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Sample records for adjusted ventilatory assist

  1. Neurally adjusted ventilatory assist : from animal studies to clinical practice

    Campoccia Jalde, Francesca

    2016-01-01

    Patients in the Intensive Care Unit (ICU) undergoing ventilator treatment may experience asynchrony with the ventilator, which has been associated with increased need of sedation, sleep disruption, prolonged mechanical ventilation and unsuccessful weaning from the ventilator. The search for new strategies to improve patient-ventilator interaction is ongoing. Neurally Adjusted Ventilatory Assist (NAVA) is a recently developed ventilator support that uses the Electrical Activity of the diaphrag...

  2. Non-invasive ventilation with neurally adjusted ventilatory assist in newborns.

    Stein, Howard; Beck, Jennifer; Dunn, Michael

    2016-06-01

    Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient. Since NAVA uses the diaphragm electrical activity (Edi) as the controller signal, it is possible to deliver synchronized non-invasive NAVA (NIV-NAVA) regardless of leaks and to monitor continuously patient respiratory pattern and drive. Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction, reliable respiratory monitoring and self-regulation of respiratory support. In theory, these characteristics make NIV-NAVA an ideal mode to provide effective, appropriate non-invasive support to newborns with respiratory insufficiency. NIV-NAVA has been successfully used clinically in neonates as a mode of ventilation to prevent intubation, to allow early extubation, and as a novel way to deliver nasal continuous positive airway pressure. The use of NAVA in neonates is described with an emphasis on studies and clinical experience with NIV-NAVA. PMID:26899957

  3. A prospective crossover comparison of neurally adjusted ventilatory assist and pressure-support ventilation in a pediatric and neonatal intensive care unit population.

    Breatnach, Cormac

    2012-02-01

    OBJECTIVE: To compare neurally adjusted ventilatory assist ventilation with pressure-support ventilation. DESIGN: Prospective, crossover comparison study. SETTING: Tertiary care pediatric and neonatal intensive care unit. PATIENTS: Sixteen ventilated infants and children: mean age = 9.7 months (range = 2 days-4 yrs) and mean weight = 6.2 kg (range = 2.4-13.7kg). INTERVENTIONS: A modified nasogastric tube was inserted and correct positioning was confirmed. Patients were ventilated in pressure-support mode with a pneumatic trigger for a 30-min period and then in neurally adjusted ventilatory assist mode for up to 4 hrs. MEASUREMENTS AND MAIN RESULTS: Data collected for comparison included activating trigger (neural vs. pneumatic), peak and mean airway pressures, expired minute and tidal volumes, heart rate, respiratory rate, pulse oximetry, end-tidal CO2 and arterial blood gases. Synchrony was improved in neurally adjusted ventilatory assist mode with 65% (+\\/-21%) of breaths triggered neurally vs. 35% pneumatically (p < .001) and 85% (+\\/-8%) of breaths cycled-off neurally vs. 15% pneumatically (p = .0001). The peak airway pressure in neurally adjusted ventilatory assist mode was significantly lower than in pressure-support mode with a 28% decrease in pressure after 30 mins (p = .003) and 32% decrease after 3 hrs (p < .001). Mean airway pressure was reduced by 11% at 30 mins (p = .13) and 9% at 3 hrs (p = .31) in neurally adjusted ventilatory assist mode although this did not reach statistical significance. Patient hemodynamics and gas exchange remained stable for the study period. No adverse patient events or device effects were noted. CONCLUSIONS: In a neonatal and pediatric intensive care unit population, ventilation in neurally adjusted ventilatory assist mode was associated with improved patient-ventilator synchrony and lower peak airway pressure when compared with pressure-support ventilation with a pneumatic trigger. Ventilating patients in this new mode

  4. Roles of neurally adjusted ventilatory assist in improving gas exchange in a severe acute respiratory distress syndrome patient after weaning from extracorporeal membrane oxygenation: a case report

    Goto, Yuya; Katayama, Shinshu; Shono, Atsuko; Mori, Yosuke; Miyazaki, Yuya; Sato, Yoko; Ozaki, Makoto; Kotani, Toru

    2016-01-01

    Background Patient-ventilator asynchrony is a major cause of difficult weaning from mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is reported useful to improve the synchrony in patients with sustained low lung compliance. However, the role of NAVA has not been fully investigated. Case presentation The patient was a 63-year-old Japanese man with acute respiratory distress syndrome secondary to respiratory infection. He was treated with extracorporeal membrane oxygenation ...

  5. A randomized clinical trial of neurally adjusted ventilatory assist versus conventional weaning mode in patients with COPD and prolonged mechanical ventilation

    Kuo NY

    2016-05-01

    Full Text Available Nai-Ying Kuo,1,2 Mei-Lien Tu,1,3 Tsai-Yi Hung,1 Shih-Feng Liu,4 Yu-Hsiu Chung,4 Meng-Chih Lin,4 Chao-Chien Wu41Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital; 2Kaohsiung Medical University; 3Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan; 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanBackground: Patient-ventilator asynchrony is a common problem in mechanically ventilated patients; the problem is especially obvious in COPD. Neutrally adjusted ventilatory assist (NAVA can improve patient-ventilator asynchrony; however, the effect in COPD patients with prolonged mechanical ventilation is still unknown. The goals of this study are to evaluate the effect of NAVA and conventional weaning mode in patients with COPD during prolonged mechanical ventilation.Methods: The study enrolled a total of 33 COPD patients with ventilator dependency for more than 21 days in the weaning center. A diaphragm electrical activity (Edi catheter was inserted in patients within 24 hours after admission to the respiratory care center, and patients were randomly allocated to NAVA or conventional group. A spontaneous breathing trial was performed every 24 hours. The results correlated with the clinical parameters.Results: There were significantly higher asynchrony incidence rates in the whole group after using Edi catheter (before vs post-Edi catheter insertion =60.6% vs 87.9%, P<0.001. Asynchrony index: before vs post-Edi catheter insertion =7.4%±8.5% vs 13.2%±13.5%, P<0.01. Asynchrony incidence: NAVA vs conventional =0% vs 84.2%, P<0.001. Asynchrony index: NAVA vs conventional =0 vs 11.9±11.2 (breath %, P<0.001. The most common asynchrony events were ineffective trigger and delayed trigger. Conclusion: Compared to conventional mode, NAVA mode can significantly enhance

  6. A randomized clinical trial of neurally adjusted ventilatory assist versus conventional weaning mode in patients with COPD and prolonged mechanical ventilation

    Kuo, Nai-Ying; Tu, Mei-Lien; Hung, Tsai-Yi; Liu, Shih-Feng; Chung, Yu-Hsiu; Lin, Meng-Chih; Wu, Chao-Chien

    2016-01-01

    Background Patient-ventilator asynchrony is a common problem in mechanically ventilated patients; the problem is especially obvious in COPD. Neutrally adjusted ventilatory assist (NAVA) can improve patient-ventilator asynchrony; however, the effect in COPD patients with prolonged mechanical ventilation is still unknown. The goals of this study are to evaluate the effect of NAVA and conventional weaning mode in patients with COPD during prolonged mechanical ventilation. Methods The study enrolled a total of 33 COPD patients with ventilator dependency for more than 21 days in the weaning center. A diaphragm electrical activity (Edi) catheter was inserted in patients within 24 hours after admission to the respiratory care center, and patients were randomly allocated to NAVA or conventional group. A spontaneous breathing trial was performed every 24 hours. The results correlated with the clinical parameters. Results There were significantly higher asynchrony incidence rates in the whole group after using Edi catheter (before vs post-Edi catheter insertion =60.6% vs 87.9%, PEdi catheter insertion =7.4%±8.5% vs 13.2%±13.5%, P<0.01. Asynchrony incidence: NAVA vs conventional =0% vs 84.2%, P<0.001. Asynchrony index: NAVA vs conventional =0 vs 11.9±11.2 (breath %), P<0.001. The most common asynchrony events were ineffective trigger and delayed trigger. Conclusion Compared to conventional mode, NAVA mode can significantly enhance respiratory monitoring and improve patient-ventilator interaction in COPD patients with prolonged mechanical ventilation in respiratory care center. PMID:27274216

  7. "Optimal" application of ventilatory assist in Cheyne-Stokes respiration: a simulation study.

    Khoo, M C; Benser, M E

    2005-01-01

    Although a variety of ventilator therapies have been employed to treat Cheyne-Stokes respiration (CSR), these modalities do not completely eliminate CSR. As well, most current strategies require that ventilatory assist be provided continuously. We used a computer model of the respiratory control system to determine whether a ventilatory assist strategy could be found that would substantially reduce the severity of CSR while minimizing the application of positive airway pressure. We assessed the effects of different levels of ventilatory assist applied during breaths that fell below selected hypopneic thresholds. These could be applied during the descending, ascending, or both phases of the CSR cycle. We found that ventilatory augmentation equal to 30-40% of eupneic drive, applied whenever ventilation fell below 70% of the eupneic level during the ascending or descending-and-ascending phases of CSR led to the greatest regularization of breathing with minimal ventilator intervention. Application of ventilatory assist during the descending phase produced little effect. PMID:17281585

  8. 75 FR 59684 - Trade Adjustment Assistance for Farmers

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the Trade Adjustment Assistance for Farmers... adjustment assistance in FY 2011. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for...

  9. Trade Liberalization and Trade Adjustment Assistance

    Fung, K. C.; Staiger, Robert W.

    1994-01-01

    We explore the relationship between trade adjustment subsidies and successful reciprocal trade liberalization. We consider economies that are faced with a periodic need to move resources out of a declining import-competing sector, and that are attempting to sustain cooperative but self-enforcing trade agreements in the face of these adjustment needs. If the limitations associated with enforcement of international trade agreements are sufficiently severe, trade adjustment assistance can facili...

  10. 75 FR 59681 - Trade Adjustment Assistance for Farmers

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief Economist... adjustment assistance in FY 2011. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for...

  11. 75 FR 59683 - Trade Adjustment Assistance for Farmers

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... for Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief... assistance in FY 2011. FOR FURTHER INFORMATION, CONTACT: Trade Adjustment Assistance for Farmers...

  12. 75 FR 59685 - Trade Adjustment Assistance for Farmers

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the Trade Adjustment Assistance for Farmers... assistance in FY 2011. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program...

  13. 75 FR 63437 - Trade Adjustment Assistance for Farmers

    2010-10-15

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief Economist... CONTACT: Trade Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA,...

  14. 75 FR 23667 - Trade Adjustment Assistance for Farmers

    2010-05-04

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... site for the Trade Adjustment Assistance for Farmers program. The URL is...

  15. 75 FR 59682 - Trade Adjustment Assistance for Farmers

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the Trade Adjustment Assistance for Farmers... Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA, or by phone at...

  16. 75 FR 43140 - Trade Adjustment Assistance for Farmers

    2010-07-23

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... assistance and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Staff... ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: July 14, 2010....

  17. Ventilation-perfusion scans in neonatal regional pulmonary emphysema complicating ventilatory assistance

    Two cases of ventilator-related neonatal lobar overexpansion with similar radiographic appearance, but probably different pathogenesis, are presented. In one infant, persistent interstitial lobar emphysema was confirmed by markedly decreased perfusion shown on scintigraphy; this information was of great value in predicting the beneficial effect of lobectomy. In the other case, ventilation and perfusion scans indicated functional value of the emphysematous lobe and correctly suggested conservative management. Radioisotope lung scans may provide valuable information regarding lung function in regional pulmonary emphysema associated with assisted ventilation in neonatal respiratory distress syndrome, and thus determine patient management

  18. 75 FR 49458 - Trade Adjustment Assistance for Farmers

    2010-08-13

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service.... FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by... TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: August 3, 2010. Suzanne...

  19. 75 FR 28780 - Trade Adjustment Assistance for Farmers

    2010-05-24

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Trade Adjustment Assistance (TAA) for Farmers petitions for Fiscal Year 2011. Petitioners must file the... Reinvestment Act of 2009 (Pub. L. 111-5) reauthorized the TAA for Farmers Program as established by Subtitle...

  20. 75 FR 48931 - Trade Adjustment Assistance for Farmers

    2010-08-12

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone... Farmers' Web site: www.fas.usda.gov/itp/taa . Dated: July 30, 2010. John D. Brewer, Administrator,...

  1. 75 FR 23227 - Trade Adjustment Assistance for Farmers

    2010-05-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Adjustment Assistance for Farmers program. The URL is http://www.fas.usda.gov/itp/taa . Dated: April 27,...

  2. 75 FR 43485 - Trade Adjustment Assistance for Farmers

    2010-07-26

    ...; ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY...: Trade Adjustment Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site:...

  3. 75 FR 11513 - Trade Adjustment Assistance for Farmers

    2010-03-11

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Adjustment Assistance (TAA) for Farmers petitions for fiscal year 2010 beginning March 11, 2010. Petitioners... in accordance with 7 CFR part 1580.201. The petition must be received by the TAA for Farmers Staff...

  4. 75 FR 48642 - Trade Adjustment Assistance for Farmers

    2010-08-11

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site:...

  5. 75 FR 45092 - Trade Adjustment Assistance for Farmers

    2010-08-02

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service.... FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by... TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: July 21, 2010. John D....

  6. Feasibility of neurally adjusted positive end-expiratory pressure in rabbits with early experimental lung injury

    Liu, Ling; Takahashi, Daijiro; Qui, Haibo; Slutsky, Arthur S.; Sinderby, Christer; Beck, Jennifer

    2015-01-01

    Background During conventional Neurally Adjusted Ventilatory Assist (NAVA), the electrical activity of the diaphragm (EAdi) is used for triggering and cycling-off inspiratory assist, with a fixed PEEP (so called “Triggered Neurally Adjusted Ventilatory Assist” or “tNAVA”). However, significant post-inspiratory activity of the diaphragm can occur, believed to play a role in maintaining end-expiratory lung volume. Adjusting pressure continuously, in proportion to both inspiratory and expiratory...

  7. 75 FR 41432 - Trade Adjustment Assistance for Farmers

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Review Committee, comprised of representatives from USDA's Office of the Chief Economist, Farm... Farmers' Program Should Contact: USDA, Farm Service Agency (at your local service center). FOR...

  8. 75 FR 23225 - Trade Adjustment Assistance for Farmers

    2010-05-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers program. The URL is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John...

  9. 75 FR 42375 - Trade Adjustment Assistance for Farmers

    2010-07-21

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa ....

  10. 75 FR 42376 - Trade Adjustment Assistance for Farmers

    2010-07-21

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site: http:// www.fas.usda.gov/itp/taa ....

  11. 75 FR 23226 - Trade Adjustment Assistance for Farmers

    2010-05-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers program. The URL is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John...

  12. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    2010-07-16

    ...; ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY... Economic Research Service and reviewed by the TAA for Farmers Review Committee, comprised of... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by...

  13. 75 FR 51978 - Trade Adjustment Assistance for Farmers

    2010-08-24

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633: or by e-mail at: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa ....

  14. 75 FR 41431 - Trade Adjustment Assistance for Farmers

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Economic Research Service and reviewed by the TAA for Farmers Review Committee, comprised of... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by...

  15. 75 FR 41433 - Trade Adjustment Assistance for Farmers

    2010-07-16

    ... petition (No. 2010003) for trade adjustment assistance (TAA) for asparagus that was filed by the National Asparagus Council and accepted for review by USDA on May 3, 2010. Individual producers, nationwide, will be... review, the Administrator determined that increased imports of asparagus during January-December...

  16. 75 FR 23226 - Trade Adjustment Assistance for Farmers

    2010-05-03

    ..., and began a review of a petition, for trade adjustment assistance by the National Asparagus Council on behalf of asparagus producers in California, Michigan, and Washington. The Administrator will determine within 40 days whether or not increasing imports of asparagus contributed importantly to a greater...

  17. 75 FR 41434 - Trade Adjustment Assistance for Farmers

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Crawfish Farmers Association and accepted for review by USDA on May 3, 2010. SUPPLEMENTARY INFORMATION: To... and reviewed by the TAA for Farmers Review Committee, comprised of representatives from USDA's...

  18. 75 FR 61121 - Trade Adjustment Assistance for Farmers

    2010-10-04

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Economic Research Service and reviewed by the TAA for Farmers Program Review Committee, comprised of... program in order to be eligible for cash benefits. Producers Certified As Eligible For TAA For...

  19. Neurally adjusted ventilator assist in very low birth weight infants: Current status.

    Narchi, Hassib; Chedid, Fares

    2015-06-26

    Continuous improvements in perinatal care have resulted in increased survival of premature infants. Their immature lungs are prone to injury with mechanical ventilation and this may develop into chronic lung disease (CLD) or bronchopulmonary dysplasia. Strategies to minimize the risk of lung injury have been developed and include improved antenatal management (education, regionalization, steroids, and antibiotics), exogenous surfactant administration and reduction of barotrauma by using exclusive or early noninvasive ventilatory support. The most frequently used mode of assisted ventilation is pressure support ventilation that may lead to patient-ventilator asynchrony that is associated with poor outcome. Ventilator-induced diaphragmatic dysfunction or disuse atrophy of diaphragm fibers may also occur. This has led to the development of new ventilation modes including neurally adjusted ventilatory assist (NAVA). This ventilation mode is controlled by electrodes embedded within a nasogastric catheter which detect the electrical diaphragmatic activity (Edi) and transmit it to trigger the ventilator in synchrony with the patient's own respiratory efforts. This permits the patient to control peak inspiratory pressure, mean airway pressure and tidal volume. Back up pressure control (PC) is provided when there is no Edi signal and no pneumatic trigger. Compared with standard conventional ventilation, NAVA improves blood gas regulation with lower peak inspiratory pressure and oxygen requirements in preterm infants. NAVA is safe mode of ventilation. The majority of studies have shown no significant adverse events in neonates ventilated with NAVA nor a difference in the rate of intraventricular hemorrhage, pneumothorax, or necrotizing enterocolitis when compared to conventional ventilation. Future large size randomized controlled trials should be established to compare NAVA with volume targeted and pressure controlled ventilation in newborns with mature respiratory drive

  20. 76 FR 65213 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-10-20

    ... Department's Notice was published in the Federal Register on August 18, 2011 (76 FR 51433). Workers at... Adjustment Assistance and Alternative Trade Adjustment Assistance; FLEXTRONICS International USA, INC...; FLEXTRONICS International USA, Inc., Infrastructure Division, Foothill Ranch, CA In accordance with...

  1. Assisting Older Persons With Adjusting to Hearing Aids.

    Lane, Kari R; Clark, M Kathleen

    2016-02-01

    This intervention study tested the feasibility and initial effect of Hearing Aid Reintroduction (HEAR) to assist persons aged 70 to 85 years adjust to hearing aids. Following this 30-day intervention, hearing aid use increased between 1 and 8 hr per day with 50% of participants able to wear them for at least 4 hr. Hearing aid satisfaction improved from not satisfied to satisfied overall. The study demonstrated that HEAR is feasible and could improve hearing aid use of a substantial number of older persons who had previously failed to adjust to their hearing aids and had given up. However, further testing among a larger and more diverse population is needed to better understand the effectiveness and sustainability of the intervention. PMID:25520326

  2. 78 FR 781 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-01-04

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... the Director, Office of Trade Adjustment Assistance, at the address shown below, not later than... of the investigations to the Director, Office of Trade Adjustment Assistance, at the address...

  3. 13 CFR 307.6 - Economic Adjustment Assistance post-approval requirements.

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Economic Adjustment Assistance post-approval requirements. 307.6 Section 307.6 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ECONOMIC ADJUSTMENT ASSISTANCE INVESTMENTS General § 307.6...

  4. 76 FR 4614 - Trade Adjustment Assistance for Firms Program Fiscal Year 2010 Annual Report

    2011-01-26

    ... economy. In general, the program provides cost-sharing technical assistance to eligible businesses to... Economic Development Administration Trade Adjustment Assistance for Firms Program Fiscal Year 2010 Annual Report AGENCY: Economic Development Administration, Commerce. ACTION: Notice. SUMMARY: This annual...

