Respiratory Aids Research Articles

Knowledge The Use of Continous Positive Airway Pressure (CPAP) In Neonatus

CPAP maintains the positive pressure of the baby's airways during spontaneous, simple, and effective breathing. The use of CPAP decreases breathing difficulties, reduces dependence on oxygen, helps repair and maintains lung residual capacity, prevents upper airway obstruction and prevents lung collapse. Good CPAP behaviour reduces the risk or complications that occur in neonates such as nasal injuries, pneumothoracs and gastric distension. The purpose of this study was to determine the relationship of knowledge with CPAP usage behaviour in neonates in the NICU room at X Bekasi Hospital and Depok Y Hospital. Quantitative research methods, descriptive analytic design. A total sampling of 30 nurse respondents worked in the NICU room in X Bekasi Hospital and Depok Y Hospital. Measuring instruments using a questionnaire. Statistical tests with Chi Square, Kendals Tau B and Kendals Tau C. The results of the majority of respondents aged 26-35 years 53.3%, D3 Nursing education 90%, working period between 1-5 years 40%, and those who have attended training 73 , 3%. There was no significant relationship between age (p = 0.136), education (p = 0.897), years of service (p = 0.099), training (p = 0.322), knowledge (p = 0.284) with CPAP usage behaviour in neonates. It is hoped that this research can improve nurses 'knowledge in caring for neonates by using respiratory aids, CPAP by conducting continuous training to improve nurses' behaviour in preventing complications.Keywords: neonates, knowledge, CPAP usage

Hak Waris Pemohon Euthanasia Pasif menurut Hukum Islam (Studi tentang Maqāṣid al-Syarī‘ah)

Such rapid development of science and technology lately resulted in such rapid changes in the social life of the human culture, one of which is medical field. But although there has been no progress there may be some problems that have not been solved by human beings, such as the discovery of drugs or a potent bidder to cure deadly diseases such AS AIDS, cancer, and other malignant diseases. These deadly diseases are a reason for someone to end his life from having to endure a long time ill one of them by asking for family assistance to end his life, which in medicine is called euthanasia. This research aims to determine how the position of passive euthanasia and birthright position for applicants of euthanasia passive according to Islamic law when viewed in terms of maqāṣid al-Syarī'ah. This research is done by collecting the library materials in the form of books, encyclopedia, and scientific works related to this discussion. The results of this study gave the answer that stopping the treatment, or releasing the organ and respiratory aids from the sick or euthanasia passive the law may but only in the case of the sick suffer the death of the brainstem. Because while using these tools is contrary to sharia teachings among them, postponing the management of dead and its funeral without emergency reasons, postponing the division of inheritance and resigning the time of his wife. Therefore, the birthright position for the heir or the family that asks or plea for passive euthanasia is not hindered by the heir. Because the passive euthanasia in this case is not classified as an act of murder.

Orthodontic plate for management of obstructive sleep apnoea in infants with Pierre Robin sequence: experience and protocol in Hong Kong.

To present the application of the pre-epiglottic baton plate (PEBP) in infants with Pierre Robin sequence (PRS) in the Southern Chinese population (Hong Kong) and to present the diagnosis and management protocol of these infants in our centre. Retrospective case series of three patients with PRS. Neonatal Intensive Care Unit in Kwong Wah Hospital and Craniofacial Orthodontic Centre in United Christian Hospital, Hong Kong. Three new-born infants (two girls, one boy) with PRS and upper airway obstruction due to glossoptosis. A protocol for the diagnosis and management of these infants in the Southern Chinese population (Hong Kong) was presented. The three patients received nasal high-flow oxygen and/or continuous positive airway pressure (CPAP) as first-line respiratory support, followed by PEBP for 3-5 months. A two-stage approach was undertaken to ensure accurate positioning of the PEBP. All three infants had improvement in clinical signs, symptoms and polysomnography upon discharge. PEBP and other respiratory aids were weaned off at 3-6 months. The PEBP, combined with other respiratory support, is a useful modality in the treatment of obstructive sleep apnoea in infants with PRS.

