Chest Wall and Neuromuscular Disease

2014 ◽  
Author(s):  
Başak Çoruh ◽  
Joshua O Benditt

Chest wall and neuromuscular diseases encompass a broad spectrum of illnesses that affect the mechanics of breathing. This chapter reviews the physiology of the respiratory system and the impact of these diseases. A brief discussion of various chest wall and neuromuscular diseases is included. The approach to the evaluation of a patient with suspected chest wall or neuromuscular disease, including key aspects of the history, physical examination, and diagnostic testing, is discussed. Respiratory care, including ventilation, cough, swallowing, and sleep, is described. Tables outline neuromuscular diseases affecting the respiratory system, causes of diaphragm weakness and paralysis, and a comprehensive approach to respiratory care in chest wall and neuromuscular disease. Figures include illustrations of the anatomy of the respiratory system and contraction of the diaphragm, pressure measures above and below the diaphragm, radiographic images of chest wall diseases and measurement of the Cobb angle, a computed tomographic scan of a patient with pectus excavatum, a graph showing patterns of pulmonary function testing in chest wall and neuromuscular disease, and photos of mouthpiece ventilation and a mechanical insufflator-exsufflator device. Videos show a fluoroscopic sniff test demonstrating unilateral diaphragm paralysis and the use of a mechanical insufflator-exsufflator device. This review contains 9 highly rendered figures, 2 videos, 3 tables, and 40 references.

2014 ◽  
Author(s):  
Başak Çoruh ◽  
Joshua O Benditt

Chest wall and neuromuscular diseases encompass a broad spectrum of illnesses that affect the mechanics of breathing. This chapter reviews the physiology of the respiratory system and the impact of these diseases. A brief discussion of various chest wall and neuromuscular diseases is included. The approach to the evaluation of a patient with suspected chest wall or neuromuscular disease, including key aspects of the history, physical examination, and diagnostic testing, is discussed. Respiratory care, including ventilation, cough, swallowing, and sleep, is described. Tables outline neuromuscular diseases affecting the respiratory system, causes of diaphragm weakness and paralysis, and a comprehensive approach to respiratory care in chest wall and neuromuscular disease. Figures include illustrations of the anatomy of the respiratory system and contraction of the diaphragm, pressure measures above and below the diaphragm, radiographic images of chest wall diseases and measurement of the Cobb angle, a computed tomographic scan of a patient with pectus excavatum, a graph showing patterns of pulmonary function testing in chest wall and neuromuscular disease, and photos of mouthpiece ventilation and a mechanical insufflator-exsufflator device. Videos show a fluoroscopic sniff test demonstrating unilateral diaphragm paralysis and the use of a mechanical insufflator-exsufflator device. This review contains 9 highly rendered figures, 2 videos, 3 tables, and 40 references.


2012 ◽  
Vol 1 (1) ◽  
Author(s):  
E. Mantellini ◽  
L. Perrero ◽  
S. Petrozzino ◽  
A. Gatta ◽  
S. Bona

Purpose: patients with neuromuscular diseases presents an high incidence of respiratory infections favoured by stagnation of deep bronchial secretions and deficit of cough. The aim of the study is to evaluate the correct treatment of this condition and the role of High Frequency Chest Wall Oscillation (HFCWO) in helping the removal of bronchial secretions and reduce the incidence of infections in patients with neuromuscular disease. Methods: analysis of the current bibliography related to respiratory infections and neuromuscular disease. PCEF (Peak Cough Expiratory Flow) is used as a standardized indicator of efficiency of cough. Results: the High Frequency Chest Wall Oscillation (HFCWO) is useful, in cases of increased production of mucus and impairment of muco-ciliary clearance, to remove the tracheobronchial secretions and reduce the incidence of infections. Conclusions: the correct approach to patients with neuromuscular disease and frequent respiratory infections is focused on treatment of cough ineffective and management of bronchial secretions. High Frequency Chest Wall Oscillation (HFCWO) (VEST) has a central role in treatment of cough ineffective and management of bronchial secretions reducing respiratory infections.


