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Pulmonology Dec 2023In this review, we present the effects of lung hyperinflation on the cardiovascular system (CVS) and the beneficial outcomes of different deflation treatment modalities.... (Review)
Review
In this review, we present the effects of lung hyperinflation on the cardiovascular system (CVS) and the beneficial outcomes of different deflation treatment modalities. We discuss the effects of long-acting bronchodilator drugs, medical and surgical lung volume reduction on the performance of the CVS. Although there is a small number of studies investigating lung deflation and the CVS, the short-term improvement in heart function was clearly demonstrated. However, more studies, with longer duration, are needed to verify these significant beneficial effects of deflation of the lungs on the CVS. Dynamic hyperinflation during exercise could be a research model to investigate further the effects of lung hyperinflation and/or deflation on the CVS.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Cardiologists; Pulmonologists; Lung; Bronchodilator Agents
PubMed: 37031001
DOI: 10.1016/j.pulmoe.2023.02.011 -
Lung India : Official Organ of Indian... 2023
PubMed: 37787351
DOI: 10.4103/lungindia.lungindia_377_23 -
Lung India : Official Organ of Indian... 2017A number of local dialects and languages exist in India, which leads to a single disease being addressed by a number of names which may overlap with other disease names...
CONTEXT
A number of local dialects and languages exist in India, which leads to a single disease being addressed by a number of names which may overlap with other disease names also. This creates misunderstanding and is a hindrance to effective patient-doctor communication.
AIMS
The paper aims to find out how effectively the name of the respiratory disease is communicated to the patient. The terminology used by patients to describe their disease was also noted at limited level.
SETTINGS AND DESIGN
The study was conducted in the form of parallel cross-sectional surveys, among pulmonologists and patients.
METHODS
Among the members of the Indian Chest Society and those attending the National Conference on Pulmonary Diseases (NAPCON-2015), 1028 pulmonologists participated in the online survey which was the first part of the study. The term used to address the common respiratory disease was inquired in the survey. To find the response of patients, a questionnaire was given to the patients attending four respiratory disease clinics of a city. They were inquired about the name of respiratory disease they were suffering from.
RESULTS
Pneumonia was the disease which was communicated with exact terminology by 898 (87.4%) doctors to their patients. In contrast, idiopathic pulmonary fibrosis was communicated with precise terminology by only 171 (16.6%) doctors. Pulmonary tuberculosis was exactly told by 708 (69%), asthma by 731 (71.1%), and chronic obstructive pulmonary disease by 593 (57.7%) doctors. However, only 17.6% of the 1122 patients participating in the survey had a knowledge of the name of disease they were suffering from.
CONCLUSIONS
The exact terminology of the common respiratory diseases is not effectively used by many doctors and most of the patients. The study identifies an important gap in patient-doctor communication, and therefore, highlights the need of effective patient education.
PubMed: 28144053
DOI: 10.4103/0970-2113.197092 -
Journal of Thoracic Disease Sep 2013Endobronchial tumors are a rare entity that presents with different pathological findings. The interventional pulmonologist, but also the thoracic surgeon have at their... (Review)
Review
Endobronchial tumors are a rare entity that presents with different pathological findings. The interventional pulmonologist, but also the thoracic surgeon have at their disposal the same techniques for diagnosis, however; the two modalities differentiate in the treatment approach. Diagnosis evaluation should include lymph node evaluation. Minimal invasive techniques under local or general anesthesia are usually preferred by the interventional pulmonologists, whereas in the surgical approach of the thoracic surgeons the general anesthesia is necessary. A more extensive surgical approach either lobotomy or pneumonectomy should be performed in cases with positive intrapulmonary lymph nodes. Carinal reconstruction should be performed skillfully to get a negative proximal margin whenever needed. In the current manuscript we will present the methods of patient evaluation and surgical techniques for the management of these lesions.