FUKUYAMA CONGENITAL MUSCULAR DYSTROPHY: P.343Complications of Fukuyama congenital muscular dystrophy revealed from a nationwide registry

Clinical characteristics Fukuyama congenital muscular dystrophy (FCMD) is characterized by hypotonia, symmetric generalized muscle weakness, and CNS migration disturbances that result in changes consistent with cobblestone lissencephaly with cerebral and cerebellar cortical dysplasia. Mild, typical, and severe phenotypes are recognized. Onset typically occurs in early infancy with poor suck, weak cry, and floppiness. Affected individuals have contractures of the hips, knees, and interphalangeal joints. Later features include myopathic facial appearance, pseudohypertrophy of the calves and forearms, motor and speech delays, intellectual disability, seizures, ophthalmologic abnormalities including visual impairment and retinal dysplasia, and progressive cardiac involvement after age ten years. Swallowing disturbance occurs in individuals with severe FCMD and in individuals older than age ten years, leading to recurrent aspiration pneumonia and death. Diagnosis/testing The diagnosis of FCMD is established in a proband by identification of biallelic pathogenic variants in FKTN on molecular genetic testing. Management Treatment of manifestations: Physical therapy and stretching exercises, treatment of orthopedic complications, assistance devices such as long leg braces and wheelchairs, use of noninvasive respiratory aids or tracheostomy, prompt treatment of acute respiratory tract infections, antiepileptic drugs, medical and/or surgical treatment for gastroesophageal reflux, gastrostomy tube placement when indicated to assure adequate caloric intake, cardiomyopathy treatment as per cardiologist. Surveillance: Monitor: Respiratory function in individuals with advanced disease; For myocardial involvement by chest x-ray, ECG, and echocardiography in individuals older than age ten years; Gastrointestinal function, and for signs/symptoms of gastroesophageal reflux; For foot deformities and scoliosis. Genetic counseling FCMD is inherited in an autosomal recessive manner. At conception, each sib of an affected individual has a 25% chance of being affected, a 50% chance of being an asymptomatic carrier, and a 25% chance of being unaffected and not a carrier. Carrier testing for at-risk family members and prenatal diagnosis for pregnancies at increased risk are possible if the pathogenic variants in the family are known.

Efektifitas Penggunaan Karbon Aktif Sebagai Filter Kompresor Untuk Penyelam Tradisional

The livelihood of the Indonesian people in the prominent grasslands is fishermen. Traditional fishermen to get a lot of fish, they use it using respiratory aids. Safety, the working health of traditional divers who breathe the burnt compressor and need to be handled properly because it can cause health problems and even death. The use of carbon as a filter that allows you to improve health status and prevent the death of traditional divers. For this reason, this study aims to prove the effectiveness of using filter filters on traditional divers. The method used to determine the concentration of O2 & CO2 gas in the economy on examination using sample gas before and after being given an activated carbon filter with a sample of 20 respondents. Statistical tests using Mann Whitney. The use of activated carbon filters has no effect on respiratory aids in traditional divers as evidenced by the Mann Whitney test showing p values at oxygen levels = 0.842 and p values at carbon dioxide levels = 0.300 ((p> α = 0.05). Activated carbon cannot be used as a respiratory aid for traditional divers and settlement of divers in traditionally carrying out effective and routine maintenance. Keywords: Traditional Divers, Compressors, Filters, Activated Carbon

Scoliosis severity in cerebral palsy patients is associated with increased need for respiratory assistive aids

Scoliosis severity in cerebral palsy patients is associated with increased need for respiratory assistive aids

Differences in mortality by educational level in Italy (2012-2014)

to evaluate socioeconomic inequalities in mortality by educational level in Italy. cohort study based on the record linkage between the 2012-2014 archives of mortality and the 2011 Italian population Census. Italian population registered in the 2011 Census. life expectancy by educational level, age-standardized mortality rates, mortality rate ratios (MRRs) for overall mortality, and 12 groups of causes of death. life expectancy at birth was 80.3 years among men and 84.9 among women. High-educated men were expected to live 3 years longer than lower educated men, while the gap was narrower in women (1.5 years). Lower educated men had a higher mortality from any cause (MRR: 1.34; 95%CI 1.33-1.35) with larger differentials for lung, upper aerodigestive, and liver cancers, respiratory system diseases, AIDS and accidents. Socioeconomic inequalities were larger in the North-West of the Country for lung and liver cancer. Educational inequalities were smaller among women for all-cause mortality, but remarkably larger for circulatory system diseases (MRR: 1.40; 95%CI 1.38-1.42), particularly in the South (MRR: 1.46; 95%CI 1.42-1.50). this study documented socioeconomic inequalities in mortality in Italy for many causes of death; some of them resulted heterogeneous by area of residence. Most of the inequalities can be counteracted with specific measures aimed to improve behavioural risk factors among less educated people.