2020 ◽  
Vol 23 (7) ◽  
pp. 777-799
Author(s):  
O.I. Shvyreva ◽  
Z.I. Kruglyak ◽  
A.V. Petukh

Subject. This article discusses the issues related to the practice of financial reporting in the face of uncertainties caused by the coronavirus contagion, as well as the specifics of the audit strategy and formation of an audit opinion on this reporting. Objectives. The article aims to identify the quality characteristics of financial reporting prepared in the context of the COVID-19 pandemic and justify the key aspects of assurance engagement completion in an extremely uncertain epidemiological and economic situation. Methods. For the study, we used an abstract-logical method, content analysis techniques, systematization, and classification. Results. Analyzing the impact of the extremely uncertain epidemiological and economic situation on financial statements, the article clarifies aspects of disclosure of events after the reporting date and threats to business continuity in the annual reporting of economic entities. The article identifies possible alternative procedures and algorithms to obtain proper evidence when it is insufficient in the face of the inability to meet certain audit standards requirements in a remote audit environment. The article defines the impact of COVID-19 risk disclosure on the structure of the audit report and opinion. Relevance. The results of the study can be used in the practical activities of economic entities that prepare financial statements in the face of significant uncertainty, as well as auditors and audit organizations.


2020 ◽  
Vol 7 (2) ◽  
pp. 305-318
Author(s):  
Eva Kowalská

AbstractStructural problems of communities affected by the “Slovak Reformation,” issues with accepting the situation or simply the relationships among various cultural phenomena, like literacy or language policies, are key aspects in studying the impact of the Reformation in Hungary, especially with respect to Slovaks. Information gathered from the Reformation had a direct and long-lasting impact on the formation of vernacular language, as well as on the search for and the construction of an ethnic identity. Searching for evidence left by the Slovak presence in the Reformation movement thus presents challenging though notable problems for Slovak historiography. The confessional division and its political as well as cultural implications have evoked long-lasting discussions among historians as well as politicians. This study focuses on the most relevant issues within these processes.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel Kasteler ◽  
Christa Lichtensteiger ◽  
Christina Schindera ◽  
Marc Ansari ◽  
Claudia E. Kuehni ◽  
...  

Abstract Background Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors. Methods We investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors. Results Forty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors. Conclusion It is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bestoon Mohammed Faraj

Abstract Background Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique. Methods Radiographic image analysis was performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10°–25°) and severe canal curvature (26°–70°). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real canal length was determined by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland). Results There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P > 0.05). Conclusions A standardized digital periapical radiographic method performed similarly to the CBCT technique near to its true working length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.


Author(s):  
Thais Pousada ◽  
Jessica Garabal-Barbeira ◽  
Cristina Martínez ◽  
Betania Groba ◽  
Laura Nieto-Riveiro ◽  
...  

(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person–technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services.


Thesis Eleven ◽  
2021 ◽  
pp. 072551362110331
Author(s):  
Jon Stratton

Panic buying of toilet rolls in Australia began in early March 2020. This was related to the realisation that the novel coronavirus was spreading across the country. To the general population the impact of the virus was unknown. Gradually the federal government started closing the country’s borders. The panic buying of toilet rolls was not unique to Australia. It happened across all societies that used toilet paper rather than water to clean after defecation and urination. However, research suggests that the panic buying was most extreme in Australia. This article argues that the panic buying was closely linked to everyday notions of Western civilisation. Pedestal toilets and toilet paper are key aspects of civilisation and the fear of the loss of toilet paper is connected to anxiety about social breakdown, the loss of civilisation. This is the fear manifested in the perceived threat posed by the virus.


Author(s):  
Omid Rashidipour ◽  
K. Ming Chan

Motor unit number estimation (MUNE) is an electrophysiological method designed to quantify motor unit loss in target muscles of interest. Most of the techniques are noninvasive and are therefore well suited for longitudinal monitoring. In this brief review, we describe the more commonly used techniques and their applications in amyotrophic lateral sclerosis, poliomyelitis, spinal muscular atrophy and hereditary sensorimotor neuropathies. Findings in some of these studies offer important pathophysiological insights. Since conventional electrophysiologic methods are not sensible measures of motor neuronal loss, MUNE could play a potentially important role in the diagnosis, monitoring of disease progression and response to treatment in neuromuscular diseases in which motor unit loss is a major feature.


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