CHARACTERIZATION OF ACUTE EXACERBATION AFTER PULMONARY REHABILITATON IN INDIVIDUALS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE SJ Carr1, 4, RS Goldstein1-4, D Brooks1, 3, 4 Graduate Department of Rehabilitation Science, 2Department of Medicine, 3Department of Physical Therapy, University of Toronto, 4Department of Respiratory Medicine, West Park Healthcare Centre, Toronto Introduction: Despite improvements in health status achieved through pulmonary rehabilitation PR ; the benefits diminish with time despite good community follow-up. Acute exacerbations AE ; of chronic obstructive pulmonary disease COPD ; negatively impact adherence and likely accelerate this diminution of benefit. A study of the effects of enhanced follow-up after PR on functional exercise capacity and health-related quality of life HRQL ; found a clear deterioration, and subjects identified experiencing AEs as a main contributing factor. Little research has been done on the effects of AEs on functional exercise capacity or HRQL. This study was designed to characterize the.

EDUCATIONAL OBJECTIVE: At the conclusion of this presentation, the participants should be able to understand the demographics of malignant otitis externa, comorbid conditions, and trends between 1990 and 2000. OBJECTIVES: To obtain a better understanding of malignant otitis externa MOE ; , its incidence, trends in co-morbid conditions, and length of hospitalization from 1990 to 2000 in California. STUDY DESIGN: Retrospective database review. METHODS: The California Hospital Discharge database was reviewed and 820 patients with a diagnosis of MOE were found over the 11 year period. Data on age, race, duration of hospitalization, the medical center, comorbid conditions, procedures performed, and total charges among others was extracted. RESULTS: The average incidence of MOE was 2.3 per 1, 000, 000 people. The median age of patients admitted with MOE was 58 years. Comorbid conditions included: diabetes mellitus 60% ; , acquired immunodeficiency syndrome AIDS ; 2% ; , chronic renal failure 1% ; , and solid organ transplant 1% ; . AIDS-related MOE did not increase in incidence during the study period. Median duration of hospitalization was 5 days range, 1 to 79 ; . Procedures performed during the hospitalization included debridement of external auditory canal 0.6% ; , mastoidectomy 1% ; , and petrosectomy 1.3% ; . Five hospitals in the state admitted 26% of the MOE patients. There was no significant difference between the duration of hospital stay at the five hospitals, from which 26% of the MOE patients were discharged, versus those that had fewer MOE discharges. CONCLUSIONS: The incidence of MOE in California has ranged from 1.8 to 3.1 per million over the last 11 years. Diabetic patients comprise the majority of MOE patients. Surgical procedures for treatment of MOE are rarely performed. 50. Is Word Recognition Correlated With the Number of Surviving Spiral Ganglion Cells and Electrode Insertion Depth in Human Subjects With Cochlear Implants? Aayesha M. Khan, MD, St. Louis, MO Ophir Handzel, MD, Boston, MA Barbara J. Burgess, Boston, MA Doris Damian, PhD, Waltham, MA Donald K. Eddington, PhD, Boston, MA Joseph B. Nadol, Jr., MD * , Boston, MA. See her that way, doesn't mean she needs drugs." Her sentiments were echoed by the JAMA study researchers. "Although they may be annoying or worrisome to the parent, " they noted that "the signs of upper respiratory tract infection, particularly cough, may not be distressing to the child, in which case it is truly the parent administering the OTC medication who is being `treated.' and lioresal and benadryl, for instance, too much benadryl. There are several types of anti-histamine on the market today including zyrtec, allegra, claritin, clarinex, and benadryl. Results Thyroid hormone levels decreased more rapidly and to a greater extent in the cholestyramine-treated group Table 1 ; . At the end of the second week, total and free T, levels had decreased more in group I than in group II total T group I vs. group II: 39% vs. 27%, P 0.047; free T group I vs. group II: 61% vs.43%, P 0.013 ; . The percent reduction in T, levels was not diffferent between the two groups at the end of the second week 48% vs. 49%, P 0.28 ; . At the end of the fourth week of treatment, total and free T, as well as total T, had decreased significantly more in the cholestyramine group 61%, 78%, and 68% in group I compared with 43%, 65%, and 50% in group II, P 0.037 for total T P 0.038 for free T P 0.012 for total T3 ; . At the end of the study, 90% of the patients in group I had achieved normal total T, and T, levels, and 70% had normalized their free T, levels. In contrast, in group II, only 50% of patients normalized their total T, levels, and only 40% normalized their total and free T, levels. Patients in group III received cholestyramine for the first 2 weeks of the study. During this time, they tended to behave like patients in group I. Thus, the percent of reduction of thyroid hormones was quite similar in groups I and III at the end of the second week Table 1 ; . However, once the cholestyramine was discontinued in this group, the rate of decline of the different thyroid hormones began to slow down, so by the end of the study the total percent reduction of thryoid hormone was the same as in group II Table 1 ; . TSH levels remained suppressed in the three groups throughout the study. All the patients tolerated the cholestyramine well. No significant bloating, flatulence, or constipation was reported. Discussion The present study shows that ionic exchange resins such as cholestyramine are effective in producing a rapid and complete decline of thryoid hormones in patients with hy and benazepril.

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