Torque Teno Virus (TTV) Among β-Thalassemia and Haemodialysis Patients in Mazandaran Province (North of Iran).

Torque Teno virus (TTV) is a transfusion transmitted virus that seems to be involved in several complications such as acute respiratory diseases, liver diseases, AIDS, cancer, and autoimmune reactions. In the present study the frequency of TTV was investigated among β- thalassemia (BT) and haemodialysis (HD) patients (high risk patients for TTV) in Mazandaran province, Iran. DNA was extracted from the serum of 82 BT and 100 HD patients, and nested PCR method was applied to detect TTV DNA. The aspartate transaminase(AST) and alanine transaminase (ALT) enzyme levels in BT patients were measured using photometric assay. The mean age of BT and HD patients as 23.4±5.4 and 48.8±8.2 years, respectively. 21% of HD and 26.8% of BT patients were infected with TTV, respectively. The frequency of TTV was not significantly different between two groups of patients and there was no significant correlation between sex and TTV infection. The mean AST and ALT levels in TTV positive BT patients was not significantly higher than TTV negative cases. The present study showed that TTV prevalence in BT patients with recurrent blood transfusion was not significantly higher than HD patients. The investigation of TTV prevalence in healthy individuals is recommended to identify if transfusion or dialysis is associated with higher TTV infection. Besides, although TTV infection did not change the AST and ALT enzymes in BT patients, the liver involvement may still exist in these patients.

Feasibility Study of Interactive Game Technologies to Improve Experience with Inhaler Spacer Devices in Young Children

The correct use of inhaler devices with facemasks and spacers in young children can be difficult for both children and parents, resulting in distress for both, poor adherence and ineffective drug delivery. The aim of this study was to develop and assess the utility and impact of an interactive electronic game designed to improve the experience of spacer devices in young asthmatic children. The Respiratory Aid For Inhaler (RAFIhaler) technology consists of a smartphone mounted on a metered dose inhaler with a valved holding chamber device (spacer) and connected to an electronic sensor adjacent to the outflow valve of the spacer. A custom-designed android application on the smartphone derives the child’s breathing patterns from the sensor, translating this information into visible effects on on-screen cartoon characters. After a period of iterative development, the final structure and software design was tested on children at Royal Manchester Children’s Hospital who had been admitted with acute wheeze. A survey, including open-ended questions, was administered to assess the parent and child’s reaction to the RAFIhaler. A total of 14 children (age range 2–7 years; 7 boys) participated in the study and used the RAFIhaler, of whom 13 completed the final survey; all 14 parents completed the survey. All 13 children reported they enjoyed playing the game. Ten of these children (91%) felt that the RAFIhaler helped them in taking their medication, and 13 of the 14 parents felt that RAFIhaler helped their children use their spacer. The one parent who felt that the RAFIhaler was not of any benefit felt his/her child already used the inhaler well. Some of the benefits of the RAFIhaler specifically voiced by parents were “enjoyable” (n = 3), “good distraction” (n = 3), “made child calmer” (n = 2), “helped in breathing/inhalation technique” (n = 3) and “would be useful in home setting” (n = 1). Young children may benefit from the incorporation of devices and game applications with use of their inhalers. Feedback from children and parents suggests potential benefits to children may include learning correct use, reducing distress and anxiety and improving overall adherence.

