1,720,991 research outputs found
ICU acquired neuropathy and myopathy
No full textPatients admitted to intensive care often develop complications. Among these, acquired difficulties with neuromuscular function are widely recognised as potential causes of clinical worsening and delayed recovery in these individuals. Critical Illness Pofineuropathy and Critical Illness Myopathy are the most commonly recognised disorders which often occur simultaneously in the critically ill patients. Incidence of both Critical Illness Polineuropathy (from 2 to 80%) and Critical Illness Myopathy (from 1 to 7%) vary consistently according to the patients' selection, being diagnosis mainly addressed by clinical signs and electromyography test. Awareness among health care professionals, early recognition and diagnosis, patient's education about outcome and long-term prognosis, streamlining rehabilitation perspectives are considered short- and long-term key aspects which may optimise care in these patients. This short review will provide the main aspects dealing with definitions, epidemiology, risk factors, and clinical management of acquired difficulties with neuromuscular function in the critical care area
Non-invasive ventilation in chronic obstructive pulmonary disease
No full textAdvanced chronic obstructive pulmonary disease (COPD) is associated with peripheral and respiratory muscular weakness with nocturnal and daytime arterial blood gas abnormalities (including hypercapnia) leading to chronic respiratory failure (CRF). At present, long-term oxygen therapy (LTOT) is the only recognized long-term treatment that has been shown to significantly improve survival in these patients. An alternative therapeutic approach proposed, especially in patients with worsening hypercapnia, is nocturnal non-invasive ventilation (NIV). The three main theories that explain the efficacy of NIV, as applied by positive pressure (NIPPV), in these patients are: opportunity for resting of fatigued respiratory muscles, improvement in thoracic-pulmonary mechanics, and the ‘resetting’ of the central respiratory drive. In contrast with the strong evidence favouring the use of NIV in acute exacerbation of COPD, many studies performed in severe but stable patients have shown inconsistent and conflicting results. In the short term, NIV has been shown to reduce the rate of hospitalization, as well as to improve both the patient’s quality of life and their functional status. However, long-term assessments did not find any effect on survival and the strongest outcomes were not affected by the use of NIPPV even when added to LTOT. Recommendations of an international consensus conference published in 1999 provided the basis for NIV prescription in stable advanced COPD patients – nocturnal hypoventilation, sleep fragmentation and daytime arterial hypercapnia – which are still considered the optimal indications for domiciliary NIV, in particular in the presence of severe-progressive deterioration of the clinical condition and instability of respiratory function
Manual massage therapy for patients with COPD: A scoping review
Full text linkBackground and objectives: Manual massage therapy is a therapeutic option for the treatment of several pathological conditions affecting the musculoskeletal system. It has been pointed out that massage might be beneficial for chronic obstructive pulmonary disease (COPD) patients thanks to therapeutic effects primarily related to hyperemia (increased skin temperature and blood flow), and activation of the lymphatic system. The present study reports current evidence on the systemic effects of manual massage in patients with COPD. Materials and Methods: A scoping review was conducted on five major databases. The search went through all databases since their inception until December 2018. Results: Seventy-eight citations were retrieved; after the selection process was completed, seven articles were considered eligible. In patients receiving manual massage, improvements were observed in Forced Expiratory Volume in 1 s, dyspnea perception, and in the 6-min walking test. Conclusions: To date, the use of manual massage in patients with COPD is not supported by substantial evidence in the literature: indeed, it is proposed as a therapeutic option in association with other interventions such as physical exercise
Multidisciplinary rehabilitation project in a disabled patient receiving mechanical ventilation
No full textPulmonary rehabilitation is a multidisciplinary non-pharmacological therapy delivered to patients with disability following respiratory chronic disorders or even post-acute respiratory consequences. The present description reports a case of rehabilitation process applied to a patient following cardio-surgery with respiratory insufficiency as a major complication. This case report shows an example of the professional integration and of the sharing process of rehabilitation. This is individually tailored and aimed at improving the patient's individual abilities and perceived quality of life
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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