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Malignant Neoplasms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Progressive liver failure often results in malignant ascites, as well as jaundice. As it progresses due to increased fluid pressure in the liver, ascites distends the peritoneal cavity with an accumulation of fluid which often becomes increasingly uncomfortable for the patient. Shortness of breath can occur due to pressure of ascites on the diaphragm. In advanced cases, fluid can migrate across the diaphragm resulting in pleural effusion. Therapeutic paracentesis, when liters of fluid are removed with a large gauge needle, can help to relieve painful pressure. For patients with chronic malignant ascites, paracentesis can be done on a routine basis for palliation or a long-term drain (e.g. PleurX) may be surgically implanted for easier drainage. For refractory cases where surgery is a choice and a viable option, transjugular intrahepatic portosystemic shunts (TIPS) may be considered when severe symptoms are uncontrolled by other interventions.
Transformation of human traits and being
Published in Antonella Sansone, Cultivating Mindfulness to Raise Children Who Thrive, 2020
Breathing allows our body to take in enough oxygen and promote its optimal heath. But most of us do not breathe properly. We undervalue the benefits of breathing properly. The physiological benefits of oxygen include eliminating toxins in tissues, cells and the bloodstream; increasing the uptake of nutrients; killing infectious bacteria; and boosting the immune system (Altman, 2007). The psychological effects include boosted energy and a calmer self-regulated nervous system. Breathing properly during pregnancy is particularly important, since the supplies of oxygen increase by 20 per cent. The enhanced body awareness also helps connect with the developing baby. You can build a habit of deep breathing during some daily activities (e.g. dishwashing, while on the train, driving, holding the baby and breastfeeding). It is important to engage the diaphragm while breathing in. Extending the exhalation as long as possible keeps the parasympathetic system (calming) active. Breathing practice helps you connect with your body by becoming aware of the breathing and body sensations, feelings and needs.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The description of the sagging right lung indicates that there is an underlying tracheobronchial injury. This injury is associated with high mortality. It usually occurs close to the carina which is fixed relative to the bronchi. Imaging features include presence of a pneumothorax which is refractory to drainage, as well as the presence of the ‘fallen lung’ sign, in which the lung sags towards the floor of the hemithorax, away from the hilum. There may also be a fractured first rib, indicating high impact force; however this is not the cause of pneumothorax in the case vignette. Diaphragm rupture can occur in cases of trauma and may be associated with complications such as herniation of abdominal viscera.
Effect of exercise intervention on lung function in asthmatic adults: a network meta-analysis
Published in Annals of Medicine, 2023
Shuangtao Xing, Shijie Feng, Dan Zeng
BT combined with AT can enhance the physical and psychological condition of adult asthmatics, primarily through the reinforcement of respiratory function during exercise. The combination of thoracic and abdominal breathing, with an emphasis on abdominal breathing, increases diaphragmatic contraction, facilitating diaphragmatic rise and fall and improving respiratory organ function by continuously altering thoracic and abdominal pressures. YG predominantly involves twisting, forward bending, and backward bending positions, which can enhance blood circulation, metabolism, and chest cavity volume. Additionally, YG incorporates lung breathing techniques that massage internal organs and improve their function. Through specific breathing training, the diaphragm within the lungs can be activated, leading to increased alveolar mobility and improved muscle activity and coordination during the respiratory cycle. Consequently, this results in substantial changes in intrapulmonary pressure, enhanced alveolar expansion and contraction, and expansion of the respiratory tract, reducing airway resistance and promoting lung ventilation and gas exchange [42]. Therefore, BT + AT and YG may represent the most effective intervention methods for enhancing lung function in adult asthmatics.
The fully engaged inspiratory muscle training reduces postoperative pulmonary complications rate and increased respiratory muscle function in patients with upper abdominal surgery: a randomized controlled trial
Published in Annals of Medicine, 2022
Yu-Ting Huang, Yih-Jyh Lin, Ching-Hsia Hung, Hui-Ching Cheng, Hsin-Lun Yang, Yi-Liang Kuo, Pei-Ming Chu, Yi-Fang Tsai, Kun-Ling Tsai
The diaphragm is the most important respiratory muscle and plays a major role in maintaining ventilation to the respiratory system. There are several clinical methods of monitoring diaphragmatic function. Diaphragm ultrasonography has played a crucial role in evaluating many aspects of critical illness and has recently been proposed as a tool to quantify the diaphragm [8]. We found that the CTL group showed a significant decrease in the diaphragmatic excursion at the end of the experiment compared to the baseline. There was a significant difference between the groups. Therefore, it could be seen that the diaphragm’s mobility is better preserved in the IMT group despite the physical damage of the surgery, and it can be inferred that the IMT program can help the recovery of the diaphragm after the operation.
Spinal cord injury and diaphragm neuromotor control
Published in Expert Review of Respiratory Medicine, 2020
Matthew J. Fogarty, Gary C. Sieck
For far too long diaphragm neuromotor control has been slavishly focused on breathing and the response of ventilation to a variety of interventions. While undoubtedly worthwhile with regard to central pattern generation control of eupnea and responses to ventilatory challenge, misguided reductionists have led to the adoption of the idea that diaphragm motor units are merely the homogeneous and monolithic intermediates (the ‘inspiratory motor neurons’) between brainstem respiratory centers and the generation of tidal volumes. In reality, the diaphragm muscle forms the posterior partition for the thoracic cavity and the anterior partition of the abdominal cavity and comprises a mixed motor unit population that allows for the generation of transdiaphragmatic pressures (Pdi) [1]. These pressures (negative in the thorax and positive in the abdomen), are essential to a variety of behaviors, with quiet breathing accounting for ~15% of the maximum pressure-generating capacity of the diaphragm muscle (Pdimax) in almost all species assessed [1,2], including humans [1–3]. In the context of spinal cord injury, the nature of functional impairments may differ along with the therapeutic approach and consequences.