MANAGEMENT OF THE PATIENT WITH ADVANCED AMYOTROPHIC LATERAL SCLEROSIS: THE CAREGIVER’S OPINION

Objectives. The possibility of prolonging and augmenting the quality of life of respiratory patients in end-stage disease and in particular neuromuscular disease patients depends on an increased level of care. Amyotrophic lateral sclerosis (ALS) is a neurological disease characterized by a fast progressive impairment of respiratory function which leads to mechanical ventilation and high burden of care. A specifically designed questionnaire was administered to caregivers to analyze the level of care provided to these patients in our districts. Patients and methods. The study population consisted of 70 patients (44 males and 26 females). Of the 70 patients, 46 were being treated with non-invasive ventilation and 24 with invasive mechanical ventilation. The questionnaire was divided in two parts: questions 1 to 13 investigated life conditions and 14 to 22 the quality of care provided. Results. The patients studied present a heavy burden of care and this is in relation to the quantity of respiratory aids prescribed. The symptom which created statistically significant problems for care was breathlessness, as is often reported in the literature. The presence of homecare tended to create conditions of greater serenity for the caregivers. Conclusions. This study shows that the burden of care in end-stage ALS patients is very onerous, and it can help to point out problems not sufficiently contemplated in healthcare planning.

Health and social conditions in Norwegian polio survivors: A 20-year follow-up study.

To explore the physical and social situation of the Norwegian polio population in 2014, and to compare the status of this population in 2014 with the results of a similar survey carried out 20 years previously, in 1994. The study was based on a questionnaire covering demographics, polio history, and current medical, psychological and social conditions. The questionnaire was prepared in cooperation with the National Society of Polio Survivors and others with known polio (n = 1,968). A total of 1,408 persons responded (72%), mean age 70 years (range 28-98 years). The most frequent health problems reported were muscle and joint pain, cold intolerance and insomnia. New muscle weakness and loss of muscle volume were reported more frequently in 2014 than in the 1994 study. The use of orthopaedic aids, assistive devices, ventilators and other respiratory aids had increased significantly, but 83% reported that they still had no home care or nursing services support. The 2014 polio population reported only minor subjective worsening of health and well-being compared with the 1994 cohort. The present study indicates that the elderly polio population are experiencing new muscle weakness and increasing health problems, but that the deterioration occurs slowly and with fewer consequences for the subjective experience of general health and well-being, indicating that the patients are adapting to their life situation. However, subgroups of the elderly polio population are in need of special care.

Microaggregate-associated protein involved in invasion of epithelial cells by Mycobacterium avium subsp. hominissuis

The environmental opportunistic pathogen Mycobacterium avium subsp hominissuis (MAH), a member of the nontuberculous mycobacteria (NTM) cluster, causes respiratory as well as disseminated disease in patients such as those with chronic respiratory illnesses or AIDS. Currently, there is no effective method to prevent NTM respiratory infections. The formation of mycobacterial microaggregates comprises of phenotypic changes that lead to efficient adherence and invasion of the respiratory mucosa in vitro and in vivo. Microaggregate adhesion to the respiratory epithelium is mediated in part through the mycobacterial protein, MAV_3013 (MBP-1). Through DNA microarray analysis, the small hypothetical gene MAV_0831 (Microaggregate Invasion Protein-1, MIP-1) was identified as being upregulated during microaggregate formation. When MIP-1 was overexpressed in poorly-invasive Mycobacterium smegmatis, it provided the bacterium the ability to bind and enter epithelial cells. In addition, incubating microaggregates with recombinant MIP-1 protein enhanced the ability of microaggregates to invade HEp-2 cells, and exposure to anti-MIP-1 immune serum reduced the invasion of the host epithelium. Through protein-protein interaction assays, MIP-1 was found to bind to the host protein filamin A, a cytoskeletal actin-binding protein integral to the modulation of host cell shape and migration. As visualized by immunofluorescence, filamin A was able to co-localize with microaggregates and to a lesser extent planktonic bacteria. Invasion of HEp-2 cells by microaggregates and planktonic bacteria was also inhibited by the addition of anti-filamin A antibody suggesting that filamin A plays an important role during infection. In addition, at earlier time points binding and invasion assay results suggest that MBP-1 participates significantly during the first interactions with the host cell while MIP-1 becomes important once the bacteria adhere to the host epithelium. In summary, we have unveiled one more step associated with MAH crossing the respiratory mucosa.

