC profile in exhaled breath determined using this new silicon microreactor technology provides for the noninvasive detection of lung cancer. PMID:24402867

Breath in the technoscientific imaginary.

PubMed

Rose, Arthur

2016-12-01

Breath has a realist function in most artistic media. It serves to remind the reader, the viewer or the spectator of the exigencies of the body. In science fiction (SF) literature and films, breath is often a plot device for human encounters with otherness, either with alien peoples, who may not breathe oxygen, or environments, where there may not be oxygen to breathe. But while there is a technoscientific quality to breath in SF, especially in its attention to physiological systems, concentrating on the technoscientific threatens to occlude other, more affective aspects raised by the literature. In order to supplement the tendency to read SF as a succession of technoscientific accounts of bodily experience, this paper recalls how SF texts draw attention to the affective, non-scientific qualities of breath, both as a metonym for life and as a metaphor for anticipation. Through an engagement with diverse examples from SF literature and films, this article considers the tension between technoscientific and affective responses to breath in order to demonstrate breath's co-determinacy in SF's blending of scientific and artistic discourses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Effects of breathing exercises on breathing pattern and thoracoabdominal motion after gastroplasty].

PubMed

Tomich, Georgia Miranda; França, Danielle Corrêa; Diniz, Marco Túlio Costa; Britto, Raquel Rodrigues; Sampaio, Rosana Ferreira; Parreira, Verônica Franco

2010-01-01

To evaluate breathing pattern and thoracoabdominal motion during breathing exercises. Twenty-four patients with class II or III obesity (18 women; 6 men) were studied on the second postoperative day after gastroplasty. The mean age was 37 +/- 11 years, and the mean BMI was 44 +/- 3 kg/m(2). Diaphragmatic breathing, incentive spirometry with a flow-oriented device and incentive spirometry with a volume-oriented device were performed in random order. Respiratory inductive plethysmography was used in order to measure respiratory variables and thoracoabdominal motion. Comparisons among the three exercises showed significant differences: tidal volume was higher during incentive spirometry (with the flow-oriented device or with the volume-oriented device) than during diaphragmatic breathing; the respiratory rate was lower during incentive spirometry with the volume-oriented device than during incentive spirometry with the flow-oriented device; and minute ventilation was higher during incentive spirometry (with the flow-oriented device or with the volume-oriented device) than during diaphragmatic breathing. Rib cage motion did not vary during breathing exercises, although there was an increase in thoracoabdominal asynchrony, especially during incentive spirometry with the flow-oriented device. Among the breathing exercises evaluated, incentive spirometry with the volume-oriented device provided the best results, because it allowed slower, deeper inhalation.

Design of a breath analysis system for diabetes screening and blood glucose level prediction.

PubMed

Yan, Ke; Zhang, David; Wu, Darong; Wei, Hua; Lu, Guangming

2014-11-01

It has been reported that concentrations of several biomarkers in diabetics' breath show significant difference from those in healthy people's breath. Concentrations of some biomarkers are also correlated with the blood glucose levels (BGLs) of diabetics. Therefore, it is possible to screen for diabetes and predict BGLs by analyzing one's breath. In this paper, we describe the design of a novel breath analysis system for this purpose. The system uses carefully selected chemical sensors to detect biomarkers in breath. Common interferential factors, including humidity and the ratio of alveolar air in breath, are compensated or handled in the algorithm. Considering the intersubject variance of the components in breath, we build subject-specific prediction models to improve the accuracy of BGL prediction. A total of 295 breath samples from healthy subjects and 279 samples from diabetic subjects were collected to evaluate the performance of the system. The sensitivity and specificity of diabetes screening are 91.51% and 90.77%, respectively. The mean relative absolute error for BGL prediction is 21.7%. Experiments show that the system is effective and that the strategies adopted in the system can improve its accuracy. The system potentially provides a noninvasive and convenient method for diabetes screening and BGL monitoring as an adjunct to the standard criteria.

