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Respiratory training

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https://www.readbyqxmd.com/read/29452814/deep-or-awake-removal-of-laryngeal-mask-airway-in-children-at-risk-of-respiratory-adverse-events-undergoing-tonsillectomy-a-randomised-controlled-trial
#1
A Ramgolam, G L Hall, G Zhang, M Hegarty, B S von Ungern-Sternberg
BACKGROUND: Laryngeal mask airways (LMA) are widely used during tonsillectomies. Contrasting evidence exists regarding the timing of the removal and the risk of perioperative respiratory adverse events. We assessed whether the likelihood of perioperative respiratory adverse events is influenced by the timing of LMA removal in children with at least one risk factor for these events. METHODS: Participants (n=290, 0-16 yr) were randomised to have their LMA removed either deep (in theatre by anaesthetist at end-tidal sevoflurane >1 minimum alveolar concentration) or awake (in theatre by anaesthetist or in postanaesthesia care unit by anaesthetist or trained nurse)...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452805/perioperative-cardiopulmonary-exercise-testing-cpet-consensus-clinical-guidelines-on-indications-organization-conduct-and-physiological-interpretation
#2
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452599/feasibility-and-acceptability-of-pre-operative-physical-activity-to-improve-patient-outcomes-after-major-cancer-surgery-study-protocol-for-a-pilot-randomised-controlled-trial-pepa-trial
#3
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29446155/not-just-trust-factors-influencing-learners-attempts-to-perform-technical-skills-on-real-patients
#4
Susan L Bannister, Mark S Dolson, Lorelei Lingard, David A Keegan
CONTEXT: As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. METHODS: A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning...
February 15, 2018: Medical Education
https://www.readbyqxmd.com/read/29438547/effectiveness-of-general-practitioner-online-training-and-an-information-booklet-for-parents-on-antibiotic-prescribing-for-children-with-respiratory-tract-infection-in-primary-care-a-cluster-randomized-controlled-trial
#5
Anne R J Dekker, Theo J M Verheij, Berna D L Broekhuizen, Christopher C Butler, Jochen W L Cals, Nick A Francis, Paul Little, Elisabeth A M Sanders, Lucy Yardley, Nicolaas P A Zuithoff, Alike W van der Velden
Objectives: Antibiotics are too often prescribed in childhood respiratory tract infection (RTI), despite limited effectiveness, potential side effects and bacterial resistance. We aimed to reduce antibiotic prescribing for children with RTI by online training for general practitioners (GPs) and information for parents. Methods: A pragmatic cluster randomized controlled trial in primary care. The intervention consisted of online training for GPs and an information booklet for parents...
February 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29438110/the-randomized-educational-acute-respiratory-distress-syndrome-diagnosis-study-a-trial-to-improve-the-radiographic-diagnosis-of-acute-respiratory-distress-syndrome
#6
Shannon L Goddard, Gordon D Rubenfeld, Venika Manoharan, Shelly P Dev, John Laffey, Giacomo Bellani, Tai Pham, Eddy Fan
OBJECTIVES: Radiographic criteria for acute respiratory distress syndrome have been criticized for poor reliability. Our objective was to test an educational intervention to improve the radiographic identification of acute respiratory distress syndrome by participants in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study. DESIGN: Randomized controlled trial. SETTINGS: Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study centers...
February 12, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29437032/computerised-interpretation-of-the-fetal-heart-rate-during-labour-a-randomised-controlled-trial-infant
#7
Peter Brocklehurst, David Field, Keith Greene, Edmund Juszczak, Sara Kenyon, Louise Linsell, Chris Mabey, Mary Newburn, Rachel Plachcinski, Maria Quigley, Philip Steer, Liz Schroeder, Oliver Rivero-Arias
BACKGROUND: Continuous electronic fetal monitoring (EFM) in labour is widely used and computerised interpretation has the potential to increase its utility. OBJECTIVES: This trial aimed to find out whether or not the addition of decision support software to assist in the interpretation of the cardiotocograph (CTG) reduced the number of poor neonatal outcomes, and whether or not it was cost-effective. DESIGN: Two-arm individually randomised controlled trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29436560/the-role-of-non-invasive-ventilation-used-immediately-after-planned-extubation-for-adults-with-chronic-respiratory-disorders
#8
Jinnan Ou, Huaying Chen, Lezhi Li, Liping Zhao, Na Nie
OBJECTIVE:  To estimate the benefits of non-invasive ventilation (NIV) used immediately after planned postextubation in patients with chronic respiratory disorders. METHODS:  Cochrane Library, PubMed, the Chinese BioMedical Literature Database of clinical trials (CBD) and Embase were searched for pertinent studies by 2 trained investigators. Pooled odds ratios and 95% confidence intervals (CIs) were calculated by employing both fixed-effects and random-effects models...
