Download or read book Effets cliniques biologiques et aspects techniques de la ventilation non invasive written by Jean-Christian Borel and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: L'hypoventilation alvéolaire chronique est considérée comme un marqueur d'évolution péjorative de différentes pathologies respiratoires. Cependant, son rôle physiopathologique dans différentes dysfonctions systémiques n'a pas été étudié de manière convaincante. Cette thèse avait pour but d'investiguer les conséquences de l'hypoventilation alvéolaire modérée au cours de l'insuffisance respiratoire chronique restrictive et les effets de son traitement par ventilation non-invasive. Nous avons montré que des patients affectés d'un syndrome obésité-hypoventilation (SOH) avaient une fonction endothéliale plus sévèrement altérée et une inflammation systémique plus importante que les patients obèses simples. La PaCO2 était corrélée à la dysfonction endothéliale (Borel et coll, manuscrit en préparation). Nous avons observé que la proportion d'hypoventilation en sommeil paradoxal, chez les sujets SOH, était associée à une réponse ventilatoire au CO2 abaissée et une somnolence diurne excessive. Pour la première fois, nous avons constaté que la ventilation non invasive nocturne améliorait la vigilance diurne objective (Chouri-Pontarollo et coll, Chest 2007). Nous menons actuellement la première étude randomisée du traitement des patients porteurs d'un SOH par VNI versus observation pendant un mois. L'analyse intermédiaire montrait qu'un mois de VNI nocturne chez les patients SOH améliorait la PaCO2 diurne, la capacité pulmonaire totale, la structure du sommeil, cependant aucun paramètre cardiovasculaire et métabolique n'était modifié.Chez des patients insuffisants respiratoires chroniques pariéto-restrictifs, la VNI utilisée au cours d'un exercice aigu, augmentait la ventilation et améliorait la tolérance à l'effort (Borel et coll, Resp Med 2008). Chez ces mêmes patients, un réentrainement à l'effort sous VNI n'apportait pas de bénéfices additionnels par rapport à un réentrainement en ventilation spontanée sauf chez les patients les plus sévères. Ces derniers, amélioraient leur périmètre de marche et leur qualité de vie. Leur fatigue en particulier était améliorée s'ils s'étaient réentraînés sous VNI (Borel et coll, Am Journal of physical med and rehab, 2008, soumis). Enfin, nous avons analysé l'impact des fuites intentionnelles des masques de VNI sur la performance des appareils de VNI bi-pressionnels. L'augmentation des fuites intentionnelles diminuait les capacités des appareils à atteindre et maintenir la pression de consigne. Ceci pouvait conduire à une diminution du volume délivré au patient, en particulier pour des fuites intentionnelles supérieures à 40 L.min-1 à 14 cm H2O de pression (Borel et al, Chest, sous presse). Conclusion : L'hypoventilation alvéolaire chronique peut-être considéré comme un déterminant physiopathologique de la dysfonction endothéliale, de l'inflammation, de la somnolence, et de l'intolérance à l'effort. La VNI, utilisée au cours des efforts, permet d'améliorer les capacités d'exercice et la qualité de vie des patients insuffisants respiratoires restrictifs les plus sévères. Malgré les limites technologiques des appareils de VNI bi-pressionnels utilisés actuellement, la VNI corrige l'hypoventilation alvéolaire des patients SOH, cependant les effets sur l'inflammation, la dysfonction endothéliale restent incertains à cours et long terme chez ces sujets obèses.
Download or read book Agrindex written by and published by . This book was released on 1990 with total page 686 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Organ Shortage The Solutions written by J.-L. Touraine and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 375 pages. Available in PDF, EPUB and Kindle. Book excerpt: Organ Shortage: The Solutions is the latest subject in the Continuing Education series, organized by Fondation Marcel Mérieux and Université Claude Bernard in Lyon. The annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments.
Download or read book Exercise Intolerance and Muscle Contracture written by Georges Serratrice and published by Springer Science & Business Media. This book was released on 1999-06 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: The main themes presented in this volume are exercise intolerance and muscle contracture. This comprehensive and updated volume allows neurologists, specialists in internal medicine, rheumatologists, pathologists, biochemists, physiatrists and all researchers interested in neuromuscular diseases to become familiar with many new and homogen data concerning exercise intolerance and muscle contracture.
