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Sample records for deep breathing heart

  1. Heart position variability during voluntary moderate deep inspiration breath-hold radiotherapy for breast cancer determined by repeat CBCT scans.

    Science.gov (United States)

    van Haaren, Paul; Claassen-Janssen, Fiere; van de Sande, Ingrid; Boersma, Liesbeth; van der Sangen, Maurice; Hurkmans, Coen

    2017-08-01

    Voluntary moderate deep inspiration breath hold (vmDIBH) in left-sided breast cancer radiotherapy reduces cardiac dose. The aim of this study was to investigate heart position variability in vmDIBH using CBCT and to compare this variability with differences in heart position between vmDIBH and free breathing (FB). For 50 patients initial heart position with respect to the field edge (HP-FE) was measured on a vmDIBH planning CT scan. Breath-hold was monitored using an in-house developed vertical plastic stick. On pre-treatment CBCT scans, heart position variability with respect to the field edge (Δ HP-FE ) was measured, reflecting heart position variability when using an offline correction protocol. After registering the CBCT scan to the planning CT, heart position variability with respect to the chest wall (Δ HP-CW ) was measured, reflecting heart position variability when using an online correction protocol. As a control group, vmDIBH and FB computed tomography (CT) scans were acquired for 30 patients and registering both scans on the chest wall. For 34 out of 50 patients, the average HP-FE and HP-CW increased over the treatment course in comparison to the planning CT. Averaged over all patients and all treatment fractions, the Δ HP-FE and the Δ HP-CW was 0.8±4.2mm (range -9.4-+10.6mm) and 1.0±4.4mm (range -8.3-+10.4mm) respectively. The average gain in heart to chest wall distance was 11.8±4.6mm when using vmDIBH instead of FB. In conclusion, substantial variability in heart position using vmDIBH was observed during the treatment course. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  2. A simple test of one minute heart rate variability during deep breathing for evaluation of sympathovagal imbalance in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Fareedabanu, A.B.

    2011-01-01

    Heart rate variability (HRV) refers to the magnitude of the fluctuation in the number of heart beats per minute in conjunction with respiration. HRV with deep breathing (HRVdb) has recently become a popular non-invasive research tool in cardiology. This study was carried out to determine and compare the HRV in patients with Type 2 DM with those of Non diabetic controls. Methods: Sixty diabetic patients attending out patient department in Karnataka Institute of Diabetology, Bangalore and 60 age-matched controls were enrolled. HRV was performed on all the subjects and the results obtained were compared between the groups. The One minute HRV was analysed during deep breathing and defined as the difference in beats/minute between the shortest and the longest heart rate interval measured by lead II electrocardiographic recording during six cycles of deep breathing. Results: Statistically significant decrease in mean minimal heart rate and 1 minute HRV (16.30 +- 6.42 vs 29.33 +- 8.39) was observed during deep breathing among Type 2 Diabetic patients on comparison with that of healthy controls. There was no significant difference in mean maximal heart rate between the groups. Conclusion: Significant decrease in HRV in Type 2 DM patients is suggestive of reduced parasympathetic activity or an imbalance between sympathetic and parasympathetic neural activity in them. Hence HRVdb provides a sensitive screening measure for parasympathetic dysfunction in many autonomic disorders. (author)

  3. Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

    International Nuclear Information System (INIS)

    McIntosh, Alyson; Shoushtari, Asal N.; Benedict, Stanley H.; Read, Paul W.; Wijesooriya, Krishni

    2011-01-01

    Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0–3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 ± 3 mm inferior, 1 ± 2 mm right, and 1 ± 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

  4. Estimation of heart-position variability in 3D-surface-image-guided deep-inspiration breath-hold radiation therapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Alderliesten, Tanja; Betgen, Anja; Elkhuizen, Paula H.M.; Vliet-Vroegindeweij, Corine van; Remeijer, Peter

    2013-01-01

    Purpose: To investigate the heart position variability in deep-inspiration breath-hold (DIBH) radiation therapy (RT) for breast cancer when 3D surface imaging would be used for monitoring the BH depth during treatment delivery. For this purpose, surface setup data were compared with heart setup data. Materials and methods: Twenty patients treated with DIBH-RT after breast-conserving surgery were included. Retrospectively, heart registrations were performed for cone-beam computed tomography (CBCT) to planning CT. Further, breast-surface registrations were performed for a surface, captured concurrently with CBCT, to planning CT. The resulting setup errors were compared with linear regression analysis. Furthermore, geometric uncertainties of the heart (systematic [Σ] and random [σ]) were estimated relative to the surface registration. Based on these uncertainties planning organ at risk volume (PRV) margins for the heart were calculated: 1.3Σ − 0.5σ. Results: Moderate correlation between surface and heart setup errors was found: R 2 = 0.64, 0.37, 0.53 in left–right (LR), cranio-caudal (CC), and in anterior–posterior (AP) direction, respectively. When surface imaging would be used for monitoring, the geometric uncertainties of the heart (cm) are [Σ = 0.14, σ = 0.14]; [Σ = 0.66, σ = 0.38]; [Σ = 0.27, σ = 0.19] in LR; CC; AP. This results in PRV margins of 0.11; 0.67; 0.25 cm in LR; CC; AP. Conclusion: When DIBH-RT after breast-conserving surgery is guided by the breast-surface position then PRV margins should be used to take into account the heart-position variability relative to the breast-surface

  5. ACTIVE CYCLE BREATHING TECHNIQUES IN HEART FAILURE ...

    African Journals Online (AJOL)

    RICHY

    Pulmonary Function Responses to Active Cycle. Breathing ... Key Words: Heart Failure, Active Cycle of Breathing ... cough, fatigue, reduced respiratory muscle mass, and. [5] ... an amount of exercise which is said to lower disease. [9].

  6. Voluntary Deep Inspiration Breath-hold Reduces the Heart Dose Without Compromising the Target Volume Coverage During Radiotherapy for Left-sided Breast Cancer.

    Science.gov (United States)

    Al-Hammadi, Noora; Caparrotti, Palmira; Naim, Carole; Hayes, Jillian; Rebecca Benson, Katherine; Vasic, Ana; Al-Abdulla, Hissa; Hammoud, Rabih; Divakar, Saju; Petric, Primoz

    2018-03-01

    During radiotherapy of left-sided breast cancer, parts of the heart are irradiated, which may lead to late toxicity. We report on the experience of single institution with cardiac-sparing radiotherapy using voluntary deep inspiration breath hold (V-DIBH) and compare its dosimetric outcome with free breathing (FB) technique. Left-sided breast cancer patients, treated at our department with postoperative radiotherapy of breast/chest wall +/- regional lymph nodes between May 2015 and January 2017, were considered for inclusion. FB-computed tomography (CT) was obtained and dose-planning performed. Cases with cardiac V25Gy ≥ 5% or risk factors for heart disease were coached for V-DIBH. Compliant patients were included. They underwent additional CT in V-DIBH for planning, followed by V-DIBH radiotherapy. Dose volume histogram parameters for heart, lung and optimized planning target volume (OPTV) were compared between FB and BH. Treatment setup shifts and systematic and random errors for V-DIBH technique were compared with FB historic control. Sixty-three patients were considered for V-DIBH. Nine (14.3%) were non-compliant at coaching, leaving 54 cases for analysis. When compared with FB, V-DIBH resulted in a significant reduction of mean cardiac dose from 6.1 +/- 2.5 to 3.2 +/- 1.4 Gy (p FB and V-DIBH, respectively (p FB- and V-DIBH-derived mean lung dose (11.3 +/- 3.2 vs. 10.6 +/- 2.6 Gy), lung V20Gy (20.5 +/- 7 vs. 19.5 +/- 5.1 Gy) and V95% for the OPTV (95.6 +/- 4.1 vs. 95.2 +/- 6.3%) were non-significant. V-DIBH-derived mean shifts for initial patient setup were ≤ 2.7 mm. Random and systematic errors were ≤ 2.1 mm. These results did not differ significantly from historic FB controls. When compared with FB, V-DIBH demonstrated high setup accuracy and enabled significant reduction of cardiac doses without compromising the target volume coverage. Differences in lung doses were non-significant.

  7. Advantage of using deep inspiration breath hold with active breathing control and image-guided radiation therapy for patients treated with lung cancers

    International Nuclear Information System (INIS)

    Muralidhar, K.R.; Madhusudhansresty; Sha, Rajib Lochan; Raut, Birendra Kumar; Poornima; Subash; Mallikarjun; Anil; Krishnam Raju, A.; Vidya; Sudarshan, G.; Mahadev, Shankar; Narayana Murthy, P.

    2008-01-01

    To evaluate the impact of moderate deep inspiration breath hold (mDIBH) using an active breathing control (ABC) apparatus on heart, spinal cord, liver and contra lateral lung doses and its volumes compared with free breathing (FB) with lung cancer irradiation

  8. Heart rate response to breathing

    DEFF Research Database (Denmark)

    Mehlsen, J; Pagh, K; Nielsen, J S

    1987-01-01

    Heart rate responses to stepwise and periodic changes in lung volume were studied in seven young healthy males. Stepwise inspiration and expiration both resulted in an increase in heart rate followed by a rapid decrease in heart rate. The fastest heart rate was reached in 1.6 +/- 0.5 s and in 3.......6 +/- 1.4 s in response to inspiration and expiration, respectively (P less than 0.01). The slowest heart rate was reached in 4.8 +/- 1.0 s and in 7.6 +/- 1.9 s in response to inspiration and expiration, respectively (P less than 0.01). Following this biphasic change the heart rate returned to a steady...... level. The difference between the fastest and the slowest heart rates was significantly larger in response to inspiration (21.7 +/- 7.3 beats per minute) than in response to expiration (12.0 +/- 7.3 beats per minute; P less than 0.01). Periodic changes in lung volume were performed with frequencies from...

  9. Influence of Deep Breathing on Heart Rate Variability in Parkinson's Disease: Co-relation with Severity of Disease and Non-Motor Symptom Scale Score.

    Science.gov (United States)

    Bidikar, Mukta Pritam; Jagtap, Gayatri J; Chakor, Rahul T

    2014-07-01

    Dysautonomia and non-motor symptoms (NMS) in Parkinson's disease (PD) are frequent, disabling and reduce quality of life of patient. There is a paucity of studies on autonomic dysfunction in PD in Indian population. The study aimed to evaluate autonomic dysfunction in PD patients and co-relate the findings with severity of PD and Non-Motor Symptoms Scale (NMSS) score. We evaluated autonomic function in 30 diagnosed patients of PD (age 55-70 years) and 30 healthy age-matched controls by 3 min deep breathing test (DBT). NMSS was used to identify non-motor symptoms and Hoehn and Yahr (HY) Scale to grade severity of PD. The DBT findings were co-related with severity of PD (HY staging) and NMSS score. DBT was found to be abnormal in 40% while it was on borderline in 33.3% of PD patients. There was a statistically significant difference (psymptom. A negative co-relation was found between results of deep breathing test and clinical severity of disease and NMSS score. Abnormalities of autonomic function and NMS were integral and present across all the stages of PD patients. Early recognition and treatment of these may decrease morbidity and improve quality of life of PD patients.

  10. How Important Is a Reproducible Breath Hold for Deep Inspiration Breath Hold Breast Radiation Therapy?

    International Nuclear Information System (INIS)

    Wiant, David; Wentworth, Stacy; Liu, Han; Sintay, Benjamin

    2015-01-01

    Purpose: Deep inspiration breath hold (DIBH) for left-sided breast cancer has been shown to reduce heart dose. Surface imaging helps to ensure accurate breast positioning, but it does not guarantee a reproducible breath hold (BH) at DIBH treatments. We examine the effects of variable BH positions for DIBH treatments. Methods and Materials: Twenty-five patients who underwent free breathing (FB) and DIBH scans were reviewed. Four plans were created for each patient: FB, DIBH, FB-DIBH (the DIBH plans were copied to the FB images and recalculated, and image registration was based on breast tissue), and P-DIBH (a partial BH with the heart shifted midway between the FB and DIBH positions). The FB-DIBH plans give a “worst-case” scenario for surface imaging DIBH, where the breast is aligned by surface imaging but the patient is not holding their breath. Kolmogorov-Smirnov tests were used to compare the dose metrics. Results: The DIBH plans gave lower heart dose and comparable breast coverage versus FB in all cases. The FB-DIBH plans showed no significant difference versus FB plans for breast coverage, mean heart dose, or maximum heart dose (P≥.10). The mean heart dose differed between FB-DIBH and FB by <2 Gy for all cases, and the maximum heart dose differed by <2 Gy for 21 cases. The P-DIBH plans showed significantly lower mean heart dose than FB (P<.01). The mean heart doses for the P-DIBH plans were < FB for 22 cases, the maximum dose was < FB for 18 cases. Conclusions: A DIBH plan delivered to a FB patient setup with surface imaging will yield dosimetry similar to that of a plan created and delivered FB. A DIBH plan delivered with even a partial BH can give reduced heart dose compared with FB techniques.

  11. How Important Is a Reproducible Breath Hold for Deep Inspiration Breath Hold Breast Radiation Therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Wiant, David, E-mail: David.wiant@conehealth.com; Wentworth, Stacy; Liu, Han; Sintay, Benjamin

    2015-11-15

    Purpose: Deep inspiration breath hold (DIBH) for left-sided breast cancer has been shown to reduce heart dose. Surface imaging helps to ensure accurate breast positioning, but it does not guarantee a reproducible breath hold (BH) at DIBH treatments. We examine the effects of variable BH positions for DIBH treatments. Methods and Materials: Twenty-five patients who underwent free breathing (FB) and DIBH scans were reviewed. Four plans were created for each patient: FB, DIBH, FB-DIBH (the DIBH plans were copied to the FB images and recalculated, and image registration was based on breast tissue), and P-DIBH (a partial BH with the heart shifted midway between the FB and DIBH positions). The FB-DIBH plans give a “worst-case” scenario for surface imaging DIBH, where the breast is aligned by surface imaging but the patient is not holding their breath. Kolmogorov-Smirnov tests were used to compare the dose metrics. Results: The DIBH plans gave lower heart dose and comparable breast coverage versus FB in all cases. The FB-DIBH plans showed no significant difference versus FB plans for breast coverage, mean heart dose, or maximum heart dose (P≥.10). The mean heart dose differed between FB-DIBH and FB by <2 Gy for all cases, and the maximum heart dose differed by <2 Gy for 21 cases. The P-DIBH plans showed significantly lower mean heart dose than FB (P<.01). The mean heart doses for the P-DIBH plans were heart dose compared with FB techniques.

  12. Optimal technique for deep breathing exercises after cardiac surgery.

    Science.gov (United States)

    Westerdahl, E

    2015-06-01

    Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breathing exercises have been implemented as a major component of postoperative care. A variety of deep breathing maneuvres are recommended to the spontaneously breathing patient to reduce atelectasis and to improve lung function in the early postoperative period. Different breathing exercises are recommended in different parts of the world, and there is no consensus about the most effective breathing technique after cardiac surgery. Arbitrary instructions are given, and recommendations on performance and duration vary between hospitals. Deep breathing exercises are a major part of this therapy, but scientific evidence for the efficacy has been lacking until recently, and there is a lack of trials describing how postoperative breathing exercises actually should be performed. The purpose of this review is to provide a brief overview of postoperative breathing exercises for patients undergoing cardiac surgery via sternotomy, and to discuss and suggest an optimal technique for the performance of deep breathing exercises.

  13. Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial.

    Science.gov (United States)

    Pettersson, Henrik; Faager, Gun; Westerdahl, Elisabeth

    2015-09-01

    Breathing exercises after cardiac surgery are often performed in a sitting position. It is unknown whether oxygenation would be better in the standing position. The aim of this study was to evaluate oxygenation and subjective breathing ability during sitting vs standing performance of deep breathing exercises on the second day after cardiac surgery. Patients undergoing coronary artery bypass grafting (n = 189) were randomized to sitting (controls) or standing. Both groups performed 3 × 10 deep breaths with a positive expiratory pressure device. Peripheral oxygen saturation was measured before, directly after, and 15 min after the intervention. Subjective breathing ability, blood pressure, heart rate, and pain were assessed. Oxygenation improved significantly in the standing group compared with controls directly after the breathing exercises (p < 0.001) and after 15 min rest (p = 0.027). The standing group reported better deep breathing ability compared with controls (p = 0.004). A slightly increased heart rate was found in the standing group (p = 0.047). After cardiac surgery, breathing exercises with positive expiratory pressure, performed in a standing position, significantly improved oxygenation and subjective breathing ability compared with sitting performance. Performance of breathing exercises in the standing position is feasible and could be a valuable treatment for patients with postoperative hypoxaemia.

  14. Review of deep inspiration breath-hold techniques for the treatment of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Latty, Drew, E-mail: drew.latty@health.nsw.gov.au [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Stuart, Kirsty E [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Wang, Wei [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Nepean Cancer Care Centre, Sydney, New South Wales (Australia); Ahern, Verity [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia)

    2015-03-15

    Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.

  15. Sleep and breathing in congestive heart failure.

    Science.gov (United States)

    Rosen, David; Roux, Francoise Joelle; Shah, Neomi

    2014-09-01

    Heart failure (HF) is one of the most prevalent and costly diseases in the United States. Sleep apnea is now recognized as a common, yet underdiagnosed, comorbidity of HF. This article discusses the unique qualities that sleep apnea has when it occurs in HF and explains the underlying pathophysiology that illuminates why sleep apnea and HF frequently occur together. The authors provide an overview of the treatment options for sleep apnea in HF and discuss the relative efficacies of these treatments. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, L; Quirk, S; Smith, WL [The University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Yeung, R; Phan, T [The University of Calgary, Calgary, AB (Canada); Hudson, A [Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients.

  17. WE-DE-209-00: Practical Implementation of Deep Inspiration Breath Hold Techniques for Breast Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  18. WE-DE-209-00: Practical Implementation of Deep Inspiration Breath Hold Techniques for Breast Radiation Therapy

    International Nuclear Information System (INIS)

    2016-01-01

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  19. Management of Sleep Disordered Breathing in Patients with Heart Failure.

    Science.gov (United States)

    Oates, Connor P; Ananthram, Manjula; Gottlieb, Stephen S

    2018-04-03

    This paper reviews treatment options for sleep disordered breathing (SDB) in patients with heart failure. We sought to identify therapies for SDB with the best evidence for long-term use in patients with heart failure and to minimize uncertainties in clinical practice by examining frequently discussed questions: what is the role of continuous positive airway pressure (CPAP) in patients with heart failure? Is adaptive servo-ventilation (ASV) safe in patients with heart failure? To what extent is SDB a modifiable risk factor? Consistent evidence has demonstrated that the development of SDB in patients with heart failure is a poor prognostic indicator and a risk factor for cardiovascular mortality. However, despite numerous available interventions for obstructive sleep apnea and central sleep apnea, it remains unclear what effect these therapies have on patients with heart failure. To date, all major randomized clinical trials have failed to demonstrate a survival benefit with SDB therapy and one major study investigating the use of adaptive servo-ventilation demonstrated harm. Significant questions persist regarding the management of SDB in patients with heart failure. Until appropriately powered trials identify a treatment modality that increases cardiovascular survival in patients with SDB and heart failure, a patient's heart failure management should remain the priority of medical care.

  20. SU-F-T-415: Differences in Lung Sparing in Deep Inspiration Breath-Hold and Free Breathing Breast Plans Calculated in Pinnacle and Monaco

    Energy Technology Data Exchange (ETDEWEB)

    Saenz, D; Stathakis, S [University of Texas Health Science Center San Antonio, San Antonio, TX (United States)

    2016-06-15

    Purpose: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle{sup 3}. Methods: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle{sup 3}. Free breathing plans were also created to clinically assure a benefit. Both plans were re-calculated in Monaco to determine if there were any significant differences. The mean heart dose, mean left lung, and mean total lung dose were compared in addition to the V20 for left and both lungs. Dose was calculated as dose to medium as well as dose to water with a statistical precision of 0.7%. Results: Mean lung dose was significantly different (p < 0.003) between the two calculations for both DIBH (11.6% higher in Monaco) and free breathing (14.2% higher in Monaco). V20 was also higher in Monaco (p < 0.05) for DIBH (5.7% higher) and free breathing (4.9% higher). The mean heart dose was not significantly different between the dose calculations for either DIBH or free breathing. Results were no more than 0.1% different when calculated as dose to water. Conclusion: The use of Monte Carlo can provide insight on the lung dose for both free breathing and DIBH techniques for whole breast irradiation. While the sparing (dose reductions with DIBH as compared to free breathing) is equivalent for either planning system, the lung doses themselves are higher when calculated with Monaco.

  1. Sleep-Disordered Breathing in Heart Failure - A Therapeutic Dilemma.

    Science.gov (United States)

    Haruki, Nobuhiko; Floras, John S

    2017-06-23

    Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life. However, the promise of observational studies and randomized trials of small size and duration describing a beneficial effect of treating SDB in HF via positive airway pressure was not realized in 2 recent randomized outcome-driven trials: SAVE, which evaluated the cardiovascular effect of treating OSA in a cohort without HF, and SERVE-HF, which reported the results of a strategy of random allocation of minute-ventilation-triggered adaptive servo-ventilation (ASV) for HF patients with CSA. Whether effective treatment of either OSA or CSA improves the HF trajectory by reducing cardiovascular morbidity or mortality has yet to be definitively established. ADVENT-HF, designed to determine the effect of treating both CSA and non-sleepy OSA HF patients with a peak-airflow triggered ASV algorithm, could resolve this present clinical equipoise concerning the treatment of SDB.

  2. Cheyne-Stokes respiration: hypoxia plus a deep breath that interrupts hypoxic drive, initiating cyclic breathing.

    Science.gov (United States)

    Guntheroth, Warren G

    2011-11-01

    In the 19th Century, Cheyne and Stokes independently reported cycles of respiration in patients with heart failure, beginning with apnea, followed by a few breaths. However Cheyne-Stokes respiration (C-SR) can also occur in healthy individuals with sleep, and was demonstrated in 1908 with voluntary hyperventilation, followed by apnea that Haldane blamed on hypoxia, subsequently called post-hyperventilation apnea. Additional theories explaining C-SR did not appear until 1954, based on control theory, specifically a feed-back regulator controlling CO(2). This certainly describes control of normal respiration, but to produce an unstable state such as C-SR requires either a very long transit time (3½ min) or an increase of the controller gain (13 times), physiologically improbable. There is general agreement that apnea initiates C-SR but that has not been well explained except for post-hyperventilation apnea, and that explanation is not compatible with a study by Nielsen and Smith in 1951. They plotted the effects of diminished oxygen on ventilation (V) in relation to CO(2) (Fig. 1). They found that the slope of V/CO(2) (gain) increased with hypoxia, but it flattened at a moderate CO(2) level and had nointercept with zero (apnea). It is also incompatible with our published findings in 1975 that showed that apnea did not occur until an extreme level of hypoxia occurred (the PO(2) fell below 10 mmHg), followed shortly by gasping. Much milder hypoxia underlies most cases of C-SR, when hypoxic drive replaces the normal CO(2)-based respiratory drive, in a failsafe role. I hypothesize that the cause of apnea is a brief interruption of hypoxic drive caused by a pulse of oxygen from a stronger than average breath, such as a sigh. The rapidity of onset of apnea in response to a pulse of oxygen, reflects the large pressure gradient for oxygen from air to lung with each breath, in contrast to CO(2). With apnea, there is a gradual fall in oxygen, resulting in a resumption of

  3. Effects of metronome breathing on the assessment of autonomic control using heart rate variability

    NARCIS (Netherlands)

    Haaksma, J; Brouwer, J; vandenBerg, MP; Dijk, WA; Dassen, WRM; Crijns, HJGM; Mulder, Lambertus; Mulder, Gysbertus

    1996-01-01

    Analysis of Heart Rate Variability is a non-invasive quantitative tool to study the influence of the autonomic nervous system on the heart. Rapid variations in heart rate, related to breathing are primarily mediated by the vagal limb of the autonomic nervous system. The resulting variations in heart

  4. Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery--a randomised controlled trial.

    Science.gov (United States)

    Urell, Charlotte; Emtner, Margareta; Hedenström, Hans; Tenling, Arne; Breidenskog, Marie; Westerdahl, Elisabeth

    2011-07-01

    In addition to early mobilisation, a variety of breathing exercises are used to prevent postoperative pulmonary complications after cardiac surgery. The optimal duration of the treatment is not well evaluated. The aim of this study was to determine the effect of 30 versus 10 deep breaths hourly, while awake, with positive expiratory pressure on oxygenation and pulmonary function the first days after cardiac surgery. A total of 181 patients, undergoing cardiac surgery, were randomised into a treatment group, performing 30 deep breaths hourly the first postoperative days, or into a control group performing 10 deep breaths hourly. The main outcome measurement arterial blood gases and the secondary outcome pulmonary function, evaluated with spirometry, were determined on the second postoperative day. Preoperatively, both study groups were similar in terms of age, SpO(2), forced expiratory volume in 1s and New York Heart Association classification. On the second postoperative day, arterial oxygen tension (PaO(2)) was 8.9 ± 1.7 kPa in the treatment group and 8.1 ± 1.4 kPa in the control group (p = 0.004). Arterial oxygen saturation (SaO(2)) was 92.7 ± 3.7% in the treatment group and 91.1 ± 3.8% in the control group (p = 0.016). There were no differences in measured lung function between the groups or in compliance to the breathing exercises. Compliance was 65% of possible breathing sessions. A significantly increased oxygenation was found in patients performing 30 deep breaths the first two postoperative days compared with control patients performing 10 deep breaths hourly. These results support the implementation of a higher rate of deep breathing exercises in the initial phase after cardiac surgery. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  5. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  6. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    International Nuclear Information System (INIS)

    Smyth, Lloyd M; Knight, Kellie A; Aarons, Yolanda K; Wasiak, Jason

    2015-01-01

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy

  7. SU-E-J-33: Cardiac Movement in Deep Inspiration Breath-Hold for Left-Breast Cancer Radiotherapy

    International Nuclear Information System (INIS)

    Kim, M; Lee, S; Suh, T

    2014-01-01

    Purpose: The present study was designed to investigate the displacement of heart using Deep Inspiration Breath Hold (DIBH) CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Methods: Treatment planning was performed on the computed tomography (CT) datasets of 20 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ≥ 95% of the prescribed dose and that the volume inside the CTV receiving > 107% of the prescribed dose should be minimized. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. Results: The maximum and minimum left-right (LR) displacements of heart were 8.9 mm and 3 mm, respectively. The heart moved > 4 mm in the LR direction in 17 of the 20 patients. The distances between the heart and left breast ranged from 8.02–17.68 mm (mean, 12.23 mm) and 7.85–12.98 mm (mean, 8.97 mm) with DIBH CT and FB CT, respectively. The maximum doses to the heart were 3115 cGy and 4652 cGy for the DIBH and FB CT dataset, respectively. Conclusion: The present study has demonstrated that the DIBH technique could help to reduce the risk of radiation dose-induced cardiac toxicity by using movement of cardiac; away from radiation field. The DIBH technique could be used in an actual treatment room for a few minutes and could effectively reduce the cardiac dose when used with a sub-device or image acquisition standard to maintain consistent respiratory motion

  8. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension.

    Science.gov (United States)

    Li, Changjun; Chang, Qinghua; Zhang, Jia; Chai, Wenshu

    2018-05-01

    This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ± 6.39 to 78.93 ± 5.04 ms/mm Hg, P hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.

  9. Can we reduce the risk of disease heart in treatments of left breast? bated breath

    International Nuclear Information System (INIS)

    Fuentemilla Urio, N.; Lozares Cordero, S.; Otal Palacin, A.; Olasolo Alonso, J.; Pellejero Pellejero, S.; Martin Albina, M. L.; Maneru Camara, F.; Miquelez Alonso, S.; Rubio Arroniz, T.; Soto Prados, P.

    2013-01-01

    In studies related to breast cancer and mortality, there has been an increase in the mortality of patients with survival greater than 10 years treated with radiotherapy. Subsequent studies it appears that the main cause is heart disease. Therefore, that the heart started to consider organ of risk in the treatment of breast cancer with radiation therapy (adjuvant). Reducing the doses both heart and coronary arteries leads to a reduction in the risk of heart disease. Currently are introducing new techniques, to reduce the dose in heart and in the left anterior descending coronary artery such as new positions or techniques of Breath bated breath hold... (Author)

  10. Time-Frequency Analysis of Terahertz Radar Signals for Rapid Heart and Breath Rate Detection

    National Research Council Canada - National Science Library

    Massar, Melody L

    2008-01-01

    We develop new time-frequency analytic techniques which facilitate the detection of a person's heart and breath rates from the Doppler shift the movement of their body induces in a terahertz radar signal...

  11. Deep Learning versus Professional Healthcare Equipment: A Fine-Grained Breathing Rate Monitoring Model

    Directory of Open Access Journals (Sweden)

    Bang Liu

    2018-01-01

    Full Text Available In mHealth field, accurate breathing rate monitoring technique has benefited a broad array of healthcare-related applications. Many approaches try to use smartphone or wearable device with fine-grained monitoring algorithm to accomplish the task, which can only be done by professional medical equipment before. However, such schemes usually result in bad performance in comparison to professional medical equipment. In this paper, we propose DeepFilter, a deep learning-based fine-grained breathing rate monitoring algorithm that works on smartphone and achieves professional-level accuracy. DeepFilter is a bidirectional recurrent neural network (RNN stacked with convolutional layers and speeded up by batch normalization. Moreover, we collect 16.17 GB breathing sound recording data of 248 hours from 109 and another 10 volunteers to train and test our model, respectively. The results show a reasonably good accuracy of breathing rate monitoring.

  12. Take a Deep Breath (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Nearly 16 million Americans have been diagnosed with COPD; however, many may not be aware they have the condition. This podcast discusses the importance of seeing a health care provider if you have trouble breathing.

  13. Take a Deep Breath (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-11-24

    Nearly 16 million Americans have been diagnosed with COPD; however, many may not be aware they have the condition. This podcast discusses the importance of seeing a health care provider if you have trouble breathing.  Created: 11/24/2016 by MMWR.   Date Released: 11/24/2016.

  14. SU-C-19A-01: A Simple Deep Inspiration Breath Hold System

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, B; Kaznowski, L; Blackburn, J; Chu, K [Marquette General Hospital, Marquette, MI (United States); Duelge, J; Baldwin, B; Valenti, M; Hunsader, A [Dickinson County Healthcare System, Iron Mountain, MI (United States)

    2014-06-15

    Purpose: Deep Inspiration Breath Hold (DIBH) Radiation therapy for left sided breast can reduce dose to the lungs and heart. The purpose of this work is to illustrate how to implement a simple method of DIBH for simulation and treatment using equipment readily available in most radiation oncology clinics. Methods: For simulation and treatment, a foam block is placed on the patient's abdomen or chest and a horizontal laser mounted on a movable slide is aimed at the center of the foam block. After a coaching session the block is marked at the average free breathing position and average DIBH position. The position of block relative to laser can be seen by the patient via prism glasses as well as the radiation therapists via a video camera system. Simulation CT scans and treatment delivery are performed under DIBH conditions. Imaging and treatment are performed by manually turning the beam on once the patient has achieved DIBH after being given verbal instructions. Results: Manually triggered imaging was used daily to verify DIBH reproducibility for all patients treated using this system. Sets of before and during port images were used to ensure patient position was appropriate for treatment. Results of the laser on block method were compared to a sister facility using surface mapping techniques for DIBH and the two methods were found to have clinically equivalent reproducibility. Conclusion: The laser and block system was found to be simple to implement and robust during patient treatment. This system can be created from readily available materials at low cost and provides adequate feedback to patient and therapists. During treatment images document the reproducibility of setup and give confidence to clinicians that this method is reproducible from day to day.

  15. SU-C-19A-01: A Simple Deep Inspiration Breath Hold System

    International Nuclear Information System (INIS)

    Rasmussen, B; Kaznowski, L; Blackburn, J; Chu, K; Duelge, J; Baldwin, B; Valenti, M; Hunsader, A

    2014-01-01

    Purpose: Deep Inspiration Breath Hold (DIBH) Radiation therapy for left sided breast can reduce dose to the lungs and heart. The purpose of this work is to illustrate how to implement a simple method of DIBH for simulation and treatment using equipment readily available in most radiation oncology clinics. Methods: For simulation and treatment, a foam block is placed on the patient's abdomen or chest and a horizontal laser mounted on a movable slide is aimed at the center of the foam block. After a coaching session the block is marked at the average free breathing position and average DIBH position. The position of block relative to laser can be seen by the patient via prism glasses as well as the radiation therapists via a video camera system. Simulation CT scans and treatment delivery are performed under DIBH conditions. Imaging and treatment are performed by manually turning the beam on once the patient has achieved DIBH after being given verbal instructions. Results: Manually triggered imaging was used daily to verify DIBH reproducibility for all patients treated using this system. Sets of before and during port images were used to ensure patient position was appropriate for treatment. Results of the laser on block method were compared to a sister facility using surface mapping techniques for DIBH and the two methods were found to have clinically equivalent reproducibility. Conclusion: The laser and block system was found to be simple to implement and robust during patient treatment. This system can be created from readily available materials at low cost and provides adequate feedback to patient and therapists. During treatment images document the reproducibility of setup and give confidence to clinicians that this method is reproducible from day to day

  16. Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis - a randomized controlled trial.

    Science.gov (United States)

    Westerdahl, Elisabeth; Wittrin, Anna; Kånåhols, Margareta; Gunnarsson, Martin; Nilsagård, Ylva

    2016-11-01

    Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials. To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes. Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH 2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period. Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups. Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained. © 2015 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

  17. Minimizing Late Effects for Patients With Mediastinal Hodgkin Lymphoma: Deep Inspiration Breath-Hold, IMRT, or Both?

    Energy Technology Data Exchange (ETDEWEB)

    Aznar, Marianne C., E-mail: marianne.camille.aznar@regionh.dk [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Faculty of Sciences, Niels Bohr Institute, and Faculty of Health Sciences, University of Copenhagen, Copenhagen (Denmark); Maraldo, Maja V.; Schut, Deborah A. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Lundemann, Michael [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Faculty of Sciences, Niels Bohr Institute, and Faculty of Health Sciences, University of Copenhagen, Copenhagen (Denmark); Brodin, N Patrik [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Institute of Onco-Physics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Vogelius, Ivan R. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Berthelsen, Anne K. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Specht, Lena; Petersen, Peter M. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

    2015-05-01

    Purpose: Hodgkin lymphoma (HL) survivors have an increased risk of cardiovascular disease (CD), lung cancer, and breast cancer. We investigated the risk for the development of CD and secondary lung, breast, and thyroid cancer after radiation therapy (RT) delivered with deep inspiration breath-hold (DIBH) compared with free-breathing (FB) using 3-dimensional conformal RT (3DCRT) and intensity modulated RT (IMRT). The aim of this study was to determine which treatment modality best reduced the combined risk of life-threatening late effects in patients with mediastinal HL. Methods and Materials: Twenty-two patients with early-stage mediastinal HL were eligible for the study. Treatment plans were calculated with both 3DCRT and IMRT on both DIBH and FB planning computed tomographic scans. We reported the estimated dose to the heart, lung, female breasts, and thyroid and calculated the estimated life years lost attributable to CD and to lung, breast, and thyroid cancer. Results: DIBH lowered the estimated dose to heart and lung regardless of delivery technique (P<.001). There was no significant difference between IMRT-FB and 3DCRT-DIBH in mean heart dose, heart V20Gy, and lung V20Gy. The mean breast dose was increased with IMRT regardless of breathing technique. Life years lost was lowest with DIBH and highest with FB. Conclusions: In this cohort, 3DCRT-DIBH resulted in lower estimated doses and lower lifetime excess risks than did IMRT-FB. Combining IMRT and DIBH could be beneficial for a subgroup of patients.

  18. Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

    Science.gov (United States)

    Bartlett, Frederick R.; Colgan, Ruth M.; Donovan, Ellen M.; Carr, Karen; Landeg, Steven; Clements, Nicola; McNair, Helen A.; Locke, Imogen; Evans, Philip M.; Haviland, Joanne S.; Yarnold, John R.; Kirby, Anna M.

    2014-01-01

    Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breath-holding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery. PMID:25046661

  19. The effect of a single session of short duration biofeedback-induced deep breathing on measures of heart rate variability during laboratory-induced cognitive stress: a pilot study.

    Science.gov (United States)

    Prinsloo, Gabriell E; Derman, Wayne E; Lambert, Michael I; Laurie Rauch, H G

    2013-06-01

    This study examines the acute effect of heart rate variability (HRV) biofeedback on HRV measures during and immediately after biofeedback and during the following laboratory-induced stress. Eighteen healthy males exposed to work-related stress were randomised into an HRV biofeedback group (BIO) or a comparative group (COM). Subjects completed a modified Stroop task before (Stroop 1) and after (Stroop 2) the intervention. Both groups had similar physiological responses to stress in Stroop 1. In Stroop 2, the COM group responded similarly to the way they did to Stroop 1: respiratory frequency (RF) and heart rate (HR) increased, RMSSD and high frequency (HF) power decreased or had a tendency to decrease, while low frequency (LF) power showed no change. The BIO group responded differently in Stroop 2: while RF increased and LF power decreased, HR, RMSSD and HF power showed no change. In the BIO group, RMSSD was higher in Stroop 2 compared to Stroop 1. In conclusion, HRV biofeedback induced a short term carry-over effect during both the following rest period and laboratory-induced stress suggesting maintained HF vagal modulation in the BIO group after the intervention, and maintained LF vagal modulation in the COM group.

  20. Effects of breathing patterns and light exercise on linear and nonlinear heart rate variability.

    Science.gov (United States)

    Weippert, Matthias; Behrens, Kristin; Rieger, Annika; Kumar, Mohit; Behrens, Martin

    2015-08-01

    Despite their use in cardiac risk stratification, the physiological meaning of nonlinear heart rate variability (HRV) measures is not well understood. The aim of this study was to elucidate effects of breathing frequency, tidal volume, and light exercise on nonlinear HRV and to determine associations with traditional HRV indices. R-R intervals, blood pressure, minute ventilation, breathing frequency, and respiratory gas concentrations were measured in 24 healthy male volunteers during 7 conditions: voluntary breathing at rest, and metronome guided breathing (0.1, 0.2 and 0.4 Hz) during rest, and cycling, respectively. The effect of physical load was significant for heart rate (HR; p < 0.001) and traditional HRV indices SDNN, RMSSD, lnLFP, and lnHFP (p < 0.01 for all). It approached significance for sample entropy (SampEn) and correlation dimension (D2) (p < 0.1 for both), while HRV detrended fluctuation analysis (DFA) measures DFAα1 and DFAα2 were not affected by load condition. Breathing did not affect HR but affected all traditional HRV measures. D2 was not affected by breathing; DFAα1 was moderately affected by breathing; and DFAα2, approximate entropy (ApEn), and SampEn were strongly affected by breathing. DFAα1 was strongly increased, whereas DFAα2, ApEn, and SampEn were decreased by slow breathing. No interaction effect of load and breathing pattern was evident. Correlations to traditional HRV indices were modest (r from -0.14 to -0.67, p < 0.05 to <0.01). In conclusion, while light exercise does not significantly affect short-time HRV nonlinear indices, respiratory activity has to be considered as a potential contributor at rest and during light dynamic exercise.

  1. Unconstrained monitoring of long-term heart and breath rates during sleep

    International Nuclear Information System (INIS)

    Chen, Wenxi; Zhu, Xin; Wei, Daming; Nemoto, Tetsu; Sugitani, Kayo; Kitamura, Kei-ichiro

    2008-01-01

    An unconstrained method for the long-term monitoring of heart and breath rates during sleep is proposed. The system includes a sensor unit and a web-based network module. The sensor unit is set beneath a pillow to pick up the pressure variations from the head induced by inhalation/exhalation movements and heart pulsation during sleep. The measured pressure signal was digitized and transferred to a remote database server via the network module. A wavelet-based algorithm was employed to detect the heart and breath rates, as well as body movement, during sleep. The overall system was utilized for a total six-month trial operation delivered to a female subject. The profiles of the heart and breath rates on a beat-by-beat and daily basis were obtained. Movements during sleep were also estimated. The results show that the daily average percentage of undetectable periods (UPs) during 881.6 sleep hours over a 180 day period was 17.2%. A total of 89.2% of sleep hours had a UP of not more than 25%. The profile of the heart rate revealed a periodic property that corresponded to the female monthly menstrual cycle. Our system shows promise as a long-term unconstrained monitor for heart and breath rates, and for other physiological parameters related to the quality of sleep and the regularity of the menstrual cycle. (note)

  2. Deep breathing exercises performed 2 months following cardiac surgery: a randomized controlled trial.

    Science.gov (United States)

    Westerdahl, Elisabeth; Urell, Charlotte; Jonsson, Marcus; Bryngelsson, Ing-Liss; Hedenström, Hans; Emtner, Margareta

    2014-01-01

    Postoperative breathing exercises are recommended to cardiac surgery patients. Instructions concerning how long patients should continue exercises after discharge vary, and the significance of treatment needs to be determined. Our aim was to assess the effects of home-based deep breathing exercises performed with a positive expiratory pressure device for 2 months following cardiac surgery. The study design was a prospective, single-blinded, parallel-group, randomized trial. Patients performing breathing exercises 2 months after cardiac surgery (n = 159) were compared with a control group (n = 154) performing no breathing exercises after discharge. The intervention consisted of 30 slow deep breaths performed with a positive expiratory pressure device (10-15 cm H2O), 5 times a day, during the first 2 months after surgery. The outcomes were lung function measurements, oxygen saturation, thoracic excursion mobility, subjective perception of breathing and pain, patient-perceived quality of recovery (40-Item Quality of Recovery score), health-related quality of life (36-Item Short Form Health Survey), and self-reported respiratory tract infection/pneumonia and antibiotic treatment. Two months postoperatively, the patients had significantly reduced lung function, with a mean decrease in forced expiratory volume in 1 second to 93 ± 12% (P< .001) of preoperative values. Oxygenation had returned to preoperative values, and 5 of 8 aspects in the 36-Item Short Form Health Survey were improved compared with preoperative values (P< .01). There were no significant differences between the groups in any of the measured outcomes. No significant differences in lung function, subjective perceptions, or quality of life were found between patients performing home-based deep breathing exercises and control patients 2 months after cardiac surgery.

  3. Contribution of the deep-inspiration breath-hold technique in patients treated for a left breast cancer by mono-isocentric conformational irradiation; Apport du blocage inspiratoire profond chez des patientes traitees pour un cancer du sein gauche par irradiation conformationnelle mono-isocentrique

    Energy Technology Data Exchange (ETDEWEB)

    Zioueche, A.; Mege, A.; Bodez, V.; Rauglaudre, G. de [Institut Sainte-Catherine, Avignon (France)

    2011-10-15

    The authors report a study which aimed at assessing the benefit of a deep-inspiration-breath-hold on heart sparing in 31 women treated in the left breast or wall and locoregional ganglionary areas by three-dimensional conformational irradiation with field-in-field optimization. All heart and lung parameters (delivered doses) have been significantly improved by a deep-inspiration-breath-hold. Short communication

  4. A sigh of relief or a sigh to relieve: The psychological and physiological relief effect of deep breaths.

    Science.gov (United States)

    Vlemincx, Elke; Van Diest, Ilse; Van den Bergh, Omer

    2016-10-15

    Both animal and human research have revealed important associations between sighs and relief. Previously we argued to conceive of sighs as resetters which temporarily induce relief. The present study aimed to investigate the psychological and physiological relief effect of sighs by instructed deep breaths and spontaneous sighs compared to a control breathing maneuver. Participants completed three blocks of 40 trials during which uncertainty cues were followed by either safety cues followed by a positive picture, or danger cues followed by a negative picture. One block was presented without breathing instructions, two subsequent blocks with breathing instructions. During the presentation of the safety and danger cues, an instruction was given to either 'take a deep breath' or 'postpone the next inhalation for 2 s (breath hold). Continuously, participants rated relief and Frontalis electromyography was recorded. Trait anxiety sensitivity was assessed by the Anxiety Sensitivity Index. Self-reported relief and physiological tension were compared 5s before and after instructed deep breaths and breath holds, and before and after spontaneous deep breaths and breath holds in the respective blocks. Results show that self-reported relief following an instructed deep breath was higher than before. Physiological tension decreased following a spontaneous sigh in high anxiety sensitive persons and following a spontaneous breath hold in low anxiety sensitive persons. These results are the first to show that a deep breath relieves and, in anxiety sensitive persons, reduces physiological tension. These findings support the hypothesis that sighs are psychological and physiological resetters. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. High-pitch coronary CT angiography in dual-source CT during free breathing vs. breath holding in patients with low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Bischoff, Bernhard, E-mail: bernhard.bischoff@med.uni-muenchen.de [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Meinel, Felix G. [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Del Prete, Alessandra [Department of Radiology Magrassi-Lanzara, Second University of Naples, Naples (Italy); Reiser, Maximilian F.; Becker, Hans-Christoph [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany)

    2013-12-01

    Background: Coronary CT angiography (CCTA) is usually performed during breath holding to reduce motion artifacts caused by respiration. However, some patients are not able to follow the breathing commands adequately due to deafness, hearing impairment, agitation or pulmonary diseases. The aim of this study was to evaluate the potential of high-pitch CCTA in free breathing patients when compared to breath holding patients. Methods: In this study we evaluated 40 patients (20 free breathing and 20 breath holding patients) with a heart rate of 60 bpm or below referred for CCTA who were examined on a 2nd generation dual-source CT system. Image quality of each coronary artery segment was rated using a 4-point grading scale (1: non diagnostic–4: excellent). Results: Mean heart rate during image acquisition was 52 ±5 bpm in both groups. There was no significant difference in mean image quality, slightly favoring image acquisition during breath holding (mean image quality score 3.76 ± 0.32 in breath holding patients vs. 3.61 ± 0.45 in free breathing patients; p = 0.411). Due to a smaller amount of injected contrast medium, there was a trend for signal intensity to be slightly lower in free breathing patients, but this was not statistically significant (435 ± 123 HU vs. 473 ± 117 HU; p = 0.648). Conclusion: In patients with a low heart rate who are not able to hold their breath adequately, CCTA can also be acquired during free breathing without substantial loss of image quality when using a high pitch scan mode in 2nd generation dual-source CT.

  6. Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer

    International Nuclear Information System (INIS)

    Mah, Dennis; Hanley, Joseph; Rosenzweig, Kenneth E.; Yorke, Ellen; Braban, Louise; Ling, C. Clifton; Leibel, Stephen A.; Mageras, Gikas

    2000-01-01

    Purpose: The goal of this paper is to describe our initial experience with the deep inspiration breath-hold (DIBH) technique in conformal treatment of non-small-cell lung cancer with particular emphasis on the technical aspects required for implementation. Methods and Materials: In the DIBH technique, the patient is verbally coached through a modified slow vital capacity maneuver and brought to a reproducible deep inspiration breath-hold level. The goal is to immobilize the tumor and to expand normal lung out of the high-dose region. A physicist or therapist monitors and records patient breathing during simulation, verification, and treatment using a spirometer with a custom computer interface. Examination of internal anatomy during fluoroscopy over multiple breath holds establishes the reproducibility of the DIBH maneuver for each patient. A reference free-breathing CT scan and DIBH planning scan are obtained. To provide an estimate of tumor motion during normal tidal breathing, additional scan sets are obtained at end inspiration and end expiration. These are also used to set the spirometer action levels for treatment. Patient lung inflation is independently verified over the course of treatment by comparing the distance from the isocenter to the diaphragm measured from the DIBH digitally reconstructed radiographs to the distance measured on the portal films. Patient breathing traces obtained during treatment were examined retrospectively to assess the reproducibility of the technique. Results: Data from the first 7 patients, encompassing over 250 treatments, were analyzed. The inferred displacement of the centroid of gross tumor volume from its position in the planning scan, as calculated from the spirometer records in over 350 breath holds was 0.02 ± 0.14 cm (mean and standard deviation). These data are consistent with the displacements of the diaphragm (-0.1 ± 0.4 cm; range, from -1.2 to 1.1 cm) relative to the isocenter, as measured on the (92) portal films

  7. The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood

    Directory of Open Access Journals (Sweden)

    Patrick R. Steffen

    2017-08-01

    Full Text Available Heart rate variability biofeedback (HRVB significantly improves heart rate variability (HRV. Breathing at resonance frequency (RF, approximately 6 breaths/min constitutes a key part of HRVB training and is hypothesized to be a pathway through which biofeedback improves HRV. No studies to date, however, have experimentally examined whether RF breathing impacts measures of HRV. The present study addressed this question by comparing three groups: the RF group breathed at their determined RF for 15 min; the RF + 1 group breathed at 1 breath/min higher than their determined RF for 15 min; and the third group sat quietly for 15 min. After this 15-min period, all groups participated in the Paced Auditory Serial Addition Task (PASAT for 8 min, and then sat quietly during a 10-min recovery period. HRV, blood pressure, and mood were measured throughout the experiment. Groups were not significantly different on any of the measures at baseline. After the breathing exercise, the RF group reported higher positive mood than the other two groups and a significantly higher LF/HF HRV ratio relative to the control group, a key goal in HRVB training (p < 0.05. Additionally, the RF group showed lower systolic blood pressure during the PASAT and during the recovery period relative to the control group, with the RF + 1 group not being significantly different from either group (p < 0.05. Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV.

  8. Increased diagnostic contribution of heart rate variability at 0.1Hz paced breathing

    Czech Academy of Sciences Publication Activity Database

    Jurák, Pavel; Halámek, Josef; Somers, V. K.; Nykodým, J.; Leinveber, P.; Fráňa, P.; Eisenberger, M.; Kára, T.

    2005-01-01

    Roč. 4, č. 1 (2005), s. 95 [World Congress on Heart Disease - New Trends in Research, Diagnosis and Treatment /12./. 16.07.2005-19.07.2005, Vancouver] R&D Projects: GA ČR(CZ) GA102/05/0402 Keywords : paced breathing * HRV * ICD Subject RIV: FS - Medical Facilities ; Equipment

  9. Ultrasound for critical care physicians: take a deep breath

    Directory of Open Access Journals (Sweden)

    Ling D

    2015-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A 40 year old man with a past medical history of intravenous drug abuse presented to the emergency department with difficulty walking and lower extremity weakness. He did admit to recent heroin use. He became somnolent in the ED and was given naloxone. However, he did not improve his level of consciousness sufficiently and was intubated for hypercarbia. The patient was transferred to the MICU and was evaluated for respiratory failure. He later that day passed a spontaneous breathing trial after he awoke and was extubated. However, he was soon thereafter was re-intubated for poor respiratory efforts and a weak cough. With an unexplained etiology for the respiratory failure, CT of the head, MRI of the brain and lab evaluation were pursued but were negative. At that point, a bedside ultrasound of the right hemi-diaphragm in the zone of apposition was obtained and is shown below: Figure 1. Ultrasound of ...

  10. Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of "coherence" during biofeedback.

    Science.gov (United States)

    Courtney, Rosalba; Cohen, Marc; van Dixhoorn, Jan

    2011-01-01

    Heart rate variability (HRV) biofeedback is a self-regulation strategy used to improve conditions including asthma, stress, hypertension, and chronic obstructive pulmonary disease. Respiratory muscle function affects hemodynamic influences on respiratory sinus arrhythmia (RSA), and HRV and HRV-biofeedback protocols often include slow abdominal breathing to achieve physiologically optimal patterns of HRV with power spectral distribution concentrated around the 0.1-Hz frequency and large amplitude. It is likely that optimal balanced breathing patterns and ability to entrain heart rhythms to breathing reflect physiological efficiency and resilience and that individuals with dysfunctional breathing patterns may have difficulty voluntarily modulating HRV and RSA. The relationship between breathing movement patterns and HRV, however, has not been investigated. This study examines how individuals' habitual breathing patterns correspond with their ability to optimize HRV and RSA. Breathing pattern was assessed using the Manual Assessment of Respiratory Motion (MARM) and the Hi Lo manual palpation techniques in 83 people with possible dysfunctional breathing before they attempted HRV biofeedback. Mean respiratory rate was also assessed. Subsequently, participants applied a brief 5-minute biofeedback protocol, involving breathing and positive emotional focus, to achieve HRV patterns proposed to reflect physiological "coherence" and entrainment of heart rhythm oscillations to other oscillating body systems. Thoracic-dominant breathing was associated with decreased coherence of HRV (r = -.463, P = .0001). Individuals with paradoxical breathing had the lowest HRV coherence (t(8) = 10.7, P = .001), and the negative relationship between coherence of HRV and extent of thoracic breathing was strongest in this group (r = -.768, P = .03). Dysfunctional breathing patterns are associated with decreased ability to achieve HRV patterns that reflect cardiorespiratory efficiency and

  11. Repeatability of FDG PET/CT metrics assessed in free breathing and deep inspiration breath hold in lung cancer patients.

    Science.gov (United States)

    Nygård, Lotte; Aznar, Marianne C; Fischer, Barbara M; Persson, Gitte F; Christensen, Charlotte B; Andersen, Flemming L; Josipovic, Mirjana; Langer, Seppo W; Kjær, Andreas; Vogelius, Ivan R; Bentzen, Søren M

    2018-01-01

    We measured the repeatability of FDG PET/CT uptake metrics when acquiring scans in free breathing (FB) conditions compared with deep inspiration breath hold (DIBH) for locally advanced lung cancer. Twenty patients were enrolled in this prospective study. Two FDG PET/CT scans per patient were conducted few days apart and in two breathing conditions (FB and DIBH). This resulted in four scans per patient. Up to four FDG PET avid lesions per patient were contoured. The following FDG metrics were measured in all lesions and in all four scans: Standardized uptake value (SUV) peak , SUV max , SUV mean , metabolic tumor volume (MTV) and total lesion glycolysis (TLG), based on an isocontur of 50% of SUV max . FDG PET avid volumes were delineated by a nuclear medicine physician. The gross tumor volumes (GTV) were contoured on the corresponding CT scans. Nineteen patients were available for analysis. Test-retest standard deviations of FDG uptake metrics in FB and DIBH were: SUV peak FB/DIBH: 16.2%/16.5%; SUV max : 18.2%/22.1%; SUV mean : 18.3%/22.1%; TLG: 32.4%/40.5%. DIBH compared to FB resulted in higher values with mean differences in SUV max of 12.6%, SUV peak 4.4% and SUV mean 11.9%. MTV, TLG and GTV were all significantly smaller on day 1 in DIBH compared to FB. However, the differences between metrics under FB and DIBH were in all cases smaller than 1 SD of the day to day repeatability. FDG acquisition in DIBH does not have a clinically relevant impact on the uptake metrics and does not improve the test-retest repeatability of FDG uptake metrics in lung cancer patients.

  12. Separating the effect of respiration from the heart rate variability for cases of constant harmonic breathing

    Directory of Open Access Journals (Sweden)

    Kircher Michael

    2015-09-01

    Full Text Available Heart Rate Variability studies are a known measure for the autonomous control of the heart rate. In special situations, its interpretation can be ambiguous, since the respiration has a major influence on the heart rate variability. For this reason it has often been proposed to measure Heart Rate Variability, while the subjects are breathing at a constant respiration rate. That way the spectral influence of the respiration is known. In this work we propose to remove this constant respiratory influence from the heart rate and the Heart Rate Variability parameters to gain respiration free autonomous controlled heart rate signal. The spectral respiratory component in the heart rate signal is detected and characterized. Subsequently the respiratory effect on Heart Rate Variability is removed using spectral filtering approaches, such as the Notch filter or the Raised Cosine filter. As a result new decoupled Heart Variability parameters are gained, which could lead to new additional interpretations of the autonomous control of the heart rate.

  13. Comparison of cardiac and lung doses for breast cancer patients with free breathing and deep inspiration breath hold technique in 3 dimensional conformal radiotherapy - a dosimetric study

    Science.gov (United States)

    Raj Mani, Karthick; Poudel, Suresh; Maria Das, K. J.

    2017-12-01

    Purpose: To investigate the cardio-pulmonary doses between Deep Inspiration Breath Hold (DIBH) and Free Breathing (FB) technique in left sided breast irradiation. Materials & Methods: DIBH CT and FB CT were acquired for 10 left sided breast patients who underwent whole breast irradiation with or without nodal irradiation. Three fields single isocenter technique were used for patients with node positive patients along with two tangential conformal fields whereas only two tangential fields were used in node negative patients. All the critical structures like lungs, heart, esophagus, thyroid, etc., were delineated in both DIBH and FB scan. Both DIBH and FB scans were fused with the Dicom origin as they were acquired with the same Dicom coordinates. Plans were created in the DIBH scan for a dose range between 50 Gy in 25 fractions. Critical structures doses were recorded from the Dose Volume Histogram for both the DIBH and FB data set for evaluation. Results: The average mean heart dose in DIBH vs FB was 13.18 Gy vs 6.97 Gy, (p = 0.0063) significantly with DIBH as compared to FB technique. The relative reduction in average mean heart dose was 47.12%. The relative V5 reduced by 14.70% (i.e. 34.42% vs 19.72%, p = 0.0080), V10 reduced by 13.83% (i.e. 27.79 % vs 13.96%, p = 0.0073). V20 reduced by 13.19% (i.e. 24.54 % vs 11.35%, p = 0.0069), V30 reduced by 12.38% (i.e. 22.27 % vs 9.89 %, p = 0.0073) significantly with DIBH as compared to FB. The average mean left lung dose reduced marginally by 1.43 Gy (13.73 Gy vs 12.30 Gy, p = 0.4599) but insignificantly with DIBH as compared to FB. Other left lung parameters (V5, V10, V20 and V30) shows marginal decreases in DIBH plans compare to FB plans. Conclusion: DIBH shows a substantial reduction of cardiac doses but slight and insignificant reduction of pulmonary doses as compared with FB technique. Using the simple DIBH technique, we can effectively reduce the cardiac morbidity and at the same time radiation induced lung

  14. Geometric uncertainties in voluntary deep inspiration breath hold radiotherapy for locally advanced lung cancer

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, G F; Dueck, Jenny

    2016-01-01

    BACKGROUND AND PURPOSE: Deep inspiration breath hold (DIBH) increases lung volume and can potentially reduce treatment-related toxicity in locally advanced lung cancer. We estimated geometric uncertainties in visually guided voluntary DIBH and derived the appropriate treatment margins for different...... image-guidance strategies. MATERIAL AND METHODS: Seventeen patients were included prospectively. An optical marker-based respiratory monitoring with visual guidance enabled comfortable DIBHs, adjusted to each patient's performance. All patients had three consecutive DIBH CTs at each of the treatment...