Breath Group Analysis for Reading and Spontaneous Speech in Healthy Adults

PubMed Central

Wang, Yu-Tsai; Green, Jordan R.; Nip, Ignatius S.B.; Kent, Ray D.; Kent, Jane Finley

2010-01-01

Aims The breath group can serve as a functional unit to define temporal and fundamental frequency (f0) features in continuous speech. These features of the breath group are determined by the physiologic, linguistic, and cognitive demands of communication. Reading and spontaneous speech are two speaking tasks that vary in these demands and are commonly used to evaluate speech performance for research and clinical applications. The purpose of this study is to examine differences between reading and spontaneous speech in the temporal and f0 aspects of their breath groups. Methods Sixteen participants read two passages and answered six questions while wearing a circumferentially vented mask connected to a pneumotach. The aerodynamic signal was used to identify inspiratory locations. The audio signal was used to analyze task differences in breath group structure, including temporal and f0 components. Results The main findings were that spontaneous speech task exhibited significantly more grammatically inappropriate breath group locations and longer breath group duration than did the passage reading task. Conclusion The task differences in the percentage of grammatically inadequate breath group locations and in breath group duration for healthy adult speakers partly explain the differences in cognitive-linguistic load between the passage reading and spontaneous speech. PMID:20588052

Breath group analysis for reading and spontaneous speech in healthy adults.

PubMed

Wang, Yu-Tsai; Green, Jordan R; Nip, Ignatius S B; Kent, Ray D; Kent, Jane Finley

2010-01-01

The breath group can serve as a functional unit to define temporal and fundamental frequency (f0) features in continuous speech. These features of the breath group are determined by the physiologic, linguistic, and cognitive demands of communication. Reading and spontaneous speech are two speaking tasks that vary in these demands and are commonly used to evaluate speech performance for research and clinical applications. The purpose of this study is to examine differences between reading and spontaneous speech in the temporal and f0 aspects of their breath groups. Sixteen participants read two passages and answered six questions while wearing a circumferentially vented mask connected to a pneumotach. The aerodynamic signal was used to identify inspiratory locations. The audio signal was used to analyze task differences in breath group structure, including temporal and f0 components. The main findings were that spontaneous speech task exhibited significantly more grammatically inappropriate breath group locations and longer breath group duration than did the passage reading task. The task differences in the percentage of grammatically inadequate breath group locations and in breath group duration for healthy adult speakers partly explain the differences in cognitive-linguistic load between the passage reading and spontaneous speech. Copyright © 2010 S. Karger AG, Basel.

New insights into sucking, swallowing and breathing central generators: A complexity analysis of rhythmic motor behaviors.

PubMed

Samson, Nathalie; Praud, Jean-Paul; Quenet, Brigitte; Similowski, Thomas; Straus, Christian

2017-01-18

Sucking, swallowing and breathing are dynamic motor behaviors. Breathing displays features of chaos-like dynamics, in particular nonlinearity and complexity, which take their source in the automatic command of breathing. In contrast, buccal/gill ventilation in amphibians is one of the rare motor behaviors that do not display nonlinear complexity. This study aimed at assessing whether sucking and swallowing would also follow nonlinear complex dynamics in the newborn lamb. Breathing movements were recorded before, during and after bottle-feeding. Sucking pressure and the integrated EMG of the thyroartenoid muscle, as an index of swallowing, were recorded during bottle-feeding. Nonlinear complexity of the whole signals was assessed through the calculation of the noise limit value (NL). Breathing and swallowing always exhibited chaos-like dynamics. The NL of breathing did not change significantly before, during or after bottle-feeding. On the other hand, sucking inconsistently and significantly less frequently than breathing exhibited a chaos-like dynamics. Therefore, the central pattern generator (CPG) that drives sucking may be functionally different from the breathing CPG. Furthermore, the analogy between buccal/gill ventilation and sucking suggests that the latter may take its phylogenetic origin in the gill ventilation CPG of the common ancestor of extant amphibians and mammals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Measurement and prediction of indoor air quality using a breathing thermal manikin.

PubMed

Melikov, A; Kaczmarczyk, J

2007-02-01

The analyses performed in this paper reveal that a breathing thermal manikin with realistic simulation of respiration including breathing cycle, pulmonary ventilation rate, frequency and breathing mode, gas concentration, humidity and temperature of exhaled air and human body shape and surface temperature is sensitive enough to perform reliable measurement of characteristics of air as inhaled by occupants. The temperature, humidity, and pollution concentration in the inhaled air can be measured accurately with a thermal manikin without breathing simulation if they are measured at the upper lip at a distance of <0.01 m from the face. Body surface temperature, shape and posture as well as clothing insulation have impact on the measured inhaled air parameters. Proper simulation of breathing, especially of exhalation, is needed for studying the transport of exhaled air between occupants. A method for predicting air acceptability based on inhaled air parameters and known exposure-response relationships established in experiments with human subjects is suggested. Recommendations for optimal simulation of human breathing by means of a breathing thermal manikin when studying pollution concentration, temperature and humidity of the inhaled air as well as the transport of exhaled air (which may carry infectious agents) between occupants are outlined. In order to compare results obtained with breathing thermal manikins, their nose and mouth geometry should be standardized.

