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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Most patients with chronic respiratory conditions are managed in the community. Despite exciting new treatments across the spectrum of respiratory disease, many conditions remain progressive and are associated with considerable morbidity. In this setting, patient education about managing their illness, combined with community support from a multidisciplinary team including specialist nurses, physiotherapists and physicians, is very important. Multidisciplinary working is also of paramount importance for patients with lung malignancy, for whom close interaction between chest physicians, oncologists and thoracic surgeons is essential for guiding management, and for patients with exacerbations of respiratory disease requiring admission to hospital. Inpatients may particularly benefit from specialist chest physiotherapy to clear secretions and encourage early mobilization.
Laparoscopic Management of T4 Tumor and Pelvic Exenteration for Locally Advanced Tumors
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
All patients planned for advanced laparoscopy procedures should undergo detailed cardio-respiratory evaluations. Whenever needed, adequate chest physiotherapy will help the patient to tolerate the procedure better. High definition laparoscopic camera systems with advanced energy sources and laparoscopic staplers are needed for all advanced colorectal cancer surgeries. Figure 26.1 elaborates on the OT set-up and the position of operating team members.
Adherence to Treatment in Children
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
The treatment of cystic fibrosis likewise involves several components. Medication includes pancreatic enzyme replacements taken with all food and drink plus vitamins and antibiotics. Chest physiotherapy must be administered several times per day to clear secretions and thus avoid infection. Exercise is necessary. Dietary recommendations require a high calorie intake irrespective of appetite, which often is poor due to digestive difficulties. Some children will also need nebulised antibiotics or drugs to thin accretions of mucus in the airways (Geiss et al., 1992).
Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making
Published in Physiotherapy Theory and Practice, 2023
Janne Hastrup Jensen, Lotte Sørensen, Sebastian Breddam Mosegaard, Inger Mechlenburg
Second, most data on predictors were obtained from medical records or from patient anamnesis, which can affect the quality and reliability of data. However, since the research physiotherapists followed a data collection manual including structured questions on self-reported predictors and were able to clarify doubt about predictors from the medical records from patient anamnesis, the risk of information problems seems minor. Moreover, the relatively small sample size necessitated a selection of potential predictors prior to model development, and potentially relevant predictors may have been omitted. Additionally, a larger sample size would have provided the analyses with more power. The few continuous predictors were categorized to make the model more manageable in a clinical setting, and because they were not expected to have a linear relationship with the outcome. A disadvantage was that predictive information may have been lost because exposure levels within a category group may vary considerably. Another limitation was that 89 of the 339 patients (24.5%) received extended physiotherapy sessions in the follow-up period. For ethical reasons, it was not possible to refrain from extended sessions, when patients were assessed to be at increased risk of postoperative pulmonary complications by the clinical physiotherapists or was medically diagnosed with e.g. pneumonia. Based on clinical reasoning, extended chest physiotherapy could perhaps modify the effect of some potential predictors like reduced lung function and habitual productive cough.
Understanding and managing respiratory infections in children and young adults with neurological impairment
Published in Expert Review of Respiratory Medicine, 2023
Marijke Proesmans, Francois Vermeulen, Mieke Boon
A recent systematic review, compiled studies that evaluate interventions for management of respiratory disease in a population of patients with NI and neuromuscular disease younger than 26 years of age [12]. The following interventions were assessed: airway clearance technique, exercise, positioning, upper airway interventions, antibiotic therapy, mealtime management, salivary managements, GI interventions and spinal surgery. Unfortunately, no studies were found measuring the effect of the intervention on ‘prevention of respiratory disease’ as an outcome measure. For the outcome measures ‘hospitalization’, ‘need for oxygen therapy’ or ‘need for chest physiotherapy’ no effect was found for all interventions studied. The only positive finding of possible therapeutic interventions was that Bobath therapy and gross motor activities had a positive effect on lung function, and respiratory muscle strength [12].
Treatment Adherence among Adolescent Cystic Fibrosis Patients
Published in Comprehensive Child and Adolescent Nursing, 2022
Surya Kant Tiwari, Rimple Sharma, Poonam Joshi, Sushil Kumar Kabra
Daily management of CF may include 2–3 times chest physiotherapy in a day, increased caloric intake and routine use of medications such as bronchodilators and antibiotics.(Bywater, 1981). In the present study, more than half of the patients miss physiotherapy ranging from occasionally to never which is in tune with findings reported by several studies.(Abbott et al., 1994,Arias Llorente et al., 2008; White et al., 2017). Along with physiotherapy, doing regular exercises are emphasized for maintaining pulmonary health as a means of clearing excessive stagnant secretions from lungs and improving lung functions. (White et al., 2017) In our study, more than half of patients (56.7%) were not doing any form of exercise, which was in agreement with other studies in adult CF patients. (Abbott et al., 1994, Carr et al., 1996; White et al., 2017) Similarly, enzymes and vitamins supplementations are essential components in the treatment of CF. Current study showed that more than half of CF patients always took their enzyme and vitamin supplements, but the remaining ones were not regular or not at all-consuming vitamins and nutritional supplements.