  15. Recognition and Management of Sleep-Disordered Breathing in Chronic Heart Failure

    Science.gov (United States)

    Kikta, Donald; Khayat, Rami

    2013-01-01

    It is increasingly recognized that sleep-disordered breathing (SDB) is a common modifiable risk factor for cardiovascular disease with significant impact on morbidity and potentially mortality. SDB is highly prevalent in patients with systolic or diastolic heart failure. A high index of suspicion is necessary to diagnose SDB in patients with heart failure because the vast majority of affected patients do not report daytime symptoms. Recent clinical trials have demonstrated improvement in heart function, exercise tolerance, and quality of life after treatment of SDB in patients with heart failure. Accumulating evidence suggests that treatment of SDB should complement the established pharmacologic therapy for chronic heart failure. However, mortality benefit has yet to be demonstrated. PMID:21086079

  16. Assessment of voluntary deep inspiration breath-hold with CINE imaging for breast radiotherapy.

    Science.gov (United States)

    Estoesta, Reuben Patrick; Attwood, Lani; Naehrig, Diana; Claridge-Mackonis, Elizabeth; Odgers, David; Martin, Darren; Pham, Melissa; Toohey, Joanne; Carroll, Susan

    2017-10-01

    Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery. Weekly CINE images were retrospectively assessed for 20 left-sided breast cancer patients receiving RT in vDIBH, and compared with CINE images of 20 patients treated in FB. The intra-beam motion was assessed and the distance from the beam central axis (CA) to the internal chest wall (ICW) was measured on each CINE image. These were then compared to the planned distance on digitally reconstructed radiograph (DRR). The maximum intra-beam motion for any one patient measurement was 0.30 cm for vDIBH and 0.20 cm for FB. The mean difference between the distance from the CA to ICW on DRR and the equivalent distance on CINE imaging (as treated) was 0.28 cm (SD 0.17) for vDIBH patients and 0.25 cm (SD 0.14) for FB patients (P = 0.458). The measured values were comparable for patients undergoing RT in vDIBH, and for those in FB. This quality assessment showed that using in-room lasers and skin tattoos to independently monitor breath-hold in vDIBH as detected by 'on-treatment' CINE imaging is safe and effective. © 2017 The Royal Australian and New Zealand College of Radiologists.

  17. With age a lower individual breathing reserve is associated with a higher maximal heart rate.

    Science.gov (United States)

    Burtscher, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Johannes

    2018-01-01

    Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax. Retrospective analyses have been conducted on the results of 129 consecutively performed routine cardiopulmonary exercise tests. The study sample comprised healthy subjects of both sexes of a broad range of age (20-86 years). Maximal values of power output, minute ventilation, oxygen uptake and heart rate were assessed by the use of incremental cycle spiroergometry. Linear multivariate regression analysis revealed that in addition to age the individual breathing reserve at maximal exercise was independently predictive for HRmax. A lower breathing reserve due to a high ventilatory demand and/or a low ventilatory capacity, which is more pronounced at a higher age, was associated with higher HRmax. Age explained the observed variance in HRmax by 72% and was improved to 83% when the variable "breathing reserve" was entered. The presented findings indicate an independent association between the breathing reserve at maximal exercise and maximal heart rate, i.e. a low individual breathing reserve is associated with a higher age-related HRmax. A deeper understanding of this association has to be investigated in a more physiological scenario. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Deep Inspiration Breath Hold—Based Radiation Therapy: A Clinical Review

    Energy Technology Data Exchange (ETDEWEB)

    Boda-Heggemann, Judit, E-mail: judit.boda-heggemann@umm.de [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim (Germany); Knopf, Antje-Christin [The Institute of Cancer Research, Royal Cancer Hospital, London (United Kingdom); Simeonova-Chergou, Anna; Wertz, Hansjörg; Stieler, Florian; Jahnke, Anika; Jahnke, Lennart; Fleckenstein, Jens; Vogel, Lena; Arns, Anna; Blessing, Manuel; Wenz, Frederik; Lohr, Frank [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim (Germany)

    2016-03-01

    Several recent developments in linear accelerator–based radiation therapy (RT) such as fast multileaf collimators, accelerated intensity modulation paradigms like volumeric modulated arc therapy and flattening filter-free (FFF) high-dose-rate therapy have dramatically shortened the duration of treatment fractions. Deliverable photon dose distributions have approached physical complexity limits as a consequence of precise dose calculation algorithms and online 3-dimensional image guided patient positioning (image guided RT). Simultaneously, beam quality and treatment speed have continuously been improved in particle beam therapy, especially for scanned particle beams. Applying complex treatment plans with steep dose gradients requires strategies to mitigate and compensate for motion effects in general, particularly breathing motion. Intrafractional breathing-related motion results in uncertainties in dose delivery and thus in target coverage. As a consequence, generous margins have been used, which, in turn, increases exposure to organs at risk. Particle therapy, particularly with scanned beams, poses additional problems such as interplay effects and range uncertainties. Among advanced strategies to compensate breathing motion such as beam gating and tracking, deep inspiration breath hold (DIBH) gating is particularly advantageous in several respects, not only for hypofractionated, high single-dose stereotactic body RT of lung, liver, and upper abdominal lesions but also for normofractionated treatment of thoracic tumors such as lung cancer, mediastinal lymphomas, and breast cancer. This review provides an in-depth discussion of the rationale and technical implementation of DIBH gating for hypofractionated and normofractionated RT of intrathoracic and upper abdominal tumors in photon and proton RT.

  19. SU-C-BRF-01: Correlation of DIBH Breath Hold Amplitude with Dosimetric Sparing of Heart and Left Anterior Descending Artery in Left Breast Radiotherapy

    International Nuclear Information System (INIS)

    Kim, Taeho; Reardon, Kelli; Sukovich, Kaitlyn; Crandley, Edwin; Read, Paul; Krishni, Wijesooriya

    2014-01-01

    Purpose: A 7.4% increase in major coronary events per 1 Gy increase in mean heart dose has been reported from the population-based analysis of radiation-induced cardiac toxicity following treatment of left sided breast cancer. Deep inhalation breath-hold (DIBH) is clinically utilized to reduce radiation dose to heart and left anterior descending artery (LAD). We investigated the correlation of dose sparing in heart and LAD with internal DIBH amplitude to develop a quantitative predictive model for expected dose to heart and LAD based on internal breath hold amplitude. Methods: A treatment planning study (Prescription Dose = 50 Gy) was performed on 50 left breast cancer patients underwent DIBH whole breast radiotherapy. Two CT datasets, free breathing (FB) and DIBH, were utilized for treatment planning and for determination of the internal anatomy DIBH amplitude (difference between sternum position at FB and DIBH). The heart and LAD dose between FB and DIBH plans was compared and dose to the heart and LAD as a function of breath hold amplitude was determined. Results: Average DIBH amplitude using internal anatomy was 13.9±4.2 mm. The DIBH amplitude-mean dose reduction correlation is 20%/5mm (0.3 Gy/5mm) for the heart and 18%/5mm (1.1 Gy/5mm) for LAD. The correlation with max dose reduction is 12%/5mm (3.8 Gy/5mm) for the heart and 16%/5mm (3.2 Gy/5mm) for LAD. We found that average dose reductions to LAD from 6.0±6.5 Gy to 2.0±1.6 Gy with DIBH (4.0 Gy reduction: -67%, p < 0.001) and average dose reduction to the heart from 1.3±0.7 Gy to 0.7±0.2 Gy with DIBH (0.6 Gy reduction: -46%, p < 0.001). That suggests using DIBH may reduce the risk of the major coronary event for left sided breast cancer patients. Conclusion: The correlation between breath hold amplitude and dosimetric sparing suggests that dose sparing linearly increases with internal DIBH amplitude

  20. Microsoft Kinect Visual and Depth Sensors for Breathing and Heart Rate Analysis

    Directory of Open Access Journals (Sweden)

    Aleš Procházka

    2016-06-01

    Full Text Available This paper is devoted to a new method of using Microsoft (MS Kinect sensors for non-contact monitoring of breathing and heart rate estimation to detect possible medical and neurological disorders. Video sequences of facial features and thorax movements are recorded by MS Kinect image, depth and infrared sensors to enable their time analysis in selected regions of interest. The proposed methodology includes the use of computational methods and functional transforms for data selection, as well as their denoising, spectral analysis and visualization, in order to determine specific biomedical features. The results that were obtained verify the correspondence between the evaluation of the breathing frequency that was obtained from the image and infrared data of the mouth area and from the thorax movement that was recorded by the depth sensor. Spectral analysis of the time evolution of the mouth area video frames was also used for heart rate estimation. Results estimated from the image and infrared data of the mouth area were compared with those obtained by contact measurements by Garmin sensors (www.garmin.com. The study proves that simple image and depth sensors can be used to efficiently record biomedical multidimensional data with sufficient accuracy to detect selected biomedical features using specific methods of computational intelligence. The achieved accuracy for non-contact detection of breathing rate was 0.26% and the accuracy of heart rate estimation was 1.47% for the infrared sensor. The following results show how video frames with depth data can be used to differentiate different kinds of breathing. The proposed method enables us to obtain and analyse data for diagnostic purposes in the home environment or during physical activities, enabling efficient human–machine interaction.

  1. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    International Nuclear Information System (INIS)

    Hepp, Rodrigo; Ammerpohl, Mark; Morgenstern, Christina; Erichsen, Patricia; Nielinger, Lisa; Abdallah, Abdallah; Galalae, Razvan

    2015-01-01

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm 3 (D 2 cm 3 ), volume receiving ≥ 5 Gy (V 5 ), 10 Gy (V 10 ), 15 Gy (V 15 ) and 20 Gy (V 20 ). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D 2 cm 3 was less than 42 Gy in DIBH. In FB the heart D 2 cm 3 was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.) [de

  2. Free breathing whole-heart 3D CINE MRI with self-gated Cartesian trajectory.

    Science.gov (United States)

    Usman, M; Ruijsink, B; Nazir, M S; Cruz, G; Prieto, C

    2017-05-01

    To present a method that uses a novel free-running self-gated acquisition to achieve isotropic resolution in whole heart 3D Cartesian cardiac CINE MRI. 3D cardiac CINE MRI using navigator gating results in long acquisition times. Recently, several frameworks based on self-gated non-Cartesian trajectories have been proposed to accelerate this acquisition. However, non-Cartesian reconstructions are computationally expensive due to gridding, particularly in 3D. In this work, we propose a novel highly efficient self-gated Cartesian approach for 3D cardiac CINE MRI. Acquisition is performed using CArtesian trajectory with Spiral PRofile ordering and Tiny golden angle step for eddy current reduction (so called here CASPR-Tiger). Data is acquired continuously under free breathing (retrospective ECG gating, no preparation pulses interruption) for 4-5min and 4D whole-heart volumes (3D+cardiac phases) with isotropic spatial resolution are reconstructed from all available data using a soft gating technique combined with temporal total variation (TV) constrained iterative SENSE reconstruction. For data acquired on eight healthy subjects and three patients, the reconstructed images using the proposed method had good contrast and spatio-temporal variations, correctly recovering diastolic and systolic cardiac phases. Non-significant differences (P>0.05) were observed in cardiac functional measurements obtained with proposed 3D approach and gold standard 2D multi-slice breath-hold acquisition. The proposed approach enables isotropic 3D whole heart Cartesian cardiac CINE MRI in 4 to 5min free breathing acquisition. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Changes in Heart Rhythm and Breathing in Acute Systemic Injury Due to Cold

    Directory of Open Access Journals (Sweden)

    D. Yu. Konnov

    2015-01-01

    Full Text Available Objective: to reveal the patterns of a change in heart rhythm and breathing in patients with acute systemic injury due to cold in hypothermic and early posthypothermic periods.Subjects and methods. Thirty patients aged 18 to 60 years (3 groups of 10 patients with mild, moderate, and severe cold injury were examined in hypothermic and posthypothermic periods. The patient groups did not differ in gender, age, and weight. Within the first 24 hours after admission, all the patients underwent high-resolution Holter electrocardiographic monitoring that recorded cardiac arrhythmias and breathing disorders.Results. During the therapy performed, as the degree of acute systemic cold injury increased, the patients were found to have a heart rate reduction (from 102 [90; 122] beats/min in Group 1 to 49 [38; 58] beats/min in Group 3 and a circadian index increase (from 105 [88; 125]% in Group 1 to 210 [185; 223]% in Group 3. With increased hypothermia, the victims were detected to have progressive cardiac rhythm and cardiac electrical conduction disturbances, such as supraventricular pacemaker migration, single and paired supraventricular premature beats, paroxysmal atrial tachycardia, atrial fibrillations, and ventricular premature beats. There was decreased heart rhythm variability in all the study groups, to the greatest extent in the patents with severe systemic cold injury. Late ventricular potentials were found in 2 and 7 patients with moderate and severe cold injury, respectively. Breathing disorders were recorded in all the study groups, the greatest increase in the frequency and duration of apnea/hypopnea episodes was noted in the patients with severe hypothermia. A fatal outcome occurred in 4 of the 10 patients with critical hypothermia due to the occurrence of idioventricular rhythm with transition to asystole.Conclusion. Systemic hypothermia is accompanied by cardiac rhythm and cardiac electrical conduction disturbances and respiratory depression

  4. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing--an experimental study.

    Science.gov (United States)

    Busch, Volker; Magerl, Walter; Kern, Uwe; Haas, Joachim; Hajak, Göran; Eichhammer, Peter

    2012-02-01

    Deep and slow breathing (DSB) techniques, as a component of various relaxation techniques, have been reported as complementary approaches in the treatment of chronic pain syndromes, but the relevance of relaxation for alleviating pain during a breathing intervention was not evaluated so far. In order to disentangle the effects of relaxation and respiration, we investigated two different DSB techniques at the same respiration rates and depths on pain perception, autonomic activity, and mood in 16 healthy subjects. In the attentive DSB intervention, subjects were asked to breathe guided by a respiratory feedback task requiring a high degree of concentration and constant attention. In the relaxing DSB intervention, the subjects relaxed during the breathing training. The skin conductance levels, indicating sympathetic tone, were measured during the breathing maneuvers. Thermal detection and pain thresholds for cold and hot stimuli and profile of mood states were examined before and after the breathing sessions. The mean detection and pain thresholds showed a significant increase resulting from the relaxing DSB, whereas no significant changes of these thresholds were found associated with the attentive DSB. The mean skin conductance levels indicating sympathetic activity decreased significantly during the relaxing DSB intervention but not during the attentive DSB. Both breathing interventions showed similar reductions in negative feelings (tension, anger, and depression). Our results suggest that the way of breathing decisively influences autonomic and pain processing, thereby identifying DSB in concert with relaxation as the essential feature in the modulation of sympathetic arousal and pain perception. Wiley Periodicals, Inc.

  5. The UK HeartSpare Study (Stage IB): Randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery

    International Nuclear Information System (INIS)

    Bartlett, Frederick R.; Colgan, Ruth M.; Donovan, Ellen M.; McNair, Helen A.; Carr, Karen; Evans, Philip M.; Griffin, Clare; Locke, Imogen; Haviland, Joanne S.; Yarnold, John R.; Kirby, Anna M.

    2015-01-01

    Purpose: To compare mean heart and left anterior descending coronary artery (LAD) doses (NTD mean ) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques. Materials and methods: Following surgery for early breast cancer, patients with estimated breast volumes >750 cm 3 underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1–7, before switching techniques for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTD mean between techniques. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. Results: 34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTD mean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p < 0.001) and 2.9 and 7.8 (p < 0.001). Clip-based CBCT errors for VBH and prone respectively were ⩽3.0 mm and ⩽6.5 mm (Σ) and ⩽3.5 mm and ⩽5.4 mm (σ). Conclusions: In larger-breasted women, supine VBH provided superior cardiac sparing and reproducibility than a free-breathing prone position

  6. Anoxia and Acidosis Tolerance of the Heart in an Air-Breathing Fish (Pangasianodon hypophthalmus).

    Science.gov (United States)

    Joyce, William; Gesser, Hans; Bayley, Mark; Wang, Tobias

    2015-01-01

    Air breathing has evolved repeatedly in fishes and may protect the heart during stress. We investigated myocardial performance in the air-breathing catfish Pangasianodon hypophthalmus, a species that can withstand prolonged exposure to severe hypoxia and acidosis. Isometric ventricular preparations were exposed to anoxia, lactic acidosis, hypercapnic acidosis, and combinations of these treatments. Ventricular preparations were remarkably tolerant to anoxia, exhibiting an inotropic reduction of only 40%, which fully recovered during reoxygenation. Myocardial anoxia tolerance was unaffected by physiologically relevant elevations of bicarbonate concentration, in contrast to previous results in other fishes. Both lactic acidosis (5 mM; pH 7.10) and hypercapnic acidosis (10% CO2; pH 6.70) elicited a biphasic response, with an initial and transient decrease in force followed by overcompensation above control values. Spongy myocardial preparations were significantly more tolerant to hypercapnic acidosis than compact myocardial preparations. While ventricular preparations were tolerant to the isolated effects of anoxia and acidosis, their combination severely impaired myocardial performance and contraction kinetics. This suggests that air breathing may be a particularly important myocardial oxygen source during combined anoxia and acidosis, which may occur during exercise or environmental stress.

  7. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

    Science.gov (United States)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-09-22

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean irradiation.

  8. Target position uncertainty during visually guided deep-inspiration breath-hold radiotherapy in locally advanced lung cancer

    DEFF Research Database (Denmark)

    Rydhog, Jonas Scherman; de Blanck, Steen Riisgaard; Josipovic, Mirjana

    2017-01-01

    Purpose: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath hold (DISH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients.Methods: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course...... of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm.Results: A mean...... small in visually guided breath-hold radiotherapy of NSCLC. Target motion could be substantially reduced, but not eliminated, using visually guided DIBH. (C) 2017 Elsevier B.V. All rights reserved....

  9. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

    International Nuclear Information System (INIS)

    Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar

    2011-01-01

    Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

  10. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

    Energy Technology Data Exchange (ETDEWEB)

    Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar (Dept. of Radiotherapy, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: vijo@sus.no

    2011-01-15

    Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

  11. Dosimetric comparison of deep inspiration breath hold and free breathing technique in stereotactic body radiotherapy for localized lung tumor using Flattening Filter Free beam

    Science.gov (United States)

    Mani, Karthick Raj; Bhuiyan, Md. Anisuzzaman; Alam, Md. Mahbub; Ahmed, Sharif; Sumon, Mostafa Aziz; Sengupta, Ashim Kumar; Rahman, Md. Shakilur; Azharul Islam, Md. S. M.

    2018-03-01

    Aim: To compare the dosimetric advantage of stereotactic body radiotherapy (SBRT) for localized lung tumor between deep inspiration breath hold technique and free breathing technique. Materials and methods: We retrospectively included ten previously treated lung tumor patients in this dosimetric study. All the ten patients underwent CT simulation using 4D-CT free breathing (FB) and deep inspiration breath hold (DIBH) techniques. Plans were created using three coplanar full modulated arc using 6 MV flattening filter free (FFF) bream with a dose rate of 1400 MU/min. Same dose constraints for the target and the critical structures for a particular patient were used during the plan optimization process in DIBH and FB datasets. We intend to deliver 50 Gy in 5 fractions for all the patients. For standardization, all the plans were normalized at target mean of the planning target volume (PTV). Doses to the critical structures and targets were recorded from the dose volume histogram for evaluation. Results: The mean right and left lung volumes were inflated by 1.55 and 1.60 times in DIBH scans compared to the FB scans. The mean internal target volume (ITV) increased in the FB datasets by 1.45 times compared to the DIBH data sets. The mean dose followed by standard deviation (x¯ ± σx¯) of ipsilateral lung for DIBH-SBRT and FB-SBRT plans were 7.48 ± 3.57 (Gy) and 10.23 ± 4.58 (Gy) respectively, with a mean reduction of 36.84% in DIBH-SBRT plans. Ipsilateral lung were reduced to 36.84% in DIBH plans compared to FB plans. Conclusion: Significant dose reduction in ipsilateral lung due to the lung inflation and target motion restriction in DIBH-SBRT plans were observed compare to FB-SBRT. DIBH-SBRT plans demonstrate superior dose reduction to the normal tissues and other critical structures.

  12. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation

    International Nuclear Information System (INIS)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-01-01

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of D mean < 4 Gy in these two cohorts. Twenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar’s test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V 20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing. All patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart D mean <4 Gy with FB. All patients met this constraint with DIBH. All patients receiving WBRT met D mean Heart < 4 Gy on FB, while only slightly over

  13. Effects of hot-iron branding on heart rate, breathing rate and behaviour of anaesthetised Steller sea lions.

    Science.gov (United States)

    Walker, K A; Mellish, J E; Weary, D M

    2011-10-01

    This study assessed the heart rate, breathing rate and behavioural responses of 12 juvenile Steller sea lions during hot-iron branding under isoflurane anaesthesia. Physiological and behavioural measures were recorded in four periods: baseline (five minutes), sham branding (one minute), branding (approximately 2.7 minutes) and postbranding (five minutes). No difference in heart rate was noted from baseline to sham branding, but heart rate increased from mean (sem) 78.3 (2.4) bpm in the baseline period to 85.6 (2.5) bpm in the branding period. Heart rate remained elevated in the postbranding period, averaging 84.7 (2.5) bpm. Breathing rate averaged 2.5 (1.0) breaths/minute in the baseline and sham branding periods increased to 8.9 (1.0) breaths/minute during branding, but returned to baseline by the postbranding period. Behaviourally, half of the sea lions exhibited trembling and head and shoulder movements during branding.

  14. Correlations between the Poincaré plot and conventional heart rate variability parameters assessed during paced breathing

    NARCIS (Netherlands)

    Guzik, P.; Piskorski, J.; Krauze, T.; Schneider, R.; Wesseling, K.H.; Wykrȩtowicz, A.; Wysocki, H.

    2007-01-01

    Aim: To analyze the correlation of the Poincaré plot descriptors of RR intervals with standard measures of heart rate variability (HRV) and spontaneous baroreflex sensitivity (BRS). A physiological model of changing respiratory rates from 6 to 15 breaths/min provided a wide range of RR intervals for

  15. Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration

    International Nuclear Information System (INIS)

    Barnes, Elizabeth A.; Murray, Brad R.; Robinson, Donald M.; Underwood, Lori J.; Hanson, John; Roa, Wilson H.Y.

    2001-01-01

    Purpose:To examine the dosimetric benefit of self-gated radiotherapy at deep-inspiration breath hold (DIBH) in the treatment of patients with non-small-cell lung cancer (NSCLC). The relative contributions of tumor immobilization at breath hold (BH) and increased lung volume at deep inspiration (DI) in sparing high-dose lung irradiation (≥20 Gy) were examined. Methods and Materials:Ten consecutive patients undergoing radiotherapy for Stage I-IIIB NSCLC who met the screening criteria were entered on this study. Patients were instructed to BH at DI without the use of external monitors or breath-holding devices (self-gating). Computed tomography (CT) scans of the thorax were performed during free breathing (FB) and DIBH. Fluoroscopy screened for reproducible tumor position throughout DIBH, and determined the maximum superior-inferior (SI) tumor motion during both FB and DIBH. Margins used to define the planning target volume (PTV) from the clinical target volume included 1 cm for setup error and organ motion, plus an additional SI margin for tumor motion, as determined from fluoroscopy. Three conformal treatment plans were then generated for each patient, one from the FB scan with FB PTV margins, a second from the DIBH scan with FB PTV margins, and a third from the DIBH scan with DIBH PTV margins. The percent of total lung volume receiving ≥20 Gy (using a prescription dose of 70.9 Gy to isocenter) was determined for each plan. Results:Self-gating at DIBH was possible for 8 of the 10 patients; 2 patients were excluded, because they were not able to perform a reproducible DIBH. For these 8 patients, the median BH time was 23 (range, 19-52) s. The mean percent of total lung volume receiving ≥20 Gy under FB conditions (FB scan with FB PTV margins) was 12.8%. With increased lung volume alone (DIBH scan with FB PTV margins), this was reduced to 11.0%, tending toward a significant decrease in lung irradiation over FB (p=0.086). With both increased lung volume and tumor

  16. Prevalence and risk factors of sleep disordered breathing in patients with rheumatic valvular heart disease.

    Science.gov (United States)

    Ding, Ning; Ni, Bu-Qing; Zhang, Xi-Long; Huang, Han-Peng; Su, Mei; Zhang, Shi-Jiang; Wang, Hong

    2013-08-15

    Sleep disordered breathing (SDB) is common in patients with chronic heart failure secondary to non-valvular heart disease; however, the prevalence and characteristics of SDB in patients with rheumatic valvular heart disease (RVHD) are unclear. This study was designed to determine the prevalence, characteristics, and risk factors for SDB in RVHD patients. A cross-sectional study was conducted in 260 RVHD patients. The following data were recorded: types of heart valve lesions, electrocardiographic, echocardiographic, arterial blood gas analysis findings, baseline medication, 6-minute walk test (6MWT) distance, and sleep parameters. Compared to patients with single leftsided valve lesions, patients with left- and rightsided valve lesions had a higher prevalence of SDB (46.2% vs. 31.2%, p = 0.013); the increased prevalence of SDB only involved central sleep apnea (CSA) (31.1% vs. 14.1%, p = 0.001). Patients with obstructive sleep apnea (OSA) or CSA were older and had a shorter 6MWT distance, lower left ventricle ejection fraction and PaO₂, a longer lung-to-finger circulation time, and a higher prevalence of atrial fibrillation (AF) and hypertension (all p < 0.05) as compared with patients without SDB. Multinomial logistic regression analysis showed that PaO2 ≤ 85 mm Hg was the only risk factor for OSA. Male gender, AF, 6MWT distance ≤ 300 m, PaO₂ ≤ 85 mmHg, and PaCO₂ ≤ 40 mm Hg were risk factors for CSA. Patients with RVHD had a high prevalence of SDB (predominantly CSA). RVHD patients with SDB, particularly those who had CSA, manifested more severe symptoms and greater impairment of cardiac function. Assessments of clinical manifestations of cardiac dysfunction may be important for predicting the risk factors for SDB.

  17. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Seeger, Achim; Fenchel, Michael C.; Kramer, Ulrich; Bretschneider, Christiane; Doering, Joerg; Claussen, Claus D.; Miller, Stephan [University of Tuebingen (Germany). Department of Diagnostic and Interventional Radiology; Greil, Gerald F. [St. Thomas Hospital, Division of Imaging Sciences, King' s College London (United Kingdom); Martirosian, Petros [University of Tuebingen, Section of Experimental Radiology, Tuebingen (Germany); Sieverding, Ludger [University of Tuebingen, Department of Pediatric Cardiology, Tuebingen (Germany)

    2009-12-15

    Patients with congenital heart disease frequently have complex cardiac and vascular malformations requiring detailed non-invasive diagnostic evaluation including functional parameters. To evaluate the morphological and functional information provided by a novel 3-D cine steady-state free-precession (SSFP) sequence. Twenty consecutive children (mean age 2.2 years, nine boys) were examined using a 1.5-T MR system including 2-D cine gradient-recalled-echo sequences, static 3-D SSFP and 3-D cine SSFP sequences. Measurement of ventricular structures and volumes showed close agreement between the 3-D cine SSFP sequence and the 2-D cine gradient-recalled-echo and static 3-D SSFP sequences (left ventricular volumes mean difference 1.0-1.9 ml and 8.8-11.4%, respectively; right ventricular volumes 1.7-2.1 ml and 9.9-16.9%, respectively). No systematic bias was observed. 3-D cine MRI provides anatomic as well as functional information with sufficient spatial and temporal resolution in free-breathing infants with congenital heart disease. (orig.)

  18. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease

    International Nuclear Information System (INIS)

    Seeger, Achim; Fenchel, Michael C.; Kramer, Ulrich; Bretschneider, Christiane; Doering, Joerg; Claussen, Claus D.; Miller, Stephan; Martirosian, Petros; Sieverding, Ludger

    2009-01-01

    Patients with congenital heart disease frequently have complex cardiac and vascular malformations requiring detailed non-invasive diagnostic evaluation including functional parameters. To evaluate the morphological and functional information provided by a novel 3-D cine steady-state free-precession (SSFP) sequence. Twenty consecutive children (mean age 2.2 years, nine boys) were examined using a 1.5-T MR system including 2-D cine gradient-recalled-echo sequences, static 3-D SSFP and 3-D cine SSFP sequences. Measurement of ventricular structures and volumes showed close agreement between the 3-D cine SSFP sequence and the 2-D cine gradient-recalled-echo and static 3-D SSFP sequences (left ventricular volumes mean difference 1.0-1.9 ml and 8.8-11.4%, respectively; right ventricular volumes 1.7-2.1 ml and 9.9-16.9%, respectively). No systematic bias was observed. 3-D cine MRI provides anatomic as well as functional information with sufficient spatial and temporal resolution in free-breathing infants with congenital heart disease. (orig.)

  19. Cardiorespiratory interactions during periodic breathing in awake chronic heart failure patients.

    Science.gov (United States)

    Pinna, G D; Maestri, R; Mortara, A; La Rovere, M T

    2000-03-01

    We applied spectral techniques to the analysis of cardiorespiratory signals [instantaneous lung volume (ILV), instantaneous tidal volume (ITV), arterial O(2) saturation (Sa(O(2))) at the ear, heart rate (HR), systolic (SAP), and diastolic (DAP) arterial pressure] during nonapneic periodic breathing (PB) in 29 awake chronic heart failure (CHF) patients and estimated the timing relationships between respiratory and slow cardiovascular (cardiorespiratory interactions during PB and 2) to test the hypothesis of a central vasomotor origin of PB. All cardiovascular signals were characterized by a dominant (>/=84% of total power) oscillation at the frequency of PB (mean +/- SE: 0.022 +/- 0.0008 Hz), highly coherent (>/=0.89), and delayed with respect to ITV (ITV-HR, 2.4 +/- 0.72 s; ITV-SAP, 6.7 +/- 0.65 s; ITV-DAP, 3.2 +/- 0.61 s; P cardiorespiratory rhythm led by the ventilatory oscillation and suggest that 1) the cyclic increase in inspiratory drive and cardiopulmonary reflexes and 2) mechanical effects of PB-induced changes in intrathoracic pressure are the more likely sources of the HR and blood pressure oscillations, respectively. The timing relationship between ITV and blood pressure signals excludes the possibility that PB represents the effect of a central vasomotor rhythm.

  20. Deep-inspiration breath-hold PET/CT versus free breathing PET/CT and respiratory gating PET for reference. Evaluation in 95 patients with lung cancer

    International Nuclear Information System (INIS)

    Kawano, Tsuyoshi; Ohtake, Eiji; Inoue, Tomio

    2011-01-01

    The objective of this study was to define the factors that correlate with differences in maximum standardized uptake value (SUV max ) in deep-inspiration breath-hold (DIBH) and free breathing (FB) positron emission tomography (PET)/CT admixed with respiratory gating (RG) PET for reference. Patients (n=95) with pulmonary lesions were evaluated at one facility over 33 months. After undergoing whole-body PET/CT, a RG PET and FB PET/CT scans were obtained, followed by a DIBH PET/CT scan. All scans were recorded using a list-mode dynamic collection method with respiratory gating. The RG PET was reconstructed using phase gating without attenuation correction; the FB PET was reconstructed from the RG PET sinogram datasets with attenuation correction. Respiratory motion distance, breathing cycle speed, and waveform of RG PET were recorded. The SUV max of FB PET/CT and DIBH PET/CT were recorded: the percent difference in SUV max between the FB and DIBH scans was defined as the %BH-index. The %BH-index was significantly higher for lesions in the lower lung area than in the upper lung area. Respiratory motion distance was significantly higher in the lower lung area than in the upper lung area. A significant relationship was observed between the %BH-index and respiratory motion distance. Waveforms without steady end-expiration tended to show a high %BH-index. Significant inverse relationships were observed between %BH-index and cycle speed, and between respiratory motion distance and cycle speed. Decrease in SUV max of FB PET/CT was due to tumor size, distribution of lower lung, long respiratory movement at slow breathing cycle speeds, and respiratory waveforms without steady end-expiration. (author)

  1. Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy

    International Nuclear Information System (INIS)

    Cervino, Laura I; Gupta, Sonia; Rose, Mary A; Yashar, Catheryn; Jiang, Steve B

    2009-01-01

    Late cardiac complications may arise after left-breast radiation therapy. Deep-inspiration breath hold (DIBH) allows reduction of the irradiated heart volume at the same time as it reduces tumor bed motion and increases lung sparing. In the present study, we have evaluated the improvement in reproducibility and stability of the DIBH for left-breast-cancer treatment when visual coaching is provided with the aid of 3D video surface imaging and video goggles. Five left-breast-cancer patients and fifteen healthy volunteers were asked to perform a series of DIBHs without and with visual coaching. Reproducibility and stability of DIBH were measured for each individual with and without visual coaching. The average reproducibility and stability changed from 2.1 mm and 1.5 mm, respectively, without visual feedback to 0.5 mm and 0.7 mm with visual feedback, showing a significant statistical difference (p 2 mm) in reproducibility and stability were observed in 35% and 15% of the subjects, respectively. The average chest wall excursion of the DIBH with respect to the free breathing preceding the DIBH was found to be 11.3 mm. The reproducibility and stability of the DIBH improve significantly from the visual coaching provided to the patient, especially in those patients with poor reproducibility and stability.

  2. Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Cervino, Laura I; Gupta, Sonia; Rose, Mary A; Yashar, Catheryn; Jiang, Steve B [Department of Radiation Oncology, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92037-0843 (United States)], E-mail: sbjiang@ucsd.edu

    2009-11-21

    Late cardiac complications may arise after left-breast radiation therapy. Deep-inspiration breath hold (DIBH) allows reduction of the irradiated heart volume at the same time as it reduces tumor bed motion and increases lung sparing. In the present study, we have evaluated the improvement in reproducibility and stability of the DIBH for left-breast-cancer treatment when visual coaching is provided with the aid of 3D video surface imaging and video goggles. Five left-breast-cancer patients and fifteen healthy volunteers were asked to perform a series of DIBHs without and with visual coaching. Reproducibility and stability of DIBH were measured for each individual with and without visual coaching. The average reproducibility and stability changed from 2.1 mm and 1.5 mm, respectively, without visual feedback to 0.5 mm and 0.7 mm with visual feedback, showing a significant statistical difference (p < 0.001 for reproducibility, p < 0.01 for stability). Significant changes (>2 mm) in reproducibility and stability were observed in 35% and 15% of the subjects, respectively. The average chest wall excursion of the DIBH with respect to the free breathing preceding the DIBH was found to be 11.3 mm. The reproducibility and stability of the DIBH improve significantly from the visual coaching provided to the patient, especially in those patients with poor reproducibility and stability.

  3. Poster - 35: Monitoring patient positioning during deep inspiration breath hold with a distance measuring laser

    International Nuclear Information System (INIS)

    Weston, Mark; Juhasz, Janos

    2016-01-01

    Purpose: The accuracy of treatment delivery for left breast/chest wall patients using deep inspiration breath hold (DIBH) is being monitored using a distance measuring laser (DML) Methods: A commercially available DML (DLS-C15, Dimetix) was mounted behind a Varian TrilogyTM linac. Relative to the machine isocenter, the laser from the beam was offset by 8 cm to the left and by 1 cm in the superior direction. This position was selected because this point is situated on the sternum for the majority of the left breast/chest-wall patients treated at our institution. The Varian Real-Time Positioning Management™ (RPM) guided DIBH treatments at our institution is delivered by placing the system’s tracking block on the patient’s abdomen. The treatment beam is enabled only when the block is in between a predefined abdomen motion range as determined during the CT simulation process. A LabVIEW program was developed to record both beam status (i.e. on/off) and distance measurements. In this study the DML was only used to monitor the position of a single point on the chest and no clinical decisions/adjustments were made based on these measurements. Results and Conclusions: Thus far, 34 fractions have been recorded for 4 patients. As such, the performance of our DIBH treatment technique cannot be fairly evaluated at this point. However, deviations between expected and measured distances have been observed and if these are found to be reproducible, then modifications in our treatment procedures and policies will have to take place.

  4. Poster - 35: Monitoring patient positioning during deep inspiration breath hold with a distance measuring laser

    Energy Technology Data Exchange (ETDEWEB)

    Weston, Mark; Juhasz, Janos [Juravinski Cancer Centre (Canada)

    2016-08-15

    Purpose: The accuracy of treatment delivery for left breast/chest wall patients using deep inspiration breath hold (DIBH) is being monitored using a distance measuring laser (DML) Methods: A commercially available DML (DLS-C15, Dimetix) was mounted behind a Varian TrilogyTM linac. Relative to the machine isocenter, the laser from the beam was offset by 8 cm to the left and by 1 cm in the superior direction. This position was selected because this point is situated on the sternum for the majority of the left breast/chest-wall patients treated at our institution. The Varian Real-Time Positioning Management™ (RPM) guided DIBH treatments at our institution is delivered by placing the system’s tracking block on the patient’s abdomen. The treatment beam is enabled only when the block is in between a predefined abdomen motion range as determined during the CT simulation process. A LabVIEW program was developed to record both beam status (i.e. on/off) and distance measurements. In this study the DML was only used to monitor the position of a single point on the chest and no clinical decisions/adjustments were made based on these measurements. Results and Conclusions: Thus far, 34 fractions have been recorded for 4 patients. As such, the performance of our DIBH treatment technique cannot be fairly evaluated at this point. However, deviations between expected and measured distances have been observed and if these are found to be reproducible, then modifications in our treatment procedures and policies will have to take place.

  5. Functional mechanism of lung mosaic CT attenuation: assessment with deep-inspiration breath-hold perfusion SPECT-CT fusion imaging and non-breath-hold Technegas SPECT.

    Science.gov (United States)

    Suga, K; Yasuhiko, K; Iwanaga, H; Tokuda, O; Matsunaga, N

    2009-01-01

    The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Although further validation is required, our results indicate that heterogeneous pulmonary arterial

  6. Free-breathing whole-heart 3D cine magnetic resonance imaging with prospective respiratory motion compensation.

    Science.gov (United States)

    Moghari, Mehdi H; Barthur, Ashita; Amaral, Maria E; Geva, Tal; Powell, Andrew J

    2018-07-01

    To develop and validate a new prospective respiratory motion compensation algorithm for free-breathing whole-heart 3D cine steady-state free precession (SSFP) imaging. In a 3D cine SSFP sequence, 4 excitations per cardiac cycle are re-purposed to prospectively track heart position. Specifically, their 1D image is reconstructed and routed into the scanner's standard diaphragmatic navigator processing system. If all 4 signals are in end-expiration, cine image data from the entire cardiac cycle is accepted for image reconstruction. Prospective validation was carried out in patients (N = 17) by comparing in each a conventional breath-hold 2D cine ventricular short-axis stack and a free-breathing whole-heart 3D cine data set. All 3D cine SSFP acquisitions were successful and the mean scan time was 5.9 ± 2.7 min. Left and right ventricular end-diastolic, end-systolic, and stroke volumes by 3D cine SSFP were all larger than those from 2D cine SSFP. This bias was 3D cine images had a lower ventricular blood-to-myocardium contrast ratio, contrast-to-noise ratio, mass, and subjective quality score. The novel prospective respiratory motion compensation method for 3D cine SSFP imaging was robust and efficient and yielded slightly larger ventricular volumes and lower mass compared to breath-hold 2D cine imaging. Magn Reson Med 80:181-189, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  7. Use of an evidence-based protocol to screen for sleep-disordered breathing in a heart failure disease management clinic.

    Science.gov (United States)

    Garner, Shelby L; Traverse, Ramona D

    2014-01-01

    Undiagnosed and untreated sleep-disordered breathing can lead to negative health outcomes and increased utilization of health resources among patients with heart failure. The purpose of this evidence-based practice project was to implement and evaluate a new multifaceted sleep-disordered breathing screening protocol in a heart failure disease management clinic. The combined use of a symptoms questionnaire, the Epworth sleepiness scale, and overnight pulse oximetry was significantly more effective in identifying patients with a positive diagnosis of sleep-disordered breathing than using the Epworth sleepiness scale alone (P < .05).

  8. Setup error and motion during deep inspiration breath-hold breast radiotherapy measured with continuous portal imaging

    DEFF Research Database (Denmark)

    Lutz, Christina Maria; Poulsen, Per Rugaard; Fledelius, Walther

    2016-01-01

    BACKGROUND: The position and residual motion of the chest wall of breast cancer patients during treatment in deep inspiration breath-hold (DIBH) were investigated. MATERIAL AND METHODS: The study included 58 left-sided breast cancer patients treated with DIBH three-dimensional (3D) conformal......). At every third treatment fraction, continuous portal images were acquired. The time-resolved chest wall position during treatment was compared with the planned position to determine the inter-fraction setup errors and the intra-fraction motion of the chest wall. RESULTS: The DIBH compliance was 95% during...

  9. Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

    International Nuclear Information System (INIS)

    Suga, K.; Yasuhiko, K.; Iwanaga, H.; Tokuda, O.; Matsunaga, N.

    2009-01-01

    Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

  10. Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Suga, K.; Yasuhiko, K. (Dept. of Radiology, St. Hill Hospital, Ube, Yamaguchi (Japan)); Iwanaga, H.; Tokuda, O.; Matsunaga, N. (Dept. of Radiology, Yamaguchi Univ. School of Medicine, Ube, Yamaguchi (Japan))

    2009-01-15

    Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

  11. Magnitude of shift of tumor position as a function of moderated deep inspiration breath-hold: An analysis of pooled data of lung patients with active breath control in image-guided radiotherapy

    Directory of Open Access Journals (Sweden)

    Muralidhar K

    2008-01-01

    Full Text Available The purpose of this study was to evaluate the reproducibility and magnitude of shift of tumor position by using active breathing control and iView-GT for patients with lung cancer with moderate deep-inspiration breath-hold (mDIBH technique. Eight patients with 10 lung tumors were studied. CT scans were performed in the breath-holding phase. Moderate deep-inspiration breath-hold under spirometer-based monitoring system was used. Few important bony anatomic details were delineated by the radiation oncologist. To evaluate the interbreath-hold reproducibility of the tumor position, we compared the digital reconstruction radiographs (DRRs from planning system with the DRRs from the iView-GT in the machine room. We measured the shift in x, y, and z directions. The reproducibility was defined as the difference between the bony landmarks from the DRR of the planning system and those from the DRR of the iView-GT. The maximum shift of the tumor position was 3.2 mm, 3.0 mm, and 2.9 mm in the longitudinal, lateral, and vertical directions. In conclusion, the moderated deep-inspiration breath-hold method using a spirometer is feasible, with relatively good reproducibility of the tumor position for image-guided radiotherapy in lung cancers.

  12. Extended prediction rule to optimise early detection of heart failure in older persons with non-acute shortness of breath : A cross-sectional study

    NARCIS (Netherlands)

    Van Riet, Evelien E S; Hoes, Arno W.; Limburg, Alexander; Landman, Marcel A J; Kemperman, Hans; Rutten, Frans H.

    2016-01-01

    Objectives: There is a need for a practical tool to aid general practitioners in early detection of heart failure in the elderly with shortness of breath. In this study, such a screening rule was developed based on an existing rule for detecting heart failure in older persons with a diagnosis of

  13. Heart rate autonomic regulation system at rest and during paced breathing among patients with CRPS as compared to age-matched healthy controls.

    Science.gov (United States)

    Bartur, Gadi; Vatine, Jean-Jacques; Raphaely-Beer, Noa; Peleg, Sara; Katz-Leurer, Michal

    2014-09-01

    The objective of this study is to assess the autonomic nerve heart rate regulation system at rest and its immediate response to paced breathing among patients with complex regional pain syndrome (CRPS) as compared with age-matched healthy controls. Quasiexperimental. Outpatient clinic. Ten patients with CRPS and 10 age- and sex-matched controls. Participants underwent Holter ECG (NorthEast Monitoring, Inc., Maynard, MA, USA) recording during rest and biofeedback-paced breathing session. Heart rate variability (HRV), time, and frequency measures were assessed. HRV and time domain values were significantly lower at rest among patients with CRPS as compared with controls. A significant association was noted between pain rank and HRV frequency measures at rest and during paced breathing; although both groups reduced breathing rate significantly during paced breathing, HRV time domain parameters increased only among the control group. The increased heart rate and decreased HRV at rest in patients with CRPS suggest a general autonomic imbalance. The inability of the patients to increase HRV time domain values during paced breathing may suggest that these patients have sustained stress response with minimal changeability in response to slow-paced breathing stimuli. Wiley Periodicals, Inc.

  14. Significant reductions in heart and lung doses using semi lateral ...

    African Journals Online (AJOL)

    Introduction: Various treatment techniques as breath hold techniques have been developed to spare the heart and lung in breast cancer patients receiving adjuvant radiotherapy. Purpose: to compare the heart and lung dosimetric parameters of semi lateral decubitus technique with and without deep inspiration breath hold ...

  15. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation : Is IMRT more beneficial than VMAT?

    Science.gov (United States)

    Sakka, Mazen; Kunzelmann, Leonie; Metzger, Martin; Grabenbauer, Gerhard G

    2017-10-01

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  16. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hepp, Rodrigo; Ammerpohl, Mark; Morgenstern, Christina; Erichsen, Patricia [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Nielinger, Lisa [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Hochschule Hamm-Lippstadt, Lippstadt (Germany); Abdallah, Abdallah [Evangelische Kliniken Gelsenkirchen, Klinik fuer Senologie, Gelsenkirchen (Germany); Galalae, Razvan [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Christian-Albrechts-Universitaet zu Kiel, Medizinische Fakultaet, Kiel (Germany)

    2015-09-15

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm{sup 3} (D{sub 2} {sub cm} {sup 3}), volume receiving ≥ 5 Gy (V{sub 5}), 10 Gy (V{sub 10}), 15 Gy (V{sub 15}) and 20 Gy (V{sub 20}). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D{sub 2} {sub cm} {sup 3} was less than 42 Gy in DIBH. In FB the heart D{sub 2} {sub cm} {sup 3} was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.) [German] Die adjuvante Strahlentherapie nach brusterhaltener Operation (BCS) bei Brustkrebs (BC) ist eine seit langem anerkannte Behandlungsform. Das postradiogene Risiko einer kardialen Ischaemie steigt linear ohne erkennbaren Schwellenwert mit der mittleren Herzdosis. Die Bestrahlung der linken Brust in tiefer Inspiration unter Anhalten der

  17. Capacitive Sensing for Non-Invasive Breathing and Heart Monitoring in Non-Restrained, Non-Sedated Laboratory Mice

    Directory of Open Access Journals (Sweden)

    Carlos González-Sánchez

    2016-07-01

    Full Text Available Animal testing plays a vital role in biomedical research. Stress reduction is important for improving research results and increasing the welfare and the quality of life of laboratory animals. To estimate stress we believe it is of great importance to develop non-invasive techniques for monitoring physiological signals during the transport of laboratory animals, thereby allowing the gathering of information on the transport conditions, and, eventually, the improvement of these conditions. Here, we study the suitability of commercially available electric potential integrated circuit (EPIC sensors, using both contact and contactless techniques, for monitoring the heart rate and breathing rate of non-restrained, non-sedated laboratory mice. The design has been tested under different scenarios with the aim of checking the plausibility of performing contactless capture of mouse heart activity (ideally with an electrocardiogram. First experimental results are shown.

  18. Capacitive Sensing for Non-Invasive Breathing and Heart Monitoring in Non-Restrained, Non-Sedated Laboratory Mice.

    Science.gov (United States)

    González-Sánchez, Carlos; Fraile, Juan-Carlos; Pérez-Turiel, Javier; Damm, Ellen; Schneider, Jochen G; Zimmermann, Heiko; Schmitt, Daniel; Ihmig, Frank R

    2016-07-07

    Animal testing plays a vital role in biomedical research. Stress reduction is important for improving research results and increasing the welfare and the quality of life of laboratory animals. To estimate stress we believe it is of great importance to develop non-invasive techniques for monitoring physiological signals during the transport of laboratory animals, thereby allowing the gathering of information on the transport conditions, and, eventually, the improvement of these conditions. Here, we study the suitability of commercially available electric potential integrated circuit (EPIC) sensors, using both contact and contactless techniques, for monitoring the heart rate and breathing rate of non-restrained, non-sedated laboratory mice. The design has been tested under different scenarios with the aim of checking the plausibility of performing contactless capture of mouse heart activity (ideally with an electrocardiogram). First experimental results are shown.

  19. Effective of deep breath-hold SPECT in torso area. Examination concerning improvement of resolution

    International Nuclear Information System (INIS)

    Kawai, Takashi; Horiuchi, Shoji; Hayashi, Masuo; Sugibayashi, Keiichi

    2007-01-01

    The routine single photon emission computed tomography (SPECT) gives images with reduced resolution of internal organs like diaphragm due to breathing movements. In the present study, authors developed a breath-hold (BH) SPECT method where SPECT projection data were acquired during BH, and examined its usefulness. Equipments used were all Toshiba's dual-detector SPECT system E.CAM, image processor GMS-5500 A/PI, fusion software ART, and CT scanner Aquillion/M8. SPECT data were alternatively acquired at steps during BH and free breath (FB), for an entire step-and-shoot SPECT cycle, and acquisition time for 1 step (view) was set to be 10-15 sec depending on the subject's BH ability. Data from BH and FB views were extracted to get respective SPECT images. An evaluation was first done for a phantom simulating the breathing lung, an elliptical acrylic shell where a balloon connected with an ambu bag was placed. Two point sources of 99m Tc (14 MBq) were attached on the balloon. The phantom study revealed BH method did not give any artifacts. Clinically, 201 Tl-SPECT images of patients with lung tumors were compared for resolution between BH and FB and for their accuracy of registration by superimposing on CT images. Such results were observed as that, when FB gave two regions of Tl accumulation, BH, one region agreeing with the one lesion in the CT image, and that, when Tl accumulation was visualized in BH, but not in FB due to its overlapping with the liver area. Thus BH method could reduce respiratory motion artifacts to improve resolution, and was thought applicable to other imaging methods. (R.T.)

  20. Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors

    International Nuclear Information System (INIS)

    Harry, Taylor; Rahn, Doug; Semenov, Denis; Gu, Xuejun; Yashar, Catheryn; Einck, John; Jiang, Steve; Cerviño, Laura

    2016-01-01

    There is a reduction in cardiac dose for left-sided breast radiotherapy during treatment with deep inspiration breath-hold (DIBH) when compared with treatment with free breathing (FB). Various levels of DIBH may occur for different treatment fractions. Dosimetric effects due to this and other motions are a major component of uncertainty in radiotherapy in this setting. Recent developments in deformable registration techniques allow displacement vectors between various temporal and spatial patient representations to be digitally quantified. We propose a method to evaluate the dosimetric effect to the heart from variable reproducibility of DIBH by using deformable registration to create new anatomical computed tomography (CT) scans. From deformable registration, 3-dimensional deformation vectors are generated with FB and DIBH. The obtained deformation vectors are scaled to 75%, 90%, and 110% and are applied to the reference image to create new CT scans at these inspirational levels. The scans are then imported into the treatment planning system and dose calculations are performed. The average mean dose to the heart was 2.5 Gy (0.7 to 9.6 Gy) at FB, 1.2 Gy (0.6 to 3.8 Gy, p < 0.001) at 75% inspiration, 1.1 Gy (0.6 to 3.1 Gy, p = 0.004) at 90% inspiration, 1.0 Gy (0.6 to 3.0 Gy) at 100% inspiration or DIBH, and 1.0 Gy (0.6 to 2.8 Gy, p = 0.019) at 110% inspiration. The average mean dose to the left anterior descending artery (LAD) was 19.9 Gy (2.4 to 46.4 Gy), 8.6 Gy (2.0 to 43.8 Gy, p < 0.001), 7.2 Gy (1.9 to 40.1 Gy, p = 0.035), 6.5 Gy (1.8 to 34.7 Gy), and 5.3 Gy (1.5 to 31.5 Gy, p < 0.001), correspondingly. This novel method enables numerous anatomical situations to be mimicked and quantifies the dosimetric effect they have on a treatment plan.

  1. Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors

    Energy Technology Data Exchange (ETDEWEB)

    Harry, Taylor [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA (United States); Department of Radiation Medicine, Oregon Health and Science University, Portland, OR (United States); Department of Nuclear Engineering and Radiation Health Physics, Oregon State University, Corvallis, OR (United States); Rahn, Doug; Semenov, Denis [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA (United States); Gu, Xuejun [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Yashar, Catheryn; Einck, John [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA (United States); Jiang, Steve [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Cerviño, Laura, E-mail: lcervino@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA (United States)

    2016-04-01

    There is a reduction in cardiac dose for left-sided breast radiotherapy during treatment with deep inspiration breath-hold (DIBH) when compared with treatment with free breathing (FB). Various levels of DIBH may occur for different treatment fractions. Dosimetric effects due to this and other motions are a major component of uncertainty in radiotherapy in this setting. Recent developments in deformable registration techniques allow displacement vectors between various temporal and spatial patient representations to be digitally quantified. We propose a method to evaluate the dosimetric effect to the heart from variable reproducibility of DIBH by using deformable registration to create new anatomical computed tomography (CT) scans. From deformable registration, 3-dimensional deformation vectors are generated with FB and DIBH. The obtained deformation vectors are scaled to 75%, 90%, and 110% and are applied to the reference image to create new CT scans at these inspirational levels. The scans are then imported into the treatment planning system and dose calculations are performed. The average mean dose to the heart was 2.5 Gy (0.7 to 9.6 Gy) at FB, 1.2 Gy (0.6 to 3.8 Gy, p < 0.001) at 75% inspiration, 1.1 Gy (0.6 to 3.1 Gy, p = 0.004) at 90% inspiration, 1.0 Gy (0.6 to 3.0 Gy) at 100% inspiration or DIBH, and 1.0 Gy (0.6 to 2.8 Gy, p = 0.019) at 110% inspiration. The average mean dose to the left anterior descending artery (LAD) was 19.9 Gy (2.4 to 46.4 Gy), 8.6 Gy (2.0 to 43.8 Gy, p < 0.001), 7.2 Gy (1.9 to 40.1 Gy, p = 0.035), 6.5 Gy (1.8 to 34.7 Gy), and 5.3 Gy (1.5 to 31.5 Gy, p < 0.001), correspondingly. This novel method enables numerous anatomical situations to be mimicked and quantifies the dosimetric effect they have on a treatment plan.

  2. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Zagar, Timothy M., E-mail: zagar@med.unc.edu [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Kaidar-Person, Orit [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Tang, Xiaoli [Memorial Sloan Kettering Cancer Center, West Harrison, New York (United States); Jones, Ellen E.; Matney, Jason; Das, Shiva K.; Green, Rebecca L. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Sheikh, Arif [Department of Radiology, Columbia University, New York, New York (United States); Khandani, Amir H.; McCartney, William H.; Oldan, Jorge Daniel; Wong, Terence Z. [Department of Radiology, University of North Carolina, Chapel Hill, North Carolina (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

    2017-04-01

    Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motion abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.

  3. Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

    2016-01-01

    OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...

  4. IMPLEMENTATION OF BIOFEEDBACK IN A CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    O. L. Kulik

    2014-06-01

    Full Text Available The effectiveness of biofeedback in a closed loop of heart rate variability (HRV and paced breathing in patients with arterial hypertension was studied. 61 subjects with arterial hypertension (31 females and 30 males, mean age 56.8 ± 6.2 years were examined. In accordance with the objective of the study all subjects were divided into 2 groups: 1 – biofeedback group (34 subjects and 2 – the comparison group (27 subjects. 5 biofeedback sessions were performed in biofeedback group. In the comparison group only two biofeedback sessions were performed – at admission and before discharge from the hospital. Efficacy of biofeedback was evaluated by comparing the values of systolic and diastolic blood pressure (SBP and DBP, respectively, heart rate (HR, HRV indices, indicators of optimality (O, sensitivity (S and efficiency (E and BQI index at admission and discharge in both groups of patients. The use of biofeedback in arterial hypertension subjects allowed to achieve better control of heart rate, systolic and diastolic blood pressure and improves HRV indices. The positive dynamics of optimality and the integral BQI values indicated a training effect of regulation systems.

  5. Identifying Predictors of Central Sleep Apnea/Cheyne-Stokes Breathing in Chronic Heart Failure: a Pathophysiological Approach

    Directory of Open Access Journals (Sweden)

    Draganova Aneliya I.

    2016-12-01

    Full Text Available Chronic heart failure (CHF is a major health problem associated with increased mortality, despite modern treatment options. Central sleep apnea (CSA/Cheyne-Stokes breathing (CSB is a common and yet largely under-diagnosed co-morbidity, adding significantly to the poor prognosis in CHF because of a number of acute and chronic effects, including intermittent hypoxia, sympathetic overactivation, disturbed sleep architecture and impaired physical tolerance. It is characterized by repetitive periods of crescendo-decrescendo ventilatory pattern, alternating with central apneas and hypopneas. The pathogenesis of CSA/CSB is based on the concept of loop gain, comprising three major components: controller gain, plant gain and feedback gain. Laboratory polysomnography, being the golden standard for diagnosing sleep-disordered breathing (SDB at present, is a costly and highly specialized procedure unable to meet the vast diagnostic demand. Unlike obstructive sleep apnea, CSA/CSB has a low clinical profile. Therefore, a reliable predictive system is needed for identifying CHF patients who are most likely to suffer from CSA/CSB, optimizing polysomnography use. The candidate predictors should be standardized, easily accessible and low-priced in order to be applied in daily medical routine.

  6. SPIRONOLACTONE IN BIOFEEDBACK SESSIONS IN THE LOOP OF PACED BREATHING AND HEART RATE VARIABILITY IN HEALTHY VOLUNTEERS

    Directory of Open Access Journals (Sweden)

    E. Nazarenko

    2015-12-01

    Full Text Available In 7 conditionally healthy volunteers, aged from 19 to 21 years (average age is 19,53 ± 1,55 years, influence of spironolactone on alterations of regulatory systems state of the organism combined with biofeedback (BFB sessions in the loop of paced breathing (PB and heart rate variability (HRV parameters was evaluated. All volunteers were conducted 2 series of everyday BFB sessions in analyzed loop for 5 days with a 3 months interval between them, 2nd series of sessions were conducted 6 hours after oral application of 25 mg spironolactone. The data was analyzed using non-parametric statistical methods. Optimization of regulatory systems state under influence of BFB sessions in the loop of PB and HRV parameters was found. Spironolactone in studied dose had no significant effect on optimization of regulatory systems state.

  7. Breath-Hold Diving.

    Science.gov (United States)

    Fitz-Clarke, John R

    2018-03-25

    Breath-hold diving is practiced by recreational divers, seafood divers, military divers, and competitive athletes. It involves highly integrated physiology and extreme responses. This article reviews human breath-hold diving physiology beginning with an historical overview followed by a summary of foundational research and a survey of some contemporary issues. Immersion and cardiovascular adjustments promote a blood shift into the heart and chest vasculature. Autonomic responses include diving bradycardia, peripheral vasoconstriction, and splenic contraction, which help conserve oxygen. Competitive divers use a technique of lung hyperinflation that raises initial volume and airway pressure to facilitate longer apnea times and greater depths. Gas compression at depth leads to sequential alveolar collapse. Airway pressure decreases with depth and becomes negative relative to ambient due to limited chest compliance at low lung volumes, raising the risk of pulmonary injury called "squeeze," characterized by postdive coughing, wheezing, and hemoptysis. Hypoxia and hypercapnia influence the terminal breakpoint beyond which voluntary apnea cannot be sustained. Ascent blackout due to hypoxia is a danger during long breath-holds, and has become common amongst high-level competitors who can suppress their urge to breathe. Decompression sickness due to nitrogen accumulation causing bubble formation can occur after multiple repetitive dives, or after single deep dives during depth record attempts. Humans experience responses similar to those seen in diving mammals, but to a lesser degree. The deepest sled-assisted breath-hold dive was to 214 m. Factors that might determine ultimate human depth capabilities are discussed. © 2018 American Physiological Society. Compr Physiol 8:585-630, 2018. Copyright © 2018 American Physiological Society. All rights reserved.

