Nitrogen dioxide (NO2), a by-product of combustion produced by indoor gas appliances such as cooking stoves, is associated with respiratory symptoms in those with obstructive airways disease. We conducted a three-armed randomized trial to evaluate the efficacy of interventions aimed at reducing indoor NO2 concentrations in homes with unvented gas stoves: (i) replacement of existing gas stove with electric stove; (ii) installation of ventilation hood over existing gas stove; and (iii) placement of air purifiers with high-efficiency particulate air (HEPA) and carbon filters. Home inspection and NO2 monitoring were conducted at 1 week pre-intervention and at 1 week and 3 months post-intervention. Stove replacement resulted in a 51% and 42% decrease in median NO2 concentration at 3 months of follow-up in the kitchen and bedroom, respectively (P = 0.01, P = 0.01); air purifier placement resulted in an immediate decrease in median NO2 concentration in the kitchen (27%, P < 0.01) and bedroom (22%, P = 0.02), but at 3 months, a significant reduction was seen only in the kitchen (20%, P = 0.05). NO2 concentrations in the kitchen and bedroom did not significantly change following ventilation hood installation. Replacing unvented gas stoves with electric stoves or placement of air purifiers with HEPA and carbon filters can decrease indoor NO2 concentrations in urban homes.
SummaryThe development of advanced revascularization techniques has resulted in the growth of a subset of patients with coronary artery disease who are nonrevascularizable and are considered to have refractory angina. Enhanced external counterpulsation (EECP) has been developed for the management of these patients with chronic, refractory disease. Evidence has shown that through improvement of vascular endothelial function and recruitment of collateral vessels, EECP provides many clinical benefits. These patients experience sustained decreases in angina, improvement in exercise time, improved myocardial perfusion, and enhanced quality of life. Furthermore, EECP appears to be safe and effective in the treatment of angina in patients with impaired systolic function and has similar potential in patients with congestive heart failure.
Bone CO2-titration curves were obtained in mature rats weighing 500-600 g. Animals were exposed for one hour to 1, 3, 5, 10, or 15% CO2 in air. Measurements of bone CO2, were made using a modified titrimetric analysis on fresh and oven-dried samples of paired rat femurs. A manometric method was used for comparison. Arterial blood samples were obtained for measurements of partial pressure of CO2 in arterial blood (PaCO2). Within the range of environmental CO2 concentrations studied, a linear relationship was observed between the PaCO2 and the increment in fresh bone CO2 content. This relationship is defined by the equation: delta fresh bone CO2 (mmol/kg) = 61.8 +/- 0.68 PaCO2. The CO2 increment was confined to a heat-labile, presumably soluble pool comprising 10.5% of the total bone CO2 content. No change in the water content of the bone was observed as a result of acute CO2 exposure. The results of this study demonstrate the rapid in vivo CO2 uptake of bone in response to exposure to increased CO2 levels.
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