scholarly journals Airway Clearance Techniques: The Right Choice for the Right Patient

2021 ◽  
Vol 8 ◽  
Author(s):  
Stefano Belli ◽  
Ilaria Prince ◽  
Gloria Savio ◽  
Elena Paracchini ◽  
Davide Cattaneo ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Wide Spectrum ◽  
Scientific Evidence ◽  
Neuromuscular Disorders ◽  
Respiratory Disorders ◽  
Bronchial Secretions ◽  
Airway Clearance ◽  
Postural Drainage ◽  
Clinical Complexity ◽  
The Right

The management of bronchial secretions is one of the main problems encountered in a wide spectrum of medical conditions ranging from respiratory disorders, neuromuscular disorders and patients undergoing either thoracic or abdominal surgery. The purpose of this review is illustrate to the reader the different ACTs currently available and the related evidence present in literature. Alongside methods with a strong background behind as postural drainage, manual techniques or PEP systems, the current orientation is increasingly aimed at devices that can mobilize and / or remove secretions. Cough Assist, Vacuum Techniques, systems that modulate airflow have more and more scientific evidence. Different principles combination is a new field of investigation that goes toward an increasing of clinical complexity that will facing us.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

scholarly journals Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis

2010 ◽  
Vol 9 (3) ◽  
pp. 187-192 ◽  
Author(s):  
J.A. Pryor ◽  
E. Tannenbaum ◽  
S.F. Scott ◽  
J. Burgess ◽  
D. Cramer ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Airway Clearance ◽  
Postural Drainage

scholarly journals Enabling Technologies for Improved Data Management: Hardware

2001 ◽  
Vol 9 (1) ◽  
pp. 11-25
Author(s):  
Kerstin van Dam-Kleese ◽  
Michael Hopewell
Keyword(s):  
Data Management ◽  
Scientific Community ◽  
Wide Spectrum ◽  
Work Force ◽  
Working Environment ◽  
Computational Techniques ◽  
Enabling Technologies ◽  
New Challenges ◽  
The Uk ◽  
The Right

The most valuable assets in every scientific community are the expert work force and the research results/data produced. The last decade has seen new experimental and computational techniques developing at an ever-faster pace, encouraging the production of ever-larger quantities of data in ever-shorter time spans. Concurrently the traditional scientific working environment has changed beyond recognition. Today scientists can use a wide spectrum of experimental, computational and analytical facilities, often widely distributed over the UK and Europe. In this environment new challenges are posed for the Management of Data every day, but are we ready to tackle them? Do we know exactly what the challenges are? Is the right technology available and is it applied where necessary? This part of enabling technologies investigates current hardware techniques and their functionalities and provides a comparison between various products.

scholarly journals Secretion management in patients with ineffective airway clearance with non-invasive mechanical ventilation use: Expert guidance for clinical practice

2021 ◽  
Author(s):  
Vijay Hadda ◽  
Tejas Menon Suri ◽  
Sourabh Pahuja ◽  
Mohamad El-Khatib ◽  
Laura D. Ciobanu ◽  
...  
Keyword(s):  
Electronic Mail ◽  
Neuromuscular Disorders ◽  
Relevant Literature ◽  
Invasive Mechanical Ventilation ◽  
Non Invasive ◽  
Airway Clearance ◽  
Non Invasive Ventilation ◽  
Airway Secretion ◽  
Secretion Clearance

Non-invasive ventilation (NIV) is a mainstay of management of chronic respiratory failure in many disorders which are known to cause abnormal airway secretion clearance. Currently, there is no guidance regarding either the secretion handling during NIV use or the role of NIV in secretion management in these patients. The aim of this document was to provide an overview of the various techniques available in the management of respiratory secretions and their use in conjunction with NIV. Literature search was performed using the keywords, “(secretion OR secretions) AND (noninvasive ventilation OR NIV)” on PubMed and EMBASE. The search yielded 1681 and 509 titles from PubMed and EMBASE, respectively. After screening, 19 articles were included in this review. Suggestions of the expert panel were formulated by mutual consensus after reviewing the relevant literature. The draft of the expert panel’s suggestions was circulated among all authors via electronic mail for comments. Any conflicts were resolved by mutual discussion to achieve agreement. The final document was approved by all. This document by the International Network for Airway Secretions Management in NIV describes various airway secretion clearance techniques. It provides the expert panel’s suggestions for the use of these techniques in conjunction with NIV for patients with muco-obstructive and neuromuscular disorders. 

Dietary flavonoids as a potential intervention to improve redox balance in obesity and related co-morbidities: a review

2018 ◽  
Vol 31 (2) ◽  
pp. 239-247 ◽  
Author(s):  
Daniela Gentile ◽  
Matteo Fornai ◽  
Carolina Pellegrini ◽  
Rocchina Colucci ◽  
Corrado Blandizzi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Biological Activities ◽  
Wide Spectrum ◽  
Scientific Evidence ◽  
Cell Cycle Control ◽  
Cell Signalling ◽  
Gastrointestinal Disorders

AbstractObesity represents one of major health problems strongly linked to other co-morbidities, such as type 2 diabetes, CVD, gastrointestinal disorders and cognitive impairment. In this context, nutritional stress, such as an excess of fat intake, promotes a systemic oxidative stress, characterised by hyperproduction of reactive oxygen species, leading to cellular alterations that include impaired energy metabolism, altered cell signalling and cell cycle control, impaired cell transport mechanisms and overall dysfunctional biological activity. Flavonoids, dietary components of plant foods, are endowed with a wide spectrum of biological activities, including antioxidant activity, and have been proposed to reduce the risk of major chronic diseases. The present review intends to highlight and critically discuss the current scientific evidence on the possible effects of flavonoids in counteracting obesity and related co-morbidities (i.e. type 2 diabetes mellitus, CVD, gastrointestinal disorders and cognitive impairment) through a decrease in oxidative stress and related inflammatory conditions.