  8. CT evaluation of patient deep inspiration self-breath-holding: How precisely can patients reproduce the tumor position in the absence of respiratory monitoring devices?

    International Nuclear Information System (INIS)

    Onishi, Hiroshi; Kuriyama, Kengo; Komiyama, Takafumi; Tanaka, Shiho; Ueki, Junko; Sano, Naoki; Araki, Tsutomu; Ikenaga, Satoshi; Tateda, Yoshihito; Aikawa, Yoshihito

    2003-01-01

    The aim of the present study was to evaluate the reproducibility of tumor position under patient deep inspiration self-breath-holding in the absence of respiratory monitoring devices, as well as to compare the reproducibility of deep inspiration self-breath-holding on the verbal command of a radiation technologist (Passive mode) with that initiated by patients' own estimation (Active mode). Twenty patients with lung cancer were shown how the tumor and diaphragm move during the respiration cycle. Patients were instructed to hold their breath during deep inspiration and reproduce identical tumor position as well as possible either by the Active mode or by the Passive mode. After patients had practiced self-breath-holding during deep inspiration, a set of three CT scans was obtained for each of the two modes of self-breath-holding (6 CT scans total) to obtain randomly timed images of 2 mm thickness in the vicinity of the tumor. The first three scans were performed during breath-hold using the Active mode, and next three scans were using the Passive mode. Maximum difference in tumor position for the three CT scans was then calculated along three axes: cranial-caudal (C-C); anterior-posterior (A-P); and right-left (R-L). In the 20 patients who underwent analysis of self-breath-holding, mean maximum difference in tumor position obtained under breath-hold using the Active and the Passive modes were: 2.2 and 3.1 mm along the C-C axis; 1.4 and 2.4 mm along the A-P axis; and 1.3 and 2.2 mm along the R-L axis, respectively. These differences in all axes were significantly smaller (p<0.05) for the Active mode than for the Passive mode. Most tumors displayed maximal respiratory movement along the C-C axis, and minimal movement along the R-L axis, but tumors located in the upper lung displayed maximal movement along the A-P axis. Significant correlation (p<0.05) was observed between differences along three axes in either mode of breath-hold. In conclusion, the reproducibility of

  9. An effective deep-inspiration breath-hold radiotherapy technique for left-breast cancer: impact of post-mastectomy treatment, nodal coverage, and dose schedule on organs at risk

    Directory of Open Access Journals (Sweden)

    Rice L

    2017-06-01

    Full Text Available Lynsey Rice,1,2 Christy Goldsmith,1,2 Melanie ML Green,2 Susan Cleator,1,2 Patricia M Price1,2 1Department of Radiation Oncology, The Harley Street Clinic, 2Department of Surgery and Cancer, Imperial College London, London, UK Background: We developed, applied, and prospectively evaluated a novel deep-inspiration breath-hold (DIBH screening and delivery technique to optimize cardiac sparing in left-breast radiotherapy (RT at our clinic. The impact of set-up and dose variables upon organs at risk (OAR dose in DIBH RT was investigated.Methods and materials: All patients with left-breast cancer referred between 2011 and 2014 – of all disease stages, set-up variations, and dose prescriptions – were included. Radiographers used simple screening criteria at CT simulation, to systematically assess patients for obvious DIBH benefit and capability. Selected patients received forward-planned intensity-modulated RT (IMRT based on a DIBH CT scan. A 3D-surface monitoring system with visual feedback assured reproducible DIBH positioning during gated radiation delivery. Patient, target set-up, and OAR dose information were collected at treatment.Results: Of 272 patients who were screened, 4 withdrew, 56 showed no obvious advantage, and 56 showed benefit but had suitability issues; 156 patients were selected and successfully completed DIBH treatment. The technique was compatible with complex set-up and optimal target coverage was maintained. Comparison of free-breathing (FB and DIBH treatment plans in the first five patients enrolled confirmed DIBH reduced heart radiation by ~80% (p = 0.032. Low OAR doses were achieved overall: the mean (95% confidence interval [CI] heart dose was 1.17 (1.12–1.22 Gy, and the mean ipsilateral lung dose was 5.26 (5.01–5.52 Gy. Patients who underwent a standard radiation schedule (40 Gy/15# after breast-conserving surgery had the lowest OAR doses: post-mastectomy treatment, simultaneous supraclavicular (SCV node

  10. Very early screening for sleep-disordered breathing in acute coronary syndrome in patients without acute heart failure.

    Science.gov (United States)

    Van den Broecke, Sandra; Jobard, Olivier; Montalescot, Gilles; Bruyneel, Marie; Ninane, Vincent; Arnulf, Isabelle; Similowski, Thomas; Attali, Valérie

    2014-12-01

    Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission. A telemonitoring (TM) system was set up to remotely monitor the signals and repair faulty sensors. The 27 recordings were analyzed as respiratory polygraphy (RP) and as PSG, and the results were compared. The TM system allowed successful intervention in 48% of recordings, resulting in excellent quality PSG for 89% of cases. The prevalence of SDB [apnea-hypopnea index (AHI) ≥ 15/h] was 82% and mainly consisted of central SDB and periodic breathing, except three patients with OSA. Compared with PSG, RP underestimated AHI, probably due to the poor sleep efficiency, reduction of slow-wave sleep, and alteration of rapid eye movement sleep. An early SDB screening by remote-attended PSG is feasible in ACS patients shortly after admission to CCU. The TM enhanced the quality of PSG. A high prevalence of central SDB was noticed, for which the etiology remains unknown. Further large-scale studies are needed to determine whether central SDB is an incidental finding in early ACS and whether the presence and severity of SDB have a prognostic impact. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Can we reduce the risk of disease heart in treatments of left breast? bated breath; Podemos reducir el riesgo de enfermedad cardiaca en tratamientos de mama izquierda? respiracion contenida

    Energy Technology Data Exchange (ETDEWEB)

    Fuentemilla Urio, N.; Lozares Cordero, S.; Otal Palacin, A.; Olasolo Alonso, J.; Pellejero Pellejero, S.; Martin Albina, M. L.; Maneru Camara, F.; Miquelez Alonso, S.; Rubio Arroniz, T.; Soto Prados, P.

    2013-07-01

    In studies related to breast cancer and mortality, there has been an increase in the mortality of patients with survival greater than 10 years treated with radiotherapy. Subsequent studies it appears that the main cause is heart disease. Therefore, that the heart started to consider organ of risk in the treatment of breast cancer with radiation therapy (adjuvant). Reducing the doses both heart and coronary arteries leads to a reduction in the risk of heart disease. Currently are introducing new techniques, to reduce the dose in heart and in the left anterior descending coronary artery such as new positions or techniques of Breath bated breath hold... (Author)

  12. SU-F-T-514: Evaluation of the Accuracy of Free-Breathing and Deep Inspiration Breath-Hold Gated Beam Delivery Using An Elekta Linac

    Energy Technology Data Exchange (ETDEWEB)

    Jermoumi, M; Cao, D; Housley, D; Shepard, D [Department of Radiation Oncology, Swedish Cancer Institute, Seattle, WA (United States); Xie, R [Ironwood Cancer and Research Centers, Chandler, AZ (United States)

    2016-06-15

    Purpose: In this study, we evaluated the performance of an Elekta linac in the delivery of gated radiotherapy. We examined whether the use of either a short gating window or a long beam hold impacts the accuracy of the delivery Methods: The performance of an Elekta linac in the delivery of gated radiotherapy was assessed using a 20cmX 20cm open field with the radiation delivered using a range of beam-on and beam-off time periods. Two SBRT plans were used to examine the accuracy of gated beam delivery for clinical treatment plans. For the SBRT cases, tests were performed for both free-breathing based gating and for gated delivery with a simulated breath-hold. A MatriXX 2D ion chamber array was used for data collection, and the gating accuracy was evaluated using gamma score. Results: For the 20cmX20cm open field, the gated beam delivery agreed closely with the non-gated delivery results. Discrepancies in the agreement, however, began to appear with a 5-to-1 ratio of the beam-off to beam-on. For these tight gating windows, each beam-on segment delivered a small number of monitor units. This finding was confirmed with dose distribution analysis from the delivery of the two VMAT plans where the gamma score(±1%,2%/1mm) showed passing rates in the range of 95% to 100% for gating windows of 25%, 38%, 50%, 63%, 75%, and 83%. Using a simulated sinusoidal breathing signal with a 4 second period, the gamma score of freebreathing gating and breath-hold gating deliveries were measured in the range of 95.7% to 100%. Conclusion: The results demonstrate that Elekta linacs can be used to accurately deliver respiratory gated treatments for both free-breathing and breath-hold patients. The accuracy of beams delivered in a gated delivery mode at low small MU proved higher than similar deliveries performed in a non-gated (manually interrupted) fashion.

  13. SU-F-T-514: Evaluation of the Accuracy of Free-Breathing and Deep Inspiration Breath-Hold Gated Beam Delivery Using An Elekta Linac

    International Nuclear Information System (INIS)

    Jermoumi, M; Cao, D; Housley, D; Shepard, D; Xie, R

    2016-01-01

    Purpose: In this study, we evaluated the performance of an Elekta linac in the delivery of gated radiotherapy. We examined whether the use of either a short gating window or a long beam hold impacts the accuracy of the delivery Methods: The performance of an Elekta linac in the delivery of gated radiotherapy was assessed using a 20cmX 20cm open field with the radiation delivered using a range of beam-on and beam-off time periods. Two SBRT plans were used to examine the accuracy of gated beam delivery for clinical treatment plans. For the SBRT cases, tests were performed for both free-breathing based gating and for gated delivery with a simulated breath-hold. A MatriXX 2D ion chamber array was used for data collection, and the gating accuracy was evaluated using gamma score. Results: For the 20cmX20cm open field, the gated beam delivery agreed closely with the non-gated delivery results. Discrepancies in the agreement, however, began to appear with a 5-to-1 ratio of the beam-off to beam-on. For these tight gating windows, each beam-on segment delivered a small number of monitor units. This finding was confirmed with dose distribution analysis from the delivery of the two VMAT plans where the gamma score(±1%,2%/1mm) showed passing rates in the range of 95% to 100% for gating windows of 25%, 38%, 50%, 63%, 75%, and 83%. Using a simulated sinusoidal breathing signal with a 4 second period, the gamma score of freebreathing gating and breath-hold gating deliveries were measured in the range of 95.7% to 100%. Conclusion: The results demonstrate that Elekta linacs can be used to accurately deliver respiratory gated treatments for both free-breathing and breath-hold patients. The accuracy of beams delivered in a gated delivery mode at low small MU proved higher than similar deliveries performed in a non-gated (manually interrupted) fashion.

  14. A better state-of-mind: deep breathing reduces state anxiety and enhances test performance through regulating test cognitions in children.

    Science.gov (United States)

    Khng, Kiat Hui

    2017-11-01

    A pre-test/post-test, intervention-versus-control experimental design was used to examine the effects, mechanisms and moderators of deep breathing on state anxiety and test performance in 122 Primary 5 students. Taking deep breaths before a timed math test significantly reduced self-reported feelings of anxiety and improved test performance. There was a statistical trend towards greater effectiveness in reducing state anxiety for boys compared to girls, and in enhancing test performance for students with higher autonomic reactivity in test-like situations. The latter moderation was significant when comparing high-versus-low autonomic reactivity groups. Mediation analyses suggest that deep breathing reduces state anxiety in test-like situations, creating a better state-of-mind by enhancing the regulation of adaptive-maladaptive thoughts during the test, allowing for better performance. The quick and simple technique can be easily learnt and effectively applied by most children to immediately alleviate some of the adverse effects of test anxiety on psychological well-being and academic performance.

  15. Shallow and deep breath lung tumor volume as estimated by spiral volumetric CT in comparison to standard axial CT using virtual simulation

    International Nuclear Information System (INIS)

    Quader, M.A.; Kalend, A.M.; Deutsch, M.; Greenberger, J.S.

    1995-01-01

    Purpose/Objective: In order to assess an individual patient tumor volume (TV) margins that are sufficient to design a beam-eye-view (BEW) conformal portal, the radiographic extent of gross tumor volume (GTV) dimensions and its fluctuation with breathing are measured by fast spiral CT scanning of patients treated for Stage II, III lung cancers using 5-6 field multi-collimated conformal beams. Materials and Methods: Over the course of conformal radiotherapy for lung cancer, a full thorax CT scans of the patient were taken by conventional axial CT scanning with patients immobilized in the treatment position and breathing normally. Patient(s) with good pulmonary function test (PFT) status were selected to perform deep breathing and re-scanned by fast spiral techniques in order to re-acquire the tomographic variation in the (GTV) with breathing. A Picker spiral ZAP-100 software running on the AQSim-PQ-2000 was used with a variable helical pitch of 1.0, 1.5 and 2.0. The variable pitch spirals were limited to tumor bed, diaphragm and lung apex area for measurements. Effect of breathing motion along x,y,z direction were then assessed for each beam-eye-view portal as seen in digitally reconstructed radiography (DRR) at the treated gantry angle. Results: Comparison of axial and spiral scans shows the progression of lung and diaphram motion with breathing can be gauged better in spiral scans. The movement of the diaphragm during shallow breathing has been found to be 2-3cm by measuring the distance between the most inferior and superior slices where diaphragm is present. The variation of the tumor dimensions along AP/PA and lateral direction seems to be less sensitive to breathing than those along inferior-superior direction. Conclusion: The fast spiral CT scanning is sensitive to patient lung motion and can be used to determine the fluctuations of the gross tumor volume with breathing. The extent of the fluctuation is location dependent and increases as one moves from the

  16. The Impact of Sleep-Disordered Breathing on Body Mass Index (BMI): The Sleep Heart Health Study (SHHS).

    Science.gov (United States)

    Brown, Mark A; Goodwin, James L; Silva, Graciela E; Behari, Ajay; Newman, Anne B; Punjabi, Naresh M; Resnick, Helaine E; Robbins, John A; Quan, Stuart F

    2011-12-08

    INTRODUCTION: It is well known that obesity is a risk factor for sleep-disordered breathing (SDB). However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS) were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors. METHODS: A full-montage unattended home polysomnogram (PSG) and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI) was categorized using clinical thresholds: sleep apnea), and ≥ 15 (moderate to severe sleep apnea). Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates. RESULTS: Mean (SD) age was 62.2 years (10.14), 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD) change of 0.53 (2.62) kg/m(2) (p=0.071). A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m(2) (p=0.055) and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m(2) (plosing weight.

  17. Association between sleep-disordered breathing, sleep-wake pattern, and cognitive impairment among patients with chronic heart failure.

    Science.gov (United States)

    Hjelm, Carina; Strömberg, Anna; Arestedt, Kristofer; Broström, Anders

    2013-05-01

    Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea-hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition. The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.

  18. IVABRADINE AND QUALITY OF BIOFEEDBACK IN THE LOOP OF PACED BREATHING UNDER THE CONTROL OF HEART RATE VARIABILITY PARAMETERS IN HEALTHY VOLUNTEERS

    Directory of Open Access Journals (Sweden)

    S. A. S. Belal

    2013-06-01

    Full Text Available On 15 healthy volunteers aged from 18 to 22 years the effect of ivabradine on the quality of biofeedback in the loop of paced breathing under the control of heart rate variability parameters were estimated. It was found that ivabradine contributes to an earlier onset and more significant optimization of regulatory systems in systematic sessions of biofeedback that allows to expand the indications for its clinical use.

  19. Coronary artery assessment using self-navigated free-breathing radial whole-heart magnetic resonance angiography in patients with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, Moritz H. [Medical University of South Carolina, Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Varga-Szemes, Akos; Schoepf, U.J.; Xu, Jiaqian; Jin, Kwang-Nam; Hlavacek, Anthony M.; Chowdhury, Shahryar M.; Suranyi, Pal; Tesche, Christian; De Cecco, Carlo N.; Nutting, Arni [Medical University of South Carolina, Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Charleston, SC (United States); Apfaltrer, Georg [Medical University of South Carolina, Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Charleston, SC (United States); University Hospital Graz, Department of Radiology, Graz (Austria); Piccini, Davide [University Hospital of Lausanne (CHUV), Department of Radiology, Centre for Biomedical Imaging (CIBM), Lausanne (Switzerland); Siemens Healthcare, IM BM PI, Advanced Clinical Imaging Technology, Lausanne (Switzerland); Stuber, Matthias; Ginami, Giulia [University Hospital of Lausanne (CHUV), Department of Radiology, Centre for Biomedical Imaging (CIBM), Lausanne (Switzerland); Vogl, Thomas J. [University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany)

    2018-03-15

    To evaluate a self-navigated free-breathing three-dimensional (SNFB3D) radial whole-heart MRA technique for assessment of main coronary arteries (CAs) and side branches in patients with congenital heart disease (CHD). SNFB3D-MRA datasets of 109 patients (20.1±11.8 years) were included. Three readers assessed the depiction of CA segments, diagnostic confidence in determining CA dominance, overall image quality and the ability to freeze cardiac and respiratory motion. Vessel sharpness was quantitatively measured. The percentages of cases with excellent CA depiction were as follows (mean score): left main, 92.6 % (1.92); left anterior descending (LAD), 88.3 % (1.88); right (RCA), 87.8 % (1.85); left circumflex, 82.8 % (1.82); posterior descending, 50.2 % (1.50) and first diagonal, 39.8 % (1.39). High diagnostic confidence for the assessment of CA dominance was achieved in 56.2 % of MRA examinations (mean score, 1.56). Cardiac motion freezing (mean score, 2.18; Pearson's r=0.73, P<0.029) affected image quality more than respiratory motion freezing (mean score, 2.20; r=0.58, P<0.029). Mean quantitative vessel sharpness of the internal thoracic artery, RCA and LAD were 53.1, 52.5 and 48.7 %, respectively. Most SNFB3D-MRA examinations allow for excellent depiction of the main CAs in young CHD patients; visualisation of side branches remains limited. (orig.)

  20. Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation

    International Nuclear Information System (INIS)

    Hanley, J.; Debois, M.M.; Raben, A.; Mageras, G.S.; Lutz, W.R.; Mychalczak, B.; Schwartz, L.H.; Gloeggler, P.J.; Leibel, S.A.; Fuks, Z.; Kutcher, G.J.

    1996-01-01

    Purpose/Objective: Lung tumors are subject to movement due to respiratory motion. Conventionally, a margin is applied to the clinical target volume (CTV) to account for this and other treatment uncertainties. The purpose of this study is to evaluate the dosimetric benefits of a deep inspiration breath-hold (DIBH) technique which has two distinct features - deep inspiration which reduces lung density and breath-hold which immobilizes lung tumors. Both properties can potentially reduce the mass of normal lung tissue in the high dose region, thus improving the possibility of dose escalation. Methods and Materials: To study the efficacy of the DIBH technique, CT scans are acquired for each patient under 4 respiration conditions: free-breathing; DIBH; shallow inspiration breath-hold; shallow expiration breath-hold. The free-breathing and DIBH scans are used to generate treatment plans for comparison of standard and DIBH techniques, while the shallow inspiration and expiration scans provide information on the maximum extent of tumor motion under free-breathing conditions. To acquire the breath-hold scans, the patients are brought to reproducible respiration levels using spirometry and slow vital capacity maneuvers. For the treatment plan comparison free-breathing and DIBH planning target volumes (PTVs) are constructed consisting of the CTV plus a margin for setup error and lung tumor motion. For both plans the margin for setup error is the same while the margin for lung tumor motion differs. The margin for organ motion in free-breathing is determined by the maximum tumor excursions in the shallow inspiration and expiration CT scans. For the DIBH, tumor motion is reduced to the extent to which DIBH can be maintained and the margin for any residual tumor motion is determined from repeat fluoroscopic movies, acquired with the patient monitored using spirometry. Three-dimensional treatment plans, generated using apertures based on the free-breathing and DIBH PTVs, are

  1. Adaptation requirements due to anatomical changes in free-breathing and deep-inspiration breath-hold for standard and dose-escalated radiotherapy of lung cancer patients

    DEFF Research Database (Denmark)

    Sibolt, Patrik; Ottosson, Wiviann; Sjöström, David

    2015-01-01

    to investigate the need for adaptation due to anatomical changes, for both standard (ST) and DE plans in free-breathing (FB) and DIBH. Material and methods. The effect of tumor shrinkage (TS), pleural effusion (PE) and atelectasis was investigated for patients and for a CIRS thorax phantom. Sixteen patients were...... volume. Results. Phantom simulations resulted in maximum deviations in mean dose to the GTV-T ( GTV-T ) of -1% for 3 cm PE and centrally located tumor, and + 3% for TS from 5 cm to 1 cm diameter for an anterior tumor location. For the majority of the patients, simulated PE resulted in a decreasing...

  2. Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing

    Directory of Open Access Journals (Sweden)

    Wen-Yao Pan

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is an independent cardiovascular risk factor to which autonomic nervous dysfunction has been reported to be an important contributor. Ninety subjects recruited from the sleep center of a single medical center were divided into four groups: normal snoring subjects without OSA (apnea hypopnea index, AHI < 5, n = 11, mild OSA (5 ≤ AHI < 15, n = 10, moderate OSA (15 ≤ AHI < 30, n = 24, and severe OSA (AHI ≥ 30, n = 45. Demographic (i.e., age, gender, anthropometric (i.e., body mass index, neck circumference, and polysomnographic (PSG data were recorded and compared among the different groups. For each subject, R-R intervals (RRI from 10 segments of 10-minute electrocardiogram recordings during non-rapid eye movement sleep at stage N2 were acquired and analyzed for heart rate variability (HRV and sample entropy using multiscale entropy index (MEI that was divided into small scale (MEISS, scale 1–5 and large scale (MEILS, scale 6–10. Our results not only demonstrated that MEISS could successfully distinguish normal snoring subjects and those with mild OSA from those with moderate and severe disease, but also revealed good correlation between MEISS and AHI with Spearman correlation analysis (r = −0.684, p < 0.001. Therefore, using the two parameters of EEG and ECG, MEISS may serve as a simple preliminary screening tool for assessing the severity of OSA before proceeding to PSG analysis.

  3. WE-DE-209-02: Active Breathing Control

    Energy Technology Data Exchange (ETDEWEB)

    Comsa, D. [Stronach Regional Cancer Centre (Canada)

    2016-06-15

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  4. WE-DE-209-02: Active Breathing Control

    International Nuclear Information System (INIS)

    Comsa, D.

    2016-01-01

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  5. The impact of sleep-disordered breathing on body mass index (BMI: the sleep heart health study (SHHS

    Directory of Open Access Journals (Sweden)

    Robbins JA

    2011-12-01

    Full Text Available Introduction: It is well known that obesity is a risk factor for sleep-disordered breathing (SDB. However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors.Methods: A full-montage unattended home polysomnogram (PSG and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI was categorized using clinical thresholds: < 5 (normal, ≥ 5 to <15 (mild sleep apnea, and ³ 15 (moderate to severe sleep apnea. Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates.Results: Mean (SD age was 62.2 years (10.14, 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD change of 0.53 (2.62 kg/m2 (p=0.071. A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m2 (p=0.055 and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m2 (p<0.001 compared to those with baseline AHI of <5.Conclusion: Our findings suggest that there is a positive association between severity of SDB and subsequent increased BMI over approximately 5 years. This observation may help explain why persons with SDB have difficulty losing weight.

  6. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation. Is IMRT more beneficial than VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Sakka, Mazen; Grabenbauer, Gerhard G. [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany); Friedrich-Alexander University of Erlangen-Nuernberg, Faculty of Medicine, Erlangen (Germany); Kunzelmann, Leonie; Metzger, Martin [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany)

    2017-10-15

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  7. Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis.

    Science.gov (United States)

    Juhl, Alexander Andersen; Hody, Sofie; Videbaek, Tina Senholt; Damsgaard, Tine Engberg; Nielsen, Per Hostrup

    2017-04-20

    The present study aimed to compare the clinical outcome for patients with or without muscle flap reconstruction after deep sternal wound infection due to open-heart surgery. The study was a retrospective cohort study, including patients who developed deep sternal wound infection after open-heart surgery in the Western Denmark Region from 1999 to 2011. Journals of included patients were reviewed for clinical data regarding the treatment of their sternal defect. Patients were divided into two groups depending on whether they received a muscle-flap-based sternal reconstruction or traditional rewiring of the sternum. A total of 130 patients developed deep sternal wound infection in the study period. In all, 12 patients died before being discharged, leaving a total of 118 patients for analysis. Of these, 50 (42%) patients received muscle flap reconstruction. Muscle flap recipients had significantly longer total hospital stays (p <0.001). However, after receiving muscle flap reconstruction, patients were discharged after a median of 14 days, with 74% not needing additional surgery. It is difficult to predict which patients eventually require muscle flap reconstruction after deep sternal wound infection. Although patients receiving muscle flap reconstructions have longer hospital stays, they are quickly discharged after the reconstruction.

  8. Lung anatomy and histology of the extant coelacanth shed light on the loss of air-breathing during deep-water adaptation in actinistians.

    Science.gov (United States)

    Cupello, Camila; Meunier, François J; Herbin, Marc; Clément, Gaël; Brito, Paulo M

    2017-03-01

    Lungs are specialized organs originated from the posterior pharyngeal cavity and considered as plesiomorphic for osteichthyans, as they are found in extant basal actinopterygians (i.e. Polypterus ) and in all major groups of extant sarcopterygians. The presence of a vestigial lung in adult stages of the extant coelacanth Latimeria chalumnae is the result of allometric growth during ontogeny, in relation with long-time adaptation to deep water. Here, we present the first detailed histological and anatomical description of the lung of Latimeria chalumnae , providing new insights into its arrested differentiation in an air-breathing complex, mainly represented by the absence of pneumocytes and of compartmentalization in the latest ontogenetic stages.

  9. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg

    2012-01-01

    . Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation chest pain. Within one hour after the primary evaluation, focused sonography of the heart, lungs and deep veins...

  10. Enhanced conflict monitoring via a short-duration, video-assisted deep breathing in healthy young adults: an event-related potential approach through the Go/NoGo paradigm

    Directory of Open Access Journals (Sweden)

    Kok Suen Cheng

    2017-10-01

    Full Text Available Objectives Practitioners of mindfulness are reported to have greater cognitive control especially in conflict monitoring, response inhibition and sustained attention. However, due to the various existing methods in each mindfulness practices and also, the high commitment factor, a barrier still exists for an individual to pick up the practices. Therefore, the effect of short duration deep breathing on the cognitive control is investigated here. Methods Short duration guided deep breathing videos consisting of 5, 7 and 9 min respectively were created and used on subjects training. The effect on cognitive control was assessed using a Go/NoGo task along with event-related potential (ERP measurements at Fz, Cz, and Pz. Results From the study, the significant outcome showed at the follow-up session in which participants engaged for 5 min deep breathing group showed a profound NoGo N2 amplitude increment as compared to the control group, indicating an enhanced conflict monitoring ability. An inverse relationship between the NoGo N2 amplitude and the breathing duration is observed as well at the follow-up session. Conclusion These results indicated the possibility of performing short duration deep breathing guided by a video to achieve an enhanced conflict monitoring as an alternative to other mindfulness practices and 5 min is found to be the optimum practice duration. Significant This study is the first to establish a relationship between deep breathing and conflict monitoring through ERP. The study population of young adults taken from the same environment reduces the variance in ERP results due to age and environment. Limitation A larger sample size would provide a greater statistical power. A longer duration of deep breathing should be investigated to further clarify the relationship between the practice duration and the NoGo N2 amplitude. The result can be split by gender and analyzed separately due to the different brain structure of males

  11. Dose evaluation and risk estimation for secondary cancer in contralateral breast and a study of correlation between thorax shape and dose to organs at risk following tangentially breast irradiation during deep inspiration breath-hold and free breathing

    International Nuclear Information System (INIS)

    Johansen, Safora; Vikstroem, Johan; Blihovde Hjelstuen, Mari Helene; Mjaaland, Ingvil; Dybvik, Kjell Ivar; Olsen, Dag Rune

    2011-01-01

    Purpose: To assess the impact of using breathing adapted radiotherapy on contralateral breast (CB) dose, to relate the thorax shape with the dose to the organs at risk (OARs) and to predict the risk for induced malignancies in CB using linear and non-linear models, following tangential irradiation of breast. Material and methods. Sixteen patients with stage I-II breast cancer treatment planned with tangential fields using deep inspiration breath hold (DIBH) and free breathing (FB) techniques were included in this analysis. The dose results mainly based on DVH analysis were compared. Four parameters were defined to describe thoracic shape. Excess relative risk (ERR) for cancer induction in CB, employing linear and non-linear models was calculated. Results. Average CB volumes exposed to a dose of 1 Gy is 1.3 times higher in DIBH plans than in FB plans. No significant difference in average V3Gy and V5Gy for DIBH and FB plans is observed. The average mean CB dose for DIBH and FB plans is 0.33 and 0.28 Gy, respectively. No correlation between thorax shape parameters and mean OARs dose is observed. The estimated average mean ERR with linear model is lower in FB plans (0.12) than for the DIBH plans (0.14). The estimated ERR with non-linear model is 0.14 for DIBH plans and 0.15 for FB plans. Conclusion. No significant difference in CB dose between DIBH and FB plans is observed. The four thorax shape parameters defined in this study can not be related to the dose at OARs using DIBH and FB radiation techniques. The ERR estimates for secondary CB cancer are nearly the same for FB and DIBH planning when using a linear and non-linear risk prediction models

  12. Quantitative assessment of irradiated lung volume and lung mass in breast cancer patients treated with tangential fields in combination with deep inspiration breath hold (DIBH)

    International Nuclear Information System (INIS)

    Kapp, Karin Sigrid; Zurl, Brigitte; Stranzl, Heidi; Winkler, Peter

    2010-01-01

    Purpose: Comparison of the amount of irradiated lung tissue volume and mass in patients with breast cancer treated with an optimized tangential-field technique with and without a deep inspiration breath-hold (DIBH) technique and its impact on the normal-tissue complication probability (NTCP). Material and Methods: Computed tomography datasets of 60 patients in normal breathing (NB) and subsequently in DIBH were compared. With a Real-Time Position Management Respiratory Gating System (RPM), anteroposterior movement of the chest wall was monitored and a lower and upper threshold were defined. Ipsilateral lung and a restricted tangential region of the lung were delineated and the mean and maximum doses calculated. Irradiated lung tissue mass was computed based on density values. NTCP for lung was calculated using a modified Lyman-Kutcher-Burman (LKB) model. Results: Mean dose to the ipsilateral lung in DIBH versus NB was significantly reduced by 15%. Mean lung mass calculation in the restricted area receiving ≤ 20 Gy (M 20 ) was reduced by 17% in DIBH but associated with an increase in volume. NTCP showed an improvement in DIBH of 20%. The correlation of individual breathing amplitude with NTCP proved to be independent. Conclusion: The delineation of a restricted area provides the lung mass calculation in patients treated with tangential fields. DIBH reduces ipsilateral lung dose by inflation so that less tissue remains in the irradiated region and its efficiency is supported by a decrease of NTCP. (orig.)

  13. EFFECTIVENESS OF BIOFEEDBACK IN THE CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING IN THE PATIENTS WITH SOMATOFORM AUTONOMIC DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    K. E. Morozova

    2014-06-01

    Full Text Available To study the effectiveness of biofeedback (BFB in the closed loop of heart rate variability (HRV and paced breathing in patients with somatoform autonomic dysfunction (SAD 20 patients with SAD (14 women and 6 men, mean age 19,53 ± 1,55 were examined. All probationers were divided into two groups comparable for sex and age: 1 – BFB group (15 patients, in which 7 sessions was held and 2 – the comparison group (5 patients, where only two sessions were completed -at the first and seventh day of the study. Additionally, all patients in both groups received diet food (Table № 10 by Pevzner, mebicar, glycine, tiotriazolin. Effectiveness of biofeedback was evaluated by comparing of parameters optimality (O, sensitivity (S, the efficiency (E and the integral index BQI in both groups. It was determined that biofeedback in the closed loop of HRV and paced breathing allows to optimize the state of the regulatory systems of the body in patients with SAD, moreover the combination of biofeedback sessions in the test loop and medical treatment are significantly better than isolated pharmacological therapy. High effectiveness of biofeedback in closed loop of HRV and paced breathing in patients with SAD allows us to recommend it as independent method of treatment, and as a component of combined therapy of this disease.

  14. Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Cemalettin Aydın

    2013-08-01

    Full Text Available Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of difficult wounds, including post-sternotomy mediastinitis.Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B between January 2006 and January 2010.Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was significantly shorter in group A (mean, 13.5 ± 3.2 days compared to 18 days (mean, 21.2 ± 16.4 days in group B (p< 0.001. Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24% patients in group B suffered recurrences. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days (p= 0.001.Conclusion: A significantly shorter healing time was confirmed with vacuum assisted closure. Hospital stay remained significantly shorter in group A (35 vs. 46 days.

  15. Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? Cluster randomised controlled trial.

    Science.gov (United States)

    Silva, Y R; Li, S K; Rickard, M J F X

    2013-09-01

    To investigate whether the inclusion of deep breathing exercises in physiotherapy-directed early mobilisation confers any additional benefit in reducing postoperative pulmonary complications (PPCs) when patients are treated once daily after elective open upper abdominal surgery. This study also compared postoperative outcomes following early and delayed mobilisation. Cluster randomised controlled trial. Single-centre study in a teaching hospital. Eighty-six high-risk patients undergoing elective open upper abdominal surgery. Three groups: early mobilisation (Group A), early mobilisation plus breathing exercises (Group B), and delayed mobilisation (mobilised from third postoperative day) plus breathing exercises (Group C). PPCs and postoperative outcomes [number of days until discharge from physiotherapy, physiotherapy input and length of stay (LOS)]. There was no significant difference in PPCs between Groups A and B. The LOS for Group A {mean 10.7 [standard deviation (SD) 5.0] days} was significantly shorter than the LOS for Groups B [mean 16.7 (SD 9.7) days] and C [mean 15.2 (SD 9.8) days; P=0.036]. The greatest difference was between Groups A and B (mean difference -5.93, 95% confidence interval -10.22 to -1.65; P=0.008). Group C had fewer smokers (26%) and patients with chronic obstructive pulmonary disease (0%) compared with Group B (53% and 14%, respectively). This may have led to fewer PPCs in Group C, but the difference was not significant. Despite Group C having fewer PPCs and less physiotherapy input, the number of days until discharge from physiotherapy and LOS were similar to Group B. The addition of deep breathing exercises to physiotherapy-directed early mobilisation did not further reduce PPCs compared with mobility alone. PPCs can be reduced with once-daily physiotherapy if the patients are mobilised to a moderate level of exertion. Delayed mobilisation tended to increase physiotherapy input and the number of days until discharge from physiotherapy

  16. Influence of heart rhythm, breathing and arm position during computed tomography scanning on the registration accuracy of electro anatomical map (EAM) images, left atrium three-dimensional computed tomography angiography images, and fluoroscopy time during ablation to treat atrial fibrillation

    International Nuclear Information System (INIS)

    Chono, Taiki; Shimoshige, Shinya; Yoshikawa, Kenta; Mizonobe, Kazuhusa; Ogura, Keishi

    2013-01-01

    In CARTOMERGE for treatment of atrial fibrillation (AF) by ablation, by integrating electro anatomical map (EAM) and left atrium three-dimensional computed tomography angiography (3D-CTA) images, identification of the ablation points is simplified and the procedure can be made carried out more rapidly. However, the influence that heart rhythm, breathing and arm position during CT scanning have on registration accuracy and fluoroscopy time is not clear. To clarify the influence on registration accuracy and fluoroscopy time of heart rhythm, breathing and arm position during CT scanning. The patients were CT-scanned during both sinus rhythm (SR) and AF in each study subject. We evaluated the registration accuracy of images reconstructed between the cardiac cycle and assessed the registration accuracy and fluoroscopy time of images obtained during inspiratory breath-hold, expiratory breath-hold and up and down position of the arm. Although the registration accuracy of the EAM image and left atrium 3D-CTA image showed a significant difference during SR, no significant difference was seen during AF. Expiratory breath-hold and down position of the arm resulted in the highest registration accuracy and the shortest fluoroscopy time. However, arm position had no significant effect on registration accuracy. Heart rhythm and breathing during CT scanning have a significant effect on the registration accuracy of EAM images, left atrium 3D-CTA images, and fluoroscopy time. (author)

  17. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF. One Year of Clinical Follow-up.

    Directory of Open Access Journals (Sweden)

    Fabiana G Marcondes-Braga

    Full Text Available The identification of new biomarkers of heart failure (HF could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis.To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF.After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months.The composite endpoint death and heart transplantation (HT were observed in 35 patients (39.3%: 29 patients (32.6% died and 6 (6.7% were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001. Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56-6.80, p = 0.002 within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels.High EBA levels could be associated to poor prognosis in HFrEF patients.

  18. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up

    Science.gov (United States)

    Saldiva, Paulo H. N.; Mangini, Sandrigo; Issa, Victor S.; Ayub-Ferreira, Silvia M.; Bocchi, Edimar A.

    2016-01-01

    Background The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. Objectives To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). Methods After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months. Results The composite endpoint death and heart transplantation (HT) were observed in 35 patients (39.3%): 29 patients (32.6%) died and 6 (6.7%) were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile) were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001). Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56–6.80, p = 0.002) within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels. Conclusions High EBA levels could be associated to poor prognosis in HFrEF patients. PMID:28030609

  19. Lung anatomy and histology of the extant coelacanth shed light on the loss of air-breathing during deep-water adaptation in actinistians

    Science.gov (United States)

    Meunier, François J.; Herbin, Marc; Clément, Gaël; Brito, Paulo M.

    2017-01-01

    Lungs are specialized organs originated from the posterior pharyngeal cavity and considered as plesiomorphic for osteichthyans, as they are found in extant basal actinopterygians (i.e. Polypterus) and in all major groups of extant sarcopterygians. The presence of a vestigial lung in adult stages of the extant coelacanth Latimeria chalumnae is the result of allometric growth during ontogeny, in relation with long-time adaptation to deep water. Here, we present the first detailed histological and anatomical description of the lung of Latimeria chalumnae, providing new insights into its arrested differentiation in an air-breathing complex, mainly represented by the absence of pneumocytes and of compartmentalization in the latest ontogenetic stages. PMID:28405393

  20. Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

    2016-01-01

    OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...... for the craniocaudal direction in FB, where it was >3 mm. On the 31st fraction, the intraobserver uncertainty increased compared with the second fraction. This increase was more pronounced in FB. Image quality scores improved in DIBH compared with FB for all parameters in all patients. Simulated tumour baseline shifts...... ≤2 mm did not affect the CBCT image quality considerably. CONCLUSION: DIBH CBCT improved image quality and reduced registration uncertainty in the craniocaudal direction in image-guided RT of locally advanced lung cancer. Baseline shifts ≤2 mm in DIBH during CBCT acquisition did not affect image...

  1. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  2. Sleep disordered breathing, insomnia, and health related quality of life -- a comparison between age and gender matched elderly with heart failure or without cardiovascular disease.

    Science.gov (United States)

    Johansson, Peter; Arestedt, Kristoffer; Alehagen, Urban; Svanborg, Eva; Dahlström, Ulf; Broström, Anders

    2010-06-01

    The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL). Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36). The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, pinsomnia or EDS. SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly. Copyright (c) 2009. Published by Elsevier B.V.

  3. Breath-hold dark-blood T{sub 2}-weighted MR imaging of the heart. Estimation of optimum preset repetition time

    Energy Technology Data Exchange (ETDEWEB)

    Sakuma, Toshiharu; Yamada, Naoaki; Yamasaki, Hidetoshi; Kita, Yoshinobu; Fujii, Hiroshi [National Cardiovascular Center, Suita, Osaka (Japan)

    1999-03-01

    It has recently become possible to obtain T{sub 2}-weighted images using turbo spin echo with a preparation pulse to inhibit the signal from flowing blood (dark blood turbo spin echo: DB-TSE) during breath holding. In order to obtain higher-quality T{sub 2}-weighted images of the heart, we assessed the optimum preset repetition time (TR preset), the interval between the dark blood preparation pulse and the end of data acquisition on DB-TSE. DB-TSE left ventricular short-axis images were obtained with varying TR presets in eight volunteers. Signal intensity was measured for the myocardium and blood in the left ventricular cavity, and the signal intensity ratio of myocardium to blood was calculated. The optimum TR preset was determined so as to give the highest signal intensity ratio of myocardium to blood. A comparison was made of the myocardium-to-blood ratios between the eight volunteers and nine patients. The optimum TR preset changed according to the cardiac cycle. By using the optimum TR preset, we obtained the peak signal intensity ratios in the volunteers and the patients. By using DB-TSE with the optimum TR preset for the cardiac cycle, we can obtain better quality T{sub 2}-weighted images of the heart. (author)

  4. The relationship between body temperature, heart rate, breathing rate, and rate of oxygen consumption, in the tegu lizard (Tupinambis merianae) at various levels of activity.

    Science.gov (United States)

    Piercy, Joanna; Rogers, Kip; Reichert, Michelle; Andrade, Denis V; Abe, Augusto S; Tattersall, Glenn J; Milsom, William K

    2015-12-01

    The present study determined whether EEG and/or EMG recordings could be used to reliably define activity states in the Brazilian black and white tegu lizard (Tupinambis merianae) and then examined the interactive effects of temperature and activity states on strategies for matching O2 supply and demand. In a first series of experiments, the rate of oxygen consumption (VO2), breathing frequency (fR), heart rate (fH), and EEG and EMG (neck muscle) activity were measured in different sleep/wake states (sleeping, awake but quiet, alert, or moving). In general, metabolic and cardio-respiratory changes were better indictors of the transition from sleep to wake than were changes in the EEG and EMG. In a second series of experiments, the interactive effects of temperature (17, 27 and 37 °C) and activity states on fR, tidal volume (VT), the fraction of oxygen extracted from the lung per breath (FIO2-FEO2), fH, and the cardiac O2 pulse were quantified to determine the relative roles of each of these variables in accommodating changes in VO2. The increases in oxygen supply to meet temperature- and activity-induced increases in oxygen demand were produced almost exclusively by increases in fH and fR. Regression analysis showed that the effects of temperature and activity state on the relationships between fH, fR and VO2 was to extend a common relationship along a single curve, rather than separate relationships for each metabolic state. For these lizards, the predictive powers of fR and fH were maximized when the effects of changes in temperature, digestive state and activity were pooled. However, the best r(2) values obtained were 0.63 and 0.74 using fR and fH as predictors of metabolic rate, respectively.

  5. More Relaxation by Deep Breath on Methacholine- Than on Exercise-Induced bronchoconstriction during the Routine Testing of Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Iulia Ioan

    2017-10-01

    Full Text Available Deep inspiration (DI dilates normal airway precontracted with methacholine. The fact that this effect is diminished or absent in asthma could be explained by the presence of bronchial inflammation. The hypothesis was tested that DI induces more relaxation in methacholine induced bronchoconstriction—solely determined by the smooth muscle contraction—than in exercise induced bronchoconstriction, which is contributed to by both smooth muscle contraction and airway wall inflammation. The respiratory conductance (Grs response to DI was monitored in asthmatic children presenting a moderately positive airway response to challenge by methacholine (n = 36 or exercise (n = 37, and expressed as the post- to pre-DI Grs ratio (GrsDI. Both groups showed similar change in FEV1 after challenge and performed a DI of similar amplitude. GrsDI however was significantly larger in methacholine than in exercise induced bronchoconstriction (p < 0.02. The bronchodilatory effect of DI is thus less during exercise- than methacholine-induced bronchoconstriction. The observation is consistent with airway wall inflammation—that characterizes exercise induced bronchoconstriction—rendering the airways less responsive to DI. More generally, it is surmised that less relief of bronchoconstriction by DI is to be expected during indirect than direct airway challenge. The current suggestion that airway smooth muscle constriction and airway wall inflammation may result in opposing effects on the bronchomotor action of DI opens important perspective to the routine testing of asthmatic children. New crossover research protocols comparing the mechanical consequences of the DI maneuver are warranted during direct and indirect bronchial challenges.

  6. Effects of auto-servo ventilation on patients with sleep-disordered breathing, stable systolic heart failure and concomitant diastolic dysfunction: subanalysis of a randomized controlled trial.

    Science.gov (United States)

    Birner, Christoph; Series, Frederic; Lewis, Keir; Benjamin, Amit; Wunderlich, Silke; Escourrou, Pierre; Zeman, Florian; Luigart, Ruth; Pfeifer, Michael; Arzt, Michael

    2014-01-01

    Systolic heart failure (HF) is frequently accompanied by diastolic dysfunction and sleep-disordered breathing (SDB). The objective of this subset analysis was to determine effect sizes of auto-servo ventilation (ASV and biphasic positive airway pressure ASV) on echocardiographic measures of diastolic function in patients with systolic HF and SDB. Thirty-two patients with stable systolic HF, concomitant diastolic dysfunction [age 66 ± 9 years old, left ventricular (LV) ejection fraction: 30 ± 7% and New York Heart Association class II: 72%] and SDB (apnea-hypopnea index, AHI: 48 ± 19/h; 53% had predominantly obstructive sleep apnea) receiving either ASV (n = 19) or optimal medical treatment (control, n = 13) were analyzed in a randomized controlled clinical trial. Polysomnographic and echocardiographic measurements were obtained at baseline and after 12 weeks. AHI significantly improved in the ASV group compared to the control group (-39 ± 18 vs. -0.2 ± 13.2/h, p control visit, diastolic function assessed by the isovolumetric relaxation time (-10.3 ± 26.1 vs. 9.3 ± 49.1, p = 0.48) and deceleration time (-43.9 ± 88.8 vs. 12.4 ± 68.8, p = 0.40) tended to improve after ASV treatment, but did not reach statistical significance. Likewise, the proportion of patients whose diastolic dysfunction improved was nonsignificantly higher in the ASV than in the control group, respectively (37 vs. 15%, p = 0.25). ASV treatment efficiently abolishes SDB in patients with stable systolic HF and concomitant diastolic dysfunction, and was associated with a statistically nonsignificant improvement in measures of diastolic dysfunction. Thus, these data provide estimates of effect size and justify the evaluation of the effects of ASV on diastolic function in larger randomized controlled trials. Copyright © 2013 S. Karger AG, Basel.

  7. SU-E-T-450: How Important Is a Reproducible Breath Hold for DIBH Breast Radiotherapy?

    International Nuclear Information System (INIS)

    Liu, H; Wentworth, S; Sintay, B; Wiant, D

    2015-01-01

    Purpose: Deep inspiration breath hold (DIBH) for left-sided breast cancer has been shown to reduce heart dose. Surface imaging helps to ensure accurate breast positioning, but does not guarantee a reproducible breath hold (BH) at DIBH treatments. We examine the effects of variable BH positions for DIBH treatments. Methods: Twenty-Five patients with free breathing (FB) and DIBH scans were reviewed. Four plans were created for each patient: 1) FB, 2) DIBH, 3) FB-DIBH – the DIBH plans were copied to the FB images and recalculated (image registration was based on breast tissue), and 4) P-DIBH – a partial BH with the heart shifted midway between the FB and DIBH positions. The FB-DIBH plans give “worst case” scenarios for surface imaging DIBH, where the breast is aligned by surface imaging but the patient is not holding their breath. Students t-tests were used to compare dose metrics. Results: The DIBH plans gave lower heart dose and comparable breast coverage versus FB in all cases. The FB-DIBH plans showed no significant difference versus FB plans for breast coverage, mean heart dose, or maximum heart dose (p >= 0.10). The mean heart dose differed between FB-DIBH and FB by < 2 Gy for all cases, the maximum heart dose differed by < 2 Gy for 21 cases. The P-DIBH plans showed significantly lower mean heart dose than FB (p = 0.01). The mean heart doses for the P-DIBH plans were < FB for 22 cases, the maximum dose < FB for 18 cases. Conclusions: A DIBH plan delivered to a FB patient set-up with surface imaging will yield similar dosimetry to a plan created and delivered FB. A DIBH plan delivered with even a partial BH can give reduced heart dose compared to FB techniques when the breast tissue is well aligned

  8. Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Yang, Dong Hyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    The potential impact of dual-source ECG-triggered sequential CT scan on coronary artery visibility has not been evaluated in free-breathing young children. To compare coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT between dual-source ECG-triggered sequential (DSET) scan and single-source non-ECG-synchronized spiral (SSNE) scan. In 93 young children, 108 cardiac 64-slice CT examinations were performed during free-breathing. Visibility of coronary arteries and side branches was compared between SSNE and DSET scans. Heart rates and trigger delays for DSET scan were recorded. Effective dose of each scan technique was calculated. Visual grades were significantly higher (P < 0.001 or =0.011) on DSET scan than on SSNE scan except for the distal left anterior descending artery. Coronary arteries were traceable in 79.3% on DSET scan and 54.3% on SSNE scan in the overlapped scan range (P < 0.0001), and 97.1% and 71.9% for the origins and proximal segments (P < 0.0001). Visibility of side branches was improved on DSET scan by a factor of 2.0. Heart rates and trigger delays for DSET scan were 131 {+-} 24 beats per min and 199 {+-} 44 ms, respectively. Effective doses of DSET and SSNE scans were 0.36 {+-} 0.12 mSv and 0.99 {+-} 0.23 mSv, respectively. DSET scan improves visibility of coronary arteries on cardiac 64-slice CT in free-breathing young children with congenital heart disease, compared with SSNE scan. (orig.)

  9. WE-DE-209-05: Self-Held Breath Control with Respiratory Monitoring and Feedback Guidance

    International Nuclear Information System (INIS)

    Gifford, K.

    2016-01-01

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  10. WE-DE-209-05: Self-Held Breath Control with Respiratory Monitoring and Feedback Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, K. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

  11. Left ventricular volume measurements with free breathing respiratory self-gated 3-dimensional golden angle radial whole-heart cine imaging - Feasibility and reproducibility.

    Science.gov (United States)

    Holst, Karen; Ugander, Martin; Sigfridsson, Andreas

    2017-11-01

    To develop and evaluate a free breathing respiratory self-gated isotropic resolution technique for left ventricular (LV) volume measurements. A 3D radial trajectory with double golden-angle ordering was used for free-running data acquisition during free breathing in 9 healthy volunteers. A respiratory self-gating signal was extracted from the center of k-space and used with the electrocardiogram to bin all data into 3 respiratory and 25 cardiac phases. 3D image volumes were reconstructed and the LV endocardial border was segmented. LV volume measurements and reproducibility from 3D free breathing cine were compared to conventional 2D breath-held cine. No difference was found between 3D free breathing cine and 2D breath-held cine with regards to LV ejection fraction, stroke volume, end-systolic volume and end-diastolic volume (Pcine and 2D breath-held cine (Pcine and conventional 2D breath-held cine showed similar values and test-retest repeatability for LV volumes in healthy volunteers. 3D free breathing cine enabled retrospective sorting and arbitrary angulation of isotropic data, and could correctly measure LV volumes during free breathing acquisition. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition. Detectability for pulmonary lesions compared with respiratory-gated PET/CT

    International Nuclear Information System (INIS)

    Yamashita, Shozo; Yamamoto, Haruki; Hiko, Shigeaki; Horita, Akihiro; Yokoyama, Kunihiko; Onoguchi, Masahisa; Nakajima, Kenichi

    2014-01-01

    Deep-inspiration breath-hold (DIBH) positron emission tomography (PET)/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used. (author)

  13. Does treadmill running performance, heart rate and breathing rate response during maximal graded exercise improve after volitional respiratory muscle training?

    Science.gov (United States)

    Radhakrishnan, K; Sharma, V K; Subramanian, S K

    2017-05-10

    Maximal physical exertion in sports usually causes fatigue in the exercising muscles, but not in the respiratory muscles due to triggering of the Respiratory muscle metabo-reflex, a sympathetic vasoconstrictor response leading to preferential increment in blood flow to respiratory muscles. 1 We planned to investigate whether a six week yogic pranayama based Volitional Respiratory Muscle Training (VRMT) can improve maximal Graded Exercise Treadmill Test (GXTT) performance in healthy adult recreational sportspersons. Consecutive, consenting healthy adult recreational sportspersons aged 20.56±2.49 years (n=30), volunteered to 'baseline recording' of resting heart rate (HR), blood pressure (BP), respiratory rate (RR), and Bruce ramp protocol maximal GXTT until volitional exhaustion providing total test time (TTT), derived VO2max, Metabolic Equivalent of Task (METs), HR and BP response during maximal GXTT and drop in recovery HR data. After six weeks of observation, they underwent 'pre-intervention recording' followed by supervised VRMT intervention for 6 weeks (30 minutes a day; 5 days a week) and then 'post-intervention recording'. Repeated measures ANOVA with pairwise t statistical comparison was used to analyse the data. After supervised VRMT, we observed significant decrease in their resting supine RR (prespiratory muscle aerobic capacity, attenuation of respiratory muscle metabo-reflex, increase in cardiac stroke volume and autonomic resetting towards parasympatho-dominance. Yogic Pranayama based VRMT can be used in sports conditioning programme of athletes to further improve their maximal exercise performance, and as part of rehabilitation training during return from injury.

  14. Breathing adapted radiotherapy for breast cancer: comparison of free breathing gating with the breath-hold technique

    DEFF Research Database (Denmark)

    Korreman, Stine Sofia; Pedersen, Anders N; Nøttrup, Trine Jakobi

    2005-01-01

    BACKGROUND AND PURPOSE: Adjuvant radiotherapy after breast-conserving surgery for breast cancer implies a risk of late cardiac and pulmonary toxicity. This is the first study to evaluate cardiopulmonary dose sparing of breathing adapted radiotherapy (BART) using free breathing gating......, and to compare this respiratory technique with voluntary breath-hold. PATIENTS AND METHODS: 17 patients were CT-scanned during non-coached breathing manoeuvre including free breathing (FB), end-inspiration gating (IG), end-expiration gating (EG), deep inspiration breath-hold (DIBH) and end-expiration breath......-hold (EBH). The Varian Real-time Position Management system (RPM) was used to monitor respiratory movement and to gate the scanner. For each breathing phase, a population based internal margin (IM) was estimated based on average chest wall excursion, and incorporated into an individually optimised three...

  15. Long-term effect of adaptive servo ventilation on patients with chronic heart failure and sleep-disordered breathing: Meta analysis

    Directory of Open Access Journals (Sweden)

    Yu-xing FEI

    2017-02-01

    Full Text Available Objective To evaluate the long-tem effect of adaptive servo ventilation (ASV on patients with chronic heart failure (CHF and sleep-disordered breathing (SDB. Methods The controlled clinical articles were searched included in PubMed, Cochrane, EMBASE and CBM, CJFD, WangFang Database from Jan. 1970 to Dec. 2015. Included standard: left ventricular ejection fraction (LVEF ≤55%, apnea hypopnea index (AHI ≥15/h, follow up period over 4 weeks. After quality assessment (modified Jadad score and data extraction by two independent reviewers, mete analysis was performed with RevMan 5.3 software. Results Thirteen studies were recruited including 442 cases being followed over 4 weeks [ASV group 233 cases and control group 216 cases (corssover design 7]. Compared to control group, LVEF increased [weighted mean difference (WMD=3.72, 95%CI: 1.80-5.64, P<0.01] and AHI decreased significantly (WMD=–18.63, 95%CI: –26.19-–11.08, the distance walked in 6 minutes increased (WMD=28.72, 95%CI: 2.26-55.18, P=0.03 and plasma N terminal brain natriuretic peptide precursor (NT-pro BNP decreased significantly (WMD=–744.03, 95%CI: –1262.45-–225.62, P<0.05 in ASV group. Conclusion Over 4 weeks ASV may improve LVEF and AHI, increase 6-min walking distance and decrease NT-pro BNP in patients with CHF and SDB. DOI: 10.11855/j.issn.0577-7402.2016.12.12

  16. Bad Breath

    Science.gov (United States)

    ... garlic, onions, cheese, orange juice, and soda poor dental hygiene (say: HI-jeen), meaning not brushing and flossing regularly smoking and other tobacco use Poor oral hygiene leads to bad breath because when food particles ...

  17. Breathing Difficulties

    Science.gov (United States)

    ... symptoms. Symptoms associated with weak respiratory muscles: Air “hunger” (gasping, labored breathing) with an without activity Fatigue ... Start your own fundraising event & help create a world without ALS Start an Event Site Map | Press ...

  18. Bad Breath

    Science.gov (United States)

    ... cabbage. And of course smoking causes its own bad smell. Some diseases and medicines can cause a specific breath odor. Having good dental habits, like brushing and flossing regularly, help fight bad ...

  19. Deep RNA sequencing reveals dynamic regulation of myocardial noncoding RNAs in failing human heart and remodeling with mechanical circulatory support.

    Science.gov (United States)

    Yang, Kai-Chien; Yamada, Kathryn A; Patel, Akshar Y; Topkara, Veli K; George, Isaac; Cheema, Faisal H; Ewald, Gregory A; Mann, Douglas L; Nerbonne, Jeanne M

    2014-03-04

    Microarrays have been used extensively to profile transcriptome remodeling in failing human heart, although the genomic coverage provided is limited and fails to provide a detailed picture of the myocardial transcriptome landscape. Here, we describe sequencing-based transcriptome profiling, providing comprehensive analysis of myocardial mRNA, microRNA (miRNA), and long noncoding RNA (lncRNA) expression in failing human heart before and after mechanical support with a left ventricular (LV) assist device (LVAD). Deep sequencing of RNA isolated from paired nonischemic (NICM; n=8) and ischemic (ICM; n=8) human failing LV samples collected before and after LVAD and from nonfailing human LV (n=8) was conducted. These analyses revealed high abundance of mRNA (37%) and lncRNA (71%) of mitochondrial origin. miRNASeq revealed 160 and 147 differentially expressed miRNAs in ICM and NICM, respectively, compared with nonfailing LV. Among these, only 2 (ICM) and 5 (NICM) miRNAs are normalized with LVAD. RNASeq detected 18 480, including 113 novel, lncRNAs in human LV. Among the 679 (ICM) and 570 (NICM) lncRNAs differentially expressed with heart failure, ≈10% are improved or normalized with LVAD. In addition, the expression signature of lncRNAs, but not miRNAs or mRNAs, distinguishes ICM from NICM. Further analysis suggests that cis-gene regulation represents a major mechanism of action of human cardiac lncRNAs. The myocardial transcriptome is dynamically regulated in advanced heart failure and after LVAD support. The expression profiles of lncRNAs, but not mRNAs or miRNAs, can discriminate failing hearts of different pathologies and are markedly altered in response to LVAD support. These results suggest an important role for lncRNAs in the pathogenesis of heart failure and in reverse remodeling observed with mechanical support.

