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PubMedDate not supplied

Promoting self-help in pulmonary patient education.

Ideally, rehabilitation restores an ill or injured person to a condition of health and useful activity. Toward this goal, patient education shows persons how they can take control of their lives and participate in their own health care. In chronic obstructive pulmonary disease, a program consisting of only classes and demonstrations on breathing exercises, oxygen therapy, and physical reconditioning is not enough. The programs that have had the greatest success establish a support network that continues long after the workshops or classes have ended.

Humans↗
PubMed1999

[Pneumothorax in cigarette smokers].

From 1.01.1992 to 31.12.1998 ill prisoners were treated because of so called spontaneous pneumothorax. Their age was between 24 to 57, which was 33 in average. All of them were males and heavy smokers. In one case of the coat pneumothorax the treatment was limited only to the breathing exercises, to ten other patients an under-water-seal drainage was applied, in the next case with pneumothorax and clear symptoms of bronchial fistula, the lung expansion was obtained no sooner than after the usage of a suction drainage. The risk of recurrence of the illness was limited by injection of 40% glucose solution through the drain to the pleural cavity to increase adhesions.

Adult↗
PubMed2000

Preoperative evaluation.

A history and physical examination, focusing on risk factors for cardiac, pulmonary and infectious complications, and a determination of a patient's functional capacity, are essential to any preoperative evaluation. In addition, the type of surgery influences the overall perioperative risk and the need for further cardiac evaluation. Routine laboratory studies are rarely helpful except to monitor known disease states. Patients with good functional capacity do not require preoperative cardiac stress testing in most surgical cases. Unstable angina, myocardial infarction within six weeks and aortic or peripheral vascular surgery place a patient into a high-risk category for perioperative cardiac complications. Patients with respiratory disease may benefit from perioperative use of bronchodilators or steroids. Patients at increased risk of pulmonary complications should receive instruction in deep-breathing exercises or incentive spirometry. Assessment of nutritional status should be performed. An albumin level of less than 3.2 mg per dL (32 g per L) suggests an increased risk of complications. Patients deemed at risk because of compromised nutritional status may benefit from pre- and postoperative nutritional supplementation.

Clinical Laboratory Techniques↗
PubMed2000

[Vocal tract disorders in women with hormonal gynecological diseases].

The paper analyzes the incidence rates and specific features of vocal apparatus disorders in dyshormonal gynecological diseases in the reproductive and menopausal periods. It presents a complex procedure for diagnosis and treatment, which includes the management of the patient by a phoniatrist jointly with an endocrinological gynecologist, a psychoneurologist, and a phonopedist. Drugs for correcting sexual hormone levels, psychoemotional status, venous tone, breathing exercises and phonopedic classes by using biological feedback, and physiotherapeutical methods of treatment have been used. Indications and contraindications for the use of hormonal drugs in the treatment of dyshormonal gynecological diseases in individuals of voice-and-speech professions are considered.

Adult↗
PubMedDate not supplied

[Pulmonary complications of acute myocardial infarct. Therapeutic orientation].

The heart and the lung make up an inseparable anatomic and functional unit. The changes in one affect the other and vice versa. In acute myocardial infarction a heart failure syndrome develops. This syndrome is characterized by passive pulmonary congestion, which leads to hypoxemia. This hypoxemia indicate the functional disturbance of the lung, and the hemodinamic evolution of the disease. Arterial gases determination is the best way to assess the sickness progression. A certain paralelism exists among the central venous saturation, cardiac insufficiency and the degree of pulmonary disfunction. Such a procedure is not very appreciable and does not substitute the direct analysis of the arterial PO2. The pulmonary complications in the myocardial infarction shock are directly responsable of death in 50% of the patients. To heart failure and shock, hipperfusion and hypoxia are added. Many vessels close due to the decrease in the pulmonary flow. This brings about the release of substances that are toxic to the vessel causing an inflammatory vascular reaction. The decrease in the flow harms the lung cell and for this reason atelectasia or alveolar colapse occur; besides inducing the formation of shunts. Under these conditions the lung compliance decreases. The areas that are badly ventilated and hypoperfused can easily become infected and pneumonitis and abscesses cause even more harm to the tissue. The decrease in the speed of circulation and hematologic changes of shock, induce a diseminated intravascular coagulation. What was stated before leads to an important reduction of the lung as a depurating organ and makes the shock irreversible. As far as therapy is concerned in the prevention of vascular colaps and the improvement of the oxemia, oxygen is very useful when there is a venous congestion (clinically, X rays, and oxemia). When the concentration of O2 is lower than 50% in the cases with slight cardiac failure; do not use oxygen in higher concentrations unless the hypoxia is associated to acute pulmonary edema and shock. Mechanic ventilators, and intermitent possitive pressure are recommended even though they have a posenous effect on the cardiac output. Always keep the air ways permeable: changing position, breathing exercises, humidifications, aspiration of secretions, intubation, or traqueostomy depending upon the various cases.