What are the causes of death of patients with tuberculosis: multiple causes of death in a cohort of cases and a research proposal of presumed causes

The objective of this study was to analyze the multiple causes of death in a cohort of patients with tuberculosis (TB) and to introduce an investigation proposal death for TB from a list of presumable causes. We performed a probabilistic record linkage with the databases of the Information System for Notifiable Diseases (SINAN) 2006 and the Mortality Information System (SIM) 2006-2008. There were 825 deaths, of which 23% for death for TB, deaths due to TB with 16% and 61% without mention of TB. Two hundred and fifteen (42.7%) deaths occurred within the period of treatment, whose profile differed from the pattern of causes when TB was an associated cause, with high frequency of respiratory diseases, AIDS and ill-defined causes. We elaborated a proposal for correction of associated causes of death and an investigation proposal death for TB from a list of presumable causes. According to the proposal, 26 deaths could have modified the underlying cause. This study highlights the importance of record linkage to TB surveillance and improvement of information the SIM and SINAN.

P96 A New Interactive Game Device May Improve Compliance With Spacer Devices In Very Young Children

Background The use of spacers in young children is not always easy and can result in distressed children and parents. We aimed to develop and assess an interactive electronic game to improve ease of use and potentially compliance with inhalers in young children. Methods The Respiratory Aid For Inhalers (RAFIhaler) consists of an electronic sensor adjacent to the outflow valve of a spacer mask, providing input every 0.1 seconds to a custom designed android application on a smartphone that is mounted, in full view of the child, on top of the spacer. The application displays on-screen characters designed to respond to correct breathing as part of a game storyline, for example by blowing away characters unfriendly to the hero (RAFI) or blowing his boat across a river. The RAFIhaler was developed through iterative testing and multiple redesigns of hardware and software until a satisfactory final module was completed. This module was tested on 14 children admitted to hospital with acute wheeze by an independent researcher, along with a survey to assess the child’s reaction and the parent and child’s perceived benefit from RAFIhaler. Open-ended questions allowed further feedback. Results Fourteen children (2–7 yrs, 7M:7F) participated; 13 children and 14 parents completed the survey. All children stated they enjoyed the activity. Eleven children responded further; 10(91%) felt the RAFIhaler helped them taking medication. All but one parent felt that RAFIhaler helped their child use the spacer. Of the thirteen parents who felt the RAFIhaler helped, three felt their child previously really struggled with the inhaler. Some benefits of RAFIhaler voiced by parents were: enjoyable (3); good distraction (3); made child calmer (2); helped in breathing/inhalation technique (3); would be useful at home (1). One parent felt RAFIhaler was not of benefit as they felt their child already took their inhaler well. Conclusions Children universally found using the RAFIhaler with their spacer enjoyable. The majority of parents felt the RAFIhaler helped their child take their medicine. The RAFIhaler may be of use both in encouraging young children to use their inhaler/spacer, and in combatting anxiety and stress associated with their use.

Physiotherapy in the Management of Post-Operative Pulmonary Complications: A Critical Review of Literature

Introduction : Postoperative pulmonary complications are the leading cause of postoperative morbidity and mortality and increase in the length of stay in hospital, medical consumption, and expenses. Physiotherapy treatment for patients with post-operative pulmonary complications consists of a variety of interventions which includes lung expansion exercises, secretion clearance techniques, limb exercises, progressive mobilisation programs, and other techniques. Aims&Objectives : To explore and present the evidence of the effectiveness of physiotherapy in the management of PPCs, the barriers for physiotherapy in critical care, the techniques and the physiological effects of Physiotherapy through a literature based review. Search Method : All relevant databases like AMED, CINAHL, PUBMED and Cochrane databases for systematic reviews were searched and evaluated to find the relevant researches on the topic. Conclusions : Non-invasive respiratory muscle aids are recommended in the treatment of atelectasis and pneumonia that occur after abdominal surgery.

Biochemical Analysis and Application of Molecular Display Technology on <i>Candida albicans</i> for Diagnosing and Preventing Candidiasis

Medical facilities and advances in therapeutics have improved world over in recent times. Concomitant with this, the human population has been growing steadily. However, emerging infectious diseases such as severe acute respiratory syndrome (SARS) and AIDS, as well as re-emerging infectious diseases such as Japanese encephalitis and dengue fever, have been spreading in recent times. Three major infectious diseases, namely AIDS, malaria, and tuberculosis, are killing around 8 million people in the world annually. Although drugs effective against these infectious diseases are available at present, drastic therapeutics have not been developed yet. In addition, vaccines against these diseases often cannot prevent infections, because pathogenic viruses or bacteria evade the immune system of the host. Many diseases and emerging infections of pathogenic bacteria cannot be controlled by conventional pharmaceutics. These pathogens secrete regulatory factors. When the produced regulatory factor attains a certain level, an active factor is then produced by the pathogen to destroy the host. Considering these phenomena, we thought investigating characteristic regulatory or active factors will pave the way for developing novel vaccines or diagnostic drugs. Therefore, candidiasis was selected as a model, and application of the secretory protease of Candida albicans was examined for the development of novel drugs. Screening of novel candidates of antigens of C. albicans and vaccine development are also underway. In this paper, our strategy of platform technology against various infectious diseases are introduced.

