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Oxygen therapy prescribing

Carol A Kelly, Dave Lynes, Mary R O'Brien, Ben Shaw
BACKGROUND: Despite emerging evidence and guidelines, poor prescribing and administration of oxygen therapy persists. This study aimed to explore healthcare professionals' (HCPs) and patients' perceptions of oxygen. DESIGN: Semi-structured interviews with 28 patients and 34 HCPs. FINDINGS: Three master themes uncovered: oxygen as a panacea, the burden of oxygen, and antecedents to beliefs. Patients used oxygen for breathlessness and as an enabler; they were grateful to oxygen and accepted it as part of the disease...
October 12, 2016: Clinical Respiratory Journal
I Cuesta López, M Sánchez Cuervo, Á Candela Toha, J Benedí González, T Bermejo Vicedo
WHAT IS KNOWN AND OBJECTIVE: The correct management of high-alert medications is a priority issue in expert recommendations for improving the clinical safety of patients. Objectives were to assess the impact of the implementation of vasoactive drug (VAD) protocols on safety and efficacy in the treatment of critically ill patients. METHODS: A prospective before-and-after study on the implementation of different VAD protocols, comparing medication errors (MEs) rates, mean intensive care unit (ICU) stay, mean blood pressure (MAP), heart rate (HR) and oxygen saturation...
October 4, 2016: Journal of Clinical Pharmacy and Therapeutics
Zainab Ahmadi, Josefin Sundh, Anna Bornefalk-Hermansson, Magnus Ekström
Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiovascular mortality compared to LTOT 15 h/day in hypoxemic COPD. This was a prospective, observational, population-based study of COPD patients starting LTOT between October 1, 2005 and June 30, 2009 in Sweden...
2016: PloS One
Abeer Anabtawi, John M Miles
OBJECTIVE: Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. This review examines the current literature regarding the nonglycemic effects and potential novel indications for metformin. METHODS: Review of the literature, with a focus on metformin use in Stage 3 chronic kidney disease (CKD-3) and heart failure (HF). RESULTS: The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin use and a reduction in stroke, atrial fibrillation and all-cause mortality...
August 2016: Endocrine Practice
Daphne J Karel
Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation due to irritant-induced chronic inflammation. A postbronchodilator forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) ratio of 0.7 or less is diagnostic in a patient with dyspnea, chronic cough or sputum production, and a history of irritant exposure. Tobacco smoking is the most significant etiology, and smoking cessation is the only intervention shown to slow disease progression. Long-acting beta2-agonists and long-acting muscarinic antagonists are first-line treatments for patients with persistently symptomatic COPD with an FEV1 of 80% or less of predicted...
September 2016: FP Essentials
Juan F Masa, Jaime Corral, Auxiliadora Romero, Candela Caballero, Joaquin Terán-Santos, Maria L Alonso-Álvarez, Teresa Gomez-Garcia, Mónica González, Soledad López-Martínez, Pilar De Lucas, José M Marin, Sergi Marti, Trinidad Díaz-Cambriles, Eusebi Chiner, Miguel Merchan, Carlos Egea, Ana Obeso, Babak Mokhlesi
RATIONALE: Low flow supplemental oxygen is commonly prescribed to patients with obesity hypoventilation syndrome (OHS). However, there is a paucity of data regarding its efficacy and safety. OBJECTIVES: To assess the medium-term treatment efficacy of adding supplemental oxygen therapy to commonly prescribed treatment modalities in OHS. METHODS: In this post hoc analysis of a previous randomized controlled trial, we studied 302 sequentially screened OHS patients who were randomly assigned to noninvasive ventilation, continuous positive airway pressure, or lifestyle modification...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Ivana Dokic, Andrea Mairani, Martin Niklas, Ferdinand Zimmermann, Naved Chaudhri, Damir Krunic, Thomas Tessonnier, Alfredo Ferrari, Katia Parodi, Oliver Jäkel, Jürgen Debus, Thomas Haberer, Amir Abdollahi
The growing number of particle therapy facilities worldwide landmarks a novel era of precision oncology. Implementation of robust biophysical readouts is urgently needed to assess the efficacy of different radiation qualities. This is the first report on biophysical evaluation of Monte Carlo simulated predictive models of prescribed dose for four particle qualities i.e., proton, helium-, carbon- or oxygen ions using raster-scanning technology and clinical therapy settings at HIT. A high level of agreement was found between the in silico simulations, the physical dosimetry and the clonogenic tumor cell survival...
