Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / AIM: The aim of this study was threefold. Firstly to determine the effect of passive thoracic flexion-rotation (PTFR) movement on the total static compliance of the respiratory system, tidal volume, respiratory rate and plateau pressure. Secondly, to identify the interventions used by physiotherapists to influence compliance and thirdly to compare the effects of these interventions. DESIGN: A one group, pre-test-post-test physiological study and a systematic review of the literature were performed. METHOD: A randomised sample consisting of 18 intubated and ventilated subjects of varying periods of ventilation and various conditions was obtained. The interventions used included tactile stimulation and PTFR movements. Subjects acted as their own controls. Objective variables namely tidal volume, respiratory rate and plateau pressure were recorded by a research assistant. These measurements were taken immediately following the intervention and repeated again three times in an interval of 20 minutes after the movement was discontinued. Total static compliance of the respiratory system was calculated as tidal volume divided by the difference between plateau pressure and positive end-expiratory pressure. The search strategy for the systematic review included the searching of five databases, a secondary search (pearling) and a hand search. Two independent reviewers agreed on the inclusion of articles and their methodological quality. A critical review form (Law et al 1998) was used for scoring methodological quality and a hierarchy of evidence for allocating the level of evidence of each study. Inclusion criteria were experimental studies, written in English and published after January 1995. Participants were intubated, ventilated humans, over the age of 18.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 4 uppsatser.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Chest pain is one of the most common symptoms responsible for emergency department and primary care office visits in the United States. Chest pain can be noncardiac and may be attributed to multiple causes. Esophageal disorders including reflux, motility and functional conditions, affect a large proportion of patients with NCCP and lead to significant morbidity. The use of HRM has changed the diagnostic approach to esophageal motility disorders. It is the most specific and sensitive test for diagnosing motor disorders and a promising procedure in detecting dysmotility disorders in patients with NCCP. Despite the increased sensitivity of HRM, the main indications for esophageal manometry exclude NCCP. This study assessed the percentage of undiagnosed esophageal motility disorders in patients with NCCP referred for high resolution manometry. Differences in HRM findings in patients with NCCP versus patients meeting AGA recommendations for the clinical use of esophageal manometry were also compared. A retrospective descriptive design was utilized. Two hundred-nineteen patient charts were reviewed. One hundred sixty-eight (77%) patients underwent HRM and met AGA recommendations for esophageal manometry; 51 (23%) patients underwent the procedure after receiving a NCCP diagnosis. Findings showed that 116 (69%) patients in the AGA group had abnormal findings while 52 (31%) did not. In the NCCP group 34 (67%) had abnormal findings compared to 17 (33%) who did not. To compare normal and abnormal HRM findings in patients with NCCP versus those meeting AGA criteria, Chi-Square analysis was performed between the groups. The results were not statistically significant (p = 0.10). iv There were no significant differences in the results of HRM in both groups indicating the findings on HRM are the same despite the indication for the procedure. The findings support the use of HRM as a diagnostic tool in patients with chest pain after cardiac workup and endoscopic evaluation. This indicates a possible need to update the AGA indications for esophageal manometry and increase the awareness among healthcare providers regarding the use of HRM in patients with chest pain. Implication for future research is also discussed.

Mobile chest radiography remains the most appropriate test for critical care patients with cardiorespiratory changes and with patients who have chest tubes and lines as a monitoring tool, and to detect complications related to their use. However, one of the most frequent issues recognized radiographically with patients in critical care is chest tubes and lines malposition. This can be related to technical quality reasons which can affect their appearance in the chest radiography. This research considers how the technical quality of the ICU/CCU chest radiography can impact upon the appearance of chest tubes/lines and how that appearance can impact on the decision making. Results show that the methods used in the chest phantom experiment to estimate the degree of angulation have a large effect upon the appearance of anatomical structures, but it does not have a particularly large effect upon the apparent changes of tube/line position central venous catheter and endotracheal tube (CVC, ETT). The study also shows that there was a little difference between the two image processing algorithms, apart from the visualisation of sharp reproduction of the trachea and proximal bronchi, which was significantly better using the standard algorithm compared to the inverted algorithm. The two methods used to estimate the degree of angulation and the apparent position of the CVC/ETT on 17 mobile chest radiographs provide limited useful information to the image interpreter in estimating the degree of angulation and degree of malpositioning of the tube and line.

