Oxygen therapy for COPD is more than 60-70 years old. In this long period, a vast amount of knowledge has been gained of both the advantages and dangers of the same. Newer ideas always spring and experiments and their evaluation is part of any scientific endeavor. Oxygen therapy is giving air enriched with oxygen to breath. One type is exertion induced COPD. Oxygen enriched air is to be breathed in only during the exercise. This is seen to increase endurance and efficacy of exercise. This helps patients to maintain or even improve their physical fitness improving the COPD also. The real need of long-term oxygen therapy is for those suffering chronic oxygen deficiency in their blood. The condition is called chronic hypoxemia or hypoxia.
Long-term oxygen treatment will improve the quality of life and also lifespan. One suffers less shortness of breath. It slows or even prevents Right Sided Heart Failure, which is the normal consequence of COPD.
Oxygen therapy for chronic COPD is resorted to after normal medical treatments for COPD have ceased to benefit the patient. There are different ways to introduce the oxygen. Oxygen concentrators, liquid oxygen devices, and the more conventional oxygen cylinders can all be used to augment the oxygen into the air that is breathed.
However, people who use oxygen therapy at home should be well aware of the dangers of oxygen. Even air enriched to seemingly low levels of 28% can cause conflagrations of unbelievable intensity. Any fuel will spontaneously catch fire in air that is of this level of enrichment. Portable systems even suitable for air travel are also available.
Studies have shown that long-term oxygen therapy (LTOT) improves one’s life quality as well as lifespan. Patients need to breathe the enriched air for at least 15 hours a day with as fewer interruptions as possible, and preferably continuously. The oxygen level in the blood is to be maintained in a narrow band of 88% to 92% saturation (titrated flow) against normal levels of 94% to 98%. To overcome the dangers of hypoxemia, the best thing to do is to use the pulse oximetry set to titrate oxygen delivery to achieve 88-92% saturation, a ‘venturi mask’ (or an air-entrainment mask) setting oxygen concentration to 25% to 28% concentration or in the absence of any of the above, a flow rate of oxygen by nasal prongs or catheter can be set 2 to 3 L/min.
Modern research has shown the better efficacy of delivering bronchodilator with a flow rate of 6L/min in acute exacerbation of COPD. The medical personnel should monitor the patient for complications of hypoxemia like carbon dioxide retention.
Food for Feline has become a controversial topic with juxtaposing opinions supporting both Canned edibles and dry kibbles alike. Most veterinarians, however, have started recommending a diet that consists solely of best-canned food for cats instead of dry kibble. Here are some reasons that indicate why Canned food is a better choice than dry kibble that we tend to feed our cats with:
All said and done, having a car of one’s own is close to being a necessity for most folks unless you happen to live in one of big cities where public transport is good, and or, the traffic is so bad you would prefer not to drive. Even in the latter scenario, there are times when having a car is needed and is very convenient and indeed, buying a car is a definite rite of passage for most Americans, and something that is looked forward to from the moment of getting that coveted driver’s license at the age of 16 years. Well, as much as a new car has its own set of appeals, often times one may not have the wherewithal to buy a shiny new car from the dealer, and so go on the hunt for used cars for sale that fits our price point and needs.
So, how do you start a search for used cars for sale? Do you ask your circle of friends and relatives if someone has or knows of a nice used car you can buy? Or do you head to the local used car dealership? Do you reach for the local newspaper or check out the leaflets and homemade flyers at the grocery store to see if anyone is listing a car for sale? Or perhaps you get on Craigslist, Car Gurus or any of the numerous other sites where you can research to your heart’s content, using filters of pricing, year, mileage, even color and make and model. Any and all of these are viable and simple options, it totally depends on your comfort level, your need and time frame, and of course, whether you prefer to go by the word of someone from your local community or circle, rather than buying from a complete stranger.
Use the Kelly Blue Book to get information on the make and model you’re interested in, and see what similar cars are valued at. This way you have a ballpark figure to begin with and have an idea about, and can negotiate with the seller accordingly. Take the car for a spin, get a trustworthy mechanic to inspect the car for you, or see if the owner has the latest papers and repair work on the car.
Pies are the best thing to eat at any time of the day. You will enjoy to bake it as much as you will love to eat it.
Ingredients
6 ½ ounces plain flour
3 ½ ounces cold butter
1 tablespoon icing sugar
1 egg yolk
For the filling
2 tablespoons corn flour
3 ½ ounces golden caster sugar
2 large lemons (finely grated zest)
4-ounce fresh lemon juice
1 small orange (juice)
3 ounces butter
3 egg yolks and 1 whole egg
For the meringue
4 white eggs, room temperature
7 ounces’ golden caster sugar
2 teaspoon corn flour
Directions
In a bowl, add flour, butter, icing sugar, egg yolk and 1 tablespoon of cold water. Churn this in a food processor. Bind it together. Pour this mixture on a surface, and fold gently until smooth. Take a fluted flan tin, line it with foil. Press the pastry into the flutes. Put it into the fridge to cool overnight.
Pre-heat the over at 350F. Bake the pastry case blind’ (filled with dry beans) for about 15 minutes. Remove the foil and bake it for eight more minutes. Ensure the pastry is pale golden.
Add corn flour, sugar, and lemon zest in a saucepan. Strain the lemon juice and stir gently. Add the orange juice into the pan. Let it heat over a medium flame, but keep stirring. The mixture needs to be thick and smooth. Let the mixture boil, and then remove it from the heat. Add in the butter, so it melts. Beat in the egg yolks and whole egg together. Heat this on a medium flame. Stir it well and make the mixture thick. Once thick, set it aside, let there be no lumps. Save the white of the eggs aside for the meringue.
Whisk the white of the eggs, and add half the sugar in intervals while you whisk. Keep beating the mixture as you add the sugar. Pour in the corn flour, and the rest of the sugar. Make the mixture thick and smooth.
Reheat the filling, and spread it into the pastry case.
Just as you spread the filling, pour in small quantities of the meringue around the edges.
Add the rest of the meringue to the center, and make sure it touches the hot surface of the filling that will allow it to cook. If you begin with adding the meringue in the center, the entire thing may sink.
Bake it in the oven for about 20 minutes, until you notice the meringue is slightly colored.
Allow the pie to set in the tin for half an hour. Once removed, let it cool for two hours before you serve.