February 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29431561/effects-of-resistance-training-of-peripheral-muscles-versus-respiratory-muscles-in-institutionalized-older-adults-with-sarcopenia-a-randomized-controlled-trial
#9
Maria À Cebrià I Iranzo, Mercè Balasch I Bernat, María Á Tortosa-Chuliá, Sebastià Balasch-Parisi
This study compares the effects of two resistance training programs in peripheral and respiratory musculature on muscle mass and strength and physical performance, and identify the appropriate muscle mass parameter for assessing the intervention effects. Thirty-seven institutionalized older Spanish adults with sarcopenia were analyzed: Control Group (n=17), Respiratory Muscle Training Group (n=9) and Peripheral Muscle Training Group (n=11). Pre and post-intervention, participants were assessed for Appendicular Skeletal Mass (ASM/height2; ASM/weight; ASM/BMI), isometric knee-extension, arm-flexion and handgrip strength, Inspiratory and Expiratory Maximal Pressures (MIP and MEP), and gait speed...
February 12, 2018: Journal of Aging and Physical Activity
https://www.readbyqxmd.com/read/29430450/diagnosis-of-acute-respiratory-distress-syndrome-by-exhaled-breath-analysis
#10
REVIEW
Lieuwe D J Bos
The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29428578/treatment-practices-of-households-and-antibiotic-dispensing-in-medicine-outlets-in-developing-countries-the-case-of-ghana
#11
Mary-Anne Ahiabu, Pascal Magnussen, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl
INTRODUCTION: Antibiotic resistance, associated with inappropriate drug use, is a global public health threat. The pharmaceutical sectors in developing countries are poorly regulated leading to antibiotic sales and use without a prescription. The study documents the treatment of acute illnesses in households and the antibiotic dispensing practices of medicine sales outlets in Eastern region, Ghana. METHOD: Twice-weekly illness recall visits were made to 12 households in three rural communities over eight consecutive weeks...
February 7, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29428556/effect-of-hypercapnia-on-self-sustained-muscle-activity
#12
Kei Hatano, Kazuki Shirakawa, Noboru Usuda, Ryouta Matsuura, Yoshinori Ohtsuka, Takahiro Yunoki
The aim of the present study was to determine the effect of hypercapnia on motor neuromuscular activity of the human triceps surae muscle. Nine subjects participated in trials in a normal breathing condition and a CO2 rebreathing condition. In both conditions, in order to provoke self-sustained muscle activity, percutaneous electrical train stimulation was applied to the tibial nerve while each subject lay on a bed. Self-sustained muscle activity, which is an indirect observation of plateau potentials in spinal motoneurons, was measured for 30 sec after the train stimulation by using surface electromyography...
February 8, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29428066/utility-of-bispectrum-in-the-screening-of-pediatric-sleep-apnea-hypopnea-syndrome-using-oximetry-recordings
#13
Fernando Vaquerizo-Villar, Daniel Álvarez, Leila Kheirandish-Gozal, Gonzalo César Gutiérrez-Tobal, Verónica Barroso-García, Andrea Crespo, Félix Del Campo, David Gozal, Roberto Hornero
BACKGROUND AND OBJECTIVE: The aim of this study was to assess the utility of bispectrum-based oximetry approaches as a complementary tool to traditional techniques in the screening of pediatric sleep apnea-hypopnea syndrome (SAHS). METHODS: 298 blood oxygen saturation (SpO 2 ) signals from children ranging 0-13 years of age were recorded during overnight polysomnography (PSG). These recordings were divided into three severity groups according to the PSG-derived apnea hypopnea index (AHI): AHI < 5 events per hour (e/h), 5 ≤ AHI < 10 e/h, AHI ≥ 10 e/h...
March 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29427982/exercise-and-asthma
#14
Andréanne Côté, Julie Turmel, Louis-Philippe Boulet
Transient airway narrowing can occur during or following exercise, a phenomenon called exercise-induced bronchoconstriction (EIB). The main mechanism of EIB is considered to be airway dehydration, resulting from increased ventilation during exercise. In asthma, such water loss causes an increase in airway fluid osmolarity, inducing airway smooth muscle contraction following the release of mediators from airway inflammatory cells. Asthmatics frequently experience EIB, but it may also be observed in others not reporting asthma symptoms, particularly elite endurance athletes...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29425367/a-rapid-handheld-device-to-assess-respiratory-resistance-clinical-and-normative-evidence
#15
Aaron B Holley, Wesley D Boose, Michael Perkins, Karen L Sheikh, Nancy P Solomon, Angela M Dietsch, Jafar Vossoughi, Arthur T Johnson, Jacob F Collen
Introduction: Following reports of respiratory symptoms among service members returning from deployment to South West Asia (SWA), an expert panel recommended pre-deployment spirometry be used to assess disease burden. Unfortunately, testing with spirometry is high cost and time-consuming. The airflow perturbation device (APD) is a handheld monitor that rapidly measures respiratory resistance (APD-Rr) and has promising but limited clinical data. Its speed and portability make it ideally suited for large volume pre-deployment screening...