August 1, 2016: Oncotarget
Joachim Wiskemann, Kai Schommer, Dirk Jaeger, Friederike Scharhag-Rosenberger
BACKGROUND: Colorectal cancer survivors are deconditioned through anticancer therapy. Furthermore, about 10% of them have a permanent ostomy which is associated with weakened abdominal muscles and an increased risk of a hernia. This case study reports on how a firefighter with rectal carcinoma and ostomy was trained to regain operational fitness. METHODS: A 44-year-old firefighter (178 cm, 82 kg) with an adenocarcinoma of the rectum (diagnosed 24 months prior) had been treated with neoadjuvant radiochemotherapy and surgery...
July 2016: Medicine (Baltimore)
Phyllis Murphie, Nick Hex, Jo Setters, Stuart Little
UNLABELLED: "Non-delivery" home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK)...
June 2016: Breathe
C J Iddins, S R Cohen, R E Goans, R Wanat, M Jenkins, D M Christensen, N Dainiak
Local cutaneous injuries induced by ionizing radiation (IR) are difficult to treat. Many have reported local injection of adipose-derived stromal vascular fraction (SVF), often with additional therapies, as an effective treatment of IR-induced injury even after other local therapies have failed. The authors report a case of a locally recurrent, IR-induced wound that was treated with autologous, non-cultured SVF without other concurrent therapy. A nondestructive testing technician was exposed to 130 kVp x rays to his non-dominant right thumb on 5 October 2011...
August 2016: Health Physics
Joyce L Cousins, Peter A B Wark, Vanessa M McDonald
Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patients who are at risk of type II respiratory failure in whom the risk of hypercapnia is well established. In recent times, several international bodies have advocated for the prescription of oxygen therapy in an attempt to reduce this risk in vulnerable patient groups. Despite this guidance, published data have demonstrated that there has been poor uptake of these recommendations...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Amanda M Thompson, Carlos R Franco Palacios, Maria N Henriksen
PURPOSE: The concurrent use of intravenous lipid emulsion (ILE) and high-dose insulin (HDI) for the management and treatment of propranolol toxicity in a pediatric patient is described. SUMMARY: A seven-month-old infant (weight, 6.1 kg) was admitted to a hospital emergency department with lethargy and bradycardia after an unintentional overdose of propranolol suspension, which had been prescribed several days previously for treatment of a scalp hemangioma. Notable physical examination and laboratory findings were as follows: blood pressure, 121/84 mm Hg (normal range, 90 ± 30/60 ± 10 mm Hg); heart rate, 62 beats/min (normal range, 100-150 beats/min); respiratory rate, 24 breaths/min (normal range, 25-35 breaths/min); oxygen saturation, 100% on room air; and rectal temperature, 35...
June 15, 2016: American Journal of Health-system Pharmacy: AJHP
J Rhet Tucker, Li Xu, Erich M Sturgis, Abdallah S R Mohamed, Theresa M Hofstede, Mark S Chambers, Stephen Y Lai, Clifton David Fuller, Beth Beadle, G Brandon Gunn, Katherine A Hutcheson
PURPOSE: The present study was undertaken to evaluate osteoradionecrosis (ORN) in patients with salivary gland malignancies (SGM) after treatment with radiation therapy. MATERIALS AND METHODS: The medical records of 172 patients treated with radiation therapy for SGM during a 12-year period (August 2001 to November 2013) were reviewed. Incidence, time to event, staging and management of ORN were analyzed. RESULTS: Of the 172 patients, 7 patients (4%) developed ORN (median latency: 19months, range: 4-72months)...
June 2016: Oral Oncology
Edwardine Labay, Helena J Mauceri, Elena V Efimova, Amy C Flor, Harold G Sutton, Stephen J Kron, Ralph R Weichselbaum
Radiation therapy remains a significant therapeutic modality in the treatment of cancer. An attractive strategy would be to enhance the benefits of ionizing radiation (IR)with radiosensitizers. A high-content drug repurposing screen of approved and investigational agents, natural products and other small molecules has identified multiple candidates that blocked repair of IR damage in vitro. Here, we validated a subset of these hits in vitro and then examined effects on tumor growth after IR in a murine tumor model...