  5. 78 FR 25307 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-04-30

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... Director, Office of Trade Adjustment Assistance, at the address shown below, not later than May 10,...

  6. 78 FR 31596 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-05-24

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... Director, Office of Trade Adjustment Assistance, at the address shown below, not later than June 3,...

  7. 77 FR 51067 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-08-23

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... to the Director, Office of Trade Adjustment Assistance, at the address shown below, not later...

  8. 77 FR 42338 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-07-18

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... Director, Office of Trade Adjustment Assistance, at the address shown below, not later than July 30,...

  9. 77 FR 67406 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-11-09

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... to the Director, Office of Trade Adjustment Assistance, at the address shown below, not later...

  10. 78 FR 2291 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-01-10

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... to the Director, Office of Trade Adjustment Assistance, at the address shown below, not later...

  11. 77 FR 59014 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-09-25

    ..., the Director of the Office of Trade Adjustment Assistance, Employment and Training Administration, has... investigations may request a public hearing, provided such request is filed in writing with the Director, Office... to the Director, Office of Trade Adjustment Assistance, at the address shown below, not later...

  12. 13 CFR 307.3 - Use of Economic Adjustment Assistance Investments.

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Use of Economic Adjustment Assistance Investments. 307.3 Section 307.3 Business Credit and Assistance ECONOMIC DEVELOPMENT... “Strategy Grant”), or to fund a Project implementing such a CEDS (an “Implementation Grant”). (a)...

  13. 13 CFR 307.2 - Criteria for Economic Adjustment Assistance Investments.

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Criteria for Economic Adjustment Assistance Investments. 307.2 Section 307.2 Business Credit and Assistance ECONOMIC DEVELOPMENT... the Project is consistent (except that this requirement shall not apply to Strategy Grants...

  14. 77 FR 28901 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance; Novartis...

    2012-05-16

    ... 24, 2012 (77 FR 3501). At the request of an Illinois State Workforce Official, the Department... Adjustment Assistance; Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division... of Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division, East...

  15. 7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

    2010-01-01

    ... National Office to fund loans to lamb processors for real estate purchases and improvements; working... 7 Agriculture 15 2010-01-01 2010-01-01 false Domestic lamb industry adjustment assistance program... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment...

  16. Psychological adjustment in adolescents conceived by assisted reproduction techniques: A systematic review

    Ilioi, Elena Cristiana; Golombok, Susan

    2014-01-01

    Background: Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching ...

  17. 75 FR 56145 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    2010-09-15

    ... 08/23/10 08/17/10 (Workers). 74542 Reader's Digest Greendale, WI 08/23/10 08/18/10 (Workers). 74543..., to FOIA Disclosure Officer, Office of Trade Adjustment Assistance (ETA), U.S. Department of Labor..., DC this 2nd of September 2010. Elliott S. Kushner, Certifying Officer, Division of Trade...

  18. Examining Differences in Psychological Adjustment Problems among Children Conceived by Assisted Reproductive Technologies

    Shelton, Katherine H.; Boivin, Jacky; Hay, Dale; van den Bree, Marianne B. M.; Rice, Frances J.; Harold, Gordon T.; Thapar, Anita

    2009-01-01

    The aim of this study was to examine whether there was variation in levels of psychological adjustment among children conceived through Assisted Reproductive Technologies using the parents' gametes (homologous), sperm donation, egg donation, embryo donation and surrogacy. Information was provided by parents about the psychological functioning of…

  19. 76 FR 2720 - Trade Adjustment Assistance Program; Designation of Certifying Officers

    2011-01-14

    .... Directive Affected. Employment and Training Order No. 1-09, July 28, 2009, 74 FR 40613 (August 12, 2009... Secretary's Order No. 6-2010, October 20, 2010 (75 FR 66267, October 27, 2010), I designate or ] redesignate... certain types of foreign trade. The Trade and Globalization Adjustment Assistance Act of 2009 amended...

  20. 78 FR 766 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-01-04

    .... 82,132B Lattice Semiconductor Hillsboro, OR........ November 2, 2011. Corporation, Finance Department.... Subject firm Location Impact date 82,171 Pearson Education, Inc., Upper Saddle River, November 21, 2011. Pearson Imaging Center. NJ. Negative Determinations for Worker Adjustment Assistance In the...

  1. Surviving Job Loss: Motivation among Second Year Trade Adjustment Assistance (TAA) Students

    Karnes, Sandra Lee

    2012-01-01

    This ethnographic case study investigated second year college students who participated in the Trade Adjustment Assistance (TAA) program at a technical college in northeastern Pennsylvania. In order to understand how learners stayed motivated in a college setting, I selected participants who were in their second year of the TAA program. A total of…

  2. 77 FR 71637 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-12-03

    ...,989 Siemens Energy, Inc, Fort Madison, IA...... Renewables (Wind Power) Division. The investigation... Fremont, CA October 1, 2011. Design, Appsun, Delta General Corporation, etc. 82,043 Advantage.......... May 8, 2011. Advantage HR. Negative Determinations for Worker Adjustment Assistance In the...

  3. 77 FR 16070 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-03-19

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  4. 76 FR 43350 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-07-20

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  5. 75 FR 49529 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-08-13

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  6. 75 FR 57980 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-09-23

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  7. 75 FR 67771 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-11-03

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  8. 78 FR 41955 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    2013-07-12

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  9. 78 FR 61390 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-10-03

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  10. 78 FR 19531 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-04-01

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  11. 78 FR 15049 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-03-08

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  12. 75 FR 41524 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-07-16

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  13. 78 FR 47779 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-08-06

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  14. 77 FR 8279 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-02-14

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  15. 75 FR 63509 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-10-15

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  16. 78 FR 52978 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    2013-08-27

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  17. 77 FR 59987 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-10-01

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  18. 77 FR 54931 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-09-06

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  19. 76 FR 37154 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-06-24

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... a shift in production by such workers' firm or ] subdivision to a foreign country of articles...

  20. 78 FR 66780 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-11-06

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  1. 76 FR 59168 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-09-23

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  2. 76 FR 51434 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-08-18

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  3. 78 FR 39776 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-07-02

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  4. 77 FR 39265 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-07-02

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  5. 78 FR 25479 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-05-01

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  6. 78 FR 11227 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-02-15

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  7. 78 FR 61392 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-10-03

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  8. 76 FR 32229 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-06-03

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  9. 78 FR 74164 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-12-10

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  10. 78 FR 63496 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-10-24

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  11. 78 FR 9941 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-02-12

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  12. 77 FR 61029 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-10-05

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  13. 78 FR 52976 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    2013-08-27

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  14. 76 FR 51432 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-08-18

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  15. 78 FR 54487 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-09-04

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  16. 78 FR 1253 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    2013-01-08

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  17. 76 FR 37156 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2011-06-24

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  18. 76 FR 76184 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2011-12-06

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  19. 78 FR 39774 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-07-02

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  20. 76 FR 32228 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2011-06-03

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... and a certification issued regarding eligibility to apply for worker adjustment assistance, each of... foreign country in the production of articles or supply of services like or directly competitive...

  1. 75 FR 57514 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-09-21

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  2. 76 FR 61742 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    2011-10-05

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... a shift in production by such workers' firm or subdivision to a foreign country of articles like...

  3. 75 FR 62425 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2010-10-08

    ... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker... firm and a certification issued regarding eligibility to apply for worker adjustment assistance, each... the workers' firm to a foreign country in the production of articles or supply of services like...

  4. 75 FR 26795 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    2010-05-12

    ... Employment and Training Administration Investigations Regarding Certifications of Eligibility To Apply for... receipt of these petitions, the Director of the Division of Trade Adjustment Assistance, Employment and... Beauty (State/One- Los Angeles, CA....... 04/13/10 04/10/10 Stop). 73907 Sherill Manufacturing...

  5. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review.

    Gourounti, Kleanthi

    2016-01-01

    The aim of this review was to examine studies describing the psychological stress and adjustment in pregnancy after an assisted reproductive technology (ART) treatment. A systematic search of the electronic databases was performed. This review considered only quantitative, primary studies in the English language, published during the period 2000-2014 and relevant to the objective. The population of interest was previously infertile pregnant women. Outcome variables were general anxiety, depressive symptoms, pregnancy-specific anxiety, quality of life, self-esteem, pregnancy attitudes and adjustment, and maternal-fetal attachment. Twenty studies met the inclusion and methodological criteria and were included in the review. The review revealed that compared to women who conceive naturally or to general norms, women who conceive after an in vitro fertilization treatment had greater pregnancy-specific anxiety, poorer quality of life, either the same or less depressive symptomatology, the same level of self-esteem, more positive attitudes toward pregnancy demands, and higher levels of maternal-fetal attachment. However, the evidence regarding the general anxiety levels in pregnancy after an ART treatment was inconclusive. Methodological limitations and differences across studies may explain the inconsistencies in their findings regarding the impact of ART. This review provides an insight into psychological reactions and adjustment in pregnancy after an ART treatment. PMID:26212077

  6. Assisted Ventilation.

    Dries, David J

    2016-01-01

    Controlled Mechanical Ventilation may be essential in the setting of severe respiratory failure but consequences to the patient including increased use of sedation and neuromuscular blockade may contribute to delirium, atelectasis, and diaphragm dysfunction. Assisted ventilation allows spontaneous breathing activity to restore physiological displacement of the diaphragm and recruit better perfused lung regions. Pressure Support Ventilation is the most frequently used mode of assisted mechanical ventilation. However, this mode continues to provide a monotonous pattern of support for respiration which is normally a dynamic process. Noisy Pressure Support Ventilation where tidal volume is varied randomly by the ventilator may improve ventilation and perfusion matching but the degree of support is still determined by the ventilator. Two more recent modes of ventilation, Proportional Assist Ventilation and Neurally Adjusted Ventilatory Assist (NAVA), allow patient determination of the pattern and depth of ventilation. Proposed advantages of Proportional Assist Ventilation and NAVA include decrease in patient ventilator asynchrony and improved adaptation of ventilator support to changing patient demand. Work of breathing can be normalized with these modes as well. To date, however, a clear pattern of clinical benefit has not been demonstrated. Existing challenges for both of the newer assist modes include monitoring patients with dynamic hyperinflation (auto-positive end expiratory pressure), obstructive lung disease, and air leaks in the ventilator system. NAVA is dependent on consistent transduction of diaphragm activity by an electrode system placed in the esophagus. Longevity of effective support with this technique is unclear. PMID:25501776

  7. Ventilatory failure due to improper capnography connector

    Prakash, Ravi; Kushwaha, Brij B.; Singh, Brijesh Pratap

    2014-01-01

    Ventilatory failure due to improper or loose breathing circuit connection can occur in anaesthetic practice and may lead to significant morbidity and mortility. We report here an unusual incidence of ventilatory failure due loose capnography connector which obstructed the outer tube of Bain's circuit and presented as airway obstruction.

  8. A Dynamic Localized Adjustable Force Field Method for Real-time Assistive Non-holonomic Mobile Robotics

    Gillham, Michael; Howells, Gareth

    2015-01-01

    Providing an assistive navigation system that augments rather than usurps user control of a powered wheelchair represents a significant technical challenge. This paper evaluates an assistive collision avoidance method for a powered wheelchair that allows the user to navigate safely whilst maintaining their overall governance of the platform motion. The paper shows that by shaping, switching and adjusting localized potential fields we are able to negotiate different obs...

  9. Ventilatory strategies in trauma patients.

    Arora, Shubhangi; Singh, Preet Mohinder; Trikha, Anjan

    2014-01-01

    Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented. PMID:24550626

  10. Ventilatory strategies in trauma patients

    Shubhangi Arora

    2014-01-01

    Full Text Available Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented.

  11. [Mechanical ventilation in chronic ventilatory insufficiency].

    Schucher, B; Magnussen, H

    2007-10-01

    Mechanical ventilation has become an important treatment option in chronic ventilatory failure. There are different diseases which lead to ventilatory failure and to home mechanical ventilation (HMV). A primary loss of in- and expiratory muscle strength is the reason for respiratory deterioration in neuromuscular disease. In most of these diseases ventilatory failure develops because of the progressive character of muscular damage. Initially, ventilatory failure can be found during night-time. In the case of hypercapnia at daytime, life expectancy is strongly reduced, especially in amyotrophic lateral sclerosis and Duchenne muscular dystrophy. HMV leads to a prolongation of life and to an increase in quality of life, if bulbar involvement is not severe. Impressive clinical improvements under HMV have been found in restrictive disorders of the rib cage like kyphoscoliosis or posttuberculosis sequelae, with an increase of quality of life, walking distance and a decrease in pulmonary hypertension. Only few data are published about long-term results of HMV in Obesity Hypoventilation. In terms of retrospective analyses of clinical data HMV seems to improve survival in this population. Some patients only need CPAP treatment, but most patients have to be treated with ventilatory support. The application of HMV in patients with chronic ventilatory failure due to chronic obstructive pulmonary disease (COPD) is growing, but there are controversial results in randomised clinical trials. Analysis of these data suggest better results of HMV in patients with severe hypercapnia, with the application of higher effective ventilatory pressure and a ventilator mode with a significant reduction in the work of breathing. Under such conditions HMV leads to a reduction of hypercapnia, an improvement in sleep quality, walking distance and quality of life, but until now there is no evidence in reduction of mortality in COPD. PMID:17620231

  12. 76 FR 14421 - Section 8 Housing Assistance Payments Program-Contract Rent Annual Adjustment Factors (AAFs...

    2011-03-16

    ... rent for a comparable unassisted unit of similar quality, type and age in the market area. 42 U.S.C... the unassisted market. Since HUD pays the full amount of any rent increases for assisted tenants... discount.'' Turnover is lower in assisted properties than in the unassisted market, so the effect of...

  13. 75 FR 6685 - Section 8 Housing Assistance Payments Program-Contract Rent Annual Adjustment Factors, Fiscal...

    2010-02-10

    ... exceed the rent for a comparable unassisted unit of similar quality, type and age in the market area. 42... movers in unassisted market. Since HUD pays the full amount of any rent increases for assisted tenants... discount.' Turnover is lower in assisted properties than in the unassisted market, so the effect of...

  14. 75 FR 63147 - Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global...

    2010-10-14

    ... and National Technical Assistance. This notice introduces the concept of funding cycles in the context... where substantial direct project-related benefits will occur, or the geographic area of poverty or...

  15. Home mechanical ventilatory support in patients with restrictive ventilatory disorders : A 48-year experience

    Duiverman, ML; Bladder, G; Meinesz, AF; Wijkstra, PJ

    2006-01-01

    We performed a retrospective analysis to the effects of negative pressure ventilation (NPV), tracheal intermittent positive pressure ventilation (TIPPV), and nasal intermittent positive pressure ventilation (NIPPV, volume or pressure-controlled ventilatory mode), in 114 patients with restrictive ven

  16. 77 FR 63874 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-10-17

    ... secondary workers of a firm and a certification issued regarding eligibility to apply for worker adjustment.... 203 6th Avenue West, Neff Motivation, Inc. 81,540A Rock Creek Athletics, Inc., Grinnell, IA April 24, 2011. 727 6th Avenue West, Neff Motivation, Inc. The following certifications have been issued....

  17. 78 FR 8594 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-02-06

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... (Union) Detroit, MI 01/14/13 01/13/13 82341 Hostess Brands, Inc. (5 WV 01/14/13 01/11/13 Locations in WV... (Union)....... Cincinnati, OH 01/15/13 01/03/13 82345 Connextions, Inc. (Workers)... Concord, NC...

  18. 78 FR 18371 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-03-26

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Peres, MO......... 02/25/13 02/22/13 LLC (Workers). 82496 NewPage Corporation (Union). Miamisburg, OH........ 02/25/13 02/22/13 82497 Trans Union (State/One-Stop) Chicago, IL 02/25/13 02/22/13 82498 Alorica,...

  19. 78 FR 28639 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-05-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Corporation Youngstown, OH........ 04/17/13 04/11/13 (Union). 82651 Anthem Workers Compensation Costa Mesa,...

  20. 78 FR 54490 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-09-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Braddock, PA 08/15/13 08/14/13 (Workers). 82995 King Brothers Woodworking Union Gap, WA 08/16/13...

  1. 78 FR 77169 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-12-20

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment.../13 11/25/13 (Union). 83245 IBM Corporation (State/One- Rochester, MN 11/26/13 11/25/13 Stop). 83246 Computershare (Workers)....... Edison, NJ 11/27/13 11/26/13 83247 AVX Corporation (Union)....... Conway &...

  2. 78 FR 12363 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2013-02-22

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Corporation (3 Perryville, MO 02/05/13 02/04/13 Locations) (Union). 82411 FPL Food LLC (Workers)..... Augusta... Owens Brockway Inc. (Union) Brockport, PA 02/06/13 01/30/13 82421 Super Media LLC (Union).......

  3. 77 FR 58584 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-09-21

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Corporation (Workers). Colorado Springs, CO.. 09/04/12 08/31/12 81937 Clearon Corporation (Union). South...). 81944 JMC Steel Group Wheatland Sharon, PA 09/06/12 09/05/12 Tube (Union). 81945 Pfizer, Inc....

  4. 77 FR 64358 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    2012-10-19

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment...-Aurora (Workers). Aurora, NC 10/01/12 09/25/12 82018 American Airlines (Union)... Fort Worth, TX... Angeles, CA....... 10/01/12 09/27/12 82022 R.G. Steel (Union) Allenport, PA......... 10/01/12...

  5. 75 FR 1345 - Solicitation of Applications for the Community Trade Adjustment Assistance Program

    2010-01-11

    ... assist communities in demonstrating trade impact significance, EDA has analyzed job-loss data in... severe economic distress such as the imminent threat of significant job loss associated with trade. For... there was a job loss of at least 413 workers in the community's CLF (413/ 50,000 = 0.00825 x 1,000 =...

  6. Unemployment Compensation and Adjustment Assistance for Displaced Workers: Policy Options for Canada

    Riddell, W. Craig

    2011-01-01

    This paper examines the role of EI in providing support to “displaced workers,†those who permanently lose their jobs because of changing circumstances. Adjusting to change benefits Canadians as a whole. However, some workers suffer much more from job loss than do others. Those who have held their jobs for an extended period experience substantial earnings losses, while those who have been employed for brief periods experience small losses. Like other job losers, long-tenure displaced work...

  7. Ventilatory decrements in former asbestos cement workers: a four year follow up

    Ohlson, C.G.; Bodin, L.; Rydman, T.; Hogstedt, C.

    1985-09-01

    A four year follow up of the ventilatory function in former asbestos cement workers has been performed to determine whether any further decrease occurred after cessation of exposure. Seventy five of 125 subjects were eligible for re-examination and were compared with local referents. None showed signs of asbestosis but 32% had pleural plaques at the renewed examination. Cumulative asbestos exposure calculated as fibre x years had been estimated individually in the original examination. After adjustment for age, height, tracheal area, and smoking category the FVC and FEV1 for all exposed subjects were on average 7% v 6% less than predicted from the referents and twice as much for the subjects with the highest exposure. The four year declines in FVC and FEV1 were larger than in the referents, significantly so for FEV1. There were no significant correlations between pleural plaque and ventilatory function after adjustment for exposure. Thus, the age adjusted reduction in ventilatory function had progressed during the follow up period despite the cessation of exposure and the lack of radiological signs of asbestosis.