Acute Disease↗
PubMed1975

Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis.

Idiopathic thoracic lordoscoliosis is more common and more productive of respiratory compromise than is kyphoscoliosis. In some patients with idiopathic scoliosis, thoracic lordosis is the predominant component of the disease. Five such patients, all of whom had idiopathic scoliosis with excessive thoracic lordosis, progressive deformity despite Milwaukee brace treatment, and significant compromise of pulmonary function, are presented. Harrington instrumentation (distraction rod only) and spine fusion improved the deformity and respiratory function. The recommended treatment for this type of idiopathic scoliosis is early recognition and prompt surgical correction. The Milwaukee brace should be avoided. Postoperative management must include early ambulation combined with vigorous breathing exercises.

Child↗
PubMedDate not supplied

Pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India. Drug treatment alone does not optimize therapy. Pulmonary rehabilitation has been found to improve the physical efficiency of COPD patients. Therefore, we evaluated the effect of domiciliary pulmonary rehabilitation programme in patients of COPD. METHODS: Forty patients of stable COPD having severe airflow obstruction were included in the study. They were divided into control and experimental groups randomly. Rehabilitation included walking, breathing exercises, postural drainage, controlled coughing and changes in life style activities. Exercises of 30 minutes duration were performed at home twice daily for four weeks supervision. Six-minute walking distance, forced expiratory volume in one seocond (FEV1) and various indices of chronic respiratory disease questionnaire (CRDQ) were measured in both experimental and control groups before and after completion of the study. RESULTS: In the experimental group, after four weeks, the mean (+/- SD) difference in six-minute walking distance, dyspnoea, mastery, fatigue and emotion scores were 54.2 (26.7) meters, 0.96 (0.26), 0.89 (0.44), 0.90 (0.40) and 0.91 (0.32) respectively. Changes in all these parameters were statistically significant (p < 0.001) as compared to the control group. There was no significant change in FEV1. CONCLUSION: It was concluded that domiciliary pulmonary rehabilitation for four weeks results in significant improvement in the quality of life and exercise tolerance, even without improvement in FEV1.

Aged↗
PubMedDate not supplied

[Medical gymnastics in the rehabilitative treatment of patients with locomotor injuries in combined and multiple trauma].

The follow-up of 70 patients with trauma-related locomotor disorders proved that breathing exercises, vibratory massage, chest heparin electrophoresis, drug inhalations early after the injury can be effective in prevention and treatment of pulmonary complications. Transcutaneous neuroelectrostimulation noticeably enhanced the recovery of the locomotor function.

Adult↗
PubMed1992

[Public patient education in pneumology].

Since February 1990 public information evenings pertaining to respiratory tract diseases have been held every month in the cities of Fellbach, Backnang and at times in Waiblingen. These sessions have met with a great show of interest from patients, doctors and the public in general, as indicated by the consistently large number of over 100 participants. This continual educational work with its accompanying measures, such as, asthma-sport, breathing exercises, and books and videos on loan, represents an effective alternative to the formally structured, patient training programs limited to a specific time period. A broad range of effectiveness is attained by engaging public media in the informative process.

Curriculum↗
PubMed2002

[Main relaxation techniques].

After having provided a detailed explanation on what relaxation consists of (see Rev. Rol Enf 2002; 25(9):582-586), the author presents a recap of the major known relaxation techniques including progressive muscular therapy, yoga stretching exercises, breathing techniques, therapeutic massages, meditation,... emphasizing the theoretical basis and practical experience as a function of each technique; each person ought to adopt those techniques which are most appropriate.

Humans↗
PubMedDate not supplied

Anaesthesia for minilaparotomy female sterilization in JUTH, Nigeria: a fourteen-year review.