PubMed: 24102010
DOI: 10.3978/j.issn.2072-1439.2013.06.22 -
The European Respiratory Journal Mar 2010
Topics: Critical Care; Humans; Pulmonary Medicine; Respiration Disorders; Respiration, Artificial
PubMed: 20190323
DOI: 10.1183/09031936.00002410 -
Jornal de Pediatria 2013To advise pediatricians, neonatologists, pulmonologists, pediatric pulmonologists, and other professionals in the area on the main indications and characteristics of... (Review)
Review
OBJECTIVE
To advise pediatricians, neonatologists, pulmonologists, pediatric pulmonologists, and other professionals in the area on the main indications and characteristics of long-term home oxygen therapy in children and adolescents.
DATA SOURCE
A literature search was carried out in the MEDLINE/PubMed database (1990 to 2011). Additionally, references from selected studies were included. As consistent scientific evidence does not exist for many aspects, some of the recommendations were based on clinical experience.
DATA SYNTHESIS
Long-term home oxygen therapy has been a growing practice in pediatric patients and is indicated in bronchopulmonary dysplasia, cystic fibrosis, bronchiolitis obliterans, interstitial lung diseases, and pulmonary hypertension, among others. The benefits are: decrease in hospitalizations, optimization of physical growth and neurological development, improvement of exercise tolerance and quality of sleep, and prevention of pulmonary hypertension/cor pulmonale. The levels of oxygen saturation indicative for oxygen therapy differ from those established for adults with chronic obstructive pulmonary disease, and vary according to age and disease. Pulse oximetry is used to evaluate oxygen saturation; arterial blood gas is unnecessary. There are three available sources of oxygen: gas cylinders, liquid oxygen, and oxygen concentrators. The flows used are usually smaller, as are the number of hours/day needed when compared to the use in adults. Some diseases show improvement and oxygen therapy discontinuation is possible.
CONCLUSIONS
Long-term home oxygen therapy is increasingly common in pediatrics and has many indications. There are relevant particularities when compared to its use in adults, regarding indications, directions for use, and monitoring.
Topics: Adolescent; Child; Home Nursing; Humans; Hypoxia; Long-Term Care; Oximetry; Oxygen; Oxygen Inhalation Therapy; Practice Guidelines as Topic; Quality of Life; Time Factors
PubMed: 23544805
DOI: 10.1016/j.jped.2013.02.003 -
Integration of 3D printing and additive manufacturing in the interventional pulmonologist's toolbox.Respiratory Medicine Jan 2018New 3D technologies are rapidly entering into the surgical landscape, including in interventional pulmonology. The transition of 2D restricted data into a physical model... (Review)
Review
New 3D technologies are rapidly entering into the surgical landscape, including in interventional pulmonology. The transition of 2D restricted data into a physical model of pathological airways by three-dimensional printing (3DP) allows rapid prototyping and fabrication of complex and patient-specific shapes and can thus help the physician to plan and guide complex procedures. Furthermore, computer-assisted designed (CAD) patient-specific devices have already helped surgeons overcome several therapeutic impasses and are likely to rapidly cover a wider range of situations. We report herein with a special focus on our clinical experience: i) how additive manufacturing is progressively integrated into the management of complex central airways diseases; ii) the appealing future directions of these new technologies, including the potential of the emerging technique of bioprinting; iii) the main pitfalls that could delay its introduction into routine care.
Topics: Bioprinting; Computer-Aided Design; Humans; Models, Anatomic; Patient-Specific Modeling; Printing, Three-Dimensional; Respiratory Tract Diseases; Stents
PubMed: 29413501
DOI: 10.1016/j.rmed.2017.11.019 -
The Netherlands Journal of Medicine Mar 2003The burden of asthma and chronic obstructive pulmonary disease (COPD) on national healthcare systems is expected to increase substantially in future years. Referral... (Comparative Study)
Comparative Study
BACKGROUND
The burden of asthma and chronic obstructive pulmonary disease (COPD) on national healthcare systems is expected to increase substantially in future years. Referral guidelines for general practitioners (GPs) and pulmonologists may lead to more efficient use of healthcare facilities. We explored the prevailing views of pulmonologists regarding referral and once-only consultation in asthma and COPD, and compared these views with recently published transmural referral guidelines for GPs and pulmonologists.
METHODS
Cross-sectional multiple case study. Twenty-nine Dutch pulmonologists working at non-university hospitals or specialised chest clinics participated in group discussion sessions.