  8. Long-term survival rates of gravity-assisted, adjustable differential pressure valves in infants with hydrocephalus.

    Gebert, Anna-Felicitas; Schulz, Matthias; Schwarz, Karin; Thomale, Ulrich-Wilhelm

    2016-05-01

    OBJECTIVE The use of adjustable differential pressure valves with gravity-assisted units in shunt therapy of children with hydrocephalus was reported to be feasible and promising as a way to avoid chronic overdrainage. In this single-center study, the authors' experiences in infants, who have higher rates of shunt complications, are presented. METHODS All data were collected from a cohort of infants (93 patients [37 girls and 56 boys], less than 1 year of age [mean age 4.1 ± 3.1 months]) who received their first adjustable pressure hydrocephalus shunt as either a primary or secondary implant between May 2007 and April 2012. Rates of valve and shunt failure were recorded for a total of 85 months until the end of the observation period in May 2014. RESULTS During a follow-up of 54.2 ± 15.9 months (range 26-85 months), the Kaplan-Meier rate of shunt survival was 69.2% at 1 year and 34.1% at 85 months; the Kaplan-Meier rate of valve survival was 77.8% at 1 year and 56% at 85 months. Survival rates of the shunt were significantly inferior if the patients had previous shunt surgery. During follow-up, 44 valves were exchanged in cases of infection (n = 19), occlusion (n = 14), dysfunction of the adjustment unit (n = 10), or to change the gravitational unit (n = 1). CONCLUSIONS Although a higher shunt complication rate is observed in infant populations compared with older children, reasonable survival rates demonstrate the feasibility of using this sophisticated valve technology. The gravitational unit of this valve is well tolerated and its adjustability offers the flexible application of opening pressure in an unpredictable cohort of patients. This may adequately address overdrainage-related complications from early in treatment. PMID:26799410

  9. Gas exchange by intratracheal insufflation in a ventilatory failure dog model.

    Gavriely, N; Eckmann, D; Grotberg, J. B.

    1992-01-01

    Respiratory insufficiency patients who need only partial ventilatory support are, nevertheless, intubated and connected to a respirator. In search of a partial respiratory assistance method we evaluated the gas exchange, mechanisms, and hemodynamic effects of intratracheal insufflation (ITI) via a narrow (0.2-cm) catheter. The effects of flow rate (0.05-0.2 liter/min per kg), catheter tip position (carina, bronchus, and trachea), and superimposed chest vibration at 22 Hz were studied in seven...

  10. A necklace sonar with adjustable scope range for assisting the visually impaired.

    Villamizar, Luz H; Gualdron, Mauricio; Gonzalez, Fabio; Aceros, Juan; Rizzo-Sierra, Carlos V

    2013-01-01

    A sonar based device with tactile feedback was developed to improve the mobility and independence of visually impaired individuals. It features a transceiver/receiver, a potentiometer, a microcontroller, a rechargeable polymer lithium ion battery, and a Nokia Cell phone vibrator. All components are commercially available and housed in a custom acrylic package with 86 mm × 34 mm × 12 mm in dimension, and 120 grms in weight. Additionally, the device features an adjustable detection scheme for user customization of distance range, and a tactile feedback system that avoids interference with auditory sensory information. The device was tested for its navigational efficacy in an artificial indoor environment, and in a live outdoor setting. Ten subjects (9 males and 1 female), with a mean age of 35 years-old (range: 17 to 52) were presented with a series of navigational tasks resulting in considerable reduction of head, shoulder, chest, and arms collisions during their locomotion. We conclude that this device greatly improves the mobility and safety of visually impaired individuals. PMID:24109971

  11. Proportional assist ventilation as an aid to exercise training in severe chronic obstructive pulmonary disease

    Hawkins, P.; Johnson, L.; Nikoletou, D; Hamnegard, C; Sherwood, R.; Polkey, M.; Moxham, J.

    2002-01-01

    Background: The effects of providing ventilatory assistance to patients with severe chronic obstructive pulmonary disease (COPD) during a high intensity outpatient cycle exercise programme were examined.

  12. Ventilator-associated lung injury during assisted mechanical ventilation.

    Saddy, Felipe; Sutherasan, Yuda; Rocco, Patricia R M; Pelosi, Paolo

    2014-08-01

    Assisted mechanical ventilation (MV) may be a favorable alternative to controlled MV at the early phase of acute respiratory distress syndrome (ARDS), since it requires less sedation, no paralysis and is associated with less hemodynamic deterioration, better distal organ perfusion, and lung protection, thus reducing the risk of ventilator-associated lung injury (VALI). In the present review, we discuss VALI in relation to assisted MV strategies, such as volume assist-control ventilation, pressure assist-control ventilation, pressure support ventilation (PSV), airway pressure release ventilation (APRV), APRV with PSV, proportional assist ventilation (PAV), noisy ventilation, and neurally adjusted ventilatory assistance (NAVA). In summary, we suggest that assisted MV can be used in ARDS patients in the following situations: (1) Pao(2)/Fio(2) >150 mm Hg and positive end-expiratory pressure ≥ 5 cm H(2)O and (2) with modalities of pressure-targeted and time-cycled breaths including more or less spontaneous or supported breaths (A-PCV [assisted pressure-controlled ventilation] or APRV). Furthermore, during assisted MV, the following parameters should be monitored: inspiratory drive, transpulmonary pressure, and tidal volume (6 mL/kg). Further studies are required to determine the impact of novel modalities of assisted ventilation such as PAV, noisy pressure support, and NAVA on VALI. PMID:25105820

  13. The relationship between ventilatory lung motion and pulmonary perfusion shown by ventilatory lung motion imaging

    Using ventilatory lung motion imaging, which was obtained from two perfusion lung scintigrams with 99mTc-macroaggregated albumin taken in maximal inspiration and maximal expiration, the lung motion (E-I/I) of the each unilateral lung was studied in various cardiopulmonary diseases. The sum of (E-I)/I(+) of the unilateral lung was decreased in the diseased lung for localized pleuropulmonary diseases, including primary lung cancer and pleural thickening, and in both lungs for heart diseases, and diffuse pulmonary diseases including diffuse interstitial pneumonia and diffuse panbronchiolitis. The sum of (E-I)/I(+) of the both lungs, which correlated with vital capacity and PaO2, was decreased in diffuse interstitial pneumonia, pulmonary emphysema, diffuse panbronchiolitis, primary lung cancer, pleural diseases and so on. (E-I)/I(+), correlated with pulmonary perfusion (n=49, r=0.51, p81mKr or 133Xe (n=49, r=0.61, p<0.001) than pulmonary perfusion. The ventilatory lung motion imaging, which demonstrates the motion of the intra-pulmonary areas and lung edges, appears useful for estimating pulmonary ventilation of the perfused area as well as pulmonary perfusion. (author)

  14. Defining obstructive ventilatory defect in 2015

    Zied Affes

    2015-10-01

    Full Text Available Introduction: There is no clear consensus as to what constitutes an obstructive ventilatory defect (OVD: Is it FEV1/FVC

  15. Brain neuropeptides in central ventilatory and cardiovascular regulation in trout.

    Jean-Claude eLe Mével

    2012-10-01

    Full Text Available Many neuropeptides and their G-protein coupled receptors (GPCRs are present within the brain area involved in ventilatory and cardiovascular regulation but only a few mammalian studies have focused on the integrative physiological actions of neuropeptides on these vital cardio-respiratory regulations. Because both the central neuroanatomical substrates that govern motor ventilatory and cardiovascular output and the primary sequence of regulatory peptides and their receptors have been mostly conserved through evolution, we have developed a trout model to study the central action of native neuropeptides on cardio-ventilatory regulation. In the present review, we summarize the most recent results obtained using this non-mammalian model with a focus on PACAP, VIP, tachykinins, CRF, urotensin-1, CGRP, angiotensin-related peptides, urotensin-II, NPY, and PYY. We propose hypotheses regarding the physiological relevance of the results obtained.

  16. 77 FR 77217 - Fiscal Year 2012 Annual Report to Congress on the Trade Adjustment Assistance for Firms Program

    2012-12-31

    ... sample of three TAACs--Western, New England, and New York State--focusing on the use of Federal funds... economically distressed U.S. businesses develop strategies to compete in the global economy. Through a... provides cost-sharing technical assistance to help eligible businesses create and implement...

  17. Factors affecting the decline of ventilatory function in chronic bronchitis.

    Campbell, A H; Barter, C. E.; O'Connell, J M; Huggins, R

    1985-01-01

    Ninety six middle aged male patients with chronic bronchitis with relatively well preserved ventilatory function who were resident in Queensland, New South Wales, or Victoria took part in a prospective study to determine the relationship of various factors to the rate of decline of the FEV1. Thirty of the subjects withdrew, leaving 66 to be followed for four to six years. The mean rate of decline of the FEV1 was 58.6 (SD 51.4) ml/year. The subjects' ventilatory responses to bronchodilator and...

  18. An Adjusted Likelihood Ratio Approach Analysing Distribution of Food Products to Assist the Investigation of Foodborne Outbreaks

    Madelaine Norström; Anja Bråthen Kristoffersen; Franziska Sophie Görlach; Karin Nygård; Petter Hopp

    2015-01-01

    In order to facilitate foodborne outbreak investigations there is a need to improve the methods for identifying the food products that should be sampled for laboratory analysis. The aim of this study was to examine the applicability of a likelihood ratio approach previously developed on simulated data, to real outbreak data. We used human case and food product distribution data from the Norwegian enterohaemorrhagic Escherichia coli outbreak in 2006. The approach was adjusted to include time, ...

  19. Dislocated Workers. Trade Adjustment Assistance Program Flawed. Statement of Linda G. Morra, Director of Education and Employment Issues, Human Resources Division. Testimony before the Subcommittee on Employment, Housing and Aviation, Committee on Government Operations, House of Representatives.

    General Accounting Office, Washington, DC. Div. of Human Resources.

    The Trade Adjustment Assistance (TAA) program is designed to help the more than 1 million workers per year who lose their jobs because of permanent layoffs or plant closures, due in part because of imports. Studies show, however, that the TAA program fails to meet the seven goals of a successful reemployment assistance program: (1) TAA benefits…

  20. Effects of hypercapnia and hypocapnia on ventilatory variability and the chaotic dynamics of ventilatory flow in humans.

    Fiamma, Marie-Noëlle; Straus, Christian; Thibault, Sylvain; Wysocki, Marc; Baconnier, Pierre; Similowski, Thomas

    2007-05-01

    In humans, lung ventilation exhibits breath-to-breath variability and dynamics that are nonlinear, complex, sensitive to initial conditions, unpredictable in the long-term, and chaotic. Hypercapnia, as produced by the inhalation of a CO(2)-enriched gas mixture, stimulates ventilation. Hypocapnia, as produced by mechanical hyperventilation, depresses ventilation in animals and in humans during sleep, but it does not induce apnea in awake humans. This emphasizes the suprapontine influences on ventilatory control. How cortical and subcortical commands interfere thus depend on the prevailing CO(2) levels. However, CO(2) also influences the variability and complexity of ventilation. This study was designed to describe how this occurs and to test the hypothesis that CO(2) chemoreceptors are important determinants of ventilatory dynamics. Spontaneous ventilatory flow was recorded in eight healthy subjects. Breath-by-breath variability was studied through the coefficient of variation of several ventilatory variables. Chaos was assessed with the noise titration method (noise limit) and characterized with numerical indexes [largest Lyapunov exponent (LLE), sensitivity to initial conditions; Kolmogorov-Sinai entropy (KSE), unpredictability; and correlation dimension (CD), irregularity]. In all subjects, under all conditions, a positive noise limit confirmed chaos. Hypercapnia reduced breathing variability, increased LLE (P = 0.0338 vs. normocapnia; P = 0.0018 vs. hypocapnia), increased KSE, and slightly reduced CD. Hypocapnia increased variability, decreased LLE and KSE, and reduced CD. These results suggest that chemoreceptors exert a strong influence on ventilatory variability and complexity. However, complexity persists in the quasi-absence of automatic drive. Ventilatory variability and complexity could be determined by the interaction between the respiratory central pattern generator and suprapontine structures. PMID:17218438

  1. Outcomes of pharmacist-assisted management of antiretroviral therapy in patients with HIV infection: A risk-adjusted analysis

    Nevo, Ofir Noah; Lesko, Catherine R.; Colwell, Bradford; Ballard, Craig; Cole, Stephen R.; Mathews, W. Christopher

    2016-01-01

    Purpose The impact of pharmacist-assisted management (PAM) of pharmacotherapy for patients with human immunodeficiency virus (HIV) infection was investigated. Methods A retrospective cohort analysis was conducted to evaluate antiretroviral therapy (ART) outcomes in treatment-naive patients initiated on ART at an HIV clinic. Eligible patients enrolled in the clinic during the period 1999–2013 were classified into two groups: those referred to a clinic-based HIV pharmacist for initiation of ART (the PAM group) and those managed by a primary care provider (the control group). The primary study objective was the median time to viral suppression; secondary objectives included the durability of response to the first ART regimen. Relative hazards for the events of interest were estimated using a marginal structural Cox proportional hazards model and Kaplan–Meier curves, with inverse probability weights used to control for selection and confounding bias. Results Patients referred for PAM services (n = 819) typically had higher baseline viral loads and lower CD4+ cell counts than those in the control group (n = 436). The likelihood of viral suppression during the first two years after ART initiation was significantly higher in the PAM group versus the control group (hazard ratio, 1.37; 95% confidence interval, 1.18–1.59; p 0.05). Conclusion In treatment-naive patients, suppression of HIV viral load occurred earlier when pharmacists assisted with initiating ART than when ART was initiated without that assistance. PMID:26294239

  2. Comparative ventilatory strategies of acclimated rats and burrowing plateau pika (Ochotona curzoniae) in response to hypoxic-hypercapnia.

    Pichon, Aurélien; Voituron, Nicolas; Bai, Zhenzhong; Jeton, Florine; Tana, Wuren; Marchant, Dominique; Jin, Guoen; Richalet, Jean-Paul; Ge, Ri-Li

    2015-09-01

    The objective of this study was to compare the different ventilatory strategies that help in coping with hypoxic-hypercapnia environment among two species: use acclimated rats and plateau pikas (Ochotona curzoniae) that live in Tibetan plateaus, and have been well adjusted to high altitude. Arterial blood samples taken at 4100 m of elevation in acclimatized rats and adapted pikas revealed inter-species differences with lower hemoglobin and hematocrit and higher blood pH in pikas. A linear and significant increase in minute ventilation was observed in pikas, which help them to cope with hypoxic-hypercapnia. Pikas also displayed a high inspiratory drive and an invariant respiratory timing regardless of the conditions. Biochemical analysis revealed that N-methyl-D-aspartate receptor (NMDA) receptor gene and nNOS gene are highly conserved between rats and pikas, however pikas have higher expression of NMDA receptors and nNOS compared to rats at the brainstem level. Taken together, these results suggest that pikas have developed a specific ventilatory pattern supported by a modification of the NMDA/NO ventilatory central pathways to survive in extreme conditions imposed on the Tibetan plateaus. These physiological adaptive strategies help in maintaining a better blood oxygenation despite high CO2 concentration in burrows at high altitude. PMID:25988712

  3. Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+).

    Georgopoulos, Dimitris; Xirouchaki, Nectaria; Tzanakis, Nikolaos; Younes, Magdy

    2016-09-01

    The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+) after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure), respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy "Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?" [1]. PMID:27358909

  4. Effects of body position on the ventilatory response to hypercapnia

    Donina Zh A

    2009-12-01

    Full Text Available Abstract Effect of posture on the hypercapnic ventilatory response was studied on the anaesthetized rats by using rebreathing techniques in the supine and head-down positions. There were no statistically significant alterations in tidal volume, frequency, minute ventilation, and PETCO2 between the head-down and supine positions during breathing at rest. However, the esophageal pressure inspiratory swings were significantly greater in the head-down compared with supine position. Moreover, we found that body position did not affect the hypercapnic ventilatory response, but did affect the relationship between inspiratory driving pressure and the increase of end tidal PCO2. Greater inspiratory pressure is required to maintain the same level of the ventilatory response to hypercapnia in the horizontal position with the head-down. We believe that the discrepancy between postural alterations in the hypercapnic ventilatory and pressure responses is presumably a result of decreased lung compliance and increased airflow impedance of respiratory system in the head-down position.

  5. Ventilatory adaptation to hypoxia occurs in serotonin-depleted rats.

    Olson, E B

    1987-08-01

    To test the hypothesis that serotonin mediated respiratory activity is involved in ventilatory adaptation to hypoxia, rats were treated with parachlorophenylalanine (PCPA), a potent, long-acting inhibitor of tryptophan hydroxylase, the rate-limiting enzyme in the biosynthesis of serotonin. In normoxia, a single, intraperitoneal injection of 300 mg PCPA/kg body weight decreased the Paco2 from a control level at 39.1 +/- 0.6 Torr (mean +/- 95% confidence limits) to 34.0 +/- 0.6 Torr measured during a period from 1 to 48 h following PCPA treatment. This PCPA-produced hyperventilation corresponds to an increase of 3.7 +/- 0.5 in the VA (BTPS)/Vco2 (STPD) ratio. Hyperventilation during ventilatory adaptation to hypoxia (PIO2 approximately equal to 90 Torr) was superimposed in an additive fashion on the underlying hyperventilation due to PCPA pretreatment. Specifically, PCPA pretreatment caused an average 3.5 +/- 1.2 increase in the VA/VCO2 ratio determined in acute (1 h) hypoxia, chronic (24 h) hypoxia and acute return to normoxia following chronic hypoxia. Since ventilatory adaptation to hypoxia occurred in rats treated with PCPA, the prolonged, serotonin mediated respiratory activity described by Millhorn et al. (1980b) is probably not important in ventilatory acclimatization to - or deacclimatization from - hypoxia. PMID:2957766

  6. Increased ventilatory variability and complexity in patients with hyperventilation disorder.

    Bokov, Plamen; Fiamma, Marie-Noëlle; Chevalier-Bidaud, Brigitte; Chenivesse, Cécile; Straus, Christian; Similowski, Thomas; Delclaux, Christophe

    2016-05-15

    It has been hypothesized that hyperventilation disorders could be characterized by an abnormal ventilatory control leading to enhanced variability of resting ventilation. The variability of tidal volume (VT) often depicts a nonnormal distribution that can be described by the negative slope characterizing augmented breaths formed by the relationship between the probability density distribution of VT and VT on a log-log scale. The objectives of this study were to describe the variability of resting ventilation [coefficient of variation (CV) of VT and slope], the stability in respiratory control (loop, controller and plant gains characterizing ventilatory-chemoresponsiveness interactions) and the chaotic-like dynamics (embedding dimension, Kappa values characterizing complexity) of resting ventilation in patients with a well-defined dysfunctional breathing pattern characterized by air hunger and constantly decreased PaCO2 during a cardiopulmonary exercise test. Compared with 14 healthy subjects with similar anthropometrics, 23 patients with hyperventilation were characterized by increased variability of resting tidal ventilation (CV of VT median [interquartile]: 26% [19-35] vs. 36% [28-48], P = 0.020; slope: -6.63 [-7.65; -5.36] vs. -3.88 [-5.91; -2.66], P = 0.004) that was not related to increased chemical drive (loop gain: 0.051 [0.039-0.221] vs. 0.044 [0.012-0.087], P = 0.149) but that was related to an increased ventilatory complexity (Kappa values, P ventilation due to increased ventilatory complexity with stable ventilatory-chemoresponsiveness interactions. PMID:26869707

  7. Accessing chemosensitivity and ventilatory stability from transient stimuli.

    Bruce, E N

    1996-12-01

    The degree of ventilatory stability of human subjects is inferred from the presence or absence of oscillations in ventilation in response to a brief CO2 disturbance using the method of pseudorandom stimulation. Simultaneously, chemosensitivity is measured. Stability and chemosensitivity are compared in hyperoxia between wakefulness and stage 2 non-rapid eye movement (NREM) sleep and between normoxia and hyperoxia awake. Stability is unchanged between wakefulness and sleep but chemosensitivity decreases in sleep. In contrast, stability is reduced in normoxia whereas chemosensitivity is larger than in hyperoxia. It is concluded that chemosensitivity and ventilatory stability may change independently, implying that chemosensitivity alone is not an adequate indicator of the likelihood of a subject to exhibit periodic breathing. PMID:9085498

  8. Tissue Functioning and Remodeling in the Circulatory and Ventilatory Systems

    Thiriet, Marc

    2013-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. Volume 5 is devoted to cells, tissues, and organs of the cardiovascular and ventilatory systems with an emphasis on mechanotransduction-based regulation of flow. The blood vessel wall is a living tissue that quickly reacts to loads applied on it by the flowing blood. In any segment of a blood vessel, the endothelial and smooth muscle cells can sense unusual time variations in small-magnitude wall shear stress and large-amplitude wall stretch generated by abnormal hemodynamic stresses. These cells respond with a short-time scale (from seconds to hours) to adapt the vessel caliber. Since such adaptive cell activities can be described using mathematical models, a key objective of this volume is to identify the mesoscopic agents and nanoscopic mediators required to derive adequate mathematical models...