  20. SU-F-BRB-03: Quantifying Patient Motion During Deep-Inspiration Breath-Hold Using the ABC System with Simultaneous Surface Photogrammetry

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, Y; Rahimi, A; Sawant, A [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Active breathing control (ABC) has been used to reduce treatment margin due to respiratory organ motion by enforcing temporary breath-holds. However, in practice, even if the ABC device indicates constant lung volume during breath-hold, the patient may still exhibit minor chest motion. Consequently, therapists are given a false sense of security that the patient is immobilized. This study aims at quantifying such motion during ABC breath-holds by monitoring the patient chest motion using a surface photogrammetry system, VisionRT. Methods: A female patient with breast cancer was selected to evaluate chest motion during ABC breath-holds. During the entire course of treatment, the patient’s chest surface was monitored by a surface photogrammetry system, VisionRT. Specifically, a user-defined region-of-interest (ROI) on the chest surface was selected for the system to track at a rate of ∼3Hz. The surface motion was estimated by rigid image registration between the current ROI image captured and a reference image. The translational and rotational displacements computed were saved in a log file. Results: A total of 20 fractions of radiation treatment were monitored by VisionRT. After removing noisy data, we obtained chest motion of 79 breath-hold sessions. Mean chest motion in AP direction during breath-holds is 1.31mm with 0.62mm standard deviation. Of the 79 sessions, the patient exhibited motion ranging from 0–1 mm (30 sessions), 1–2 mm (37 sessions), 2–3 mm (11 sessions) and >3 mm (1 session). Conclusion: Contrary to popular assumptions, the patient is not completely still during ABC breath-hold sessions. In this particular case studied, the patient exhibited chest motion over 2mm in 14 out of 79 breath-holds. Underestimating treatment margin for radiation therapy with ABC could reduce treatment effectiveness due to geometric miss or overdose of critical organs. The senior author receives research funding from NIH, VisionRT, Varian Medical Systems

  1. Optimal Blood Suppression inversion time based on breathing rates and heart rates to improve renal artery visibility in spatial labeling with multiple inversion pulses: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Pei, Yi Gang; Li, Fang; Long, Xue Ying; Liu, Hui; Wang, Xiao Yi; Liu, Jin Kang; Li, Wen Zheng [Dept. of Radiology, Xiangya Hospital, Central South University, Changsha (China); Shen, Hao [GE Healthcare, Waukesha (United States)

    2016-02-15

    To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients' BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (κ = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17-19/min (BR1) and 74-82 bpm (HR1) for reader#1 and 17-19/min (BR2) and 74-83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14-15/min (BR1, 2) and 71-76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13-16/min (BR1) and 63-68 bpm (HR1) for reader#1 and 14-15/min (BR2) and 64-70 bpm (HR2) for reader#2. In SLEEK, BSP TI is affected by patients' BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency.

  2. Medical Issues: Breathing

    Science.gov (United States)

    ... Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At ... curesma.org > support & care > living with sma > medical issues > breathing Breathing Breathing problems are the most common ...

  3. A deep-learning classifier identifies patients with clinical heart failure using whole-slide images of H&E tissue.

    Directory of Open Access Journals (Sweden)

    Jeffrey J Nirschl

    Full Text Available Over 26 million people worldwide suffer from heart failure annually. When the cause of heart failure cannot be identified, endomyocardial biopsy (EMB represents the gold-standard for the evaluation of disease. However, manual EMB interpretation has high inter-rater variability. Deep convolutional neural networks (CNNs have been successfully applied to detect cancer, diabetic retinopathy, and dermatologic lesions from images. In this study, we develop a CNN classifier to detect clinical heart failure from H&E stained whole-slide images from a total of 209 patients, 104 patients were used for training and the remaining 105 patients for independent testing. The CNN was able to identify patients with heart failure or severe pathology with a 99% sensitivity and 94% specificity on the test set, outperforming conventional feature-engineering approaches. Importantly, the CNN outperformed two expert pathologists by nearly 20%. Our results suggest that deep learning analytics of EMB can be used to predict cardiac outcome.

  4. Focused sonographic examination of the heart, lungs and deep veins in an unselected population of acute admitted patients with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg

    2012-01-01

    symptoms, can be diagnosed with sonography. The protocol describes a prospective, blinded, randomised controlled trial that aims to assess the diagnostic impact of a pragmatic implementation of focused sonography of the heart, lungs and deep veins as a diagnostic modality in acute admitted patients...... diagnostic work up is supplemented by focused sonographic examination of the heart, lungs and deep veins of the legs. In the control group, usual diagnostic work up is performed. The χ(2) test, alternatively the Fischer exact test will be used, to establish whether there is a difference in the distribution...

  5. Comparison of left and right ventricular ejection and filling parameters by fast cine MR imaging in breath-hold technique: clinical study of 42 patients with cardiomyopathy and coronary heart disease

    International Nuclear Information System (INIS)

    Rominger, M.B.; Bachmann, G.F.; Geuer, M.; Puzik, M.; Rau, W.S.; Ricken, W.W.

    1999-01-01

    Purpose: Quantification of left and right ventricular filling and ejection of localized and diffuse heart diseases with fast cine MR imaging in breath-hold technique. Methods: 42 patients (14 idiopathic dilated cardiomyopathies (DCM), 13 hypertrophic cardiomyopathies (HCM) and 15 coronary artery diseases (CAD)) and 10 healthy volunteers were examined. Time-volume-curves of three left ventricular and one right ventricular slices were evaluated and peak ejection and filling rates (PER, PFR end-diastolic volume (EDV)/s) time to PER and PFR (TPER, TPFR ms) and time of end-systole (TSYS in % RR-intervall) were calculated. Results: There were significant regional and left-/right-sided differences of the filling and ejection of both ventricles within and between the different groups. In DCM the left ventricular PFR was reduced (DCM 3.1 EDV/s; volunteers 4.9 EDV/s) and Z-SYS prolonged (DCM 50.1%; volunteers 35.4%). In CAD there were localized decreased filling rates in comparison to the normal volunteer group (left ventricle: basal: 2.9 and 6.3 EDV/s, apical: 4.4 and 6.3 EDV/s; right ventricle: 3.6 and 5.7 EDV/s). HCM typically showed an isovolumetric lengthening of the endsystole. Conclusions: Cardiac MR imaging in breath-hold technique is suitable for measuring contraction and relaxation disturbances of localized and diffuse heart diseases by means of ejection and filling volume indices. (orig.) [de

  6. Crackle pitch and rate do not vary significantly during a single automated-auscultation session in patients with pneumonia, congestive heart failure, or interstitial pulmonary fibrosis.

    Science.gov (United States)

    Vyshedskiy, Andrey; Ishikawa, Sadamu; Murphy, Raymond L H

    2011-06-01

    To determine the variability of crackle pitch and crackle rate during a single automated-auscultation session with a computerized 16-channel lung-sound analyzer. Forty-nine patients with pneumonia, 52 with congestive heart failure (CHF), and 18 with interstitial pulmonary fibrosis (IPF) performed breathing maneuvers in the following sequence: normal breathing, deep breathing, cough several times; deep breathing, vital-capacity maneuver, and deep breathing. From the auscultation recordings we measured the crackle pitch and crackle rate. Crackle pitch variability, expressed as a percentage of the average crackle pitch, was small in all patients and in all maneuvers: pneumonia 11%, CHF 11%, pulmonary fibrosis 7%. Crackle rate variability was also small: pneumonia 31%, CHF 32%, IPF 24%. Compared to the first deep-breathing maneuver (100%), the average crackle pitch did not significantly change following coughing (pneumonia 100%, CHF 103%, IPF 100%), the vital-capacity maneuver (pneumonia 100%, CHF 92%, IPF 104%), or during quiet breathing (pneumonia 97%, CHF 100%, IPF 104%). Similarly, the average crackle rate did not change significantly following coughing (pneumonia 105%, CHF 110%, IPF 90%) or the vital-capacity maneuver (pneumonia 102%, CHF 101%, IPF 99%). However, during normal breathing the crackle rate was significantly lower in the patients with pneumonia (74%, P auscultation session suggests that crackle rate can be used to follow the course of cardiopulmonary illnesses such as pneumonia, IPF, and CHF.

  7. Cardiorespiratory interactions during resistive load breathing.

    Science.gov (United States)

    Calabrese, P; Perrault, H; Dinh, T P; Eberhard, A; Benchetrit, G

    2000-12-01

    The addition to the respiratory system of a resistive load results in breathing pattern changes and in negative intrathoracic pressure increases. The aim of this study was to use resistive load breathing as a stimulus to the cardiorespiratory interaction and to examine the extent of the changes in heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) in relation to the breathing pattern changes. HRV and RSA were studied in seven healthy subjects where four resistive loads were applied in a random order during the breath and 8-min recording made in each condition. The HRV spectral power components were computed from the R-R interval sequences, and the RSA amplitude and phase were computed from the sinusoid fitting the instantaneous heart rate within each breath. Adding resistive loads resulted in 1) increasing respiratory period, 2) unchanging heart rate, and 3) increasing HRV and changing RSA characteristics. HRV and RSA characteristics are linearly correlated to the respiratory period. These modifications appear to be linked to load-induced changes in the respiratory period in each individual, because HRV and RSA characteristics are similar at a respiratory period obtained either by loading or by imposed frequency breathing. The present results are discussed with regard to the importance of the breathing cycle duration in these cardiorespiratory interactions, suggesting that these interactions may depend on the time necessary for activation and dissipation of neurotransmitters involved in RSA.

  8. SU-F-T-254: Dose Volume Histogram (DVH) Analysis of Breath Hold Vs Free Breathing Techniques for Esophageal Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Badkul, R; Doke, K; Pokhrel, D; Aguilera, N; Lominska, C [University of Kansas Medical Center, Kansas City, KS (United States)

    2016-06-15

    Purpose: Lung and heart doses and associated toxicity are of concern in radiotherapy for esophageal cancer. This study evaluates the dosimetry of deep-inspiration-breath-hold (DIBH) technique as compared to freebreathing( FB) using 3D-conformal treatment(3D-CRT) of esophageal cancer. Methods: Eight patients were planned with FB and DIBH CT scans. DIBH scans were acquired using Varian RPM system. FB and DIBH CTs were contoured per RTOG-1010 to create the planning target volume(PTV) as well as organs at risk volumes(OAR). Two sets of gross target volumes(GTV) with 5cm length were contoured for each patient: proximal at the level of the carina and distal at the level of gastroesophageal junction and were enlarged with appropriate margin to generate Clinical Target Volume and PTV. 3D-CRT plans were created on Eclipse planning system for 45Gy to cover 95% of PTV in 25 fractions for both proximal and distal tumors on FB and DIBH scans. For distal tumors celiac nodes were covered electively. DVH parameters for lung and heart OARs were generated and analyzed. Results: All DIBH DVH parameters were normalized to FB plan values. Average of heart-mean and heart-V40 was 0.70 and 0.66 for proximal lesions. For distal lesions ratios were 1.21 and 2.22 respectively. For DIBH total lung volume increased by 2.43 times versus FB scan. Average of lung-mean, V30, V20, V10, V5 are 0.82, 0.92, 0.76, 0.77 and 0.79 for proximal lesions and 1.17,0.66,0.87,0.93 and 1.03 for distal lesions. Heart doses were lower for breath-hold proximal lesions but higher for distal lesions as compared to free-breathing plans. Lung doses were lower for both proximal and distal breath-hold lesions except mean lung dose and V5 for distal lesions. Conclusion: This study showed improvement of OAR doses for esophageal lesions at mid-thoracic level utilizing DIBH vs FB technique but did not show consistent OAR sparing with DIBH for distal lesions.

  9. SU-F-T-254: Dose Volume Histogram (DVH) Analysis of Breath Hold Vs Free Breathing Techniques for Esophageal Tumors

    International Nuclear Information System (INIS)

    Badkul, R; Doke, K; Pokhrel, D; Aguilera, N; Lominska, C

    2016-01-01

    Purpose: Lung and heart doses and associated toxicity are of concern in radiotherapy for esophageal cancer. This study evaluates the dosimetry of deep-inspiration-breath-hold (DIBH) technique as compared to freebreathing( FB) using 3D-conformal treatment(3D-CRT) of esophageal cancer. Methods: Eight patients were planned with FB and DIBH CT scans. DIBH scans were acquired using Varian RPM system. FB and DIBH CTs were contoured per RTOG-1010 to create the planning target volume(PTV) as well as organs at risk volumes(OAR). Two sets of gross target volumes(GTV) with 5cm length were contoured for each patient: proximal at the level of the carina and distal at the level of gastroesophageal junction and were enlarged with appropriate margin to generate Clinical Target Volume and PTV. 3D-CRT plans were created on Eclipse planning system for 45Gy to cover 95% of PTV in 25 fractions for both proximal and distal tumors on FB and DIBH scans. For distal tumors celiac nodes were covered electively. DVH parameters for lung and heart OARs were generated and analyzed. Results: All DIBH DVH parameters were normalized to FB plan values. Average of heart-mean and heart-V40 was 0.70 and 0.66 for proximal lesions. For distal lesions ratios were 1.21 and 2.22 respectively. For DIBH total lung volume increased by 2.43 times versus FB scan. Average of lung-mean, V30, V20, V10, V5 are 0.82, 0.92, 0.76, 0.77 and 0.79 for proximal lesions and 1.17,0.66,0.87,0.93 and 1.03 for distal lesions. Heart doses were lower for breath-hold proximal lesions but higher for distal lesions as compared to free-breathing plans. Lung doses were lower for both proximal and distal breath-hold lesions except mean lung dose and V5 for distal lesions. Conclusion: This study showed improvement of OAR doses for esophageal lesions at mid-thoracic level utilizing DIBH vs FB technique but did not show consistent OAR sparing with DIBH for distal lesions.

  10. Safely prolonging single breath-holds to >5 min in patients with cancer; feasibility and applications for radiotherapy

    Science.gov (United States)

    Green, Stuart; Stevens, Andrea M; Parveen, Sophia; Stephens, Rebecca; Clutton-Brock, Thomas H

    2016-01-01

    Objective: Multiple, short and deep inspiratory breath-holds with air of approximately 20 s are now used in radiotherapy to reduce the influence of ventilatory motion and damage to healthy tissue. There may be further clinical advantages in delivering each treatment session in only one single, prolonged breath-hold. We have previously developed techniques enabling healthy subjects to breath-hold for 7 min. Here, we demonstrate their successful application in patients with cancer. Methods: 15 patients aged 37–74 years undergoing radiotherapy for breast cancer were trained to breath-hold safely with pre-oxygenation and mechanically induced hypocapnia under simulated radiotherapy treatment conditions. Results: The mean breath-hold duration was 5.3 ± 0.2 min. At breakpoint, all patients were normocapnic and normoxic [mean end-tidal partial pressure of carbon dioxide was 36 ± 1 standard error millimetre of mercury, (mmHg) and mean oxygen saturation was 100 ± 0 standard error %]. None were distressed, nor had gasping, dizziness or disturbed breathing in the post-breath-hold period. Mean blood pressure had risen significantly from 125 ± 3 to 166 ± 4 mmHg at breakpoint (without heart rate falling), but normalized within approximately 20 s of the breakpoint. During breath-holding, the mean linear anteroposterior displacement slope of the L breast marker was radiotherapy treatment conditions for longer than the typical beam-on time of a single fraction. We discuss the important applications of this technique for radiotherapy. Advances in knowledge: We demonstrate for the first time a technique enabling patients with cancer to deliver safely a single prolonged breath-hold of >5 min (10 times longer than currently used in radiotherapy practice), under simulated radiotherapy treatment conditions. PMID:27168468

  11. Rapid shallow breathing

    Science.gov (United States)

    Tachypnea; Breathing - rapid and shallow; Fast shallow breathing; Respiratory rate - rapid and shallow ... Shallow, rapid breathing has many possible medical causes, including: Asthma Blood clot in an artery in the ...

  12. Doppler ultrasound surveillance in deep tunneling compressed-air work with Trimix breathing: bounce dive technique compared to saturation-excursion technique

    NARCIS (Netherlands)

    Vellinga, T. P. Van Rees; Sterk, W.; de Boer, A. G. E. M.; van der Beek, A. J.; Verhoeven, A. C.; van Dijk, F. J. H.

    2008-01-01

    The Western Scheldt Tunneling Project in The Netherlands provided a unique opportunity to evaluate two deep-diving techniques with Doppler ultrasound surveillance. Divers used the bounce diving techniques for repair and maintenance of the TBM. The tunnel boring machine jammed at its deepest depth.

  13. Heart-Rate Variability During Deep Sleep in World-Class Alpine Skiers: A Time-Efficient Alternative to Morning Supine Measurements.

    Science.gov (United States)

    Herzig, David; Testorelli, Moreno; Olstad, Daniela Schäfer; Erlacher, Daniel; Achermann, Peter; Eser, Prisca; Wilhelm, Matthias

    2017-05-01

    It is increasingly popular to use heart-rate variability (HRV) to tailor training for athletes. A time-efficient method is HRV assessment during deep sleep. To validate the selection of deep-sleep segments identified by RR intervals with simultaneous electroencephalography (EEG) recordings and to compare HRV parameters of these segments with those of standard morning supine measurements. In 11 world-class alpine skiers, RR intervals were monitored during 10 nights, and simultaneous EEGs were recorded during 2-4 nights. Deep sleep was determined from the HRV signal and verified by delta power from the EEG recordings. Four further segments were chosen for HRV determination, namely, a 4-h segment from midnight to 4 AM and three 5-min segments: 1 just before awakening, 1 after waking in supine position, and 1 in standing after orthostatic challenge. Training load was recorded every day. A total of 80 night and 68 morning measurements of 9 athletes were analyzed. Good correspondence between the phases selected by RR intervals vs those selected by EEG was found. Concerning root-mean-squared difference of successive RR intervals (RMSSD), a marker for parasympathetic activity, the best relationship with the morning supine measurement was found in deep sleep. HRV is a simple tool for approximating deep-sleep phases, and HRV measurement during deep sleep could provide a time-efficient alternative to HRV in supine position.

  14. Coronary Artery Dissection: Not Just a Heart Attack

    Science.gov (United States)

    ... for Heart.org CPR & ECC for Heart.org Shop for Heart.org Causes for Heart.org Advocate ... chest pain or pressure, shortness of breath, profuse sweating and dizziness. “Around 80 percent of the time, ...

  15. Doppler ultrasound surveillance in deep tunneling compressed-air work with Trimix breathing: bounce dive technique compared to saturation-excursion technique.

    Science.gov (United States)

    Vellinga, T P van Rees; Sterk, W; de Boer, A G E M; van der Beek, A J; Verhoeven, A C; van Dijk, F J H

    2008-01-01

    The Western Scheldt Tunneling Project in The Netherlands provided a unique opportunity to evaluate two deep-diving techniques with Doppler ultrasound surveillance. Divers used the bounce diving techniques for repair and maintenance of the TBM. The tunnel boring machine jammed at its deepest depth. As a result the work time was not sufficient. The saturation diving technique was developed and permitted longer work time at great depth. Thirty-one divers were involved in this project. Twenty-three divers were examined using Doppler ultrasound. Data analysis addressed 52 exposures to Trimix at 4.6-4.8 bar gauge using the bounce technique and 354 exposures to Trimix at 4.0-6.9 bar gauge on saturation excursions. No decompression incidents occurred with either technique during the described phase of the project. Doppler ultrasound revealed that the bubble loads assessed in both techniques were generally low. We find out, that despite longer working hours, shorter decompression times and larger physical workloads, the saturation-excursion technique was associated with significant lower bubble grades than in the bounce technique using Doppler Ultrasound. We conclude that the saturation-excursion technique with Trimix is a good option for deep and long exposures in caisson work. The Doppler technique proved valuable, and it should be incorporated in future compressed-air work.

  16. Racionalidade e métodos: estudo BREATHE - I registro brasileiro de insuficiência cardíaca Rationale and design: BREATHE registry - I brazilian registry of heart failure

    Directory of Open Access Journals (Sweden)

    2013-05-01

    Full Text Available FUNDAMENTO: Diversos registros locais buscam de forma isolada retratar características clínicas de pacientes internados com Insuficiência Cardíaca (IC em hospitais e comunidades brasileiras. De forma geral, a análise desses dados sugere que existam diferenças importantes na etiologia, nos fatores de descompensação, no tratamento e no prognóstico de pacientes com IC nas diferentes regiões brasileiras. OBJETIVOS: Avaliar as características demográficas, clínicas, prognósticas de 1.200 pacientes admitidos com diagnóstico clínico de insuficiência cardíaca descompensada em um grupo de 60 hospitais representativos das diferentes regiões brasileiras. MÉTODOS: Estudo observacional transversal (registro com seguimento longitudinal de doze meses (visitas de admissão, alta hospitalar, três meses, seis meses e doze meses após inclusão, em que pacientes admitidos em hospitais da rede pública e privada com quadro clínico primariamente de IC definida serão estudados. RESULTADOS: Os resultados serão apresentados logo após o término da coleta, avaliação da qualidade e análise estatística dos dados. CONCLUSÕES: A análise dos resultados deste registro multicêntrico permitirá um planejamento mais adequado do aporte de recursos financeiros, pessoais e tecnológicos para a área da saúde, bem como o planejamento de medidas preventivas mais eficazes na IC descompensada.BACKGROUND: Several local registries have sought to individually depict clinical characteristics of patients hospitalized with heart failure (HF in Brazilian hospitals and communities. Overall, the analysis of these data suggests that there are important differences in etiology, decompensation factors, treatment and prognosis of patients with HF in different Brazilian regions. OBJECTIVES: To evaluate the demographic, clinical and prognostic characteristics of 1,200 patients admitted with a clinical diagnosis of decompensated HF in a group of 60 hospitals

  17. Stress and your heart

    Science.gov (United States)

    Coronary heart disease - stress; Coronary artery disease - stress ... Your body responds to stress on many levels. First, it releases stress hormones that make you breathe faster. Your blood pressure goes up. Your muscles ...

  18. Slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with chronic heart failure: from modeling to clinical application.

    Science.gov (United States)

    Harada, Daisuke; Asanoi, Hidetsugu; Takagawa, Junya; Ishise, Hisanari; Ueno, Hiroshi; Oda, Yoshitaka; Goso, Yukiko; Joho, Shuji; Inoue, Hiroshi

    2014-10-15

    Influences of slow and deep respiration on steady-state sympathetic nerve activity remain controversial in humans and could vary depending on disease conditions and basal sympathetic nerve activity. To elucidate the respiratory modulation of steady-state sympathetic nerve activity, we modeled the dynamic nature of the relationship between lung inflation and muscle sympathetic nerve activity (MSNA) in 11 heart failure patients with exaggerated sympathetic outflow at rest. An autoregressive exogenous input model was utilized to simulate entire responses of MSNA to variable respiratory patterns. In another 18 patients, we determined the influence of increasing tidal volume and slowing respiratory frequency on MSNA; 10 patients underwent a 15-min device-guided slow respiration and the remaining 8 had no respiratory modification. The model predicted that a 1-liter, step increase of lung volume decreased MSNA dynamically; its nadir (-33 ± 22%) occurred at 2.4 s; and steady-state decrease (-15 ± 5%), at 6 s. Actually, in patients with the device-guided slow and deep respiration, respiratory frequency effectively fell from 16.4 ± 3.9 to 6.7 ± 2.8/min (P state MSNA was decreased by 31% (P state MSNA. Thus slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with high levels of resting sympathetic tone as in heart failure. Copyright © 2014 the American Physiological Society.

  19. COPD: When You Learn More, You'll Breathe Better

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues COPD: When You Learn More, You'll Breathe Better ... Trial to Look at Home Oxygen Therapy for COPD The National Heart, Lung, and Blood Institute (NHLBI) ...

  20. News from the Breath Analysis Summit 2011.

    Science.gov (United States)

    Corradi, Massimo; Mutti, Antonio

    2012-06-01

    (oxygen, nitrogen, water vapour and CO(2)) in patient respiratory monitoring have served as a platform for technological growth in clinical breath-testing applications. A few exhaled breath tests have demonstrated clinical utility and are in widespread use, and several FDA-approved devices are available. These widely used exhaled breath tests include detection of blood alcohol concentration and exhaled CO(2). Other clinical applications of exhaled breath analysis include testing for H. pylori infection, lactose intolerance, heart transplant rejection and, more recently, monitoring of airway inflammation by means of exhaled NO. Examination of exhaled breath has the potential to change the existing routine approaches in human medicine. The rapidly developing new analytical and computer technologies along with novel, unorthodox ideas are prerequisites for future advances in this field. Scientists who participated in the Breath Analysis Summit 2011 were invited to submit a full length paper to the Journal of Breath Research and this issue includes eight articles which describe the different applications of breath analysis. We thank all the authors for their valuable contribution and we trust that this collection will provide useful information and an update to this rapidly evolving field, giving an example of integration among scientists who address the same topic-breath analysis-from different and complementary perspectives, from basic to clinical research.

  1. THE INFLUENCE OF BIOFEEDBACK SESSIONS IN CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING ON SYSTOLIC BLOOD PRESSURE CONTROL DURING STANDARD DRUG THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. A. S. Belal

    2015-06-01

    Full Text Available Changes of systolic blood pressure (SBP in biofeedback (BFB sessions with closed loop of paced breathing (PB and heart rate variability (HRV during standard drug therapy of arterial hypertension (AH was studied. 275 patients with 1-3 degree of AH (143 men and 132 women, mean age 58,55 ± 7,99 years was divided into two comparable groups: 1 - BFB (139 patients in investigated PB loop, 2 - control group (136 patients with BFB without PB. In both groups was performed 10 sessions of BFB. Changes of SBP depending on the stage and degree of AH, gender and age was assessed. BP was measured by the method of Korotkov’s with monometer Microlife BP AG1-20 in same conditions. Data were processed by parametric and nonparametric statistics. It is proved that the use of biofeedback in the loop of PB and HRV significantly (p < 0.01 exceeds in efficiency an isolated drug therapy in control of SBP at any stage and degree of AH in patients of both sexes in all age groups. Extent of the effect increases with the stage and degree of the disease and not related to the sex and age of the patient. Findings allow to recommend this technique in clinical practice.

  2. Towards The Design of a Smartphone-Based Biofeedback Breathing Training: Identifying Diaphragmatic Breathing Patterns from a Smartphone’s Microphone

    OpenAIRE

    Shih, Chen-Hsuan Iris; Kowatsch, Tobias; Tinschert, Peter; Barata, Filipe; Nißen, Marcia Katharina

    2016-01-01

    Asthma, diabetes, hypertension, or major depression are non-communicable diseases (NCDs) and impose a major burden on global health. Stress is linked to both the causes and consequences of NCDs and it has been shown that biofeedback-based breathing trainings (BBTs) are effective in coping with stress. Here, diaphragmatic breathing, i.e. deep abdominal breathing, belongs to the most distinguished breathing techniques. However, high costs and low scalability of state-of-the-art BBTs that requir...

  3. What Causes Bad Breath?

    Science.gov (United States)

    ... Videos for Educators Search English Español What Causes Bad Breath? KidsHealth / For Teens / What Causes Bad Breath? Print en español ¿Qué es lo que provoca el mal aliento? Bad breath, or halitosis , can be a major problem, ...

  4. Chronic heart failure

    OpenAIRE

    Hopper, Ingrid; Easton, Kellie

    2017-01-01

    1. The common symptoms and signs of chronic heart failure are dyspnoea, ankle swelling, raised jugular venous pressure and basal crepitations. Other conditions may be confused with chronic heart failure, including dependent oedema or oedema due to renal or hepatic disease. Shortness of breath may be due to respiratory disease or severe anaemia. Heart failure secondary to lung disease (cor pulmonale) should be distinguished from congestive cardiac failure. Heart failure may also present with l...

  5. Open heart surgery with deep hypothermic cardiopulmonary bypass and more than 90 minutes of aortic cross clamp time in 10 small dogs

    Directory of Open Access Journals (Sweden)

    Kippei Mihara

    2017-04-01

    Full Text Available No previous reports have described cardiopulmonary bypass (CPB techniques involving long aortic cross clamp (ACC times in small-breed dogs. We previously described open heart surgery under deep hypothermic CPB in small and toy dogs with an approximate ACC time limit of 1 hour, given the low success rate beyond 90 minutes of ACC time. Herein, we describe improvements in cardiac anesthesia, CPB, and cardioplegia that led to a high success rate of open heart surgery with a long ACC time in small dogs. Ten small-breed dogs with severe mitral regurgitation were subjected to mitral valve plasty that necessitated cardiopulmonary bypass (CPB beyond 90 minutes of ACC time. In the present study, all dogs survived surgery; 7 survived to discharge. In other words, we achieved a high success rate of 70% with mitral valve plasty beyond 90 minutes of ACC time (mean, 105.1 minutes: range, 90-117 minutes. For small dogs, successful open heart surgery with a long ACC time may require cardiac balanced anesthesia, CPB with increased drainage and, importantly, thorough cardioplegia without hemodilution.

  6. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation

    International Nuclear Information System (INIS)

    Osman, Sarah O.S.; Hol, Sandra; Poortmans, Philip M.; Essers, Marion

    2014-01-01

    Purpose: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. Materials and methods: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42.56 Gy in 16 fractions. For 10 additional patients, 3D-CRT and VMAT in vmDIBH only were also compared. Results: Dose conformity, PTV coverage, ipsilateral and total lung doses were significantly better for VMAT plans compared to 3D-CRT. Mean heart dose (D mean,heart ) reduction in 3D-CRT(vmDIBH) was between 0.9 and 8.6 Gy, depending on initial D mean,heart (in 3D-CRT(FB) plans). VMAT(vmDIBH) reduced the D mean,heart further when D mean,heart was still >3.2 Gy in 3D-CRT(vmDIBH). Mean contralateral breast dose was higher for VMAT plans (2.7 Gy) compared to 3DCRT plans (0.7 Gy). Conclusions: VMAT and 3D-CRT(vmDIBH) significantly reduced heart dose for patients treated with locoregional RT of left-sided breast cancer. When D mean,heart exceeded 3.2 Gy in 3D-CRT(vmDIBH) plans, VMAT(vmDIBH) resulted in a cumulative heart dose reduction. VMAT also provided better target coverage and reduced ipsilateral lung dose, at the expense of a small increase in the dose to the contralateral breast

  7. The HeartShield device reduces the risk for right ventricular damage in patients with deep sternal wound infection.

    Science.gov (United States)

    Ingemansson, Richard; Malmsjö, Malin; Lindstedt, Sandra

    2014-01-01

    Right ventricular rupture, resulting in serious bleeding, is a life-threatening complication associated with negative-pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier between the heart and the sharp sternal edges has been successfully tested on pigs. In the present article, we demonstrate increased safety in NPWT through the use of the HeartShield device. Six patients were treated with a specially designed device in combination with NPWT. The device consists of a horizontally placed disk covered in foam. The back of the T-shaped device sticks up between the sternal edges and up above skin level. This part of the device is also covered in foam. Drainage is performed through two holes at the top of the device. The device and foam are changed every second to third day, and -120 mm Hg of continuous therapy is used. Six patients were treated with traditional NPWT, serving as control group. No signs of calluslike formation were seen on the right ventricle in the group treated with the HeartShield device. In the conventional NPWT control group, all six patients had calluslike formation (>1 × 2 cm2) on the anterior part of the right ventricle. All patients in the HeartShield group had grade 1 epicardial petechial bleeding (the right ventricle. In the control group, one patient had grade 1 (2.0 cm2) epicardial petechial bleeding on the right ventricle. No major bleeding or mortality was observed in either group during the course of the study. The use of the HeartShield device significantly minimizes the contact between the right ventricle and the sternal edges, thereby decreasing the risk for life-threatening complications due to bleeding.

  8. An exercise in preferential unilateral breathing

    International Nuclear Information System (INIS)

    Cheong, D.; Tucker, B.; Jenkins, S.; Robinson, P.; Curtin University, Shenton Park, WA

    1999-01-01

    Full text: In preparation for major thoracic surgery, physiotherapists have traditionally taught unilateral breathing exercises. There are no studies that prove that these exercises are effective This study was undertaken to demonstrate the effects of unilateral thoracic expansion exercises (TEE) using 99 Tc m -Technegas Ten physiotherapists were taught unilateral TEE to increase ventilation to the right lower lobe. Each subject underwent two separate Technegas ventilation studies using a single-breath technique, one with normal deep inspiration and the other during a right TEE. Dynamic and static images were acquired in the seated position for each ventilation study. Analysis was undertaken by dividing the lungs into 6 zones of equal height and calculating the relative ventilation of each zone and each lung. Seven subjects (70%) achieved significantly increased ventilation to the right lower zone, while 9 (90%) achieved greater ventilation to the right lung. Total lung ventilation was reduced during right TEE when compared with normal deep inspiration

  9. Breath biomarkers in toxicology.

    Science.gov (United States)

    Pleil, Joachim D

    2016-11-01

    Exhaled breath has joined blood and urine as a valuable resource for sampling and analyzing biomarkers in human media for assessing exposure, uptake metabolism, and elimination of toxic chemicals. This article focuses current use of exhaled gas, aerosols, and vapor in human breath, the methods for collection, and ultimately the use of the resulting data. Some advantages of breath are the noninvasive and self-administered nature of collection, the essentially inexhaustible supply, and that breath sampling does not produce potentially infectious waste such as needles, wipes, bandages, and glassware. In contrast to blood and urine, breath samples can be collected on demand in rapid succession and so allow toxicokinetic observations of uptake and elimination in any time frame. Furthermore, new technologies now allow capturing condensed breath vapor directly, or just the aerosol fraction alone, to gain access to inorganic species, lung pH, proteins and protein fragments, cellular DNA, and whole microorganisms from the pulmonary microbiome. Future applications are discussed, especially the use of isotopically labeled probes, non-targeted (discovery) analysis, cellular level toxicity testing, and ultimately assessing "crowd breath" of groups of people and the relation to dose of airborne and other environmental chemicals at the population level.

  10. Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles.

    Science.gov (United States)

    Celhay, Isabel; Cordova, Rosa; Miralles, Rodolfo; Meza, Francisco; Erices, Pia; Barrientos, Camilo; Valenzuela, Saúl

    2015-04-01

    To compare electromyographic (EMG) activity in young-adult subjects with different breathing types. This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word 'Mississippi'; (3) swallowing saliva; and (4) forced deep breathing. Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test). Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.

  11. The use of active breathing control (ABC) to reduce margin for breathing motion

    International Nuclear Information System (INIS)

    Wong, John W.; Sharpe, Michael B.; Jaffray, David A.; Kini, Vijay R.; Robertson, John M.; Stromberg, Jannifer S.; Martinez, Alavro A.

    1999-01-01

    Purpose: For tumors in the thorax and abdomen, reducing the treatment margin for organ motion due to breathing reduces the volume of normal tissues that will be irradiated. A higher dose can be delivered to the target, provided that the risk of marginal misses is not increased. To ensure safe margin reduction, we investigated the feasibility of using active breathing control (ABC) to temporarily immobilize the patient's breathing. Treatment planning and delivery can then be performed at identical ABC conditions with minimal margin for breathing motion. Methods and Materials: An ABC apparatus is constructed consisting of 2 pairs of flow monitor and scissor valve, 1 each to control the inspiration and expiration paths to the patient. The patient breathes through a mouth-piece connected to the ABC apparatus. The respiratory signal is processed continuously, using a personal computer that displays the changing lung volume in real-time. After the patient's breathing pattern becomes stable, the operator activates ABC at a preselected phase in the breathing cycle. Both valves are then closed to immobilize breathing motion. Breathing motion of 12 patients were held with ABC to examine their acceptance of the procedure. The feasibility of applying ABC for treatment was tested in 5 patients by acquiring volumetric scans with a spiral computed tomography (CT) scanner during active breath-hold. Two patients had Hodgkin's disease, 2 had metastatic liver cancer, and 1 had lung cancer. Two intrafraction ABC scans were acquired at the same respiratory phase near the end of normal or deep inspiration. An additional ABC scan near the end of normal expiration was acquired for 2 patients. The ABC scans were also repeated 1 week later for a Hodgkin's patient. In 1 liver patient, ABC scans were acquired at 7 different phases of the breathing cycle to facilitate examination of the liver motion associated with ventilation. Contours of the lungs and livers were outlined when applicable

  12. Breathing and Relaxation

    Science.gov (United States)

    ... Find a Doctor Relaxation is the absence of tension in muscle groups and a minimum or absence ... Drill Meditation Progressive Muscle Relaxation Minimizing Shortness of Breath Visualization This information has been approved by Shelby ...

  13. Learn More Breathe Better

    Centers for Disease Control (CDC) Podcasts

    Chronic obstructive pulmonary disease (COPD) is a serious lung disease that makes breathing very difficult and can affect your quality of life. Learn the causes of COPD and what you can do to prevent it.

  14. Shortness of Breath

    Science.gov (United States)

    ... filled with air (called pneumotho- rax), it will hinder expansion of the lung, resulting in shortness of ... of Chest Physi- cians. Shortness of Breath: Patient Education. http: / / www. onebreath. org/ document. doc? id= 113. ...

  15. Breath-Holding Spells

    Science.gov (United States)

    ... reviewed: October 2016 More on this topic for: Parents Is It Normal for Children to Hold Their Breath? Taming Tempers Disciplining Your Child Disciplining Your Toddler Temper Tantrums Separation Anxiety View more About Us Contact Us Partners ...

  16. Breath in the technoscientific imaginary

    OpenAIRE

    Rose, Arthur

    2016-01-01

    Breath has a realist function in most artistic media. It serves to remind the reader, the viewer or the spectator of the exigencies of the body. In science fiction (SF) literature and films, breath is often a plot device for human encounters with otherness, either with alien peoples, who may not breathe oxygen, or environments, where there may not be oxygen to breathe. But while there is a technoscientific quality to breath in SF, especially in its attention to physiological systems, concentr...

  17. Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits

    International Nuclear Information System (INIS)

    Claude, Line; Malet, Claude Phys.; Pommier, Pascal; Thiesse, Philippe; Chabaud, Sylvie; Carrie, Christian

    2007-01-01

    Purpose: The challenge in early Hodgkin's disease (HD) in children is to maintain good survival rates while sparing organs at risk. This study assesses the feasibility of active breathing control (ABC) in children, and compares normal tissue irradiation with and without ABC. Methods and Materials: Between May 2003 and June 2004, seven children with HD with mediastinal involvement, median age 15, were treated by chemotherapy and involved-field radiation therapy. A free-breathing computed tomography simulation scan and one additional scan during deep inspiration using ABC were performed. A comparison between planning treatment with clinical target volume including supraclavicular regions, mediastinum, and hila was performed, both in free breathing and using ABC. Results: For a prescription of 36 Gy, pulmonary dose-volume histograms revealed a mean reduction in lung volume irradiated at more than 20 Gy (V20) and 30 Gy (V30) of 25% and 26%, respectively, using ABC (p = 0.016). The mean volume of heart irradiated at 30 Gy or more decreased from 15% to 12% (nonsignificant). The mean dose delivered to breasts in girls was small in both situations (less than 2 Gy) and stable with or without ABC. Considering axillary irradiation, the mean dose delivered to breasts remained low (<9 Gy), without significant difference using ABC or not. The mean radiation dose delivered to thyroid was stable using ABC or not. Conclusions: Using ABC is feasible in childhood. The use of ABC decreases normal lung tissue irradiation. Concerning heart irradiation, a minimal gain is also shown. No significant change has been demonstrated concerning breast and thyroid irradiation

  18. A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving.

    Science.gov (United States)

    Meule, Adrian; Kübler, Andrea

    2017-03-01

    Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

  19. Heart attack - discharge

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

  20. Imposed Work of Breathing and Breathing Comfort of Nonintubated Volunteers Breathing with Three Portable Ventilators and a Critical Care Ventilator

    National Research Council Canada - National Science Library

    Austin, Paul

    2001-01-01

    .... The purpose of this study was to assess the imposed inspiratory work of breathing and breathing comfort of nonintubated healthy volunteers breathing spontaneously through three portable ventilators...

  1. SU-G-BRC-13: Model Based Classification for Optimal Position Selection for Left-Sided Breast Radiotherapy: Free Breathing, DIBH, Or Prone

    Energy Technology Data Exchange (ETDEWEB)

    Lin, H; Liu, T; Xu, X [Rensselaer Polytechnic Institute, Troy, NY (United States); Shi, C [Saint Vincent Medical Center, Bridgeport, CT (United States); Petillion, S; Kindts, I [University Hospitals Leuven, Leuven, Vlaams-Brabant (Belgium); Tang, X [Memorial Sloan Kettering Cancer Center, West Harrison, NY (United States)

    2016-06-15

    Purpose: There are clinical decision challenges to select optimal treatment positions for left-sided breast cancer patients—supine free breathing (FB), supine Deep Inspiration Breath Hold (DIBH) and prone free breathing (prone). Physicians often make the decision based on experiences and trials, which might not always result optimal OAR doses. We herein propose a mathematical model to predict the lowest OAR doses among these three positions, providing a quantitative tool for corresponding clinical decision. Methods: Patients were scanned in FB, DIBH, and prone positions under an IRB approved protocol. Tangential beam plans were generated for each position, and OAR doses were calculated. The position with least OAR doses is defined as the optimal position. The following features were extracted from each scan to build the model: heart, ipsilateral lung, breast volume, in-field heart, ipsilateral lung volume, distance between heart and target, laterality of heart, and dose to heart and ipsilateral lung. Principal Components Analysis (PCA) was applied to remove the co-linearity of the input data and also to lower the data dimensionality. Feature selection, another method to reduce dimensionality, was applied as a comparison. Support Vector Machine (SVM) was then used for classification. Thirtyseven patient data were acquired; up to now, five patient plans were available. K-fold cross validation was used to validate the accuracy of the classifier model with small training size. Results: The classification results and K-fold cross validation demonstrated the model is capable of predicting the optimal position for patients. The accuracy of K-fold cross validations has reached 80%. Compared to PCA, feature selection allows causal features of dose to be determined. This provides more clinical insights. Conclusion: The proposed classification system appeared to be feasible. We are generating plans for the rest of the 37 patient images, and more statistically significant

  2. Practical recommendations for breathing-adapted radiotherapy

    International Nuclear Information System (INIS)

    Simon, L.; Giraud, P.; Rosenwald, J.C.; Dumas, J.L.; Lorchel, F.; Marre, D.; Dupont, S.; Varmenot, N.; Ginestet, C.; Caron, J.; Marchesi, V.; Ferreira, I.; Garcia, R.

    2007-01-01

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  3. Improving the performance of AlGaN-based deep-ultraviolet light-emitting diodes using electron blocking layer with a heart-shaped graded Al composition

    Science.gov (United States)

    Kwon, M. R.; Park, T. H.; Lee, T. H.; Lee, B. R.; Kim, T. G.

    2018-04-01

    We propose a design for highly efficient AlGaN-based deep-ultraviolet light-emitting diodes (DUV LEDs) using a heart-shaped graded Al composition electron-blocking layer (EBL). This novel structure reduced downward band bending at the interface between the last quantum barrier and the EBL and flattened the electrostatic field in the interlayer between the barriers of the multi-quantum barrier EBL. Consequently, electron leakage was significantly suppressed and hole injection efficiency was found to have improved. The parameter values of simulation were extracted from the experimental data of the reference DUV LEDs. Using the SimuLED, we compared the electrical and optical properties of three structures with different Al compositions in the active region and the EBL. The internal quantum efficiency of the proposed structure was shown to exceed those of the reference DUV LEDs by a factor of 1.9. Additionally, the output power at 20 mA was found to increase by a factor of 2.1.

  4. Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension.

    Science.gov (United States)

    Ublosakka-Jones, Chulee; Tongdee, Phailin; Pachirat, Orathai; Jones, David A

    2018-03-28

    Hypertension and reduced lung function are important features of aging. Slow loaded breathing training reduces resting blood pressure and the question is whether this can also improve lung function. Thirty-two people (67 ± 5 years, 16 male) with controlled isolated systolic hypertension undertook an eight weeks randomised controlled training trial with an inspiratory load of 25% maximum inspiratory pressure (MIP) at 6 breaths per minute (slow loaded breathing; SLB) or deep breathing control (CON). Outcome measures were resting blood pressure (BP) and heart rate; MIP; lung capacity; chest and abdominal expansion; arm cranking exercise endurance at 50% heart rate reserve. Home based measurement of resting systolic BP decreased by 20 mm Hg (15 to 25) (Mean and 95%CI) for SLB and by 5 mm Hg (1 to 7) for CON. Heart rate and diastolic BP also decreased significantly for SLB but not CON. MIP increased by 15.8 cm H 2 O (11.8 to 19.8) and slow vital capacity by 0.21 L (0.15 to 0.27) for SLB but not for CON. Chest and abdominal expansion increased by 2.3 cm (2.05 to 2.55) and 2.5 cm (2.15 to 2.85), respectively for SLB and by 0.5 cm (0.26 to 0.74) and 1.7 cm (1.32 to 2.08) for CON. Arm exercise time increased by 4.9 min (3.65 to 5.15) for SLB with no significant change for CON. Slow inspiratory muscle training is not only effective in reducing resting BP, even in older people with well controlled isolated systolic hypertension but also increases inspiratory muscle strength, lung capacity and arm exercise duration. Copyright © 2018. Published by Elsevier Inc.

  5. Power spectral analysis of heart rate in hyperthyroidism.

    Science.gov (United States)

    Cacciatori, V; Bellavere, F; Pezzarossa, A; Dellera, A; Gemma, M L; Thomaseth, K; Castello, R; Moghetti, P; Muggeo, M

    1996-08-01

    The aim of the present study was to evaluate the impact of hyperthyroidism on the cardiovascular system by separately analyzing the sympathetic and parasympathetic influences on heart rate. Heart rate variability was evaluated by autoregressive power spectral analysis. This method allows a reliable quantification of the low frequency (LF) and high frequency (HF) components of the heart rate power spectral density; these are considered to be under mainly sympathetic and pure parasympathetic control, respectively. In 10 newly diagnosed untreated hyperthyroid patients with Graves' disease, we analyzed power spectral density of heart rate cyclic variations at rest, while lying, and while standing. In addition, heart rate variations during deep breathing, lying and standing, and Valsalva's maneuver were analyzed. The results were compared to those obtained from 10 age-, sex-, and body mass index-matched control subjects. In 8 hyperthyroid patients, the same evaluation was repeated after the induction of stable euthyroidism by methimazole. Heart rate power spectral analysis showed a sharp reduction of HF components in hyperthyroid subjects compared to controls [lying, 13.3 +/- 4.1 vs. 32.0 +/- 5.6 normalized units (NU; P hyperthyroid subjects while both lying (11.3 +/- 4.5 vs. 3.5 +/- 1.1; P hyperthyroid patients than in controls (1.12 +/- 0.03 vs. 1.31 +/- 0.04; P activity and, thus, a relative hypersympathetic tone.

  6. Breathing, feeding, and neuroprotection

    National Research Council Canada - National Science Library

    Homma, Ikuo; Shioda, S

    2006-01-01

    ... of knowledge of brain functions and morphology. Akiyoshi Hosoyamada, M.D., Ph.D. President Showa University, Tokyo 142-8555, Japan December 2005Preface Brain research is on the march, with several advanced technical developments and new findings uncovered almost daily. Within the brain-research fields, we focus on breathing, neuroprotection, an...

  7. Breathing Like a Fish

    Science.gov (United States)

    Katsioloudis, Petros J.

    2010-01-01

    Being able to dive and breathe underwater has been a challenge for thousands of years. In 1980, Fuji Systems of Tokyo developed a series of prototype gills for divers as a way of demonstrating just how good its membranes are. Even though gill technology has not yet reached the point where recipients can efficiently use implants to dive underwater,…

  8. Breathing difficulty - lying down

    Science.gov (United States)

    ... other conditions that lead to it) Panic disorder Sleep apnea Snoring Home Care Your health care provider may recommend self-care measures. For example, weight loss may be suggested if you are obese. When to Contact a Medical Professional If you have any unexplained difficulty in breathing ...

  9. The Breath of Chemistry

    DEFF Research Database (Denmark)

    Josephsen, Jens

    The present preliminary text is a short thematic presentation in biological inorganic chemistry meant to illustrate general and inorganic (especially coordination) chemistry in biochemistry. The emphasis is on molecular models to explain features of the complicated mechanisms essential to breathing...

  10. Mapleson's Breathing Systems.

    Science.gov (United States)

    Kaul, Tej K; Mittal, Geeta

    2013-09-01

    Mapleson breathing systems are used for delivering oxygen and anaesthetic agents and to eliminate carbon dioxide during anaesthesia. They consist of different components: Fresh gas flow, reservoir bag, breathing tubes, expiratory valve, and patient connection. There are five basic types of Mapleson system: A, B, C, D and E depending upon the different arrangements of these components. Mapleson F was added later. For adults, Mapleson A is the circuit of choice for spontaneous respiration where as Mapleson D and its Bains modifications are best available circuits for controlled ventilation. For neonates and paediatric patients Mapleson E and F (Jackson Rees modification) are the best circuits. In this review article, we will discuss the structure of the circuits and functional analysis of various types of Mapleson systems and their advantages and disadvantages.

  11. Learn More Breathe Better

    Centers for Disease Control (CDC) Podcasts

    2011-11-16

    Chronic obstructive pulmonary disease (COPD) is a serious lung disease that makes breathing very difficult and can affect your quality of life. Learn the causes of COPD and what you can do to prevent it.  Created: 11/16/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health (NCCDPHP, DACH).   Date Released: 11/16/2011.

  12. Cardiorespiratory and autonomic interactions during snoring related resistive breathing.

    Science.gov (United States)

    Mateika, J H; Mitru, G

    2001-03-15

    We hypothesized that blood pressure (BP) is less during snoring as compared to periods of non-snoring in non-apneic individuals. Furthermore, we hypothesized that this reduction may be accompanied by a simultaneous decrease in sympathetic (SNSA) and parasympathetic (PNSA) nervous system activity and an increase in heart rate (HR). N/A. N/A. N/A. The variables mentioned above in addition to breathing frequency were measured in 9 subjects during NREM sleep. In addition, the lowest systolic (SBP) and diastolic blood pressure (DBP) during inspiration and the highest SBP and DBP during expiration was determined breath-by-breath from segments selected from each NREM cycle. Heart rate variability was used as a marker of autonomic nervous system activity. Our results showed that BP during snoring decreased compared to non-snoring and the breath-by-breath BP analysis suggested that this difference may have been mediated by changes in intrathoracic pressure. In conjunction with the decrease in BP, SNSA decreased and HR increased however PNSA remained constant. Thus, a decrease in PNSA was likely not the primary mechanism responsible for the HR response. We conclude that BP responses and SNSA during snoring are similar to that reported previously in non-snoring individuals. However, the causal mechanisms maybe different and manifested in other measures such as HR. Thus, nocturnal cardiovascular and autonomic function maybe uniquely different in non-apneic snoring individuals.

  13. MRI-based volumetric assessment of cardiac anatomy and dose reduction via active breathing control during irradiation for left-sided breast cancer

    International Nuclear Information System (INIS)

    Krauss, Daniel J.; Kestin, Larry L.; Raff, Gilbert; Yan Di; Wong, John; Gentry, Ralph; Letts, Nicola; Vargas, Carlos E.; Martinez, Alvaro A.; Vicini, Frank A.

    2005-01-01

    Purpose: Heart dose-volume analysis using computed tomography (CT) is limited because of motion artifact and poor delineation between myocardium and ventricular space. We used dedicated cardiac magnetic resonance imaging (MRI) to quantify exclusion of left ventricular (LV) myocardium via active breathing control (ABC) during left breast irradiation and to determine the correlation between irradiated whole heart and LV volumes. Methods and materials: Fifteen patients who completed adjuvant irradiation for early-stage left breast cancer participated. Treatment consisted of 45 Gy to the entire breast using ABC followed by a 16-Gy electron boost to the lumpectomy cavity. Patients underwent planning CT scans in free breathing (FB) and moderate deep inspiration breath hold (mDIBH). Electrocardiogram-gated cardiac MRI was performed in the treatment position using α-cradle immobilization. MRI scans were acquired in late diastole (LD), mid-diastole (MD), and systole (S) for both FB and mDIBH. After image fusion with the patients' radiation therapy planning CT scan, MRI LV volumes were defined for the three examined phases of the cardiac cycle, and comparative dose-volume analysis was performed. Results: Cardiac volume definition was found to differ significantly because of combinations of respiratory and intrinsic heart motion. The fraction of LV myocardium receiving 50% (22.5 Gy) of the prescribed whole breast dose (V 22.5 ) was reduced by 85.3%, 91.8%, and 94.6% via ABC for LD, MD, and S, respectively. Linear regression revealed strong correlation between MRI-defined whole heart and LV V 22.5 reduction via ABC, suggesting that LV myocardium accounts for up to approximately 50% of the excluded heart volume through this technique. Significant but weaker correlations were noted between CT-defined whole heart and LV V 22.5 reductions with marked variability in the measurements of patients with larger amounts of heart in the treatment field. Conclusions: Cardiac MRI

  14. Feasibility and Diagnostic Accuracy of Whole Heart Coronary MR Angiography Using Free-Breathing 3D Balanced Turbo-Field-Echo with SENSE and the Half-Fourier Acquisition Technique

    International Nuclear Information System (INIS)

    Kim, Young Jin; Seo, Jae Seung; Choi, Byoung Wook; Choe, Kyu Ok; Jang, Yang Soo; Ko, Young Guk

    2006-01-01

    We wanted to assess the feasibility and diagnostic accuracy of whole heart coronary magnetic resonance angiography (MRA) with using 3D balanced turbo-field-echo (b-TFE) with SENSE and the half-Fourier acquisition technique for identifying stenoses of the coronary artery. Twenty-one patients who underwent both whole heart coronary MRA examinations and conventional catheter coronary angiography examinations were enrolled in the study. The whole heart coronary MRA images were acquired using a navigator gated 3D b-TFE sequence with SENSE and the half-Fourier acquisition technique to reduce the acquisition time. The imaging slab covered the whole heart (80 contiguous slices with a reconstructed slice thickness of 1.5 mm) along the transverse axis. The quality of the images was evaluated by using a 5-point scale (0 - uninterpretable, 1 - poor, 2 - fair, 3 - good, 4 - excellent). Ten coronary segments of the heart were evaluated in each case; the left main coronary artery (LM), and the proximal, middle and distal segments of the left anterior descending (LAD), the left circumflex (LCX) and the right coronary artery (RCA). The diagnostic accuracy of whole heart coronary MRA for detecting significant coronary artery stenosis was determined on the segment-bysegment basis, and it was compared with the results obtained by conventional catheter angiography, which is the gold standard. The mean image quality was 3.7 in the LM, 3.2 in the LAD, 2.5 in the LCX, and 3.3 in the RCA, respectively (the overall image quality was 3.0 ± 0.1). 168 (84%) of the 201 segments had an acceptable image quality (≥ grade 2). The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the whole heart coronary MRA images for detecting significant stenosis were 81.3%, 92.1%, 91.1%, 97.9%, and 52.0%, respectively. The mean coronary MRA acquisition time was 9 min 22 sec (± 125 sec). Whole heart coronary MRA is a feasible technique, and it has good potential to

  15. Dysfunctional breathing: a review of the literature and proposal for classification

    Directory of Open Access Journals (Sweden)

    Richard Boulding

    2016-09-01

    Full Text Available Dysfunctional breathing is a term describing breathing disorders where chronic changes in breathing pattern result in dyspnoea and other symptoms in the absence or in excess of the magnitude of physiological respiratory or cardiac disease. We reviewed the literature and propose a classification system for the common dysfunctional breathing patterns described. The literature was searched using the terms: dysfunctional breathing, hyperventilation, Nijmegen questionnaire and thoraco-abdominal asynchrony. We have summarised the presentation, assessment and treatment of dysfunctional breathing, and propose that the following system be used for classification. 1 Hyperventilation syndrome: associated with symptoms both related to respiratory alkalosis and independent of hypocapnia. 2 Periodic deep sighing: frequent sighing with an irregular breathing pattern. 3 Thoracic dominant breathing: can often manifest in somatic disease, if occurring without disease it may be considered dysfunctional and results in dyspnoea. 4 Forced abdominal expiration: these patients utilise inappropriate and excessive abdominal muscle contraction to aid expiration. 5 Thoraco-abdominal asynchrony: where there is delay between rib cage and abdominal contraction resulting in ineffective breathing mechanics. This review highlights the common abnormalities, current diagnostic methods and therapeutic implications in dysfunctional breathing. Future work should aim to further investigate the prevalence, clinical associations and treatment of these presentations.

  16. Impact of breath holding on cardiovascular respiratory and cerebrovascular health.

    Science.gov (United States)

    Dujic, Zeljko; Breskovic, Toni

    2012-06-01

    Human underwater breath-hold diving is a fascinating example of applied environmental physiology. In combination with swimming, it is one of the most popular forms of summer outdoor physical activities. It is performed by a variety of individuals ranging from elite breath-hold divers, underwater hockey and rugby players, synchronized and sprint swimmers, spear fishermen, sponge harvesters and up to recreational swimmers. Very few data currently exist concerning the influence of regular breath holding on possible health risks such as cerebrovascular, cardiovascular and respiratory diseases. A literature search of the PubMed electronic search engine using keywords 'breath-hold diving' and 'apnoea diving' was performed. This review focuses on recent advances in knowledge regarding possibly harmful physiological changes and/or potential health risks associated with breath-hold diving. Available evidence indicates that deep breath-hold dives can be very dangerous and can cause serious acute health problems such a collapse of the lungs, barotrauma at descent and ascent, pulmonary oedema and alveolar haemorrhage, cardiac arrest, blackouts, nitrogen narcosis, decompression sickness and death. Moreover, even shallow apnoea dives, which are far more frequent, can present a significant health risk. The state of affairs is disturbing as athletes, as well as recreational individuals, practice voluntary apnoea on a regular basis. Long-term health risks of frequent maximal breath holds are at present unknown, but should be addressed in future research. Clearly, further studies are needed to better understand the mechanisms related to the possible development or worsening of different clinical disorders in recreational or competitive breath holding and to determine the potential changes in training/competition regimens in order to prevent these adverse events.

  17. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  18. Breath-by-breath analysis of cardiorespiratory interaction for quantifying developmental maturity in premature infants

    Science.gov (United States)

    Rusin, Craig G.; Hudson, John L.; Lee, Hoshik; Delos, John B.; Guin, Lauren E.; Vergales, Brooke D.; Paget-Brown, Alix; Kattwinkel, John; Lake, Douglas E.; Moorman, J. Randall

    2012-01-01

    In healthy neonates, connections between the heart and lungs through brain stem chemosensory pathways and the autonomic nervous system result in cardiorespiratory synchronization. This interdependence between cardiac and respiratory dynamics can be difficult to measure because of intermittent signal quality in intensive care settings and variability of heart and breathing rates. We employed a phase-based measure suggested by Schäfer and coworkers (Schäfer C, Rosenblum MG, Kurths J, Abel HH. Nature 392: 239–240, 1998) to obtain a breath-by-breath analysis of cardiorespiratory interaction. This measure of cardiorespiratory interaction does not distinguish between cardiac control of respiration associated with cardioventilatory coupling and respiratory influences on the heart rate associated with respiratory sinus arrhythmia. We calculated, in sliding 4-min windows, the probability density of heartbeats as a function of the concurrent phase of the respiratory cycle. Probability density functions whose Shannon entropy had a interaction. In this way, we analyzed 18 infant-years of data from 1,202 patients in the Neonatal Intensive Care Unit at University of Virginia. We found evidence of interaction in 3.3 patient-years of data (18%). Cardiorespiratory interaction increased several-fold with postnatal development, but, surprisingly, the rate of increase was not affected by gestational age at birth. We find evidence for moderate correspondence between this measure of cardiorespiratory interaction and cardioventilatory coupling and no evidence for respiratory sinus arrhythmia, leading to the need for further investigation of the underlying mechanism. Such continuous measures of physiological interaction may serve to gauge developmental maturity in neonatal intensive care patients and prove useful in decisions about incipient illness and about hospital discharge. PMID:22174403

  19. Body composition variation following diaphragmatic breathing ...

    African Journals Online (AJOL)

    Body composition variation following diaphragmatic breathing. ... effect of commonly prescribed diaphragmatic breathing training on the body composition ... a non-exercising control (NE) group (n = 22) or diaphragmatic breathing (DB) group.