June 7, 2016: Oncotarget
Takeshi Ninchoji, Sota Iwatani, Masahiro Nishiyama, Naohiro Kamiyoshi, Mariko Taniguchi-Ikeda, Naoya Morisada, Kazuto Ishibashi, Kazumoto Iijima, Akihito Ishida, Ichiro Morioka
OBJECTIVE: Anaphylaxis is a systemic allergic reaction that sometimes requires prompt treatment with intramuscular adrenaline. The aim of the study was to investigate the current situation regarding anaphylaxis treatment in a representative pediatric primary emergency facility in Japan. METHODS: We retrospectively examined the medical records dating from April 2011 through March 2014 from Kobe Children's Primary Emergency Medical Center, where general pediatricians work on a part-time basis...
April 13, 2016: Pediatric Emergency Care
Antonella Belfatto, Derek A White, Ralph P Mason, Zhang Zhang, Strahinja Stojadinovic, Guido Baroni, Pietro Cerveri
PURPOSE: Radiation therapy is one of the most common treatments in the fight against prostate cancer, since it is used to control the tumor (early stages), to slow its progression, and even to control pain (metastasis). Although many factors (e.g., tumor oxygenation) are known to influence treatment efficacy, radiotherapy doses and fractionation schedules are often prescribed according to the principle "one-fits-all," with little personalization. Therefore, the authors aim at predicting the outcome of radiation therapy a priori starting from morphologic and functional information to move a step forward in the treatment customization...
March 2016: Medical Physics
S Schwarz, A Boscheri, J Christle, A Duvinage, K Esefeld, H Fricke, N Pitsch, A Pressler, M Weichenberger, M Halle
Exercise training has been firmly established as an additional therapeutic strategy in addition to pharmacological and interventional treatment in patients with cardiovascular disease. Benefits for quality of life as well as prognosis have been confirmed for cardiovascular risk factors, ischemic heart disease, after myocardial infarction, in heart failure with preserved as well as reduced ejection fraction, in atrial fibrillation and in patients after catheter-assisted aortic valve implantation (TAVI), with an implantable cardioverter defibrillator (ICD) or with left ventricular assist devices (VAD)...
March 2016: Herz
Amitesh Agarwal, Wei Zhang, YongFang Kuo, Gulshan Sharma
OBJECTIVES: To examine the process and outcomes of care of COPD patients by Advanced Practice Providers (APPs) and primary care physicians. METHODS: We conducted a cross sectional retrospective cohort study of Medicare beneficiaries with COPD who had at least one hospitalization in 2010. We examined the process measures of receipt of spirometry evaluation, influenza and pneumococcal vaccine, use of COPD medications, and referral to a pulmonary specialist visit. Outcome measures were emergency department (ER) visit, number of hospitalizations and 30-day readmission in 2010...
2016: PloS One
Manabu Hayama, Hidekazu Suzuki, Takayuki Shiroyama, Motohiro Tamiya, Norio Okamoto, Ayako Tanaka, Naoko Morishita, Takuji Nishida, Takashi Nishihara, Tomonori Hirashima
BACKGROUND: Long-term oxygen therapy (LTOT) is sometimes prescribed for patients with advanced lung cancer who are potential candidates for chemotherapy. The aim of this study was to assess the usefulness of chemotherapy for patients with this disease who require LTOT. METHODS: The medical records of 40 patients with advanced lung cancer who received LTOT while undergoing systemic chemotherapy at our institution between January 2009 and December 2014 were retrospectively reviewed...
January 2016: Journal of Thoracic Disease
François Lamontagne, Maureen O Meade, Paul C Hébert, Pierre Asfar, François Lauzier, Andrew J E Seely, Andrew G Day, Sangeeta Mehta, John Muscedere, Sean M Bagshaw, Niall D Ferguson, Deborah J Cook, Salmaan Kanji, Alexis F Turgeon, Margaret S Herridge, Sanjay Subramanian, Jacques Lacroix, Neill K J Adhikari, Damon C Scales, Alison Fox-Robichaud, Yoanna Skrobik, Richard P Whitlock, Robert S Green, Karen K Y Koo, Teddie Tanguay, Sheldon Magder, Daren K Heyland
PURPOSE: In shock, hypotension may contribute to inadequate oxygen delivery, organ failure and death. We conducted the Optimal Vasopressor Titration (OVATION) pilot trial to inform the design of a larger trial examining the effect of lower versus higher mean arterial pressure (MAP) targets for vasopressor therapy in shock. METHODS: We randomly assigned critically ill patients who were presumed to suffer from vasodilatory shock regardless of admission diagnosis to a lower (60-65 mmHg) versus a higher (75-80 mmHg) MAP target...
April 2016: Intensive Care Medicine
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