Measurement of hepatic functional mass by means of 13C-methacetin and 13C-phenylalanine breath tests in chronic liver disease: Comparison with Child-Pugh score and serum bile acid levels

PubMed Central

Festi, D.; Capodicasa, S.; Sandri, L.; Colaiocco-Ferrante, L.; Staniscia, T.; Vitacolonna, E.; Vestito, A.; Simoni, P.; Mazzella, G.; Portincasa, P.; Roda, E.; Colecchia, A.

2005-01-01

AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels. METHODS: One hundred and forty patients (50 HCV- related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated. RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids. Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test. CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients. PMID:15609414

From breathing to respiration.

PubMed

Fitting, Jean-William

2015-01-01

The purpose of breathing remained an enigma for a long time. The Hippocratic school described breathing patterns but did not associate breathing with the lungs. Empedocles and Plato postulated that breathing was linked to the passage of air through pores of the skin. This was refuted by Aristotle who believed that the role of breathing was to cool the heart. In Alexandria, breakthroughs were accomplished in the anatomy and physiology of the respiratory system. Later, Galen proposed an accurate description of the respiratory muscles and the mechanics of breathing. However, his heart-lung model was hampered by the traditional view of two non-communicating vascular systems - veins and arteries. After a period of stagnation in the Middle Ages, knowledge progressed with the discovery of pulmonary circulation. The comprehension of the purpose of breathing progressed by steps thanks to Boyle and Mayow among others, and culminated with the contribution of Priestley and the discovery of oxygen by Lavoisier. Only then was breathing recognized as fulfilling the purpose of respiration, or gas exchange. A century later, a controversy emerged concerning the active or passive transfer of oxygen from alveoli to the blood. August and Marie Krogh settled the dispute, showing that passive diffusion was sufficient to meet the oxygen needs. © 2014 S. Karger AG, Basel.

Effect of oxygenation on breath-by-breath response of the genioglossus muscle during occlusion.

PubMed

Gauda, E B; Carroll, J L; McColley, S; Smith, P L

1991-10-01

We investigated the effect of different levels of O2 tension (hypoxia, normoxia, and hyperoxia) on the breath-by-breath onset and peak electromyographic (EMG) activity of the genioglossus (GG) muscle during a five-breath end-expiratory tracheal occlusion of 20- to 30-s duration. GG and diaphragmatic (DIA) EMG activity were measured with needle electrodes in eight anesthetized tracheotomized adult cats. In response to occlusion, the increase in the number of animals with GG EMG activity was different during hypoxia, normoxia, and hyperoxia (P = 0.003, Friedman). During hypoxia, eight of eight of the animals had GG EMG activity by the third occluded effort. In contrast, during normoxia, only four of eight and, during hyperoxia, only three of eight animals had GG EMG activity throughout the entire five-breath occlusion. Similarly, at release of the occlusion, more animals had persistent GG EMG activity on the postocclusion breaths during hypoxia than during normoxia or hyperoxia. Breath-by-breath augmentation of peak amplitude of the GG and DIA EMGs on each occluded effort was accentuated during hypoxia (P less than 0.01) and abolished during hyperoxia (P = 0.10). These results suggest that hypoxemia is a major determinant of the rapidity of onset, magnitude, and sustained activity of upper airway muscles during airway occlusion.

Oral breathing challenge in participants with vocal attrition.

PubMed

Sivasankar, Mahalakshmi; Fisher, Kimberly V

2003-12-01

Vocal folds undergo osmotic challenge by mouth breathing during singing, exercising, and loud speaking. Just 15 min of obligatory oral breathing, to dry the vocal folds, increases phonation threshold pressure (Pth) and expiratory vocal effort in healthy speakers (M. Sivasankar & K. Fisher, 2002). We questioned whether oral breathing is more detrimental to phonation in healthy participants with a history of temporary vocal attrition. The effects of a 15-min oral or nasal breathing challenge on Pth and perceived expiratory vocal effort were compared for participants reporting symptoms of vocal attrition (N = 18, ages 19-38 years) and normal controls (N = 20, ages 19-33 years). Post-challenge-prechallenge differences in Pth (deltaPth) and effort (deltaEffort) revealed that oral breathing, but not nasal breathing, increased Pth (p < .001 ) and effort (p < .001) at low, comfortable, and high pitch. deltaPth was significantly greater in participants with vocal attrition than in normal controls (p < .001). Nasal breathing reduced Pth for all controls but not for all participants reporting vocal attrition. deltaPth was significantly and linearly correlated with deltaEffort (rvocal attrition = .81, p < .001; rcontrol = .84, p < .001). We speculate that the greater increases in Pth in participants reporting vocal attrition may result from delayed or inadequate compensatory response to superficial laryngeal dehydration. Obligatory oral breathing may place voice users at risk for exacerbating vocal attrition. That sol layer depletion by obligatory oral breathing increased Pth and vocal effort provides support for the role of superficial hydration in maintaining ease of phonation.

