Baseline Spirometry as a Predictor of Positive Methacholine Challenge Testing for Exertional Dyspnea.

Background: There are several tests recommended by the American Thoracic Society (ATS) to evaluate for airway hyper-responsiveness (AHR), one of which is methacholine challenge testing (MCT). Few studies have examined the correlation of baseline spirometry to predict AHR in MCT, especially in the younger, relatively healthy military population under clinical evaluation for symptoms of exertional dyspnea. The study aim was to retrospectively correlate baseline spirometry values with MCT responsiveness.

Longitudinal Changes in Spirometry in Deployed Air Force Firefighters.

Introduction: Inhalational exposures are common among service members who deploy to southwest Asia. The objective of this study is to determine if deployed Air Force firefighters have any decline in spirometry related to deployment.

Methods: This study is a retrospective chart review.

Evaluation of Supranormal Spirometry Values With an Obstructive Ratio for Airway Hyperreactivity.

Background: Published guidelines on spirometry interpretation suggest an elevated FVC and FEV1 > 100% of predicted with an obstructive ratio may represent a physiological variant. Further evidence is needed on whether this finding indicates symptomatic airways obstruction and what additional evaluation should be done.

Methods: Participants were prospectively enrolled to undergo additional testing for a technically adequate spirometry study with an FEV1 > 90% of predicted, and FEV1/FVC below the lower limit of normal, based on 95th percentile confidence intervals.

Clinical Evaluation of Deployed Military Personnel With Chronic Respiratory Symptoms: Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures (STAMPEDE) III.

Background: Chronic respiratory symptoms are frequently reported after Southwest Asia deployment in support of combat operations. The full spectrum of clinical lung diseases related to these deployments is not well characterized.

Methods: Military personnel with chronic symptoms, primarily exertional dyspnea, underwent a standardized cardiopulmonary evaluation at two tertiary medical centers.

Pulmonary Function and Respiratory Health of Military Personnel Before Southwest Asia Deployment.

Background: Significant concern exists regarding the respiratory health of military personnel deployed to Southwest Asia, given their exposures to numerous environmental hazards. Although the deployed military force is generally assumed to be fit, the pre-deployment respiratory health of these individuals is largely unknown.

Methods: Soldiers deploying to Southwest Asia were recruited from the pre-deployment processing center at Fort Hood, Texas.

Effects of Electrolyte Replacement Protocol Implementation in a Medical Intensive Care Unit.

Purpose: To evaluate the effects of electrolyte replacement protocol (ERP) implementation in the medical intensive care unit (MICU) setting. We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement.

Methods: This was a retrospective review of electronic medical record data before and after implementation of a standardized ERP in an 18-bed military tertiary care MICU.

Transudative chylothorax from cirrhosis complicated by lung entrapment.

A patient with long-standing cirrhosis due to hepatitis C and hepatic hydrothorax was evaluated for increasing symptoms and presence of a large right pleural effusion. Thoracentesis revealed evidence of a chylothorax with rapid reaccumulation of pleural fluid. Repeat thoracentesis with manometry identified presence of entrapped lung which complicated treatment options.