MotherCare App for Expectant Mothers in Interior Parts of Pakistan

2020 ◽  
pp. 147-167
Author(s):  
Muhammad Abdul Tawab Khalil ◽  
Saifullah Jan ◽  
Wajid Ali ◽  
Adnan Khan
Keyword(s):  
Wide Spectrum ◽  
Healthcare Services ◽  
Anxiety And Depression ◽  
Social Fabric ◽  
The Third ◽  
Expectant Mothers ◽  
The Right ◽  
The Third World ◽  
Physical Changes ◽  
User Friendly

Pregnancy, as a matter of fact, is always physically and emotionally challenging for women. Rapid physical changes with baby's growth in the womb exposes the mother to severe mood swings from short spell of merriment to long spells of anxiety and depression about upcoming child's health, its wellbeing, and so on. Most of the third world countries with their struggling economies have patriarchal social fabric, a fact that makes it worse for women of these societies to healthily tackle or seek help during gestation. The main goal of the proposed application, MothersCare, is to help the expecting mothers when they need it most. It will help them choose the right physician and request appointments from the comfort of homes, barring cumbersome wait for turn in long queues in rush hours for appointments with doctors at hospitals. This app is absolutely user-friendly in terms of simplicity of use and wide spectrum of maternal healthcare services it offers.

Ineffective airway clearance in adult patients after thoracic and upper abdominal surgery

2016 ◽  
Vol 31 ◽  
pp. 24-28 ◽  
Author(s):  
Lívia Maia Pascoal ◽  
Jéssica Pereira Alves de Carvalho ◽  
Vanessa Emille Carvalho de Sousa ◽  
Francisco Dimitre Rodrigo Pereira Santos ◽  
Pedro Martins Lima Neto ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Adult Patients ◽  
Airway Clearance ◽  
Upper Abdominal Surgery ◽  
Upper Abdominal

Neuromuscular Disorders and Anesthesia

2018 ◽  
Author(s):  
Mariel Manlapaz ◽  
Perin Kothari
Keyword(s):  
Perioperative Management ◽  
Neuromuscular Disorders ◽  
Neuromuscular Diseases ◽  
Tonic Contraction ◽  
Endocrine Dysfunction ◽  
Muscle Involvement ◽  
Disease States ◽  
Anesthetic Drugs ◽  
Anesthetic Considerations ◽  
The Right

The various neuromuscular diseases present with different airway, cardiovascular, pulmonary, and anesthetic considerations. It is useful to categorize these different diseases into nerve, neuromuscular junction, and primary muscle diseases. Understanding their pathophysiology is paramount in choosing the right anesthetic drugs (for example, depolarizing versus nondepolarizing and regional versus general anesthesia). Knowing their manifestations such as autonomic dysfunction, skeletal/cardiac/smooth/bulbar muscle involvement, or tendency for tonic contraction, allows for expectant perioperative management. Finally appreciating their association with certain disease states such as malignant hyperthermia or endocrine dysfunction can prevent complications. A brief review of myotonic dystrophy is presented here, followed by a brief summary of anesthetic considerations for various neuromuscular diseases.

scholarly journals DIFFERENTIAL TOLERANCE OF SUGARCANE CULTIVARS TO CLOMAZONE

2017 ◽  
Vol 35 (0) ◽  
Author(s):  
L.H. BARCELLOS JÚNIOR ◽  
G.A.M. PEREIRA ◽  
V.A. GONÇALVES ◽  
C.C. MATOS ◽  
A.A. SILVA
Keyword(s):  
Reducing Sugars ◽  
Lower Cost ◽  
Scientific Evidence ◽  
Crop Productivity ◽  
Soluble Solids ◽  
Herbicide Application ◽  
Sugarcane Crop ◽  
Crop Development ◽  
The Right ◽  
Plant Control

ABSTRACT Weed control is one of the most relevant costs of sugarcane production. If weeds are not controlled at the right time, the productivity and longevity of sugarcane plantations are reduced. In this crop, chemical control is the most used method, since it is efficient and it has a lower cost. Differentiated tolerance of sugarcane cultivars to the herbicide clomazone has been observed in the fields. However, there is no scientific evidence of this effect on the productivity of crops. This study evaluated the effects of clomazone on three sugarcane cultivars (RB966928, RB93579 and RB867515). Herbicide application was performed 40 days after the emergence of sugarcane plants and 7, 14, 21 and 28 days after the application, the toxicity caused by the herbicide in the culture was evaluated through grades ranging from 0 (no toxicity) to 100 (plant death). The harvest was performed 580 days after the herbicide application. On this occasion, the length and diameter of the stem, number of tillers, tons of stems per hectare, total soluble solids of the juice, sucrose of the juice, apparent purity of the juice, sugarcane fiber, reducing sugars and total recoverable sugars were evaluated. The differential tolerance among sugarcane cultivars in response to clomazone application in the early stages of crop development was confirmed. Nevertheless, in all cultivars, the symptoms of intoxication disappeared over time and did not reflect on crop productivity. It was concluded that plant control in the sugarcane crop with clomazone, following the recommendation of the manufacturer, does not interfere negatively in the growth, development and productivity of the crop.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

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