Impact of endotracheal tube shortening on work of breathing in neonatal and pediatric in vitro lung models.

PubMed

Mohr, Rebecca; Thomas, Jörg; Cannizzaro, Vincenzo; Weiss, Markus; Schmidt, Alexander R

2017-09-01

Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings. We hypothesized that endotracheal tube shortening significantly reduces work of breathing. We used the Active-Servo-Lung 5000 to simulate different clinical scenarios in mechanically ventilated infants and neonates under spontaneous breathing with and without pressure support. Endotracheal tube size, lung resistance, and compliance, as well as respiratory settings such as respiratory rate and tidal volume were weight and age adapted for each lung model. Work of breathing was measured before and after maximal endotracheal tube shortening and the reduction of the daily energy demand calculated. Tube shortening with and without pressure support decreased work of breathing to a maximum of 10.1% and 8.1%, respectively. As a result, the calculated reduction of total daily energy demand by endotracheal tube shortening was between 0.002% and 0.02%. In this in vitro lung model, endotracheal tube shortening had minimal effects on work of breathing. Moreover, the calculated percentage reduction of the total daily energy demand after endotracheal tube shortening was minimal. © 2017 John Wiley & Sons Ltd.

Social relations and breath odour.

PubMed

McKeown, L

2003-11-01

In this retrospective qualitative study, the researcher reviewed 55 client records of The Breath Odour Clinic. The purpose was to determine if individuals attended a clinic specialised in treating oral malodour for medical or social reasons. The study focused on the psychosocial and breath odour history. Clients had agreed to the use of information for research purposes. Society uses odour as a means to define and interact with the world. The olfactory, smelling experience is intimate, emotionally charged and connects us with the world. It follows that the smell from mouth breath odour can connect or disconnect a person from their social environment and intimate relationships. How one experiences one's own body is very personal and private but also very public. Breath odour is public as it occurs within a social and cultural context and personal as it affects one's body image and self-confidence. Body image, self-image and social relations mesh, interact and impact upon each other. Breath odour is a dynamic and interactive aspect of the self-image. In addition, breath odour may be value-coded as 'bad'. In 75% of the cases reviewed, decreased self-confidence and insecurity in social and intimate relations led clients to seek treatment at the specialised breath odour clinic. Their doctor, dental hygienist or dentist had treated medical and oral conditions but not resolved their breath odour problem. When a person perceives a constant bad breath problem, she/he uses defence techniques, and may avoid social situations and social relations. This affects a person's well-being.

Dataset of breath research manuscripts curated using PubMed search strings from 1995-2016.

PubMed

Geer Wallace, M Ariel; Pleil, Joachim D

2018-06-01

The data contained in this article are PubMed search strings and search string builders used to curate breath research manuscripts published from 1995-2016 and the respective number of articles found that satisfied the search requirements for selected categories. Breath sampling represents a non-invasive technique that has gained usefulness for public health, clinical, diagnostic, and environmental exposure assessment applications over the years. This data article includes search strings that were utilized to retrieve publications through the PubMed database for different breath research-related topics that were related to the analysis of exhaled breath, exhaled breath condensate (EBC), and exhaled breath aerosol (EBA) as well as the analysis of cellular headspace. Manuscripts were curated for topics including EBC, EBA, Direct MS, GC-MS, LC-MS, alcohol, and sensors. A summary of the number of papers published per year for the data retrieved using each of the search strings is also included. These data can be utilized to discern trends in the number of breath research publications in each of the different topics over time. A supplementary Appendix A containing the titles, author lists, journal names, publication dates, PMID numbers, and EntrezUID numbers for each of the journal articles curated using the finalized search strings for the seven breath research-related topics can also be found within this article. The selected manuscripts can be used to explore the impact that breath research has had on expanding the scientific knowledge in each of the investigated topics.

Breathing pattern and head posture: changes in craniocervical angles.