RESULTS
The outcome of the discussions and recently published referral guidelines for GPs and pulmonologists showed considerable similarity, but also some marked discrepancies. During the discussions, the main points of disagreement among the pulmonologists were: 1) should GPs or pulmonologists add long-acting beta2-agonists to asthma treatment regimens; 2) should the current cut-off point 'predicted FEV1 <50%' for referral of COPD patients be increased to 60 or 70%; and 3) should an annual exacerbation rate of two episodes a year be used as an undifferentiated referral criterion for COPD patients? For asthma, proposed back-referral (i.e. from pulmonologist to GP) criteria rested on: required dose of inhaled steroids, persistent need for long-acting beta2-agonists, duration of clinical stability and persistence of airway obstruction. Back-referral criteria for COPD rested on age, blood-gas abnormalities and ventilatory limitations. Primary care monitoring facilities and 'shared-care' constructions were considered to be facilitating conditions for back-referral.
CONCLUSIONS
This explorative study provided insights into how pulmonologists visualise a rational referral policy for patients with asthma or COPD. These insights can be taken into consideration in future revisions of referral and back-referral guidelines for GPs and pulmonologists.
Topics: Adult; Aged; Asthma; Attitude of Health Personnel; Cross-Sectional Studies; Family Practice; Female; Health Care Surveys; Humans; Male; Middle Aged; Netherlands; Practice Guidelines as Topic; Practice Patterns, Physicians'; Pulmonary Disease, Chronic Obstructive; Pulmonary Medicine; Quality of Health Care; Referral and Consultation; Severity of Illness Index
PubMed: 12765227
DOI: No ID Found -
NPJ Primary Care Respiratory Medicine May 2020American and European societies' (ATS/ERS) criteria for spirometry are often not met in primary care. Yet, it is unknown if quality is sufficient for daily clinical use....
American and European societies' (ATS/ERS) criteria for spirometry are often not met in primary care. Yet, it is unknown if quality is sufficient for daily clinical use. We evaluated quality of spirometry in primary care based on clinical usefulness, meeting ATS/ERS criteria and agreement on diagnosis between general practitioners (GPs) and pulmonologists. GPs included ten consecutive spirometry tests and detailed history questionnaires of patients who underwent spirometry as part of usual care. GPs and two pulmonologists assessed the spirometry tests and questionnaires on clinical usefulness and formulated a diagnosis. In total, 149 participants covering 15 GPs were included. Low agreements were found on diagnosis between GPs and pulmonologists 1 (κ = 0.39) and 2 (κ = 0.44). GPs and pulmonologists rated >88% of the tests as clinically useful, although 13% met ATS/ERS criteria. This real-life study demonstrated that clinical usefulness of routine primary care spirometry tests was high, although agreement on diagnosis was low.
Topics: Asthma; Female; Humans; Lung Diseases; Male; Middle Aged; Observer Variation; Primary Health Care; Pulmonary Disease, Chronic Obstructive; Pulmonologists; Quality of Health Care; Spirometry; Surveys and Questionnaires
PubMed: 32415077
DOI: 10.1038/s41533-020-0177-z -
Respiratory Medicine Aug 2013Respiratory failure is an unavoidable event in the natural history of some neuromuscular diseases, while appearing very infrequently in others. In some cases, such as... (Review)
Review
Respiratory failure is an unavoidable event in the natural history of some neuromuscular diseases, while appearing very infrequently in others. In some cases, such as Pompe disease, respiratory failure progresses more rapidly than motor impairment, sometimes being the onset event. Home mechanical ventilation improves survival and quality of life of these patients, with a reduction in healthcare costs. Therefore, pulmonologists must improve their skills in order to play a more relevant role in the care of these patients. The aim of this statement is to provide pulmonologists with some simple information in order for them to fulfil their role of primary caregiver, enabling appropriate and rapid diagnosis and treatment.
Topics: Cough; Dyspnea; Early Diagnosis; Glycogen Storage Disease Type II; Humans; Interprofessional Relations; Long-Term Care; Neurology; Patient Care Planning; Patient Care Team; Pulmonary Medicine; Respiration, Artificial; Respiratory Insufficiency; Tracheostomy
PubMed: 23587901
DOI: 10.1016/j.rmed.2013.03.004