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Biomedical subjects

T G Zullo

Publications and source records attributed to T G Zullo.

At least 19 recordsLinked to original sources

Nasal cannula and transtracheal oxygen delivery. A comparison of patient response after 6 months of each technique.

The purpose of this study was to compare the efficacy of transtracheal (TT) oxygen delivery to that of nasal cannula delivery in subjects with chronic obstructive pulmonary disease (COPD). Twenty subjects (14 men, 6 women) were followed for 6 months during nasal cannula delivery. A TT catheter was then inserted, and measurements were repeated during TT use. With TT delivery, subjects required 45% less oxygen at rest and 39% less during exercise (p less than 0.0001). Oxygen use, measured by pounds of oxygen delivered to the home, also decreased, but the magnitude of change was less than anticipated (mean, 14%; range, +4% to -32%). Hospital days decreased from 12 +/- 10 during nasal cannula use to 4 +/- 6 during TT use (p less than 0.002). Exercise tolerance, as measured by a 12-min walk distance, was greater during TT use (p less than 0.0001). No change was seen in spirometry or acid-base balance. Also, no change was seen in Profile of Mood States, Sickness Impact Profile or Katz Adjustment Scale scores. Some problems were encountered relating to use of the catheter (displacement, mucus balls), but they were minor, and most were confined to the initial 2 months of TT use when the tract was immature. Our experience suggests that, in addition to decreasing oxygen flow rate, use of TT delivery may confer benefits that result in improved exercise tolerance and decreased hospitalization in patients with COPD.

Catheterization

Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters.

OBJECTIVE: To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. DESIGN: A quasi-experimental, within-subject, repeated-measures design was used. SUBJECTS: 18 patients ventilated on a fraction of inspired oxygen of 0.47 +/- 0.17 and 2.3 +/- 5.0 cm H2O positive end-expiratory pressure. INTERVENTIONS: Two suction passes were performed, with measurements at baseline, immediately after the first suction pass, immediately before the second suction pass, immediately after the second suction pass, 2 minutes after the second suction pass and 5 minutes after the second suction pass. No hyperoxygenation was used. RESULTS: Significant differences were seen over time for arterial oxygen saturation, respiratory rate and inspiratory:expiratory ratio. Arterial oxygen saturation decreased to less than 90% in four subjects (range 88% to 89%), with a maximum fall of 9%. No significant differences were seen for heart rate, blood pressure, partial pressure of carbon dioxide, bicarbonate, time to nadir (lowest arterial oxygen saturation) or recovery time. CONCLUSIONS: Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.

Aged

Pulp test response of the maxillary anterior teeth in cleft palate patients.

The relative pulpal responsiveness of the six maxillary incisors to electrical and cold thermal stimuli was tested in patients with complete unilateral and bilateral clefts. The six maxillary anterior teeth were tested at random to electrical stimuli. After a 5-minute interval, the same teeth were tested at random to cold stimuli with an ice pencil. Unilateral and bilateral cleft palate patients had statistically significant higher mean electrical pulp test thresholds for the maxillary anterior teeth than the noncleft palate patients. No statistically significant difference between unilateral and bilateral cleft palate patients was found in electric pulp test responses of the maxillary anterior teeth. No statistically differences in electric pulp test responses and cold test responses of the maxillary anterior teeth in both cleft palate and noncleft palate individuals based on differences in sex were observed. No statistically significant difference in cold test responses were observed between cleft palate and noncleft palate patients. Cleft palate patients who completed orthodontic treatment within 1 year of testing showed elevated mean electrical pulp test thresholds as did noncleft palate patients who received orthodontic treatment within 1 year of testing.

Adolescent

Patient response to transtracheal oxygen delivery.

We compared the effectiveness of transtracheal oxygen delivery with that of nasal cannula delivery in 10 subjects with severe hypoxemia who had previously used a portable liquid oxygen system for 20 +/- 12 months. Arterial blood gas measurements, spirometry, and an exercise test were performed prior to catheter insertion and at 2 and 6 months after insertion. With transtracheal oxygen delivery, subjects significantly (p less than 0.0001) reduced their oxygen requirement while maintaining previous exercise capacity. No change occurred in pH, PaCO2, or in spirometry. Of the 10 subjects, 4 have continued catheter use with excellent acceptance. Three experienced complications after insertion, which necessitated catheter removal. Two elected to discontinue the catheter despite subjective improvement in dyspnea. One subject died after an exacerbation of COPD. Our experience confirms findings of others that transtracheal oxygen delivery significantly reduces oxygen requirement. However, in this study, we encountered complications requiring removal of the catheter and variability in patient acceptance. Results indicate the need for additional controlled studies to identify which patients will benefit most from those potentially promising system for delivery of chronic oxygen therapy.

Catheterization

Evaluation of two methods used to stabilize oral endotracheal tubes.