PubMed

Sabatucci, A; Raffaeli, F; Mastrovincenzo, M; Luchetta, A; Giannone, A; Ciavarella, D

2015-04-01

The aim of this study was to observe the influence of oral breathing on head posture and to establish possible postural changes observing the variation of craniocervical angles NSL/OPT and NSL/CVT between oral breathing subjects and physiological breathing subjects. A cross-sectional study was conducted. The sample included 115 subject, 56 boys and 59 girls, 5-22-year-old. Among these, 80 were classified as oral breathers and 35 as physiological breathers. The diagnosis of oral breathing was carried out thanks to characteristic signs and symptoms evaluated on clinical examination, the analysis of characteristic X-ray images, ENT examination with active anterior rhinomanometric (AAR) test. The structural and postural analysis was carried out, calculating the craniofacial angles NSL/OPT and NSL/CVT. Both NSL/OPT and NSL/CVT appear to be significantly greater to those observed in physiological breathing patients. This means that patients who tend to breathe through the mouth rather than exclusively through the nose show a reduction of cervical lordosis and a proinclination of the head. Our study confirms that the oral breathing modifies head position. The significant increase of the craniocervical angles NSL/OPT and NSL/CVT in patients with this altered breathing pattern suggests an elevation of the head and a greater extension of the head compared with the cervical spine. So, to correct the breathing pattern early, either during childhood or during adolescence, can lead to a progressive normalization of craniofacial morphology and head posture.

Aspiration tests in aqueous foam using a breathing simulator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Archuleta, M.M.

1995-12-01

Non-toxic aqueous foams are being developed by Sandia National Laboratories (SNL) for the National Institute of Justice (NIJ) for use in crowd control, cell extractions, and group disturbances in the criminal justice prison systems. The potential for aspiration of aqueous foam during its use and the resulting adverse effects associated with complete immersion in aqueous foam is of major concern to the NIJ when examining the effectiveness and safety of using this technology as a Less-Than-Lethal weapon. This preliminary study was designed to evaluate the maximum quantity of foam that might be aspirated by an individual following total immersion inmore » an SNL-developed aqueous foam. A.T.W. Reed Breathing simulator equipped with a 622 Silverman cam was used to simulate the aspiration of an ammonium laureth sulfate aqueous foam developed by SNL and generated at expansion ratios in the range of 500:1 to 1000:1. Although the natural instinct of an individual immersed in foam is to cover their nose and mouth with a hand or cloth, thus breaking the bubbles and decreasing the potential for aspiration, this study was performed to examine a worst case scenario where mouth breathing only was examined, and no attempt was made to block foam entry into the breathing port. Two breathing rates were examined: one that simulated a sedentary individual with a mean breathing rate of 6.27 breaths/minute, and one that simulated an agitated or heavily breathing individual with a mean breathing rate of 23.7 breaths/minute. The results of this study indicate that, if breathing in aqueous foam without movement, an air pocket forms around the nose and mouth within one minute of immersion.« less

A reservoir nasal cannula improves protection given by oxygen during muscular exercise in COPD.

PubMed

Arlati, S; Rolo, J; Micallef, E; Sacerdoti, C; Brambilla, I

1988-06-01

We verified the utility of an oxygen economizer (Pendant Oxymizer) in assuring greater protection than nasal prongs against worsening of oxyhemoglobin resting desaturation (delta SaO2) induced by muscular exercise in 16 patients (ten with chronic obstructive pulmonary disease [COPD] and six with restrictive pulmonary disease). This worsening was quantified as desaturation surface accumulated within five minutes of exercise and was expressed in arbitrary units (au). Each patient carried out the same exercise three times, in a randomized fashion (breathing air or breathing supplemental oxygen [3 L/min] delivered by either nasal prongs or by oxygen economizer). In patients with obstructive disease, delta SaO2 was reduced from 38 +/- 12.0 au when they were breathing air to 18.1 +/- 11.7 au when breathing oxygen by nasal prongs (p less than 0.001) and to 10.1 +/- 9.5 au when breathing oxygen by economizer (p less than 0.001). In patients with restrictive disease, delta SaO2 was reduced from 35.6 +/- 9.9 au when breathing air to 14.9 +/- 10.2 au breathing oxygen by nasal prongs (p less than 0.01) and to 13.7 +/- 10.3 au breathing oxygen by economizer (p less than 0.01). The difference between breathing by economizer and nasal prongs was significant (paired t-test; p less than 0.01) only in patients with COPD. One explanation could lie in the different values of the respiratory rate, which was significantly greater in patients with restrictive disease (20.7 +/- 1.2 breaths per minute at rest and 25.8 +/- 1.5 with exercise) than in patients with obstructive disease (15.3 +/- 1.2 breaths per minute at rest and 20.8 +/- 1.4 with exercise).

Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

PubMed

Krakow, Barry; Ulibarri, Victor A

2013-03-01

Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

Breath detection by transcutaneous electromyography of the diaphragm and the Graseby capsule in preterm infants.