This is a retrospective study aimed at evaluating the various anaesthetic methods used for minilaparotomy female sterilization. During the fourteen-year period, 2913 clients had minilaparotomy female sterilization. Their mean age was 36.35 +/- 4.19 years. Mean number of living children was 6.82 +/- 1.64. 74.87% of the clients did not have any formal education, but were aware of other contraceptive options. In all 98.42% of the clients were married and in a stable relationships. Local anaesthesia with 1% xylocaine (10-20 mls) was used in 83.69% of the cases. Local anaesthesia with sedation in 13.53% and general anaesthesia in only 2.78%. Above 93.55% (2725) of the sterilization was carried out as an interval procedure, while 6.45% (188) were done postpartum. Pomeroy's technique was used in 96.98% of the tubal ligation. There was no mortality. The morbidity was vomiting and hallucination and it occurred in 0.20% amongst the clients who had sedation or general anaesthesia. Minilaparotomy under local anaesthesia for female sterilization has been found to be safe an effective outpatient procedure, and it is currently and established family planning option in our institution. The use of local anaesthesia alone gradually rose from 1987 up to date. The successful outcome was attributable to psychological and emotional preparation of the clients who also had to learn abdominal breathing exercises (for easy access to the fallopian tubes) from the trained personnel before the procedure.

Adult↗
PubMed2003

[Psychosocial support for pulmonary rehabilitation in patients with Chronic Obstructive Pulmonary Disease].

INTRODUCTION: This paper focuses on recent studies examining psychosocial support provided in pulmonary rehabilitation programmes for patients with Chronic Obstructive Pulmonary Disease (COPD). STATE OF ART: The literature shows the impact that psychological variables have on COPD consequences and on compliance with treatment. These parameters influenced rehabilitation outcomes. Psychosocial support, such as group discussions, reduces incapacity (dyspnoea control) and handicap situations (reductions in anxiety and depression, improvements in coping strategies, autonomy and social participation). PERSPECTIVES: Further studies are needed to optimise psychosocial input particularly by combining it with education sessions. CONCLUSIONS: Psychosocial support is nowadays recommended as part of pulmonary rehabilitation programmes for patients with stable COPD. It complements the other components of exercise, breathing techniques and health education.

Adaptation, Psychological↗
PubMed2003

Spontaneous tracheal rupture associated with acquired tracheobronchomalacia.

We report here a very rare case of pneumomediastinum due to spontaneous tracheal rupture with tracheobronchomalacia. The patient was a 74-year-old woman who had suffered nocturnal dyspnea due to productive cough for five days prior to admission and had been treated with corticosteroids for five years at another hospital after being diagnosed with bronchial asthma. Computed tomographic scanning of the chest demonstrated over 1 cm longitudinal small air collections behind the upper trachea. Crescent-type tracheobronchomalacia was diagnosed by emergency bronchoscopy. At the right side of the upper trachea, a 1-cm laceration was revealed. Fibrin glue (Bolheal, Kaketsuken, Kumamoto, Japan) was sprayed on the laceration through an instrument of our design for endoscopic gluing and she was intubated for three days. Furthermore, treatment including administration of antibiotics, an antitussive agent, and a mucolytic agent, in addition to pulmonary physical therapy involving pursed lip breathing exercises and smoking cessation improved her complaints one month after admission.

Aged↗
PubMed2004

Complementary and alternative medicine use among adults: United States, 2002.

OBJECTIVE: This report presents selected estimates of complementary and alternative medicine (CAM) use among U.S. adults, using data from the 2002 National Health Interview Survey (NHIS), conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). METHODS: Data for the U.S. civilian noninstitutionalized population were collected using computer-assisted personal interviews (CAPI). This report is based on 31,044 interviews of adults age 18 years and over. Statistics shown in this report were age adjusted to the year 2000 U.S. standard population. RESULTS: Sixty-two percent of adults used some form of CAM therapy during the past 12 months when the definition of CAM therapy included prayer specifically for health reasons. When prayer specifically for health reasons was excluded from the definition, 36% of adults used some form of CAM therapy during the past 12 months. The 10 most commonly used CAM therapies during the past 12 months were use of prayer specifically for one's own health (43.0%), prayer by others for one's own health (24.4%), natural products (18.9%), deep breathing exercises (11.6%), participation in prayer group for one's own health (9.6%), meditation (7.6%), chiropractic care (7.5%), yoga (5.1%), massage (5.0%), and diet-based therapies (3.5%). Use of CAM varies by sex, race, geographic region, health insurance status, use of cigarettes or alcohol, and hospitalization. CAM was most often used to treat back pain or back problems, head or chest colds, neck pain or neck problems, joint pain or stiffness, and anxiety or depression. Adults age 18 years or over who used CAM were more likely to do so because they believed that CAM combined with conventional medical treatments would help (54.9%) and/or they thought it would be interesting to try (50.1%). Most adults who have ever used CAM have used it within the past 12 months, although there is variation by CAM therapy.