February 7, 2018: Military Medicine
https://www.readbyqxmd.com/read/29424007/inspiratory-muscle-training-improves-exercise-capacity-with-thoracic-load-carriage
#16
Ren-Jay Shei, Robert F Chapman, Allison H Gruber, Timothy D Mickleborough
Thoracic load carriage (LC) exercise impairs exercise performance compared to unloaded exercise, partially due to impaired respiratory mechanics. We investigated the effects of LC on exercise and diaphragmatic fatigue in a constant-load exercise task; and whether inspiratory muscle training (IMT) improved exercise capacity and diaphragmatic fatigue with LC. Twelve recreationally active males completed three separate running trials to exhaustion (Tlim ) at a fixed speed eliciting 70% of their V˙O2max . The first two trials were completed either unloaded (UL) or while carrying a 10 kg backpack (LC)...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29422548/africa-wide-evaluation-of-host-biomarkers-in-quantiferon-supernatants-for-the-diagnosis-of-pulmonary-tuberculosis
#17
Novel N Chegou, Jayne S Sutherland, Anna-Ritah Namuganga, Paul Lam Corstjens, Annemieke Geluk, Gebremedhin Gebremichael, Joseph Mendy, Stephanus Malherbe, Kim Stanley, Gian D van der Spuy, Magdalena Kriel, Andre G Loxton, Belinda Kriel, Felanji Simukonda, Yonas Bekele, Jacob A Sheehama, Josefina Nelongo, Marieta van der Vyver, Atsbeha Gebrexabher, Habteyes Hailu, Maria M Esterhuyse, Ida Rosenkrands, Claus Aagard, Martin Kidd, Desta Kassa, Adane Mihret, Rawleigh Howe, Jacqueline M Cliff, Amelia C Crampin, Harriet Mayanja-Kizza, Stefan H E Kaufmann, Hazel M Dockrell, Tom H M Ottenhoff, Gerhard Walzl
We investigated host-derived biomarkers that were previously identified in QuantiFERON supernatants, in a large pan-African study. We recruited individuals presenting with symptoms of pulmonary TB at seven peripheral healthcare facilities in six African countries, prior to assessment for TB disease. We then evaluated the concentrations of 12 biomarkers in stored QuantiFERON supernatants using the Luminex platform. Based on laboratory, clinical and radiological findings and a pre-established algorithm, participants were classified as TB disease or other respiratory diseases(ORD)...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29413508/weaning-failure-and-respiratory-muscle-function-what-has-been-done-and-what-can-be-improved
#18
REVIEW
Paulo A F Magalhães, Carlos A Camillo, Daniel Langer, Lívia B Andrade, Maria do Carmo M B Duarte, Rik Gosselink
INTRODUCTION: Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Inspiratory muscle training (IMT) has been described as an important contributor to the treatment of respiratory muscle dysfunction in critically ill patients. Its effectiveness is however yet controversial. OBJECTIVE: To discuss evidence for assessment of readiness and the effectiveness of interventions for liberation from MV, with special attention to the role of IMT...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29413495/effects-of-respiratory-muscle-training-on-endothelium-and-oxidative-stress-biomarkers-in-hemodialysis-patients-a-randomized-clinical-trial
#19
Nataly Gurgel Campos, Débora Fortes Marizeiro, Ana Carolina Lins Florêncio, Ítalo Caldas Silva, Gdayllon Cavalcante Meneses, Gabriela Freire Bezerra, Alice Maria Costa Martins, Alexandre Braga Libório
INTRODUCTION: Hemodialysis (HD) patients have altered pulmonary function and this is associated with impaired endothelial function and cardiovascular events. Respiratory muscle training (RMT) has the potential to improve cardiovascular outcomes in patients undergoing maintenance HD. Here, we evaluated the effects of RMT on endothelium/glycocalyx, oxidative stress biomarkers and pulmonary function test in HD patients. METHODS: This is a randomized controlled clinical trial including 41 patients undergoing thrice-weekly maintenance HD...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29412234/combination-of-preoperative-pulmonary-and-nutritional-preparation-for-esophagectomy
#20
Taciana Freitas Agrelli, Marisa de Carvalho Borges, Fernanda Maria Rodrigues da Cunha, Élida Mara Carneiro da Silva, Júverson Alves Terra Júnior, Eduardo Crema
PURPOSE: To compare pulmonary and nutritional parameters before and after inspiratory muscle training (IMT) and enteral feeding support in patients with esophageal disease undergoing preoperative outpatient follow-up. METHODS: Thirty patients with a mean age of 55.83 years, 16 men and 14 women, were included. Pulmonary assessment consisted of the measurement of MIP, MEP, and spirometry. Anthropometric measurements and laboratory tests were performed for nutritional assessment...
January 2018: Acta Cirúrgica Brasileira
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