PubMed

de Waal, Cornelia G; Kraaijenga, Juliette V; Hutten, Gerard J; de Jongh, Frans H; van Kaam, Anton H

2017-12-01

To compare triggering, breath detection and delay time of the Graseby capsule (GC) and transcutaneous electromyography of the diaphragm (dEMG) in spontaneous breathing preterm infants. In this observational study, a 30 minutes respiration measurement was conducted by respiratory inductance plethysmography (RIP), the GC, and dEMG in stable preterm infants. Triggering was investigated with an in vitro set-up using the Infant Flow ® SiPAP TM system. The possibility to optimize breath detection was tested by developing new algorithms with the abdominal RIP band (RIP AB ) as gold standard. In a subset of breaths, the delay time was calculated between the inspiratory onset in the RIP AB signal and in the GC and dEMG signal. Fifteen preterm infants with a mean gestational age of 28 ± 2 weeks and a mean birth weight of 1086 ± 317 g were included. In total, 14 773 breaths were analyzed. Based on the GC and dEMG signal, the Infant Flow ® SiPAP™ system, respectively, triggered 67.8% and 62.6% of the breaths. Breath detection was improved to 99.9% for the GC and 113.4% for dEMG in new algorithms. In 1492 stable breaths, the median delay time of inspiratory onset detection was +154 ms (IQR +118 to +164) in the GC and -50 ms (IQR -90 to -22) in the dEMG signal. Breath detection using the GC can be improved by optimizing the algorithm. Transcutaneous dEMG provides similar breath detection but with the advantage of detecting the onset of inspiration earlier than the GC. © 2017 Wiley Periodicals, Inc.

Exhaled human breath measurement method for assessing exposure to halogenated volatile organic compounds.

PubMed

Pleil, J D; Lindstrom, A B

1997-05-01

The organic constituents of exhaled human breath are representative of blood-borne concentrations through gas exchange in the blood/breath interface in the lungs. The presence of specific compounds can be an indicator of recent exposure or represent a biological response of the subject. For volatile organic compounds (VOCs), sampling and analysis of breath is preferred to direct measurement from blood samples because breath collection is noninvasive, potentially infectious waste is avoided, and the measurement of gas-phase analytes is much simpler in a gas matrix rather than in a complex biological tissue such as blood. To exploit these advantages, we have developed the "single breath canister" (SBC) technique, a simple direct collection method for individual alveolar breath samples, and adapted conventional gas chromatography-mass spectrometry analytical methods for trace-concentration VOC analysis. The focus of this paper is to describe briefly the techniques for making VOC measurements in breath, to present some specific applications for which these methods are relevant, and to demonstrate how to estimate exposure to example VOCs on the basis of breath elimination. We present data from three different exposure scenarios: (a) vinyl chloride and cis-1,2-dichloroethene from showering with contaminated water from a private well, (b) chloroform and bromodichloromethane from high-intensity swimming in chlorinated pool water, and (c) trichloroethene from a controlled exposure chamber experiment. In all cases, for all subjects, the experiment is the same: preexposure breath measurement, exposure to halogenated VOC, and a postexposure time-dependent series of breath measurements. Data are presented only to demonstrate the use of the method and how to interpret the analytical results.

Relationship between Musical Characteristics and Temporal Breathing Pattern in Piano Performance

PubMed Central

Sakaguchi, Yutaka; Aiba, Eriko

2016-01-01

Although there is growing evidence that breathing is modulated by various motor and cognitive activities, the nature of breathing in musical performance has been little explored. The present study examined the temporal breath pattern in piano performance, aiming to elucidate how breath timing is related to musical organization/events and performance. In the experiments, the respiration of 15 professional and amateur pianists, playing 10 music excerpts in total (from four-octave C major scale, Hanon's exercise, J. S. Bach's Invention, Mozart's Sonatas, and Debussy's Clair de lune), was monitored by capnography. The relationship between breathing and musical characteristics was analyzed. Five major results were obtained. (1) Mean breath interval was shortened for excerpts in faster tempi. (2) Fluctuation of breath intervals was reduced for the pieces for finger exercise and those in faster tempi. Pianists showing large within-trial fluctuation also exhibited large inter-excerpt difference. (3) Inter-trial consistency of the breath patterns depended on the excerpts. Consistency was generally reduced for the excerpts that could be performed mechanically (i.e., pieces for finger exercise), but interestingly, one third of the participant showed consistent patterns for the simple scale, correlated with the ascending/descending sequences. (4) Pianists tended to exhale just after the music onsets, inhale at the rests, and inhibit inhale during the slur parts. There was correlation between breathing pattern and two-voice polyphonic structure for several participants. (5) Respiratory patterns were notably different among the pianists. Every pianist showed his or her own characteristic features commonly for various musical works. These findings suggest that breathing in piano performance depends not only on musical parameters and organization written in the score but also some pianist-dependent factors which might be ingrained to individual pianists. PMID:27516736

Relationship between Musical Characteristics and Temporal Breathing Pattern in Piano Performance.

