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Biomedical subjects

D N Ostrow

Publications and source records attributed to D N Ostrow.

30 records · Page 2Linked to original sources
PubMed1985

Managing chronic airflow obstruction: Part I.

The term "senile emphysema" has been largely abandoned. The lungs do, however, tend to lose their elastic recoil with age. The alveolar ducts enlarge, and the alveolar surface area decreases with age. Total lung capacity does not increase, but the residual volume and functional residual capacity do, with a concomitant decrease in vital capacity. The concern about lung cancer in these patients should be great, as the prevalence for that condition overlaps that of CAO. A routine chest roentgenograph and sputum samples for cytologic examination are the most commonly used techniques to diagnose lung cancer.

Adult↗
PubMed1984

Role of computed tomography in the recognition of bronchiectasis.

To assess the accuracy of computed tomography (CT) in the recognition of bronchiectasis, CT was performed in 11 patients with clinical findings strongly suggestive of this diagnosis. In two patients, CT showed extensive bilateral cystic and varicose bronchiectasis, and bronchography was considered unwarranted. In four patients, bilateral, and in five, unilateral bronchograms were obtained. Correlation was made between the CT and bronchographic findings in these 13 lungs. In only six bronchograms did CT give an accurate assessment of the presence and extent of disease. In five, the diagnosis of cylindrical and varicose bronchiectasis was missed on CT. In two, CT suggested the diagnosis of cylindrical bronchiectasis but the bronchogram was normal. It was concluded that CT may be useful in the diagnosis of cystic bronchiectasis, but is unreliable in detecting cylindrical and varicose changes. Bronchography, therefore, remains the definitive method for establishing the diagnosis, extent, and severity of bronchiectasis.

Adult↗
PubMed1984

CT diagnosis of laryngeal cricoid chondrosarcoma.

Computerized tomography is the imaging method of choice for evaluation of neoplastic involvement of the larynx. There are unusual primary neoplasms of the larynx which include chondroma and chondrosarcoma. These lesions may cause vocal cord paralysis and respiratory symptoms secondary to compression of the recurrent laryngeal nerve. We present a single patient with computerized tomographic imaging of laryngeal chondrosarcoma resulting in unilateral vocal cord paralysis and hoarseness.

Aged↗
PubMed1980

Chronic obstructive pulmonary disease following idiopathic pulmonary fibrosis.

The rapid development of irreversible airflow obstruction in two nonsmoking women who recovered from acute idiopathic pulmonary fibrosis is discussed. Pulmonary fibrosis was diagnosed clinically and by lung biopsy. Recovery both clinically and radiologically was complete. Several pulmonary function studies in both patients showed a typical restrictive pattern (reduced lung volumes and carbon dioxide diffusing capacity, normal FEV1/FVC ratio). Within one year both patients exhibited an obstructive pattern of dysfunction (hyperinflation, gas trapping, reduced airflow measurements). These patients illustrated irreversible airway obstruction following recovery from the restrictive stage of pulmonary fibrosis.

Airway Resistance↗
PubMed1978

Professional patient-instructors in the teaching of the pelvic examination.

A class of 100 second-year medical students was randomly divided into two groups for instruction in the techniques of the gynecologic examination. Each group received a lecture and a demonstration film. The control group then had practical instruction on office or clinic patients. The study group was instructed by specially trained clinical teaching associates who acted both as professional patients and as teachers. After practice in clinics and offices, both groups received a common evaluation by gynecologists and teaching associates. Students who were instructed by clinical teaching associates performed better on subsequent pelvic examinations and demonstrated superior communications skills compared with the control group.

Educational Measurement↗
PubMed1978

Alpha1-antitrypsin phenotypes and lung function in a moderately polluted northern Ontario community.

To determine whether persons with intermediate value alpha1-antitrypsin phenotypes living in a polluted environment manifest significant abnormalities in lung function, a study was undertaken of an age-, sex- and smoking-stratified sample of 391 persons from the town of Fort Frances, Ont., which has elevated values of total dustfall, suspended particulates and hydrogen sulfide. Indices of pulmonary function were derived from the maximum expiratory flow and the single breath expiratory flow and the single breath expiratory nitrogen washout curves. The percentage frequency of the M, MS and MZ pheontypes was 91.7, 7.3 and 0.8, respectively. There was no significant difference between the M and MS groups as indicated by the nitrogen washout curve and maximum expiratory flow curve. There was no significant difference between the three MZ subjects and the M group. In both M and MS groups smokers displayed evidence of airflow obstruction when compared with nonsmokers. It would appear that, when compared with M subjects, persons with the MS phenotype living in a moderately polluted area show no changes in indicators of pulmonary function, including tests of early airway disease, that cannot be attributed to their smoking habit.

