Forty patients with cystic fibrosis and chronic broncho-pulmonary Pseudomonas aeruginosa infection entered a prospective double-blind placebo-controlled study of colistin inhalation. Active treatment consisted of inhalation of colistin one million units twice daily for three months and was compared to placebo inhalations of isotonic saline. Significantly more patients in the colistin inhalation group completed the study as compared to the placebo group (18 versus 11). Colistin treatment was superior to placebo treatment in terms of a significantly better clinical symptom score, maintenance of pulmonary function and inflammatory parameters. We recommend colistin inhalation therapy for cystic fibrosis patients with chronic P. aeruginosa lung infection as a supplementary treatment to frequent courses of intravenous anti-pseudomonas chemotherapy.
This study determined whether marked hyperthermia alone or in combination with dehydration reduces the initial rate of rise in O(2) consumption (VO(2) on-kinetics) and the maximal rate of O(2) uptake (VO(2 max)) during intense cycling exercise. Six endurance-trained male cyclists completed four maximal cycle ergometer exercise tests (402 +/- 4 W) when euhydrated or dehydrated (4% body wt) with normal (starting esophageal temperature, 37.5 +/- 0.2 degrees C; mean skin temperature, approximately 31 degrees C) or elevated (+1 and +6 degrees C, respectively) thermal strain. In the euhydrated and normal condition, subjects reached VO(2 max) (4.7 +/- 0.2 l/min) in 228 +/- 34 s, with a mean response time of 42 +/- 2 s, and fatigued after 353 +/- 39 s. Hyperthermia alone or in combination with dehydration reduced mean response time (17-23%), VO(2 max) (16%), and performance time (51-53%) (all P < 0.01) but did not alter the absolute response time (i.e., the time to reach 63% response in the control trial, 3.2 +/- 0.1 l/min, 42 s). Reduction in VO(2 max) was accompanied by proportional decline in O(2) pulse and significantly elevated maximal heart rate (195 vs. 190 beats/min for hyperthermia vs. normal). Preventing hyperthermia in dehydrated subjects restored VO(2 max) and performance time by 65 and 50%, respectively. These results demonstrate that impaired high-intensity exercise performance with marked skin and internal body hyperthermia alone or in combination with dehydration is not associated with a diminished rate of rise in VO(2) but decreased VO(2 max).
We compare vertical seasonal loading deformation observed by continuous GPS stations in southern Alaska and modeled vertical displacements due to seasonal hydrological loading inferred from GRACE. Seasonal displacements are significant, and GPS‐observed and GRACE‐modeled seasonal displacements are highly correlated. We define a measure called the WRMS Reduction Ratio to measure the fraction of the position variations at seasonal periods removed by correcting the GPS time series using a seasonal model based on GRACE. The median WRMS Reduction Ratio is 0.82 and the mean is 0.73 ± 0.26, with a value of 1.0 indicating perfect agreement of GPS and GRACE. The effects of atmosphere and non‐tidal ocean loading are important; we add the AOD1B de‐aliasing model to the GRACE solutions because the displacements due to these loads are present in the GPS data, and this improves the correlations between these two geodetic measurements. We find weak correlations for some stations located in areas where the magnitude of the load changes over a short distance, due to GRACE's limited spatial resolution. GRACE models can correct seasonal displacements for campaign GPS measurements as well.
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