Oxygen saturation after birth in preterm infants treated with continuous positive airway pressure and air: assessment of gender differences and comparison with a published nomogram

AimsThe goal of the study was to compare preductal SpO2 in the first 10 min after birth in preterm infants treated with non-invasive continuous positive airway pressure (CPAP) and air...

Fatores associados à displasia broncopulmonar em prematuros sob ventilação mecânica precoce

OBJETIVOS: descrever os fatores neonatais e de assistência ventilatória associados à displasia broncopulmonar (DBP), e verificar sua frequência em recém-nascidos prematuros submetidos à ventilação mecânica (VM) na primeira semana de vida. MÉTODOS: coorte retrospectiva, realizada em Unidade de Terapia Intensiva Neonatal. Foram analisados prontuários de 86 prematuros, sob VM na primeira semana de vida e registrados dados neonatais, parâmetros da VM e sua relação com a DBP. Para verificar a associação entre as variáveis do estudo e a DBP utilizou-se o teste do qui-quadrado e o Exato de Fisher quando indicado. O teste t e o Kruskal Wallis foram utilizados para a comparação das médias das variáveis contínuas. RESULTADOS: a DBP ocorreu em 17,4%. Foram relacionados à doença: menor peso ao nascer e idade gestacional, Apgar <7 no 1º e 5º minutos, maior tempo sob antibioticoterapia, nutrição parenteral e VM, valores elevados de fração inspirada de oxigênio (FiO2), VM como primeiro suporte respiratório, menor volume de nutrição enteral e ganho ponderal . Não houve diferença nos níveis de pressão positiva inspiratória, pressão positiva expiratória final e diferença de pressão. CONCLUSÕES: a ocorrência da DBP foi baixa e relacionada ao manejo clínico e nutricional e VM precoce e prolongada. Excetuando-se a FiO2 média não foi encontrada relação entre a doença e os demais parâmetros ventilatórios.

Double trouble: Spinal muscular atrophy type II and seropositive myasthenia gravis in the same patient

Autosomal recessive proximal spinal muscular atrophy is caused by deletions in the survival of motor neuron (SMN1) gene, while autoimmune myasthenia gravis is an acquired disorder. An association between these two diseases has not been reported. Our patient with intermediate spinal muscular atrophy (SMA type II) did not need alimentary or respiratory aid until age 51 when he suddenly developed bulbar weakness and respiratory insufficiency. Seropositive myasthenia gravis was confirmed and the corresponding symptoms resolved on treatment.

Pulmonary Rehabilitation for Patients with Paralytic Condition

Paralytic condition is a kind of respiratory impairment, which mainly features global alveolar hypoventilation. This condition comprises spinal cord disorders and motor unit diseases, and may also include patients undergoing sedation. Although patients with paralytic and obstructive conditions are both candidates for comprehensive pulmonary rehabilitation, the approach used to treat either condition differs considerably. Patients with paralytic condition often lose their inspiratory and expiratory muscle strength. They need physical medicine respiratory aids, and they should be managed to maintain lung and chest wall compliance, cough ability sufficient enough to clear secretions, and ventilation. Noninvasive positive pressure ventilation and related aids are widespread in the treatment of these conditions. Appropriate use of these methods is very important in order to prolong and maintain quality of life. Impairment of bulbar function and intelligence, and disease progression should also be considered in rehabilitation for such individuals. Although establishing a system for the rehabilitation team is important, the present conditions locally are insufficient to provide this care. Several clinical guidelines have been published to spread information on the methods to treat patients. We are planning to develop new guidelines that include the necessary care required for paralytic condition patients, thereby hoping to spread this rehabilitation system.