  20. BREATHE to Understand©

    Science.gov (United States)

    Swisa, Maxine

    2015-01-01

    BREATHE is an acronym for Breathe, Reflect, Empathize, Accept, Thank, Hearten, Engage. The addition of Understand allows for a holistic approach to living a healthy and balanced life both inside and outside the classroom. This paper took form as a result of my personal, spiritual journey, as well as my teaching practice. I noticed that the…

  1. Breath in the technoscientific imaginary.

    Science.gov (United States)

    Rose, Arthur

    2016-12-01

    Breath has a realist function in most artistic media. It serves to remind the reader, the viewer or the spectator of the exigencies of the body. In science fiction (SF) literature and films, breath is often a plot device for human encounters with otherness, either with alien peoples, who may not breathe oxygen, or environments, where there may not be oxygen to breathe. But while there is a technoscientific quality to breath in SF, especially in its attention to physiological systems, concentrating on the technoscientific threatens to occlude other, more affective aspects raised by the literature. In order to supplement the tendency to read SF as a succession of technoscientific accounts of bodily experience, this paper recalls how SF texts draw attention to the affective, non-scientific qualities of breath, both as a metonym for life and as a metaphor for anticipation. Through an engagement with diverse examples from SF literature and films, this article considers the tension between technoscientific and affective responses to breath in order to demonstrate breath's co-determinacy in SF's blending of scientific and artistic discourses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Patient's breath controls comfort devices

    Science.gov (United States)

    Schrader, M.; Carpenter, B.; Nichols, C. D.

    1972-01-01

    Patient assist system for totally disabled persons was developed which permits a person, so paralyzed as to be unable to move, to activate by breathing, a call system to summon assistance, turn the page of a book, ajust his bed, or do any one of a number of other things. System consists of patient assist control and breath actuated switch.

  3. Are Changes in Heart Rate Variability During Hypoglycemia Confounded by the Presence of Cardiovascular Autonomic Neuropathy in Patients with Diabetes?

    DEFF Research Database (Denmark)

    Cichosz, Simon Lebech; Frystyk, Jan; Tarnow, Lise

    2017-01-01

    BACKGROUND: We have recently shown how the combination of information from continuous glucose monitor (CGM) and heart rate variability (HRV) measurements can be used to construct an algorithm for prediction of hypoglycemia in both bedbound and active patients with type 1 diabetes (T1D). Questions...... with CGM and a Holter device while they performed normal daily activities. CAN was diagnosed using two cardiac reflex tests: (1) deep breathing and (2) orthostatic hypotension and end organ symptoms. Early CAN was defined as the presence of one abnormal reflex test and severe CAN was defined as two...

  4. FMWC Radar for Breath Detection

    DEFF Research Database (Denmark)

    Suhr, Lau Frejstrup; Tafur Monroy, Idelfonso; Vegas Olmos, Juan José

    We report on the experimental demonstration of an FMCW radar operating in the 25.7 - 26.6 GHz range with a repetition rate of 500 sweeps per second. The radar is able to track the breathing rate of an adult human from a distance of 1 meter. The experiments have utilized a 50 second recording window...... to accurately track the breathing rate. The radar utilizes a saw tooth modulation format and a low latency receiver. A breath tracking radar is useful both in medical scenarios, diagnosing disorders such as sleep apnea, and for home use where the user can monitor its health. Breathing is a central part of every...... radar chip which, through the use of a simple modulation scheme, is able to measure the breathing rate of an adult human from a distance. A high frequency output makes sure that the radar cannot penetrate solid obstacles which is a wanted feature in private homes where people therefore cannot measure...

  5. Breath of hospitality.

    Science.gov (United States)

    Škof, Lenart

    2016-12-01

    In this paper we outline the possibilities of an ethic of care based on our self-affection and subjectivity in the ethical spaces between-two. In this we first refer to three Irigarayan concepts - breath, silence and listening from the third phase of her philosophy, and discuss them within the methodological framework of an ethics of intersubjectivity and interiority. Together with attentiveness, we analyse them as four categories of our ethical becoming. Furthermore, we argue that self-affection is based on our inchoate receptivity for the needs of the other(s) and is thus dialectical in its character. In this we critically confront some epistemological views of our ethical becoming. We wind up this paper with a proposal for an ethics towards two autonomous subjects, based on care and our shared ethical becoming - both as signs of our deepest hospitality towards the other.

  6. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  7. Sleep-disordered breathing and mortality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naresh M Punjabi

    2009-08-01

    Full Text Available Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older.We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women died. Compared to those without sleep-disordered breathing (AHI: or=30.0 events/h sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08, 1.17 (95% CI: 0.97-1.42, and 1.46 (95% CI: 1.14-1.86, respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33. Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality.Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the article for the Editors' Summary.

  8. Comparison of spontaneous vs. metronome-guided breathing on assessment of vagal modulation using RR variability.

    Science.gov (United States)

    Bloomfield, D M; Magnano, A; Bigger, J T; Rivadeneira, H; Parides, M; Steinman, R C

    2001-03-01

    R-R interval variability (RR variability) is increasingly being used as an index of autonomic activity. High-frequency (HF) power reflects vagal modulation of the sinus node. Since vagal modulation occurs at the respiratory frequency, some investigators have suggested that HF power cannot be interpreted unless the breathing rate is controlled. We hypothesized that HF power during spontaneous breathing would not differ significantly from HF power during metronome-guided breathing. We measured HF power during spontaneous breathing in 20 healthy subjects and 19 patients with heart disease. Each subject's spontaneous breathing rate was determined, and the calculation of HF power was repeated with a metronome set to his or her average spontaneous breathing rate. There was no significant difference between the logarithm of HF power measured during spontaneous and metronome-guided breathing [4.88 +/- 0.29 vs. 5.29 +/- 0.30 ln(ms(2)), P = 0.32] in the group as a whole and when patients and healthy subjects were examined separately. We did observe a small (9.9%) decrease in HF power with increasing metronome-guided breathing rates (from 9 to 20 breaths/min). These data indicate that HF power during spontaneous and metronome-guided breathing differs at most by very small amounts. This variability is several logarithmic units less than the wide discrepancies observed between healthy subjects and cardiac patients with a heterogeneous group of cardiovascular disorders. In addition, HF power is relatively constant across the range of typical breathing rates. These data indicate that there is no need to control breathing rate to interpret HF power when RR variability (and specifically HF power) is used to identify high-risk cardiac patients.

  9. How to breathe when you are short of breath

    Science.gov (United States)

    ... you: Watch TV Use your computer Read a newspaper How to do Pursed lip Breathing The steps ... of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also ...

  10. MO-FG-BRA-02: A Feasibility Study of Integrating Breathing Audio Signal with Surface Surrogates for Respiratory Motion Management

    Energy Technology Data Exchange (ETDEWEB)

    Lei, Y; Zhu, X; Zheng, D; Li, S; Ma, R; Zhang, M; Fan, Q; Wang, X; Verma, V; Zhou, S [University of Nebraska Medical Center, Omaha, NE (United States); Tang, X [Memorial Sloan Kettering Cancer Center, West Harrison, NY (United States)

    2016-06-15

    Purpose: Tracking the surrogate placed on patient skin surface sometimes leads to problematic signals for certain patients, such as shallow breathers. This in turn impairs the 4D CT image quality and dosimetric accuracy. In this pilot study, we explored the feasibility of monitoring human breathing motion by integrating breathing sound signal with surface surrogates. Methods: The breathing sound signals were acquired though a microphone attached adjacently to volunteer’s nostrils, and breathing curve were analyzed using a low pass filter. Simultaneously, the Real-time Position Management™ (RPM) system from Varian were employed on a volunteer to monitor respiratory motion including both shallow and deep breath modes. The similar experiment was performed by using Calypso system, and three beacons taped on volunteer abdominal region to capture breath motion. The period of each breathing curves were calculated with autocorrelation functions. The coherence and consistency between breathing signals using different acquisition methods were examined. Results: Clear breathing patterns were revealed by the sound signal which was coherent with the signal obtained from both the RPM system and Calypso system. For shallow breathing, the periods of breathing cycle were 3.00±0.19 sec (sound) and 3.00±0.21 sec (RPM); For deep breathing, the periods were 3.49± 0.11 sec (sound) and 3.49±0.12 sec (RPM). Compared with 4.54±0.66 sec period recorded by the calypso system, the sound measured 4.64±0.54 sec. The additional signal from sound could be supplement to the surface monitoring, and provide new parameters to model the hysteresis lung motion. Conclusion: Our preliminary study shows that the breathing sound signal can provide a comparable way as the RPM system to evaluate the respiratory motion. It’s instantaneous and robust characteristics facilitate it possibly to be a either independently or as auxiliary methods to manage respiratory motion in radiotherapy.

  11. MO-FG-BRA-02: A Feasibility Study of Integrating Breathing Audio Signal with Surface Surrogates for Respiratory Motion Management

    International Nuclear Information System (INIS)

    Lei, Y; Zhu, X; Zheng, D; Li, S; Ma, R; Zhang, M; Fan, Q; Wang, X; Verma, V; Zhou, S; Tang, X

    2016-01-01

    Purpose: Tracking the surrogate placed on patient skin surface sometimes leads to problematic signals for certain patients, such as shallow breathers. This in turn impairs the 4D CT image quality and dosimetric accuracy. In this pilot study, we explored the feasibility of monitoring human breathing motion by integrating breathing sound signal with surface surrogates. Methods: The breathing sound signals were acquired though a microphone attached adjacently to volunteer’s nostrils, and breathing curve were analyzed using a low pass filter. Simultaneously, the Real-time Position Management™ (RPM) system from Varian were employed on a volunteer to monitor respiratory motion including both shallow and deep breath modes. The similar experiment was performed by using Calypso system, and three beacons taped on volunteer abdominal region to capture breath motion. The period of each breathing curves were calculated with autocorrelation functions. The coherence and consistency between breathing signals using different acquisition methods were examined. Results: Clear breathing patterns were revealed by the sound signal which was coherent with the signal obtained from both the RPM system and Calypso system. For shallow breathing, the periods of breathing cycle were 3.00±0.19 sec (sound) and 3.00±0.21 sec (RPM); For deep breathing, the periods were 3.49± 0.11 sec (sound) and 3.49±0.12 sec (RPM). Compared with 4.54±0.66 sec period recorded by the calypso system, the sound measured 4.64±0.54 sec. The additional signal from sound could be supplement to the surface monitoring, and provide new parameters to model the hysteresis lung motion. Conclusion: Our preliminary study shows that the breathing sound signal can provide a comparable way as the RPM system to evaluate the respiratory motion. It’s instantaneous and robust characteristics facilitate it possibly to be a either independently or as auxiliary methods to manage respiratory motion in radiotherapy.

  12. Autonomic control of the heart in the Asian swamp eel (Monopterus albus)

    DEFF Research Database (Denmark)

    Iversen, Nina Kerting; Huong, Do Thi Thanh; Bayley, Mark

    2011-01-01

    The Asian swamp eel (Monopterus albus) is an air-breathing teleost with very reduced gills that uses the buccal cavity for air-breathing. Here we characterise the cardiovascular changes associated with the intermittent breathing pattern in M. albus and we study the autonomic control of the heart.......3 cm H2O). The autonomic control of the heart during water- and air-breathing was revealed by infusion of the β-adrenergic antagonist propranolol and muscarinic antagonist atropine (3 mg kg− 1) in eels instrumented with an arterial catheter. Inhibition of the sympathetic and parasympathetic...... innervations of the heart revealed a strong vagal tone on the heart of water-breathing eels and that the tachycardia during air-breathing is primarily mediated by withdrawal of cholinergic tone....

  13. Visualizing Breath using Digital Holography

    Science.gov (United States)

    Hobson, P. R.; Reid, I. D.; Wilton, J. B.

    2013-02-01

    Artist Jayne Wilton and physicists Peter Hobson and Ivan Reid of Brunel University are collaborating at Brunel University on a project which aims to use a range of techniques to make visible the normally invisible dynamics of the breath and the verbal and non-verbal communication it facilitates. The breath is a source of a wide range of chemical, auditory and physical exchanges with the direct environment. Digital Holography is being investigated to enable a visually stimulating articulation of the physical trajectory of the breath as it leaves the mouth. Initial findings of this research are presented. Real time digital hologram replay allows the audience to move through holographs of breath-born particles.

  14. Heart murmurs

    Science.gov (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  15. Blue breath holding is benign.

    OpenAIRE

    Stephenson, J B

    1991-01-01

    In their recent publication in this journal, Southall et al described typical cyanotic breath holding spells, both in otherwise healthy children and in those with brainstem lesions and other malformations. Their suggestions regarding possible autonomic disturbances may require further study, but they have adduced no scientific evidence to contradict the accepted view that in the intact child blue breath holding spells are benign. Those families in which an infant suffers an 'apparently life t...

  16. Effects of age and physical activity on the autonomic control of heart rate in healthy men

    Directory of Open Access Journals (Sweden)

    R.C. Melo

    2005-09-01

    Full Text Available The effects of the aging process and an active life-style on the autonomic control of heart rate (HR were investigated in nine young sedentary (YS, 23 ± 2.4 years, 16 young active (YA, 22 ± 2.1 years, 8 older sedentary (OS, 63 ± 2.4 years and 8 older active (OA, 61 ± 1.1 years healthy men. Electrocardiogram was continuously recorded for 15 min at rest and for 4 min in the deep breathing test, with a breath rate of 5 to 6 cycles/min in the supine position. Resting HR and RR intervals were analyzed by time (RMSSD index and frequency domain methods. The power spectral components are reported in normalized units (nu at low (LF and high (HF frequency, and as the LF/HF ratio. The deep breathing test was analyzed by the respiratory sinus arrhythmia indices: expiration/inspiration ratio (E/I and inspiration-expiration difference (deltaIE. The active groups had lower HR and higher RMSSD index than the sedentary groups (life-style condition: sedentary vs active, P < 0.05. The older groups showed lower HFnu, higher LFnu and higher LF/HF ratio than the young groups (aging effect: young vs older, P < 0.05. The OS group had a lower E/I ratio (1.16 and deltaIE (9.7 bpm than the other groups studied (YS: 1.38, 22.4 bpm; YA: 1.40, 21.3 bpm; OA: 1.38, 18.5 bpm. The interaction between aging and life-style effects had a P < 0.05. These results suggest that aging reduces HR variability. However, regular physical activity positively affects vagal activity on the heart and consequently attenuates the effects of aging in the autonomic control of HR.

  17. An Acute Bout of a Controlled Breathing Frequency Lowers Sympathetic Neural Outflow but not Blood Pressure in Healthy Normotensive Subjects

    Science.gov (United States)

    MCCLAIN, SHANNON L.; BROOKS, ALEXA M.; JARVIS, SARA S.

    2017-01-01

    Controlled or paced breathing is often used as a stress reduction technique but the impact on blood pressure (BP) and sympathetic outflow have not been consistently reported. The purpose of this study was to determine whether a controlled breathing (12 breaths/min, CB) rate would be similar to an individual’s spontaneous breathing (SB) rate. Secondly, would a CB rate of 12 breaths/min alter heart rate (HR), BP, and indices of muscle sympathetic nerve activity (MSNA). Twenty-one subjects (10 women, 11 men) performed two trials: SB, where the subject chose a comfortable breathing rate; and CB, where the subject breathed at a pace of 12 breaths/min. Each trial was 6 min during which respiratory waveforms, HR, BP (systolic, SBP; diastolic, DBP), and MSNA were recorded. During CB, the 6 min average breathing frequency (14±4 vs 12±1 breaths/min, P<0.05 for SB and CB, respectively), MSNA burst frequency (18±12 vs 14±10 bursts/min, P<0.01) and MSNA burst incidence (28±19 vs 21± 6 bursts/100 heart beats, P<0.01) were significantly lower than during SB. HR (66±9 vs 67±9 beats/min, P<0.05) was higher during CB. SBP (120±13 vs 121±15 mmHg, P=0.741), DBP (56±8 vs 57±9 mmHg, P=0.768), and MSNA total activity (166±94 vs 145±102 a.u./min, P=0.145) were not different between the breathing conditions. In conclusion, an acute reduction in breathing frequency such as that observed during CB elicited a decrease in indices of MSNA (burst frequency and incidence) with no change in BP. PMID:28344733

  18. Simultaneous measurement of instantaneous heart rate and chest wall plethysmography in short-term, metronome guided heart rate variability studies: suitability for assessment of autonomic dysfunction.

    Science.gov (United States)

    Perring, S; Jones, E

    2003-08-01

    Instantaneous heart rate and chest wall motion were measured using a 3-lead ECG and an air pressure chest wall plethysmography system. Chest wall plethysmography traces were found to accurately represent the breathing pattern as measured by spirometry (average correlation coefficient 0.944); though no attempt was made to calibrate plethysmography voltage output to tidal volume. Simultaneous measurements of heart rate and chest wall motion were made for short periods under metronome guided breathing at 6 breaths per minute. The average peak to trough heart rate change per breath cycle (AVEMAX) and maximum correlation between heart rate and breathing cycle (HRBRCORR) were measured. Studies of 44 normal volunteers indicated clear inverse correlation of heart rate variability parameters with age (AVEMAX R = -0.502, P < 0.001) but no significant change in HRBRCORR with age (R = -0.115). Comparison of normal volunteers with diabetics with no history of symptoms associated with autonomic failure indicated significant lower heart rate variability in diabetics (P = 0.005 for AVEMAX) and significantly worse correlation between heart rate and breathing (P < 0.001 for HRBRCORR). Simultaneous measurement of heart rate and breathing offers the possibility of more sensitive diagnosis of autonomic failure in a simple bedside test and gives further insight into the nature of cardio-ventilatory coupling.

  19. Rationale and design of the SERVE-HF study: treatment of sleep-disordered breathing with predominant central sleep apnoea with adaptive servo-ventilation in patients with chronic heart failure.

    Science.gov (United States)

    Cowie, Martin R; Woehrle, Holger; Wegscheider, Karl; Angermann, Christiane; d'Ortho, Marie-Pia; Erdmann, Erland; Levy, Patrick; Simonds, Anita; Somers, Virend K; Zannad, Faiez; Teschler, Helmut

    2013-08-01

    Central sleep apnoea/Cheyne-Stokes respiration (CSA/CSR) is a risk factor for increased mortality and morbidity in heart failure (HF). Adaptive servo-ventilation (ASV) is a non-invasive ventilation modality for the treatment of CSA/CSR in patients with HF. SERVE-HF is a multinational, multicentre, randomized, parallel trial designed to assess the effects of addition of ASV (PaceWave, AutoSet CS; ResMed) to optimal medical management compared with medical management alone (control group) in patients with symptomatic chronic HF, LVEF ≤45%, and predominant CSA. The trial is based on an event-driven group sequential design, and the final analysis will be performed when 651 events have been observed or the study is terminated at one of the two interim analyses. The aim is to randomize ∼1200 patients to be followed for a minimum of 2 years. Patients are to stay in the trial up to study termination. The first patient was randomized in February 2008 and the study is expected to end mid 2015. The primary combined endpoint is the time to first event of all-cause death, unplanned hospitalization (or unplanned prolongation of a planned hospitalization) for worsening (chronic) HF, cardiac transplantation, resuscitation of sudden cardiac arrest, or appropriate life-saving shock for ventricular fibrillation or fast ventricular tachycardia in implantable cardioverter defibrillator patients. The SERVE-HF study is a randomized study that will provide important data on the effect of treatment with ASV on morbidity and mortality, as well as the cost-effectiveness of this therapy, in patients with chronic HF and predominantly CSA/CSR. ISRCTN19572887.

  20. Breath-hold duration in man and the diving response induced by face immersion.

    Science.gov (United States)

    Sterba, J A; Lundgren, C E

    1988-09-01

    The objective of this study in 5 selected volunteer subjects was to see whether the circulatory diving response which is elicited by breath holding and by cold water on the face would affect the duration of maximal-effort breath holds. Compared to control measurements (breath holding during resting, breathing with 35 degrees C water on the face) breath holding with the face cooled by 20 degrees C water caused a 12% reduction of heart rate, 6% reduction of cardiac output, 33% reduction in [corrected] forearm blood flow, and 9% rise in mean arterial blood pressure, but there was no difference in breath-hold duration (control and experimental both 94 s). There were also no differences in time of appearance of the first involuntary respiratory efforts during breath holding, in alveolar gas exchange, or in breaking-point alveolar O2 and CO2 tensions. When the diving response was magnified by a brief bout of exercise so that there was a 19% [corrected] reduction in heart rate, 23% reduction in cardiac output, and 48% reduction in forearm blood flow, breath-hold duration was still unaffected by face cooling. Compared to intermittent immersions, continuous exposure of the face to cold water abolished the diving response, probably by a cold adaptation of facial thermal receptors. These results with cooling of the face only are consistent with our earlier finding that there was a negative correlation between the duration of a maximal-effort breath hold and the diving response during whole-body submersion in cold water.

  1. Enlarged Heart

    Science.gov (United States)

    ... rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge. Disease of the heart ...

  2. Quantification of volatile organic compounds in exhaled human breath. Acetonitrile as biomarker for passive smoking. Model for isoprene in human breath

    International Nuclear Information System (INIS)

    Prazeller, P.

    2000-03-01

    concentration increases within a few seconds after starting exercise or awakening during the night as a result of a rapid increase in heart rate, and then reaches a lower steady state when breath rate stabilizes. A gas exchange model was developed and shows excellent fit to breath isoprene measured during exercise. We demonstrated that atorvastatin therapy leads to a decrease in serum cholesterol and LDL levels and a parallel decrease in breath isoprene levels. This work suggests that there is constant endogenous production of isoprene during the day and night, and reaffirms the possibility that breath isoprene can be a non-invasive marker of cholesterologenesis, if care is taken to measure breath isoprene under standard conditions. The third part of the thesis presents results out of the field of food chemistry. The effectiveness of thermal deactivation of the enzyme allinase is demonstrated using breath analysis after eating garlic. With highly time resolved measurements we succeeded in monitoring reactions occurring when garlic is crushed and in distinguishing between aerobic and anaerobic steps. (author)

  3. Radiotherapy of lung cancer: the inspiration breath hold with a spirometric monitoring

    International Nuclear Information System (INIS)

    Garcia, R.; Oozeer, R.; Le Thanh, H.; Chastel, D.; Doyen, J.C.; Chauvet, B.; Reboul, F.

    2002-01-01

    A CT acquisition during a free breathing examination generates images of poor quality. It creates an uncertainty on the reconstructed gross tumour volume and dose distribution. The aim of this study is to test the feasibility of a breath hold method applied in all preparation and treatment days. Five patients received a thoracic radiotherapy with the benefit of this procedure. The breathing of the patient was measured with a spirometer. The patient was coached to reproduce a constant level of breath-hold in a deep inspiration. Video glasses helped the patients to fix the breath-hold at the reference level. The patients followed the coaching during preparation and treatment, without any difficulty. The better quality of the CT reconstructed images resulted in an easier contouring. No movements of the gross tumour volume lead to a better coverage. The deep breath hold decreased the volume of irradiated lung. This method improves the reproducibility of the thoracic irradiation. The decrease of irradiated lung volume offers prospects in dose escalation and intensity modulation radiotherapy. (authors)

  4. Take a Deep Breath (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-11-24

    Chronic obstructive pulmonary disease, or COPD, is a common condition in the United States. In this podcast, Dr. Anne Wheaton discusses COPD.  Created: 11/24/2016 by MMWR.   Date Released: 11/24/2016.

  5. Oral breathing and speech disorders in children

    Directory of Open Access Journals (Sweden)

    Silvia F. Hitos

    2013-07-01

    Conclusion: Mouth breathing can affect speech development, socialization, and school performance. Early detection of mouth breathing is essential to prevent and minimize its negative effects on the overall development of individuals.

  6. Can bats sense smoke during deep torpor?

    Science.gov (United States)

    Doty, Anna C; Currie, Shannon E; Stawski, Clare; Geiser, Fritz

    2018-03-01

    While torpor is a beneficial energy-saving strategy, it may incur costs if an animal is unable to respond appropriately to external stimuli, which is particularly true when it is necessary to escape from threats such as fire. We aimed to determine whether torpid bats, which are potentially threatened because they must fly to escape, can sense smoke and whether respiration rate (RR), heart rate (HR) and reaction time of torpid bats prior to and following smoke introduction is temperature-dependent. To test this we quantified RR and HR of captive Australian tree-roosting bats, Nyctophilus gouldi (n=5, ~10g), in steady-state torpor in response to short-term exposure to smoke from Eucalyptus spp. leaves between ambient temperatures (T a ) of 11 and 23°C. Bats at lower T a took significantly longer (28-fold) to respond to smoke, indicated by a cessation of episodic breathing and a rapid increase in RR. Bats at lower T a returned to torpor more swiftly following smoke exposure than bats at higher T a . Interestingly, bats at T a <15°C never returned to thermoconforming steady-state torpor prior to the end of the experimental day, whereas all bats at T a ≥15°C did, as indicated by apnoeic HR. This shows that although bats at lower T a took longer to respond, they appear to maintain vigilance and prevent deep torpor after the first smoke exposure, likely to enable fast escape. Our study reveals that bats can respond to smoke stimuli while in deep torpor. These results are particularly vital within the framework of fire management conducted at T a <15°C, as most management burns are undertaken during winter when bats will likely respond more slowly to fire cues such as smoke, delaying the time to escape from the fire. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. eAMI: A Qualitative Quantification of Periodic Breathing Based on Amplitude of Oscillations

    Science.gov (United States)

    Fernandez Tellez, Helio; Pattyn, Nathalie; Mairesse, Olivier; Dolenc-Groselj, Leja; Eiken, Ola; Mekjavic, Igor B.; Migeotte, P. F.; Macdonald-Nethercott, Eoin; Meeusen, Romain; Neyt, Xavier

    2015-01-01

    Study Objectives: Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). Patients or Participants: Antarctic cohort (3,800 meters): 13 normal individuals. Clinical cohort: 39 different patients suffering from diverse sleep-related pathologies. Measurements and Results: When tested in a population with high levels of periodic breathing (Antarctic cohort), eAMI was closely correlated with AHI (r = 0.95, P Dolenc-Groselj L, Eiken O, Mekjavic IB, Migeotte PF, Macdonald-Nethercott E, Meeusen R, Neyt X. eAMI: a qualitative quantification of periodic breathing based on amplitude of oscillations. SLEEP 2015;38(3):381–389. PMID:25581914

  8. Volatile sulphur compounds in morning breath of human volunteers.

    NARCIS (Netherlands)

    Snel, J.; Burgering, M.; Smit, B.; Noordman, W.; Tangerman, A.; Winkel, E.G.; Kleerebezem, M.

    2011-01-01

    OBJECTIVE: morning breath contains elevated concentrations of volatile sulphur components (VSCs). Therefore, morning breath is recognised as a surrogate target for interventions on breath quality. Nevertheless, factors influencing morning breath are poorly understood. Our aim was to evaluate

  9. Volatile sulphur compounds in morning breath of human volunteers

    NARCIS (Netherlands)

    Snel, Johannes; Burgering, Maurits; Smit, Bart; Noordman, Wouter; Tangerman, Albert; Winkel, Edwin G.; Kleerebezem, Michiel

    Objective: Morning breath contains elevated concentrations of volatile sulphur components (VSCs). Therefore, morning breath is recognised as a surrogate target for interventions on breath quality. Nevertheless, factors influencing morning breath are poorly understood. Our aim was to evaluate

  10. Air-breathing fishes in aquaculture. What can we learn from physiology?

    Science.gov (United States)

    Lefevre, S; Wang, T; Jensen, A; Cong, N V; Huong, D T T; Phuong, N T; Bayley, M

    2014-03-01

    During the past decade, the culture of air-breathing fish species has increased dramatically and is now a significant global source of protein for human consumption. This development has generated a need for specific information on how to maximize growth and minimize the environmental effect of culture systems. Here, the existing data on metabolism in air-breathing fishes are reviewed, with the aim of shedding new light on the oxygen requirements of air-breathing fishes in aquaculture, reaching the conclusion that aquatic oxygenation is much more important than previously assumed. In addition, the possible effects on growth of the recurrent exposure to deep hypoxia and associated elevated concentrations of carbon dioxide, ammonia and nitrite, that occurs in the culture ponds used for air-breathing fishes, are discussed. Where data on air-breathing fishes are simply lacking, data for a few water-breathing species will be reviewed, to put the physiological effects into a growth perspective. It is argued that an understanding of air-breathing fishes' respiratory physiology, including metabolic rate, partitioning of oxygen uptake from air and water in facultative air breathers, the critical oxygen tension, can provide important input for the optimization of culture practices. Given the growing importance of air breathers in aquaculture production, there is an urgent need for further data on these issues. © 2014 The Fisheries Society of the British Isles.

  11. Periaqueductal Gray Control of Breathing

    NARCIS (Netherlands)

    Subramanian, Hari H.; Holstege, Gert; Homma,; Onimaru, H; Fukuchi, Y

    2010-01-01

    Change of the basic respiratory rhythm (eupnea) is a pre-requisite for survival. For example, sudden escape from danger needs rapid shallow breathing, strenuous exercise requires tachypnea for sufficient supply of oxygen and a strong anxiety reaction necessitates gasping. Also for vocalization (and

  12. Relationships between breath ratios, spirituality and health ...

    African Journals Online (AJOL)

    The aim of this retrospective, quantitative study was to investigate relationships between breath ratios, spirituality perceptions and health perceptions, with special reference to breath ratios that best predict optimal health and spirituality. Significant negative correlations were found between breath ratios and spirituality ...

  13. Liquid breathing - Prevention of pulmonary arterial-venous shunting during acceleration.

    Science.gov (United States)

    Sass, D. J.; Ritman, E. L.; Caskey, P. E.; Banchero, N.; Wood, E. H.

    1972-01-01

    Dependent pulmonary atelectasis, arterial-venous shunting, and downward displacement of the heart caused by the gravitational-inertial force environment were prevented in dogs breathing oxygenated liquid fluorocarbon in a whole-body water-immersion respirator. Partial closure of the major airways during part of the expiratory phase of liquid respiration was a significant problem initially but was minimized in subsequent studies.

  14. Use of an Impedance Threshold Device in Spontaneously Breathing Patients with Hypotension Secondary to Trauma: An Observational Cohort Feasibility Study

    Science.gov (United States)

    2014-09-09

    hypotensive patient. Crystalloid infusion is not necessarily benign.1,2 Difficult vascular access, hemodilution, acidosis , decreased oxygen delivery, and...blood pressure, heart rate (HR), respiratory rate, and arterial oxygen saturation (SpO2) were recorded im- mediately before application of the ITD...per minute (p = 0.007). The respiratory rate was constant: 19 (7) breaths before to 18 (4) breaths (p = 0.31) per minute after ITD use. Oxygen

  15. Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing.

    Science.gov (United States)

    Jahani, Nariman; Choi, Sanghun; Choi, Jiwoong; Iyer, Krishna; Hoffman, Eric A; Lin, Ching-Long

    2015-11-15

    This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R(2) ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs. Copyright © 2015 the American Physiological Society.

  16. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure.

    Science.gov (United States)

    Porciello, F; Rishniw, M; Ljungvall, I; Ferasin, L; Haggstrom, J; Ohad, D G

    2016-01-01

    Sleeping and resting respiratory rates (SRR and RRR, respectively) are commonly used to monitor dogs and cats with left-sided cardiac disease and to identify animals with left-sided congestive heart failure (L-CHF). Dogs and cats with subclinical heart disease have SRRmean values dogs and cats with CHF that is well controlled with medical therapy. In this study, SRR and RRR were measured by the owners of 51 dogs and 22 cats with stable, well-controlled CHF. Median canine SRRmean was 20 breaths/min (7-39 breaths/min); eight dogs were ≥25 breaths/min and one dog only was ≥30 breaths/min. Canine SRRmean was unrelated to pulmonary hypertension or diuretic dose. Median feline SRRmean was 20 breaths/min (13-31 breaths/min); four cats were ≥25 breaths/min and only one cat was ≥30 breaths/min. Feline SRRmean was unrelated to diuretic dose. SRR remained stable during collection in both species with little day-to-day variability. The median canine RRRmean was 24 breaths/min (12-44 breaths/min), 17 were ≥25 breaths/min, seven were ≥30 breaths/min, two were >40 breaths/min. Median feline RRRmean was 24 breaths/min (15-45 breaths/min); five cats had RRRmean ≥25 breaths/min; one had ≥30 breaths/min, and two had ≥40 breaths/min. These data suggest that most dogs and cats with CHF that is medically well-controlled and stable have SRRmean and RRRmean dogs and cats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Analysis of Exhaled Breath for Disease Detection

    Science.gov (United States)

    Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

    2014-06-01

    Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

  18. Comparação entre exercícios de respiração profunda e espirometria de incentivo no pós-operatório de cirurgia de revascularização do miocárdio Comparison between deep breathing exercises and incentive spirometry after CABG surgery

    Directory of Open Access Journals (Sweden)

    Julia Alencar Renault

    2009-06-01

    Full Text Available OBJETIVO: Comparar os efeitos dos exercícios de respiração profunda (ERP e espirômetro de incentivo a fluxo (EI em pacientes submetidos a cirurgia de revascularização do miocárdio (CRVM por meio das seguintes variáveis: capacidade vital forçada - CVF, volume expiratório forçado de primeiro segundo - VEF1, pressões respiratórias máximas e saturação de oxigênio. MÉTODOS: Trinta e seis pacientes foram submetidos a aplicação de ventilação não-invasiva por dois períodos de 30 minutos durante as primeiras 24 horas pós-extubação e distribuídos randomicamente em dois grupos, a saber: ERP (n=18 e EI (n=18, sendo as variáveis espirométricas avaliadas no pré-operatório e sétimo dia pós-operatório (DPO e a força da musculatura respiratória e saturação de oxigênio no pré-operatório, primeiro, segundo e sétimo DPO. RESULTADOS: Os grupos foram considerados homogêneos em relação às variáveis demográficas e cirúrgicas. Observouse queda dos valores referentes à CVF e VEF1 entre o préoperatório e o sétimo DPO, porém sem diferença estatística entre os grupos. Houve queda das pressões respiratórias máximas no primeiro DPO, mas com restabelecimento gradual e parcial até o sétimo DPO, também sem diferença estatística entre os grupos. A saturação de oxigênio foi a única variável restabelecida no sétimo DPO, mas também sem diferença estatística entre os grupos. CONCLUSÃO: Não foram observadas diferenças significativas nas pressões respiratórias máximas, variáveis espirométricas e saturação de oxigênio entre pacientes submetidos a exercícios de respiração profunda e espirometria de incentivo no pós-operatório de cirurgia de revascularização miocárdica.OBJECTIVE: To compare the effects of deep breathing exercises (DBE and the flow-oriented incentive spirometry (IS in patients undergone coronary artery bypass grafting (CABG through the following variables: forced vital capacity

  19. The assessment of the breath hold and the free breath methods about the blood flow evaluation by using phase contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho [Dept. of Radiology, Konkuk Medical center, Seoul (Korea, Republic of)

    2016-06-15

    Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/ velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were 96.17±19.12 ml/sec, 17.04±4.12 cm/sec respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of 72.31±13.27 ml and 12.32±3.85. On the other hand, the average 2NEX blood flow and mean flow velocity is 101.90±24.09, 16.84±4.32, 3NEX 103.06±25.49, 16.88±4.19 did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were 76.68±19.72 ml/s, and 22.23±4.8, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

  20. Mapleson′s breathing systems

    Directory of Open Access Journals (Sweden)

    Tej K Kaul

    2013-01-01

    Full Text Available Mapleson breathing systems are used for delivering oxygen and anaesthetic agents and to eliminate carbon dioxide during anaesthesia. They consist of different components: Fresh gas flow, reservoir bag, breathing tubes, expiratory valve, and patient connection. There are five basic types of Mapleson system: A, B, C, D and E depending upon the different arrangements of these components. Mapleson F was added later. For adults, Mapleson A is the circuit of choice for spontaneous respiration where as Mapleson D and its Bains modifications are best available circuits for controlled ventilation. For neonates and paediatric patients Mapleson E and F (Jackson Rees modification are the best circuits. In this review article, we will discuss the structure of the circuits and functional analysis of various types of Mapleson systems and their advantages and disadvantages.

  1. Running and Breathing in Mammals

    Science.gov (United States)

    Bramble, Dennis M.; Carrier, David R.

    1983-01-01

    Mechanical constraints appear to require that locomotion and breathing be synchronized in running mammals. Phase locking of limb and respiratory frequency has now been recorded during treadmill running in jackrabbits and during locomotion on solid ground in dogs, horses, and humans. Quadrupedal species normally synchronize the locomotor and respiratory cycles at a constant ratio of 1:1 (strides per breath) in both the trot and gallop. Human runners differ from quadrupeds in that while running they employ several phase-locked patterns (4:1, 3:1, 2:1, 1:1, 5:2, and 3:2), although a 2:1 coupling ratio appears to be favored. Even though the evolution of bipedal gait has reduced the mechanical constraints on respiration in man, thereby permitting greater flexibility in breathing pattern, it has seemingly not eliminated the need for the synchronization of respiration and body motion during sustained running. Flying birds have independently achieved phase-locked locomotor and respiratory cycles. This hints that strict locomotor-respiratory coupling may be a vital factor in the sustained aerobic exercise of endothermic vertebrates, especially those in which the stresses of locomotion tend to deform the thoracic complex.

  2. New insights into gill chemoreception: receptor distribution and roles in water and air breathing fish.

    Science.gov (United States)

    Milsom, William K

    2012-12-01

    The location (gills, oro-branchial cavity or elsewhere) and orientation (external (water) or internal (blood) sensing) of the receptors involved in reflex changes in each of the different components of the cardiorespiratory response (breathing frequency, breath amplitude, heart rate, systemic vascular resistance) to hypoxia and hypercarbia are highly variable between species of water and air breathing fish. Although not universal, the receptors involved in eliciting changes in heart rate and breathing frequency in response to hypoxia and hypercarbia tend to be restricted exclusively to the gills while those producing increases in breath amplitude are more wide spread, frequently also being found at extrabranchial sites. The distribution of the chemoreceptors sensitive to CO(2) in the gills involved in producing ventilatory responses tend to be more restricted than that of the O(2)-sensitive chemoreceptors and the specific location of the receptors involved in the various components of the cardiorespiratory response can vary from those of the O(2)-sensitive chemoreceptors. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Bio-magnetic signatures of fetal breathing movement

    International Nuclear Information System (INIS)

    Ulusar, U D; Wilson, J D; Murphy, P; Govindan, R B; Preissl, H; Lowery, C L; Eswaran, H

    2011-01-01

    The purpose of fetal magnetoencephalography (fMEG) is to record and analyze fetal brain activity. Unavoidably, these recordings consist of a complex mixture of bio-magnetic signals from both mother and fetus. The acquired data include biological signals that are related to maternal and fetal heart function as well as fetal gross body and breathing movements. Since fetal breathing generates a significant source of bio-magnetic interference during these recordings, the goal of this study was to identify and quantify the signatures pertaining to fetal breathing movements (FBM). The fMEG signals were captured using superconducting quantum interference devices (SQUIDs) The existence of FBM was verified and recorded concurrently by an ultrasound-based video technique. This simultaneous recording is challenging since SQUIDs are extremely sensitive to magnetic signals and highly susceptible to interference from electronic equipment. For each recording, an ultrasound-FBM (UFBM) signal was extracted by tracing the displacement of the boundary defined by the fetal thorax frame by frame. The start of each FBM was identified by using the peak points of the UFBM signal. The bio-magnetic signals associated with FBM were obtained by averaging the bio-magnetic signals time locked to the FBMs. The results showed the existence of a distinctive sinusoidal signal pattern of FBM in fMEG data

  4. Thoracic radiotherapy and breath control: current prospects

    International Nuclear Information System (INIS)

    Reboul, F.; Mineur, L.; Paoli, J.B.; Bodez, V.; Oozeer, R.; Garcia, R.

    2002-01-01

    Three-dimensional conformal radiotherapy (3D CRT) is adversely affected by setup error and organ motion. In thoracic 3D CRT, breathing accounts for most of intra-fraction movements, thus impairing treatment quality. Breath control clearly exhibits dosimetric improvement compared to free breathing, leading to various techniques for gated treatments. We review benefits of different breath control methods -i.e. breath-holding or beam gating, with spirometric, isometric or X-ray respiration sensor- and argument the choice of expiration versus inspiration, with consideration to dosimetric concerns. All steps of 3D-CRT can be improved with breath control. Contouring of organs at risk (OAR) and target are easier and more accurate on breath controlled CT-scans. Inter- and intra-fraction target immobilisation allows smaller margins with better coverage. Lung outcome predictors (NTCP, Mean Dose, LV20, LV30) are improved with breath-control. In addition, inspiration breath control facilitates beam arrangement since it widens the distance between OAR and target, and leaves less lung normal tissue within the high dose region. Last, lung density, as of CT scan, is more accurate, improving dosimetry. Our institutions choice is to use spirometry driven, patient controlled high-inspiration breath-hold; this technique gives excellent immobilization results, with high reproducibility, yet it is easy to implement and costs little extra treatment time. Breath control, whatever technique is employed, proves superior to free breathing treatment when using 3D-CRT. Breath control should then be used whenever possible, and is probably mandatory for IMRT. (authors)

  5. Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden--a national survey of practice.

    Science.gov (United States)

    Westerdahl, E; Olsén, M Fagevik

    2011-06-01

    Various chest physiotherapy techniques are recommended after cardiac surgery around the world. There is limited published data on what breathing exercises actually are recommended to patients after surgery in Europe. The aim of this national survey was to establish the current practice of chest physiotherapy and breathing exercises for adult patients following cardiac surgery in Sweden. A postal questionnaire was sent to a total population sample of 33 Swedish physiotherapists working at the departments of cardiothoracic surgery in December 2007 and January 2008. In total, 29 replies (88%) were received. Seven male and twenty two female physiotherapists completed the questionnaire. All physiotherapists instructed, on a regular basis, the cardiac surgery patients to perform post-operative breathing exercises. Positive expiratory pressure (PEP) breathing was routinely used as the first choice for treatment by 22 (83%) of the physiotherapists. Expiratory pressures used varied between 2 and 20 cm H2O. Recommended frequency and duration of the exercises varied from 4 to 30 breaths hourly during the daytime in the first post-operative days. All physiotherapists provided coughing support to the patients. Recommendations to continue breathing exercises after discharge varied from not at all up to 3 months after surgery. Breathing exercises are regularly prescribed during the initial post-operative days after cardiac surgery in Sweden. Hourly deep breathing exercises performed with or without a PEP device were reported to be first choice treatments during the hospital stay. Instructions concerning how long patients should continue the exercises after discharge varied notably.

  6. Kidney motion during free breathing and breath hold for MR-guided radiotherapy

    International Nuclear Information System (INIS)

    Stam, Mette K; Van Vulpen, Marco; Intven, Martijn; Crijns, Sjoerd P M; Lagendijk, Jan J W; Raaymakers, Bas W; Barendrecht, Maurits M; Zonnenberg, Bernard A

    2013-01-01

    Current treatments for renal cell carcinoma have a high complication rate due to the invasiveness of the treatment. With the MRI-linac it may be possible to treat renal tumours non-invasively with high-precision radiotherapy. This is expected to reduce complications. To deliver a static dose distribution, radiation gating will be used. In this study the reproducibility and efficiency of free breathing gating and a breath hold treatment of the kidney was investigated. For 15 patients with a renal lesion the kidney motion during 2 min of free breathing and 10 consecutive expiration breath holds was studied with 2D cine MRI. The variability in kidney expiration position and treatment efficiency for gating windows of 1 to 20 mm was measured for both breathing patterns. Additionally the time trend in free breathing and the variation in expiration breath hold kidney position with baseline shift correction was determined. In 80% of the patients the variation in expiration position during free breathing is smaller than 2 mm. No clinically relevant time trends were detected. The variation in expiration breath hold is for all patients larger than the free breathing expiration variation. Gating on free breathing is, for gating windows of 1 to 5 mm more efficient than breath hold without baseline correction. When applying a baseline correction to the breath hold it increases the treatment efficiency. The kidney position is more reproducible in expiration free breathing than non-guided expiration breath hold. For small gating windows it is also more time efficient. Since free breathing also seems more comfortable for the patients it is the preferred breathing pattern for MRI-Linac treatments of the kidney. (paper)

  7. Relationships between hippocampal activity and breathing patterns

    DEFF Research Database (Denmark)

    Harper, R M; Poe, G R; Rector, D M

    1998-01-01

    Single cell discharge, EEG activity, and optical changes accompanying alterations in breathing patterns, as well as the knowledge that respiratory musculature is heavily involved in movement and other behavioral acts, implicate hippocampal regions in some aspects of breathing control. The control...... is unlikely to reside in oscillatory breathing movements, because such patterns emerge in preparations retaining only the medulla (and perhaps only the spinal cord). However, momentary changes in breathing patterns induced by affect, startle, whole-body movement changes, or compensatory ventilatory changes...... of hippocampal contributions to breathing control should be viewed in the context that significant interactions exist between blood pressure changes and ventilation, and that modest breathing challenges, such as exposure to hypercapnia or to increased resistive loads, bring into action a vast array of brain...

  8. Decompression sickness in breath-hold divers: a review.

    Science.gov (United States)

    Lemaitre, Frederic; Fahlman, Andreas; Gardette, Bernard; Kohshi, Kiyotaka

    2009-12-01

    Although it has been generally assumed that the risk of decompression sickness is virtually zero during a single breath-hold dive in humans, repeated dives may result in a cumulative increase in the tissue and blood nitrogen tension. Many species of marine mammals perform extensive foraging bouts with deep and long dives interspersed by a short surface interval, and some human divers regularly perform repeated dives to 30-40 m or a single dive to more than 200 m, all of which may result in nitrogen concentrations that elicit symptoms of decompression sickness. Neurological problems have been reported in humans after single or repeated dives and recent necropsy reports in stranded marine mammals were suggestive of decompression sickness-like symptoms. Modelling attempts have suggested that marine mammals may live permanently with elevated nitrogen concentrations and may be at risk when altering their dive behaviour. In humans, non-pathogenic bubbles have been recorded and symptoms of decompression sickness have been reported after repeated dives to modest depths. The mechanisms implicated in these accidents indicate that repeated breath-hold dives with short surface intervals are factors that predispose to decompression sickness. During deep diving, the effect of pulmonary shunts and/or lung collapse may play a major role in reducing the incidence of decompression sickness in humans and marine mammals.

  9. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

  10. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  11. Sleep disordered breathing in pregnancy

    Directory of Open Access Journals (Sweden)

    Bilgay Izci Balserak

    2015-12-01

    Sleep disordered breathing (SDB is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

  12. Environmental contamination and breathing disease

    International Nuclear Information System (INIS)

    Cardona A, Jose D

    2003-01-01

    The atmospheric contamination is the main component of the environmental contamination and it can be defined as the presence in the atmosphere of an or several substances in enough quantity to produce alterations of the health, it is presented in aerosol form, with its gassy and specific components, altering the quality of the population's life and the degradation of the ecosystems. The main pollutant, as much for the frequency as for the importance of its effects, is the smoke of cigarettes. The paper mentions other types of polluting agents and their effects in the breathing apparatus

  13. The effects of metronome breathing on the variability of autonomic activity measurements.

    Science.gov (United States)

    Driscoll, D; Dicicco, G

    2000-01-01

    Many chiropractors hypothesize that spinal manipulation affects the autonomic nervous system (ANS). However, the ANS responses to chiropractic manipulative therapy are not well documented, and more research is needed to support this hypothesis. This study represents a step toward the development of a reliable method by which to document that chiropractic manipulative therapy does affect the ANS by exploring the use of paced breathing as a way to reduce the inherent variability in ANS measurements. To examine the hypothesis that the variability of ANS measurements would be reduced if breathing were paced to a metronome at 12 breaths/min. The study was performed at Parker College Research Institute. Eight normotensive subjects were recruited from the student body and staff. Respiration frequency was measured through a strain gauge. A 3-lead electrocardiogram (ECG) was used to register the electric activity of the heart, and arterial tonometry monitors were used to record the left and right radial artery blood pressures. Signals were recorded on an IBM-compatible computer with a sampling frequency of 100 Hz. Normal breathing was used for the first 3 recordings, and breathing was paced to a metronome for the final 3 recordings at 12 breaths/min. Fourier analysis was performed on the beat-by-beat fluctuations of the ECG-determined R-R interval and systolic arterial pressure (SBP). Low-frequency fluctuations (LF; 0.04-0.15 Hz) reflected sympathetic activity, whereas high-frequency fluctuations (HF; 0.15-0.4 Hz) represented parasympathetic activity. Sympathovagal indices were determined from the ratio of the two bandwidths (LF/HF). The coefficient of variation (CV%) for autonomic parameters was calculated ([average/SD] x 100%) to compare breathing normally and breathing to a metronome with respect to variability. One-way analysis of variance was used to detect differences. A value of P Metronome breathing did not produce any significant changes in blood pressure for the

  14. Submarines, spacecraft and exhaled breath.

    Science.gov (United States)

    Pleil, Joachim D; Hansel, Armin

    2012-03-01

    Foreword The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled breath. What may have escaped our notice is a complementary field of research that explores the creation and maintenance of artificial atmospheres practised by the submarine air monitoring and air purification (SAMAP) community. SAMAP is comprised of manufacturers, researchers and medical professionals dealing with the engineering and instrumentation to support human life in submarines and spacecraft (including shuttlecraft and manned rockets, high-altitude aircraft, and the International Space Station (ISS)). Here, the immediate concerns are short-term survival and long-term health in fairly confined environments where one cannot simply 'open the window' for fresh air. As such, one of the main concerns is air monitoring and the main sources of contamination are CO(2) and other constituents of human exhaled breath. Since the inaugural meeting in 1994 in Adelaide, Australia, SAMAP meetings have been held every two or three years alternating between the North American and European continents. The meetings are organized by Dr Wally Mazurek (a member of IABR) of the Defense Systems Technology Organization (DSTO) of Australia, and individual meetings are co-hosted by the navies of the countries in which they are held. An overriding focus at SAMAP is life support (oxygen availability and carbon dioxide removal). Certainly, other air constituents are also important; for example, the closed environment of a submarine or the ISS can build up contaminants from consumer products, cooking, refrigeration, accidental fires, propulsion and atmosphere maintenance. However, the most immediate concern is sustaining human metabolism: removing exhaled CO(2) and replacing metabolized O(2). Another

  15. Modified Qigong Breathing Exercise for Reducing the Sense of Hunger on an Empty Stomach

    Science.gov (United States)

    Voroshilov, Alexander P.; Wang, Zhixin; Marchenko, Elena V.

    2017-01-01

    Background. The aims of this study were to determine whether a modified Qigong breathing exercise can reduce the sense of hunger and identify possible mechanisms. Methods. The results from the test group, which performed the exercise, are compared with the control group, which performed deep breathing. Intestinal pressure measurements, stomach pH monitoring, and participant surveys were used for assessment. Results. Stomach pH was increased by 3 (0.2) and intestinal pressure was reduced by 12 (0.5) mm Hg in the experimental group and did not change significantly in the control group. The study provides strong evidence that the exercise can significantly reduce, or even suppress the sense of hunger on an empty stomach. Conclusion. This breathing exercise provides comfort in different circumstances, such as lack of regular meals, limited volume or caloric diet, and even during temporary complete absence of food in therapeutic fasting. PMID:28497701

  16. How Does a Hopping Kangaroo Breathe?

    Science.gov (United States)

    Giuliodori, Mauricio J.; Lujan, Heidi L.; Janbaih, Hussein; DiCarlo, Stephen E.

    2010-01-01

    We developed a model to demonstrate how a hopping kangaroo breathes. Interestingly, a kangaroo uses less energy to breathe while hopping than while standing still. This occurs, in part, because rather than using muscle power to move air into and out of the lungs, air is pulled into (inspiration) and pushed out of (expiration) the lungs as the…

  17. Deep frying

    NARCIS (Netherlands)

    Koerten, van K.N.

    2016-01-01

    Deep frying is one of the most used methods in the food processing industry. Though practically any food can be fried, French fries are probably the most well-known deep fried products. The popularity of French fries stems from their unique taste and texture, a crispy outside with a mealy soft

  18. Exaggerated heart rate oscillations during two meditation techniques.

    Science.gov (United States)

    Peng, C K; Mietus, J E; Liu, Y; Khalsa, G; Douglas, P S; Benson, H; Goldberger, A L

    1999-07-31

    We report extremely prominent heart rate oscillations associated with slow breathing during specific traditional forms of Chinese Chi and Kundalini Yoga meditation techniques in healthy young adults. We applied both spectral analysis and a novel analytic technique based on the Hilbert transform to quantify these heart rate dynamics. The amplitude of these oscillations during meditation was significantly greater than in the pre-meditation control state and also in three non-meditation control groups: i) elite athletes during sleep, ii) healthy young adults during metronomic breathing, and iii) healthy young adults during spontaneous nocturnal breathing. This finding, along with the marked variability of the beat-to-beat heart rate dynamics during such profound meditative states, challenges the notion of meditation as only an autonomically quiescent state.

  19. Deep learning

    CERN Document Server

    Goodfellow, Ian; Courville, Aaron

    2016-01-01

    Deep learning is a form of machine learning that enables computers to learn from experience and understand the world in terms of a hierarchy of concepts. Because the computer gathers knowledge from experience, there is no need for a human computer operator to formally specify all the knowledge that the computer needs. The hierarchy of concepts allows the computer to learn complicated concepts by building them out of simpler ones; a graph of these hierarchies would be many layers deep. This book introduces a broad range of topics in deep learning. The text offers mathematical and conceptual background, covering relevant concepts in linear algebra, probability theory and information theory, numerical computation, and machine learning. It describes deep learning techniques used by practitioners in industry, including deep feedforward networks, regularization, optimization algorithms, convolutional networks, sequence modeling, and practical methodology; and it surveys such applications as natural language proces...

  20. Adaption of cardio-respiratory balance during day-rest compared to deep sleep--an indicator for quality of life?

    Science.gov (United States)

    von Bonin, Dietrich; Grote, Vincent; Buri, Caroline; Cysarz, Dirk; Heusser, Peter; Moser, Max; Wolf, Ursula; Laederach, Kurt

    2014-11-30

    Heart rate and breathing rate fluctuations represent interacting physiological oscillations. These interactions are commonly studied using respiratory sinus arrhythmia (RSA) of heart rate variability (HRV) or analyzing cardiorespiratory synchronization. Earlier work has focused on a third type of relationship, the temporal ratio of respiration rate and heart rate (HRR). Each method seems to reveal a specific aspect of cardiorespiratory interaction and may be suitable for assessing states of arousal and relaxation of the organism. We used HRR in a study with 87 healthy subjects to determine the ability to relax during 5 day-resting periods in comparison to deep sleep relaxation. The degree to which a person during waking state could relax was compared to somatic complaints, health-related quality of life, anxiety and depression. Our results show, that HRR is barely connected to balance (LF/HF) in HRV, but significantly correlates to the perception of general health and mental well-being as well as to depression. If relaxation, as expressed in HRR, during day-resting is near to deep sleep relaxation, the subjects felt healthier, indicated better mental well-being and less depressive moods. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Time Breath of Psychological Theories

    DEFF Research Database (Denmark)

    Tateo, Luca; Valsiner, Jaan

    2015-01-01

    Psychology as a self-aspiring, ambitious, developmental science faces the crucial limit of time—both theoretically and practically. The issue of time in constructing psychology’s theories is a major unresolved metatheoretical task. This raises several questions about generalization of knowledge...... of time—or fail to do that? How can they generalize with respect to time? The different conceptions of time often remain implicit, while shaping the concepts used in understanding psychological processes. Any preconception about time in human development will foster the generalizability of theory, as well......: which is the time length of breath of psychological theories? Which is the temporal dimension of psychological processes? In this article we discuss the role of different axiomatic assumptions about time in the construction of psychological theories. How could different theories include a concept...

  2. The indoor air we breathe.

    Science.gov (United States)

    Oliver, L C; Shackleton, B W

    1998-01-01

    Increasingly recognized as a potential public health problem since the outbreak of Legionnaire's disease in Philadelphia in 1976, polluted indoor air has been associated with health problems that include asthma, sick building syndrome, multiple chemical sensitivity, and hypersensitivity pneumonitis. Symptoms are often nonspecific and include headache, eye and throat irritation, chest tightness and shortness of breath, and fatigue. Air-borne contaminants include commonly used chemicals, vehicular exhaust, microbial organisms, fibrous glass particles, and dust. Identified causes include defective building design and construction, aging of buildings and their ventilation systems, poor climate control, inattention to building maintenance. A major contributory factor is the explosion in the use of chemicals in building construction and furnishing materials over the past four decades. Organizational issues and psychological variables often contribute to the problem and hinder its resolution. This article describes the health problems related to poor indoor air quality and offers solutions.

  3. Physiological coherence in healthy volunteers during laboratory-induced stress and controlled breathing.

    Science.gov (United States)

    Mejía-Mejía, Elisa; Torres, Robinson; Restrepo, Diana

    2018-06-01

    Physiological coherence has been related with a general sense of well-being and improvements in health and physical, social, and cognitive performance. The aim of this study was to evaluate the relationship between acute stress, controlled breathing, and physiological coherence, and the degree of body systems synchronization during a coherence-generation exercise. Thirty-four university employees were evaluated during a 20-min test consisting of four stages of 5-min duration each, during which basal measurements were obtained (Stage 1), acute stress was induced using validated mental stressors (Stroop test and mental arithmetic task, during Stage 2 and 3, respectively), and coherence states were generated using a controlled breathing technique (Stage 4). Physiological coherence and cardiorespiratory synchronization were assessed during each stage from heart rate variability, pulse transit time, and respiration. Coherence measurements derived from the three analyzed variables increased during controlled respiration. Moreover, signals synchronized during the controlled breathing stage, implying a cardiorespiratory synchronization was achieved by most participants. Hence, physiological coherence and cardiopulmonary synchronization, which could lead to improvements in health and better life quality, can be achieved using slow, controlled breathing exercises. Meanwhile, coherence measured during basal state and stressful situations did not show relevant differences using heart rate variability and pulse transit time. More studies are needed to evaluate the ability of coherence ratio to reflect acute stress. © 2017 Society for Psychophysiological Research.

  4. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  5. Heart Disease

    Science.gov (United States)

    ... it may be caused by diseases, such as connective tissue disorders, excessive iron buildup in your body (hemochromatosis), the buildup of abnormal proteins (amyloidosis) or by some cancer treatments. Causes of heart infection A heart infection, ...

  6. Heart Attack

    Science.gov (United States)

    ... family history of heart attack race – African Americans, Mexican Americans, Native Americans, and native Hawaiians are at ... Your doctor will prescribe the medicines that are right for you. If you have had a heart ...

