Blood Biochemistry Analysis to Detect Smoking Status and Quantify Accelerated Aging in Smokers.

There is an association between smoking and cancer, cardiovascular disease and all-cause mortality. However, currently, there are no affordable and informative tests for assessing the effects of smoking on the rate of biological aging. In this study we demonstrate for the first time that smoking status can be predicted using blood biochemistry and cell count results andthe recent advances in artificial intelligence (AI).

Effects of high-frequency chest wall oscillation on pleural pressure and oscillated flow.

The effectiveness of high-frequency chest wall oscillation (HF-CWO) is directly related to the level of oscillated flow (osc) in the airways. We used the Vest system to investigate the effects of HFCWO on chest wall and pleural pressures and we correlated these pressures to the resultant osc. We also compared the latest HFCWO device with it predecessor.

Approach to outpatient management of adult sleep apnea.

Objective: To describe an approach to sleep apnea for family physicians based on a review of current practice limitations for Canadian family physicians, validated risk prediction tools, and ambulatory sleep apnea technologies.

Sources Of Information: Published epidemiologic studies focused on family practice management of sleep apnea, clinical practice guidelines, risk prediction tools for sleep apnea, randomized controlled treatment trials, and the author's community practice audit. Evidence was levels I, II, and III.

The pulse oxygen saturation: inspired oxygen pressure (SpO2:PIO2) diagram: application in the ambulatory assessment of pulmonary vascular disease.

Background: The inspired oxygen to pulse saturation (SpO2:PIO2) curve mirrors the oxyhaemoglobin dissociation curve but is shifted to the right by the difference between inspired and alveolar oxygen fractions. Inspection of the curve has been used to discern changes in shunt.

Aims: We aimed to demonstrate the SpO2: PIO2 curve's quantification using readily available software, and its clinical utility in assessing ambulatory patients.

Immunological diagnosis of cutaneous-pulmonary hypersensitivity vasculitis.

A 47-year-old woman had episodic dyspnoea, fatigue, chest radiograph opacifications, and palpable purpura whose biopsy showed leucocytoclastic vasculitis. Negative immunoglobulin A immunofluorescence staining and clinical exclusion of other disorders narrowed her diagnosis to cutaneous pulmonary hypersensitivity vasculitis.

Drotrecogin alpha (activated) in two patients with the hantavirus cardiopulmonary syndrome.

Hantavirus cardiopulmonary syndrome (HCPS) is associated with rapid cardiopulmonary collapse from endothelial injury, resulting in massive capillary leak, shock and severe hypoxemic respiratory failure. To date, treatment remains supportive and includes mechanical ventilation, vasopressors and extracorporeal membrane oxygenation, with mortality approaching 50%. Two HCPS survivors initially given drotrecogin alpha (activated) (DAA) for presumed bacterial septic shock are described.

Improving adherence to a mechanical ventilation weaning protocol for critically ill adults: outcomes after an implementation program.

Background: Despite multiple reminders, education sessions, and multidisciplinary team involvement, adherence to an evidence-based mechanical ventilation weaning protocol had been less than 1% in a general systems intensive care unit since implementation.

Objective: To assess the effectiveness of using an implementation program, the Model for Accelerating Improvement, to improve adherence and clinical outcomes after restarting a mechanical ventilation weaning protocol in an adult general systems intensive care unit.

Methods: A prospective comparative design, before and after implementation of the Model for Accelerating Improvement, was used with a consecutive sample of 129 patients and 112 multidisciplinary team members.

Pharmacokinetics of rofecoxib: a specific cyclo-oxygenase-2 inhibitor.

Rofecoxib is a commonly used specific cyclo-oxygenase-2 (COX-2) inhibitor. Rofecoxib has high bioavailability, poor aqueous solubility, an elimination half-life suitable for daily administration and a volume of distribution approximating body mass. Species-specific, predominantly hepatic, metabolism occurs, with novel enterohepatic circulation in rats and O-glucuronidation by uridine diphosphate-glucuronosyl transferase (UGT) 2B7 and 2B15 in human liver microsomes.