Diagnostic for TTNA using a Thoracic Ultrasound Guidance for Diagnosing Lung Cancer
Cut Adeya Adella in Stem Cell Oncology, 2018
Our technique for the US-guided TTNA was as follows: preliminary localizing scans were obtained by using 3.5-MHz or 4-MHz multi-frequency sector transducers or a 5-MHz linear transducer (Sonix 01: Ultrasonix Medical Corporation S/N: SX1.1-0809.1841). When necessary, color Doppler was used to detecting potential vessels in the path of the needle. The scans were obtained with the patient in the supine, prone, or decubitus. Frequently, the aspiration was performed by using US transducer with a needle-guide attachment, but in our setting, we used a separate transducer and needle. We marked the location and inserted the needle separately. The transthoracic needle aspiration was performed by using a 25-gauge needle for both images guidance. The aspiration was performed either by one of our pulmonologists with a subspecialty in thoracic oncology or pulmonology residents under the close supervision of the pulmonologist.
Medical Therapy for Glaucoma
Neil T. Choplin, Carlo E. Traverso in Atlas of Glaucoma, 2014
Betaxolol (Figure 14.8) is the only commercially available topical β1 selective intraocular pressure-lowering medication. It is available as a 0.25% suspension (Betoptic-S) and a 0.5% solution. The suspension is more comfortable than the solution for most patients, but the two are equally efficacious. Both formulations lower intraocular pressure between 20% and 25% from baseline. This agent can be considered in patients with mild to moderate pulmonary disease without other contraindications to this class of compounds. All β-adrenoreceptor antagonists must be used with caution in any patient with a history of reactive airway disease. It is advisable to consult with a patient’s internist or pulmonologist prior to prescribing these agents in patients with pulmonary disease. Betaxolol has intrinsic calcium channel blocking activity, which may increase ocular blood flow. Additional investigations of this property and the potential clinical benefit need to be conducted.
Complications of Open Renal Surgery
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
Pulmonary function can be significantly impaired during open renal surgery. Ventilation-perfusion mismatch can occur in the flank position, in addition to hypoventilation of the dependent hemithorax as a result of compression (3,4). Trendelenburg positioning can also exaggerate pulmonary hypoventilation, allowing the weight of the abdominal contents to impede diaphragmatic excursion (2). These issues can result in hypoxemia in an individual with moderate to severe chronic obstructive pulmonary disease. Therefore, it is essential to identify patients with pulmonary symptoms preoperatively and have them properly evaluated by a pulmonologist if clinically indicated. An operative incision can then be selected to minimize pulmonary complications.
Asthma treatment and outcomes for children in the emergency department and hospital
Published in Journal of Asthma, 2018
Rupali Drewek, Lucia Mirea, Aparna Rao, Peter Touresian, Philip David Adelson
The impact of subspecialty care in reducing the rate of asthma readmission is sparsely reported in the literature. Schatz [26] reported a reduction in ED visits for asthma with allergy-specialist care, although statistical significance was at borderline. Bucknall et al. [27] demonstrated a significant decline in the readmission rate among patients seen by a physician with a special interest in respiratory medicine versus without this interest. Kelly et al. [28] demonstrated a significant benefit when patients were seen at an allergy clinic versus general pediatric clinic in terms of hospitalizations and ED visits. In our study, there was no significant difference in the readmission rate after seeing a pulmonologist on the ambulatory side. There was also no difference in the readmission rate after consulting a pulmonologist during hospitalization. The reason for this can vary but still remains unclear. It is possible that the lack of efficacy demonstrated in this study is due to the small sample size. It is also possible that the lack of difference was due to a higher rate of severe persistent asthmatics referred to the subspecialist and issues of prescription and compliance with the recommendations for preventative care. Further study for this is required to better define and improve the quality role of the subspecialist pulmonologist in this patient population.
Clinical experience in idiopathic pulmonary fibrosis: a retrospective study
Published in Acta Clinica Belgica, 2018
Julien Guiot, Bernard Duysinx, Laurence Seidel, Monique Henket, Fanny Gester, Olivier Bonhomme, Jean-Louis Corhay, Renaud Louis
We retrospectively studied patients recruited from our ambulatory care policlinic at CHU from 1 January 2009 to 1 January 2017. We excluded all patients treated with specific anti-fibrotic therapy. The diagnosis of IPF was made according to the international recommendations of the ATS/ERS [1,15] using the respiratory function tests, high-resolution computed tomography scan (probable UIP pattern), bronchoalveolar lavage (when available), as well as the clinical history of the patient. We excluded all other causes of interstitial lung disease (such as asbestosis, hypersensitivity pneumonitis, pneumonia associated with connective tissue disease or toxic pneumonitis). We combined the different results for the diagnosis. All cases were discussed in a multidisciplinary group about interstitial lung diseases composed of a pulmonologist, a specialist in pulmonary rehabilitation, a rheumatologist, a radiologist, a pathologist and a specialist in occupational medicine.
Development of self-assessed work ability among middle-aged asthma patients—a 10 year follow-up study
Published in Journal of Asthma, 2021
Eveliina Hirvonen, Antti Karlsson, Maritta Kilpeläinen, Ari Lindqvist, Tarja Laitinen
The study population represent a subpopulation of the Finnish Chronic Obstructive Airway Disease (CAD) cohort. The cohort enrolled through the Pulmonary Clinics of Helsinki and Turku University Hospitals during the years 2005–2007 (17). The patients were identified using ICD10 code J44.8 or J45. All patients between 18 and 75 years of age were invited to join the study through a two-phase mailing campaign. Their asthma diagnosis, including lung function tests, age at onset, and possible co-morbidities, were carefully evaluated by a pulmonologist by using the participants’ medical records from all health care providers (hospitals, health care centers, outpatient clinics) that had treated the patient during the past 5 years. Social security numbers were used to combine the records from different data sources. All patients had given their informed consent for data collection and analysis.
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