Eucapnic voluntary hyperventilation is superior to methacholine challenge testing for detecting airway hyperreactivity in nonathletes.

Introduction: Response to eucapnic voluntary hyperventilation (EVH) has not been compared with methacholine challenge testing (MCCT) in nonathletes being evaluated for dyspnea on exertion.

Objective: To determine the airway response to EVH and MCCT in a population of nonathletes who exercise regularly but have symptoms with exertion.

Methods: We reviewed records for all patients with exercise symptoms who underwent both EVH and MCCT.

Fatal transfusion-associated graft-versus-host disease with concomitant immune hemolysis in a group A combat trauma patient resuscitated with group O fresh whole blood.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but well-established fatal complication of blood transfusion. It can occur in immunocompetent patients when they receive transfusions from human leukocyte antigen-haploidentical donors who have lymphocytes with antigens that are not recognized as foreign by the host, but that recognize the host's tissues as foreign. It is generally viewed as a T-cell-mediated process.

Racial discordance in spirometry comparing four commonly used reference equations to the National Health and Nutrition Examination Study III.

Diagnosing lung function abnormalities requires application of the appropriate reference equation for a given patient population. Current guidelines recommend the National Health and Examination Study III data set for evaluating patients in the United States. In Caucasian patients, relying on older reference equations, as opposed to those derived from the NHANES III data set, will often result in a different interpretation of a patient's spirometry.

Effects of a short course of eszopiclone on continuous positive airway pressure adherence: a randomized trial.

Background: Adherence to short-term continuous positive airway pressure (CPAP) may predict long-term use. Unfortunately, initial CPAP intolerance may lead to poor adherence or abandonment of therapy.

Objective: To determine whether a short course of eszopiclone at the onset of therapy improves long-term CPAP adherence more than placebo in adults with obstructive sleep apnea.

The impact of split-night versus traditional sleep studies on CPAP compliance.

Background: Split-night polysomnography allows for the diagnosis of obstructive sleep apnea and titration of continuous positive airway pressure in a single study. However, there is concern that split-night studies do not provide sufficient time for optimal continuous positive airway pressure (CPAP) titration, which may lead to a poor initial experience with CPAP and potentially, worse adherence. Our goal was to determine whether CPAP use, after a split-night examination, is comparable to the use following separate diagnostic and titration studies.

Clinical and polysomnographic predictors of short-term continuous positive airway pressure compliance.

Background: Poor compliance and initial intolerance limit the effectiveness of continuous positive airway pressure (CPAP) in obstructive sleep apnea. Short-term compliance has been shown to predict long-term use. Unfortunately, few identified variables reliably predict initial CPAP tolerance and use.

The prevalence and impact of respiratory symptoms in asthmatics and nonasthmatics during deployment.

Objective: The purpose of this study was to compare the prevalence, severity, and impact of respiratory symptoms in asthmatics and nonasthmatics during Operation Enduring Freedom and Operation Iraqi Freedom.

Methods: A survey was given to 1,250 active duty soldiers and Department of Defense contractors returning from Operation Enduring Freedom/Operation Iraqi Freedom. Subjects were asked about demographics, smoking habits, respiratory symptoms, and impact on job performance before and during deployment.

Bacteriology of war wounds at the time of injury.

Bacterial contamination of war wounds occurs either at the time of injury or during the course of therapy. Characterization of the bacteria recovered at the time of initial trauma could influence the selection of empiric antimicrobial agents used to prevent infection. In the spring of 2004, U.

Bacteria recovered from patients admitted to a deployed U.S. military hospital in Baghdad, Iraq.

The predominant bacteria and antimicrobial susceptibilities were surveyed from a deployed, military, tertiary care facility in Baghdad, Iraq, serving U.S. troops, coalition forces, and Iraqis, from August 2003 through July 2004.

Medical problems of detainees after the conclusion of major ground combat during Operation Iraqi Freedom.

After the conclusion of major ground combat operations during Operation Iraqi Freedom, the focus of the mission changed, although intense armed conflict continued. Included in this mission was management of security detainees, including provision of their medical care. We retrospectively reviewed the admission records identified at a short-term holding facility over 2 months and diagnoses of detainees admitted to a combat support hospital over 4 months as a health care service utilization statistics review.

Inhalational exposure to nerve agents.

The respiratory system plays a major role in the pathogenesis of nerve agent toxicity. It is the major route of entry and absorption of nerve agent vapor, and respiratory failure is the most common cause of death follow-ing exposure. Respiratory symptoms are mediated by chemical irritation,muscarinic and nicotinic receptor overstimulation, and central nervous system effects.