Facemask design, facial deposition, and delivered dose of nebulized aerosols.

Nebulizers are often interfaced to patients using facemasks, especially when the patient is sick and uncooperative. Tight-fitting masks are thought to improve drug delivery, but recent studies have indicated that facemask seal can impact facial and eye deposition of aerosol. The purpose of the present study was to define the factors that influence drug delivery to the lung in pediatric patients using nebulizers and facemasks; particularly the roles of facemask seal, mask vents and nebulizer flow.

Stenting of atherosclerotic stenoses in anomalously arising coronary arteries.

This description of five cases brings to 37 the total number of reported patients in whom atherosclerotic lesions of anomalously arising coronary arteries have been stented. One-half of these have been right coronary arteries arising from the left sinus of Valsalva, followed in frequency by branches of single coronary arteries arising from solitary aortic ostia and left circumflex arteries arising from the right sinus of Valsalva or from the proximal portion of the right coronary artery. Proper guide-catheter selection, essential for successful stenting, usually matches the guide's configuration to the sinus of Valsalva from which the anomalous artery originates rather than to the final distribution of the coronary artery.

Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation.

Aerosol delivery via a mechanical ventilator remains unregulated with no standards for drug delivery to intubated patients. Bench models predicting drug delivery have not been validated in vivo. For modern ventilator designs, we chose to identify, on the bench, the most important variables affecting aerosol delivery and to correlate in vitro predictions of aerosol delivery with in vivo end points independent of patient response.

Risk factors among medically indigent women < or = 45 years old with angiographically proven obstructive coronary arterial disease.

Background: Risk factors for angiographically proven coronary arterial disease (CAD) have not been assessed in a large cohort of young medically indigent women, who are known to have more CAD than better educated and more affluent women.

Methods: In a 2-year period, 165 medically indigent women < or = 45 years old underwent coronary arteriography for symptoms suggesting CAD. We compared the prevalence of risk factors in the 100 with obstructive CAD with the prevalence in the 65 with non-obstructive or no CAD.