  9. Ventilatory function test values of health adult Jordanians.

    Sliman, N A; Dajani, B M; Dajani, H M

    1981-01-01

    A sample of 144 male, and 117 female healthy adults was selected to determine the normal ventilatory functions for Jordanians. Forced vital capacity, FEV1, and FMF 25-75% were determined using a dry bellows spirometer. Linear regression curves and nomograms were constructed for predicted values. Jordanian values for FVC and FEV1 were similar to those of Caucasians living in the western hemisphere.

  10. Ventilatory support in critically ill hematology patients with respiratory failure

    Molina Lobo, Rosario; Bernal del Castillo, Teresa; Borges, Marcio; Zaragoza Crespo, Rafael; Bonastre Mora, Juan; Granada Vicente, Rosa María; Rodríguez-Borregán, Juan Carlos; Nuñez, Karla; Seijas Betolaza, Iratxe; Ayestaran, Ignacio; Muñiz Albaiceta, Guillermo; EMEHU Study Investigators

    2012-01-01

    Introduction Hematology patients admitted to the ICU frequently experience respiratory failure and require mechanical ventilation. Noninvasive mechanical ventilation (NIMV) may decrease the risk of intubation, but NIMV failure poses its own risks. Methods To establish the impact of ventilatory management and NIMV failure on outcome, data from a prospective, multicenter, observational study were analyzed. All hematology patients admitted to one of the 34 participating ICUs in a 17-month period...

  11. Ventilatory responses to dynamic exercise elicited by intramuscular sensors

    Smith, S. A.; Gallagher, K. M.; Norton, K. H.; Querry, R. G.; Welch-O'Connor, R. M.; Raven, P. B.

    1999-01-01

    PURPOSE: Eight subjects, aged 27.0+/-1.6 yr, performed incremental workload cycling to investigate the contribution of skeletal muscle mechano- and metaboreceptors to ventilatory control during dynamic exercise. METHODS: Each subject performed four bouts of exercise: exercise with no intervention (CON); exercise with bilateral thigh cuffs inflated to 90 mm Hg (CUFF); exercise with application of lower-body positive pressure (LBPP) to 45 torr (PP); and exercise with 90 mm Hg thigh cuff inflation and 45 torr LBPP (CUFF+PP). Ventilatory responses and pulmonary gas exchange variables were collected breath-by-breath with concomitant measurement of leg intramuscular pressure. RESULTS: Ventilation (VE) was significantly elevated from CON during PP and CUFF+PP at workloads corresponding to > or = 60% CON peak oxygen uptake (VO2peak) and during CUFF at workloads > or = 80% CON VO2peak, P perfusion pressure and decreases in venous outflow resulting from inflation of bilateral thigh cuffs may generate a metabolite sensitive intramuscular ventilatory stimulus.

  12. Ventilatory responses to dynamic exercise elicited by intramuscular sensors

    Smith, S. A.; Gallagher, K. M.; Norton, K. H.; Querry, R. G.; Welch-O'Connor, R. M.; Raven, P. B.

    1999-01-01

    PURPOSE: Eight subjects, aged 27.0+/-1.6 yr, performed incremental workload cycling to investigate the contribution of skeletal muscle mechano- and metaboreceptors to ventilatory control during dynamic exercise. METHODS: Each subject performed four bouts of exercise: exercise with no intervention (CON); exercise with bilateral thigh cuffs inflated to 90 mm Hg (CUFF); exercise with application of lower-body positive pressure (LBPP) to 45 torr (PP); and exercise with 90 mm Hg thigh cuff inflation and 45 torr LBPP (CUFF+PP). Ventilatory responses and pulmonary gas exchange variables were collected breath-by-breath with concomitant measurement of leg intramuscular pressure. RESULTS: Ventilation (VE) was significantly elevated from CON during PP and CUFF+PP at workloads corresponding to > or = 60% CON peak oxygen uptake (VO2peak) and during CUFF at workloads > or = 80% CON VO2peak, P relationship was increased from CON by approximately 22% during CUFF, 40% during PP, and 41% during CUFF+PP. CONCLUSIONS: As intramuscular pressure was significantly elevated immediately upon application of LBPP during PP and CUFF+PP without a concomitant increase in VE, it seems unlikely that LBPP-induced increases in VE can be attributed to activation of the mechanoreflex. These findings suggest that LBPP-induced reductions in perfusion pressure and decreases in venous outflow resulting from inflation of bilateral thigh cuffs may generate a metabolite sensitive intramuscular ventilatory stimulus.

  13. Predictive value of ventilatory inflection points determined under field conditions.

    Heyde, Christian; Mahler, Hubert; Roecker, Kai; Gollhofer, Albert

    2016-05-01

    The aim of this study was to evaluate the predictive potential provided by two ventilatory inflection points (VIP1 and VIP2) examined in field without using gas analysis systems and uncomfortable facemasks. A calibrated respiratory inductance plethysmograph (RIP) and a computerised routine were utilised, respectively, to derive ventilation and to detect VIP1 and VIP2 during a standardised field ramp test on a 400 m running track on 81 participants. In addition, average running speed of a competitive 1000 m run (S1k) was observed as criterion. The predictive value of running speed at VIP1 (SVIP1) and the speed range between VIP1 and VIP2 in relation to VIP2 (VIPSPAN) was analysed via regression analysis. VIPSPAN rather than running speed at VIP2 (SVIP2) was operationalised as a predictor to consider the covariance between SVIP1 and SVIP2. SVIP1 and VIPSPAN, respectively, provided 58.9% and 22.9% of explained variance in regard to S1k. Considering covariance, the timing of two ventilatory inflection points provides predictive value in regard to a competitive 1000 m run. This is the first study to apply computerised detection of ventilatory inflection points in a field setting independent on measurements of the respiratory gas exchange and without using any facemasks. PMID:26190229

  14. Ventilatory and arousal responses to hypoxia in sleeping humans.

    Berthon-Jones, M; Sullivan, C E

    1982-06-01

    We measured ventilatory and arousal responses to progressive eucapnic hypoxia during wakefulness, nonrapid-eye-movement (NREM) sleep, and rapid-eye-movement (REM) sleep using a progressive isocapnic rebreathing method. Nine healthy adults (4 female, 5 male) slept with a mask glued to the face with medical silicone rubber and breathed from a closed valveless biased flow circuit, including an in-line bag-in-box and a variable soda-lime absorber. Progressive hypoxia was induced by consumption of oxygen and by gradual replacement of circuit volume with nitrogen. Tidal volume was measured by electrical integration of the flow signal from a pneumotach on the box. Arterial hemoglobin oxygen saturation (SaO2) was measured with an ear oximeter and end-tidal CO2 tension (PetCO2) was measured continuously and kept constant by variable absorption. Sleep state was identified using standard criteria with 2 channels each of EEG, submental EMG, and EOG. There was marked variability in arousal level both in NREM and REM sleep, with subjects failing to awaken by 70% SaO2, our previously agreed safety limit, on 12 of 26 NREM tests, and 7 of 15 REM tests. During wakefulness, the mean slope +/- SEM of the ventilatory response to hypoxia was 0.68 +/- 0.07 L/min% SaO2 (n = 36, mean PetCO2 = 37.0 mmHg). In NREM sleep, this response decreased to a mean of 0.42 +/- 0.06 L/min/% SaO2 (n = 26, mean PetCO2 = 37.2 mmHg). In REM sleep, the average ventilatory response was further decreased to 0.33 +/- 0.06 L/min/% SaO2 (n = 15, mean PetCO2 = 37.8 mmHg). Analysis of variance showed a significant state-dependent effect on ventilatory response (p less than 0.01). The wake-NREM and wake-REM differences were significantly different (p less than 0.05), but the NREM-REM difference was not (p greater than 0.2). In REM sleep, breath-to-breath variability was marked, and in 2 cases, the response was not significantly different from zero. In all 3 states, the entire ventilatory response was due to

  15. P ET CO2 e SpO2 permitem ajuste ventilatório adequado em pacientes obesos mórbidos P ET CO2 y SpO2 permiten ajuste de ventilación adecuada en pacientes obesos mórbidos P ET CO2 and SpO2 allow adequate ventilatory adjustment in morbidly obese patients

    Fábio Ely Martins Benseñor

    2004-08-01

    O2 mayor que 95%. No se utilizó PEEP. A través de monitor respiratorio CO2SMO Plus, se midió espacios muertos fisiológico, alveolar y de vías aéreas (VD phy, VD alv y VD aw y el volumen corriente alveolar (VT alv. Muestras de sangre arterial y venoso central permitieron calcular PaO2/FIO2 y VD phy/VT. Los datos fueron comparados y analizados por ANOVA (p BACKGROUND AND OBJECTIVES: Ventilation strategies for anesthesia in morbidly obese patients have been investigated, but an agreement has not been achieved yet. This study aimed at clinically evaluating ventilation adjustments based on oximetry and capnography readings in these patients during anesthesia. METHODS: Consent was obtained from the Institutional Ethics Committee and from patients. Smokers and respiratory or cardiac disease patients were excluded. Eleven patients with Body Mass Index (BMI of 59.2 ± 8.3 undergoing gastroplasty under general anesthesia were studied (Group O, with a control group (NO composed of 8 non-obese patients (BMI 20.2 ± 3.9 submitted to gastrectomy. Ventilator was adjusted to keep P ET CO2 below 40 mmHg and SpO2 above 95%. PEEP was not used. Through a CO2SMO Plus respiratory monitor, airway, alveolar and physiologic dead spaces (respectively VD aw, VD phy and VD alv, as well as alveolar tidal volume (TV alv were measured. Arterial and central venous blood samples were used to calculate PaO2/FIO2 and VD phy/TV relationships. Data were compared and evaluated by ANOVA (p < 0.05. RESULTS: Tidal volume was 4.2 ± 0.4 mL.kg-1 in Group O and 7.9 ± 2.3 mL.kg-1 in Group NO for measured weight, and 11.5 ± 1.8 mL.kg-1 in Group O and 6.6 ± 1.1 mL.kg-1 in Group NO for ideal weight. PaO2 was lower and TV alv was higher in Group O (p < 0.008 and 0.0001, respectively. No difference was found in PaCO2, VD phy, VD alv and VD aw. CONCLUSIONS: SpO2 and P ET CO2 seem to assure adequate ventilation, which can be achieved in morbidly obese patients with tidal volumes adjusted to ideal weight.

  16. Improvement of ventilatory function by spa therapy in patients with intractable asthma.

    Tanizaki,Yoshiro

    1986-01-01

    Twenty-five patients with intractable asthma had swimming training in a hot spring pool for 3 months. The subjects were divided into three groups according to their clinical symptoms and ages. Changes of ventilatory function during swimming training were observed in in each group. The ventilatory function test revealed that free swimming training in a hot spring pool for 30 min did not induce bronchoconstriction in any of the groups. The values of ventilatory parameters such as FEV 1.0%, %PEF...

  17. Failure of propranolol and metoprolol to alter ventilatory responses to carbon dioxide and exercise.

    Leitch, A. G.; Hopkin, J M; Ellis, D A; Clarkson, D M; Merchant, S; McHardy, G J

    1980-01-01

    Neither propranolol (80 mg) nor metoprolol (100 mg) give orally to eight normal subjects altered mean ventilatory responses to carbon dioxide or to moderate graded exercise. Incremental doses of the drugs to totals of 320 mg propranolol and 400 mg metoprolol also did not effect these ventilatory responses. Both drugs markedly decreased the heart rate response to exercise. Neither propranolol nor metoprolol are likely to cause CO2 retention by an effect on the ventilatory responses to inhaled ...

  18. Mechanisms of pentazocine-induced ventilatory depression and antinociception in anesthetized rats.

    Kimura, Satoko; Ohi, Yoshiaki; Haji, Akira

    2016-03-01

    This study was performed to clarify mechanisms underlying pentazocine-induced ventilatory depression and antinociception. Spontaneous ventilation and hind leg withdrawal response against nociceptive thermal stimulation were simultaneously recorded in anesthetized rats. Pentazocine decreased minute volume resulting from depression of the ventilatory rate and tracheal airflow, and prolonged the latency of withdrawal response. Pre-treatment of β-funaltorexamine, but not nor-binaltorphimine, significantly attenuated pentazocine-induced ventilatory depression, while either antagonist weakened its analgesic potency. Comparing with effects of fentanyl and U50488, the present results suggest that ventilatory depression induced by pentazocine is mediated by mainly μ receptors and analgesia by both μ and κ receptors. PMID:27021234

  19. DETECTION OF VENTILATORY ABNORMALITIES IN VARIOUS RESPIRATORY DISEASES

    Dumpa Vasudeva; Sundar Raj; Yugandhar; Satya Sri

    2015-01-01

    : The study involved 100 patients who presented at Department of pulmonary medicine, Alluri sitaramaraju academy of medical sciences, Eluru between December 2011 and December 2012. Also 100 normal persons were taken in to the study to compare the normal ventilatory function with the standards. There was a male preponderance in the study, about 75% of the study group were males. The mean height of males in the control group was 164.12±8.6 and 152±5.8 cm for females. The mean height...

  20. Alveolar recruitment maneuver and perioperative ventilatory support in obese patients undergoing abdominal surgery

    Forgiarini Júnior, Luiz Alberto; Rezende, Juliana Castilhos; Forgiarini, Soraia Genebra Ibrahim

    2013-01-01

    The development of abdominal surgery represents an alternative therapy for the morbidly obese; however, patients undergoing this surgical procedure often experience postoperative pulmonary complications. The use of alveolar recruitment maneuvers and/or perioperative ventilatory strategies is a possible alternative to reduce these complications, focusing on the reduction of postoperative pulmonary complications. In this review, the benefits of perioperative ventilatory strategies and the imple...

  1. Ventilatory pattern and associated episodic hypoxaemia in the late postoperative period in the general surgical ward

    Rosenberg, J; Rasmussen, G I; Wøjdemann, K R;

    1999-01-01

    , the median (range) respiratory disturbance index (apnoeas + hypopnoeas per h) was 12 (0-121), with the patients spending 6% (0-65%) of the night in some kind of ventilatory disturbance. It was not possible from pre-operative snoring habits to predict patients who developed postoperative ventilatory...

  2. IMPACT OF SMOKING ON ADULTS LUNG AGE AND VENTILATORY FUNCTION

    Omar Farouk Helal

    2014-04-01

    Full Text Available Background: Although a large body of evidence exists on the effect of smoking on lung age and pulmonary function, much less attention has been dedicated to using these effects as an effective strategy in smoking cessation. Objective: The present study was carried out to investigate the impact of smoking on lung age and ventilatory function in adult Saudi in order to use these effects in a future strategy for smoking cessation. Methods: Eighty one smoker students with their mean age 23.88 ± 2.7 years were enrolled in this study. Every student performed a ventilatory function tests in order to measure lung age, forced vital capacity (FVC, forced expiratory volume at the end of the first second (FEV1, FEV1/FVC ratio and peak expiratory flow rate PEFR. Results: The result showed significant deterioration in the mean value of FEV1, PEFR and the estimated lung age and a non-significant difference in the mean values of FVC. Conclusion: Smoking has a significant effect on ventilaroty function and deteriorating estimated lung age.

  3. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  4. ADJUSTMENT FACTORS AND ADJUSTMENT STRUCTURE

    Tao Benzao

    2003-01-01

    In this paper, adjustment factors J and R put forward by professor Zhou Jiangwen are introduced and the nature of the adjustment factors and their role in evaluating adjustment structure is discussed and proved.

  5. Regional ventilatory evaluation using dynamic SPET imaging of xenon-133 washout in obstructive lung disease: an initial study

    Regional ventilatory abnormalities in obstructive lung disease were evaluated by dynamic single-photon emission tomography (SPET) of pulmonary washout of xenon-133 (133Xe) gas. The subjects included seven healthy volunteers. 17 patients with obstructive lung disease, and seven patients with restrictive lung disease. Following 6 min of inhalation of 133Xe gas (60-72 MBq/1), equilibrium and subsequent washout SPET images during spontaneous breathing were sequentially acquired every 30 s for 6-7 min, using a triple-head SPET system with the return mode of continuous repetitive rotating acquisition. A gravity-induced gradient of ventilation was demonstrated in the volunteers' lungs. Compared with the normal subjects, all the patients with obstructive disease showed abnormal 133Xe retention on the washout SPET images, with or without abnormalities on chest X-ray computed tomography, whereas the patients with restrictive disease did not show any significant delays in washout. This modality may assist in the evaluation of the three-dimensional dynamic process of ventilatory abnormalities in obstructive lung disease. (orig.)

  6. 7 CFR 251.7 - Formula adjustments.

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Formula adjustments. 251.7 Section 251.7 Agriculture... GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION THE EMERGENCY FOOD ASSISTANCE PROGRAM § 251.7 Formula adjustments. Formula adjustments. (a) Commodity adjustments. The Department will make annual adjustments...

  7. [Noninvasive ventilation: efficacy of a new ventilatory mode in patients with obesity-hypoventilation syndrome].

    Couillard, A; Pepin, J-L; Rabec, C; Cuvelier, A; Portmann, A; Muir, J-F

    2015-03-01

    Noninvasive ventilation is recommended to correct the nocturnal hypoventilation and relieve the symptoms of patients with the obesity-hypoventilation syndrome (OHS). The benefits of fixed pressure ventilation (S/T technology) are recognized but limited on account of the variability of nocturnal ventilatory requirements. The new technique AVAPS-AE (automatic EPAP) allows adjustment of the pressure according to the volume currently targeted. Its efficacy has not yet been evaluated. Our objectives are to evaluate firstly, whether AVAPS-AE optimizes the benefits of S/T technology on sleep architecture and quality, secondly, whether these benefits are associated with an improvement in gas exchange, symptoms, exercise tolerance, level of physical activity and quality of life of patients with OHS. In this multicenter trial, 60 newly diagnosed patients with OHS will be randomized to the control (S/T) and trial (AVAPS-AE) groups. A standardized titration procedure will be followed for the calibration of the ventilators. Functional evaluations (polysomnography, blood gases, impedance measurements and walking tests), questionnaires (physical activity, quality of life, quality of sleep and daytime somnolence) visual scales (fatigue, headaches) and a recording of activity will be undertaken after two months of ventilation. PMID:25847207

  8. Significant ventilatory findings on ventilation-perfusion scintigraphy

    Full text: Despite recent advances in CT technology, ventilation -perfusion scintigraphy continues to remain a cost-effective, sensitive and well-utilised method for the assessment of pulmonary thrombo-embolic disease. The ventilation findings are often also of benefit in that they may give a clue to underlying parenchymal lung disease. Occasionally the assessment of ventilation can lead to critical diagnoses which may otherwise have not been appreciated. We present 2 such cases where the ventilatory findings indicated significant pathology - in one case post-operative upper airway stenosis and in the other complete lower airway obstruction. The cases and the imaging findings are discussed. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  9. Intracellular Signaling Mediators in the Circulatory and Ventilatory Systems

    Thiriet, Marc

    2013-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to phenomenological models of nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 4 is devoted to major sets of intracellular mediators that transmit signals upon stimulation of cell-surface receptors.  Activation of...

