High-velocity nasal insufflation versus noninvasive positive pressure ventilation for moderate acute exacerbation of chronic obstructive pulmonary disease in the emergency department: A randomized clinical trial.

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department (ED) involve dyspnea, cough, and chest discomfort; frequent exacerbations are associated with increased mortality and reduced quality of life. Noninvasive positive pressure ventilation (NiPPV) is commonly used to help relieve symptoms but is limited due to patient intolerance. We aimed to determine whether high-velocity nasal insufflation (HVNI) is noninferior to NiPPV in relieving dyspnea within 4 h in ED patients with acute hypercapnic respiratory failure.

The influence of wear paths produced by hip replacement patients during normal walking on wear rates.

Variation in wear paths is known to greatly affect wear rates in vitro, with multidirectional paths producing much greater wear than unidirectional paths. This study investigated the relationship between multidirectional motion at the hip joint, as measured by aspect ratio, sliding distance, and wear rate for 164 hip replacements. Kinematic input from three-dimensional gait analysis was used to determine the wear paths.

The validity of an existing gait classification system when applied to a representative population of children with hemiplegia.

This study describes sagittal plane gait patterns in a representative sample of children with hemiplegic cerebral palsy (CP). Ninety-four children were prospectively recruited to the study (age range 5-18 yrs, mean age 10 yrs 7 mo) and valid kinematic data was captured for 91 participants. Data was also captured for 49 children (age range 5-18 yrs, mean age 10 yrs) with no physical impairment.