Short-term effects of positive expiratory pressure mask on ventilation inhomogeneity in children with cystic fibrosis: A randomized, sham-controlled crossover study.

Background: Can physiotherapy with a positive expiratory pressure (PEP) mask improve peripheral ventilation inhomogeneity, a typical feature of children with cystic fibrosis (cwCF)? To answer this question, we used the nitrogen multiple-breath washout (NMBW) test to measure diffusion-convection-dependent inhomogeneity arising within the intracinar compartment (S*VT).

Methods: For this randomized, sham-controlled crossover trial, two NMBW tests were performed near the hospital discharge date: one before and the other after PEP mask therapy (1 min of breathing through a flow-dependent PEP device attached to a face mask, followed by three huffs and one cough repeated 10 times) by either a standard (10-15 cmH0) or a sham (<5 cmH0) procedure on two consecutive mornings. Deception entailed misinforming the subjects about the nature of the study; also the NMBW operators were blinded to treatment allocation.

Surgery for near occlusion of the internal carotid arteries. A single center experience.

Several experiences have shown the benefits of carotid endarterectomy (CEA) to treat symptomatic acute occlusion of common and internal carotid arteries. Instead, surgery for carotid near occlusion remains controversial. We report successful surgical treatment in three patients with near occluded carotid artery.