  10. Control of Cell Fate in the Circulatory and Ventilatory Systems

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volumes 1 and 2 are devoted to cell organization and fate, as well as activities that are autoregulated and/or controlled by the cell environment. Volume 1 examined cellular features that allow adaptation to env...

  11. Investigation of prevalence of ventilatory defects of textile mill workers in the Yazd province

    Salary M

    1999-08-01

    Full Text Available This study was conducted to investigate the prevalence of pulmonary problems, among a group of 1600 selected textile mill workers in the Yazd province. A standard questionnaire on respiratory symptoms was administered and forced vital capacity (FVC and forced expiratory volume in one second (FEV1 were determined for each worker. The results obtained were as follow: Obstructive ventilatory defect 15 cases (0.9 percent, restrictive ventilatory defect 16 cases (1 percent, combined obstructive and restrictive ventilatory defect (Mix 53 cases (3.3 percent and normal 1516 cases (94.8 percent.

  12. Convexity Adjustments

    M. Gaspar, Raquel; Murgoci, Agatha

    2010-01-01

    A convexity adjustment (or convexity correction) in fixed income markets arises when one uses prices of standard (plain vanilla) products plus an adjustment to price nonstandard products. We explain the basic and appealing idea behind the use of convexity adjustments and focus on the situations o...

  13. Improvement of ventilatory function by spa therapy in patients with intractable asthma.

    Tanizaki,Yoshiro

    1986-02-01

    Full Text Available Twenty-five patients with intractable asthma had swimming training in a hot spring pool for 3 months. The subjects were divided into three groups according to their clinical symptoms and ages. Changes of ventilatory function during swimming training were observed in in each group. The ventilatory function test revealed that free swimming training in a hot spring pool for 30 min did not induce bronchoconstriction in any of the groups. The values of ventilatory parameters such as FEV 1.0%, %PEFR, %V50 and %V25 were improved after the 3-month swimming training. The improvement of ventilatory parameters, especially %MMF, %V50 and %V25, by the training was most remarkable in the type II asthma group. The percent increase in %MMF, %V50 and %V25 was highest in patients more than 61 years of age, and higher in patients aged 40 to 60 years than in younger patients.

  14. Investigation of prevalence of ventilatory defects of textile mill workers in the Yazd province

    Salary M; Barkhordary A; Zahedpooranaraky M

    1999-01-01

    This study was conducted to investigate the prevalence of pulmonary problems, among a group of 1600 selected textile mill workers in the Yazd province. A standard questionnaire on respiratory symptoms was administered and forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were determined for each worker. The results obtained were as follow: Obstructive ventilatory defect 15 cases (0.9 percent), restrictive ventilatory defect 16 cases (1 percent), combined obstructiv...

  15. Alveolar recruitment maneuver and perioperative ventilatory support in obese patients undergoing abdominal surgery.

    Forgiarini Júnior, Luiz Alberto; Rezende, Juliana Castilhos; Forgiarini, Soraia Genebra Ibrahim

    2013-01-01

    The development of abdominal surgery represents an alternative therapy for the morbidly obese; however, patients undergoing this surgical procedure often experience postoperative pulmonary complications. The use of alveolar recruitment maneuvers and/or perioperative ventilatory strategies is a possible alternative to reduce these complications, focusing on the reduction of postoperative pulmonary complications. In this review, the benefits of perioperative ventilatory strategies and the implementation of alveolar recruitment maneuvers in obese patients undergoing abdominal surgery are described. PMID:24553513

  16. Possibilities of bronchography in diagnosis of ventilatory failure in chronic pulmonary diseases

    Ventilatory disorders have been studied in 187 patients by means of X-ray examination of the respiratory tract and its functional changes with the help of improved method of aspiration bronchography. The data obtained permit to distinguish the causes of ventilatory function disorders (obstructive and restrictive alterations) and the process spreading (diffuse or regional character). Timely detection of these lesions could help to avoid undesirable consequences in the treatment of patients

  17. Occurrence of respiratory symptoms in persons with restrictive ventilatory impairment compared with persons with chronic obstructive pulmonary disease: The PLATINO study.

    Nonato, Nívia L; Nascimento, Oliver A; Padilla, Rogelio P; de Oca, Maria M; Tálamo, Carlos; Valdivia, Gonzalo; Lisboa, Carmen; López, Maria V; Celli, Bartolomé; Menezes, Ana Maria B; Jardim, José R

    2015-08-01

    Patients with chronic obstructive pulmonary disease (COPD) usually complain of symptoms such as cough, sputum, wheezing, and dyspnea. Little is known about clinical symptoms in individuals with restrictive ventilatory impairment. The aim of this study was to compare the prevalence and type of respiratory symptoms in patients with COPD to those reported by individuals with restrictive ventilatory impairment in the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study. Between 2002 and 2004, individuals ≥40 years of age from five cities in Latin America performed pre and post-bronchodilator spirometry and had their respiratory symptoms recorded in a standardized questionnaire. Among the 5315 individuals evaluated, 260 (5.1%) had a restrictive spirometric diagnosis (forced vital capacity (FVC) normal (LLN) with forced expiratory volume in the first second to forced vital capacity ratio (FEV1/FVC) ≥ LLN; American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005) and 610 (11.9%) were diagnosed with an obstructive pattern (FEV1/FVC < LLN; ATS/ERS 2005). Patients with mild restriction wheezed more ((30.8%) vs. (17.8%); p < 0.028). No difference was seen in dyspnea, cough, and sputum between the two groups after adjusting for severity stage. The health status scores for the short form 12 questionnaire were similar in restricted and obstructed patients for both physical (48.4 ± 9.4 vs. 48.3 ± 9.8) and mental (50.8 ± 10.6 vs. 50.0 ± 11.5) domains. Overall, respiratory symptoms are not frequently reported by patients with restricted and obstructed patterns as defined by spirometry. Wheezing was more frequent in patients with restricted pattern compared with those with obstructive ventilatory defect. However, the prevalence of cough, sputum production, and dyspnea are not different between the two groups when adjusted by the same severity stage. PMID:26041119

  18. Gas inertia and ventilatory measurements under pressure: methodological considerations.

    Hickey, D D; Marky, D C; Smith, R J

    1983-12-01

    A bag-in-box apparatus with a spirometer was used to measure the ventilatory minute volume in subjects exercising at air pressures up to 6.8 atm. During rest there was good agreement between minute volumes derived from the expired gas in the bag and the sum of tidal volumes from the spirometer, whereas during exercise the bag volume exceeded the spirometer volume by up to 20%. This was found to be due to the inertia of high density gas in the breathing hoses. Given sufficient flow rate the gas would continue to flow from the box to the bag following end expiration and end inspiration. The spirometer would not record this because it only responds to changes in the sum of box and bag volumes, whereas emptying the bag through a gas meter records the volume of gas actually moved. A model was constructed to investigate the phenomenon. It was concluded that many different conventional setups for respiratory measurements may be subject to this type of error. Solutions to the problem include a collapsible tube section downstream from the subject, pneumotachometers, chest-mounted magnetometers, or inductive plethysmographs. PMID:6675225

  19. The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease

    Danilo M.L. Prado

    2015-01-01

    Full Text Available OBJECTIVE: To test the hypotheses that 1 coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2 coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO217.5 and 24.5 ml/kg/min. All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowest VE/VCO2 ratio observed. The exercise training program comprised moderate-intensity aerobic exercise performed 3 times per week for 3 months. Clinicaltrials.gov: NCT02106533 RESULTS: Before intervention, group 1 exhibited both lower peak VO2 and lower ventilatory efficiency compared with the other 2 groups (p<0.05. After the exercise training program, group 1 exhibited greater improvements in aerobic fitness and ventilatory efficiency compared with the 2 other groups (group 1: ▵ = -2.5±0.5 units; group 2: ▵ = -0.8±0.3 units; and group 3: ▵ = -1.4±0.6 units, respectively; p<0.05. CONCLUSIONS: Coronary artery disease patients with lower aerobic fitness status exhibited lower ventilatory efficiency during a graded exercise test. In addition, after 3 months of aerobic exercise training, only the patients with initially lower levels of aerobic fitness exhibited greater improvements in ventilatory efficiency.

  20. Increased ventilatory response to carbon dioxide in COPD patients following vitamin C administration

    Sara E. Hartmann

    2015-09-01

    Full Text Available Patients with chronic obstructive pulmonary disease (COPD have decreased ventilatory and cerebrovascular responses to hypercapnia. Antioxidants increase the ventilatory response to hypercapnia in healthy humans. Cerebral blood flow is an important determinant of carbon dioxide/hydrogen ion concentration at the central chemoreceptors and may be affected by antioxidants. It is unknown whether antioxidants can improve the ventilatory and cerebral blood flow response in individuals in whom these are diminished. Thus, we aimed to determine the effect of vitamin C administration on the ventilatory and cerebrovascular responses to hypercapnia during healthy ageing and in COPD. Using transcranial Doppler ultrasound, we measured the ventilatory and cerebral blood flow responses to hyperoxic hypercapnia before and after an intravenous vitamin C infusion in healthy young (Younger and older (Older subjects and in moderate COPD. Vitamin C increased the ventilatory response in COPD patients (mean (95% CI 1.1 (0.9–1.1 versus 1.5 (1.1–2.0 L·min−1·mmHg−1, p0.05 or Older (1.3 (1.0–1.7 versus 1.3 (1.0–1.7 L·min−1·mmHg−1, p>0.05 healthy subjects. Vitamin C did not affect the cerebral blood flow response in the young or older healthy subjects or COPD subjects (p>0.05. Vitamin C increases the ventilatory but not cerebrovascular response to hyperoxic hypercapnia in patients with moderate COPD.

  1. Effect of exercise training on ventilatory efficiency in patients with heart disease: a review.

    Prado, D M L; Rocco, E A; Silva, A G; Rocco, D F; Pacheco, M T; Furlan, V

    2016-06-20

    The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved. PMID:27332771

  2. Effects of inspiratory loading on the chaotic dynamics of ventilatory flow in humans.

    Samara, Ziyad; Raux, Mathieu; Fiamma, Marie-Noëlle; Gharbi, Alexandre; Gottfried, Stewart B; Poon, Chi-Sang; Similowski, Thomas; Straus, Christian

    2009-01-01

    Human ventilation at rest exhibits complexity and chaos. The aim of this study was to determine whether suprapontine interferences with the automatic breathing control could contribute to ventilatory chaos. We conducted a post hoc analysis of a previous study performed in awake volunteers exhibiting cortical pre-motor potentials during inspiratory loading. In eight subjects, flow was recorded at rest, while breathing against inspiratory threshold loads (median 21.5 cm H(2)O) and resistive loads (50 cm H(2)Ol(-1)s(-1)) loads, and while inhaling 7% CO(2)-93% O(2). Chaos was identified through noise titration (noise limit, NL) and the sensitivity to initial conditions was assessed through the largest Lyapunov exponent (LLE). Breath-by-breath variability was evaluated using the coefficient of variation of several ventilatory variables. Chaos was consistently present in ventilatory flow recordings, but mechanical loading did not alter NL, LLE, or variability. In contrast, CO(2) altered chaos and reduced variability. In conclusion, inspiratory loading - and any resultant respiratory-related cortical activity - were not associated with changes in ventilatory chaos in this study, arguing against suprapontine contributions to ventilatory complexity. PMID:19013545

  3. Effect of exercise training on ventilatory efficiency in patients with heart disease: a review

    Prado, D.M.L.; Rocco, E.A.; Silva, A.G.; Rocco, D.F.; Pacheco, M.T.; Furlan, V.

    2016-01-01

    The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved. PMID:27332771

  4. Hypoxic ventilatory drive in dogs during thiopental, ketamine, or pentobarbital anesthesia.

    Hirshman, C A; McCullough, R E; Cohen, P J; Weil, J V

    1975-12-01

    The ventilatory responses to isocapnic hypoxia and hypercapnia were studied in seven chronically tracheostomized dogs awake and during anesthesia with pentobarbital (30 mg/kg, iv), ketamine, or thiopental (10 and 15 mg/kg, respectively, followed by infusion). Isocapnic hypoxic ventilatory drive (HVD) was expressed as the parameter A such that the higher the A, the greater the hypoxic drive. HVD(A) was significantly reduced from 259 +/- 28 (mean +/- SEM) in awake dogs, to 96 +/- 14 after pentobarbital, 161 +/- 27 after thiopental, and 213 +/- 23 after ketamine. Hypercapnic ventilatory drive (HCVD) as measured by S (slope of the VE-PACO2 response curve) was significantly reduced from 1.3 +/- .32 in awake dogs to 0.4 +/- .13 after pentobarbital, 0.5 +/- .12 after thiopental, and 0.6 +/- .11 after ketamine. In addition, hypercapnia-induced augmentation of hypoxic drive was markedly diminished by the two barbiturates but was unaffected by ketamine. Therefore, ketamine at this dose level afforded greater protection during exposure to hypoxia than did barbiturates. (Key words: Ventilation, hypoxic response; Hypoxia, ventilation; Oxygen, ventilatory response; Carbon dioxide, ventilatory response; Anesthetics, intravenous, ketamine; Anesthetics, intravenous, thiopental; Hypnotics, barbiturates, pentobarbital.) PMID:1190538

  5. Adjustment disorder

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Fava ...

  6. Adjustment disorder

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, Va: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Rosenbaum ...

  7. Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients

    Karoliny dos Santos

    2016-01-01

    Full Text Available ABSTRACT Background Airflow limitation frequently leads to the interruption of activities of daily living (ADL in patients with Chronic Obstructive Pulmonary Disease (COPD. These patients commonly show absence of ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH. Objective To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects. Method Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred; control group: 14 healthy subjects (64±4 years matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF; and a modified shelf protocol isolating activity with upper limbs (TSHELF-M. Ventilatory response and inspiratory capacity were evaluated. Results Baseline ventilatory variables were similar between groups (p>0.05. The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p0.05 and ventilatory demand increased at the end of the tests (p<0.05 but to a lower extent than the COPD group. Conclusion The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload.

  8. Noninvasive Ventilatory Correction as an Adjunct to an Experimental Systemic Reperfusion Therapy in Acute Ischemic Stroke

    Kristian Barlinn

    2010-01-01

    Full Text Available Background. Obstructive sleep apnea (OSA is a common condition in patients with acute ischemic stroke and associated with early clinical deterioration and poor functional outcome. However, noninvasive ventilatory correction is hardly considered as a complementary treatment option during the treatment phase of acute ischemic stroke. Summary of Case. A 55-year-old woman with an acute middle cerebral artery (MCA occlusion received intravenous tissue plasminogen activator (tPA and enrolled into a thrombolytic research study. During tPA infusion, she became drowsy, developed apnea episodes, desaturated and neurologically deteriorated without recanalization, re-occlusion or intracerebral hemorrhage. Urgent noninvasive ventilatory correction with biphasic positive airway pressure (BiPAP reversed neurological fluctuation. Her MCA completely recanalized 24 hours later. Conclusions. Noninvasive ventilatory correction should be considered more aggressively as a complementary treatment option in selected acute stroke patients. Early initiation of BiPAP can stabilize cerebral hemodynamics and may unmask the true potential of other therapies.

  9. Oxygen diffusion limitation triggers ventilatory movements during spiracle closure when insects breathe discontinuously.

    Huang, Shu-Ping; Sender, Roi; Gefen, Eran

    2014-07-01

    During discontinuous gas exchange cycles in insects, spiracular opening follows a typical prolonged period of spiracle closure. Gas exchange with the environment occurs mostly during the period of full spiracular opening. In this study we tested the hypothesis that recently reported ventilatory movements during the spiracle closure period serve to mix the tracheal system gaseous contents, and support diffusive exchanges with the tissues. Using heliox (21% O2, 79% He), we found that by increasing oxygen diffusivity in the gas phase, ventilatory movements of Schistocerca gregaria were significantly delayed compared with normoxic conditions. Exposure to hyperoxic conditions (40% O2, 60% N2) resulted in a similar delay in forced ventilation. Together, these results indicate that limits to oxygen diffusion to the tissues during spiracle closure trigger ventilatory movements, which in turn support tissue demands. These findings contribute to our understanding of the mechanistic basis of respiratory gas exchange between insect tissues and the environment. PMID:24737753

  10. Chemosensitivity, Cardiovascular Risk, and the Ventilatory Response to Exercise in COPD.

    Michael K Stickland

    Full Text Available COPD is associated with elevated cardiovascular risk and a potentiated ventilatory response to exercise. Enhanced carotid chemoreceptor (CC activity/sensitivity is present in other clinical conditions, has been shown to contribute to sympathetic vasoconstrictor outflow, and is predictive of mortality. CC activity/sensitivity, and the resulting functional significance, has not been well examined in COPD. We hypothesized that CC activity/sensitivity would be elevated in COPD, and related to increased pulse wave velocity (a marker of CV risk and the ventilatory response to exercise.30 COPD patients and 10 healthy age-matched controls were examined. Participants performed baseline cardiopulmonary exercise and pulmonary function testing. CC activity was later evaluated by the drop in ventilation with breathing 100% O2, and CC sensitivity was then assessed by the ventilatory response to hypoxia (ΔVE/ΔSpO2. Peripheral arterial stiffness was subsequently evaluated by measurement of pulse wave velocity (PWV using applanation tonometry while the subjects were breathing room air, and then following chemoreceptor inhibition by breathing 100% O2 for 2 minutes.CC activity, CC sensitivity, PWV and the ventilatory response to exercise were all increased in COPD relative to controls. CC sensitivity was related to PWV; however, neither CC activity nor CC sensitivity was related to the ventilatory response to exercise in COPD. CC inhibition by breathing 100% O2 normalized PWV in COPD, while no effect was observed in controls.CC activity and sensitivity are elevated in COPD, and appear related to cardiovascular risk; however, CC activity/sensitivity does not contribute to the potentiated ventilatory response to exercise.

  11. Gender differences in continuous-flow left ventricular assist device therapy as a bridge to transplantation: a risk-adjusted comparison using a propensity score-matching analysis.

