Predictors of Obstructive Sleep Apnea on Polysomnography after a Technically Inadequate or Normal Home Sleep Test.

Study Objectives: Home sleep testing (HST) is an accepted alternative to polysomnography (PSG) for diagnosing obstructive sleep apnea (OSA) in high-risk populations. Clinical guidelines recommend PSG in cases where the HST is technically inadequate (TI) or fails to establish the diagnosis of OSA in patients with high pretest probability. This retrospective study evaluated predictors of OSA on PSG within patients who had a TI or normal HST.

Clinical control in the dual diagnosis of obstructive sleep apnea syndrome and rhinitis: a prospective analysis.

Background: Obstructive sleep apnea syndrome (OSAS) and allergic rhinitis (AR) are common coexisting disorders. Upper airway, specifically nasal resistance, is thought to increase during exacerbations of AR and nonallergic rhinitis (NAR), as well as in OSAS. The study objective was to determine if a correlation exists between clinical control of rhinitis and OSAS.

Development of transcriptomic biomarker signature in human saliva to detect lung cancer.

Lung cancer is the leading cause of cancer death for both men and women worldwide. Since most of the symptoms found for lung cancer are nonspecific, diagnosis is mostly done at late and progressed stage with the consecutive poor therapy outcome. Effective early detection techniques are sorely needed.

Contralateral decubitus positioning enhances computed tomographic angiographic evaluation of pulmonary vasculature in a patient with a pulmonary arteriovenous malformation.

Computed tomographic pulmonary angiography has become the diagnostic procedure of choice in patients suspected of having a pulmonary embolus. However, intrapulmonary shunting of blood in a variety of pathologic conditions can cause suboptimal opacification of the pulmonary arterial circulation and result in a suboptimal or even nondiagnostic study. Radiologists should be aware of these conditions and be familiar with positioning techniques to minimize such shunting.

Prevalence of comorbid obstructive sleep apnea and metabolic syndrome: syndrome Z and maxillofacial surgery implications.

Purpose: To determine the prevalence of the recently identified syndrome Z (SZ), which is the co-occurrence of obstructive sleep apnea (OSA; hypoxia, systemic and pulmonary hypertension, nocturnal arrhythmias) and metabolic syndrome (MetS; increased abdominal girth, hypertriglyceridemia, decreased high-density lipoprotein, hypertension, increased fasting glucose), which places the surgical patient at heightened risk of perioperative complications (myocardial infarction, stroke, pneumonia, wound infection).

Materials And Methods: Electronic medical records of 296 male veterans were assessed for the presence of SZ using the American Academy of Sleep Medicine definition of OSA and a modified Adult Treatment Panel III definition of MetS, where obesity was defined by a body mass index of at least 30 kg/m(2) rather than by waist circumference.

Results: SZ was diagnosed in 59% of patients.

Anxiety during respirator use: comparison of two respirator types.

Anxiety may interfere with proper respirator use. This study directly compares the effect of two types of respirators--elastomeric half-face mask with dual-cartridges (HFM) and N95 filtering facepiece--on anxiety levels. Twelve volunteers with normal or mildly impaired respiratory conditions performed a series of simulated work tasks using the HFM and N95 on different days.

Respirator impact on work task performance.

Objective: Respirators are used to maintain work performance and protect against inhaled toxins. The study compared the effects of two commonly used respirator classes--dual cartridge half face mask (HFM) and filtering face piece (N95)--upon work productivity.

Methods: 107 volunteers performed eight simulated work tasks when using the HFM and N95 respirators.

Respirator physiologic impact in persons with mild respiratory disease.

Objective: To assess whether mild respiratory disease affects physiologic adaptation to respirator use.

Methods: The study compared the respiratory effects of dual cartridge half face mask and filtering facepeice (N95) respirators while performing simulated-work tasks. Subjects with mild chronic obstructive pulmonary disease (n = 14), asthma (n = 42), chronic rhinitis (n = 17), and normal respiratory status (n = 24) were studied.

Subjective response to respirator type: effect of disease status and gender.

Objective: To assess the effect of respirator type and user characteristics (eg, health status) on the subjective response to respirator use.

Methods: The subjective responses for multiple domains were evaluated in 104 volunteers performing work tasks in a simulated work environment. Each used a dual cartridge half face mask and a filtering facepiece (N95) respirator.

Respirator physiological effects under simulated work conditions.

This study compared the physiological impacts of two respirator types in simulated work conditions. Fifty-six subjects included normal volunteers and persons with mild respiratory impairments (chronic rhinitis, mild COPD, and mild asthma). Respiratory parameters and electrocardiogram were measured using respiratory inductive plethysmography while performing eight work tasks involving low to moderate exertion using two respirators: (1) a dual cartridge half face mask (HFM) respirator, and (2) the N95.

Multidomain subjective response to respirator use during simulated work.

Objective: : Evaluate subjective tolerance to respirator use outside of traditional industrial settings by users including persons with mild respiratory impairment.

Methods: : The response to respirator use (half face mask dual cartridge and N95) was measured during eight types of work activities as well as in an exercise laboratory setting. The 43 research subjects included persons with mild respiratory impairments.

Efficacy of pursed-lips breathing: a breathing pattern retraining strategy for dyspnea reduction.

Purpose: Breathing pattern retraining is frequently used for exertional dyspnea relief in adults with moderate to severe chronic obstructive pulmonary disease. However, there is contradictory evidence to support its use. The study objective was to compare 2 programs of prolonging expiratory time (pursed-lips breathing and expiratory muscle training) on dyspnea and functional performance.

Idiopathic pulmonary fibrosis: evaluation with positron emission tomography.

Background: The pathogenesis of interstitial lung disease remains under investigation, but may be related to increased inflammatory or cellular activity. This activity may be detectable with physiologic imaging.

Objectives: We investigated the role of physiologic imaging using (18)F-2-fluoro-2-deoxy-D-glucose ((18)FDG)-positron emission tomography (PET) scans in idiopathic pulmonary fibrosis (IPF).

Usefulness of the human activity profile, a functional performance measure, in people with chronic obstructive pulmonary disease.

Purpose: To further evaluate the usefulness of the Human Activity Profile (HAP) as a functional performance measure for those with chronic obstructive pulmonary disease (COPD).

Methods: Phase 1. The sample consisted of 53 outpatients (51 male) with stable COPD (forced expiratory volume in 1 second% predicted (FEV1% pred) = 38 +/- 14 (mean +/- standard deviation) at a university-affiliated veterans affairs medical center.

Pulmonary hypertension in men with thyrotoxicosis.

Thyrotoxicosis has a myriad of respiratory symptoms including dyspnea. Pulmonary hypertension may contribute to the respiratory symptoms of thyrotoxicosis, but is often unrecognized. We describe 3 male patients with thyrotoxicosis and associated pulmonary hypertension.

Racial differences pertaining to a belief about lung cancer surgery: results of a multicenter survey.

Background: Patients at the Philadelphia Veterans Affairs Medical Center frequently voice concern that air exposure during lung cancer surgery might cause tumor spread. Several African-American patients asserted that this belief was common in the African-American community.

Objective: To assess the prevalence of the belief that air exposure during lung cancer surgery might cause tumor spread and gauge the influence of this belief on the willingness of African-American and white patients to have lung cancer surgery.