216 research outputs found
Supplemental Material - Clinical implications of frailty assessed in hospitalized patients with acute-exacerbation of interstitial lung disease
No full textSupplemental Material for Clinical implications of frailty assessed in hospitalized patients with acute-exacerbation of interstitial lung disease by Marine Van Hollebeke Karan Chohan, Colin Adams, Jolene H Fisher, Shane Shapera, Lee Fidler, Ewan C Goligher, Tereza Martinu, Lisa Wickerson, Sunita Mathur, Lianne G Singer, W Darlene Reid and Dmitry Rozenberg in Chronic Respiratory Disease.</p
Chronic Candida dubliniensis meningitis in a lung transplant recipient
No full textCandida spp. are common colonizers of the oral mucosa and respiratory tract in lung transplant recipients. Although thought to be non-pathogenic in most cases, donor derived infections related to Candida spp. have been described. Among the manifestations of invasive candidiasis, chronic meningitis is one of the rarest and one of the most challenging to diagnose, due to the indolence of the disease and the low yield of the CSF cultures. It is associated with severe morbidity and a high mortality. Fungal PCR and BD glucan assays can be assistance in its diagnosis, although these tests are not widely available. We report a case of a possible donor derived Candida dubliniensis infection in a lung transplant recipient, who initially presented with empyema that was treated successfully, but subsequently developed chronic meningitis. Diagnosis was delayed due to the low yield of CSF cultures, and was confirmed with fungal PCR and BD glucan assay. Keywords: Candida meningitis, Chronic meningitis, Candida dubliniensis, Lung transplant, Immunocompromise
Skeletal Muscle Dysfunction in Lung Transplant Patients
No full textLung transplantation improves health-related quality of life (HRQL), daily function and survival for individuals with advanced lung disease. However, lung transplantation is now offered to older and more complex patients who are at a higher risk of skeletal muscle dysfunction; the implications of which remain uncertain. The overall objective was to assess how elements of muscle dysfunction (mass, strength and function) are associated with pre- and post-transplant physical function, HRQL, and clinical outcomes. We hypothesized that pre-transplant skeletal muscle dysfunction would be associated with impairments in pre-transplant HRQL, activities of daily-living (ADL), six-minute walk distance (6MWD), and worse post-transplant functional recovery with increased pre- and post-transplant mortality. Three studies targeting the pre- and post-transplant periods were undertaken. In study 1, a novel method of muscle mass quantification using computed tomography (CT) was retrospectively evaluated in 527 lung transplant candidates. CT muscle cross-sectional area in transplant candidates was 10% lower than age and sex-matched controls and independently associated with 6MWD, strength training volumes and post-transplant hospital length of stay (LOS), but no association was observed with pre- or post-transplant mortality. In study 2, muscle mass assessed with bio-electrical impedance, quadriceps strength, and function (Short Physical Performance Battery, SPPB) were prospectively evaluated in 50 lung transplant candidates. Quadriceps strength and SPPB were associated with pre-transplant HRQL, ADL, and 6MWD. Number of muscle deficits (mass, strength and/or function) was directly correlated with post-transplant hospital LOS, but not with delisting/mortality or post-transplant 6MWD. In study 3, the impact of pre-transplant skeletal muscle mass and function on post-transplant functional independence, HRQL, and 6MWD was evaluated in a select group of lung transplant recipients with prolonged mechanical ventilation (â Ľ 7 days). Age and intensive care unit (ICU) LOS were the only determinants of early post-transplant functional recovery, highlighting the importance of ICU-acquired morbidity. In summary, these studies demonstrate that skeletal muscle function is an important marker of pre-transplant daily function and predicts post-transplant hospital LOS, but is not a significant predictor of post-transplant function or mortality. Future studies should examine whether targeted rehabilitation strategies in the pre-transplant period may improve daily function and early post-transplant outcomes.Ph.D
Skeletal Muscle Dysfunction in Lung Transplant Patients