Adult↗
PubMed1975

Learning pulmonary function interpretation: deductive versus inductive methods.

Volunteer undergraduate medical students were randomly divided into 2 groups. One group were given pulmonary function data and the correct diagnoses from 18 patients. They were told to try to derive the rules by which the diagnoses were made. The other group were given the data from the same 18 patients, but were required to use a computer-assisted instructional program to arrive at the diagnoses in a deductive fashion. Both groups were pre- and post-tested. The deductive method provided higher post-test results. The inductive method took longer and produced more dropouts from the study.

Analysis of Variance↗
PubMedDate not supplied

The determination of relevant goals and criteria used to select an automated patient care information system: a Delphi approach.

OBJECTIVES: To determine the relevant weighted goals and criteria for use in the selection of an automated patient care information system (PCIS) using a modified Delphi technique to achieve consensus. DESIGN: A three-phase, six-round modified Delphi process was implemented by a ten-member PCIS selection task force. The first phase consisted of an exploratory round. It was followed by the second phase, of two rounds, to determine the selection goals and finally the third phase, of three rounds, to finalize the selection criteria. RESULTS: Consensus on the goals and criteria for selecting a PCIS was measured during the Delphi process by reviewing the mean and standard deviation of the previous round's responses. After the study was completed, the results were analyzed using a limits-of-agreement indicator that showed strong agreement of each individual's responses between each of the goal determination rounds. Further analysis for variability in the group's response showed a significant movement to consensus after the first goal-determination iteration, with consensus reached on all goals by the end of the second iteration. CONCLUSION: The results indicated that the relevant weighted goals and criteria used to make the final decision for an automated PCIS were developed as a result of strong agreement among members of the PCIS selection task force. It is therefore recognized that the use of the Delphi process was beneficial in achieving consensus among clinical and nonclinical members in a relatively short time while avoiding a decision based on political biases and the "groupthink" of traditional committee meetings. The results suggest that improvements could be made in lessening the number of rounds by having information available through side conversations, by having other statistical indicators besides the mean and standard deviation available between rounds, and by having a content expert address questions between rounds.

British Columbia↗
PubMedDate not supplied

Assessment of patient acceptance and inhalation technique of a pressurized aerosol inhaler and two breath-actuated devices.

OBJECTIVE: To assess inhalation technique in patients after written instruction alone, written and verbal instruction, and clinical use of two new inhalation devices. DESIGN: Randomized, crossover evaluation of the albuterol Diskhaler and the terbutaline Turbuhaler. SETTING: Canadian tertiary-care hospital. PATIENTS: Twenty hospitalized adults with asthma or chronic obstructive pulmonary disease currently using an albuterol metered-dose inhaler (MDI). Nineteen patients received Diskhaler, 16 received Turbuhaler, 15 received both inhalers, and 10 patients used both inhalers for three days each. INTERVENTIONS: Patients were randomized to receive either Diskhaler or Turbuhaler for three days. Inhaler technique was assessed after written instruction, written plus verbal instruction, at the first scheduled dose after instruction, and after three days of clinical use. Patients remaining in the hospital after three days crossed over to the other study inhaler and the same protocol was followed. MAIN OUTCOME MEASURES: Patient inhalation technique was assessed and compared for the MDI, Diskhaler, and Turbuhaler. RESULTS: Assessment of MDI technique revealed that 35 percent of patients used their MDI correctly on the first puff, and 42 percent used it correctly on the second puff. Following written instruction alone, correct technique was demonstrated by 32 percent of patients with Diskhaler and 6 percent with Turbuhaler. Technique significantly improved following verbal instruction, although 40 percent of the patients required up to three attempts to demonstrate correct technique on at least one of the study inhalers. After three days of clinical use, correct technique was demonstrated in only 54 percent of the Diskhaler and 64 percent of the Turbuhaler assessments. Performance at this assessment was, however, significantly better on the Turbuhaler than on the MDI (p = 0.01). Performance on the Diskhaler was not significantly different from the performance on the other inhalers. CONCLUSIONS: Written instruction alone is inadequate in teaching correct inhalation technique. Verbal instruction and technique assessment are essential for patients to achieve proper technique. Patients may perform better on the Turbuhaler than on other inhalation devices.

Administration, Inhalation↗