    Weymann, Alexander; Patil, Nikhil Prakash; Sabashnikov, Anton; Mohite, Prashant N; García Sáez, Diana; Amrani, Mohamed; Bahrami, Toufan; De Robertis, Fabio; Wahlers, Thorsten; Banner, Nicholas R; Popov, Aron-Frederik; Simon, André R

    2015-03-01

    The purpose of this study was to evaluate gender differences regarding outcome after continuous-flow left ventricular assist device (cfLVAD) implantation. The study was a retrospective review of prospectively collected data. Included were 24 consecutive female cfLVAD recipients and 24 male recipients (62.5% HeartMate II, 37.5% HeartWare) who received their devices between July 2007 and May 2013. Subjects were matched using propensity score analysis based on age, diagnosis, body surface area, preoperative mechanical circulatory support, heart failure severity score (INTERMACS class), and comorbidities. Female patients were significantly sicker before operation. After propensity score matching, there were no statistically significant differences in demographics or clinical baseline characteristics between male and female LVAD recipients. Also, there was a trend towards a longer postoperative intensive care unit stay in the female group (median 9 days [interquartile range 5-17] versus 15 days [interquartile range 8-33]; P < 0.061) and higher postoperative bilirubin values (median 14 mmol/L [interquartile range 10-17] versus 21 mmol/L [interquartile range 13-30]). However, there were no significant differences between the two groups in terms of outcome (P < 0.569). The overall survival was comparable between the two groups (log rank P < 0.389). Half (50%) of female patients required inotropic support for more than 7 days compared with 21.7% in the male group (P < 0.048). Half (50%) of female recipients required short-term postoperative right ventricular assist device implantation compared with 16.7% in the male group (P < 0.014). In conclusion, cfLVAD implantation as a bridge to transplantation is associated with longer duration of inotropic support and higher requirement for postoperative mechanical right ventricular support in women with similar survival rates. Further studies are required to identify additional demographic and clinical

  12. Effect of menstrual cycle phase on the ventilatory response to rising body temperature during exercise.

    Hayashi, Keiji; Kawashima, Takayo; Suzuki, Yuichi

    2012-07-01

    To examine the effect of menstrual cycle on the ventilatory sensitivity to rising body temperature, ten healthy women exercised for ~60 min on a cycle ergometer at 50% of peak oxygen uptake during the follicular and luteal phases of their cycle. Esophageal temperature, mean skin temperature, mean body temperature, minute ventilation, and tidal volume were all significantly higher at baseline and during exercise in the luteal phase than the follicular phase. On the other hand, end-tidal partial pressure of carbon dioxide was significantly lower during exercise in the luteal phase than the follicular phase. Plotting ventilatory parameters against esophageal temperature revealed there to be no significant menstrual cycle-related differences in the slopes or intercepts of the regression lines, although minute ventilation and tidal volume did significantly differ during exercise with mild hyperthermia. To evaluate the cutaneous vasodilatory response, relative laser-Doppler flowmetry values were plotted against mean body temperature, which revealed that the mean body temperature threshold for cutaneous vasodilation was significantly higher in the luteal phase than the follicular phase, but there were no significant differences in the sensitivity or peak values. These results suggest that the menstrual cycle phase influences the cutaneous vasodilatory response during exercise and the ventilatory response at rest and during exercise with mild hyperthermia, but it does not influence ventilatory responses during exercise with moderate hyperthermia. PMID:22604882

  13. Ventilatory efficiency and breathing pattern in world-class cyclists: A three-year observational study.

    Salazar-Martínez, Eduardo; Terrados, Nicolás; Burtscher, Martin; Santalla, Alfredo; Naranjo Orellana, José

    2016-07-15

    The purpose of this three-year observational study was to analyze the ventilatory efficiency and breathing pattern in world-class professional cyclists. Twelve athletes (22.61±3.8years; 177.38±5.5cm; 68.96±5.5kg and VO2max 75.51±3.3mLkg(-1)min(-1)) were analyzed retrospectively. For each subject, respiratory and performance variables were recorded during incremental spiroergometry: oxygen uptake (VO2), carbon dioxide output (VCO2), pulmonary ventilation (VE), tidal volume (Vt), breathing frequency (fR), driving (Vt/Ti), timing (Ti/Ttot), peak power output (PPO) and maximum oxygen uptake (VO2max). Ventilatory efficiency (VE/VCO2 slope) was calculated from the beginning of exercise testing to the second ventilatory threshold (VT2). The VE/VCO2 slope was unaffected during the study period (24.63±3.07; 23.61±2:79; 24:89±2:61) with a low effect size (ES=0.04). The PPO improved significantly in the third year (365±33.74; 386.36±32.33; 415.00±24.15) (pperformance in world-class professional cyclists do not modify breathing variables related to the control of ventilatory efficiency. PMID:27083403

  14. An experimental randomized study of six different ventilatory modes in a piglet model with normal lungs

    Nielsen, J B; Sjöstrand, U H; Henneberg, S W

    1991-01-01

    -controlled intermittent positive-pressure ventilation; and SV-20P denotes pressure-controlled intermittent positive-pressure ventilation. With all modes of ventilation a PEEP of 7.5 cm H2O was used. In the abbreviations used, the number denotes the ventilatory frequency in breaths per minute (bpm). HFV indicates that all...

  15. Salary adjustments

    HR Department

    2008-01-01

    In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, the following elements do not increase: a)\tFamily Allowance, Child Allowance and Infant Allowance (Annex R A 3); b)\tReimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be applied, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and rounding effects. Human Resources Department Tel. 73566

  16. Salary adjustments

    HR Department

    2008-01-01

    In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, following elements do not increase: a) Family Allowance, Child Allowance and Infant Allowance (Annex R A 3). b) Reimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be implemented, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and the rounding effects. Human Resources Department Tel. 73566

  17. 24 CFR 886.312 - Rent adjustments.

    2010-04-01

    ... levels of such expenses in comparable assisted and unassisted housing in the area to ensure that... assisted and comparable unassisted units. Contract rents may be adjusted upward or downward as may be...) Comparability between assisted and unassisted units. Notwithstanding any other provisions of this...

  18. Adjustable collimator

    In a rotating fan beam tomographic scanner there is included an adjustable collimator and shutter assembly. The assembly includes a fan angle collimation cylinder having a plurality of different length slots through which the beam may pass for adjusting the fan angle of the beam. It also includes a beam thickness cylinder having a plurality of slots of different widths for adjusting the thickness of the beam. Further, some of the slots have filter materials mounted therein so that the operator may select from a plurality of filters. Also disclosed is a servo motor system which allows the operator to select the desired fan angle, beam thickness and filter from a remote location. An additional feature is a failsafe shutter assembly which includes a spring biased shutter cylinder mounted in the collimation cylinders. The servo motor control circuit checks several system conditions before the shutter is rendered openable. Further, the circuit cuts off the radiation if the shutter fails to open or close properly. A still further feature is a reference radiation intensity monitor which includes a tuning-fork shaped light conducting element having a scintillation crystal mounted on each tine. The monitor is placed adjacent the collimator between it and the source with the pair of crystals to either side of the fan beam

  19. Assessing and Managing Medically Fragile Children: Tracheostomy and Ventilatory Support

    Woodnorth, Geralyn Harvey

    2004-01-01

    Over the past decade, there has been an increase in premature births. Children born prematurely often present with complex medical conditions; some require a tracheostomy. Although many children with tracheostomies require assistance to achieve effective communication, speech-language pathologists may have limited information with respect to the…

  20. Oral beraprost sodium improves exercise capacity and ventilatory efficiency in patients with primary or thromboembolic pulmonary hypertension

    Nagaya, N; Shimizu, Y; Satoh, T.; Oya, H.; Uematsu, M.; Kyotani, S; Sakamaki, F; N. Sato; Nakanishi, N; Miyatake, K

    2002-01-01

    Objective: To investigate the effect of beraprost sodium, an orally active prostacyclin analogue, on exercise capacity and ventilatory efficiency in patients with primary pulmonary hypertension and chronic thromboembolic pulmonary hypertension.

  1. Selective antagonism of opioid-induced ventilatory depression by an ampakine molecule in humans without loss of opioid analgesia.

    Oertel, B G; Felden, L; Tran, P V; Bradshaw, M H; Angst, M S; Schmidt, H; Johnson, S; Greer, J J; Geisslinger, G; Varney, M A; Lötsch, J

    2010-02-01

    Ventilatory depression is a significant risk associated with the use of opioids. We assessed whether opioid-induced ventilatory depression can be selectively antagonized by an ampakine without reduction of analgesia. In 16 healthy men, after a single oral dose of 1,500 mg of the ampakine CX717, a target concentration of 100 ng/ml alfentanil decreased the respiratory frequency by only 2.9 +/- 33.4% as compared with 25.6 +/- 27.9% during placebo coadministration (P CX717 than with placebo. In contrast, CX717 did not affect alfentanil-induced analgesia in either electrical or heat-based experimental models of pain. Both ventilatory depression and analgesia were reversed with 1.6 mg of naloxone. These results support the use of ampakines as selective antidotes in humans to counter opioid-induced ventilatory depression without affecting opioid-mediated analgesia. PMID:19907420

  2. Acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension

    Iwase, T.; Nagaya, N; Ando, M.; Satoh, T.; Sakamaki, F; Kyotani, S; Takaki, H; Goto, Y.; Ohkita, Y; Uematsu, M.; Nakanishi, N; Miyatake, K

    2001-01-01

    OBJECTIVE—To assess acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension (CTEPH).
DESIGN—Cardiopulmonary exercise testing was performed in 20 patients with CTEPH before thromboendarterectomy (baseline), one month after (early phase), and four months after (late phase). Peak oxygen uptake (peak V̇O2) and the ventilatory response to carbon dioxide production (V̇E-V̇CO2 slope) we...

  3. Estimates of restrictive ventilatory defect in the mining industry. Considerations for epidemiological investigations: a cross-sectional study

    Odo, Nnaemeka U; Mandel, Jeffrey H.; Perlman, David M; Alexander, Bruce H.; Scanlon, Paul D.

    2013-01-01

    Objectives (1) To assess the impact of American Thoracic Society and European Respiratory Society (ATS/ERS) ‘acceptability’ and ‘usability’ criteria for spirometry on the estimates of restrictive ventilatory defect in a population of taconite miners. (2) To compare estimates of restrictive ventilatory defect with three different pulmonary function tests (spirometry, alveolar volume (VA) and diffusing capacity (DL,CO)). (3) To assess the role of population characteristics on these estimates. D...

  4. Cardiovascular and ventilatory responses to electrically induced cycling with complete epidural anaesthesia in humans

    Kjaer, M; Perko, G; Secher, N H;

    1994-01-01

    Cardiovascular and ventilatory responses to electrically induced dynamic exercise were investigated in eight healthy young males with afferent neural influence from the legs blocked by epidural anaesthesia (25 ml 2% lidocaine) at L3-L4. This caused cutaneous sensory anaesthesia below T8-T9 and.......1 vs. 17.3 +/- 0.91 min-1) were similar, and ventilation (54 +/- 5 vs. 45 +/- 41 min-1) was higher (P <0.05). In contrast, the rise in mean arterial blood pressure during voluntary exercise (93 +/- 4 (rest) to 119 +/- 4 mmHg (exercise)) was not manifest during electrically induced exercise with...... epidural anaesthesia [93 +/- 3 (rest) to 95 +/- 5 mmHg (exercise)]. As there is ample evidence for similar cardiovascular and ventilatory responses to electrically induced and voluntary exercise (Strange et al. 1993), the present results support the fact that the neural input from working muscle is crucial...

  5. Sleep state dependence of ventilatory long-term facilitation following acute intermittent hypoxia in Lewis rats

    Nakamura, A.; Olson, E B; Terada, J.; Wenninger, J. M.; Bisgard, G. E.; Mitchell, G.S.

    2010-01-01

    Ventilatory long-term facilitation (vLTF) is a form of respiratory plasticity induced by acute intermittent hypoxia (AIH). Although vLTF has been reported in unanesthetized animals, little is known concerning the effects of vigilance state on vLTF expression. We hypothesized that AIH-induced vLTF is preferentially expressed in sleeping vs. awake male Lewis rats. Vigilance state was assessed in unanesthetized rats with chronically implanted EEG and nuchal EMG electrodes, while tidal volume, fr...

  6. Ventilatory stability to transient CO2 disturbances in hyperoxia and normoxia in awake humans.

    Lai, J; Bruce, E N

    1997-08-01

    Modarreszadeh and Bruce (J. Appl. Physiol. 76: 2765-2775, 1994) proposed that continuous random disturbances in arterial PCO2 are more likely to elicit ventilatory oscillation patterns that mimic periodic breathing in normoxia than in hyperoxia. To test this hypothesis experimentally, in nine awake humans we applied pseudorandom binary inspired CO2 fraction stimulation in normoxia and hyperoxia to derive the closed-loop and open-loop ventilatory responses to a brief CO2 disturbance in terms of impulse responses and transfer functions. The closed-loop impulse response has a significantly higher peak value [0.143 +/- 0.071 vs. 0.079 +/- 0.034 (SD) l . min-1 . 0.01 l CO2-1, P = 0.014] and a significantly shorter 50% response duration (42.7 +/- 13.3 vs. 72.3 +/- 27.6 s, P = 0.020) in normoxia than in hyperoxia. Therefore, the ventilatory responses to transient CO2 disturbances are less damped (but generally not oscillatory) in normoxia than in hyperoxia. For the closed-loop transfer function, the gain in normoxia increased significantly (P < 0.0005), while phase delay decreased significantly (P < 0.0005). The gain increased by 108.5, 186.0, and 240.6%, while phase delay decreased by 26.0, 18.1, and 17.3%, at 0. 01, 0.03, and 0.05 Hz, respectively. Changes in the same direction were found for the open-loop system. Generally, an oscillatory ventilatory response to a small transient CO2 disturbance is unlikely during wakefulness. However, changes in parameters that lead to additional increases in chemoreflex loop gain are more likely to initiate oscillations in normoxia than in hyperoxia. PMID:9262442

  7. Ventilatory responses to exercise in adults after repair of tetralogy of Fallot.

    Clark, A. L.; M.A. Gatzoulis; Redington, A N

    1995-01-01

    BACKGROUND--Adult patients with total correction of tetralogy of Fallot may have poor exercise capacity associated with impaired right heart function and in particular pulmonary regurgitation. The ventilatory responses to exercise were studied in a group of such patients to assess relations between ventilation, exercise capacity, and right ventricular function. METHODS--30 patients (7 female) (aged 27.8 (6.0) years) and 30 (7 female) controls of a similar age range were studied prospectively....

  8. Prepubescents' ventilatory responses to exercise with reference to sex and body size

    McManus, AM; Armstrong, N; Kirby, BJ; Welsman, JR

    1997-01-01

    Study objectives: To examine the ventilatory responses of prepubescent children to submaximal and peak exercise using appropriate allometric modeling to control for differences in body size. Design: Cross-sectional study of a representative sample of children. Setting: Middle schools (8 to 11 years) in Exeter, UK. Participants: We studied 101 boys and 76 girls aged 11.1 (0.4) years and classified Tanner stage 1 for pubic hair (no true pubic hair). Measurements: At rest: stature, mass, sum of ...

  9. Ventilatory compensation of the alkaline tide during digestion in the snake Boa constrictor.

    Andrade, Denis V; De Toledo, Luis Felipe; Abe, Augusto S; Wang, Tobias

    2004-03-01

    The increased metabolic rate during digestion is associated with changes in arterial acid-base parameters that are caused by gastric acid secretion (the 'alkaline tide'). Net transfer of HCl to the stomach lumen causes an increase in plasma HCO3- levels, but arterial pH does not change because of a ventilatory compensation that counters the metabolic alkalosis. It seems, therefore, that ventilation is controlled to preserve pH and not PCO2 during the postprandial period. To investigate this possibility, we determined arterial acid-base parameters and the metabolic response to digestion in the snake Boa constrictor, where gastric acid secretion was inhibited pharmacologically by oral administration of omeprazole. The increase in oxygen consumption of omeprazole-treated snakes after ingestion of 30% of their own body mass was quantitatively similar to the response in untreated snakes, although the peak of the metabolic response occurred later (36 h versus 24 h). Untreated control animals exhibited a large increase in arterial plasma HCO3- concentration of approximately 12 mmol l(-1), but arterial pH only increased by 0.12 pH units because of a simultaneous increase in arterial PCO2 by about 10 mmHg. Omeprazole virtually abolished the changes in arterial pH and plasma HCO3- concentration during digestion and there was no increase in arterial PCO2. The increased arterial PCO2 during digestion is not caused, therefore, by the increased metabolism during digestion or a lower ventilatory responsiveness to ventilatory stimuli during a presumably relaxed state in digestion. Furthermore, the constant arterial PCO2, in the absence of an alkaline tide, of omeprazole-treated snakes strongly suggests that pH rather than PCO2 normally affects chemoreceptor activity and ventilatory drive. PMID:15010489

  10. Withdrawal of ventilatory support outside the intensive care unit: guidance for practice

    Laddie, J.; Craig, F; Brierley, J; Kelly, P; Bluebond-Langner, M.

    2014-01-01

    Objective To review the work of one tertiary paediatric palliative care service in facilitating planned withdrawal of ventilatory support outside the intensive care setting, with the purpose of developing local guidance for practice. Methods Retrospective 10-year (2003–2012) case note review of intensive care patients whose parents elected to withdraw ventilation in another setting. Demographic and clinical data revealed common themes and specific incidents relevant to local guideline develop...

  11. Unusual features in chronic inflammatory demyelinating polyneuropathy: Good outcome after prolonged ventilatory support

    Sanjeev Jha; M K Ansari; K K Sonkar; Paliwal, V. K.

    2011-01-01

    Severe respiratory muscle paralysis and ventilatory failure is rare in chronic inflammatory demyelinating polyneuropathy (CIDP). We report a 14 year child who presented with respiratory failure, bulbar and multiple cranial nerves involvement along with bilateral phrenic nerve paralysis. He was diagnosed with CIDP after electrophysiological evaluation. He required AMBU ventilation for about 4 months (including domiciliary use), after which he recovered significantly. Along with several unusual...

  12. Noninvasive Ventilatory Correction as an Adjunct to an Experimental Systemic Reperfusion Therapy in Acute Ischemic Stroke

    April Sisson; Alexandrov, Andrei V; Paola Palazzo; Kristian Barlinn; Limin Zhao; Clotilde Balucani

    2010-01-01

    Background. Obstructive sleep apnea (OSA) is a common condition in patients with acute ischemic stroke and associated with early clinical deterioration and poor functional outcome. However, noninvasive ventilatory correction is hardly considered as a complementary treatment option during the treatment phase of acute ischemic stroke. Summary of Case. A 55-year-old woman with an acute middle cerebral artery (MCA) occlusion received intravenous tissue plasminogen activator (tPA) and enrolled int...

  13. Ventilatory decrements in former asbestos cement workers: a four year follow up.

    Ohlson, C G; Bodin, L; Rydman, T; Hogstedt, C

    1985-01-01

    A four year follow up of the ventilatory function in former asbestos cement workers has been performed to determine whether any further decrease occurred after cessation of exposure. Seventy five of 125 subjects were eligible for re-examination and were compared with local referents. None showed signs of asbestosis but 32% had pleural plaques at the renewed examination. Cumulative asbestos exposure calculated as fibre x years had been estimated individually in the original examination. After ...

  14. Comparison of mechanical ventilatory constraints between continuous and intermittent exercises in healthy prepubescent children.

    Borel, Benoit; Leclair, Erwan; Thevenet, Delphine; BEGHIN, Laurent; Gottrand, Frédéric; Fabre, Claudine

    2011-01-01

    Abstract BBackground: The aim of this study was to evaluate the occurrence and severity of mechanical ventilatory constraints in healthy prepubescent children during continuous and intermittent exercise. Methods: Twelve prepubescent children (7 ? 11 years old) performed 7 exercises on a treadmill: one graded test for the determination of maximal aerobic speed (MAS), three continuous exercises (CE) at 60, 70 and 80% of MAS and three intermittent exercises (IE), alternating 15s of...

  15. Short term variability in FEV1 and bronchodilator responsiveness in patients with obstructive ventilatory defects.

    Tweeddale, P M; Alexander, F.; McHardy, G J

    1987-01-01

    Short term variability in FEV1 and responsiveness to inhaled bronchodilator were measured in 150 patients with obstructive ventilatory defects. The range of initial FEV1 was 0.5-4.71 and the natural variability over a 20 minute period when expressed in absolute terms was similar over the entire range, and differed insignificantly from that found in normal subjects. The increase in FEV1 and vital capacity (VC) required to exclude natural variability with 95% confidence in these patients was 16...

  16. The ventilatory response to hypoxia: how much is good for a mountaineer?

    Milledge, J S

    1987-01-01

    Methods for measuring the ventilatory response to hypoxia (HVR) are reviewed. The criteria for success as a high altitude mountaineer are defined as freedom from acute mountain sickness (AMS) and ability to perform well at extreme altitude. The evidence for a brisk HVR being protective against AMS and associated with successful high altitude performance is reviewed. The contrary evidence of blunted HVR in high altitude residence and some elite climbers is discussed. The effect of a brisk HVR ...

  17. Ventilatory and metabolic responses of burrowing owls, Athene cunicularia, to moderate and extreme hypoxia: analysis of the hypoxic ventilatory threshold vs. hemoglobin oxygen affinity relationship in birds.