No full textLung transplantation improves health-related quality of life (HRQL), daily function and survival for individuals with advanced lung disease. However, lung transplantation is now offered to older and more complex patients who are at a higher risk of skeletal muscle dysfunction; the implications of which remain uncertain. The overall objective was to assess how elements of muscle dysfunction (mass, strength and function) are associated with pre- and post-transplant physical function, HRQL, and clinical outcomes. We hypothesized that pre-transplant skeletal muscle dysfunction would be associated with impairments in pre-transplant HRQL, activities of daily-living (ADL), six-minute walk distance (6MWD), and worse post-transplant functional recovery with increased pre- and post-transplant mortality. Three studies targeting the pre- and post-transplant periods were undertaken. In study 1, a novel method of muscle mass quantification using computed tomography (CT) was retrospectively evaluated in 527 lung transplant candidates. CT muscle cross-sectional area in transplant candidates was 10% lower than age and sex-matched controls and independently associated with 6MWD, strength training volumes and post-transplant hospital length of stay (LOS), but no association was observed with pre- or post-transplant mortality. In study 2, muscle mass assessed with bio-electrical impedance, quadriceps strength, and function (Short Physical Performance Battery, SPPB) were prospectively evaluated in 50 lung transplant candidates. Quadriceps strength and SPPB were associated with pre-transplant HRQL, ADL, and 6MWD. Number of muscle deficits (mass, strength and/or function) was directly correlated with post-transplant hospital LOS, but not with delisting/mortality or post-transplant 6MWD. In study 3, the impact of pre-transplant skeletal muscle mass and function on post-transplant functional independence, HRQL, and 6MWD was evaluated in a select group of lung transplant recipients with prolonged mechanical ventilation (â Ľ 7 days). Age and intensive care unit (ICU) LOS were the only determinants of early post-transplant functional recovery, highlighting the importance of ICU-acquired morbidity. In summary, these studies demonstrate that skeletal muscle function is an important marker of pre-transplant daily function and predicts post-transplant hospital LOS, but is not a significant predictor of post-transplant function or mortality. Future studies should examine whether targeted rehabilitation strategies in the pre-transplant period may improve daily function and early post-transplant outcomes.Ph.D
Quality of Life in Lung Transplantation
No full textImproving health-related quality of life is an important goal of lung transplantation. This review describes background concepts, including definitions, measurement and interpretation of health-related quality of life (HRQL), and other patient-reported outcomes. Lung transplantation is associated with dramatic and sustained improvements in HRQL, particularly in measures of physical health and functioning. Physical rehabilitation may augment the early improvements in HRQL, whereas bronchiolitis obliterans syndrome and psychological conditions have a negative impact. More research is needed, particularly longitudinal, multicenter studies, to better understand the trajectory and determinants of HRQL after lung transplantation, and the impact of targeted interventions to improve HRQL
Rescue craft davit performance on an FPSO in heavy sea states & davit design proposal
No full textThe aim of this research is to increase the workability of a rescue craft launch and retrieval system on FPSOs in heavy sea states. Although a rescue craft’s purpose is to improve safety, multiple incidents recorded in the GISIS database have proven that the launch and recovery operation can be dangerous or even deadly. The problem research shows that the davit system is the main cause for incidents, which are related to design flaws, lack of maintenance and human errors, the three parameters for a successful launch. The opinion of the author is that a different type of launch and recovery system can lead to improvement of these three parameters and to an increased workability of the system. To compare a new design with the conventional design, a computational model of both designs is built in Matlab to simulate the launch of a rescue craft from an FPSO in various sea states. The conventional model shows dangerous accelerations in high sea states and the risk to collide with the hull of the FPSO. The concept design aims to reduce these motions and, in addition, provide a more redundant design with easy maintenance and focused on reducing human errors. After comparison, the concept design proves to reduce dangerous motions during launch and increase the workability in high sea states, while being very simplistic, robust and easy to operate. However, in the splash zone the concept model does not mitigate dangerous motions sufficiently. To further substantiate this conclusion, it is advised to further investigate the splash zone model and to develop a more detailed model of the concept design