No / Neonatal chest radiography is a frequently performed diagnostic examination, particularly in preterm infants where anatomical and/or biochemical immaturity impacts on respiratory function. However, the quality of neonatal radiographic images has been criticized internationally and a prevailing concern has been that radiographers (radiologic technologists) fail to appreciate the unique nature of neonatal and infant anatomical proportions. The aim of this study was to undertake a retrospective evaluation of neonatal chest radiography image acquisition techniques against key technical criteria. Methods Hundred neonatal chest radiographs, randomly selected from all those acquired in 2014, were retrospectively evaluated. Inclusion criteria for radiographs acquisition were as follows: anterior-posterior supine; within 30 days of birth; and with all preprocessed collimation boundaries visible. Image evaluation was systematically undertaken using an image assessment tool. To test for statistical significance, Student's t-test, χ2 test, and logistic regression were undertaken. Results Only 47% of the radiographs were considered straight in both upper and lower thoraces. The cranial collimation border extended beyond the upper border of the third cervical vertebra in 30% of cases, and the caudal border extended below the lower border of the first lumbar vertebra in 20% of cases, suggesting high possibility of neonatal overirradiation. Upper thorax rotation was significantly associated with head position (χ2 = 10.907; P < .001) as has been stated in many published textbooks internationally, but arm position had no apparent influence on rotation of the upper thorax (χ2 = 5.1260; P = .275). Birth weight was associated with accurate midline centering of central ray (logistic regression; OR = 1.0005; P = .009; CI, 1.00139–1.000957) with greater accuracy observed in images of neonates with higher birth weight. Conclusion This study has highlighted areas for neonatal chest radiography improvement. Importantly, the findings bring into question commonly advocated radiographic techniques relating to arm positioning and assessment of rotation while confirming the importance of other technical factors. These findings begin the work toward developing the evidence base to underpin neonatal chest radiograph acquisition, but further prospective work and multicenter/multinational data comparison are required to confirm the findings.

Thyroxine is the main thyroid gland's hormone. The state, when the thyroid gland does not produce enough of it into the bloodstream is called hypothyroidism. Hypothyroidism is related with several health complications; therefore it is required to take replacement therapy in adequate doses. Concerning pregnant women, it is important especially to keep the blood level of thyroxine in the normal, because increasing or decreasing of it, has an adverse effect on the health of the mother and also on the normal child development. The objective of my thesis was to describe malformations spectra of thyroxine, to find out the beginning of its embryotoxicity dose range for chick embryos, and recalculate this value for human embryos, allowing us to decide, if the level of thyroxine was increased by a replacement therapy, this could be embryotoxic for human. The experimental part of my work was to search an alternative method for testing embryotoxicity on chick embryos in ovo - CHEST, testing of embryotoxic potential of the thyroxine. Embryotoxicity is a feature of the external factors affecting the embryo, it may manifest as lethality, growth retardation, and teratogenicity; which is an ability of the external factor to induce the developmental defect. The most common manifestation of embryotoxicity in this...

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Mounting evidence suggests that the superposition of anatomical clutter in x-ray chest radiography poses a major impediment to the detectability of subtle lung nodules. Through decomposition of projections acquired using different x-ray energy spectra, dual-energy (DE) imaging offers to dramatically improve lung nodule conspicuity. The development of a high-performance DE chest imaging system is reported, with design and implementation guided by fundamental imaging performance metrics. Analytical and experimental studies of imaging performance guided the optimization of key acquisition technique parameters, including x-ray filtration, allocation of dose between low- and high-energy projections, and peak-kilovoltage selection. To minimize anatomical misregistration between images, a cardiac gating system was designed and implemented to direct x-ray exposures to within the quiescent period of the heart cycle. The instrumentation and optimal imaging techniques have been incorporated in a DE imaging prototype system now deployed in a clinical study to evaluate the diagnostic performance of DE imaging.