    Kilgore, Delbert L; Boggs, Dona F; Kilgore, Trevor J; Colby, Conrad; Williams, Burl R; Bavis, Ryan W

    2008-06-01

    We measured ventilation, oxygen consumption and blood gases in burrowing owls (Athene cunicularia) breathing moderate and extreme hypoxic gas mixtures to determine their hypoxic ventilatory threshold (HVT) and to assess if they, like other birds and mammals, exhibit a relationship between HVT and hemoglobin O2 affinity (P(50)) of their blood. An earlier report of an attenuated ventilatory responsiveness of this species to hypoxia was enigmatic given the low O2 affinity (high P(50)) of burrowing owl hemoglobin. In the current study, burrowing owls breathing 11% and 9% O2 showed a significantly elevated total ventilation. The arterial partial pressure of oxygen (PaO2) at which ventilation is elevated above normoxic values in burrowing owls was 58 mm Hg. This threshold value conforms well to expectations based on the high P(50) of their hemoglobin and the HVT vs. P(50) relationship for birds developed in this study. Correcting for phylogenetic relatedness in the multi-species analysis had no effect on the HVT vs. P(50) relationship. Also, because burrowing owls in this study did not show a hypometabolic response at any level of hypoxia (even at 9% O2); HVT described in terms of percent change in oxygen convection requirement is identical to that based on ventilation alone. PMID:17561426

  18. Time Domains of the Hypoxic Ventilatory Response and Their Molecular Basis.

    Pamenter, Mathhew E; Powell, Frank L

    2016-01-01

    Ventilatory responses to hypoxia vary widely depending on the pattern and length of hypoxic exposure. Acute, prolonged, or intermittent hypoxic episodes can increase or decrease breathing for seconds to years, both during the hypoxic stimulus, and also after its removal. These myriad effects are the result of a complicated web of molecular interactions that underlie plasticity in the respiratory control reflex circuits and ultimately control the physiology of breathing in hypoxia. Since the time domains of the physiological hypoxic ventilatory response (HVR) were identified, considerable research effort has gone toward elucidating the underlying molecular mechanisms that mediate these varied responses. This research has begun to describe complicated and plastic interactions in the relay circuits between the peripheral chemoreceptors and the ventilatory control circuits within the central nervous system. Intriguingly, many of these molecular pathways seem to share key components between the different time domains, suggesting that varied physiological HVRs are the result of specific modifications to overlapping pathways. This review highlights what has been discovered regarding the cell and molecular level control of the time domains of the HVR, and highlights key areas where further research is required. Understanding the molecular control of ventilation in hypoxia has important implications for basic physiology and is emerging as an important component of several clinical fields. © 2016 American Physiological Society. Compr Physiol 6:1345-1385, 2016. PMID:27347896

  19. Ventilatory thresholds during wheelchair exercise in individuals with spinal cord injuries.

    Coutts, K D; McKenzie, D C

    1995-07-01

    The ventilatory thresholds of 30 male wheelchair athletes were determined from their respiratory and metabolic responses to a continuously progressive exercise protocol to peak oxygen uptake on a wheelchair ergometer. The peak oxygen uptake (peak VO2), ventilatory threshold in 1 min-1 (VTL), and ventilatory threshold expressed as a percentage of peak VO2 (VT%) were measured for all subjects. Statistical analyses of selected subsamples were used to note sport and functional ability level differences in these variables. Analysis of peak VO2 by functional classification (old International Stoke Mandeville Games Federation system; classes 1A-5, plus an amputee class) indicated that paraplegic (classes 2-5) and the amputee class athletes (2.48 1 min-1) were higher than tetraplegic (classes 1A-1C) athletes (0.95 1 min-1). The paraplegic and amputee classes were combined for a comparison of peak VO2 by sport which showed that track athletes (2.80 1 min-1) were higher than basketball players (2.41 1 min-1) who were higher than athletes from other sports (1.88 1 min-1). The VTL analyses demonstrated differences similar to the peak VO2 analyses. The VT% analyses, however, showed no sport differences, but the tetraplegic athletes had higher VT% values (87%) than the paraplegic plus amputee group (69%). PMID:7478733

  20. Adjustment Policies in the United States

    Blandford, David

    2003-01-01

    Principal adjustment programs are reviewed unemployment insurance (UI) and related long-term programs for displaced workers, and trade adjustment assistance (TAA). None of these programs has had wide application in agriculture, although the current trade act contains a new program specifically for farmers.

  1. 24 CFR 886.112 - Rent adjustments.

    2010-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  2. Sleep state dependence of ventilatory long-term facilitation following acute intermittent hypoxia in Lewis rats.

    Nakamura, A; Olson, E B; Terada, J; Wenninger, J M; Bisgard, G E; Mitchell, G S

    2010-08-01

    Ventilatory long-term facilitation (vLTF) is a form of respiratory plasticity induced by acute intermittent hypoxia (AIH). Although vLTF has been reported in unanesthetized animals, little is known concerning the effects of vigilance state on vLTF expression. We hypothesized that AIH-induced vLTF is preferentially expressed in sleeping vs. awake male Lewis rats. Vigilance state was assessed in unanesthetized rats with chronically implanted EEG and nuchal EMG electrodes, while tidal volume, frequency, minute ventilation (Ve), and CO(2) production were measured via plethysmography, before, during, and after AIH (five 5-min episodes of 10.5% O(2) separated by 5-min normoxic intervals), acute sustained hypoxia (25 min of 10.5% O(2)), or a sham protocol without hypoxia. Vigilance state was classified as quiet wakefulness (QW), light and deep non-rapid eye movement (NREM) sleep (l-NREM and d-NREM sleep, respectively), or rapid eye movement sleep. Ventilatory variables were normalized to pretreatment baseline values in the same vigilance state. During d-NREM sleep, vLTF was observed as a progressive increase in Ve post-AIH (27 + or - 5% average, 30-60 min post-AIH). In association, Ve/Vco(2) (36 + or - 2%), tidal volume (14 + or - 2%), and frequency (7 + or - 2%) were increased 30-60 min post-AIH during d-NREM sleep. vLTF was significant but less robust during l-NREM sleep, was minimal during QW, and was not observed following acute sustained hypoxia or sham protocols in any vigilance state. Thus, vLTF is state-dependent and pattern-sensitive in unanesthetized Lewis rats, with the greatest effects during d-NREM sleep. Although the physiological significance of vLTF is not clear, its greatest significance to ventilatory control is most likely during sleep. PMID:20360430

  3. EFFECT OF TIME OF DAY ON THE RELATIONSHIP BETWEEN LACTATE AND VENTILATORY THRESHOLDS: A BRIEF REPORT

    Fadil Ozyener

    2002-12-01

    Full Text Available The purpose of this investigation was to study the effect of time of day on the relationship between lactate (LT and ventilatory thresholds (VT of pulmonary oxygen uptake (VO2. Seven moderately active male volunteers (26.3±3.0 years, 1.74±0.08 m, 76±5 kg performed a maximal incremental test (increases of 30 W every 2 min on a cycle ergometer on consecutive days at 0900 h, 1400h and 1900 h in a randomized fashion. The anaerobic threshold was determined using both ventilatory gas analysis and blood lactate measures. Each of the following variables was recorded both at VT and the LT; heart rate (HR, beats.min-1, minute ventilation (VE, L.min-1, respiratory exchange ratio (RER, time to threshold (Time, sec, oxygen uptake (VO2, ml.kg-1.min-1 and VO2 as a percentage of maximal oxygen uptake (%VO2max. The correlations between VT and LT variables analyzed by Pearson product moment correlations for each time of day. ANOVA was used to compare the data obtained at different times of the day. There were no significant differences for the data related to time of day either for ventilatory gas analysis or lactate measurements. The correlation coefficients between VT and LT variables were moderate to high (r=0.56-0.94 for time of day. However, the correlations for HR, VO2, and %VO2max (r=0.81-0.94 were slightly stronger compared with Time, VE and RER (r=0.56-0.88. It was concluded that, the data at VT and LT were not influenced by time of day

  4. GABA representation in hypoxia sensing: a ventilatory study in the rat.

    Tarakanov, I; Tikhomirova, L; Tarasova, N; Safonov, V; Bialkowska, M; Pokorski, M

    2011-01-01

    Phenibut, a nonspecific GABA derivative, is clinically used as an anxiolytic and tranquilizer in psychosomatic conditions. A GABA-ergic inhibitory pathway is engaged in respiratory control at both central and peripheral levels. However, the potential of phenibut to affect the O2-related chemoreflexes has not yet been studied. In this study we seek to determine the ventilatory responses to changes in inspired O2 content in anesthetized, spontaneously-breathing rats. Steady-state 5-min responses to 10% O2 in N2 and 100% O2 were taken in each animal before and 1 h after phenibut administration in a dose 450 mg/kg, i.p. Minute ventilation and its frequency and tidal components were obtained from the respiratory flow signal. We found that after a period of irregular extension of the respiratory cycle, phenibut stabilized resting ventilation at a lower level [20.0±3.3 (SD) vs 31.1±5.2 ml/min before phenibut; Pphenibut was not reflected in the hypoxic response. In relative terms, this response was actually accentuated after phenibut; the peak hypoxic ventilation increased by 164% from baseline vs the 100% increase before phenibut. Regarding hyperoxia, its inhibitory effect on breathing was more expressed after phenibut. In conclusion, the GABA-mimetic phenibut did not curtail hypoxic ventilatory responsiveness, despite the presence of GABA-ergic pathways in both central and peripheral, carotid body mechanisms mediating the hypoxic chemoreflex. Thus, GABA-mediated synaptic inhibition may be elaborated in a way to sustain the primarily defensive ventilatory chemoreflex. PMID:21880205

  5. Hypoxic ventilatory response after dopamine D2 receptor blockade in unilateral rat model of Parkinson's disease.

    Andrzejewski, K; Budzińska, K; Zaremba, M; Kaczyńska, K

    2016-03-01

    Modified non-motor brainstem ventilatory control might be involved in Parkinson's disease. Our study was designed to investigate the impact of degeneration of the nigrostriatal dopaminergic pathway on resting breathing and hypoxic ventilatory response in conscious rats. The role of central and peripheral dopamine D2 receptors in the modulation of the hypoxic ventilatory response in conditions of dopamine shortage was examined. Adult Wistar rats received a unilateral double 6-hydroxydopamine lesion of the right medial forebrain bundle. After surgery, animals were placed in whole-body plethysmographic chamber and exposed to hypoxia (8% O2). One group of animals received inraperitoneal injections of either haloperidol or domperidone before hypoxia. Levels of dopamine and its metabolite in the brainstem and striatum were assessed. Neurotoxin treatment evoked limb use asymmetry. No effect on the resting normoxic respiration was observed. An increase in tidal volume and a decrease in respiratory rate during respiratory response to hypoxia with short magnification of minute ventilation were predominant effects. Domperidone treatment in intact animals evoked a significant increase in normoxic tidal volume, while haloperidol potentiated tidal volume increase in response to hypoxia. After the lesion, the effects of both antagonists were absent. In rats with Parkinson's, the content of dopamine and its metabolite decreased substantially in the injured striatum. Augmentation of a tidal volume response to hypoxia, and the absence of stimulatory effect of intraperitoneal domperidone on normoxic and haloperidol on hypoxic tidal volume, in lesioned rats indicated altered control of breathing. This could be the result of a dopamine deficiency in the striatum and an increased turnover of DOPAC/DA in the brainstem. PMID:26705738

  6. The effects of acute L-carnitine administration on ventilatory breakpoint and exercise performanceduring incremental exercise

    Mojtaba Kaviani

    2009-01-01

    Full Text Available (Received 31 October, 2009 ; Accepted 10 March, 2010AbstractBackground and purpose: Many athletes adopt nutritional manipulations to improve their performance. Among the substances generally consumed is carnitine (L-trimethyl-3-hydroxy-ammoniobutanoate which has been used by athletes as an ergogenic aid, due to its role in the transport of long-chain fatty acids across mitochondrial membranes. Nutritional supplements containing carbohydrates, proteins, vitamins, and minerals have been widely used in various sporting fields to provide a boost to the recommended daily allowance. The aim of this study is to investigate the effects of acute L-carnitine administration on ventilatory breakpoint, an exercise performance during incremental exercise.Materials and methods: This study was double-blind, randomized and crossover in design. The subjects were 12 randomly selected active male physical education students, 21.75±0.64 years old, with a mean body mass index (BMI of 23.7±0.94kg/m2, divided into 2 groups. They received orally either 2g of L-carnitine dissolved in 200 ml of water, plus 6 drops of lemon juice or a placebo (6 ml lemon juice dissolved in 200 ml of water 90 minutes before they began to exercise on a treadmill. They performed a modified protocol of Conconi test to exhaustion. One-way analysis of variance with repeated measurements was used for data analysis.Results: The results showed that exercise performance improved in LC group (2980±155 meter compared with placebo group (2331±51 meter. Furthermore, no significant difference was found in ventilatory breakpoint between the two groups.Conclusion: This finding indicates that administration of L- Carnitine, 90 minutes prior to exercise may improve performance; despite the ventilatory breakpoint as one of the anaerobic system indices that had no effect. J Mazand Univ Med Sci 2009; 19(73: 43-50 (Persian.

  7. Aerosol contributions to the investigation of lung structure and ventilatory function

    The use of aerosols in the clinical investigations of lung structure and ventilatory function is reviewed. First, the use of inert, non-radioactive particles to study gas mixing and airspace dimensions in providing quantitative evidence of the contribution that bulk transfer makes to the mixing of gases within the lung is discussed. Secondly, the way in which radioaerosol deposition patterns relate to airways obstruction is described. Finally the pros and cons of radioaerosol ventilation imaging in clinical practice are considered. (U.K.)

  8. Potentiation of the hypoxic ventilatory response by one day of hyperoxia in neonatal rats

    Roeser, Jeffrey C.; Brackett, Diane G.; van Heerden, Eliza S.; Young, Kristen M.; Bavis, Ryan W.

    2011-01-01

    The O2 sensitivity of the neonatal rat carotid body is increased after one day in moderate hyperoxia (60% O2) (Donnelly et al., Respir. Physiol. Neurobiol. 168: 189–197, 2009). We investigated whether this enhanced peripheral chemosensitivity increases the hypoxic ventilatory response (HVR) and tested the hypothesis that this plasticity is mediated by the superoxide anion. Neonatal rats (7 d old) were injected with saline or MnTMPyP, a superoxide scavenger, and placed into 60% O2 for 23–28 h....

  9. Unusual features in chronic inflammatory demyelinating polyneuropathy: Good outcome after prolonged ventilatory support

    Sanjeev Jha

    2011-01-01

    Full Text Available Severe respiratory muscle paralysis and ventilatory failure is rare in chronic inflammatory demyelinating polyneuropathy (CIDP. We report a 14 year child who presented with respiratory failure, bulbar and multiple cranial nerves involvement along with bilateral phrenic nerve paralysis. He was diagnosed with CIDP after electrophysiological evaluation. He required AMBU ventilation for about 4 months (including domiciliary use, after which he recovered significantly. Along with several unusual features of CIDP, this report highlights good example of steady basic intensive care to save lives and rewarding outcome of prolonged respiratory support, provided by AMBU ventilation which is a rather primitive, but inexpensive device.

  10. Heart rate deflection point relates to second ventilatory threshold in a tennis test

    Baiget i Vidal, Ernest; Fernandez-Fernandez, Jaime; Iglesias i Reig, Xavier; Rodríguez, Ferran A

    2015-01-01

    The relationship between heart rate deflection point (HRDP) and the second ventilatory threshold (VT2) has been studied in continuous sports, but never in a tennis-specific test. The aim of the study was to assess the relationships between HRDP and the VT2, and between themaximal test performance and the maximal oxygen uptake (V_ O2max) in an on-court specific endurance tennis test. Thirty-five high-level tennis players performed a progressive tennis-specific field test t...

  11. VALIDITY OF THE MODIFIED CONCONI TEST FOR DETERMINING VENTILATORY THRESHOLD DURING ON-WATER ROWING

    Jorge Villamil Cabo

    2011-12-01

    Full Text Available The objectives of this study were to design a field test based on the Conconi protocol to determine the ventilatory threshold of rowers and to test its reliability and validity. A group of sixteen oarsmen completed a modified Conconi test for on-water rowing. The reliability of the detection of the heart rate threshold was evaluated using heart rate breaking point in the Conconi test and retest. Heart rate threshold was detected in 88.8% of cases in the test-retest. The validity of the modified Conconi test was evaluated by comparing the heart rate threshold data acquired with that obtained in a ventilatory threshold test (VT2. No significant differences were found for the values of different intensity parameters i.e. heart rate (HR, oxygen consumption (VO2, stroke rate (SR and speed (S between the heart rate threshold and the ventilatory threshold, (170.9 ± 6.8 vs. 169.3 ± 6.4 beats·min-1; 42.0 ± 8.6 vs. 43.5 ± 8.3 ml·kg-1·min-1; 25.8 ± 3.3 vs. 27.0 ± 3.2 strokes·min-1 and 14.4 ± 0.8 vs. 14.6 ± 0.8 km·h-1. The differences in averages obtained in the Conconi test-retest were small with a low standard error of the mean. The reliability data between the Conconi test-retest showed low coefficients of variations (CV and high intraclass correlation coefficients (ICC. The total errors for the Conconi test-retest are low for the measured variables (1.31 HR, 0.87 VO2, 0.65 SR, and 0.1 S. The Bland- Altman's method for analysis validity showed a strong concordance according to the analyzed variables. We conclude that the modified Conconi test for on-water rowing is a valid and reliable method for the determination of the second ventilatory threshold (VT2.

  12. Adjustments and Depression

    Full Text Available ... to my SCI? How do I deal with depression and adjustment to my SCI? ☷ ▾ Page contents The ... the moment you are injured. Understanding adjustment and depression Adjustment to paralysis is a process of changing ...

  13. Ventilatory dynamics during transient arousal from NREM sleep: implications for respiratory control stability.

    Khoo, M C; Koh, S S; Shin, J J; Westbrook, P R; Berry, R B

    1996-05-01

    The polysomnographic and ventilatory patterns of nine normal adults were measured during non-rapid-eye-movement (NREM) stage 2 sleep before and after repeated administrations of a tone (40-72 dB) lasting 5 s. The ventilatory response to arousal (VRA) was determined in data sections showing electrocortical arousal following the start of the tone. Mean inspiratory flow and tidal volume increased significantly above control levels in the first seven breaths after the start of arousal, with peak increases (64.2% > control) occurring on the second breath. Breath-to-breath occlusion pressure 100 ms after the start of inspiration showed significant increases only on the second and third postarousal breaths, whereas upper airway resistance declined immediately and remained below control for > or = 7 consecutive breaths. These results suggest that the first breath and latter portion of the VRA are determined more by upper airway dynamics than by changes in the neural drive to breathe. Computer model simulations comparing different VRA time courses show that sustained periodic apnea is more likely to occur when the fall in the postarousal increase in ventilation is more abrupt. PMID:8727529

  14. Cerebral and muscle deoxygenation, hypoxic ventilatory chemosensitivity and cerebrovascular responsiveness during incremental exercise.