PubMed

Sakaguchi, Yutaka; Aiba, Eriko

2016-01-01

Although there is growing evidence that breathing is modulated by various motor and cognitive activities, the nature of breathing in musical performance has been little explored. The present study examined the temporal breath pattern in piano performance, aiming to elucidate how breath timing is related to musical organization/events and performance. In the experiments, the respiration of 15 professional and amateur pianists, playing 10 music excerpts in total (from four-octave C major scale, Hanon's exercise, J. S. Bach's Invention, Mozart's Sonatas, and Debussy's Clair de lune), was monitored by capnography. The relationship between breathing and musical characteristics was analyzed. Five major results were obtained. (1) Mean breath interval was shortened for excerpts in faster tempi. (2) Fluctuation of breath intervals was reduced for the pieces for finger exercise and those in faster tempi. Pianists showing large within-trial fluctuation also exhibited large inter-excerpt difference. (3) Inter-trial consistency of the breath patterns depended on the excerpts. Consistency was generally reduced for the excerpts that could be performed mechanically (i.e., pieces for finger exercise), but interestingly, one third of the participant showed consistent patterns for the simple scale, correlated with the ascending/descending sequences. (4) Pianists tended to exhale just after the music onsets, inhale at the rests, and inhibit inhale during the slur parts. There was correlation between breathing pattern and two-voice polyphonic structure for several participants. (5) Respiratory patterns were notably different among the pianists. Every pianist showed his or her own characteristic features commonly for various musical works. These findings suggest that breathing in piano performance depends not only on musical parameters and organization written in the score but also some pianist-dependent factors which might be ingrained to individual pianists.

Mechanics of lung ventilation in a post-metamorphic salamander, Ambystoma Tigrinum.

PubMed

Simons, R S; Bennett, W O; Brainerd, E L

2000-03-01

The mechanics of lung ventilation in frogs and aquatic salamanders has been well characterized, whereas lung ventilation in terrestrial-phase (post-metamorphic) salamanders has received little attention. We used electromyography (EMG), X-ray videography, standard videography and buccal and body cavity pressure measurements to characterize the ventilation mechanics of adult (post-metamorphic) tiger salamanders (Ambystoma tigrinum). Three results emerged: (i) under terrestrial conditions or when floating at the surface of the water, adult A. tigrinum breathed through their nares using a two-stroke buccal pump; (ii) in addition to this narial two-stroke pump, adult tiger salamanders also gulped air in through their mouths using a modified two-stroke buccal pump when in an aquatic environment; and (iii) exhalation in adult tiger salamanders is active during aquatic gulping breaths, whereas exhalation appears to be passive during terrestrial breathing at rest. Active exhalation in aquatic breaths is indicated by an increase in body cavity pressure during exhalation and associated EMG activity in the lateral hypaxial musculature, particularly the M. transversus abdominis. In terrestrial breathing, no EMG activity in the lateral hypaxial muscles is generally present, and body cavity pressure decreases during exhalation. In aquatic breaths, tidal volume is larger than in terrestrial breaths, and breathing frequency is much lower (approximately 1 breath 10 min(-)(1 )versus 4-6 breaths min(-)(1)). The use of hypaxial muscles to power active exhalation in the aquatic environment may result from the need for more complete exhalation and larger tidal volumes when breathing infrequently. This hypothesis is supported by previous findings that terrestrial frogs ventilate their lungs with small tidal volumes and exhale passively, whereas aquatic frogs and salamanders use large tidal volumes and and exhale actively.

