Thursday, August 30, 2012

The purpose of this study was to analyse the information provided by different techniques used in the assessment of patients with idiopathic pulmonary fibrosis (IPF) and their role in the prediction of lung function decline with the decline. Twenty seven subjects with IPF (55 +/- 14 (mean +/- SD) yrs) were studied at the initial staging. Nineteen of them (70%) were included in a follow-up over 3 yrs (32 +/- 6 months), whilst the remaining 8 patients were lost to follow-up. During the period of the study, 6 of the 19 patients died. A significant correlation between diffusing capacity of the lungs for carbon monoxide (DLCO) (and carbon monoxide transfer coefficient (KCO) = DLCO/alveolar volume (VA)) and the increase in alveolar-arterial oxygen tension difference (A-aPO2) during exercise (delta A-aPO2) was observed at diagnosis (r = -0.58). Despite the treatment with prednisone (1 mg.kg-1 daily during 4 weeks, tapered to an individualized maintenance daily dose of 15-30 mg), the 13 patients controlled throughout the whole period of the study showed a marked impairment in lung volumes; forced vital capacity (FVC) -0.46 +/- 0.09 l, from 69 +/- 16 to 52 +/- 11% of predicted, and total lung capacity (TLC) -0.39 +/- 0.11 l, from 75 +/- 16 to 62 +/- 14%, and in DLCO -0.6 +/- 0.2 mmol.min-1.kPa-1, from 56 +/- 15 to 47 +/- 18%, predicted. By contrast, both mean arterial oxygen tension (PaO2) and A-aPO2 at rest remained unchanged throughout the 3 yrs follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID:: 8005243; [PubMed - indexed for MEDLINE]

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Sunday, August 19, 2012

Medical State of Mind

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Iron bar removed from builder's head | World news | guardian.co.uk

http://www.guardian.co.uk/world/2012/aug/17/iron-bar-removed-builders-head

Iron bar removed from builder's head | World news | guardian.co.uk

A builder is recovering after an operation to remove a 1.8m-long iron bar from his head.

The bar fell from the fifth floor of a building under construction, went through Eduardo Leite's hard hat, pierced the back of his skull and exited between his eyes.

Amazingly the 24-year-old survived and when he arrived at hospital he was conscious and able to tell doctors what had happened.

Luiz Alexandre Essinger, chief of staff of Miguel Couto hospital, Rio de Janeiro, said doctors successfully withdrew the bar during a five-hour operation on Wednesday.

"He was taken to the operating room, his skull was opened, they examined the brain and the surgeon decided to pull the metal bar out from the front in the same direction it entered the brain," Essinger said.

He said Leite was lucid and showed no negative consequences after the operation. "Today, he continues well, with few complaints for a five-hour-long surgery," Essinger said. "He says he feels little pain."

Essinger added that "it really was a miracle" Leite survived.

"They told me he was laying down (in the ambulance) with the bar pointing upward," said Leite's wife, Lilian Regina da Silva Costa. "He was holding it and his face covered in blood. His look was as if nothing had happened. When he arrived he told the doctors he wasn't feeling anything, no pain, nothing. It's unbelievable."

Ruy Monteiro, the hospital's head of neurosurgery, told the Globo TV network Leite escaped losing one eye and becoming paralysed on the left side of his body by just a few centimetres.

He said the bar entered a "non-eloquent" area of the brain that doesn't have a specific, major known function. Leite is expected to remain in hospital for at least two weeks.

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