  7. The role of size in synchronous air breathing of Hoplosternum littorale.

    Science.gov (United States)

    Sloman, Katherine A; Sloman, Richard D; De Boeck, Gudrun; Scott, Graham R; Iftikar, Fathima I; Wood, Chris M; Almeida-Val, Vera M F; Val, Adalberto L

    2009-01-01

    Synchronized air breathing may have evolved as a way of minimizing the predation risk known to be associated with air breathing in fish. Little is known about how the size of individuals affects synchronized air breathing and whether some individuals are required to surface earlier than necessary in support of conspecifics, while others delay air intake. Here, the air-breathing behavior of Hoplosternum littorale held in groups or in isolation was investigated in relation to body mass, oxygen tensions, and a variety of other physiological parameters (plasma lactate, hepatic glycogen, hematocrit, hemoglobin, and size of heart, branchial basket, liver, and air-breathing organ [ABO]). A mass-specific relationship with oxygen tension of first surfacing was seen when fish were held in isolation; smaller individuals surfaced at higher oxygen tensions. However, this relationship was lost when the same individuals were held in social groups of four, where synchronous air breathing was observed. In isolation, 62% of fish first surfaced at an oxygen tension lower than the calculated P(crit) (8.13 kPa), but in the group environment this was reduced to 38% of individuals. Higher oxygen tensions at first surfacing in the group environment were related to higher levels of activity rather than any of the physiological parameters measured. In fish held in isolation but denied access to the water surface for 12 h before behavioral testing, there was no mass-specific relationship with oxygen tension at first surfacing. Larger individuals with a greater capacity to store air in their ABOs may, therefore, remain in hypoxic waters for longer periods than smaller individuals when held in isolation unless prior access to the air is prevented. This study highlights how social interaction can affect air-breathing behaviors and the importance of considering both behavioral and physiological responses of fish to hypoxia to understand the survival mechanisms they employ.

  8. Efficacy and tolerability of yoga breathing in patients with chronic obstructive pulmonary disease: a pilot study.

    Science.gov (United States)

    Pomidori, Luca; Campigotto, Federica; Amatya, Tara Man; Bernardi, Luciano; Cogo, Annalisa

    2009-01-01

    Yoga-derived breathing has been reported to improve gas exchange in patients with chronic heart failure and in participants exposed to high-altitude hypoxia. We investigated the tolerability and effect of yoga breathing on ventilatory pattern and oxygenation in patients with chronic obstructive pulmonary disease (COPD). Patients with COPD (N = 11, 3 women) without previous yoga practice and taking only short-acting beta2-adrenergic blocking drugs were enrolled. Ventilatory pattern and oxygen saturation were monitored by means of inductive plethysmography during 30-minute spontaneous breathing at rest (sb) and during a 30-minute yoga lesson (y). During the yoga lesson, the patients were requested to mobilize in sequence the diaphragm, lower chest, and upper chest adopting a slower and deeper breathing. We evaluated oxygen saturation (SaO2%), tidal volume (VT), minute ventilation (E), respiratory rate (i>f), inspiratory time, total breath time, fractional inspiratory time, an index of thoracoabdominal coordination, and an index of rapid shallow breathing. Changes in dyspnea during the yoga lesson were assessed with the Borg scale. During the yoga lesson, data showed the adoption of a deeper and slower breathing pattern (VTsb L 0.54[0.04], VTy L 0.74[0.08], P = .01; i>fsb 20.8[1.3], i>fy 13.8[0.2], P = .001) and a significant improvement in SaO2% with no change in E (SaO2%sb 91.5%[1.13], SaO2%y 93.5%[0.99], P = .02; Esb L/min 11.2[1.1], Ey L/min 10.2[0.9]). All the participants reported to be comfortable during the yoga lesson, with no increase in dyspnea index. We conclude that short-term training in yoga is well tolerated and induces favorable respiratory changes in patients with COPD.

  9. Heart pacemaker

    Science.gov (United States)

    Cardiac pacemaker implantation; Artificial pacemaker; Permanent pacemaker; Internal pacemaker; Cardiac resynchronization therapy; CRT; Biventricular pacemaker; Arrhythmia - pacemaker; Abnormal heart ...

  10. Free-breathing motion-corrected late-gadolinium-enhancement imaging improves image quality in children

    International Nuclear Information System (INIS)

    Olivieri, Laura; O'Brien, Kendall J.; Cross, Russell; Xue, Hui; Kellman, Peter; Hansen, Michael S.

    2016-01-01

    The value of late-gadolinium-enhancement (LGE) imaging in the diagnosis and management of pediatric and congenital heart disease is clear; however current acquisition techniques are susceptible to error and artifacts when performed in children because of children's higher heart rates, higher prevalence of sinus arrhythmia, and inability to breath-hold. Commonly used techniques in pediatric LGE imaging include breath-held segmented FLASH (segFLASH) and steady-state free precession-based (segSSFP) imaging. More recently, single-shot SSFP techniques with respiratory motion-corrected averaging have emerged. This study tested and compared single-shot free-breathing LGE techniques with standard segmented breath-held techniques in children undergoing LGE imaging. Thirty-two consecutive children underwent clinically indicated late-enhancement imaging using intravenous gadobutrol 0.15 mmol/kg. Breath-held segSSFP, breath-held segFLASH, and free-breathing single-shot SSFP LGE sequences were performed in consecutive series in each child. Two blinded reviewers evaluated the quality of the images and rated them on a scale of 1-5 (1 = poor, 5 = superior) based on blood pool-myocardial definition, presence of cardiac motion, presence of respiratory motion artifacts, and image acquisition artifact. We used analysis of variance (ANOVA) to compare groups. Patients ranged in age from 9 months to 18 years, with a mean +/- standard deviation (SD) of 13.3 +/- 4.8 years. R-R interval at the time of acquisition ranged 366-1,265 milliseconds (ms) (47-164 beats per minute [bpm]), mean +/- SD of 843+/-231 ms (72+/-21 bpm). Mean +/- SD quality ratings for long-axis imaging for segFLASH, segSSFP and single-shot SSFP were 3.1+/-0.9, 3.4+/-0.9 and 4.0+/-0.9, respectively (P < 0.01 by ANOVA). Mean +/- SD quality ratings for short-axis imaging for segFLASH, segSSFP and single-shot SSFP were 3.4+/-1, 3.8+/-0.9 and 4.3+/-0.7, respectively (P < 0.01 by ANOVA). Single-shot late

  11. Free-breathing motion-corrected late-gadolinium-enhancement imaging improves image quality in children

    Energy Technology Data Exchange (ETDEWEB)

    Olivieri, Laura; O' Brien, Kendall J. [Children' s National Health System, Division of Cardiology, Washington, DC (United States); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (United States); Cross, Russell [Children' s National Health System, Division of Cardiology, Washington, DC (United States); Xue, Hui; Kellman, Peter; Hansen, Michael S. [National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (United States)

    2016-06-15

    The value of late-gadolinium-enhancement (LGE) imaging in the diagnosis and management of pediatric and congenital heart disease is clear; however current acquisition techniques are susceptible to error and artifacts when performed in children because of children's higher heart rates, higher prevalence of sinus arrhythmia, and inability to breath-hold. Commonly used techniques in pediatric LGE imaging include breath-held segmented FLASH (segFLASH) and steady-state free precession-based (segSSFP) imaging. More recently, single-shot SSFP techniques with respiratory motion-corrected averaging have emerged. This study tested and compared single-shot free-breathing LGE techniques with standard segmented breath-held techniques in children undergoing LGE imaging. Thirty-two consecutive children underwent clinically indicated late-enhancement imaging using intravenous gadobutrol 0.15 mmol/kg. Breath-held segSSFP, breath-held segFLASH, and free-breathing single-shot SSFP LGE sequences were performed in consecutive series in each child. Two blinded reviewers evaluated the quality of the images and rated them on a scale of 1-5 (1 = poor, 5 = superior) based on blood pool-myocardial definition, presence of cardiac motion, presence of respiratory motion artifacts, and image acquisition artifact. We used analysis of variance (ANOVA) to compare groups. Patients ranged in age from 9 months to 18 years, with a mean +/- standard deviation (SD) of 13.3 +/- 4.8 years. R-R interval at the time of acquisition ranged 366-1,265 milliseconds (ms) (47-164 beats per minute [bpm]), mean +/- SD of 843+/-231 ms (72+/-21 bpm). Mean +/- SD quality ratings for long-axis imaging for segFLASH, segSSFP and single-shot SSFP were 3.1+/-0.9, 3.4+/-0.9 and 4.0+/-0.9, respectively (P < 0.01 by ANOVA). Mean +/- SD quality ratings for short-axis imaging for segFLASH, segSSFP and single-shot SSFP were 3.4+/-1, 3.8+/-0.9 and 4.3+/-0.7, respectively (P < 0.01 by ANOVA). Single-shot late

  12. Optimal ventilatory patterns in periodic breathing.

    Science.gov (United States)

    Ghazanshahi, S D; Khoo, M C

    1993-01-01

    The goal of this study was to determine whether periodic breathing (PB), which is highly prevalent during sleep at high altitudes, imposes physiological penalties on the respiratory system in the absence of any accompanying disease. Using a computer model of respiratory gas exchange, we compared the effects of a variety of PB patterns on the chemical and mechanical costs of breathing to those resulting from regular tidal breathing. Although PB produced considerable fluctuation in arterial blood gas tensions, for the same cycle-averaged ventilation, higher arterial oxygen saturation and lower arterial carbon dioxide levels were achieved. This result can be explained by the fact that the combination of large breaths and apnea in PB leads to a substantial reduction in dead space ventilation. At the same time, the savings in mechanical cost achieved by the respiratory muscles during apnea partially offset the increase during the breathing phase. Consequently, the "pressure cost," a criterion based on mean inspiratory pressure, was elevated only slightly, although the average work rate of breathing increased significantly. We found that, at extreme altitudes, PB patterns with clusters of 2 to 4 large breaths that alternate with apnea produce the highest arterial oxygenation levels and lowest pressure costs. The common occurrence of PB patterns with closely similar features has been reported in sleeping healthy sojourners at extreme altitudes. Taken together, these findings suggest that PB favors a reduction in the oxygen demands of the respiratory muscles and therefore may not be as detrimental as it is generally believed to be.

  13. An Ultrasonic Contactless Sensor for Breathing Monitoring

    Directory of Open Access Journals (Sweden)

    Philippe Arlotto

    2014-08-01

    Full Text Available The monitoring of human breathing activity during a long period has multiple fundamental applications in medicine. In breathing sleep disorders such as apnea, the diagnosis is based on events during which the person stops breathing for several periods during sleep. In polysomnography, the standard for sleep disordered breathing analysis, chest movement and airflow are used to monitor the respiratory activity. However, this method has serious drawbacks. Indeed, as the subject should sleep overnight in a laboratory and because of sensors being in direct contact with him, artifacts modifying sleep quality are often observed. This work investigates an analysis of the viability of an ultrasonic device to quantify the breathing activity, without contact and without any perception by the subject. Based on a low power ultrasonic active source and transducer, the device measures the frequency shift produced by the velocity difference between the exhaled air flow and the ambient environment, i.e., the Doppler effect. After acquisition and digitization, a specific signal processing is applied to separate the effects of breath from those due to subject movements from the Doppler signal. The distance between the source and the sensor, about 50 cm, and the use of ultrasound frequency well above audible frequencies, 40 kHz, allow monitoring the breathing activity without any perception by the subject, and therefore without any modification of the sleep quality which is very important for sleep disorders diagnostic applications. This work is patented (patent pending 2013-7-31 number FR.13/57569.

  14. Effect of isobaric breathing gas shifts from air to heliox mixtures on resolution of air bubbles in lipid and aqueous tissues of recompressed rats

    DEFF Research Database (Denmark)

    Hyldegaard, Ole; Kerem, Dikla; Melamed, Y

    2011-01-01

    Deep tissue isobaric counterdiffusion that may cause unwanted bubble formation or transient bubble growth has been referred to in theoretical models and demonstrated by intravascular gas formation in animals, when changing inert breathing gas from nitrogen to helium after hyperbaric air breathing....... We visually followed the in vivo resolution of extravascular air bubbles injected at 101 kPa into nitrogen supersaturated rat tissues: adipose, spinal white matter, skeletal muscle or tail tendon. Bubbles were observed during isobaric breathing-gas shifts from air to normoxic (80:20) heliox mixture...... breathing. No such bubble growth was observed in spinal white matter, skeletal muscle or tendon. In spinal white matter, an immediate breathing gas shift after the hyperbaric air exposure from air to both (80:20) and (50:50) heliox, coincident with recompression to either 285 or 405 kPa, caused consistent...

  15. Is breath acetone a biomarker of diabetes? A historical review on breath acetone measurements.

    Science.gov (United States)

    Wang, Zhennan; Wang, Chuji

    2013-09-01

    Since the ancient discovery of the 'sweet odor' in human breath gas, pursuits of the breath analysis-based disease diagnostics have never stopped. Actually, the 'smell' of the breath, as one of three key disease diagnostic techniques, has been used in Eastern-Medicine for more than three thousand years. With advancement of measuring technologies in sensitivity and selectivity, more specific breath gas species have been identified and established as a biomarker of a particular disease. Acetone is one of the breath gases and its concentration in exhaled breath can now be determined with high accuracy using various techniques and methods. With the worldwide prevalence of diabetes that is typically diagnosed through blood testing, human desire to achieve non-blood based diabetic diagnostics and monitoring has never been quenched. Questions, such as is breath acetone a biomarker of diabetes and how is the breath acetone related to the blood glucose (BG) level (the golden criterion currently used in clinic for diabetes diagnostic, monitoring, and management), remain to be answered. A majority of current research efforts in breath acetone measurements and its technology developments focus on addressing the first question. The effort to tackle the second question has begun recently. The earliest breath acetone measurement in clearly defined diabetic patients was reported more than 60 years ago. For more than a half-century, as reviewed in this paper, there have been more than 41 independent studies of breath acetone using various techniques and methods, and more than 3211 human subjects, including 1581 healthy people, 242 Type 1 diabetic patients, 384 Type 2 diabetic patients, 174 unspecified diabetic patients, and 830 non-diabetic patients or healthy subjects who are under various physiological conditions, have been used in the studies. The results of the breath acetone measurements collected in this review support that many conditions might cause changes to breath

  16. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  17. Walk test and school performance in mouth-breathing children.

    Science.gov (United States)

    Boas, Ana Paula Dias Vilas; Marson, Fernando Augusto de Lima; Ribeiro, Maria Angela Gonçalves de Oliveira; Sakano, Eulália; Conti, Patricia Blau Margosian; Toro, Adyléia Dalbo Contrera; Ribeiro, José Dirceu

    2013-01-01

    In recent decades, many studies on mouth breathing (MB) have been published; however, little is known about many aspects of this syndrome, including severity, impact on physical and academic performances. Compare the physical performance in a six minutes walk test (6MWT) and the academic performance of MB and nasal-breathing (NB) children and adolescents. This is a descriptive, cross-sectional, and prospective study with MB and NB children submitted to the 6MWT and scholar performance assessment. We included 156 children, 87 girls (60 NB and 27 MB) and 69 boys (44 NB and 25 MB). Variables were analyzed during the 6MWT: heart rate (HR), respiratory rate, oxygen saturation, distance walked in six minutes and modified Borg scale. All the variables studied were statistically different between groups NB and MB, with the exception of school performance and HR in 6MWT. MB affects physical performance and not the academic performance, we noticed a changed pattern in the 6MWT in the MB group. Since the MBs in our study were classified as non-severe, other studies comparing the academic performance variables and 6MWT are needed to better understand the process of physical and academic performances in MB children.

  18. 46 CFR 197.456 - Breathing supply hoses.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Breathing supply hoses. 197.456 Section 197.456 Shipping....456 Breathing supply hoses. (a) The diving supervisor shall insure that— (1) Each breathing supply....5 times its maximum working pressure; (2) Each breathing supply hose assembly, prior to being placed...

  19. 21 CFR 862.3080 - Breath nitric oxide test system.

    Science.gov (United States)

    2010-04-01

    ... Systems § 862.3080 Breath nitric oxide test system. (a) Identification. A breath nitric oxide test system... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breath nitric oxide test system. 862.3080 Section... fractional nitric oxide concentration in expired breath aids in evaluating an asthma patient's response to...

  20. Analysis for drugs in saliva and breath

    Science.gov (United States)

    1981-09-25

    Collection devices for saliva and breath that involved non-invasive techniques for sample collection were evaluated. Having subjects simply spit into a specially prepared glass vial was found to be an efficient, inexpensive and simple way to collect ...

  1. Analysis for drug in saliva and breath

    Science.gov (United States)

    1981-09-25

    Collection devices for saliva and breath that involved non-invasive : techniques for sample collection were evaluated. Having subjects simply : spit into a specially prepared glass vial was found to be an efficient, : inexpensive and simple way to co...

  2. Humidifiers: Air Moisture Eases Skin, Breathing Symptoms

    Science.gov (United States)

    ... create deposits inside your humidifier that promote bacterial growth. And, when released into the air, these minerals often appear as white dust on your furniture. You may also breathe in some minerals that ...

  3. Swimming in air-breathing fishes.

    Science.gov (United States)

    Lefevre, S; Domenici, P; McKenzie, D J

    2014-03-01

    Fishes with bimodal respiration differ in the extent of their reliance on air breathing to support aerobic metabolism, which is reflected in their lifestyles and ecologies. Many freshwater species undertake seasonal and reproductive migrations that presumably involve sustained aerobic exercise. In the six species studied to date, aerobic exercise in swim flumes stimulated air-breathing behaviour, and there is evidence that surfacing frequency and oxygen uptake from air show an exponential increase with increasing swimming speed. In some species, this was associated with an increase in the proportion of aerobic metabolism met by aerial respiration, while in others the proportion remained relatively constant. The ecological significance of anaerobic swimming activities, such as sprinting and fast-start manoeuvres during predator-prey interactions, has been little studied in air-breathing fishes. Some species practise air breathing during recovery itself, while others prefer to increase aquatic respiration, possibly to promote branchial ion exchange to restore acid-base balance, and to remain quiescent and avoid being visible to predators. Overall, the diversity of air-breathing fishes is reflected in their swimming physiology as well, and further research is needed to increase the understanding of the differences and the mechanisms through which air breathing is controlled and used during exercise. © 2014 The Fisheries Society of the British Isles.

  4. Optoacoustic 13C-breath test analyzer

    Science.gov (United States)

    Harde, Hermann; Helmrich, Günther; Wolff, Marcus

    2010-02-01

    The composition and concentration of exhaled volatile gases reflects the physical ability of a patient. Therefore, a breath analysis allows to recognize an infectious disease in an organ or even to identify a tumor. One of the most prominent breath tests is the 13C-urea-breath test, applied to ascertain the presence of the bacterium helicobacter pylori in the stomach wall as an indication of a gastric ulcer. In this contribution we present a new optical analyzer that employs a compact and simple set-up based on photoacoustic spectroscopy. It consists of two identical photoacoustic cells containing two breath samples, one taken before and one after capturing an isotope-marked substrate, where the most common isotope 12C is replaced to a large extent by 13C. The analyzer measures simultaneously the relative CO2 isotopologue concentrations in both samples by exciting the molecules on specially selected absorption lines with a semiconductor laser operating at a wavelength of 2.744 μm. For a reliable diagnosis changes of the 13CO2 concentration of 1% in the exhaled breath have to be detected at a concentration level of this isotope in the breath of about 500 ppm.

  5. Heart regeneration.

    Science.gov (United States)

    Breckwoldt, Kaja; Weinberger, Florian; Eschenhagen, Thomas

    2016-07-01

    Regenerating an injured heart holds great promise for millions of patients suffering from heart diseases. Since the human heart has very limited regenerative capacity, this is a challenging task. Numerous strategies aiming to improve heart function have been developed. In this review we focus on approaches intending to replace damaged heart muscle by new cardiomyocytes. Different strategies for the production of cardiomyocytes from human embryonic stem cells or human induced pluripotent stem cells, by direct reprogramming and induction of cardiomyocyte proliferation are discussed regarding their therapeutic potential and respective advantages and disadvantages. Furthermore, different methods for the transplantation of pluripotent stem cell-derived cardiomyocytes are described and their clinical perspectives are discussed. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Heart Failure

    OpenAIRE

    McMurray, John; Ponikowski, Piotr

    2011-01-01

    Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure.

  7. Artificial heart

    Energy Technology Data Exchange (ETDEWEB)

    1984-10-18

    Super-pure plutonium-238 could use heat produced during fission to power an implanted artificial heart. Three model hearts have worked for some time. Concern that excess heat would make the procedure unsafe for humans has broadened the search for another energy source, such as electrohydraulic drive or an external power battery. A back pack approach may provide an interim solution until materials are developed which can withstand heart activity and be small enough for implantation.

  8. Types of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and procedures related to heart disease and stroke. Heart Failure Questions to Ask Your Doctor Use these questions ...

  9. In vivo proton MRS of normal pancreas metabolites during breath-holding and free-breathing

    International Nuclear Information System (INIS)

    Su, T.-H.; Jin, E.-H.; Shen, H.; Zhang, Y.; He, W.

    2012-01-01

    Aim: To characterize normal pancreas metabolites using in vivo proton magnetic resonance spectroscopy ( 1 H MRS) at 3 T under conditions of breath-holding and free-breathing. Materials and methods: The pancreases of 32 healthy volunteers were examined using 1 H MRS during breath-holding and free-breathing acquisitions in a single-voxel point-resolved selective spectroscopy sequence (PRESS) technique using a 3 T MRI system. Resonances were compared between paired spectra of the two breathing modes. Furthermore, correlations between lipid (Lip) content and age, body-mass index (BMI), as well as choline (Cho) peak visibility of the normal pancreas were analysed during breath-holding. Results: Twenty-nine pairs of spectra were successfully obtained showing three major resonances, Lip, Cho, cholesterol and the unsaturated parts of the olefinic region of fatty acids (Chol + Unsat). Breath-hold spectra were generally better, with higher signal-to-noise ratios (SNR; Z=–2.646, p = 0.008) and Cho peak visible status (Z=–2.449, p = 0.014). Correlations were significant between spectra acquired by the two breathing modes, especially for Lip height, Lip area, and the area of other peaks at 1.9–4.1 ppm. However, the Lip resonance was significantly different between the spectra of the two breathing modes (p 1 H MRS of the normal pancreas at 3 T is technically feasible and can characterize several metabolites. 1 H MRS during breath-holding acquisition is superior to that during free-breathing acquisition.

  10. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

    Directory of Open Access Journals (Sweden)

    Masateru Takigawa, MD

    2017-08-01

    Conclusion: This unique airway management technique using a pediatric intubation tube for CA procedures performed in adult patients with AF under continuous deep sedation was easy, safe, and effective.

  12. Chemical sensors for breath gas analysis: the latest developments at the Breath Analysis Summit 2013.

    Science.gov (United States)

    Tisch, Ulrike; Haick, Hossam

    2014-06-01

    Profiling the body chemistry by means of volatile organic compounds (VOCs) in the breath opens exciting new avenues in medical diagnostics. Gas sensors could provide ideal platforms for realizing portable, hand-held breath testing devices in the near future. This review summarizes the latest developments and applications in the field of chemical sensors for diagnostic breath testing that were presented at the Breath Analysis Summit 2013 in Wallerfangen, Germany. Considerable progress has been made towards clinically applicable breath testing devices, especially by utilizing chemo-sensitive nanomaterials. Examples of several specialized breath testing applications are presented that are either based on stand-alone nanomaterial-based sensors being highly sensitive and specific to individual breath compounds over others, or on combinations of several highly specific sensors, or on experimental nanomaterial-based sensors arrays. Other interesting approaches include the adaption of a commercially available MOx-based sensor array to indirect breath testing applications, using a sample pre-concentration method, and the development of compact integrated GC-sensor systems. The recent trend towards device integration has led to the development of fully integrated prototypes of point-of-care devices. We describe and compare the performance of several prototypes that are based on different sensing technologies and evaluate their potential as low-cost and readily available next-generation medical devices.

  13. Breath tests: principles, problems, and promise

    International Nuclear Information System (INIS)

    Lo, C.W.; Carter, E.A.; Walker, W.A.

    1982-01-01

    Breath tests rely on the measurement of gases produced in the intestine, absorbed, and expired in the breath. Carbohydrates, such as lactose and sucrose, can be administered in ysiologic doses; if malabsorbed, they will be metabolized to hydrogen by colonic bacteria. Since hydrogen is not produced by human metabolic reactions, a rise in breath hydrogen, as measured by gas chromatography, is evidence of carbohydrate malabsorption. Likewise, a rise in breath hydrogen marks the transit time of nonabsorbable carbohydrates such as lactulose through the small intestine into the colon. Simple end-expiratory interval collection into nonsiliconized vacutainer tubes has made these noninvasive tests quite convenient to perform, but various problems, including changes in stool pH intestinal motility, or metabolic rate, may influence results. Another group of breath tests uses substrates labeled with radioactive or stable isotopes of carbon. Labeled fat substrates such as trioctanoin, tripalmitin, and triolein do not produce the expected rise in labeled breath CO 2 if there is fat malabsorption. Bile acid malabsorption and small intestinal bacterial overgrowth can be measured with labeled cholylglycine or cholyltaurine. Labeled drugs such as aminopyrine, methacetin, and phenacetin can be used as an indication of drug metabolism and liver function. Radioactive substrates have been used to trace metabolic pathways and can be measured by scintillation counters. The availability of nonradioactive stable isotopes has made these ideal for use in children and pregnant women, but the cost of substrates and the mass spectrometers to measure them has so far limited their use to research centers. It is hoped that new techniques of processing and measurement will allow further realization of the exciting potential breath analysis has in a growing list of clinical applications

  14. Heart rate variability and baroreflex sensitivity in bilateral lung transplant recipients.

    Science.gov (United States)

    Fontolliet, Timothée; Gianella, Pietro; Pichot, Vincent; Barthélémy, Jean-Claude; Gasche-Soccal, Paola; Ferretti, Guido; Lador, Frédéric

    2018-01-09

    The effects of lung afferents denervation on cardiovascular regulation can be assessed on bilateral lung transplantation patients. The high-frequency component of heart rate variability is known to be synchronous with breathing frequency. Then, if heart beat is neurally modulated by breathing frequency, we may expect disappearance of high frequency of heart rate variability in bilateral lung transplantation patients. On 11 patients and 11 matching healthy controls, we measured R-R interval (electrocardiography), blood pressure (Portapres ® ) and breathing frequency (ultrasonic device) in supine rest, during 10-min free breathing, 10-min cadenced breathing (0·25 Hz) and 5-min handgrip. We analysed heart rate variability and spontaneous variability of arterial blood pressure, by power spectral analysis, and baroreflex sensitivity, by the sequence method. Concerning heart rate variability, with respect to controls, transplant recipients had lower total power and lower low- and high-frequency power. The low-frequency/high-frequency ratio was higher. Concerning systolic, diastolic and mean arterial pressure variability, transplant recipients had lower total power (only for cadenced breathing), low frequency and low-frequency/high-frequency ratio during free and cadenced breathing. Baroreflex sensitivity was decreased. Denervated lungs induced strong heart rate variability reduction. The higher low-frequency/high-frequency ratio suggested that the total power drop was mostly due to high frequency. These results support the hypothesis that neural modulation from lung afferents contributes to the high frequency of heart rate variability. © 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy].

    Science.gov (United States)

    Monda, Cinzia; Scala, Oriana; Paolillo, Stefania; Savarese, Gianluigi; Cecere, Milena; D'Amore, Carmen; Parente, Antonio; Musella, Francesca; Mosca, Susanna; Filardi, Pasquale Perrone

    2010-11-01

    Sleep apnea, defined as a pathologic pause in breathing during sleep >10 s, promotes the progression of chronic heart failure and may be a predictor of poor prognosis. It causes, in fact, several mechanical, hemodynamic, chemical and inflammatory changes that negatively compromise cardiovascular homeostasis of heart failure patients. Sleep apnea is recognized as sleep apnea syndrome when specific symptoms, such as sleepiness and headache during the daytime and snoring, are present and is diagnosed with an overnight test called polysomnography. There are two different forms of sleep apnea, central and obstructive. Breathing is interrupted by the loss of respiratory drive and the lack of respiratory effort in the central form, which affects about 40-60% of heart failure patients. In obstructive sleep apnea, breathing stops when throat muscles relax, despite respiratory effort. This form affects about 3% of the general population, while it is present in at least 30% of heart failure patients. The diagnosis of sleep disorders in heart failure becomes very important to help patients adopting lifestyle changes and starting specific therapies to improve quality of life and retard the progression of chronic heart failure.

  16. Sudarshan kriya yoga: Breathing for health

    Directory of Open Access Journals (Sweden)

    Sameer A Zope

    2013-01-01

    Full Text Available Breathing techniques are regularly recommended for relaxation, stress management, control of psychophysiological states, and to improve organ function. Yogic breathing, defined as a manipulation of breath movement, has been shown to positively affect immune function, autonomic nervous system imbalances, and psychological or stress-related disorders. The aim of this study was to assess and provide a comprehensive review of the physiological mechanisms, the mind-body connection, and the benefits of Sudarshan Kriya Yoga (SKY in a wide range of clinical conditions. Various online databases searched were Medline, Psychinfo, EMBASE, and Google Scholar. All the results were carefully screened and articles on SKY were selected. The references from these articles were checked to find any other potentially relevant articles. SKY, a unique yogic breathing practice, involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating. There is mounting evidence to suggest that SKY can be a beneficial, low-risk, low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder, depression, stress-related medical illnesses, substance abuse, and rehabilitation of criminal offenders.

  17. A non-contact high resolution piezoelectric film based sensor for monitoring breathing during sleep

    Science.gov (United States)

    Johnston, Robert; Nakano, Katsuya; Fujita, Kento; Misaki, Shinya; Fujii, Hiroyuki; Misaki, Yukinori

    2017-07-01

    Currently, research for measuring human breathing during sleep is actively being conducted into using technologies that include piezoelectric, ultrasonic, microwave and infrared rays. But various problems have led to not many practical applications. As such, it was decided to develop a PVDF (PolyVinylidene DiFluoride) based non-contact high resolution sensor for monitoring a subject's breathing as they sleep. Development of the high resolution respiration sensor was possible through the use of PVDF piezoelectric film and the development of a new sensor configuration. Although there was already an existing respiration sensor research resulting product available, is weak signal strength made it very sensitive to noise and difficult to measure respiration accurately. As such, complicated circuits and signal processing were needed. A new high resolution breathing sensor was developed with greater signal strength and with just the use of some simple circuits and signal processing, was able to accurately measure subject breathing. Also due to the greater signal strength, it became possible to measure both heart rate and respiration rate simultaneously.

  18. The impact of breathing on HRV measurements: implications for the longitudinal follow-up of athletes.

    Science.gov (United States)

    Saboul, Damien; Pialoux, Vincent; Hautier, Christophe

    2013-01-01

    The purpose of the present work was to compare daily variations of heart rate variability (HRV) parameters between controlled breathing (CB) and spontaneous breathing (SB) sessions during a longitudinal follow-up of athletes. HRV measurements were performed daily on 10 healthy male runners for 21 consecutive days. The signals were recorded during two successive randomised 5-minutes sessions. One session was performed in CB and the other in SB. The results showed significant differences between the two respiration methods in the temporal, nonlinear and frequency domains. However, significant correlations were observed between CB and SB (higher than 0.70 for RMSSD and SD1), demonstrating that during a longitudinal follow-up, these markers provide the same HRV variations regardless of breathing pattern. By contrast, independent day-to-day variations were observed with HF and LF/HF frequency markers, indicating no significant relationship between SB and CB data over time. Therefore, we consider that SB and CB may be used for HRV longitudinal follow-ups only for temporal and nonlinear markers. Indeed, the same daily increases and decreases were observed whatever the breathing method employed. Conversely, frequency markers did not provide the same variations between SB and CB and we propose that these indicators are not reliable enough to be used for day-to-day HRV monitoring.

  19. Practical recommendations for breathing-adapted radiotherapy; Bonnes pratiques pour la radiotherapie asservie a la respiration

    Energy Technology Data Exchange (ETDEWEB)

    Simon, L.; Giraud, P.; Rosenwald, J.C. [Institut Curie, Dept. d' Oncologie-radiotherapie, 75 - Paris (France); Dumas, J.L.; Lorchel, F. [CHU de Besancon, Hopital Jean-Minjoz, Service Radiotherapie, 25 - Besancon (France); Marre, D. [Institut Claudius-Regaud, Dept. des Radiations, 31 - Toulouse (France); Dupont, S. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Varmenot, N. [Centre Henri-Becquerel, UnitE de Physique Medicale, 76 - Rouen (France); Ginestet, C. [Centre Leon-Berard, Dept. de Radiotherapie, 69 - Lyon (France); Caron, J. [Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Marchesi, V. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Ferreira, I. [Institut Gustave-Roussy, Dept. d' Oncologie Radiotherapie, 94 - Villejuif (France); Garcia, R. [Institut Sainte-Catherine, Service de Radiotherapie, 84 - Avignon (France)

    2007-06-15

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  20. Definition and Classification of Heart Failure

    Directory of Open Access Journals (Sweden)

    Mitja Lainscak

    2017-01-01

    Full Text Available A review of the definition and classification of heart failure, updated since the recent 2016 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure. Heart failure is defined by the European Society of Cardiology (ESC as a clinical syndrome characterised by symptoms such as shortness of breath, persistent coughing or wheezing, ankle swelling and fatigue, that may be accompanied by the following signs: jugular venous pressure, pulmonary crackles, increased heart rate and peripheral oedema. However, these signs may not be present in the early stages and in patients treated with diuretics. When apparent, they are due to a structural and/or functional cardiac abnormality, leading to systolic and/or diastolic ventricular dysfunction, resulting in a reduced cardiac output and/or elevated intra- cardiac pressures at rest or during stress. According to the most recent ESC guidelines the initial evaluation of patients with suspected heart failure should include a clinical history and physical examination, laboratory assessment, chest radiography, and electrocardiography. Echocardiography can confirm the diagnosis. Beyond detecting myocardial abnormality, other impairments such as abnormalities of the valves, pericardium, endocardium, heart rhythm, and conduction may be found. The identification of the underlying aetiology is pivotal for the diagnosis of heart failure and its treatment. The authors review the definitions and classifications of heart failure.

  1. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  2. Clinical Applications of CO2 and H2 Breath Test

    Directory of Open Access Journals (Sweden)

    ZHAO Si-qian;CHEN Bao-jun;LUO Zhi-fu

    2016-08-01

    Full Text Available Breath test is non-invasive, high sensitivity and high specificity. In this article, CO2 breath test, H2 breath test and their clinical applications were elaborated. The main applications of CO2 breath test include helicobacter pylori test, liver function detection, gastric emptying test, insulin resistance test, pancreatic exocrine secretion test, etc. H2 breath test can be applied in the diagnosis of lactose malabsorption and detecting small intestinal bacterial overgrowth. With further research, the breath test is expected to be applied in more diseases diagnosis.

  3. Deep Learning

    DEFF Research Database (Denmark)

    Jensen, Morten Bornø; Bahnsen, Chris Holmberg; Nasrollahi, Kamal

    2018-01-01

    I løbet af de sidste 10 år er kunstige neurale netværk gået fra at være en støvet, udstødt tekno-logi til at spille en hovedrolle i udviklingen af kunstig intelligens. Dette fænomen kaldes deep learning og er inspireret af hjernens opbygning.......I løbet af de sidste 10 år er kunstige neurale netværk gået fra at være en støvet, udstødt tekno-logi til at spille en hovedrolle i udviklingen af kunstig intelligens. Dette fænomen kaldes deep learning og er inspireret af hjernens opbygning....

  4. Deep geothermics

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The hot-dry-rocks located at 3-4 km of depth correspond to low permeable rocks carrying a large amount of heat. The extraction of this heat usually requires artificial hydraulic fracturing of the rock to increase its permeability before water injection. Hot-dry-rocks geothermics or deep geothermics is not today a commercial channel but only a scientific and technological research field. The Soultz-sous-Forets site (Northern Alsace, France) is characterized by a 6 degrees per meter geothermal gradient and is used as a natural laboratory for deep geothermal and geological studies in the framework of a European research program. Two boreholes have been drilled up to 3600 m of depth in the highly-fractured granite massif beneath the site. The aim is to create a deep heat exchanger using only the natural fracturing for water transfer. A consortium of german, french and italian industrial companies (Pfalzwerke, Badenwerk, EdF and Enel) has been created for a more active participation to the pilot phase. (J.S.). 1 fig., 2 photos

  5. Effect of oxygenation on breath-by-breath response of the genioglossus muscle during occlusion.

    Science.gov (United States)

    Gauda, E B; Carroll, J L; McColley, S; Smith, P L

    1991-10-01

    We investigated the effect of different levels of O2 tension (hypoxia, normoxia, and hyperoxia) on the breath-by-breath onset and peak electromyographic (EMG) activity of the genioglossus (GG) muscle during a five-breath end-expiratory tracheal occlusion of 20- to 30-s duration. GG and diaphragmatic (DIA) EMG activity were measured with needle electrodes in eight anesthetized tracheotomized adult cats. In response to occlusion, the increase in the number of animals with GG EMG activity was different during hypoxia, normoxia, and hyperoxia (P = 0.003, Friedman). During hypoxia, eight of eight of the animals had GG EMG activity by the third occluded effort. In contrast, during normoxia, only four of eight and, during hyperoxia, only three of eight animals had GG EMG activity throughout the entire five-breath occlusion. Similarly, at release of the occlusion, more animals had persistent GG EMG activity on the postocclusion breaths during hypoxia than during normoxia or hyperoxia. Breath-by-breath augmentation of peak amplitude of the GG and DIA EMGs on each occluded effort was accentuated during hypoxia (P less than 0.01) and abolished during hyperoxia (P = 0.10). These results suggest that hypoxemia is a major determinant of the rapidity of onset, magnitude, and sustained activity of upper airway muscles during airway occlusion.

  6. Breathing adapted radiotherapy: final clinic results of the program for the support to costly innovating techniques (Stic) of 2003

    International Nuclear Information System (INIS)

    Giraud, P.; Giraud, P.; Morvan, E.; Djadi-Prat, J.; Rosenwald, J.C.; Carrere, M.O.

    2010-01-01

    The authors report the comparison, from a clinic point of view, between breathing adapted conformational radiotherapy (BART) and conventional conformational radiotherapy, in the case of lung and breast cancers. The assessment comprised a clinic examination, a thoracic radiography, breathing functional tests, a thoracic scanography at different moments (3, 6, 12, 18 and 24 months), and dosimetric criteria for tumour target volumes and the different thoracic organs at risk. Data have been collected among more than six hundred patients. Breathing adapted techniques allow acute and late toxicity to be reduced, notably for the lung, heart and oesophagus during a lung irradiation. They are less interesting for mammary irradiation, but could be important for a radiotherapy of the left breast. Short communication

  7. Medication effects on sleep and breathing.

    Science.gov (United States)

    Seda, Gilbert; Tsai, Sheila; Lee-Chiong, Teofilo

    2014-09-01

    Sleep respiration is regulated by circadian, endocrine, mechanical and chemical factors, and characterized by diminished ventilatory drive and changes in Pao2 and Paco2 thresholds. Hypoxemia and hypercapnia are more pronounced during rapid eye movement. Breathing is influenced by sleep stage and airway muscle tone. Patient factors include medical comorbidities and body habitus. Medications partially improve obstructive sleep apnea and stabilize periodic breathing at altitude. Potential adverse consequences of medications include precipitation or worsening of disorders. Risk factors for adverse medication effects include aging, medical disorders, and use of multiple medications that affect respiration. Published by Elsevier Inc.

  8. Effect of breathing technique of blowing on the extent of damage to the perineum at the moment of delivery: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Zohre Ahmadi

    2017-01-01

    Full Text Available Introduction: One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women. Materials and Methods: This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full-term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group and valsalva maneuver (control group. In the control group, pushing was done with holding the breath. In the case group, the women were asked to take 2 deep abdominal breaths at the onset of pain, then take another deep breath, and push 4–5 seconds with the open mouth while controlling exhalation. From the crowning stage onward, the women were directed to control their pushing, and do the blowing technique. Results: According to the results, intact perineum was more observed in the case group (P = 0.002. Posterior tears (Grade 1, 2, and 3 was considerably higher in the control group (P = 0.003. Anterior tears (labias and episiotomy were not significantly different in the two groups. Conclusions: It was concluded that breathing technique of blowing can be a good alternative to Valsalva maneuver in order to reduce perineal damage in laboring women.

  9. Heart Failure

    Science.gov (United States)

    ... Other diseases. Chronic diseases — such as diabetes, HIV, hyperthyroidism, hypothyroidism, or a buildup of iron (hemochromatosis) or ... transplantation or support with a ventricular assist device. Prevention The key to preventing heart failure is to ...

  10. Heart Attack

    Science.gov (United States)

    ... properly causes your body's blood sugar levels to rise, increasing your risk of heart attack. Metabolic syndrome. This occurs when you have obesity, high blood pressure and high blood sugar. Having metabolic ...

  11. 3D confocal imaging in CUBIC-cleared mouse heart

    Energy Technology Data Exchange (ETDEWEB)

    Nehrhoff, I.; Bocancea, D.; Vaquero, J.; Vaquero, J.J.; Lorrio, M.T.; Ripoll, J.; Desco, M.; Gomez-Gaviro, M.V.

    2016-07-01

    Acquiring high resolution 3D images of the heart enables the ability to study heart diseases more in detail. Here, the CUBIC (clear, unobstructed brain imaging cocktails and computational analysis) clearing protocol was adapted for thick mouse heart sections to increase the penetration depth of the confocal microscope lasers into the tissue. The adapted CUBIC clearing of the heart lets the antibody penetrate deeper into the tissue by a factor of five. The here shown protocol enables deep 3D highresolution image acquisition in the heart. This allows a much more accurate assessment of the cellular and structural changes that underlie heart diseases. (Author)

  12. 3D confocal imaging in CUBIC-cleared mouse heart

    International Nuclear Information System (INIS)

    Nehrhoff, I.; Bocancea, D.; Vaquero, J.; Vaquero, J.J.; Lorrio, M.T.; Ripoll, J.; Desco, M.; Gomez-Gaviro, M.V.

    2016-01-01

    Acquiring high resolution 3D images of the heart enables the ability to study heart diseases more in detail. Here, the CUBIC (clear, unobstructed brain imaging cocktails and computational analysis) clearing protocol was adapted for thick mouse heart sections to increase the penetration depth of the confocal microscope lasers into the tissue. The adapted CUBIC clearing of the heart lets the antibody penetrate deeper into the tissue by a factor of five. The here shown protocol enables deep 3D highresolution image acquisition in the heart. This allows a much more accurate assessment of the cellular and structural changes that underlie heart diseases. (Author)

  13. Classes of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

  14. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  15. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  16. Effect of dead space on breathing stability at exercise in hypoxia.

    Science.gov (United States)

    Hermand, Eric; Lhuissier, François J; Richalet, Jean-Paul

    2017-12-01

    Recent studies have shown that normal subjects exhibit periodic breathing when submitted to concomitant environmental (hypoxia) and physiological (exercise) stresses. A mathematical model including mass balance equations confirmed the short period of ventilatory oscillations and pointed out an important role of dead space in the genesis of these phenomena. Ten healthy subjects performed mild exercise on a cycloergometer in different conditions: rest/exercise, normoxia/hypoxia and no added dead space/added dead space (aDS). Ventilatory oscillations (V˙E peak power) were augmented by exercise, hypoxia and aDS (Pspace. This underlines opposite effects observed in heart failure patients and normal subjects, in which added dead space drastically reduced periodic breathing and sleep apneas. It also points out that alveolar ventilation remains very close to metabolic needs and is not affected by an added dead space. Clinical Trial reg. n°: NCT02201875. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Self contained compressed air breathing apparatus to facilitate personnel decontamination

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, C W [Radiological and Safety Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1963-11-15

    This report describes the modification of a Self Contained Compressed Air Breathing Apparatus to provide extended respiratory protection to grossly contaminated personnel during a decontamination period which may exceed the duration of the Breathing Apparatus air supply. (author)

  18. Self contained compressed air breathing apparatus to facilitate personnel decontamination

    International Nuclear Information System (INIS)

    McDonald, C.W.

    1963-11-01

    This report describes the modification of a Self Contained Compressed Air Breathing Apparatus to provide extended respiratory protection to grossly contaminated personnel during a decontamination period which may exceed the duration of the Breathing Apparatus air supply. (author)

  19. Respiration Induced Heart Motion and Indications of Gated Delivery for Left-Sided Breast Irradiation

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Hu, Angela; Wang Kai; Newman, Francis; Crosby, Marcus; Hu Bin; White, Julia; Li, X. Allen

    2012-01-01

    Purpose: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. Methods and Materials: Images of 4DCT acquired during free breathing for 20 left-sided breast cancer patients, who underwent whole breast irradiation with or without regional nodal irradiation, were analyzed retrospectively. Dose distributions were reconstructed in the phases of 0%, 20%, and 50%. The intrafractional heart displacement was measured in three selected transverse CT slices using D LAD (the distance from left ascending aorta to a fixed line [connecting middle point of sternum and the body] drawn on each slice) and maximum heart depth (MHD, the distance of the forefront of the heart to the line). Linear regression analysis was used to correlate these indices with mean heart dose and heart dose volume at different breathing phases. Results: Respiration-induced heart displacement resulted in observable variations in dose delivered to the heart. During a normal free-breathing cycle, heart-induced motion D LAD and MHD changed up to 9 and 11 mm respectively, resulting in up to 38% and 39% increases of mean doses and V 25.2 for the heart. MHD and D LAD were positively correlated with mean heart dose and heart dose volume. Respiratory-adapted gated treatment may better spare heart and ipsilateral-lung compared with the conventional non-gated plan in a subset of patients with large D LAD or MHD variations. Conclusion: Proposed indices offer novel assessment of heart displacement based on 4DCT images. MHD and D LAD can be used independently or jointly as selection criteria for respiratory gating procedure before treatment planning. Patients with great intrafractional MHD variations or tumor(s) close to the diaphragm may particularly benefit from the gated treatment.

  20. Difficult cases in heart failure: the challenge of neurocognitive dysfunction in severe heart failure.

    Science.gov (United States)

    Sangha, Sumadeep S; Uber, Patricia A; Park, Myung H; Scott, Robert L; Mehra, Mandeep R

    2002-01-01

    Often ignored, neurocognitive dysfunction in chronic heart failure represents a daunting morbidity progressing to loss of self-reliance. Although the precise mechanisms arbitrating the development of this disorder remain elusive, microembolization and cerebral hypoperfusion are implicated. Other causes of cognitive decline may include prior cardiac surgery, chronic hypertension, sleep disordered breathing, hyperhomocysteinemia, dementia of aging, and more traditional causes such as Alzheimer's disease. The discovery of neurocognitive defects in heart failure must prompt a well-constructed diagnostic evaluation to search for the underlying causes since this process may be at least partially reversible in many cases. Copyright 2002 CHF, Inc

  1. Deep smarts.

    Science.gov (United States)

    Leonard, Dorothy; Swap, Walter

    2004-09-01

    When a person sizes up a complex situation and rapidly comes to a decision that proves to be not just good but brilliant, you think, "That was smart." After you watch him do this a few times, you realize you're in the presence of something special. It's not raw brainpower, though that helps. It's not emotional intelligence, either, though that, too, is often involved. It's deep smarts. Deep smarts are not philosophical--they're not"wisdom" in that sense, but they're as close to wisdom as business gets. You see them in the manager who understands when and how to move into a new international market, in the executive who knows just what kind of talk to give when her organization is in crisis, in the technician who can track a product failure back to an interaction between independently produced elements. These are people whose knowledge would be hard to purchase on the open market. Their insight is based on know-how more than on know-what; it comprises a system view as well as expertise in individual areas. Because deep smarts are experienced based and often context specific, they can't be produced overnight or readily imported into an organization. It takes years for an individual to develop them--and no time at all for an organization to lose them when a valued veteran walks out the door. They can be taught, however, with the right techniques. Drawing on their forthcoming book Deep Smarts, Dorothy Leonard and Walter Swap say the best way to transfer such expertise to novices--and, on a larger scale, to make individual knowledge institutional--isn't through PowerPoint slides, a Web site of best practices, online training, project reports, or lectures. Rather, the sage needs to teach the neophyte individually how to draw wisdom from experience. Companies have to be willing to dedicate time and effort to such extensive training, but the investment more than pays for itself.

  2. [Death by erotic asphyxiation (breath control play)].

    Science.gov (United States)

    Madea, Burkhard; Hagemeier, Lars

    2013-01-01

    Most cases of sexual asphyxia are due to autoerotic activity. Asphyxia due to oronasal occlusion is mostly seen in very old or very young victims. Oronasal occlusion is also used in sadomasochistic sexual practices like "breath control play" or "erotic asphyxiation". If life saving time limitations of oronasal occlusion are not observed, conviction for homicide caused by negligence is possible.

  3. Detection of bronchial breathing caused by pneumonia.

    Science.gov (United States)

    Gross, V; Fachinger, P; Penzel, Th; Koehler, U; von Wichert, P; Vogelmeier, C

    2002-06-01

    The classic auscultation with stethoscope is the established clinical method for the detection of lung diseases. The interpretation of the sounds depends on the experience of the investigating physician. Therefore, a new computer-based method has been developed to classify breath sounds from digital lung sound recordings. Lung sounds of 11 patients with one-sided pneumonia and bronchial breathing were recorded on both the pneumonia side and on contralateral healthy side simultaneously using two microphones. The spectral power for the 300-600 Hz frequency band was computed for four respiratory cycles and normalized. For each breath, the ratio R between the time-segments (duration = 0.1 s) with the highest inspiratory and highest expiratory flow was calculated and averaged. We found significant differences in R between the pneumonia side (R = 1.4 +/- 1.3) and the healthy side (R = 0.5 +/- 0.5; p = 0.003 Wilcoxon-test) of lung. In 218 healthy volunteers we found R = 0.3 +/- 0.2 as a reference-value. The differences of ratio R (delta R) between the pneumonia side and the healthy side (delta R = 1.0 +/- 0.9) were significantly higher compared to follow-up studies after recovery (delta R = 0.0 +/- 0.1, p = 0.005 Wilcoxon-test). The computer based detection of bronchial breathing can be considered useful as part of a quantitative monitoring of patients at risk to develop pneumonia.

  4. CONTINUOUS EXHALED BREATH ANALYSIS ON THE ICU

    International Nuclear Information System (INIS)

    Bos, Lieuwe D. J.; Sterk, Peter J.; Schultz, Marcus J.

    2011-01-01

    During admittance to the ICU, critically ill patients frequently develop secondary infections and/or multiple organ failure. Continuous monitoring of biological markers is very much needed. This study describes a new method to continuously monitor biomarkers in exhaled breath with an electronic nose.

  5. A simple, remote, video based breathing monitor.

    Science.gov (United States)

    Regev, Nir; Wulich, Dov

    2017-07-01

    Breathing monitors have become the all-important cornerstone of a wide variety of commercial and personal safety applications, ranging from elderly care to baby monitoring. Many such monitors exist in the market, some, with vital signs monitoring capabilities, but none remote. This paper presents a simple, yet efficient, real time method of extracting the subject's breathing sinus rhythm. Points of interest are detected on the subject's body, and the corresponding optical flow is estimated and tracked using the well known Lucas-Kanade algorithm on a frame by frame basis. A generalized likelihood ratio test is then utilized on each of the many interest points to detect which is moving in harmonic fashion. Finally, a spectral estimation algorithm based on Pisarenko harmonic decomposition tracks the harmonic frequency in real time, and a fusion maximum likelihood algorithm optimally estimates the breathing rate using all points considered. The results show a maximal error of 1 BPM between the true breathing rate and the algorithm's calculated rate, based on experiments on two babies and three adults.

  6. Breathing easier: Indonesia works towards cleaner air

    International Nuclear Information System (INIS)

    Madsen, Michael Amdi

    2015-01-01

    Indonesians can look forward to breathing cleaner air following upcoming changes in regulations introduced as a result of a study conducted using nuclear analytical techniques. Lead pollution and other fine particulate matter in the air is now, for the first time, being accurately monitored and is giving Indonesian officials a good understanding of their air pollution problem and how to manage it.

  7. Multi-layered breathing architectural envelope

    DEFF Research Database (Denmark)

    Lund Larsen, Andreas; Foged, Isak Worre; Jensen, Rasmus Lund

    2014-01-01

    A multi layered breathing envelope is developed as a method of natural ventilation. The two main layers consist of mineral wool and air permeable concrete. The mineral wool works as a dynamic insulation and the permeable concrete as a heat recovery system with a high thermal mass for heat storage...

  8. A breath actuated dry powder inhaler

    NARCIS (Netherlands)

    de Boer, Anne; Frijlink, Henderik W.; Hagedoorn, Paul

    2015-01-01

    A breath actuated dry powder inhaler with a single air circulation chamber for de-agglomeration of entrained powdered medicament using the energy of the inspiratory air stream. The chamber has a substantially polygonal sidewall, a plurality of air supply channels entering the chamber substantially

  9. 21 CFR 862.3050 - Breath-alcohol test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breath-alcohol test system. 862.3050 Section 862.3050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....3050 Breath-alcohol test system. (a) Identification. A breath-alcohol test system is a device intened...

  10. 46 CFR 197.340 - Breathing gas supply.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Breathing gas supply. 197.340 Section 197.340 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.340 Breathing gas supply. (a) A primary breathing gas supply for surface-supplied diving must be sufficient to support the following for the...

  11. 46 CFR 197.312 - Breathing supply hoses.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Breathing supply hoses. 197.312 Section 197.312 Shipping... GENERAL PROVISIONS Commercial Diving Operations Equipment § 197.312 Breathing supply hoses. (a) Each breathing supply hose must— (1) Have a maximum working pressure that is equal to or exceeds— (i) The maximum...

  12. 21 CFR 868.5240 - Anesthesia breathing circuit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to a...

  13. IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

    Directory of Open Access Journals (Sweden)

    Veronique Sousa

    2017-07-01

    Conclusion: Statistically significant associations were established between the breathing pattern and the horizontal alignment of acromions, as well as the horizontal and vertical alignment of the head; between the pattern of breathing and swallowing with occlusal relationship anteroposterior and occlusal relationship vertical and also between breathing pattern and swallowing with digital sucking habits and pacifier use.

  14. Efficacy of device-guided breathing for hypertension in blinded, randomized, active-controlled trials : a meta-analysis of individual patient data

    NARCIS (Netherlands)

    Landman, Gijs W. D.; van Hateren, Kornelis J. J.; van Dijk, Peter R.; Logtenberg, Susan J. J.; Houweling, Sebastiaan T.; Groenier, Klaas H.; Bilo, Henk J. G.; Kleefstra, Nanne

    IMPORTANCE: Device-guided breathing (DGB) is recommended by the American Heart Association for its blood pressure-lowering effects. Most previous studies that showed beneficial effects on blood pressure had low methodological quality and only investigated short-term blood pressure effects.

  15. Comparison of two single-breath-held 3-D acquisitions with multi-breath-held 2-D cine steady-state free precession MRI acquisition in children with single ventricles

    Energy Technology Data Exchange (ETDEWEB)

    Atweh, Lamya A.; Dodd, Nicholas A.; Krishnamurthy, Ramkumar; Chu, Zili D. [Texas Children' s Hospital, EB Singleton Department of Pediatric Radiology, Cardiovascular Imaging, Houston, TX (United States); Pednekar, Amol [Philips Healthcare, Houston, TX (United States); Krishnamurthy, Rajesh [Texas Children' s Hospital, EB Singleton Department of Pediatric Radiology, Cardiovascular Imaging, Houston, TX (United States); Baylor College of Medicine, Department of Radiology, Houston, TX (United States); Baylor College of Medicine, Department of Pediatrics, Houston, TX (United States)

    2016-05-15

    Breath-held two-dimensional balanced steady-state free precession cine acquisition (2-D breath-held SSFP), accelerated with parallel imaging, is the method of choice for evaluating ventricular function due to its superior blood-to-myocardial contrast, edge definition and high intrinsic signal-to-noise ratio throughout the cardiac cycle. The purpose of this study is to qualitatively and quantitatively compare the two different single-breath-hold 3-D cine SSFP acquisitions using 1) multidirectional sensitivity encoding (SENSE) acceleration factors (3-D multiple SENSE SSFP), and 2) k-t broad-use linear acceleration speed-up technique (3-D k-t SSFP) with the conventional 2-D breath-held SSFP in non-sedated asymptomatic volunteers and children with single ventricle congenital heart disease. Our prospective study was performed on 30 non-sedated subjects (9 healthy volunteers and 21 functional single ventricle patients), ages 12.5 +/- 2.8 years. Two-dimensional breath-held SSFP with SENSE acceleration factor of 2, eight-fold accelerated 3-D k-t SSFP, and 3-D multiple SENSE SSFP with total parallel imaging factor of 4 were performed to evaluate ventricular volumes and mass in the short-axis orientation. Image quality scores (blood myocardial contrast, edge definition and interslice alignment) and volumetric analysis (end systolic volume, end diastolic volume and ejection fraction) were performed on the data sets by experienced users. Paired t-test was performed to compare each of the 3-D k-t SSFP and 3-D multiple SENSE SSFP clinical scores against 2-D breath-held SSFP. Bland-Altman analysis was performed on left ventricle (LV) and single ventricle volumetry. Interobserver and intraobserver variability in volumetric measurements were determined using intraclass coefficients. The clinical scores were highest for the 2-D breath-held SSFP images. Between the two 3-D sequences, 3-D multiple SENSE SSFP performed better than 3-D k-t SSFP. Bland-Altman analysis for volumes

  16. Heart rate response to hypoxic exercise

    DEFF Research Database (Denmark)

    Lundby, C; Møller, P; Kanstrup, I L

    2001-01-01

    progressively decreased the maximal heart rate from day 1 and onwards; also, hypoxia by itself increased plasma noradrenaline levels after maximal exercise. Domperidone further increased maximal noradrenaline concentrations, but had no effect on maximal heart rate. On each study day at altitude, oxygen......This study examined the effects of dopamine D(2)-receptor blockade on the early decrease in maximal heart rate at high altitude (4559 m). We also attempted to clarify the time-dependent component of this reduction and the extent to which it is reversed by oxygen breathing. Twelve subjects performed...... two consecutive maximal exercise tests, without and with oxygen supplementation respectively, at sea level and after 1, 3 and 5 days at altitude. On each study day, domperidone (30 mg; n=6) or no medication (n=6) was given 1 h before the first exercise session. Compared with sea level, hypoxia...

  17. Heart valve surgery

    Science.gov (United States)

    ... replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... surgery. Your heart valve has been damaged by infection ( endocarditis ). You have received a new heart valve ...

  18. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  19. Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy

    NARCIS (Netherlands)

    Wieling, W.; van Brederode, J. F.; de Rijk, L. G.; Borst, C.; Dunning, A. J.