Adult↗
PubMed2004

Role of yoga in stress management.

The state of the mind and that of the body are intimately related. If the mind is relaxed, the muscles in the body will also be relaxed. Stress produces a state of physical and mental tension. Yoga, developed thousands of years ago, is recognized as a form of mind-body medicine. In yoga, physical postures and breathing exercises improve muscle strength, flexibility, blood circulation and oxygen uptake as well as hormone function. In addition, the relaxation induced by meditation helps to stabilize the autonomic nervous system with a tendency towards parasympathetic dominance. Physiological benefits which follow, help yoga practitioners become more resilient to stressful conditions and reduce a variety of important risk factors for various diseases, especially cardio-respiratory diseases.

Humans↗
PubMed2005

[Qi Gong: medicine or enlightenment?].

According to Dr. Yang Jwing-Ming, the translation for Qi Gong would be "Whatever practice or study related with Qi which requires a lot of time and effort". Qi Gong is a practice which combines posture exercises, gestures, breathing and a mental attitude destined to make Qi circulate in order to preserve one's health, cure diseases and prolong life.

Breathing Exercises↗
PubMed2005

[Feasibility of cardiopulmonary rehabilitation in patients with idiopathic pulmonary arterial hypertension treated with intravenous prostacyclin infusion therapy].

OBJECTIVES: To evaluate cardiopulmonary rehabilitation in patients with idiopathic pulmonary arterial hypertension who had severe heart failure. METHODS: The subjects comprised 11 men and 13 women aged 5 to 37 years old with idiopathic pulmonary arterial hypertension, who received cardiopulmonary rehabilitation following the start of continuous intravenous prostacyclin administration between January 1999 and September 2003. Fifteen patients were categorized in New York Heart Association (NYHA) functional class-III and 9 were class-IV on admission. Patients received cardiopulmonary rehabilitation consisting of breathing exercise, training of upper extremity muscles, gait training, bicycle ergometer training, and treadmill walking for 30 to 60 min per day, 5 days a week. Cardiothoracic ratio, NYHA class, heart rate, pulse oximeter saturation, plasma levels of human atrial natriuretic peptide and brain natriuretic peptide, tricuspid regurgitation, and right ventricular myocardial index (RV Tei index) were evaluated by echocardiography, lower extremity muscle strength, ambulation ability, Barthel index, and 6-minute walking distance at the beginning and end of cardiopulmonary rehabilitation. RESULTS: The average period of cardiopulmonary rehabilitation was 6.7 weeks. There was no deterioration in cardiothoracic ratio, human atrial natriuretic peptide, brain natriuretic peptide levels, tricuspid regurgitation, RV Tei index and pulse oximeter saturation. The results also showed decreased heart rate at rest (p = 0.007), and improved NYHA class (p = 0.010), lower extremity strength (p < 0.001), ambulation ability (p < 0.001), Barthel index (p < 0.001), and 6-minute walking distance (p = 0.001). CONCLUSIONS: Cardiopulmonary rehabilitation is safe and effective for idiopathic pulmonary arterial hypertension patients in NYHA class-III and IV during intravenous prostacyclin infusion without deterioration of cardiac functions, despite the conventional contraindication.

Activities of Daily Living↗
PubMed2005

[Community pneumonia in recruits: the algorithm of complex two-staged rehabilitation treatment].

The program of complex recovery therapy and medical rehabilitation (MR) for treating the patients with mild form of community-acquired pneumonia (CAP) is presented. 89 servicemen-recruits with CAP mild form treated during 2003-2005 in the Field Therapy Clinic of Saratov Military Medical Institute were investigated. MR was conducted on the basis of medical station (MS) and lasted for 15 days. Physiological, laboratory and instrumental parameters were evaluated at the day of antibiotic therapy cancel, on discharge from hospital, on the 5-th and 15-th day of MR. The peroxidation activity, intensity of unspecific resistance mechanisms and obstructive impairment of bronchial passages remained during CAP late phases. Only on the 15th day of extensive medical rehabilitation measures in 80,7% of those suffered from CAP the reserve capacity indices of cardiovascular system reached the lower level of the border state of PWC170 test scales, Skibinskiy's and Bogomazov's tests. The proposed two-staged program of medical rehabilitation in CP cases which includes the combined use of actoprotector and antioxidant, restoration of bronchial tree drainage function, early introduction of breathing exercises and cyclotraining allowed achieving the restoration of working and fighting capacity in short terms. The stay in pulmonologic in-patient department became 3 days less.

Algorithms↗