SU-E-T-247: Determinations of the Optimal Phase for Respiratory Gated Radiotherapy From Statistical Analysis Using a Visible Guidance System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oh, S; Yea, J; Kang, M

Purpose: Respiratory gated radiation therapy (RGRT) is used to minimize the radiation dose to normal tissue in lung cancer patients. Determination of the optimal point in the respiratory phase of a patient is important in RGRT but it is not easy. The goal of the present study was to see if a visible guidance system is helpful in determining the optimal phase in respiratory gated therapy. Methods: The breathing signals of 23 lung cancer patients were recorded with a Real-time Position Management (RPM) respiratory gating system (Varian, USA). The patients underwent breathing training with our visible guidance system, after whichmore » their breathing signals were recorded during 5 min of free breathing and 5 min of guided breathing. The breathing signals recorded between 3 and 5 min before and after training were compared. We performed statistical analysis of the breathing signals to find the optimal duty cycle in guided breathing for RGRT. Results: The breathing signals aided by the visible guidance system had more regular cycles over time and smaller variations in the positions of the marker block than the free breathing signals. Of the 23 lung cancer patients, 19 showed statistically significant differences by time when the values obtained before and after breathing were compared (p < 0.05); 30% and 40% of the duty cycle, respectively, was determined to be the most effective, and the corresponding phases were 30 60% (duty cycle, 30%; p < 0.05) and 30 70% (duty cycle, 40%; p < 0.05). Conclusion: Respiratory regularity was significantly improved with the use of the RPM with our visible guiding system; therefore, it would help improve the accuracy and efficiency of RGRT.« less

Respiratory rate extraction from pulse oximeter and electrocardiographic recordings.

PubMed

Lee, Jinseok; Florian, John P; Chon, Ki H

2011-11-01

We present an algorithm of respiratory rate extraction using particle filter (PF), which is applicable to both photoplethysmogram (PPG) and electrocardiogram (ECG) signals. For the respiratory rate estimation, 1 min data are analyzed with combination of a PF method and an autoregressive model where among the resultant coefficients, the corresponding pole angle with the highest magnitude is searched since this reflects the closest approximation of the true breathing rate. The PPG data were collected from 15 subjects with the metronome breathing rate ranging from 24 to 36 breaths per minute in the supine and upright positions. The ECG data were collected from 11 subjects with spontaneous breathing ranging from 36 to 60 breaths per minute during treadmill exercises. Our method was able to accurately extract respiratory rates for both metronome and spontaneous breathing even during strenuous exercises. More importantly, despite slow increases in breathing rates concomitant with greater exercise vigor with time, our method was able to accurately track these progressive increases in respiratory rates. We quantified the accuracy of our method by using the mean, standard deviation and interquartile range of the error rates which all reflected high accuracy in estimating the true breathing rates. We are not aware of any other algorithms that are able to provide accurate respiratory rates directly from either ECG signals or PPG signals with spontaneous breathing during strenuous exercises. Our method is near real-time realizable because the computational time on 1 min data segment takes only 10 ms on a 2.66 GHz Intel Core2 microprocessor; the data are subsequently shifted every 10 s to obtain near-continuous breathing rates. This is an attractive feature since most other techniques require offline data analyses to estimate breathing rates.

Volatile organic compounds as breath biomarkers for active and passive smoking.

PubMed

Gordon, Sydney M; Wallace, Lance A; Brinkman, Marielle C; Callahan, Patrick J; Kenny, Donald V

2002-07-01

We used real-time breath measurement technology to investigate the suitability of some volatile organic compounds (VOCs) as breath biomarkers for active and passive smoking and to measure actual exposures and resulting breath concentrations for persons exposed to tobacco smoke. Experiments were conducted with five smoker/nonsmoker pairs. The target VOCs included benzene, 1,3-butadiene, and the cigarette smoke biomarker 2,5-dimethylfuran. This study includes what we believe to be the first measurements of 1,3-butadiene in smokers' and nonsmokers' breath. The 1,3-butadiene and 2,5-dimethylfuran peak levels in the smokers' breath were similar (360 and 376 microg/m(3), respectively); the average benzene peak level was 522 microg/m(3). We found higher peak values of the target chemicals and shorter residence times in the body than previously reported, probably because of the improved time resolution made possible by the continuous breath measurement method. The real-time breath analyzer also showed the presence of the chemicals after exposure in the breath of the nonsmokers, but at greatly reduced levels. Single breath samples collected in evacuated canisters and analyzed independently with gas chromatography/mass spectrometry confirmed the presence of the target compounds in the postexposure breath of the nonsmokers but indicated that there was some contamination of the breath analyzer measurements. This was likely caused by desorption of organics from condensed tar in the analyzer tubing and on the quartz fiber filter used to remove particles. We used the decay data from the smokers to estimate residence times for the target chemicals. A two-compartment exponential model generally gave a better fit to the experimental decay data from the smokers than a single-compartment model. Residence times for benzene, 1,3-butadiene, and 2,5-dimethylfuran ranged from 0.5 (1,3-butadiene) to 0.9 min (benzene) for tau1 and were essentially constant (14 min) for tau2. These findings will be useful in models of environmental tobacco smoke exposure and risk.