    1982-01-01

    We examined the heart rate changes induced by forced breathing and by standing up in 133 healthy subjects in the age range 10-65 years in order to establish a data base for studies on parasympathetic heart rate control in autonomic neuropathy. Test results declined with age. Log-transformation was

  20. UNDERWATER STROKE KINEMATICS DURING BREATHING AND BREATH-HOLDING FRONT CRAWL SWIMMING

    Directory of Open Access Journals (Sweden)

    Nickos Vezos

    2007-03-01

    Full Text Available The aim of the present study was to determine the effects of breathing on the three - dimensional underwater stroke kinematics of front crawl swimming. Ten female competitive freestyle swimmers participated in the study. Each subject swam a number of front crawl trials of 25 m at a constant speed under breathing and breath-holding conditions. The underwater motion of each subject's right arm was filmed using two S-VHS cameras, operating at 60 Hz, which were positioned behind two underwater viewing windows. The spatial coordinates of selected points were calculated using the DLT procedure with 30 control points and after the digital filtering of the raw data with a cut-off frequency of 6 Hz, the hand's linear displacements and velocities were calculated. The results revealed that breathing caused significantly increases in the stroke duration (t9 = 2.764; p < 0.05, the backward hand displacement relative to the water (t9 = 2.471; p<0.05 and the lateral displacement of the hand in the X - axis during the downsweep (t9 = 2.638; p < 0.05. On the contrary, the peak backward hand velocity during the insweep (t9 = 2.368; p < 0.05 and the displacement of the hand during the push phase (t9 = -2.297; p < 0.05 were greatly reduced when breathing was involved. From the above, it was concluded that breathing action in front crawl swimming caused significant modifications in both the basic stroke parameters and the overall motor pattern were, possibly due to body roll during breathing

  1. Breath Analysis Using Laser Spectroscopic Techniques: Breath Biomarkers, Spectral Fingerprints, and Detection Limits

    Directory of Open Access Journals (Sweden)

    Peeyush Sahay

    2009-10-01

    Full Text Available Breath analysis, a promising new field of medicine and medical instrumentation, potentially offers noninvasive, real-time, and point-of-care (POC disease diagnostics and metabolic status monitoring. Numerous breath biomarkers have been detected and quantified so far by using the GC-MS technique. Recent advances in laser spectroscopic techniques and laser sources have driven breath analysis to new heights, moving from laboratory research to commercial reality. Laser spectroscopic detection techniques not only have high-sensitivity and high-selectivity, as equivalently offered by the MS-based techniques, but also have the advantageous features of near real-time response, low instrument costs, and POC function. Of the approximately 35 established breath biomarkers, such as acetone, ammonia, carbon dioxide, ethane, methane, and nitric oxide, 14 species in exhaled human breath have been analyzed by high-sensitivity laser spectroscopic techniques, namely, tunable diode laser absorption spectroscopy (TDLAS, cavity ringdown spectroscopy (CRDS, integrated cavity output spectroscopy (ICOS, cavity enhanced absorption spectroscopy (CEAS, cavity leak-out spectroscopy (CALOS, photoacoustic spectroscopy (PAS, quartz-enhanced photoacoustic spectroscopy (QEPAS, and optical frequency comb cavity-enhanced absorption spectroscopy (OFC-CEAS. Spectral fingerprints of the measured biomarkers span from the UV to the mid-IR spectral regions and the detection limits achieved by the laser techniques range from parts per million to parts per billion levels. Sensors using the laser spectroscopic techniques for a few breath biomarkers, e.g., carbon dioxide, nitric oxide, etc. are commercially available. This review presents an update on the latest developments in laser-based breath analysis.

  2. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter ... most common heart attack symptom in men and women is chest pain or discomfort. However, women also ...

  3. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  4. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  5. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

  6. Thoron-in-breath monitoring at CRNL

    International Nuclear Information System (INIS)

    Peterman, B.F.

    1985-04-01

    This report contains a description of the thoron-in-breath monitor (TIBM) developed at CRNL. This monitor can be used to estimate the amount of thorium (Th-232 and/or Th-228) in humans. Thoron-in-breath monitoring is based on the fact that thoron (Rn-220) is a decay product of thorium, and hence deposited thorium produces thoron in vivo, a fraction of which will be exhaled. Experiences with the TIBM indicate that the monitoring is easy to perform and the results in terms of contaminated vs uncontaminated subjects can be easily interpreted. Work on relationships between thoron exhaled and deposited thorium and hence between thoron exhaled and dose, is continuing

  7. Weyl magnons in breathing pyrochlore antiferromagnets

    Science.gov (United States)

    Li, Fei-Ye; Li, Yao-Dong; Kim, Yong Baek; Balents, Leon; Yu, Yue; Chen, Gang

    2016-01-01

    Frustrated quantum magnets not only provide exotic ground states and unusual magnetic structures, but also support unconventional excitations in many cases. Using a physically relevant spin model for a breathing pyrochlore lattice, we discuss the presence of topological linear band crossings of magnons in antiferromagnets. These are the analogues of Weyl fermions in electronic systems, which we dub Weyl magnons. The bulk Weyl magnon implies the presence of chiral magnon surface states forming arcs at finite energy. We argue that such antiferromagnets present a unique example, in which Weyl points can be manipulated in situ in the laboratory by applied fields. We discuss their appearance specifically in the breathing pyrochlore lattice, and give some general discussion of conditions to find Weyl magnons, and how they may be probed experimentally. Our work may inspire a re-examination of the magnetic excitations in many magnetically ordered systems. PMID:27650053

  8. Universe out of a breathing bubble

    International Nuclear Information System (INIS)

    Guendelman, Eduardo I.; Sakai, Nobuyuki

    2008-01-01

    We consider the model of a false-vacuum bubble with a thin wall where the surface energy density is composed of two different components, 'domain-wall' type and 'dust' type, with opposite signs. We find stably oscillating solutions, which we call 'breathing bubbles'. By decay to a lower mass state, such a breathing bubble could become either (i) a child universe or ii) a bubble that 'eats up' the original universe, depending on the sign of the surface energy of the domain-wall component. We also discuss the effect of the finite-thickness corrections to the thin-wall approximation and possible origins of the energy contents of our model

  9. Primary fibro sarcoma of the heart.

    Science.gov (United States)

    Kabashi, Serbeze; Hoxha, Naim; Gashi, Shkelzen; Ahmegjekaj, Ilir; Bejta, Ilir; Sadiku, Muharrem; Ymeri, Halit; Kabashi, Antigona; Bicaj, Xhavit; Mucaj, Sefedin

    2013-01-01

    Primary malignant heart tumors represent rare entities where fibro sarcoma represents about 3% of all. Introducing the patient: A 15 years old patient with cardiac insufficiency (heart failure) symptoms, such as weakness, cyanosis, palpitations and breathing difficulties; enlargement of upper mediastinum and pleural effusion. Through echocardiography a pericardial effusion and intracavitary thrombus in atrium was diagnosed. With computed tomography is diagnosed a tumoral mass in right atrium which is also spread in the right ventricle of the heart. Tumor is completely removed; pat histology result showed primary fibro sarcoma of the heart. At that time no metastasis was found. Conclusion. Primary malignant heart tumors may manifest like cardiac insufficiency or like systemic diseases. Fibrosarcomas are rare and have bad prognosis. On average patients can live around six months after initial symptoms appeared and diagnosis of the tumor was done. In the case of cardiac insufficiency with differential diagnosis we should also think of heart tumors, which could certainly be proved for or eliminated by echocardiography.

  10. A mechanical breathing simulator for respirator test

    International Nuclear Information System (INIS)

    Murata, Mikio; Ikezawa, Yoshio; Yoshida, Yoshikazu

    1976-01-01

    A mechanical breathing simulator has been developed to produce the human respiration for use in respirator test. The respirations were produced through the strokes of piston controlled by a rockerarm with adjustable fulcrum. The respiration rate was governed by motor-speed control, independent of the tidal volume achieved by adjustment of the piston stroke. By the breather, the simulated respirations for work rate 0, 208, 415, 622 and 830 kg-m/min could be produced through the typical dummy head. (auth.)

  11. The experimental modification of sonorous breathing.

    OpenAIRE

    Josephson, S C; Rosen, R C

    1980-01-01

    Loud snoring is a noxious habit and potential personal health risk. We are reporting the first experimental study of simple behavioral techniques for the modification of chronic snoring. Twenty-four volunteers participated in a repeated measures, randomized group design over 2 weeks of intervention and one-month follow-up. Treatment groups included a contingent-awakening and breathing retraining (self-control) condition. Both treatment groups were compared to a no-treatment control. Despite c...

  12. Breathing conditions for animals in radiobiological experiments

    International Nuclear Information System (INIS)

    Stevens, G.N.; Michael, B.D.

    1988-01-01

    In the course of experiments designed to determine the influence of redox agents on the radiosensitivity of murine normal tissues, an unexpected scatter of data points relating to jejunal crypt regeneration was found in mice irradiated under supposedly air-breathing conditions. One possible explanation for the scatter in the data related to variation in the oxygen tension within the jig at the time of irradiation, and the jig modified accordingly. (author)

  13. Breathing air trailer acceptance test report

    International Nuclear Information System (INIS)

    Kostelnik, A.J.

    1996-01-01

    This Acceptance Test Report documents compliance with the requirements of specification WHC-S-0251, Rev.0 and ECNs 613530 and 606113. The equipment was tested according to WHC-SD-WM-ATP-104. The equipment tested is a Breathing Air Supply Trailer purchased as a design and fabrication procurement activity. The ATP was written by the Seller and was performed by the Seller with representatives of the Westinghouse Hanford Company witnessing portions of the test at the Seller's location

  14. C-130J Breathing Resistance Study

    Science.gov (United States)

    2016-05-01

    scientific and technical information exchange , and its publication does not constitute the Government’s approval or disapproval of its ideas or findings...regulator and MBU- 20/P oxygen mask, was supplied gaseous Aviators’ Breathing Oxygen (ABO). The regulator was operated in various operating modes, at...Generating System (OBOGS) Laboratory, Area B, Wright-Patterson AFB OH. The CRU-73 oxygen regulator was supplied with 50 pounds/square inch of gaseous

  15. Houses need to breathe--right?

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.

    2004-10-01

    Houses need to breathe, but we can no longer leave the important functions associated with ventilation to be met accidentally. A designed ventilation system must be considered as much a part of a home as its heating system. Windows are a key part of that system because they allow a quick increase in ventilation for unusual events, but neither they nor a leaky building shell can be counted on to provide minimum levels.

  16. Breath tests and irritable bowel syndrome.

    Science.gov (United States)

    Rana, Satya Vati; Malik, Aastha

    2014-06-28

    Breath tests are non-invasive tests and can detect H₂ and CH₄ gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H₂ breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients.

  17. Forced Air-Breathing PEMFC Stacks

    Directory of Open Access Journals (Sweden)

    K. S. Dhathathreyan

    2012-01-01

    Full Text Available Air-breathing fuel cells have a great potential as power sources for various electronic devices. They differ from conventional fuel cells in which the cells take up oxygen from ambient air by active or passive methods. The air flow occurs through the channels due to concentration and temperature gradient between the cell and the ambient conditions. However developing a stack is very difficult as the individual cell performance may not be uniform. In order to make such a system more realistic, an open-cathode forced air-breathing stacks were developed by making appropriate channel dimensions for the air flow for uniform performance in a stack. At CFCT-ARCI (Centre for Fuel Cell Technology-ARC International we have developed forced air-breathing fuel cell stacks with varying capacity ranging from 50 watts to 1500 watts. The performance of the stack was analysed based on the air flow, humidity, stability, and so forth, The major advantage of the system is the reduced number of bipolar plates and thereby reduction in volume and weight. However, the thermal management is a challenge due to the non-availability of sufficient air flow to remove the heat from the system during continuous operation. These results will be discussed in this paper.

  18. Breathing is different in the quantum world

    Science.gov (United States)

    Bonitz, Michael; Bauch, Sebastian; Balzer, Karsten; Henning, Christian; Hochstuhl, David

    2009-11-01

    Interacting classicle particles in a harmonic trap are known to possess a radial collective oscillation -- the breathing mode (BM). In case of Coulomb interaction its frequency is universal -- it is independent of the particle number and system dimensionality [1]. Here we study strongly correlated quantum systems. We report a qualitatively different breathing behavior: a quantum system has two BMs one of which is universal whereas the frequency of the other varies with system dimensionality, the particle spin and the strength of the pair interaction. The results are based on exact solutions of the time-dependent Schr"odinger equation for two particles and on time-dependent many-body results for larger particle numbers. Finally, we discuss experimental ways to excite and measure the breathing frequencies which should give direct access to key properties of trapped particles, including their many-body effects [2]. [4pt] [1] C. Henning et al., Phys. Rev. Lett. 101, 045002 (2008) [0pt] [2] S. Bauch, K. Balzer, C. Henning, and M. Bonitz, submitted to Phys. Rev. Lett., arXiv:0903.1993

  19. Physiological techniques for detecting expiratory flow limitation during tidal breathing

    Directory of Open Access Journals (Sweden)

    N.G. Koulouris

    2011-09-01

    Full Text Available Patients with severe chronic obstructive pulmonary disease (COPD often exhale along the same flow–volume curve during quiet breathing as they do during the forced expiratory vital capacity manoeuvre, and this has been taken as an indicator of expiratory flow limitation at rest (EFLT. Therefore, EFLT, namely attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFLT leads to small airway injury and promotes dynamic pulmonary hyperinflation, with concurrent dyspnoea and exercise limitation. In fact, EFLT occurs commonly in COPD patients (mainly in Global Initiative for Chronic Obstructive Lung Disease III and IV stage, in whom the latter symptoms are common, but is not exclusive to COPD, since it can also be detected in other pulmonary and nonpulmonary diseases like asthma, acute respiratory distress syndrome, heart failure and obesity, etc. The existing up to date physiological techniques of assessing EFLT are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, noninvasive, practical and accurate new technique.

  20. Pericarditis - after heart attack

    Science.gov (United States)

    ... include: A previous heart attack Open heart surgery Chest trauma A heart attack that has affected the thickness of your heart muscle Symptoms Symptoms include: Anxiety Chest pain from the swollen pericardium rubbing on the ...

  1. Heart failure - home monitoring

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000113.htm Heart failure - home monitoring To use the sharing features on ... your high blood pressure Fast food tips Heart failure - discharge Heart failure - fluids and diuretics Heart failure - what to ...

  2. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular or abnormal ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  3. Heart disease and diet

    Science.gov (United States)

    Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet ... diet and lifestyle can reduce your risk of: Heart disease, heart attacks, and stroke Conditions that lead ...

  4. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

  5. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  6. Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants.

    Science.gov (United States)

    Gillies, Donna; Spence, Kaye

    2011-07-06

    Mechanical ventilation is commonly used in Neonatal Intensive Care Units to assist breathing in a variety of conditions. Mechanical ventilation is achieved through the placement of an endotracheal tube (ETT) which is left in-situ. The ETT is suctioned to prevent a build-up of secretions and blockage of the airway. Methods of suctioning the endotracheal tube vary according to institutional practice and the individual clinician performing the task. The depth of suctioning is one of these variables. The catheter may be passed to the tip of the ETT or beyond the tip into the trachea or bronchi to facilitate removal of secretions. However, trauma to the lower airways may result from the suction catheter being passed into the airway beyond the tip of the endotracheal tube. To compare the effectiveness and complications of deep (catheter passed beyond the tip of the ETT) versus shallow (catheter passed to length of ETT only) suctioning of the endotracheal tube in ventilated infants. In this first update the searches were expanded to the Cochrane Central Register of Controlled Trials (The Cochrane Library, March 30), MEDLINE (from January 1966 to May 30 2011), CINAHL (from 1982 to May 30 2011) and EMBASE (1980 to May 2011) using text words and subject headings relevant to endotracheal suctioning. There were no language restrictions. Controlled trials using random or quasi-random allocation of neonates receiving ventilatory support via an endotracheal tube to either deep or shallow endotracheal suctioning. The updated search resulted in 149 potentially relevant references. Two of the studies from this search were identified as potentially relevant. We included one of the potentially relevant studies and the other was excluded because it did not fit the inclusion criteria. One small crossover trial (n = 27) of shallow versus deep suctioning met the criteria for inclusion in this review. The reported outcomes were oxygen saturation and heart rate, during and after suctioning

  7. Development of a 4D numerical chest phantom with customizable breathing.

    Science.gov (United States)

    Leni, Pierre-Emmanuel; Laurent, Rémy; Salomon, Michel; Gschwind, Régine; Makovicka, Libor; Henriet, Julien

    2016-06-01

    Respiratory movement information is useful for radiation therapy, and is generally obtained using 4D scanners (4DCT). In the interest of patient safety, reducing the use of 4DCT could be a significant step in reducing radiation exposure, the effects of which are not well documented. The authors propose a customized 4D numerical phantom representing the organ contours. Firstly, breathing movement can be simulated and customized according to the patient's anthroporadiametric data. Using learning sets constituted by 4D scanners, artificial neural networks can be trained to interpolate the lung contours corresponding to an unknown patient, and then to simulate its respiration. Lung movement during the breathing cycle is modeled by predicting the lung contours at any respiratory phases. The interpolation is validated comparing the obtained lung contours with 4DCT via Dice coefficient. Secondly, a preliminary study of cardiac and œsophageal motion is also presented to demonstrate the flexibility of this approach. The application may simulate the position and volume of the lungs, the œsophagus and the heart at every phase of the respiratory cycle with a good accuracy: the validation of the lung modeling gives a Dice index greater than 0.93 with 4DCT over a breath cycle. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. DiapHRaGM: A mnemonic to describe the work of breathing in patients with respiratory failure.

    Directory of Open Access Journals (Sweden)

    Aiman Tulaimat

    Full Text Available The assessment of the work of breathing in the definitions of respiratory failure is vague and variable.Identify a parsimonious set of signs to describe the work of breathing in hypoxemic, acutely ill patients.We examined consecutive medical ICU patients receiving oxygen with a mask, non-invasive ventilation, or T-piece. A physician inspected each patient for 10 seconds, rated the level of respiratory distress, and then examined the patient for vital signs and 17 other physical signs. We used the rating of distress as a surrogate for measuring the work of breathing, constructed three multivariate models to identify the one with the smallest number of signs and largest explained variance, and validated it with bootstrap analysis.We performed 402 observations on 240 patients. Respiratory distress was absent in 78, mild in 157, moderate in 107, and severe in 60. Respiratory rate, hypoxia, heart rate, and frequency of most signs increased as distress increased. Respiratory rate and hypoxia explained 43% of the variance in respiratory distress. Diaphoresis, gasping, and contraction of the sternomastoid explained an additional 28%. Heart rate, blood pressure, alertness, agitation, body posture, nasal flaring, audible breathing, cyanosis, tracheal tug, retractions, paradox, scalene or abdominal muscles contraction did not increase the explained variance in respiratory distress.Most of the variance is respiratory distress can be explained by five signs summarized by the mnemonic DiapHRaGM (diaphoresis, hypoxia, respiratory rate, gasping, accessory muscle. This set of signs may allow for efficient, standardized assessments of the work of breathing of hypoxic patients.

  9. The development of glossopharyngeal breathing and palatal myoclonus in a 29 year old after scuba diving

    Directory of Open Access Journals (Sweden)

    Thomas AR

    2011-02-01

    Full Text Available Palatal myoclonus is a rare movement disorder characterized by brief, rhythmic involuntary movements of the soft palate. Palatal myoclonus is further subdivided into “essential palatal tremor” (EPT and “symptomatic palatal tremor” (SPT. EPT is characterized by involvement of the tensor veli palatini, myoclonus that might persist during sleep, as well as ear clicks, usually the patient’s presenting complaint. The MRI and neurological exam are normal in EPT. SPT is characterized by involvement of the levator veli palatini and myoclonus which consistently perseveres during sleep. The MRI shows olivary hypertrophy and clinical features may include ataxia, dysarthria and nystagmus, depending on the size of the lesion1. Glossopharyngeal breathing is a technique used by deep-sea divers to increase lung vital capacity, which is also useful in patients with ventilator dependence from poliomyelitis and Duchenne muscular dystrophy. To date there have been no reported cases of palatal myoclonus and glossopharyngeal breathing occurring simultaneously. We present the case of a 29 year-old female with palatal myoclonus and glossopharyngeal breathing after scuba-diving.

  10. Cardiorespiratory physiological phenotypic plasticity in developing air-breathing anabantid fishes (Betta splendens and Trichopodus trichopterus).

    Science.gov (United States)

    Mendez-Sanchez, Jose F; Burggren, Warren W

    2017-08-01

    Developmental plasticity of cardiorespiratory physiology in response to chronic hypoxia is poorly understood in larval fishes, especially larval air-breathing fishes, which eventually in their development can at least partially "escape" hypoxia through air breathing. Whether the development air breathing makes these larval fishes less or more developmentally plastic than strictly water breathing larval fishes remains unknown. Consequently, developmental plasticity of cardiorespiratory physiology was determined in two air-breathing anabantid fishes ( Betta splendens and Trichopodus trichopterus ). Larvae of both species experienced an hypoxic exposure that mimicked their natural environmental conditions, namely chronic nocturnal hypoxia (12 h at 17 kPa or 14 kPa), with a daily return to diurnal normoxia. Chronic hypoxic exposures were made from hatching through 35 days postfertilization, and opercular and heart rates measured as development progressed. Opercular and heart rates in normoxia were not affected by chronic nocturnal hypoxic. However, routine oxygen consumption M˙O2 (~4  μ mol·O 2 /g per hour in normoxia in larval Betta ) was significantly elevated by chronic nocturnal hypoxia at 17 kPa but not by more severe (14 kPa) nocturnal hypoxia. Routine M˙O2 in Trichopodus (6-7  μ mol·O 2 /g per hour), significantly higher than in Betta , was unaffected by either level of chronic hypoxia. P Crit , the PO 2 at which M˙O2 decreases as ambient PO 2 falls, was measured at 35 dpf, and decreased with increasing chronic hypoxia in Betta , indicating a large, relatively plastic hypoxic tolerance. However, in contrast, P Crit in Trichopodus increased as rearing conditions grew more hypoxic, suggesting that hypoxic acclimation led to lowered hypoxic resistance. Species-specific differences in larval physiological developmental plasticity thus emerge between the relatively closely related Betta and Trichopodus Hypoxic rearing increased hypoxic tolerance in

  11. Optimization of sampling parameters for standardized exhaled breath sampling.

    Science.gov (United States)

    Doran, Sophie; Romano, Andrea; Hanna, George B

    2017-09-05

    The lack of standardization of breath sampling is a major contributing factor to the poor repeatability of results and hence represents a barrier to the adoption of breath tests in clinical practice. On-line and bag breath sampling have advantages but do not suit multicentre clinical studies whereas storage and robust transport are essential for the conduct of wide-scale studies. Several devices have been developed to control sampling parameters and to concentrate volatile organic compounds (VOCs) onto thermal desorption (TD) tubes and subsequently transport those tubes for laboratory analysis. We conducted three experiments to investigate (i) the fraction of breath sampled (whole vs. lower expiratory exhaled breath); (ii) breath sample volume (125, 250, 500 and 1000ml) and (iii) breath sample flow rate (400, 200, 100 and 50 ml/min). The target VOCs were acetone and potential volatile biomarkers for oesophago-gastric cancer belonging to the aldehyde, fatty acids and phenol chemical classes. We also examined the collection execution time and the impact of environmental contamination. The experiments showed that the use of exhaled breath-sampling devices requires the selection of optimum sampling parameters. The increase in sample volume has improved the levels of VOCs detected. However, the influence of the fraction of exhaled breath and the flow rate depends on the target VOCs measured. The concentration of potential volatile biomarkers for oesophago-gastric cancer was not significantly different between the whole and lower airway exhaled breath. While the recovery of phenols and acetone from TD tubes was lower when breath sampling was performed at a higher flow rate, other VOCs were not affected. A dedicated 'clean air supply' overcomes the contamination from ambient air, but the breath collection device itself can be a source of contaminants. In clinical studies using VOCs to diagnose gastro-oesophageal cancer, the optimum parameters are 500mls sample volume

  12. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  13. Quantification of volatile organic compounds in exhaled human breath. Acetonitrile as biomarker for passive smoking. Model for isoprene in human breath; Quantifizierung organischer Spurenkomponenten in der menschlichen Atemluft. Acetonitril als Biomarker fuer Passivrauchen. Modell fuer Isopren im Atem, Zusammenhang Isoprenkonzentration, Cholesterinsynthese, lebensmittelchemische Untersuchungen an Knoblauch und Zwiebel

    Energy Technology Data Exchange (ETDEWEB)

    Prazeller, P

    2000-03-01

    concentration increases within a few seconds after starting exercise or awakening during the night as a result of a rapid increase in heart rate, and then reaches a lower steady state when breath rate stabilizes. A gas exchange model was developed and shows excellent fit to breath isoprene measured during exercise. We demonstrated that atorvastatin therapy leads to a decrease in serum cholesterol and LDL levels and a parallel decrease in breath isoprene levels. This work suggests that there is constant endogenous production of isoprene during the day and night, and reaffirms the possibility that breath isoprene can be a non-invasive marker of cholesterologenesis, if care is taken to measure breath isoprene under standard conditions. The third part of the thesis presents results out of the field of food chemistry. The effectiveness of thermal deactivation of the enzyme allinase is demonstrated using breath analysis after eating garlic. With highly time resolved measurements we succeeded in monitoring reactions occurring when garlic is crushed and in distinguishing between aerobic and anaerobic steps. (author)

  14. Effects of low temperature on breathing pattern and ventilatory responses during hibernation in the golden-mantled ground squirrel.

    Science.gov (United States)

    Webb, Cheryl L; Milsom, William K

    2017-07-01

    During entrance into hibernation in golden-mantled ground squirrels (Callospermophilus lateralis), ventilation decreases as metabolic rate and body temperature fall. Two patterns of respiration occur during deep hibernation. At 7 °C body temperature (T b ), a breathing pattern characterized by episodes of multiple breaths (20.6 ± 1.9 breaths/episode) separated by long apneas or nonventilatory periods (T nvp ) (mean = 11.1 ± 1.2 min) occurs, while at 4 °C T b , a pattern in which breaths are evenly distributed and separated by a relatively short T nvp (0.5 ± 0.05 min) occurs. Squirrels exhibiting each pattern have similar metabolic rates and levels of total ventilation (0.2 and 0.23 ml O 2 /hr/kg and 0.11 and 0.16 ml air/min/kg, respectively). Squirrels at 7 °C T b exhibit a significant hypoxic ventilatory response, while squirrels at 4 °C T b do not respond to hypoxia at any level of O 2 tested. Squirrels at both temperatures exhibit a significant hypercapnic ventilatory response, but the response is significantly reduced in the 4 °C T b squirrels. Carotid body denervation has little effect on the breathing patterns or on the hypercapnic ventilatory responses. It does reduce the magnitude and threshold for the hypoxic ventilatory response. Taken together the data suggest that (1) the fundamental rhythm generator remains functional at low temperatures; (2) the hypercapnic ventilatory response arises from central chemoreceptors that remain functional at very low temperatures; (3) the hypoxic ventilatory response arises from both carotid body and aortic chemoreceptors that are silenced at lower temperatures; and (4) there is a strong correlation between breathing pattern and chemosensitivity.

  15. New breathing functions for the transverse breathing crack of the cracked rotor system: Approach for critical and subcritical harmonic analysis

    Science.gov (United States)

    Al-Shudeifat, Mohammad A.; Butcher, Eric A.

    2011-01-01

    The actual breathing mechanism of the transverse breathing crack in the cracked rotor system that appears due to the shaft weight is addressed here. As a result, the correct time-varying area moments of inertia for the cracked element cross-section during shaft rotation are also determined. Hence, two new breathing functions are identified to represent the actual breathing effect on the cracked element stiffness matrix. The new breathing functions are used in formulating the time-varying finite element stiffness matrix of the cracked element. The finite element equations of motion are then formulated for the cracked rotor system and solved via harmonic balance method for response, whirl orbits and the shift in the critical and subcritical speeds. The analytical results of this approach are compared with some previously published results obtained using approximate formulas for the breathing mechanism. The comparison shows that the previously used breathing function is a weak model for the breathing mechanism in the cracked rotor even for small crack depths. The new breathing functions give more accurate results for the dynamic behavior of the cracked rotor system for a wide range of the crack depths. The current approach is found to be efficient for crack detection since the critical and subcritical shaft speeds, the unique vibration signature in the neighborhood of the subcritical speeds and the sensitivity to the unbalance force direction all together can be utilized to detect the breathing crack before further damage occurs.

  16. DeepPy: Pythonic deep learning

    DEFF Research Database (Denmark)

    Larsen, Anders Boesen Lindbo

    This technical report introduces DeepPy – a deep learning framework built on top of NumPy with GPU acceleration. DeepPy bridges the gap between highperformance neural networks and the ease of development from Python/NumPy. Users with a background in scientific computing in Python will quickly...... be able to understand and change the DeepPy codebase as it is mainly implemented using high-level NumPy primitives. Moreover, DeepPy supports complex network architectures by letting the user compose mathematical expressions as directed graphs. The latest version is available at http...

  17. EIT based pulsatile impedance monitoring during spontaneous breathing in cystic fibrosis.

    Science.gov (United States)

    Krueger-Ziolek, Sabine; Schullcke, Benjamin; Gong, Bo; Müller-Lisse, Ullrich; Moeller, Knut

    2017-06-01

    Evaluating the lung function in patients with obstructive lung disease by electrical impedance tomography (EIT) usually requires breathing maneuvers containing deep inspirations and forced expirations. Since these maneuvers strongly depend on the patient's co-operation and health status, normal tidal breathing was investigated in an attempt to develop continuous maneuver-free measurements. Ventilation related and pulsatile impedance changes were systematically analyzed during normal tidal breathing in 12 cystic fibrosis (CF) patients and 12 lung-healthy controls (HL). Tidal breaths were subdivided into three inspiratory (In1, In2, In3) and three expiratory (Ex1, Ex2, Ex3) sections of the same amplitude of global impedance change. Maximal changes of the ventilation and the pulsatile impedance signal occurring during these sections were determined (▵I V and ▵I P ). Differences in ▵I V and ▵I P among sections were ascertained in relation to the first inspiratory section. In addition, ▵I V /▵I P was calculated for each section. Medians of changes in ▵I V were  <0.05% in all sections for both subject groups. Both groups showed a similar pattern of ▵I P changes during tidal breathing. Changes in ▵I P first decreased during inspiration (In2), then increased towards the end of inspiration (In3) and reached a maximum at the beginning of expiration (Ex1). During the last two sections of expiration (Ex2, Ex3) ▵I P changes decreased. The CF patients showed higher variations in ▵I P changes compared to the controls (CF:  -426.5%, HL:  -158.1%, coefficient of variation). Furthermore, ▵I V /▵I P significantly differed between expiratory sections for the CF patients (Ex1-Ex2, p  <  0.01; Ex1-Ex3, p  <  0.001; Ex2-Ex3, p  <  0.05), but not for the controls. No significant differences in ▵I V /▵I P between inspiratory sections were determined for both groups. Differences in ▵I P changes and in ▵I V /▵I P between

  18. [Diuretics and their potential effect on breath-alcohol concentration--a case report].

    Science.gov (United States)

    Schmitt, Georg; Skopp, Gisela

    2015-01-01

    Many objections were raised to breath-alcohol analysis upon its introduction in the field of traffic law enforcement in Germany, but in the meantime this issue has become less relevant in forensic routine work. In the present case, the defending lawyer claimed that the ethanol concentration in the blood and hence in the breath of his client, which was 0.35 mg/l according to the Dräger Alcotest 7110® Evidential and thus above the legal limit of 0.25 mg/l, had been changed by diuretics taken 4 hours before the breath alcohol test, viz. 10 mg of torasemide, a loop diuretic, and 50 mg of spironolactone, a competitive aldosterone antagonist. According to the literature, the maximum urinary output in healthy subjects within the first 4 hours after 10 mg torasemide was 1450 ml. In patients suffering from heart failure, the urinary volume was reduced by a factor of 2.5-3; after chronic intake of torasemide, water loss did not differ from placebo. Spironolactone, which acts on the distal tubule, has little effect on urinary output. In a publication, the loss of water in excess within 24 hours was 90 ml. Co-administration of 100 mg spironolactone and 20 mg furosemide, which roughly compares to 10 mg torasemide, resulted in a mean urinary volume of 1566 ml within the first 4 hours. In terms of the reported case and provided that no compensatory fluid had been taken, a purely theoretical maximum shift of 0.007 mg/ may occur in the breath-alcohol concentration due to the smaller distribution volume even considering maximum urinary excretion values. On the other hand, already mild levels of dehydration may be associated with negative symptoms affecting driving ability.

  19. Respiratory variations in the photoplethysmographic waveform: acute hypovolaemia during spontaneous breathing is not detected

    International Nuclear Information System (INIS)

    Nilsson, Lena; Goscinski, Tomas; Lindenberger, Marcus; Länne, Toste; Johansson, Anders

    2010-01-01

    Recent studies using photoplethysmographic (PPG) signals from pulse oximeters have shown potential to assess hypovolaemia during spontaneous breathing. This signal is heavily filtered and reports are based on respiratory variations in the small pulse synchronous variation of PPG. There are stronger respiratory variations such as respiratory synchronous variation (PPGr) in the baseline of the unfiltered PPG signal. We hypothesized that PPGr would increase during hypovolaemia during spontaneous breathing. Hemodynamic and respiratory data were recorded together with PPG infrared signals from the finger, ear and forearm from 12 healthy male volunteers, at rest and during hypovolaemia created by the application of a lower body negative pressure (LBNP) of 15, 30 and 60 cmH 2 O. Hemodynamic and respiratory values changed significantly. From rest to the LBNP of 60 cmH 2 O systolic blood pressure fell from median (IQR) 116 (16) to 101 (23) mmHg, the heart rate increased from 58 (16) to 73 (16) beats min −1 , and the respiratory rate increased from 9.5 (2.0) to 11.5 (4.0) breaths min −1 . The amplitude of PPGr did not change significantly at any measurement site. The strongest effect was seen at the ear, where the LBNP of 60 cmH 2 O gave an amplitude increase from 1.0 (0.0) to 1.31 (2.24) AU. PPG baseline respiratory variations cannot be used for detecting hypovolaemia in spontaneously breathing subjects

  20. A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Youbing, E-mail: youbing-yin@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Department of Radiology, The University of Iowa, Iowa City, IA 52242 (United States); Choi, Jiwoong, E-mail: jiwoong-choi@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Hoffman, Eric A., E-mail: eric-hoffman@uiowa.edu [Department of Radiology, The University of Iowa, Iowa City, IA 52242 (United States); Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242 (United States); Department of Internal Medicine, The University of Iowa, Iowa City, IA 52242 (United States); Tawhai, Merryn H., E-mail: m.tawhai@auckland.ac.nz [Auckland Bioengineering Institute, The University of Auckland, Auckland (New Zealand); Lin, Ching-Long, E-mail: ching-long-lin@uiowa.edu [Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242 (United States); IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, IA 52242 (United States)

    2013-07-01

    A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C{sub 1} continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung.

  1. A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

    Science.gov (United States)

    Yin, Youbing; Choi, Jiwoong; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

    2012-01-01

    A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C1 continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung. PMID:23794749

  2. Ontogenetic changes and developmental adjustments in lactate dehydrogenase isozymes of an obligate air-breathing fish Channa punctatus during deprivation of air access.

    Science.gov (United States)

    Ahmad, Riaz; Hasnain, Absar-Ul

    2005-02-01

    In air-breathing snakehead Channa punctatus, Ldh-B is expressed at all ontogenetic and developmental stages, while Ldh-A is expressed temporally in pre-hatchlings 12-13 days ahead of bimodal respiration marked by air-breathing. Remarkable differences are observed in the LDH isozyme expression among various ontogenetic and developmental stages upon denying air access. When denied air access, water-breathing larvae show two distinct characteristics: (i) they survive longer than transitory air-breathers due to independence from air-breathing and (ii) there is more transient induction of Ldh-B than Ldh-A. Transition to bimodal breathing, which occurred post-hatching in 15-day old larvae, is coincidental with inducibility of Ldh-A and concomitant down-regulation of Ldh-B. Heart tissue from air-breathing adults denied air access shows a preferential expression of LDH-A subunit and slight down-regulation of LDH-B. Heterotetramers of A and B subunits participate in adjusting LDH levels among those stages which either precede air-breathing switchover, or are subsequent to this transition. The contribution of heterotetramers depends on the stage-specific levels of LDH homotetramers A(4) or B(4). Scaling of muscle mass during growth, tolerance to extended deprivation of air access and induction of Ldh-A are correlated. Response to restoring air contact indicated that advanced air-breathing stages of C. punctatus possess an inherent capacity to sense surface air. In kinetic properties, LDH isozymes of C. punctatus are teleost-like but species specificity is displayed in oxidative potential by cardiac muscle and in L-lactate reduction by skeletal muscle.

  3. Sleep-disordered breathing and mortality: a prospective cohort study.

    OpenAIRE

    Naresh M Punjabi; Brian S Caffo; James L Goodwin; Daniel J Gottlieb; Anne B Newman; George T O'Connor; David M Rapoport; Susan Redline; Helaine E Resnick; John A Robbins; Eyal Shahar; Mark L Unruh; Jonathan M Samet

    2009-01-01

    Editors' Summary Background About 1 in 10 women and 1 in 4 men have a chronic condition called sleep-disordered breathing although most are unaware of their problem. Sleep-disordered breathing, which is commonest in middle-aged and elderly people, is characterized by numerous, brief (10 second or so) interruptions of breathing during sleep. These interruptions, which usually occur when relaxation of the upper airway muscles decreases airflow, lower the level of oxygen in the blood and, as a r...

  4. Apparatus and method for monitoring breath acetone and diabetic diagnostics

    Science.gov (United States)

    Duan, Yixiang [Los Alamos, NM; Cao, Wenqing [Los Alamos, NM

    2008-08-26

    An apparatus and method for monitoring diabetes through breath acetone detection and quantitation employs a microplasma source in combination with a spectrometer. The microplasma source provides sufficient energy to produce excited acetone fragments from the breath gas that emit light. The emitted light is sent to the spectrometer, which generates an emission spectrum that is used to detect and quantify acetone in the breath gas.

  5. First aid to miners suffering from overheating in deep coal mines

    Energy Technology Data Exchange (ETDEWEB)

    Makartsev, V.I.; Tsepurdei, A.A.; Zabolotnii, V.N.; Mozhaev, G.A.; Gridin, V.S. (Vsesoyuznyi Nauchno-Issledovatel' skii Institut Gornospasatel' nogo Dela (Russian Federation))

    1993-03-01

    Describes the symptoms of hyperthermia and approaching thermal shock in coal miners working in deep coal mines. First aid is given to miners suffering from hyperthermia and thermal shock. It is pointed out that prolonged exposure to elevated temperatures at workplaces can result in thermal exhaustion with a deficit of body fluids and minerals. Thermal exhaustion is characterized by general weakness, headaches, insomnia, sleepiness, choleric mood, emotional upset, tremulous pulse and labored breathing. Preventive measures against overheating in deep coal mines are listed.

  6. A fibre-optic oxygen sensor for monitoring human breathing

    International Nuclear Information System (INIS)

    Chen, Rongsheng; Formenti, Federico; Hahn, Clive E W; Farmery, Andrew D; Obeid, Andy

    2013-01-01

    The development and construction of a tapered-tip fibre-optic fluorescence based oxygen sensor is described. The sensor is suitable for fast and real-time monitoring of human breathing. The sensitivity and response time of the oxygen sensor were evaluated in vitro with a gas pressure chamber system, where oxygen partial pressure was rapidly changed between 5 and 15 kPa, and then in vivo in five healthy adult participants who synchronized their breathing to a metronome set at 10, 20, 30, 40, 50, and 60 breaths min –1 . A Datex Ultima medical gas analyser was used to monitor breathing rate as a comparator. The sensor's response time in vitro was less than 150 ms, which allows accurate continuous measurement of inspired and expired oxygen pressure. Measurements of breathing rate by means of our oxygen sensor and of the Datex Ultima were in strong agreement. The results demonstrate that the device can reliably resolve breathing rates up to 60 breaths min –1 , and that it is a suitable cost-effective alternative for monitoring breathing rates and end-tidal oxygen partial pressure in the clinical setting. The rapid response time of the sensor may allow its use for monitoring rapid breathing rates as occur in children and the newborn. (note)

  7. Progress of air-breathing cathode in microbial fuel cells

    Science.gov (United States)

    Wang, Zejie; Mahadevan, Gurumurthy Dummi; Wu, Yicheng; Zhao, Feng

    2017-07-01

    Microbial fuel cell (MFC) is an emerging technology to produce green energy and vanquish the effects of environmental contaminants. Cathodic reactions are vital for high electrical power density generated from MFCs. Recently tremendous attentions were paid towards developing high performance air-breathing cathodes. A typical air-breathing cathode comprises of electrode substrate, catalyst layer, and air-diffusion layer. Prior researches demonstrated that each component influenced the performance of air-breathing cathode MFCs. This review summarized the progress in development of the individual component and elaborated main factors to the performance of air-breathing cathode.

  8. Breathing pattern and head posture: changes in craniocervical angles.

    Science.gov (United States)

    Sabatucci, A; Raffaeli, F; Mastrovincenzo, M; Luchetta, A; Giannone, A; Ciavarella, D

    2015-04-01

    The aim of this study was to observe the influence of oral breathing on head posture and to establish possible postural changes observing the variation of craniocervical angles NSL/OPT and NSL/CVT between oral breathing subjects and physiological breathing subjects. A cross-sectional study was conducted. The sample included 115 subject, 56 boys and 59 girls, 5-22-year-old. Among these, 80 were classified as oral breathers and 35 as physiological breathers. The diagnosis of oral breathing was carried out thanks to characteristic signs and symptoms evaluated on clinical examination, the analysis of characteristic X-ray images, ENT examination with active anterior rhinomanometric (AAR) test. The structural and postural analysis was carried out, calculating the craniofacial angles NSL/OPT and NSL/CVT. Both NSL/OPT and NSL/CVT appear to be significantly greater to those observed in physiological breathing patients. This means that patients who tend to breathe through the mouth rather than exclusively through the nose show a reduction of cervical lordosis and a proinclination of the head. Our study confirms that the oral breathing modifies head position. The significant increase of the craniocervical angles NSL/OPT and NSL/CVT in patients with this altered breathing pattern suggests an elevation of the head and a greater extension of the head compared with the cervical spine. So, to correct the breathing pattern early, either during childhood or during adolescence, can lead to a progressive normalization of craniofacial morphology and head posture.

  9. Sports-related lung injury during breath-hold diving

    Directory of Open Access Journals (Sweden)

    Tanja Mijacika

    2016-12-01

    Full Text Available The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise. In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition. According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.

  10. Can resistive breathing injure the lung? Implications for COPD exacerbations

    Directory of Open Access Journals (Sweden)

    Vassilakopoulos T

    2016-09-01

    Full Text Available Theodoros Vassilakopoulos, Dimitrios Toumpanakis Pulmonary and Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Greece Abstract: In obstructive lung diseases, airway inflammation leads to bronchospasm and thus resistive breathing, especially during exacerbations. This commentary discusses experimental evidence that resistive breathing per se (the mechanical stimulus in the absence of underlying airway inflammation leads to lung injury and inflammation (mechanotransduction. The potential implications of resistive breathing-induced mechanotrasduction in COPD exacerbations are presented along with the available clinical evidence. Keywords: resistive breathing, COPD, mechanotransduction, bronchoconstriction, inflammation

  11. Exhaled Breath Condensate for Proteomic Biomarker Discovery

    Directory of Open Access Journals (Sweden)

    Sean W. Harshman

    2014-07-01

    Full Text Available Exhaled breath condensate (EBC has been established as a potential source of respiratory biomarkers. Compared to the numerous small molecules identified, the protein content of EBC has remained relatively unstudied due to the methodological and technical difficulties surrounding EBC analysis. In this review, we discuss the proteins identified in EBC, by mass spectrometry, focusing on the significance of those proteins identified. We will also review the limitations surrounding mass spectral EBC protein analysis emphasizing recommendations to enhance EBC protein identifications by mass spectrometry. Finally, we will provide insight into the future directions of the EBC proteomics field.

  12. STOPDVTs: Development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for Deep Vein Thrombosis.

    Science.gov (United States)

    O'Brien, Alanna; Redley, Bernice; Wood, Beverley; Botti, Mari; Hutchinson, Anastasia F

    2018-03-01

    To develop and test a clinical tool to guide nurses' assessment of postoperative patients for Deep Vein Thrombosis. Preventing venous thromboembolism in hospitalised patients is an international patient safety priority. Despite high-level evidence for optimal venous thromboembolism prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis remains high. A two-stage sequential multi-method design was used. In stage 1, the STOPDVTs tool was developed using a review of the literature and focus groups with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical nurses who conducted repeated assessments on a prospective sample of 50 postoperative orthopaedic patients. Stage 1: The focus group members who were members of the nursing leadership team agreed on eight local and systemic signs and symptoms that should be included in a nursing patient assessment tool for early Deep Vein Thrombosis. Local symptoms were pain in the limbs, calf swelling and tightness, changes in the affected limb's skin temperature. Systemic signs included in the tool were as follows: increased shortness of breath, increased respiratory and heart rates, and decreased oxygen saturation. Stage 2: The STOPDVTs tool had acceptable face and content validity, the agreement between the expert nurse and surgical nurses on assessments of individual signs and symptoms varied between 44%-94%. Surgical nurses were less likely than the expert nurse to identify signs indicative of Deep Vein Thrombosis. Despite finding the STOPDVTs clinical assessment tool was a useful guide for nursing assessment, surgical nurses often underestimated the potential importance of clinical signs. The findings reveal a gap in nursing knowledge and skill in assessing for Deep Vein Thrombosis in postoperative orthopaedic patients. This study identified a possible risk to patient safety related to under-recognition of the signs and symptoms of possible Deep Vein Thrombosis (DVT) in

  13. Appropriate sample bags and syringes for preserving breath samples in breath odor research : a technical note

    NARCIS (Netherlands)

    Winkel, E. G.; Tangerman, A.

    It is now generally accepted that the volatile sulfur compounds (VSCs) hydrogen sulfide, methyl mercaptan and dimethyl sulfide are the main contributors to halitosis when of oropharyngeal origin. The VSCs hydrogen sulfide and methyl mercaptan are the major causes of bad breath in oral malodour

  14. Fast-starting for a breath: Air breathing in Hoplosternum littorale

    DEFF Research Database (Denmark)

    Domenici, Paolo; Norin, Tommy; Bushnell, Peter G.

    by the fall of a prey item on the water surface, and in tapping motions of goldfish, a behaviour that was interpreted to be food-related. Little is known about C-starts being used outside the context of escaping or feeding. Here, we test the hypothesis that air-breathing fish may use C-starts when gulping air...

  15. Determination of left ventricular heart volume by fast MRI in breath-hold technique: how different are quantitative ventricular angiography, quantitative MRI, and visual echocardiography?; Linksventrikulaere Herzvoluminabestimmung mittels schneller MRT in Atemanhaltetechnik: Wie unterschiedlich sind quantitativer Herzkatheter, quantitativer MRT und visuelle Echokardiographie?

    Energy Technology Data Exchange (ETDEWEB)

    Rominger, M.B.; Bachmann, G.F. [Giessen Univ. (Germany). Diagnostische Radiologie; Kerckhoff-Klinik GmbH, Bad Nauheim (Germany). Projektgruppe Magnetresonanztomographie; Pabst, W. [Giessen Univ. (Germany). Inst. fuer Medizinische Informatik; Ricken, W.W. [Kerckhoff-Klinik GmbH, Bad Nauheim (Germany). Projektgruppe Magnetresonanztomographie; Dinkel, H.P.; Rau, W.S. [Giessen Univ. (Germany). Diagnostische Radiologie

    2000-01-01

    Goal: Comparison of fast MRI, echocardiography (Echo), and ventricular angiography (Cath) in the assessment of left ventricular global function. Methods: Fast MRI in short axis plane, biplane Cath, and 2D Echo were performed in 62 patients [35 coronary artery diseases, 16 acquired valvular diseases (VD), 9 dilated cardiomyopathies (DCM), 1 congenital heart disease and 1 heart transplantation]. Enddiastolic (EDV), endsystolic (ESV), stroke volumes (SV), cardiac output (CO), and ejection fraction (EF) were compared in MRI and Cath. EF was visually estimated in 2D Echo by an experienced observer. Results: In comparison to MRI, Cath overestimated EF by 8.4%, and Echo underestimated EF by 5.6%. The limits of agreement between MRI and Cath in EF were {+-}23.8%, between MRI and Echo {+-}18%, and between Echo and Cath {+-}19.4%. Significant differences were found between Cath and MRI in EDV, SV, and CO, but not for ESV. The best agreement in EF was found in the group with DCM, the worst in the group with VD. Conclusion: Important systemic and random errors were found in the comparison of MRI, Echo, and Cath. For therapy decision and follow-up, the methods should not be exchanged unscrupulously. (orig.) [German] Ziel: Methodenvergleich von schneller Magnetresonanztomographie (MRT), Echokardiographie (Echo) und Herzkatheter (HK) in der Bestimmung linksventrikulaerer globaler Funktionsparameter. Material und Methoden: Bei 62 Patienten (35 koronare Herzerkrankungen, 16 Herzklappenvitien (KV), 9 idiopathische dilatative Kardiomyopathien (DCM), 1 kongenitale Herzerkrankung und 1 Herzktransplantation) wurde ein Methodenvergleich zwischen schneller Cine MRT im Kurzachsenschnitt, biplanarem HK und 2D Echo durchgefuehrt. Verglichen wurden in MRT und HK linksventrikulaeres enddiastolisches (EDV) und endsystolisches Volumen (ESV), Schlagvolumen (SV), Herzzeitvolumen (HZV) und Ejektionsfraktion (EF). In der Echo wurde die EF visuell durch einen erfahrenen Untersucher bestimmt

  16. The effect of various breathing exercises (pranayama in patients with bronchial asthma of mild to moderate severity

    Directory of Open Access Journals (Sweden)

    Saxena Tarun

    2009-01-01

    Full Text Available Background/Aim: The incidence of bronchial asthma is on increase. Chemotherapy is helpful during early course of the disease, but later on morbidity and mortality increases. The efficacy of yoga therapy though appreciated is yet to be defined and modified. Aim: To study the effect of breathing exercises ( pranayama in patients with bronchial asthma of mild to moderate severity. Materials and Methods: Fifty cases of bronchial asthma (Forced Expiratory Volume in one second (FEV1 > 70% were studied for 12 weeks. Patients were allocated to two groups: group A and group B (control group. Patients in group A were treated with breathing exercises (deep breathing, Brahmari , and Omkara , etc. for 20 minutes twice daily for a period of 12 weeks. Patients were trained to perform Omkara at high pitch (forceful with prolonged exhalation as compared to normal Omkara . Group B was treated with meditation for 20 minutes twice daily for a period of 12 weeks. Subjective assessment, FEV1%, and Peak Expiratory Flow Rate (PEFR were done in each case initially and after 12 weeks. Results: After 12 weeks, group A subjects had significant improvement in symptoms, FEV1, and PEFR as compared to group B subjects. Conclusion: Breathing exercises ( pranayama , mainly expiratory exercises, improved lung function subjectively and objectively and should be regular part of therapy.

  17. Cardiorespiratory adaptation to breath-holding in air: Analysis via a cardiopulmonary simulation model.

    Science.gov (United States)

    Albanese, Antonio; Limei Cheng; Ursino, Mauro; Chbat, Nicolas W

    2015-01-01

    Apnea via breath-holding (BH) in air induces cardiorespiratory adaptation that involves the activation of several reflex mechanisms and their complex interactions. Hence, the effects of BH in air on cardiorespiratory function can become hardly predictable and difficult to be interpreted. Particularly, the effect on heart rate is not yet completely understood because of the contradicting results of different physiological studies. In this paper we apply our previously developed cardiopulmonary model (CP Model) to a scenario of BH with a twofold intent: (1) further validating the CP Model via comparison against experimental data; (2) gaining insights into the physiological reasoning for such contradicting experimental results. Model predictions agreed with published experimental animal and human data and indicated that heart rate increases during BH in air. Changes in the balance between sympathetic and vagal effects on heart rate within the model proved to be effective in inverting directions of the heart rate changes during BH. Hence, the model suggests that intra-subject differences in such sympatho-vagal balance may be one of the reasons for the contradicting experimental results.

  18. Heart failure - surgeries and devices

    Science.gov (United States)

    ... surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure ... problem may cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or ...

  19. Greedy Deep Dictionary Learning

    OpenAIRE

    Tariyal, Snigdha; Majumdar, Angshul; Singh, Richa; Vatsa, Mayank

    2016-01-01

    In this work we propose a new deep learning tool called deep dictionary learning. Multi-level dictionaries are learnt in a greedy fashion, one layer at a time. This requires solving a simple (shallow) dictionary learning problem, the solution to this is well known. We apply the proposed technique on some benchmark deep learning datasets. We compare our results with other deep learning tools like stacked autoencoder and deep belief network; and state of the art supervised dictionary learning t...

  20. Evaluation of the Electromagnetic Power Absorption in Humans Exposed to Plane Waves: The Effect of Breathing Activity

    Directory of Open Access Journals (Sweden)

    Marta Cavagnaro

    2013-01-01

    Full Text Available The safety aspects of the exposure of people to uniform plane waves in the frequency range from 900 MHz to 5 GHz are analyzed. Starting from a human body model available in the literature, representing a man in resting state, two new anatomical models are considered, representing different phases of the respiratory activity: tidal breath and deep breath. These models have been used to evaluate the whole body Specific Absorption Rate (SAR and the 10-g averaged and 1-g averaged SAR. The analysis is performed using a parallel implementation of the finite difference time domain method. A uniform plane wave, with vertical polarization, is used as an incident field since this is the canonical exposure situation used in safety guidelines. Results show that if the incident electromagnetic field is compliant with the reference levels promulgated by the International Commission on Non-Ionizing Radiation Protection and by IEEE, the computed SAR values are lower than the corresponding basic restrictions, as expected. On the other side, when the Federal Communications Commission reference levels are considered, 1-g SAR values exceeding the basic restrictions for exposure at 4 GHz and above are obtained. Furthermore, results show that the whole body SAR values increase passing from the resting state model to the deep breath model, for all the considered frequencies.

  1. Exhaled Breath Condensate: Technical and Diagnostic Aspects.

    Science.gov (United States)

    Konstantinidi, Efstathia M; Lappas, Andreas S; Tzortzi, Anna S; Behrakis, Panagiotis K

    2015-01-01

    The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.

  2. Exhaled Breath Condensate: Technical and Diagnostic Aspects

    Directory of Open Access Journals (Sweden)

    Efstathia M. Konstantinidi

    2015-01-01

    Full Text Available Purpose. The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. Methods. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC, biomarkers, pH, asthma, gastroesophageal reflux (GERD, smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH, idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA, and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.

  3. Valvular Heart Disease in Heart Failure

    Directory of Open Access Journals (Sweden)

    Giuseppe MC Rosano

    2017-01-01

    Full Text Available Structural valvular heart disease may be the cause of heart failure or may worsen the clinical status of patients with heart failure. Heart failure may also develop in patients treated with valve surgery. Patients with heart failure with valvular heart disease are at increased risk of events including sudden cardiac death. Before considering intervention (surgical or percutaneous all patients should receive appropriate medical and device therapy taking into account that vasodilators must be used with caution in patients with severe aortic stenosis. Numerous percutaneous and/or hybrid procedures have been introduced in the past few years and they are changing the management of valvular heart disease. In patients with heart failure and valvular heart disease, either primary or functional, the whole process of decision-making should be staged through a comprehensive evaluation of the risk– benefit ratio of different treatment strategies and should be made by a multidisciplinary ‘heart team’ with a particular expertise in valvular heart disease. The heart team should include heart failure cardiologists, cardiac surgeons/structural valve interventionists, imaging specialists, anaesthetists, geriatricians and intensive care specialists. This article will review recent developments and distill practical guidance in the management of this important heart failure co-morbidity.

  4. A fully integrated standalone portable cavity ringdown breath acetone analyzer

    Science.gov (United States)

    Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

    2015-09-01

    Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

  5. A fully integrated standalone portable cavity ringdown breath acetone analyzer.

    Science.gov (United States)

    Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

    2015-09-01

    Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

  6. Management of Mechanical Ventilation in Decompensated Heart Failure

    Directory of Open Access Journals (Sweden)

    Brooks T. Kuhn

    2016-12-01

    Full Text Available Mechanical ventilation (MV is a life-saving intervention for respiratory failure, including decompensated congestive heart failure. MV can reduce ventricular preload and afterload, decrease extra-vascular lung water, and decrease the work of breathing in heart failure. The advantages of positive pressure ventilation must be balanced with potential harm from MV: volutrauma, hyperoxia-induced injury, and difficulty assessing readiness for liberation. In this review, we will focus on cardiac, pulmonary, and broader effects of MV on patients with decompensated HF, focusing on practical considerations for management and supporting evidence.

  7. Effects of energy drink consumption on corrected QT interval and heart rate variability in young obese Saudi male university students.

    Science.gov (United States)

    Alsunni, Ahmed; Majeed, Farrukh; Yar, Talay; AlRahim, Ahmed; Alhawaj, Ali Fouad; Alzaki, Muneer

    2015-01-01

    Consumption of energy drinks has adverse effects on the heart that might be potentiated in obese individuals. Since the incidence of obesity and use of energy drinks is high among Saudi youth, we used non-invasive tests to study hemodynamic changes produced by altered autonomic cardiac activ.ity following consumption of energy drinks in obese male students. This cross-sectional study was carried out at Department of Physiology, College of Medicine, University of Dammam, Saudi Arabia, over a one-year period from December 2013 to December 2014. In Saudi male university students we measured continuous ECG recordings and a one-minute deep breathing maneuver to measure the expiratory-to-inspiratory ratio, the mean heart rate range (MHRR), the mean percentage variability. (M%VHR) and the corrected QT interval (QTc) at 0, 30 and 60 minutes after consumption of energy drink. We enrolled 31 students (18 overweight/obese and 13 normal weights. QTc was significantly in.creased at 60 min as compared with the resting state in overweight/obese subjects (P=.006). Heart rate variability was significantly less in obese as compared with normal weight subjects at 60 minutes as indicated by E:I ratio, (P=.037), MHRR (P=.012), M%VHR (P=.040) after energy drink consumption. Significant increases in diastolic (P=.020) and mean arterial blood pressure (P=.024) were observed at 30 minutes in the obese group. Hemodynamic changes after intake of energy drinks in obese subjects indicate that obesity and energy drinks could synergistically induce harmful effects. This finding warrants efforts to caution the obese on intake of energy drinks and timely intervention to motivate changes in lifestyle.