Acupuncture for IVF and assisted reproduction : an integrated approach to treatment and management /
No full textIncorporating orthodox medical theory and the existing evidenced-base for the use of acupuncture therapy, Acupuncture for IVF and Assisted Reproduction enables acupuncture practitioners to provide appropriate advice regarding diagnoses, orthodox tests and investigations, and tailor acupuncture treatment according to the stage of the fertility cycle, and associated underlying condition. An essential manual for all practitioners working in this area, or planning to do so.Includes bibliographical references and index.Incorporating orthodox medical theory and the existing evidenced-base for the use of acupuncture therapy, Acupuncture for IVF and Assisted Reproduction enables acupuncture practitioners to provide appropriate advice regarding diagnoses, orthodox tests and investigations, and tailor acupuncture treatment according to the stage of the fertility cycle, and associated underlying condition. An essential manual for all practitioners working in this area, or planning to do so.Print version record.Front Cover; Dedication ; Acupuncture for IVF and Assisted Reproduction: An Integrated Approach to Treatment and Management ; Copyright ; Contents ; Biographies ; IRINA SZMELSKYJ; LIANNE AQUILINA; ALAN SZMELSKYJ; Foreword ; Preface ; Acknowledgements ; Chapter 1: Subfertility overview; Introduction; Definition of Infertility Disorder; Definition of pregnancy; Definition of regular intercourse; Length of time to achieve pregnancy; Implications; Prevalence of Infertility; Infertility trends; Infertility treatment seeking; Major Causes of Subfertility from an Orthodox Medical Point of View.Common medical causes of subfertility presenting in acupuncture practiceImportance of treating both male and female partners; Contributory Subfertility Factors: The Orthodox Medical Perspective; Socioeconomic factors; Delayed parenthood; Education and financial status; Political policies; Healthcare spending; Traditions, culture, and family values; Environmental factors; Occupational factors; Overview of other factors; Increased stress levels; Nutrition, weight, and exercise; Early puberty; Sexual intercourse; Reproductive tract infections; Negative lifestyle habits.Causes of Subfertility from the TCM Point of ViewInternal causes of disease/injury through emotion; Anger; Contemplation or worry; Anxiety; Fear; Sadness and grief; Guilt; Interrelationship between the emotions, the body, and the Spirit; External causes of disease; Cold EPF; Heat/Fire EPF; Damp EPF; Miscellaneous causes of disease; Constitution; Inappropriate diet; Surgery; Social, recreational, and physical overexertion; Work and rest; Previous fertility treatment; Miscarriages; Coitus and family planning; Contraception; Summary of the causes of diseases in subfertility.Reproductive History and Development from an Orthodox Medical PerspectiveReproductive History and Development from a TCM Perspective; View and worship of fertility; Works of classical Chinese medicine physicians; Recognition by Chinese medicine of some of the fundamental concepts of fertility; Fertile window and intercourse timing; The effect of age on fertility; Importance of optimizing natural fertility; Integrated approach; Summary; References; Chapter 2: Anatomy and physiology of the reproductive system: Prerequirements for conception.Functional Anatomy of the Reproductive System from an Orthodox Medical PerspectiveFemale reproductive anatomy; The ovaries and follicles; The fallopian tubes; Uterus; Vagina; Abnormalities of the female reproductive anatomy; Ovarian factors; Tubal factors; Uterine factors; Male reproductive anatomy; Testes; Epididymides; Vas deferens; Seminal vesicles; Ejaculatory ducts, prostate gland, and prostatic urethra; Urethra; Penis; Abnormalities of the male reproductive anatomy; Sperm and Egg Production; Spermatogenesis and spermiogenesis; Structure of sperm; Oogenesis; Structure of the egg.Elsevie
An Opposition Commentary
No full textThe author, being the MP for Panmure and Labour Associate Spokesperson for Justice, provides a commentary on Rt Hon Justice Hardie Boys' paper, "Judicial Attitudes to Family Property". The author adopts the view of her predecessor Lianne Dalziel and the Labour Women's Council: that the law should recognise the changes in family patterns in New Zealand and should acknowledge the intent of the Human Rights Act 1993 to outlaw discrimination on the basis of marital status and sexual orientation. 
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