Biomedical subjects

Paul D Boyce

Publications and source records attributed to Paul D Boyce.

3 recordsLinked to original sources

PubMed2006

pH increase observed in exhaled breath condensate from welding fume exposure.

OBJECTIVES: We sought to investigate changes in exhaled breath condensate (EBC) pH in healthy workers exposed to welding fumes. METHODS: Fourteen exposed participants (median age 39 years, 5 smokers) and 8 nonexposed controls (median age 44 years, 1 smoker) were monitored at an apprentice welding school. Exposure to fine particulate matter less than 2.5 microm (PM2.5) was assessed using cyclone samplers. EBC samples were collected at baseline and at the end of the work shift. EBC samples were deaerated using argon and pH values were measured using standard pH microelectrodes. RESULTS: Mean +/- SEM PM2.5 levels were 1.17 +/- 0.18 mg/m for exposed subjects and 0.03 +/- 0.01 mg/m for controls. Baseline median (range) EBC pH values for the control and exposed group were similar (P = 0.86), 7.21 (4.91 to 8.26), and 7.39 (4.85 to 7.79), respectively. The exposed subjects had a small-but-marginally significant (P = 0.07) pre- to post-work shift increase in pH of 0.28, whereas the control group showed a minimal increase of only 0.03 (P = 0.56). Compared with the control group, the exposed group had a median cross-shift pH increase of 0.25 (P = 0.49). CONCLUSIONS: The aerosolized fine particulate matter contained in metal fumes may be associated with an acute increase in EBC pH values. Further study is necessary to investigate the acute rise in EBC pH after acute exposure to welding fume.

Adult↗

PubMed2005

Clinical predictors of and mortality in acute respiratory distress syndrome: potential role of red cell transfusion.

OBJECTIVE: Clinical predictors for acute respiratory distress syndrome (ARDS) have been studied in few prospective studies. Although transfusions are common in the intensive care unit, the role of submassive transfusion in non-trauma-related ARDS has not been studied. We describe here the clinical predictors of ARDS risk and mortality including the role of red cell transfusion. DESIGN: Observational prospective cohort. SETTING: Intensive care unit of Massachusetts General Hospital. PATIENTS: We studied 688 patients with sepsis, trauma, aspiration, and hypertransfusion. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred twenty-one (32%) subjects developed ARDS with a 60-day mortality rate of 46%. Significant predictors for ARDS on multivariate analyses included trauma (adjusted odds ratio [ORadj] 0.22, 95% confidence interval [CI] 0.09-0.53), diabetes (ORadj 0.58, 95% CI 0.36-0.92), direct pulmonary injury (ORadj 3.78, 95% CI 2.45-5.81), hematologic failure (ORadj 1.84, 95% CI 1.05-3.21), transfer from another hospital (ORadj 2.08, 95% CI 1.33-3.25), respiratory rate >33 breaths/min (ORadj 2.39, 95% CI 1.51-3.78), hematocrit >37.5% (ORadj 1.77, 95% CI 1.14-2.77), arterial pH <7.33 (ORadj 2.00, 95% CI 1.31-3.05), and albumin </=2.3 g/dL (ORadj 1.80, 95% CI 1.18-2.73). Packed red blood cell transfusion was associated with ARDS (ORadj 1.52, 95% CI 1.00-2.31, p = .05). Significant predictors for mortality in ARDS included age (ORadj 1.96, 95% CI 1.50-2.53), Acute Physiology and Chronic Health Evaluation III score (ORadj 1.78, 95% CI 1.16-2.73), trauma (ORadj 0.075, 95% CI 0.006-0.96), corticosteroids before ARDS (ORadj 4.65, 95% CI 1.47-14.7), and arterial pH <7.22 (ORadj 2.32, 95% CI 1.02-5.25). Packed red blood cell transfusions were associated with increased mortality in ARDS (ORadj 1.10 per unit transfused; 95% CI 1.04-1.17) with a significant dose-dependent response (p = .02). CONCLUSIONS: Important predictors for the development of and mortality in ARDS were identified. Packed red blood cell transfusion was associated with an increased development of and increased mortality in ARDS.

Adolescent↗

PubMedDate not supplied

Pulmonary hypertension: work in progress.

Pulmonary arterial hypertension is a rare disorder defined by mean pulmonary artery pressures that exceed 25 mm Hg at rest or are greater than 30 mm Hg with exercise. The mortality rate is high for untreated patients, mainly as a result of progressive right heart dysfunction. Pulmonary arterial hypertension has been historically classified as primary pulmonary hypertension or pulmonary hypertension resulting from an underlying disease process. Ongoing research in the nuclear medicine field holds great promise for understanding the pathophysiologic pathways for this condition, as well as the monitoring of the continually evolving therapeutic options.

Blood Pressure↗