    Peltonen, Juha E; Paterson, Donald H; Shoemaker, J Kevin; Delorey, Darren S; Dumanoir, Gregory R; Petrella, Robert J; Kowalchuk, John M

    2009-10-31

    To examine if cerebral (frontal cortex) and skeletal muscle (m. vastus lateralis) deoxygenation and cerebral blood flow velocity (V(mean)) in the middle cerebral artery differentiated between normoxic and hypoxic (end-tidal P(O)(2) 71 mmHg) conditions, and if they were associated with hypoxic ventilatory chemosensitivity and cerebrovascular responsiveness, 8 men performed incremental cycling trials (30W/min ramp) under normoxic (T1-N) and hypoxic (T1-H) conditions until volitional fatigue, or until arterial O2 saturation decreased below 80%. The tests were repeated (T2-N; T2-H) on another day with supplemental O2 (Sup-O2) at the end of exercise. The V(mean) response was similar in normoxia and hypoxia. In hypoxia compared to normoxia, cerebral deoxygenation ( upward arrow deoxyhemoglobin concentration (Delta[HHb]) and downward arrow tissue oxygenation index (TOI)) was greater at a given work rate. A strong hypoxic ventilatory chemosensitivity was associated with a rapid reduction of cerebral TOI (r=0.94, PMuscle deoxygenation was similar in normoxia and hypoxia suggesting greater muscle blood flow in hypoxia compared to normoxia and thus the existence of control features that match muscle perfusion and O2 delivery tightly with O2 demand during exercise. Sup-O2 reduced both cerebral and muscle deoxygenation, at least transiently. PMID:19729079

  15. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure

    Mugford Miranda

    2006-12-01

    Full Text Available Abstract Background An estimated 350 adults develop severe, but potentially reversible respiratory failure in the UK annually. Current management uses intermittent positive pressure ventilation, but barotrauma, volutrauma and oxygen toxicity can prevent lung recovery. An alternative treatment, extracorporeal membrane oxygenation, uses cardio-pulmonary bypass technology to temporarily provide gas exchange, allowing ventilator settings to be reduced. While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. Methods/Design The aim of the randomised controlled trial of Conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR is to assess whether, for patients with severe, but potentially reversible, respiratory failure, extracorporeal membrane oxygenation will increase the rate of survival without severe disability ('confined to bed' and 'unable to wash or dress' by six months post-randomisation, and be cost effective from the viewpoints of the NHS and society, compared to conventional ventilatory support. Following assent from a relative, adults (18–65 years with severe, but potentially reversible, respiratory failure (Murray score ≥ 3.0 or hypercapnea with pH Discussion Analysis will be based on intention to treat. A concurrent economic evaluation will also be performed to compare the costs and outcomes of both treatments.

  16. Role of central hydrogen sulfide on ventilatory and cardiovascular responses to hypoxia in spontaneous hypertensive rats.

    Sabino, João Paulo J; Traslaviña, Guillermo A Ariza; Branco, Luiz G S

    2016-09-01

    Central hydrogen sulfide (H2S) has been reported to act as a gaseous neuromodulator involved in the ventilatory and cardiovascular control of normotensive rats, whereas no information is available in spontaneously hypertensive rats (SHR). We recorded minute ventilation (VE), mean arterial pressure (MAP) and heart rate (HR) before and after blocking of enzyme Cystathionine β-synthase (CBS) producing H2S in neural tissue by microinjection of aminooxyacetate (inhibitor of CBS) into the fourth ventricle of Wistar normotensive rats (WNR) and SHR followed by 30min of normoxia (21% inspired O2) or hypoxia (10% inspired O2) exposure. Microinjection of AOA or saline (1μL) did not change VE, MAP and HR during normoxia in both WNR and SHR. In WNR, hypoxia caused an increase in VE, HR and a decrease in MAP and these responses were unaltered by AOA. In SHR, hypoxia produced a higher increase of VE, and decrease in MAP and HR when compared to WNR, and these responses were all blunted by AOA. In conclusion, endogenous H2S plays important modulatory roles on hypoxia-induced ventilatory and cardiovascular responses, inhibiting the cardiovascular and stimulating the respiratory systems in SHR. PMID:27238370

  17. Inductive plethysmography potential as a surrogate for ventilatory measurements during rest and moderate physical exercise

    Ramona Cabiddu

    2016-01-01

    Full Text Available Background: Portable respiratory inductive plethysmography (RIP systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based exercise, intensity is usually constant and submaximal. A demonstration of the ability of RIP to detect respiratory measurements accurately during constant intensity conditions would promote and validate the routine use of portable RIP devices as an alternative to ergospirometry (ES, the current gold standard technique for ventilatory measures. Objective: To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. Method: Tidal volume (VT, respiratory rate (RR and minute ventilation (VE were concurrently acquired by portable RIP and ES in seven healthy male volunteers during standing rest position and constant intensity treadmill exercise. Results: Significant agreement was found between RIP and ES acquisitions during the standing rest position and constant intensity treadmill exercise for RR and during the standing rest position for VE. Conclusion: Our results suggest that portable RIP devices might represent a suitable alternative to ES during rest and during constant submaximal exercise.

  18. Impaired ventilatory and thermoregulatory responses to hypoxic stress in newborn Phox2b heterozygous knockout mice

    Nelina eRamanantsoa

    2011-09-01

    Full Text Available The Phox2b gene is necessary for the development of the autonomic nervous system, and especially, of respiratory neuronal circuits. In the present study, we examined the role of Phox2b in ventilatory and thermoregulatory responses to hypoxic stress, which are closely related in the postnatal period. Hypoxic stress was generated by strong thermal stimulus, combined or not with reduced inspired O2. To this end, we exposed 6-day-old Phox2b+/- pups and their wild-type littermates (Phox2b+/+ to hypoxia (10% O2 or hypercapnia (8% CO2 under thermoneutral (33°C or cold (26°C conditions. We found that Phox2b+/- pups showed less normoxic ventilation (VE in the cold than Phox2b+/+ pups. Phox2b+/- pups also showed lower oxygen consumption (VO2 in the cold, reflecting reduced thermogenesis and a lower body temperature. Furthermore, while the cold depressed ventilatory responses to hypoxia and hypercapnia in both genotype groups, this effect was less pronounced in Phox2b+/- pups. Finally, because serotonin (5-HT neurons are pivotal to respiratory and thermoregulatory circuits and depend on Phox2b for their differentiation, we studied 5-HT metabolism using high-pressure liquid chromatography, and found that it was altered in Phox2b+/- pups. We conclude that Phox2b haploinsufficiency alters the ability of newborns to cope with metabolic challenges, possibly due to 5-HT signaling impairments.

  19. 28 CFR 100.19 - Adjustments to agreement estimate.

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Adjustments to agreement estimate. 100.19..., COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.19 Adjustments to agreement estimate. (a... the adjustment results in an increase in the estimated reimbursement, the FBI will review...

  20. Effect of Same-day Sequential Exposure to Nitrogen Dioxide and Ozone on Cardiac and Ventilatory Function in Mice

    This study examines the cardiac and ventilatory effects of sequential exposure to nitrogen dioxide and then ozone. The data show that mice exposed to both gases have increased arrhythmia and breathing changes not observed in the other groups. Although the mechanisms underlying ai...

  1. Rh protein expression in branchial neuroepithelial cells, and the role of ammonia in ventilatory control in fish.

    Zhang, Li; Michele Nawata, C; De Boeck, Gudrun; Wood, Chris M

    2015-08-01

    Bill Milsom has made seminal contributions to our understanding of ventilatory control in a wide range of vertebrates. Teleosts are particularly interesting, because they produce a 3rd, potentially toxic respiratory gas (ammonia) in large amounts. Fish are well known to hyperventilate under high environmental ammonia (HEA), but only recently has the potential role of ammonia in normal ventilatory control been investigated. It is now clear that ammonia can act directly as a ventilatory stimulant in trout, independent of its effects on acid-base balance. Even in ureotelic dogfish sharks, acute elevations in ammonia cause increases in ventilation. Peripherally, the detection of elevated ammonia resides in gill arches I and II in trout, and in vitro, neuroepithelial cells (NECs) from these arches are sensitive to ammonia, responding with elevations in intracellular Ca(2+) ([Ca(2+)]i). Centrally, hyperventilatory responses to ammonia correlate more closely with concentrations of ammonia in the brain than in plasma or CSF. After chronic HEA exposure, ventilatory responsiveness to ammonia is lost, associated with both an attenuation of the [Ca(2+)]i response in NECs, and the absence of elevation in brain ammonia concentration. Chronic exposure to HEA also causes increases in the mRNA expression of several Rh proteins (ammonia-conductive channels) in both brain and gills. "Single cell" PCR techniques have been used to isolate the individual responses of NECs versus other gill cell types. We suggest several circumstances (post-feeding, post-exercise) where the role of ammonia as a ventilatory stimulant may have adaptive benefits for O2 uptake in fish. PMID:25465530

  2. Running velocity at the ventilatory threshold and at VO2max, before and after the eight-week cardiovascular endurance training

    Stojiljković Stanimir

    2005-01-01

    Full Text Available Introduction The purpose of this research was to compare changes in running velocity at ventilatory threshold with the veliocity at VO2max, before and after the eight-week exercise program. Material and methods 32 male subjects (age: 22.3± 2.5 years, height: 179.8± 7.6 cm, body mass: 76.8± 9.0 kg performed a progressive test for ventilatory threshold (VT measurement and VO2max on treadmill. After 8 weeks of endurance training (3 times per week, 30 to 70 min, in different zones in respect to the ventilatory threshold the performed the same test. Results Running velocity at ventilatory threshold increased significantly (p=0.000I, between initial and final measurements (10.88±2.09, 12.94± 1.90 km/h, respectively: as well as at VO2max H4.63±1.86, 16.44±1.59 km/h, respectively. At the initial test, velocity at ventilatory threshold was 74.11% of VO2max. At the final test, velocity at ventilatory threshold was 78.43% of VO2max. Running velocity at ventilatory threshold has significantly increased at final test (p=0.001. Discussion Running velocity at ventilatory threshold has significantly increased after eight weeks of endurance training (p -0.001, when expressed in absolute values and percentage of velocity at vo2max. Conclusion Comparison between the initial and final test demonstrated a significant increase of observed variables, under experimental conditions: at final test running velocity has increased at ventilatory threshold, in respect to absolute values and expressed as percentage at VO2max. .

  3. Signaling at the cell surface in the circulatory and ventilatory systems

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 3 is devoted to the set of mediators of the cell surface, especially ion and molecular carriers and catalytic receptors that, once liganded and activated, initiat...

  4. Differences in Ventilatory Threshold for Exercise Prescription in Outpatient Diabetic and Sarcopenic Obese Subjects

    Gian Pietro Emerenziani; Maria Chiara Gallotta; Silvia Migliaccio; Greco, Emanuela A.; Chiara Marocco; Luca di Lazzaro; Rachele Fornari; Andrea Lenzi; Carlo Baldari; Laura Guidetti

    2016-01-01

    Aim of the study was to examine cardiorespiratory parameters at individual ventilatory threshold (IVT) and peak exercise capacity ( V ˙ O 2 p e a k ) in outpatient diabetic and sarcopenic obese subjects. Seventeen obese subjects (BMI: 36.6 ± 4.1 kg·m−1) and sixteen SO subjects (BMI: 37.0 ± 7.3 kg·m−1) were compared with sixteen T2DM subjects (BMI: 37.7 ± 5.6 kg·m−1). All groups performed an incremental exercise test on a treadmill according to their physical ability. V ˙ O 2 p e a k , %HRmax,...

  5. Evaluation of imaging of the ventilatory lung motion in pulmonary diseases

    Using perfusion lung scintigram with 99mTc-macroaggregated albumin at maximal expiration (E) and inspiration (I), images of the motion of the regional pulmonary areas and lung margins during ventilation ((E-I)/I) was obtained in patients with various respiratory diseases. The image of (E-I)/I consisted of positive and negative components. The former component visualized the motion of the regional pulmonary areas that corresponded with the ventilatory amplitude of the videodensigram. The sum of the positive component of (E-I)/I in both lungs correlated with the vital capacity (n = 50, r = 0.62). It was 163.5 ± 52.5 in cases with a vital capacity of more than 3.01, 94.1 ± 61.5 in primary lung cancer, 89.2 ± 44.7 in chronic obstructive lung diseases and 69.0 ± 27.5 in diffuse interstitial pneumonia. The distribution pattern of pulmonary perfusion and the positive component of (E-I)/I matched fairly in many cases, but did not match in some cases. The negative component of (E-I)/I demonstrated the ventilatory motion of the lung margin and its decreased activity was shown in cases with hypoventilation of various causes including pleural diseases. The sum of the negative component of (E-I)/I in the both lungs correlated with the vital capacity (n = 50, r = 0.44). These results suggest that this technique is useful to estimate the regional pulmonary ventilatioin and motion of the lung margins. (author)

  6. The effect of ozone inhalation on metabolic functioning of vascular endothelium and on ventilatory function

    The primary purpose of this research was to determine the effect of ozone inhalation on pulmonary vascular endothelium. Male Fischer-344 rats were exposed to 0.5 or 0.7 ppm ozone, 20 hr/day for 7 days. Lungs were excised and perfused with Krebs medium containing [14C]serotonin or [14C]hippurylhistidylleucine (HHL). When compared to controls, the animals exposed to the lower ozone concentration showed no statistically significant changes in serotonin removal. In contrast, the higher ozone concentration resulted in a 32% decrease (p less than 0.0001) in serotonin removal, but had no effect on HHL. Rats similarly exposed to 0.7 ppm ozone but allowed to recover for 14 days in clean air showed no decrease in serotonin removal compared to their controls. Animals exposed sequentially to 0.5 ppm ozone for 7 days and then to 0.7 ppm for 7 days showed no alteration in serotonin metabolism, suggesting the development of tolerance initiated by the lower dose. After 7 days exposure to 0.7 ppm ozone, lung ventilatory function measurements revealed small though significant decreases in several parameters. Electron microscopic evaluation of lung capillary endothelium from animals exposed to the 0.7 ppm ozone showed no changes. Positive control animals exposed to greater than 95% oxygen, 20 hr/day for 2 days showed a 23% decrease in serotonin removal (p less than 0.03) and a 12% decrease in HHL removal (p less than 0.017). These studies indicate that inhalation of ozone can induce functional alterations in the lung endothelium, and that this effect occurs at a dosage of ozone that produces minimal ventilatory changes and no observable endothelial ultrastructural changes

  7. Immediate effect of suryanadi pranayama on pulmonary function (ventilatory volumes and capacities in healthy volunteers

    Shravya Keerthi G, Hari Krishna Bandi, Suresh M, Mallikarjuna Reddy N

    2013-10-01

    Full Text Available Objectives: we found only effects of at least a short term practice extended over a period of a few days to weeks of pranayama (alternate nostril breathing rather than acute effects of unilateral right nostril breathing (suryanadi pranayama. Keeping this in mind the present study was designed to test the hypothesis that 10 min. of right nostril breathing have any immediate effect on ventilatory volumes and capacities in healthy volunteers. Methodology: Forced vital capacity (FVC, Forced expiratory volume in the first second (FEV1, Forced expiratory volume percent (FEV1/FVC%, Peak expiratory flow rate (PEFR, Forced expiratory flow25-75% (FEF25-75%, Maximum voluntary ventilation (MVV, Slow vital capacity (SVC, Expiratory reserve volume (ERV, Inspiratory reserve volume (IRV and Tidal volume (TV were recorded before and after Surya Nadi Pranayama. Results & Conclusion: There was a significant increase in FVC (p<0.0001, FEV1 (p<0.0007, PEFR (p<0.0001, FEF25-75% (p<0.0001, MVV (p<0.0001, SVC (p<0.0001, ERV (0.0006, IRV (p<0.0001 and TV (0.0055 after suryanadi pranayama. The immediate effect of suryanadi pranayama practice showed alleviation of ventilatory capacities and volumes. Any practice that increases PEFR and FEF25–75% is expected to retard the development of COPD’s. The increase in PEFR, vital capacities and flow rates by suryanadi pranayama practice obviously offers an increment in respiratory efficiency and it can be advocated to the patients of early bronchitis and as a preventive measure for COPD.

  8. Ventilatory function assessment in safety pharmacology: Optimization of rodent studies using normocapnic or hypercapnic conditions

    Although the whole body plethysmography for unrestrained animals is the most widely used method to assess the respiratory risk of new drugs in safety pharmacology, non-appropriate experimental conditions may mask deleterious side effects of some substances. If stimulant or bronchodilatory effects can be easily evidenced in rodents under standard experimental conditions, i.e. normal air breathing and diurnal phase, drug-induced respiratory depression remains more difficult to detect. This study was aimed at comparing the responsiveness of Wistar rats, Duncan Hartley guinea-pigs or BALB/c mice to the respiratory properties of theophylline (50 or 100 mg/kg p.o.) or morphine (30 mg/kg i.p.) under varying conditions (100% air versus 5% CO2-enriched air, light versus dark day phase), in order to select the most appropriate experimental conditions to each species for safety airway investigations. Our results showed that under normocapnia the ventilatory depressant effects of morphine can be easily evidenced in mice, slightly observed in guinea-pigs and not detected in rats in any day phase. Slight hypercapnic conditions enhanced the responsiveness of rats to morphine but not that of guinea-pigs and importantly they did not blunt the airway responsiveness of rats to the stimulation and bronchodilation evoked by theophylline, the most widely used reference agent in safety pharmacology studies. In conclusion, hypercapnic conditions associated with the non-invasive whole body plethysmography should be considered for optimizing the assessment of both the ventilatory depressant potential of morphine-like substances or the respiratory stimulant effects of new drugs in the rat, the most extensively used species in rodent safety and toxicological investigations.

  9. Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep

    D. Pevernagie

    2007-12-01

    Full Text Available The concept of central sleep apnoea or hypoventilation encompasses hypercapnic central hypoventilation, such as obesity hypoventilation syndrome and eucapnic or hypocapnic central sleep apnoea. Among subjects with eucapnic or hypocapnic central sleep apnoea, several therapeutic options are available for those with Cheyne–Stokes respiration (CSR. CSR is frequent in patients with New York Heart Association stage III and IV chronic heart failure, and in various neurological disorders. In these patients, treatment modalities include optimising cardiac condition and drugs, such as theophylline, acetazolamide and/or oxygen. Ventilatory support, such as nasal continuous positive airway pressure (CPAP, bi-level pressure support, or adaptive servo-ventilation (ASV, has been shown to improve CSR in patients with cardiac failure; however, convincing evidence that nasal CPAP improves life expectancy in these patients is lacking. Nevertheless, the treatment of associated obstructive sleep-disordered breathing is indicated per se, as it may improve cardiac function. There is currently no proof that bi-level ventilation is superior to nasal CPAP. The few available studies that have focused on ASV have shown satisfactory control of CSR in cardiac failure patients. While ASV is not a first-line treatment choice, it appears to be superior to oxygen, CPAP and bi-level pressure ventilation in controlling the apnoea/hypopnea index and probably sleep fragmentation. As yet there are no data on mortality and, as such, firm conclusions cannot be drawn as to the role of ASV in the management of cardiac failure patients suffering from CSR. Obesity-related hypoventilation has increased dramatically over recent decades due to the epidemic increase in obesity in the developed countries. Obesity hypoventilation syndrome predisposes to the development of pulmonary hypertension and cor pulmonale. Noninvasive home ventilation is increasingly applied in obese patients with

  10. Ventilatory steady state measurement of regional pulmonary function with 133Xe, 2

    The ventilatory steady state measurement with 133Xe, using a xenon lung function unit and a large area scintillation camera combined with a computer analysing technique has been employed to evaluate the regional pulmonary functions of 7 normal subjects and 6 patients with emphysema, chronic bronchitis, bronchial asthma, lung cancer and progressive systemic sclerosis (PSS). Regional ventilation indices, perfusion indices and clearance half-times were calculated for each lung field divided into 24 zones. Comparing these data with clinical courses, routine pulmonary function data and X-ray findings, the measurement of regional pulmonary function with 133Xe showed to be very useful in clinical application. In the patient with emphysema, clearance half-times were markedly prolonged in all lung fields and ventilation indices balanced comparatively. In contrast to these findings, in chronic bronchitis, ventilation indices were reduced and clearance half-times were slightly prolonged in areas showing inflammation detected by bronchography. Regional ventilatory impairment was found in the patient with bronchial asthma in remission, however, indices in perfusion remained almost normal. In view of reproducibility, the clearance half-time seemed to be a better parameter than the ventilation index by the single breath method for the estimation of regional ventilation. Comparing such parameters in a patient with lung cancer before and after treatment by 60Co irradiation, the blood flow was restored remarkably even in impaired lung fields. As clearance half times were prolonged and perfusion indices were reduced in limited lower lung zones of the patient with PSS, it was considered that interstitial fibrosis and local emphysematous changes have been progressive in these regions. (auth.)