  8. SU-E-T-361: Clinical Benefit of Automatic Beam Gating Mixed with Breath Hold in Radiation Therapy of Left Breast

    International Nuclear Information System (INIS)

    Wu, J; Hill, G; Spiegel, J; Ye, J; Mehta, V

    2014-01-01

    Purpose: To investigate the clinical and dosimetric benefits of automatic gating of left breast mixed with breath-hold technique. Methods: Two Active Breathing Control systems, ABC2.0 and ABC3.0, were used during simulation and treatment delivery. The two systems are different such that ABC2.0 is a breath-hold system without beam control capability, while ABC3.0 has capability in both breath-hold and beam gating. At simulation, each patient was scanned twice: one with free breathing (FB) and one with breath hold through ABC. Treatment plan was generated on the CT with ABC. The same plan was also recalculated on the CT with FB. These two plans were compared to assess plan quality. For treatments with ABC2.0, beams with MU > 55 were manually split into multiple subfields. All subfields were identical and shared the total MU. For treatment with ABC3.0, beam splitting was unnecessary. Instead, treatment was delivered in gating mode mixed with breath-hold technique. Treatment delivery efficiency using the two systems was compared. Results: The prescribed dose was 50.4Gy at 1.8Gy/fraction. The maximum heart dose averaged over 10 patients was 46.0±2.5Gy and 24.5±12.2Gy for treatments with FB and with ABC respectively. The corresponding heart V10 was 13.2±3.6% and 1.0±1.6% respectively. The averaged MUs were 99.8±7.5 for LMT, 99.2±9.4 for LLT. For treatment with ABC2.0, normally the original beam was split into 2 subfields. The averaged total time to delivery all beams was 4.3±0.4min for treatments with ABC2.0 and 3.3±0.6min for treatments with ABC3.0 in gating mode. Conclusion: Treatment with ABC tremendously reduced heart dose. Compared to treatments with ABC2.0, gating with ABC3.0 reduced the total treatment time by 23%. Use of ABC3.0 improved the delivery efficiency, and eliminated the possibility of mistreatments. The latter may happen with ABC2.0 where beam is not terminated when breath signal falls outside of the treatment window

  9. Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer.

    Science.gov (United States)

    Sun, Meixiu; Chen, Zhuying; Gong, Zhiyong; Zhao, Xiaomeng; Jiang, Chenyu; Yuan, Yuan; Wang, Zhennang; Li, Yingxin; Wang, Chuji

    2015-02-01

    Over 90% of diabetic patients have Type 2 diabetes. Although an elevated mean breath acetone concentration has been found to exist in Type 1 diabetes (T1D), information on breath acetone in Type 2 diabetes (T2D) has yet to be obtained. In this study, we first used gas chromatography-mass spectrometry (GC-MS) to validate a ringdown breath-acetone analyzer based on the cavity-ringdown-spectroscopy technique, through comparing breath acetone concentrations in the range 0.5-2.5 ppm measured using both methods. The linear fitting of R = 0.99 suggests that the acetone concentrations obtained using both methods are consistent with a largest standard deviation of ±0.4 ppm in the lowest concentration of the range. Next, 620 breath samples from 149 T2D patients and 42 healthy subjects were collected and tested using the breath analyzer. Four breath samples were taken from each subject under each of four different conditions: fasting, 2 h post-breakfast, 2 h post-lunch, and 2 h post-dinner. Simultaneous blood glucose levels were also measured using a standard diabetic-management blood-glucose meter. For the 149 T2D subjects, their exhaled breath acetone concentrations ranged from 0.1 to 19.8 ppm; four different ranges of breath acetone concentration, 0.1-19.8, 0.1-7.1, 0.1-6.3, and 0.1-9.5 ppm, were obtained for the subjects under the four different conditions, respectively. For the 42 healthy subjects, their breath acetone concentration ranged from 0.1 to 2.6 ppm; four different ranges of breath acetone concentration, 0.3-2.6, 0.1-2.6, 0.1-1.7, and 0.3-1.6 ppm, were obtained for the four different conditions. The mean breath acetone concentration of the 149 T2D subjects was determined to be 1.5 ± 1.5 ppm, which was 1.5 times that of 1.0 ± 0.6 ppm for the 42 healthy subjects. No correlation was found between the breath acetone concentration and the blood glucose level of the T2D subjects and the healthy volunteers. This study using a relatively large number of

  10. 21 CFR 868.5260 - Breathing circuit bacterial filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breathing circuit bacterial filter. 868.5260 Section 868.5260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... filter. (a) Identification. A breathing circuit bacterial filter is a device that is intended to remove...

  11. Health, social and economical consequences of sleep-disordered breathing

    DEFF Research Database (Denmark)

    Jennum, Poul; Kjellberg, Jakob

    2011-01-01

    The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described.......The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described....

  12. 21 CFR 868.2375 - Breathing frequency monitor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breathing frequency monitor. 868.2375 Section 868.2375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Monitoring Devices § 868.2375 Breathing frequency monitor. (a...

  13. The breathtaking truth about breath alcohol readings of zero

    NARCIS (Netherlands)

    Verster, Joris C; Mackus, Marlou; van de Loo, Aurora Jae; Garssen, Johan; Scholey, Andrew

    INTRODUCTION: It has been postulated that the hangover state starts when breath alcohol concentration is zero. METHODS: Data from 2 studies that assessed ethanol in breath, blood and urine were compared. RESULTS: The data revealed that ethanol may still be present in the blood and urine during the

  14. Influence of Continuous Table Motion on Patient Breathing Patterns

    International Nuclear Information System (INIS)

    Wilbert, Juergen; Baier, Kurt; Richter, Anne; Herrmann, Christian; Ma Lei; Flentje, Michael; Guckenberger, Matthias

    2010-01-01

    Purpose: To investigate the influence of continuous table motion on patient breathing patterns for compensation of moving targets by a robotic treatment couch. Methods and Materials: Fifteen volunteers were placed on a robotic treatment couch, and the couch was moved on different breathing-correlated and -uncorrelated trajectories. External abdominal breathing motion of the patients was measured using an infrared camera system. The influence of table motion on breathing range and pattern was analyzed. Results: Continuous table motion was tolerated well by all test persons. Volunteers reacted differently to table motion. Four test persons showed no change of breathing range and pattern. Increased irregular breathing was observed in 4 patients; however, irregularity was not correlated with table motion. Only 4 test persons showed an increase in mean breathing amplitude of more than 2mm during motion of the couch. The mean cycle period decreased by more than 1 s for 2 test persons only. No abrupt changes in amplitude or cycle period could be observed. Conclusions: The observed small changes in breathing patterns support the application of motion compensation by a robotic treatment couch.

  15. Symptoms of Sleep Disordered Breathing and Risk of Cancer

    DEFF Research Database (Denmark)

    Christensen, Anne Sofie; Clark, Alice; Salo, Paula

    2013-01-01

    Sleep disordered breathing (SDB) has been associated with oxidative stress, inflammation, and altered hormonal levels, all of which could affect the risk of cancer. The aim of the study is to examine if symptoms of SDB including snoring, breathing cessations, and daytime sleepiness affect...

  16. Molecular Epidemiology of Heart Failure

    Directory of Open Access Journals (Sweden)

    J. Gustav Smith, MD, PhD

    2017-12-01

    Full Text Available Heart failure (HF is the end-stage of all heart disease and arguably constitutes the greatest unmet therapeutic need in cardiovascular medicine today. Classic epidemiological studies have established clinical risk factors for HF, but the cause remains poorly understood in many cases. Biochemical analyses of small case-control series and animal models have described a plethora of molecular characteristics of HF, but a single unifying pathogenic theory is lacking. Heart failure appears to result not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, metabolic, inflammatory, and other biochemical factors acting on the heart. Recent development of robust, high-throughput tools in molecular biology provides opportunity for deep molecular characterization of population-representative cohorts and HF cases (molecular epidemiology, including genome sequencing, profiling of myocardial gene expression and chromatin modifications, plasma composition of proteins and metabolites, and microbiomes. The integration of such detailed information holds promise for improving understanding of HF pathophysiology in humans, identification of therapeutic targets, and definition of disease subgroups beyond the current classification based on ejection fraction which may benefit from improved individual tailoring of therapy. Challenges include: 1 the need for large cohorts with deep, uniform phenotyping; 2 access to the relevant tissues, ideally with repeated sampling to capture dynamic processes; and 3 analytical issues related to integration and analysis of complex datasets. International research consortia have formed to address these challenges and combine datasets, and cohorts with up to 1 million participants are being collected. This paper describes the molecular epidemiology of HF and provides an overview of methods and tissue types and examples of published and ongoing efforts to systematically evaluate molecular

  17. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    with reference to Tillich’s account of the meaning of revelation through culture and art, summed up in the statement that “(...) revelation is the manifestation of the ground of being for human knowledge” (Tillich, 1951, p.94), which, we argue, can be extended to everyday experiences, for example, in business......Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem...... life. In Tillich’s own terms, even preliminary concerns may point at an ultimate concern (Tillich, 1964), which can also be understood as ‘knowledge of the heart’. Our account is also connected to wider discussions concerning the nature of intuition....

  18. Compressed breathing air - the potential for evil from within.

    Science.gov (United States)

    Millar, Ian L; Mouldey, Peter G

    2008-06-01

    Human underwater activities rely on an adequate supply of breathable compressed gas, usually air, free from contaminants that could cause incapacitation underwater or post-dive or longer-term health effects. Potentially fatal but well-known hazards are hypoxia secondary to steel cylinder corrosion and carbon monoxide (CO) poisoning due to contaminated intake air. Another phenomenon may be behind some previously unexplained episodes of underwater incapacitation and perhaps death: low-level CO poisoning and/or the effects of gaseous contaminants generated within the compressor, including toluene and other volatile compounds. Many low molecular weight volatile contaminants are anaesthetic and will be potentiated by pressure and nitrogen narcosis. In sub-anaesthetic doses, impaired judgement, lowered seizure threshold and sensitisation of the heart to arrhythmias may occur. Toxic compounds can be volatilised from some compressor oils, especially mineral oils, in overheated compressors, or be created de novo under certain combinations of temperature, humidity and pressure, perhaps catalysed by metal traces from compressor wear and tear. Most volatiles can be removed by activated carbon filtration but many filters are undersized and may overload in hot, moist conditions and with short dwell times. A compressor that passes normal testing could contaminate one or more cylinders after heating up and then return to producing clean air as the filters dry and the systems cool. The scope of this problem is very unclear as air quality is tested infrequently and often inadequately, even after fatalities. More research is needed as well as better education regarding the safe operation and limitations of high-pressure breathing air compressors.

  19. Regulation of Breathing and Autonomic Outflows by Chemoreceptors

    Science.gov (United States)

    Guyenet, Patrice G.

    2016-01-01

    Lung ventilation fluctuates widely with behavior but arterial PCO2 remains stable. Under normal conditions, the chemoreflexes contribute to PaCO2 stability by producing small corrective cardiorespiratory adjustments mediated by lower brainstem circuits. Carotid body (CB) information reaches the respiratory pattern generator (RPG) via nucleus solitarius (NTS) glutamatergic neurons which also target rostral ventrolateral medulla (RVLM) presympathetic neurons thereby raising sympathetic nerve activity (SNA). Chemoreceptors also regulate presympathetic neurons and cardiovagal preganglionic neurons indirectly via inputs from the RPG. Secondary effects of chemoreceptors on the autonomic outflows result from changes in lung stretch afferent and baroreceptor activity. Central respiratory chemosensitivity is caused by direct effects of acid on neurons and indirect effects of CO2 via astrocytes. Central respiratory chemoreceptors are not definitively identified but the retrotrapezoid nucleus (RTN) is a particularly strong candidate. The absence of RTN likely causes severe central apneas in congenital central hypoventilation syndrome. Like other stressors, intense chemosensory stimuli produce arousal and activate circuits that are wake- or attention-promoting. Such pathways (e.g., locus coeruleus, raphe, and orexin system) modulate the chemoreflexes in a state-dependent manner and their activation by strong chemosensory stimuli intensifies these reflexes. In essential hypertension, obstructive sleep apnea and congestive heart failure, chronically elevated CB afferent activity contributes to raising SNA but breathing is unchanged or becomes periodic (severe CHF). Extreme CNS hypoxia produces a stereotyped cardiorespiratory response (gasping, increased SNA). The effects of these various pathologies on brainstem cardiorespiratory networks are discussed, special consideration being given to the interactions between central and peripheral chemoreflexes. PMID:25428853

  20. Getting a New Heart

    Science.gov (United States)

    ... may be able to replace it with an artificial (man-made) valve. Cardiac size reduction . During this procedure, your doctor removes a piece of the heart muscle from an enlarged heart. This makes your heart ...

  1. Heart-Health Screenings

    Science.gov (United States)

    ... Tools For Your Heart Health • Watch, Learn & Live Animations Library Subscribe to Heart Insight magazine and monthly ... in Spanish . Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  2. Heart Attack Recovery FAQs

    Science.gov (United States)

    ... recommendations to make a full recovery. View an animation of a heart attack . Heart Attack Recovery Questions ... Support Network Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  3. Open heart surgery

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002950.htm Open heart surgery To use the sharing features on this ... large arteries connected to the heart. The term "open heart surgery" means that you are connected to a ...

  4. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  5. Congenital Heart Information Network

    Science.gov (United States)

    ... heart defects. Important Notice The Congenital Heart Information Network website is temporarily out of service. Please join ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright © ...

  6. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  7. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  8. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  9. Right heart ventriculography

    Science.gov (United States)

    Angiography - right heart ... moved forward into the right side of the heart. As the catheter is advanced, the doctor can ... is injected into the right side of the heart. It helps the cardiologist determine the size and ...

  10. Congenital heart disease

    Science.gov (United States)

    Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. ... Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... Sabiston Textbook of Surgery: The Biological Basis of Modern ...

  11. Heart Disease Risk Factors

    Science.gov (United States)

    ... About CDC.gov . Home About Heart Disease Coronary Artery Disease Heart Attack Heart Attack Signs and Symptoms ... Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO ( ...

  12. The phylogeny and ontogeny of autonomic control of the heart and cardiorespiratory interactions in vertebrates.

    Science.gov (United States)

    Taylor, Edwin W; Leite, Cleo A C; Sartori, Marina R; Wang, Tobias; Abe, Augusto S; Crossley, Dane A

    2014-03-01

    Heart rate in vertebrates is controlled by activity in the autonomic nervous system. In spontaneously active or experimentally prepared animals, inhibitory parasympathetic control is predominant and is responsible for instantaneous changes in heart rate, such as occur at the first air breath following a period of apnoea in discontinuous breathers like inactive reptiles or species that surface to air breathe after a period of submersion. Parasympathetic control, exerted via fast-conducting, myelinated efferent fibres in the vagus nerve, is also responsible for beat-to-beat changes in heart rate such as the high frequency components observed in spectral analysis of heart rate variability. These include respiratory modulation of the heartbeat that can generate cardiorespiratory synchrony in fish and respiratory sinus arrhythmia in mammals. Both may increase the effectiveness of respiratory gas exchange. Although the central interactions generating respiratory modulation of the heartbeat seem to be highly conserved through vertebrate phylogeny, they are different in kind and location, and in most species are as yet little understood. The heart in vertebrate embryos possesses both muscarinic cholinergic and β-adrenergic receptors very early in development. Adrenergic control by circulating catecholamines seems important throughout development. However, innervation of the cardiac receptors is delayed and first evidence of a functional cholinergic tonus on the heart, exerted via the vagus nerve, is often seen shortly before or immediately after hatching or birth, suggesting that it may be coordinated with the onset of central respiratory rhythmicity and subsequent breathing.

  13. Natural Vibration of a Beam with a Breathing Oblique Crack

    Directory of Open Access Journals (Sweden)

    Yijiang Ma

    2017-01-01

    Full Text Available An analytical method is proposed to calculate the natural frequency of a cantilever beam with a breathing oblique crack. A double-linear-springs-model is developed in the modal analysis process to describe the breathing oblique crack, and the breathing behaviour of the oblique crack is objectively simulated. The finite element method (FEM analysis software ABAQUS is used to calculate the geometric correction factors when the cracked plate is subjected to a pure bending moment at different oblique crack angles and relative depths. The Galerkin method is applied to simplify the cracked beam to a single degree of freedom system, allowing the natural frequency of the beam with the breathing oblique crack to be calculated. Compared with the natural frequencies of the breathing oblique cracked beam obtained using the ABAQUS FEM method, the proposed analytical method exhibits a high computational accuracy, with a maximum error of only 4.65%.

  14. ABA-Cloud: support for collaborative breath research.

    Science.gov (United States)

    Elsayed, Ibrahim; Ludescher, Thomas; King, Julian; Ager, Clemens; Trosin, Michael; Senocak, Uygar; Brezany, Peter; Feilhauer, Thomas; Amann, Anton

    2013-06-01

    This paper introduces the advanced breath analysis (ABA) platform, an innovative scientific research platform for the entire breath research domain. Within the ABA project, we are investigating novel data management concepts and semantic web technologies to document breath analysis studies for the long run as well as to enable their full automatic reproducibility. We propose several concept taxonomies (a hierarchical order of terms from a glossary of terms), which can be seen as a first step toward the definition of conceptualized terms commonly used by the international community of breath researchers. They build the basis for the development of an ontology (a concept from computer science used for communication between machines and/or humans and representation and reuse of knowledge) dedicated to breath research.

  15. Initial experience with active breathing control of liver motion during ventilation

    International Nuclear Information System (INIS)

    Robertson, John M.; Sharpe, Michael B.; Jaffray, David A.; Wong, John W.

    1997-01-01

    -inspiration appeared to be more stable, as all patients could tolerate up to 20 seconds of breath-hold. At deep inspiration, up to 50 seconds of breath-hold was tolerable. End-expiration was more difficult and resulted in motion artifact on the CT scans when a 20 second breath-hold was attempted. Contours of the liver at end-inspiration were repeated immediately and one week later. Registration of the repeat CT scans allowed comparison at end-inspiration both immediately and one week later, the volumes superimposed to within 0.5 cm CT slice resolution. Conclusion: Preliminary results suggest that ABC is a safe and comfortable procedure which will allow more precise definition of organ motion during ventilation. The ABC device was easy to use and did not require modification of the CT scanner. For ABC during treatment, modification of the linear accelerator would not be required, unlike other proposed mechanisms of gating treatment to ventilation. If reproducibility is maintained with a larger number of patients, we anticipate the clinical use of this device in the near future

  16. Imaging analysis of heart movement for improving the respiration-gated radiotherapy in patients with left sided breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Abdelhamid, Rania; Farrag, A.; Khalifa, A. [Clinical Oncology Department, Assiut University (Egypt); Block, Andreas [Institut fuer Medizinische Strahlenphysik und Strahlenschutz, Klinikum Dortmund (Germany)

    2012-07-01

    Respiration induced heart movement during radiotherapy exposes the heart to the inevitable risks of radio-exposure, and hence radiation injury, in cases of Lt. sided breast cancer. The impact of such a risk is additionally aggravated by the use of radiotherapy in combination with cardiotoxic chemotherapeutic agents. Radio-oncologists pay special attention to the coronary arteries that might be included in this small part of the heart exposed to radiation. The aim of this study was to include the internal heart movement for improving respiration-gated radiotherapy of left sided breast cancer. For 70 patients, all females left sided breast cancer, two planning CT's in inspiration and expiration, and one free breathing scan are performed. The heart motion was analyzed with the clinic-developed software ORAT in the simulator sequence for acquiring information of the cranio-caudal amplitude of heart movements in free breathing (respiration-induced amplitude) and a 15 seconds breath-hold phase (inherent amplitude). The role of inherent heart movement varies from one patient to another which should be taken in consideration during defining the parameters of respiration-gated radiotherapy. The inherent amplitude of the heart motion is the physiological lower limit of the respiration-gating window.

  17. Heart rate variability analysed by Poincaré plot in patients with metabolic syndrome

    Czech Academy of Sciences Publication Activity Database

    Kubíčková, A.; Kozumplík, J.; Nováková, Z.; Plachý, M.; Jurák, Pavel; Lipoldová, J.

    2016-01-01

    Roč. 49, č. 1 (2016), s. 23-28 ISSN 0022-0736 R&D Projects: GA ČR GAP102/12/2034 Institutional support: RVO:68081731 Keywords : heart rate variability * metabolic syndrome * Poincaré plot * tilt table test * controlled breathing Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 1.514, year: 2016

  18. Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

    OpenAIRE

    Arden-Close, E; Yardley, L; Kirby, S; Thomas, M; Bruton, A

    2017-01-01

    Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retr...

  19. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers

    Directory of Open Access Journals (Sweden)

    Hua Ting

    2014-05-01

    Full Text Available Background: Sleepiness-at-the-wheel has been identified as a major cause of highway accidents. The aim of our study is identifying the candidate measures for home-based screening of sleep disordered breathing in Taiwanese bus drivers, instead of polysomnography. Methods: Overnight polysomnography accompanied with simultaneous measurements of alternative screening devices (pulse oximetry, ApneaLink, and Actigraphy, heart rate variability, wake-up systolic blood pressure and questionnaires were completed by 151 eligible participants who were long-haul bus drivers with a duty period of more than 12 h a day and duty shifting. Results: 63.6% of professional bus drivers were diagnosed as having sleep disordered breathing and had a higher body mass index, neck circumference, systolic blood pressure, arousal index and desaturation index than those professional bus drivers without evidence of sleep disordered breathing. Simple home-based candidate measures: (1 Pulse oximetry, oxygen-desaturation indices by ≥3% and 4% (r = 0.87~0.92; (2 Pulse oximetry, pulse-rising indices by ≥7% and 8% from a baseline (r = 0.61~0.89; and (3 ApneaLink airflow detection, apnea-hypopnea indices (r = 0.70~0.70, based on recording-time or Actigraphy-corrected total sleep time were all significantly correlated with, and had high agreement with, corresponding polysomnographic apnea-hypopnea indices [(1 94.5%~96.6%, (2 93.8%~97.2%, (3 91.1%~91.3%, respectively]. Conversely, no validities of SDB screening were found in the multi-variables apnea prediction questionnaire, Epworth Sleepiness Scale, night-sleep heart rate variability, wake-up systolic blood pressure and anthropometric variables. Conclusions: The indices of pulse oximetry and apnea flow detection are eligible criteria for home-based screening of sleep disordered breathing, specifically for professional drivers.

  20. Aspiration tests in aqueous foam using a breathing simulator

    Energy Technology Data Exchange (ETDEWEB)

    Archuleta, M.M.

    1995-12-01

    Non-toxic aqueous foams are being developed by Sandia National Laboratories (SNL) for the National Institute of Justice (NIJ) for use in crowd control, cell extractions, and group disturbances in the criminal justice prison systems. The potential for aspiration of aqueous foam during its use and the resulting adverse effects associated with complete immersion in aqueous foam is of major concern to the NIJ when examining the effectiveness and safety of using this technology as a Less-Than-Lethal weapon. This preliminary study was designed to evaluate the maximum quantity of foam that might be aspirated by an individual following total immersion in an SNL-developed aqueous foam. A.T.W. Reed Breathing simulator equipped with a 622 Silverman cam was used to simulate the aspiration of an ammonium laureth sulfate aqueous foam developed by SNL and generated at expansion ratios in the range of 500:1 to 1000:1. Although the natural instinct of an individual immersed in foam is to cover their nose and mouth with a hand or cloth, thus breaking the bubbles and decreasing the potential for aspiration, this study was performed to examine a worst case scenario where mouth breathing only was examined, and no attempt was made to block foam entry into the breathing port. Two breathing rates were examined: one that simulated a sedentary individual with a mean breathing rate of 6.27 breaths/minute, and one that simulated an agitated or heavily breathing individual with a mean breathing rate of 23.7 breaths/minute. The results of this study indicate that, if breathing in aqueous foam without movement, an air pocket forms around the nose and mouth within one minute of immersion.

  1. Target Heart Rates

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  2. Alcohol and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  3. Caffeine and Heart Disease

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  4. Protein and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  5. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  6. Sleep disordered breathing following spinal cord injury

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Jennum, Poul; Laub, Michael

    2009-01-01

    Individuals with spinal cord injury (SCI) commonly complain about difficulty in sleeping. Although various sleep disordered breathing definitions and indices are used that make comparisons between studies difficult, it seems evident that the frequency of sleep disorders is higher in individuals...... with SCI, especially with regard to obstructive sleep apnea. In addition, there is a correlation between the incidence of sleep disturbances and the spinal cord level injured, age, body mass index, neck circumference, abdominal girth, and use of sedating medications. Regulation of respiration is dependent...... on wakefulness and sleep. Thus, it is important to be aware of basic mechanisms in the regulation and control of sleep and awake states. Supine position decreases the vital capacity in tetraplegic individuals, and diminished responsiveness to Pa(CO)(2) may further decrease ventilatory reserve. There also may...

  7. Sleep disordered breathing in children with achondroplasia.

    Science.gov (United States)

    Zaffanello, Marco; Cantalupo, Gaetano; Piacentini, Giorgio; Gasperi, Emma; Nosetti, Luana; Cavarzere, Paolo; Ramaroli, Diego Alberto; Mittal, Aliza; Antoniazzi, Franco

    2017-02-01

    Children with achondroplasia often have breathing problems, especially during sleep. The most important treatments are adenotonsillectomy (for treating upper obstruction) and/or neurosurgery (for resolving cervicomedullar junction stenosis). We reviewed the scientific literature on polysomnographic investigations which assessed the severity of respiratory disorders during sleep. Recent findings have highlighted the importance of clinical investigations in patients with achondroplasia, differentiating between those that look for neurological patterns and those that look for respiratory problems during sleep. In particular, magnetic resonance imaging (MRI) and somatosensory evoked potentials are the main tools to evaluate necessary neurosurgery and over myelopathy, respectively. The use of polysomnography enables clinicians to identify children with upper airway obstruction and to quantify disease severity; it is not suitable for MRI and/or neurosurgery considerations.

  8. The breathing mode and the nuclear surface

    International Nuclear Information System (INIS)

    Blaizot, J.P.; Grammaticos, B.

    1981-01-01

    The role of nuclear surface in the breathing mode of nuclei is analyzed. We discuss a simple model in which the density varies according to a scaling of the coordinates. We show that this model reproduces accurately the results of microscopic calculations in heavy nuclei, and we use it to estimate the contribution of the surface to the effective compression modulus of semi-infinite nuclear matter. The calculation is performed in the framework of an extended Thomas-Fermi approximation and using several effective interactions. It is shown that the surface energy is maximum with respect to variations of the density around saturation density. The reduction of the effective compression modulus due to the surface turns to be proportional to the bulk compression modulus. The magnitude of the effect is compared with results of RPA calculations. Other contributions to the effective compressions modulus of finite nuclei are also discussed. (orig.)

  9. The effect of climbing Mount Everest on spleen contraction and increase in hemoglobin concentration during breath holding and exercise.

    Science.gov (United States)

    Engan, Harald K; Lodin-Sundström, Angelica; Schagatay, Fanny; Schagatay, Erika

    2014-04-01

    Release of stored red blood cells resulting from spleen contraction improves human performance in various hypoxic situations. This study determined spleen volume resulting from two contraction-evoking stimuli: breath holding and exercise before and after altitude acclimatization during a Mount Everest ascent (8848 m). Eight climbers performed the following protocol before and after the climb: 5 min ambient air respiration at 1370 m during rest, 20 min oxygen respiration, 20 min ambient air respiration at 1370 m, three maximal-effort breath holds spaced by 2 min, 10 min ambient air respiration, 5 min of cycling at 100 W, and finally 10 min ambient air respiration. We measured spleen volume by ultrasound and capillary hemoglobin (HB) concentration after each exposure, and heart rate (HR) and arterial oxygen saturation (Sao2) continuously. Mean (SD) baseline spleen volume was unchanged at 213 (101) mL before and 206 (52) mL after the climb. Before the climb, spleen volume was reduced to 184 (83) mL after three breath holds, and after the climb three breath holds resulted in a spleen volume of 132 (26) mL (p=0.032). After exercise, the preclimb spleen volume was 186 (89) mL vs. 112 (389) mL) after the climb (p=0.003). Breath hold duration and cardiovascular responses were unchanged after the climb. We concluded that spleen contraction may be enhanced by altitude acclimatization, probably reflecting both the acclimatization to chronic hypoxic exposure and acute hypoxia during physical work.

  10. Breath-holding times in various phases of respiration and effect of respiratory training in lung cancer patients.

    Science.gov (United States)

    Tibdewal, Anil; Munshi, Anusheel; Pathak, Rima; Misra, Shagun; Daptardar, Anuradha; Singh, Vincent; Agarwal, Jai Prakash

    2015-08-01

    Breath-holding (BH) technique is used for reducing the intrafraction-tumour motion in mobile lung tumours treated with radiotherapy (RT). There is paucity of literature evaluating differences in BH times in various phases of respiration in patients with lung cancer. One hundred consecutive patients with lung cancer planned for radical RT/chemoradiation were accrued in the study. Eighty-seven patients were eligible for analysis at RT conclusion. Baseline pulmonary function test (PFT) were performed in all patients, and respiratory training was given from the day of RT planning. Deep inspiration breath hold (DIBH), deep expiration breath hold (DEBH) and mid-ventilation breath hold (MVBH) were recorded manually with a stopwatch for each patient at four time points (RT planning/baseline, RT starting, during RT and RT conclusion). Median DIBH times at RT planning, RT starting, during RT and RT conclusion were 21.2, 20.6, 20.1 and 21.1 s, respectively. The corresponding median DEBH and MVBH times were 16.3, 18.2, 18.3, 18.5 s and 19.9, 20.5, 21.3, 22.1 s, respectively. Respiratory training increased MVBH time at RT conclusion compared to baseline, which was statistically significant (19.9-22.1 s, P = 0.002). DIBH or DEBH times were stable at various time points with neither a significant improvement nor decline. Among various patient and tumour factors Forced Vital Capacity pre-bronchodilation (FVCpre ) was the only factor that consistently predicted DIBH, DEBH and MVBH at all four time points with P value phases of respiration. Respiratory training improved MVBH time while consistently maintaining DIBH and DEBH times throughout the course of radiotherapy. © 2015 The Royal Australian and New Zealand College of Radiologists.

  11. Particle transport in breathing quantum graph

    International Nuclear Information System (INIS)

    Matrasulov, D.U.; Yusupov, J.R.; Sabirov, K.K.; Sobirov, Z.A.

    2012-01-01

    Full text: Particle transport in nanoscale networks and discrete structures is of fundamental and practical importance. Usually such systems are modeled by so-called quantum graphs, the systems attracting much attention in physics and mathematics during past two decades [1-5]. During last two decades quantum graphs found numerous applications in modeling different discrete structures and networks in nanoscale and mesoscopic physics (e.g., see reviews [1-3]). Despite considerable progress made in the study of particle dynamics most of the problems deal with unperturbed case and the case of time-dependent perturbation has not yet be explored. In this work we treat particle dynamics for quantum star graph with time-dependent bonds. In particular, we consider harmonically breathing quantum star graphs, the cases of monotonically contracting and expanding graphs. The latter can be solved exactly analytically. Edge boundaries are considered to be time-dependent, while branching point is assumed to be fixed. Quantum dynamics of a particle in such graphs is studied by solving Schrodinger equation with time-dependent boundary conditions given on a star graph. Time-dependence of the average kinetic energy is analyzed. Space-time evolution of the Gaussian wave packet is treated for harmonically breathing star graph. It is found that for certain frequencies energy is a periodic function of time, while for others it can be non-monotonically growing function of time. Such a feature can be caused by possible synchronization of the particles motion and the motions of the moving edges of graph bonds. (authors) References: [1] Tsampikos Kottos and Uzy Smilansky, Ann. Phys., 76, 274 (1999). [2] Sven Gnutzmann and Uzy Smilansky, Adv. Phys. 55, 527 (2006). [3] S. GnutzmannJ.P. Keating, F. Piotet, Ann. Phys., 325, 2595 (2010). [4] P.Exner, P.Seba, P.Stovicek, J. Phys. A: Math. Gen. 21, 4009 (1988). [5] J. Boman, P. Kurasov, Adv. Appl. Math., 35, 58 (2005)

  12. Oral breathing: new early treatment protocol

    Directory of Open Access Journals (Sweden)

    Gloria Denotti

    2014-01-01

    Full Text Available Oral breathing is a respiratory dysfunction that affects approximately 10-15% of child population. It is responsable of local effects and systemic effects, both immediate and long-term. They affect the growth of the subject and his physical health in many ways: pediatric, psycho-behavioral and cognitive. The etiology is multifactorial. It’s important the establishment of a vicious circle involving more areas and it is essential to stop it as soon as possible. In order to correct this anomaly, the pediatric dentist must be able to make a correct diagnosis to treat early the disfunction and to avoid the onset of cascade mechanisms. Who plays a central role is the pediatrician who first and frequently come into contact with little patients. He can identify the anomalies, and therefore collaborate with other specialists, including the dentist. The key aspect that guides us in the diagnosis, and allows us to identify the oral respirator, is the “adenoid facies”. The purpose of the study is to highlight the importance and benefits of an early and multidisciplinary intervention (pediatric, orthopedic-orthodontic-functional. A sample of 20 patients was selected with the following inclusion criteria: mouth breathing, transverse discrepancy > 4 mm, early mixed dentition, central and lateral permenent incisors, overjet increased, lip and nasal incompetence, snoring and/or sleep apnea episodes. The protocol of intervention includes the use of the following devices and procedures: a maxillary rapid expander (to correct the transverse discrepancy, to increase the amplitude of the upper respiratory airway and to reduce nasal resistances tract in association with myo-functional devices (nasal stimulator and oral obturator. They allow the reconstruction of a physiological balance between the perioral musculature and tongue, the acquisition of nasal and lips competence and the reduction of overjet. This protocol speeds up and stabilizes the results. The

  13. Breathing and Singing: Objective Characterization of Breathing Patterns in Classical Singers.

    Science.gov (United States)

    Salomoni, Sauro; van den Hoorn, Wolbert; Hodges, Paul

    2016-01-01

    Singing involves distinct respiratory kinematics (i.e. movements of rib cage and abdomen) to quiet breathing because of different demands on the respiratory system. Professional classical singers often advocate for the advantages of an active control of the abdomen on singing performance. This is presumed to prevent shortening of the diaphragm, elevate the rib cage, and thus promote efficient generation of subglottal pressure during phonation. However, few studies have investigated these patterns quantitatively and inter-subject variability has hindered the identification of stereotypical patterns of respiratory kinematics. Here, seven professional classical singers and four untrained individuals were assessed during quiet breathing, and when singing both a standard song and a piece of choice. Several parameters were extracted from respiratory kinematics and airflow, and principal component analysis was used to identify typical patterns of respiratory kinematics. No group differences were observed during quiet breathing. During singing, both groups adapted to rhythmical constraints with decreased time of inspiration and increased peak airflow. In contrast to untrained individuals, classical singers used greater percentage of abdominal contribution to lung volume during singing and greater asynchrony between movements of rib cage and abdomen. Classical singers substantially altered the coordination of rib cage and abdomen during singing from that used for quiet breathing. Despite variations between participants, principal component analysis revealed consistent pre-phonatory inward movements of the abdominal wall during singing. This contrasted with untrained individuals, who demonstrated synchronous respiratory movements during all tasks. The inward abdominal movements observed in classical singers elevates intra-abdominal pressure and may increase the length and the pressure-generating capacity of rib cage expiratory muscles for potential improvements in voice

  14. Taoism and Deep Ecology.

    Science.gov (United States)

    Sylvan, Richard; Bennett, David

    1988-01-01

    Contrasted are the philosophies of Deep Ecology and ancient Chinese. Discusses the cosmology, morality, lifestyle, views of power, politics, and environmental philosophies of each. Concludes that Deep Ecology could gain much from Taoism. (CW)

  15. Deep Incremental Boosting

    OpenAIRE

    Mosca, Alan; Magoulas, George D

    2017-01-01

    This paper introduces Deep Incremental Boosting, a new technique derived from AdaBoost, specifically adapted to work with Deep Learning methods, that reduces the required training time and improves generalisation. We draw inspiration from Transfer of Learning approaches to reduce the start-up time to training each incremental Ensemble member. We show a set of experiments that outlines some preliminary results on some common Deep Learning datasets and discuss the potential improvements Deep In...

  16. Efficacy of a Respiratory Training System on the Regularity of Breathing

    International Nuclear Information System (INIS)

    Shin, Eun Hyuk; Park, Hee Chul; Han, Young Yih; Ju, Sang Gyu; Shin, Jung Suk; Ahn, Yong Chan

    2008-01-01

    In order to enhance the efficiency of respiratory gated 4-dimensional radiation therapy for more regular and stable respiratory period and amplitude, a respiration training system was designed, and its efficacy was evaluated. Materials and Methods: The experiment was designed to measure the difference in respiration regularity following the use of a training system. A total of 11 subjects (9 volunteers and 2 patients) were included in the experiments. Three different breathing signals, including free breathing (free-breathing), guided breathing that followed training software (guided-breathing), and free breathing after the guided-breathing (post guided-breathing), were consecutively recorded in each subject. The peak-to-peak (PTP) period of the breathing signal, standard deviation (SD), peak-amplitude and its SD, area of the one cycle of the breathing wave form, and its root mean square (RMS) were measured and computed. Results: The temporal regularity was significantly improved in guided-breathing since the SD of breathing period reduced (free-breathing 0.568 vs guided-breathing 0.344, p=0.0013). The SD of the breathing period representing the post guided-breathing was also reduced, but the difference was not statistically significant (free-breathing 0.568 vs. guided-breathing 0.512, p=ns). Also the SD of measured amplitude was reduced in guided-breathing (free-breathing 1.317 vs. guided-breathing 1.068, p=0.187), although not significant. This indicated that the tidal volume for each breath was kept more even in guided-breathing compared to free-breathing. There was no change in breathing pattern between free-breathing and guided-breathing. The average area of breathing wave form and its RMS in postguided-breathing, however, was reduced by 7% and 5.9%, respectively. Conclusion: The guided-breathing was more stable and regular than the other forms of breathing data. Therefore, the developed respiratory training system was effective in improving the temporal

  17. Take heart!

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Recently, ten new semi-automatic defibrillators were installed at various locations around CERN. This is a preventive measure intended to provide cardiac arrest victims with the best possible response. The first responder could be you!   The Director-General has welcomed the initiative of the Medical Service and Fire Brigade for the installation of ten new semi-automatic defibrillators. You have probably seen them on your way to the restaurant, for example:  brand new semi-automatic defibrillators, ready for an emergency. Housed in a white wall-mounted case, the bright red defibrillators are marked with a white heart symbol crossed by a lightning bolt (see photo). The defibrillator is designed so that anyone can use it. “Anyone can use it, you don’t need to be a health professional,” says Dr Reymond from CERN's Medical Service. Together with the CERN Fire Brigade, he is behind the initiative to have these units put in place. And with good reason, as the unit...

  18. Deep Space Telecommunications

    Science.gov (United States)

    Kuiper, T. B. H.; Resch, G. M.

    2000-01-01

    The increasing load on NASA's deep Space Network, the new capabilities for deep space missions inherent in a next-generation radio telescope, and the potential of new telescope technology for reducing construction and operation costs suggest a natural marriage between radio astronomy and deep space telecommunications in developing advanced radio telescope concepts.

  19. Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment.

    Science.gov (United States)

    Sivathamboo, Shobi; Perucca, Piero; Velakoulis, Dennis; Jones, Nigel C; Goldin, Jeremy; Kwan, Patrick; O'Brien, Terence J

    2018-04-01

    Epilepsy is a group of neurological conditions in which there is a pathological and enduring predisposition to generate recurrent seizures. Evidence over the last few decades suggests that epilepsy may be associated with increased sleep-disordered breathing, which may contribute towards sleep fragmentation, daytime somnolence, reduced seizure control, and cardiovascular-related morbidity and mortality. Chronic sleep-disordered breathing can result in loss of gray matter and cause deficits to memory and global cognitive function. Sleep-disordered breathing is a novel and independent predictor of sudden cardiac death and, as such, may be involved in the mechanisms leading to sudden unexpected death in epilepsy. Despite this, the long-term consequences of sleep-disordered breathing in epilepsy remain unknown, and there are no guidelines for screening or treating this population. There is currently insufficient evidence to indicate continuous positive airway pressure (CPAP) for the primary or secondary prevention of cardiovascular disease, and recent evidence has failed to show any reduction of fatal or nonfatal cardiovascular endpoints. Treatment of sleep-disordered breathing may potentially improve seizure control, daytime somnolence, and neurocognitive outcomes, but few studies have examined this relationship. In this review, we examine sleep-disordered breathing in epilepsy, and discuss the potential effect of epilepsy treatments. We consider the role of CPAP and other interventions for sleep-disordered breathing and discuss their implications for epilepsy management.

  20. Sleep disordered breathing in spinal cord injury: A systematic review.

    Science.gov (United States)

    Chiodo, Anthony E; Sitrin, Robert G; Bauman, Kristy A

    2016-07-01

    Spinal cord injury commonly results in neuromuscular weakness that impacts respiratory function. This would be expected to be associated with an increased likelihood of sleep-disordered breathing. (1) Understand the incidence and prevalence of sleep disordered breathing in spinal cord injury. (2) Understand the relationship between injury and patient characteristics and the incidence of sleep disordered breathing in spinal cord injury. (3) Distinguish between obstructive sleep apnea and central sleep apnea incidence in spinal cord injury. (4) Clarify the relationship between sleep disordered breathing and stroke, myocardial infarction, metabolic dysfunction, injuries, autonomic dysreflexia and spasticity incidence in persons with spinal cord injury. (5) Understand treatment tolerance and outcome in persons with spinal cord injury and sleep disordered breathing. Extensive database search including PubMed, Cochrane Library, CINAHL and Web of Science. Given the current literature limitations, sleep disordered breathing as currently defined is high in patients with spinal cord injury, approaching 60% in motor complete persons with tetraplegia. Central apnea is more common in patients with tetraplegia than in patients with paraplegia. Early formal sleep study in patients with acute complete tetraplegia is recommended. In patients with incomplete tetraplegia and with paraplegia, the incidence of sleep-disordered breathing is significantly higher than the general population. With the lack of correlation between symptoms and SDB, formal study would be reasonable. There is insufficient evidence in the literature on the impact of treatment on morbidity, mortality and quality of life outcomes.

  1. Computational models for the study of heart-lung interactions in mammals.

    Science.gov (United States)

    Ben-Tal, Alona

    2012-01-01

    The operation and regulation of the lungs and the heart are closely related. This is evident when examining the anatomy within the thorax cavity, in the brainstem and in the aortic and carotid arteries where chemoreceptors and baroreceptors, which provide feedback affecting the regulation of both organs, are concentrated. This is also evident in phenomena such as respiratory sinus arrhythmia where the heart rate increases during inspiration and decreases during expiration, in other types of synchronization between the heart and the lungs known as cardioventilatory coupling and in the association between heart failure and sleep apnea where breathing is interrupted periodically by periods of no-breathing. The full implication and physiological significance of the cardiorespiratory coupling under normal, pathological, or extreme physiological conditions are still unknown and are subject to ongoing investigation both experimentally and theoretically using mathematical models. This article reviews mathematical models that take heart-lung interactions into account. The main ideas behind low dimensional, phenomenological models for the study of the heart-lung synchronization and sleep apnea are described first. Higher dimensions, physiology-based models are described next. These models can vary widely in detail and scope and are characterized by the way the heart-lung interaction is taken into account: via gas exchange, via the central nervous system, via the mechanical interactions, and via time delays. The article emphasizes the need for the integration of the different sources of heart-lung coupling as well as the different mathematical approaches. Copyright © 2011 Wiley Periodicals, Inc.

  2. Off-line breath acetone analysis in critical illness.

    Science.gov (United States)

    Sturney, S C; Storer, M K; Shaw, G M; Shaw, D E; Epton, M J

    2013-09-01

    Analysis of breath acetone could be useful in the Intensive Care Unit (ICU) setting to monitor evidence of starvation and metabolic stress. The aims of this study were to examine the relationship between acetone concentrations in breath and blood in critical illness, to explore any changes in breath acetone concentration over time and correlate these with clinical features. Consecutive patients, ventilated on controlled modes in a mixed ICU, with stress hyperglycaemia requiring insulin therapy and/or new pulmonary infiltrates on chest radiograph were recruited. Once daily, triplicate end-tidal breath samples were collected and analysed off-line by selected ion flow tube mass spectrometry (SIFT-MS). Thirty-two patients were recruited (20 males), median age 61.5 years (range 26-85 years). The median breath acetone concentration of all samples was 853 ppb (range 162-11 375 ppb) collected over a median of 3 days (range 1-8). There was a trend towards a reduction in breath acetone concentration over time. Relationships were seen between breath acetone and arterial acetone (rs = 0.64, p acetone concentration over time corresponded to changes in arterial acetone concentration. Some patients remained ketotic despite insulin therapy and normal arterial glucose concentrations. This is the first study to look at breath acetone concentration in ICU patients for up to 8 days. Breath acetone concentration may be used as a surrogate for arterial acetone concentration, which may in future have a role in the modulation of insulin and feeding in critical illness.

  3. Advanced Heart Failure

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:May 9,2017 When heart failure (HF) ... Making This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  4. Breathing multichimera states in nonlocally coupled phase oscillators

    Science.gov (United States)

    Suda, Yusuke; Okuda, Koji

    2018-04-01

    Chimera states for the one-dimensional array of nonlocally coupled phase oscillators in the continuum limit are assumed to be stationary states in most studies, but a few studies report the existence of breathing chimera states. We focus on multichimera states with two coherent and incoherent regions and numerically demonstrate that breathing multichimera states, whose global order parameter oscillates temporally, can appear. Moreover, we show that the system exhibits a Hopf bifurcation from a stationary multichimera to a breathing one by the linear stability analysis for the stationary multichimera.

  5. Development and Evaluation of Algorithms for Breath Alcohol Screening.

    Science.gov (United States)

    Ljungblad, Jonas; Hök, Bertil; Ekström, Mikael

    2016-04-01

    Breath alcohol screening is important for traffic safety, access control and other areas of health promotion. A family of sensor devices useful for these purposes is being developed and evaluated. This paper is focusing on algorithms for the determination of breath alcohol concentration in diluted breath samples using carbon dioxide to compensate for the dilution. The examined algorithms make use of signal averaging, weighting and personalization to reduce estimation errors. Evaluation has been performed by using data from a previously conducted human study. It is concluded that these features in combination will significantly reduce the random error compared to the signal averaging algorithm taken alone.

  6. Cheyne-stokes respiration in patients with heart failure.

    Science.gov (United States)

    AlDabal, Laila; BaHammam, Ahmed S

    2010-01-01

    Cheyne-Stokes respiration (CSR) is a form of central sleep-disordered breathing (SDB) in which there are cyclical fluctuations in breathing that lead to periods of central apneas/hypopnea, which alternate with periods of hyperpnea. The crescendo-decrescendo pattern of respiration in CSR is a compensation for the changing levels of blood oxygen and carbon dioxide. Severe congestive heart failure seems to be the most important risk factor for the development of CSR. A number of pathophysiologic changes, such as sleep disruption, arousals, hypoxemia-reoxygenation, hypercapnia/hypocapnia, and changes in intrathoracic pressure have harmful effects on the cardiovascular system, and the presence of CSR is associated with increased mortality and morbidity in subjects with variable degrees of heart failure. The management of CSR involves optimal control of underlying heart failure, oxygen therapy, and positive airway pressure support. In this review, we initially define and describe the epidemiology of central sleep apnea (CSA) and CSR, its pathogenesis, clinical presentation, diagnostic methods, and then discuss the recent developments in the management in patients with heart failure.

  7. Deep learning with Python

    CERN Document Server

    Chollet, Francois

    2018-01-01

    DESCRIPTION Deep learning is applicable to a widening range of artificial intelligence problems, such as image classification, speech recognition, text classification, question answering, text-to-speech, and optical character recognition. Deep Learning with Python is structured around a series of practical code examples that illustrate each new concept introduced and demonstrate best practices. By the time you reach the end of this book, you will have become a Keras expert and will be able to apply deep learning in your own projects. KEY FEATURES • Practical code examples • In-depth introduction to Keras • Teaches the difference between Deep Learning and AI ABOUT THE TECHNOLOGY Deep learning is the technology behind photo tagging systems at Facebook and Google, self-driving cars, speech recognition systems on your smartphone, and much more. AUTHOR BIO Francois Chollet is the author of Keras, one of the most widely used libraries for deep learning in Python. He has been working with deep neural ...

  8. Quantitating aortic regurgitation by cardiovascular magnetic resonance: significant variations due to slice location and breath holding

    International Nuclear Information System (INIS)

    Chaturvedi, Abhishek; Hamilton-Craig, Christian; Cawley, Peter J.; Maki, Jeffrey H.; Mitsumori, Lee M.; Otto, Catherine M.

    2016-01-01

    Compare variability in flow measurements by phase contrast MRI, performed at different locations in the aorta and pulmonary artery (PA) using breath-held (BH) and free-breathing (FB) sequences. Fifty-seven patients with valvular heart disease, confirmed by echocardiography, were scanned using BH technique at 3 locations in the ascending aorta (SOV = sinus of Valsalva, STJ = sinotubular junction, ASC = ascending aorta at level of right pulmonary artery) and 2 locations in PA. Single FB measurement was obtained at STJ for aorta. Obtained metrics (SV = stroke volume, FV = forward volume, BV = backward volume, RF = regurgitant fraction) were evaluated separately for patients with aortic regurgitation (AR, n = 31) and mitral regurgitation (n = 26). No difference was noted between the two measurements in the PA. Significant differences were noted in measured SV at different aortic locations. SV measurements obtained at ASC correlated best with the measurements obtained in the PA. Strongest correlation of AR was measured at the STJ. Measurements of flow volumes by phase contrast MRI differ depending on slice location. When using stroke volumes to calculate pulmonary to systemic blood flow ratio (Qp/Qs), ASC should be used. For quantifying aortic regurgitation, measurement should be obtained at STJ. (orig.)

  9. Exhaled breath condensate pH and hydrogen peroxide as non-invasive markers for asthma

    International Nuclear Information System (INIS)

    Al-Obaidy, Amina H.; Al-Samarai, Abdul-Gahni M.

    2007-01-01

    Objective was to estimate the predictive value of exhaled breath condensate (EBC) hydrogen peroxide (H2O2) concentration and pH as non-invasive markers in asthma. Fifty patients with unstable, steroid naive atopic asthma were included in this study, 25 with persistent asthma. Asthma diagnosis was according to the National Heart Lung and Blood Institute guidelines for the diagnosis and management of asthma. Forced expiratory volume in one second (FEV1) was measured by computerized spirometry. The EBC H2O2 assay was carried out using the colorimetric assay. The study was conducted from January to December 2005 in the Asthma and Allergy Center, Tikrit, Iraq. The EBC H2O2 concentration was higher in the asthmatic group (0.91mol) as compared with the control (0.23 mol). There was inverse correlation between EBC H2O2 concentration and FEV1 predicted percent for asthmatic patients. The mean EBC pH was lower in the asthmatic than the control group. There was a positive correlation between EBC pH and FEV 1 predicted percent for asthmatic patients. There was an inverse correlation between EBC H2O2 concentration and pH for all asthmatic patients, intermittent, and persistent asthmatic group. Exhaled breath condensate hydrogen peroxide concentration and pH was a good non-invasive marker for asthma, whether it was with a persistent or intermittent course. (author)

  10. Canadian Thoracic Society 2011 Guideline Update: Diagnosis and Treatment of Sleep Disordered Breathing

    Directory of Open Access Journals (Sweden)

    John Fleetham

    2011-01-01

    Full Text Available The Canadian Thoracic Society (CTS published an executive summary of guidelines for the diagnosis and treatment of sleep disordered breathing in 2006/2007. These guidelines were developed during several meetings by a group of experts with evidence grading based on committee consensus. These guidelines were well received and the majority of the recommendations remain unchanged. The CTS embarked on a more rigorous process for the 2011 guideline update, and addressed eight areas that were believed to be controversial or in which new data emerged. The CTS Sleep Disordered Breathing Committee posed specific questions for each area. The recommendations regarding maximum assessment wait times, portable monitoring, treatment of asymptomatic adult obstructive sleep apnea patients, treatment with conventional continuous positive airway pressure compared with automatic continuous positive airway pressure, and treatment of central sleep apnea syndrome in heart failure patients replace the recommendations in the 2006/2007 guidelines. The recommendations on bariatric surgery, complex sleep apnea and optimum positive airway pressure technologies are new topics, which were not covered in the 2006/2007 guidelines.

  11. Deep learning evaluation using deep linguistic processing

    OpenAIRE

    Kuhnle, Alexander; Copestake, Ann

    2017-01-01

    We discuss problems with the standard approaches to evaluation for tasks like visual question answering, and argue that artificial data can be used to address these as a complement to current practice. We demonstrate that with the help of existing 'deep' linguistic processing technology we are able to create challenging abstract datasets, which enable us to investigate the language understanding abilities of multimodal deep learning models in detail, as compared to a single performance value ...

  12. Heart Age PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.

  13. Vertebral scale system to measure canine heart size in radiographs

    International Nuclear Information System (INIS)

    Buchanan, J.W.; Bucheler, J.

    1995-01-01

    A method for measuring canine heart size in radiographs was developed on the basis that there is a good correlation between heart size and body length regardless of the conformation of the thorax. The lengths of the long and short axes of the heart of 100 clinically normal dogs were determined with calipers, and the dimensions were scaled against the length of vertebrae dorsal to the heart beginning with T4. The sum of the long and short axes of the heart expressed as vertebral heart size was 9.7 +/- 0.5 vertebrae. The differences between dogs with a wide or deep thorax, males and females, and right or left lateral recumbency were not significant. The caudal vena cava was 0.75 vertebrae +/- 0.13 in comparison to the length of the vertebra over the tracheal bifurcation

  14. Health and efficiency in trimix versus air breathing in compressed air workers.

    Science.gov (United States)

    Van Rees Vellinga, T P; Verhoeven, A C; Van Dijk, F J H; Sterk, W

    2006-01-01

    The Western Scheldt Tunneling Project in the Netherlands provided a unique opportunity to evaluate the effects of trimix usage on the health of compressed air workers and the efficiency of the project. Data analysis addressed 318 exposures to compressed air at 3.9-4.4 bar gauge and 52 exposures to trimix (25% oxygen, 25% helium, and 50% nitrogen) at 4.6-4.8 bar gauge. Results revealed three incidents of decompression sickness all of which involved the use of compressed air. During exposure to compressed air, the effects of nitrogen narcosis were manifested in operational errors and increased fatigue among the workers. When using trimix, less effort was required for breathing, and mandatory decompression times for stays of a specific duration and maximum depth were considerably shorter. We conclude that it might be rational--for both medical and operational reasons--to use breathing gases with lower nitrogen fractions (e.g., trimix) for deep-caisson work at pressures exceeding 3 bar gauge, although definitive studies are needed.

  15. Effects of Controlled Breathing, With or Without Aromatherapy, in the Treatment of Postoperative Nausea.

    Science.gov (United States)

    Cronin, Sherill Nones; Odom-Forren, Jan; Roberts, Holli; Thomas, Melissa; Williams, Sandy; Wright, Margaret Imelda

    2015-10-01

    The purpose of this study was to compare the effectiveness of controlled breathing (CB), with and without aromatherapy (isopropyl alcohol [IPA]), in the treatment of postoperative nausea (PON) in adult females undergoing elective outpatient laparoscopic procedures. A prospective randomized two-group quasi-experimental design was used. A convenience sample was used. Patients were consented and assigned to either a control (CB) or treatment (IPA) group. Symptomatic patients rated nausea severity before and at 2 and 5 minutes after receiving either CB or CB with IPA. Complete data for one episode of nausea were obtained on 82 patients (41 in each group). Results showed that although nausea severity decreased significantly over time, there was no significant difference in PON treatment effectiveness between the two groups, nor was there a difference in requests for rescue medications. Patients who experience PON should be encouraged to take slow deep breaths as an initial response to symptoms. This approach has no side effects or costs and could also aid the patient to self-manage symptoms after discharge. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  16. Exposure of the Heart in Breast Cancer Radiation Therapy: A Systematic Review of Heart Doses Published During 2003 to 2013

    International Nuclear Information System (INIS)

    Taylor, Carolyn W.; Wang, Zhe; Macaulay, Elizabeth; Jagsi, Reshma; Duane, Frances; Darby, Sarah C.

    2015-01-01

    Purpose: Breast cancer radiation therapy cures many women, but where the heart is exposed, it can cause heart disease. We report a systematic review of heart doses from breast cancer radiation therapy that were published during 2003 to 2013. Methods and Materials: Eligible studies were those reporting whole-heart dose (ie, dose averaged over the whole heart). Analyses considered the arithmetic mean of the whole-heart doses for the CT plans for each regimen in each study. We termed this “mean heart dose.” Results: In left-sided breast cancer, mean heart dose averaged over all 398 regimens reported in 149 studies from 28 countries was 5.4 Gy (range, <0.1-28.6 Gy). In regimens that did not include the internal mammary chain (IMC), average mean heart dose was 4.2 Gy and varied with the target tissues irradiated. The lowest average mean heart doses were from tangential radiation therapy with either breathing control (1.3 Gy; range, 0.4-2.5 Gy) or treatment in the lateral decubitus position (1.2 Gy; range, 0.8-1.7 Gy), or from proton radiation therapy (0.5 Gy; range, 0.1-0.8 Gy). For intensity modulated radiation therapy mean heart dose was 5.6 Gy (range, <0.1-23.0 Gy). Where the IMC was irradiated, average mean heart dose was around 8 Gy and varied little according to which other targets were irradiated. Proton radiation therapy delivered the lowest average mean heart dose (2.6 Gy, range, 1.0-6.0 Gy), and tangential radiation therapy with a separate IMC field the highest (9.2 Gy, range, 1.9-21.0 Gy). In right-sided breast cancer, the average mean heart dose was 3.3 Gy based on 45 regimens in 23 studies. Conclusions: Recent estimates of typical heart doses from left breast cancer radiation therapy vary widely between studies, even for apparently similar regimens. Maneuvers to reduce heart dose in left tangential radiation therapy were successful. Proton radiation therapy delivered the lowest doses. Inclusion of the IMC doubled typical heart dose.

  17. Nursing diagnoses in children with congenital heart disease: a survival analysis.

    Science.gov (United States)

    Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira; Leite de Araujo, Thelma

    2007-01-01

    To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively.

  18. Exhaled breath condensate metabolome clusters for endotype discovery in asthma

    NARCIS (Netherlands)

    Sinha, Anirban; Desiraju, Koundinya; Aggarwal, Kunal; Kutum, Rintu; Roy, Siddhartha; Lodha, Rakesh; Kabra, S. K.; Ghosh, Balaram; Sethi, Tavpritesh; Agrawal, Anurag

    2017-01-01

    Asthma is a complex, heterogeneous disorder with similar presenting symptoms but with varying underlying pathologies. Exhaled breath condensate (EBC) is a relatively unexplored matrix which reflects the signatures of respiratory epithelium, but is difficult to normalize for dilution. Here we

  19. Pulmonary Effects of Submerged Breathing of Air or Oxygen

    National Research Council Canada - National Science Library

    Shykoff, B

    2002-01-01

    ...). The risks of developing PO2T are poorly characterized. The current shallow-water exposure limit, four hours breathing oxygen at 25 fsw or less in any 24-hour period, was established somewhat arbitrarily as a known "safe" exposure...

  20. Training Studies with Compressed Air Breathing Apparatus – Methodology, Exercises

    Directory of Open Access Journals (Sweden)

    Buks Roberts

    2015-11-01

    Full Text Available The current article describes topics ranging from the respiratory physiology and the structure of compressed air breathing apparatus to the performance of practical training exercises in an unbreathable environment (hereinafter referred to as UE.