Traumatic nasal impaction.
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Biomedical subjects
Publications and source records attributed to R Waugh.
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PURPOSE: To compare three equations developed to predict VO2 among patients diagnosed with one of two chronic diseases: essential hypertension (HTN), and fibromyalgia (FM). The equations included the American College of Sports Medicine (ACSM) equation, the FAST equation developed from the Fitness and Arthritis in Seniors Trial (FAST), and an equation developed by Foster et al. METHODS: One hundred twenty-two HTN subjects and 68 FM subjects completed a maximum exercise test according to the Duke/Wake Forest protocol. Measured peak VO2 was then compared with the VO2 predicted by the ACSM, FAST and FOSTER equations, using several statistical methods. RESULTS: The ACSM equation overpredicted peak VO2 in the HTN group by 10.0 +/- 4.0 mL/kg-1/min-1, and in the FM group by 8.6 +/- 4.9 mL/kg-1/min-1 (P < 0.0001). The FAST equation, however, underestimated peak VO2 by 1.5 +/- 4.2 mL/kg-1/min-1 (P < 0.01) and 1.0 +/- 3.3 mL/kg-1/min-1 (P < 0.0001) in the HTN and FM groups, respectively. The FOSTER equation overestimated peak VO2 by 2.3 +/- 3.6 mL/kg-1/min-1 in the HTN group and by 2.1 +/- 3.5 mL/kg-1/min-1 in the FM group (P < 0.0001). A large degree of variability was found for each of the equations. CONCLUSION: Results of this investigation indicate that all three equations produced peak VO2 values that were statistically different from measured values. Although the ACSM equation overestimated VO2 by more than 2 metabolic equivalents (METs) in each patient group, both the FAST and FOSTER equations produced differences that were less than 1 MET. Further research is needed to examine the FAST and FOSTER equations among other patient populations and with other exercise protocols.
Primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC) are the most common cholestatic disorders in adulthood requiring hepatic transplantation. Although they run similar courses, they may have different problems before and after transplantation. The aim of this study was to compare pre- and post-transplant complications and outcomes in these two similar but distinct patient groups. One hundred and seventeen adult patients underwent liver transplantation at our institution over a 6 year period, including 19 with PSC and 20 with PBC. Pre-transplant there were no significant differences in age, liver biochemistry, haematology or Child-Pugh scores between the two groups. The mean duration of disease before transplant was longer in PSC patients (11.7 vs 6.5 years; P < 0.05). The prevalence of septic cholangitis was greater in PSC (58 vs 5%; P < 0.01) as was the requirement for surgical or radiological interventional procedures, excluding cholecystectomy (53 vs 0%; P < 0.01). At transplantation, four patients with PSC had previously unrecognized cholangiocarcinoma. In the pre-transplant period these four patients had uncontrolled biliary sepsis at the time of transplant vs five of 15 PSC patients without cholangiocarcinoma. Postoperatively, PSC patients had a greater prevalence of intra-abdominal sepsis requiring surgical or radiological intervention (42 vs 5%; P < 0.05). In comparison, patients with PBC had a high prevalence of skeletal complications (30 vs 10%; P < 0.05) particularly avascular necrosis (15 vs 0%). The prevalence of chronic rejection was similar in both groups (15%). Overall survival was higher in PBC patients (85 vs 63%; P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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