Nasal airflow resistances were studied in 20 healthy subjects at rest, with exercise, and during recovery from exercise. Resistances were first measured under resting conditions. As a basis for comparison 0.1% xylometazoline was applied by insufflation; it reduced nasal resistance by an average of 49%. On a subsequent occasion, the degree and time course of changes in resistance were measured 1) during 5-min exercise bouts at rest 25, 50, and 75% of predicted maximum O2 intake (VO2max), 2) during 5-, 10-, and 15-min exercise bouts at 50% of VO2max, and 3) during recovery from exercise. Resistance decreased with intensity but not duration of exercise; an initial sudden decrease was followed by a more gradual but progressive decrease, which continued for several minutes following vigorous short duration exercise. Thus following 5 min of effort at 75% of VO2max, resistance reached a nadir (46% fall) 5 min after cessation of exercise. Recovery of preexercise values required 5 min after 5 min of exercise at 25% of VO2max and 10 min after 5 min of exercise at 50% of VO2max. Some decrease persisted 15 min after 5 min of exercise at 75% of VO2max.

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This study provides evidence that oral TA is a clinically effective and cost-efficient alternative to IV TA in the setting of THA and TKA.

Background Acute decompensated heart failure (ADHF) can present similarly to pulmonary infections. The additional volume and sodium received from intravenous antibiotics (IVAB) can be counterproductive, especially when strong evidence of infection is lacking. Objective The objective was to evaluate the impact of potentially unwarranted IVAB on clinical outcomes in patients with ADHF. Methods This multicenter, retrospective, cohort study evaluated adults admitted with ADHF, a chest radiograph within 24 hours, B-natriuretic peptide >100 pg/mL, and either received no IVAB or IVAB for at least 48 hours. Subjects with recent antibiotics, justification for antibiotics, or transferred to the intensive care unit (ICU) within 24 hours of admission were excluded. The primary outcome was hospital length of stay (LOS). Secondary outcomes included utilization of loop diuretics, administration of fluid and sodium, mortality, and 30-day readmissions. Results Out of 240 subjects included, 120 received IVAB. LOS was significantly longer in the IVAB group (5.12 days vs 3.73 days; P < .001). LOS remained significantly longer in the IVAB group in a propensity score matched cohort (5.26 days vs 3.70 days; P < .001). The IVAB group received more volume and sodium from intravenous fluids ( P < .001). ICU admission greater than 24 hours after admission was higher with IVAB (20% vs 7.5%; P = .049). No significant differences in total loop diuretics, intubation rate, mortality, and 30-day readmissions were identified. Conclusion ADHF patients who received potentially unwarranted IVAB had longer hospital LOS and were more likely to be admitted to the ICU after 24 hours of hospitalization.

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