Evaluation of transcutaneous and end-tidal carbon dioxide levels during inhalation sedation in volunteers

Measurement of end-tidal carbon dioxide (P_ETCO₂) is useful because of its noninvasiveness, continuity, and response time when sudden changes in ventilation occur during inhalation sedation. We compared the accuracy of P_ETCO₂ using a nasal mask and nasal cannula with the accuracy of transcutaneous carbon dioxide (TC-CO₂) and determined which method is more useful during inhalation sedation in volunteers. We used a modified nasal mask (MNM) and modified nasal cannula (MNC) for measurement of P_ETCO₂. The capnometer measured P_ETCO₂ in the gas expired from the nasal cavity by means of two devices. The volunteers received supplemental O₂ by means of each device at a flow rate of 6 L/min. After the volunteers lay quietly for 5 min with a supply of 100 % O₂, they received supplemental N₂O by means of each device at concentrations of 10, 20, and 25 % for 5 min and 30 % for 25 min. The correlation coefficient was poorer in the MNM than in the MNC, and the mean difference between TC-CO₂ and P_ETCO₂ in the MNM was greater than that in the MNC. The difference between the TC-CO₂ and P_ETCO₂ ranged from 3 to 6 mmHg in the MNM and from 2 to 5 mmHg in the MNC. The difference between two variables against the TC-CO₂ and the CO₂ waveforms obtained by means of the two devices were within the clinically acceptable range. Our two devices can provide continuous monitoring of P_ETCO₂ with a supply of N₂O/O₂ in patients undergoing inhalation sedation.     

An assessment of the construct validity of the CHU9D in the Australian adolescent general population

Purpose  

To assess the construct validity of the CHU9D in an adolescent general population sample. The CHU9D is a new generic preference-based measure of health-related quality of life developed specifically for application in the economic evaluation of health care treatments and interventions for young people.     

Effects of Air Pollution on Adults with Chronic Obstructive Pulmonary Disease

Few studies have been conducted on the effects of air pollution on patients with chronic obstructive pulmonary disease (COPD). During a 14-mo period, 39 Parisian adults with severe COPD were monitored by their physicians. Daily levels of 4 air pollutants were provided by an urban air-quality network. Exacerbation of COPD was associated only with ozone (O₃) (odds ratio [OR] = 1.44 for a 10-μg/m³ increase in O₃; 95% confidence interval [Cl] = 1.14, 1.82), with a lag of 2-3 days. The effect of O₃ was greater in patients whose carbon dioxide pressure (PaCO₂) was higher than 43 mm Hg (OR = 1.83; 95% Cl = 1.36, 2.47) vs. those with a lower PaCO₂ (OR = 1.26; 95% Cl = 0.90, 1.77). The effect of O₃ was unchanged, regardless of the maintenance medications used. The only air pollutant to which patients with severe COPD were particularly sensitive was O₃.     

Hemangiomas of the external auditory canal:a literature review and two new case reports

Aim  

The aim of this paper is to present two case reports of patients with hemangiomas of the external auditory canal, and to overview all cases published in English language literature so far.