This study examined the effects of using an oral endotracheal tube holder versus conventional taping for stabilization of oral endotracheal tubes. Twenty-five patients were studied for 4 days, while 5 remained in the study 3 days. Each of the 30 patients had each of the two methods of stabilization in place for at least 1 day. The oral endotracheal tube holder significantly (p less than 0.0001) decreased both internal and external movement of the tube. Although self-extubation did occur in two instances, it was evaluated as less likely to occur when the tube holder was used to secure the endotracheal tube. Skin breakdown was also observed less frequently with the tube holder. Overall, nursing staff had a higher level of acceptance of the tube holder as the method of choice for stabilization of an oral endotracheal tube. Patient perceptions of the system were not evaluated because of the degree of illness of the patients.

Adhesives

Relationship of skeletal pattern and nasal form.

This article investigates the relationship of skeletal facial pattern and soft-tissue nasal form. The case sample comprises 123 white female subjects, aged 11.0 to 20.6 years, with no histories of pathology, trauma, surgical intervention, or orthodontic treatment. Measurements were made from cephalometric radiographs, posteroanterior radiographs, and the physioprint photographs. Skeletal classifications were based on the relationship of the maxilla to the mandible; the three classifications were straight profile, retrusive chin profile, and prognathic profile. Pearson product--moment correlation coefficients were used to test intercorrelations of all quantitative variables (including age) with each other. Correlations were highly significant for age, the three profile measurements, and two of the frontal measurements. Hence, noses and skeletal structures showed, as expected, increases with age. Also, profile measurements were highly significantly correlated; larger noses were larger in all profile dimensions. A stepwise discriminant analysis was used to study nonquantitative categories of nasal shape (straight, convex, and concave). This analysis indicated that more than 86% of patients in the sample of 123 demonstrated a correlation of nasal shapes with specific skeletal groupings. Patients with straight profiles tended to have straight noses; convex profiles accompanied convex nasal shapes; and concave profiles were found with concave nasal shapes. The clinical significance of this research is to emphasize the importance of total facial harmony (especially nasal shape) during orthodontic diagnosis and treatment planning.

Adolescent

Changing trends of tobacco use in a teenage population in western Pennsylvania.

Information on tobacco use was obtained from an anonymous questionnaire distributed to 609 8th, 9th, and 10th grade students in the Pittsburgh area. The data disclosed that 22 per cent of the girls and 11 per cent of the boys were smoking. However, 35 per cent of the young men reported using smokeless tobacco; snuff dipping (6 per cent), tobacco chewing (10 per cent), and snuff and/or tobacco chewing (19 per cent).

Adolescent

The influence of perennial allergic rhinitis on facial type and a pilot study of the effect of allergy management on facial growth patterns.

Perennial rhinitis with an allergic component (PRAC) in association with chronic mouthbreathing has been thought to cause skeletal open-bite facial type and narrow transverse facial dimensions. The object of this study was to supply data for this theory and to determine if allergy management would alter the course of facial growth. When a group of children, aged 5 to 10 years, with PRAC was compared with a matched control sample, a significantly larger palatomandibular angle and lower anterior facial height were found for the PRAC group. Transverse cephalometric measurements showed significantly narrower bilateral orbital breadth, bizygomatic, and binasal dimensions (narrower face) of the PRAC patients compared with the control sample. A pilot study of twelve PRAC patients who received 2 1/2 years of allergy management revealed no significant dento-facial dimensional change. This study suggests that PRAC with chronic mouthbreathing can alter the development of the midface. Whether allergy therapy can prevent or change this is as yet uncertain.

Cephalometry

Serum long-chain alcohol levels in healthy individuals and in patients with breast cancer.

Total long-chain alcohols were analyzed in blood sera from normal individuals and patients with diagnosed breast cancer. Tetra-, hexa- and octadecan-1-ol were the major long-chain alcohols detected in both groups. While the qualitative composition of the serum alcohols was similar in the two groups the average alcohol content of the serum of the breast cancer patients was approximately six times greater than that of the normal group. This difference in serum alcohol levels between the two groups was significant at p less than 0.01.

Adolescent

Factor analysis of comprehensive examinations.

In working toward new, integrated curricula, dental schools have often failed to concurrently revise their evaluative techniques to be more compatible with the objectives of the curriculum. One question of major importance is whether the schools are totally aware of their students' capabilities or are graduating students proficient in some fields while lacking in others. Is the student's overall or total score satisfactory even though deficiencies may exist in certain areas? This latter situation is a real possibility when the simple sum of subtest scores is used as the primary means in assessing students. Using factor analysis, the scores on the subtests of eight dental school comprehensive examinations (total of 1,023 subjects, on first-, second-, and third-year examinations given between December 1970 and May 1972) at the University of Pittsburgh School of Dental Medicine were examined. The results, culled from the correlation matrices, Chi-square analysis, and factor matrices, indicated that the subtests did not form a homogenous unit (one, general factor), and hence that use of the total score is questionable.

Analysis of Variance