114 research outputs found
Obstructive sleep apnea and pulmonary hypertension
No full textObstructive sleep apnea (OSA) is associated with repetitive nocturnal arterial oxygen desaturation and hypercapnia, large intrathoracic negative pressure swings, and acute increases in pulmonary artery pressure. Rodents when exposed to brief, intermittent hypoxia for several hours per day to mimic OSA developed pulmonary vascular remodeling and sustained pulmonary hypertension and right ventricular hypertrophy within a few weeks. Until recently, however, it was unclear whether episodic nocturnal hypoxemia associated with OSA was sufficient to cause similar changes in humans. This controversy appears to have been resolved by several recent studies that have shown (a) pulmonary hypertension in 20% to 40% of patients with OSA in the absence of other known cardiopulmonary disorders and (b) reductions in pulmonary artery pressure in patients with OSA after nocturnal continuous positive airway pressure (CPAP) treatment. The pulmonary hypertension associated with OSA appears to be mild and may be due to a combination of precapillary and postcapillary factors including pulmonary arteriolar remodeling and hyperreactivity to hypoxia and left ventricular diastolic dysfunction and left atrial enlargement. Although measurable changes in the structure and function of the right ventricle have been reported in association with OSA, the clinical significance of these changes is uncertain. Right ventricular failure in OSA appears to be uncommon and is more likely if there is coexisting left-sided heart disease or chronic hypoxic respiratory disease.Dimitar Sajkov and R. Doug McEvo
Comparison of effects of sustained isocapnic hypoxia on ventilation in men and women
No full text Sajkov, Dimitar, Alister Neill, Nicholas A. Saunders, and R. Douglas McEvoy. Comparison of the effects of sustained isocapnic hypoxia on ventilation in men and women. J. Appl. Physiol. 83(2): 599–607, 1997.—Sleep-related respiratory disturbances are more common in men than in premenopausal women. This might, in part, be due to different susceptibilities to the respiratory depressant effects of hypoxia. Therefore, we compared ventilation during 10 min of baseline room-air breathing and 20-min sustained isocapnic hypoxia (fractional inspired O2 = 11%, arterial saturation of O2 ≈ 80%) followed by 10 min of breathing 100% O2 in 10 normal men and in 10 women in the follicular phase of the menstrual cycle. Control measurements were made during two transitions from room air (10 min) to 100% O2 (10 min) and averaged. Inspired minute ventilation (V˙i) after 2 min of hypoxia was the same in men and women [131 ± 6.1% baseline for men, 136 ± 7.7% baseline for women; not significant (NS)] and declined to the same level after 20 min (115 ± 5.0% baseline for men, 116 ± 6.6% baseline for women; NS) associated with a similar decline in inspiratory time and tidal volume. Breathing frequency did not change.V˙i decreased transiently during subsequent 100% O2 breathing in both men and women, associated with reduced frequency and duty cycle and increased expiratory time. The fall inV˙i was significantly greater than that observed during control hyperoxia experiments in men but not in women. We conclude that ventilatory responses to sustained isocapnic hypoxia do not differ between awake healthy men and women in the follicular phase of their menstrual cycle. However, after termination of isocapnic hypoxia, men appear to depress their ventilation to a greater degree than women. </jats:p
Is unitary and integral Yugoslavia possible?
No full textTitle: Bъзмοжнa πu e euòннa u uяπocmнa Юƨocπaeuя? Ha ƨpaнuyama мeжòy noπumuκama u фuπocoфuяma (Is unitary and integral Yugoslavia possible? On the borderline between politics and philosophy) Originally published: in the magazine Фuπocoфcκu npeƨπeò, IV, 1932, vol. III, pp. 197–227. Language: BulgarianThe excerpts used are from the original, pp. 213–214, 220, 221–223. About the author Dimitar Mihalchev [1880, Lozengrad (Tur. Kirklareli, present-day Turkey) – 1967, Sofia]: philosopher and diplom..
THE IDIOLECT OF REVEREND ECONOMOS DIMITAR POPNIKOLOV PETKANOV
No full textA less studied talented author and brother of the popular fiction writer Konstantin Petkanov, priest
Dimitar wrote in the 1950s. This publication analyzes several parameters of his idiolect: phonetic peculiarities (reflex of ѣ, ѫ,
ъ; epenthetic [l]; reflexes of the [tʃ] [dʒ] groups; phonetic dialectisms; phonetic doublets); morphological paradigm (case
inflections; noun form for number; dualis; nomina collectiva; extended Church Slavonic suffix for adjectives; dialectal and
contracted pronoun forms; a temporal system characterized by high frequency of the verbs in terms of origin, distribution and
stylistic differentiation); lexical specifics (in terms of origin, distribution and stylistic differentiation). Emphasis is placed on
those lexical layers that constitute and ditinguish the author’s language. Hapaxes (produced using morphological and non-
morphological methods), rare words, semantic transponents, dialectisms, colloquial vocabulary and foreign words are studied.
All linguistic phenomena are examined retrospectively and in comparison with the synchronous linguistic situation before and
after the orthographic reform of 1945 in order to highlight the innovative contribution and the mechanisms through which the
author enriched the contemporary Bulgarian vocabulary. Occasionalisms, dialectal and archaic units occur more often in
Petkanov’s poetic works than in his fiction. The source material has been excerpted from Volume 1 (January – March) and
Volume 2 (April – June) of the hagiographic tetralogy “The Year of Our Lord“ and the memoir “A Book about My Brother –
the Writer Konstantin N. Petkanov“, which were published a few years ago by Dimitar Petkanov’s heirs
Imperium Militiae(I)
No full textThe most common idea in Romance studies is that Romans, as practical people, didn’t conduct theoretical research on their country or their army, but they gradually built them both. Meanwhile, they reformed and upgraded it, so that they could respond to the challenges of their age. Moreover, the basis of their research was not explicit doctrines, or prior concepts, in fact they used their own, or the experience of others, to find concrete solutions to daily problems. Just as the Hellenic romanophile Polibius (200-120 B.C), in his work Historia, asks the crucial question: ”Is it possible to have such an unreliable man who is not interested in how the Romans, with their unicipal structure, managed to conquer the whole world”? - in the same way the author of this paper, as much as its content allows, humbly and unpretentiously tries to answer the crucial question: “What kind of military structure
created and defended one of the biggest and most enduring empires in world’s history, and what rules governed it”
Accidental Rivaroxaban Overdose in a Patient with Pulmonary Embolism: Some Lessons for Managing New Oral Anticoagulants
No full textRivaroxaban is an orally active direct factor Xa inhibitor used to treat venous thromboembolism with approved starting dose of 15 mg twice-daily. We present a case of an accidental overdose in a patient with pulmonary thromboembolism, when the patient received two 150 mg doses of rivaroxaban, instead of 15 mg as prescribed, given 12 hours apart. This error was recognised ten minutes after the second dose, when 50 gm oral activated charcoal was given. Rivaroxaban was stopped and rivaroxaban concentrations, INR, and APTT were monitored. The overdose was uncomplicated and 15 mg twice-daily rivaroxaban was restarted on day two. Apparently unlikely and potentially hazardous dispensing errors do happen. Each oral anticoagulant has a different dosing schedule. In our patient, the prescription for 15 mg twice-daily rivaroxaban was misread as 150 mg twice-daily (a correct dose for dabigatran in atrial fibrillation). Such errors are preventable. Prompt administration of activated charcoal under monitoring of a specific rivaroxaban assay can greatly help management of unusual situations like this one
- …