Download or read book Urolithiasis written by and published by Springer. This book was released on 2011-11-17 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the early days of medicine one concern of doctors has been the removal of kidney stones and prevention of recurrence. Owing to the hesitancy of progress in the prevention of initial stone formation and of relapse, however, removal of stones from the kidney and ureter were developed to highly refined techniques and they formerly accounted for a major proportion of the urological operations performed. In the last few years developments in the treatment of kidney stones have taken a completely different turn. In the majority of cases suit able methods are available to bring about spontaneous passage of the stones, while in a smaller proportion drug-induced litholysis is pos sible. Stones that cannot be passed are now treated mainly with extra corporeal shockwave lithotripsy, percutaneous litholapaxy or uretero renoscopy. These methods are often used in combination and comple ment each other. Nonetheless, despite the accumulating experience with the new methods there will still be situations in which stones can not be removed except by open surgery. "Our skill as surgeons and the management of the brilliantly designed equipment would amount to nothing more than highly skilled mechanical work if they did not go hand in hand with enhanced insight into the cause of lithiasis and thus into ways of preventing it - or at least of preventing the relapse that is the lot of most patients.
Download or read book Management of the Difficult and Failed Airway Second Edition written by Orlando Hung and published by McGraw-Hill Education / Medical. This book was released on 2011-12-07 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: Meet the clinical challenge of the difficult and failed airway with this updated full-color guide A Doody's Core Title for 2015! Includes DVD with airway techniques! "This beautifully illustrated and extensively referenced textbook provides a comprehensive review of the available options for airway management....For the busy clinician, this book provides the most up-to-date review available of the many innovations that have been introduced in the past 10 years."--Steven L. Shafer, MD, Columbia University Written by the founders of The Difficult Airway Course: AnesthesiaTM and utilizing an instructive case-based approach, this text/DVD presents all of the leading-edge principles, tools, and procedures of airway assessment and management. The scope of the book encompasses the many airway devices that have been developed since the publication of the first edition, many of which have the potential to markedly enhance airway management. Extensively revised and updated, the second edition of Management of the Difficult and Failed Airway emphasizes how airway management is context-sensitive: included are strategies for treating patients in a range of settings, from prehospital care to the ER, as well as proven techniques for special patient populations. In addition, new chapters have been added to further refresh the book’s content and provide you with a solid grasp of the most critical topics in this fast-evolving area. The book’s effective organization has been maintained, beginning with the first section’s focus on the basic foundations of difficult and failed airway management. The second section reviews must-know airway devices and techniques, while the third part of the text introduces case studies that thoroughly examine the application of these techniques in complex clinical situations. A final section covers the practical considerations, such as difficult airway carts and teaching and simulation in airway management. FEATURES Skill-building, case-based approach highlights the right tools and techniques for stabilizing the patient, plus important safety precautions relevant to the clinical setting New “context-sensitive” focus links airway techniques to specific clinical environments, including airway cases in prehospital care, the emergency department, the critical care unit, and the operating room Essential new chapters cover the fundamental principles of bag-mask-ventilation, single lung ventilation using double lumen tubes, and airway management in austere environments, in addition to airway education and simulation Mnemonics, easy-to-follow algorithms, and alternative strategies (Plan A, Plan B, etc.) in every chapter reinforce pivotal concepts Chapter-ending questions offer effective self-assessment Accompanying DVD with instructive video visually explains common procedures in a learn-as-you-go style
Download or read book Global Burden of Disease and Risk Factors written by Alan D. Lopez and published by World Bank Publications. This book was released on 2006-04-02 with total page 511 pages. Available in PDF, EPUB and Kindle. Book excerpt: Strategic health planning, the cornerstone of initiatives designed to achieve health improvement goals around the world, requires an understanding of the comparative burden of diseases and injuries, their corresponding risk factors and the likely effects of invervention options. The Global Burden of Disease framework, originally published in 1990, has been widely adopted as the preferred method for health accounting and has become the standard to guide the setting of health research priorities. This publication sets out an updated assessment of the situation, with an analysis of trends observed since 1990 and a chapter on the sensitivity of GBD estimates to various sources of uncertainty in methods and data.
Download or read book Extracorporeal Life Support for Adults written by Gregory A Schmidt and published by Humana. This book was released on 2016-08-23 with total page 269 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents a concise, evidence-based review of extracorporeal life support (ECLS) for adult diseases. It describes the use of ECLS with patients who are experiencing severe hypoxemic respiratory failure (ARDS and pneumonia), ventilatory failure (status asthmaticus and COPD), cardiogenic shock and circulatory or gas exchange failure following complications in cardiothoracic surgery, as well as its use as a bridge to lung transplant. Historically, clinicians have used ECLS as a last resort; however, this text details the technological improvements, evidence of improved outcomes and adverse consequences of alternative treatments that are causing this modality to be more commonly adopted. Topics include a description of the complex physiology and technology underlying ECLS; the evidence base for its use in specific clinical conditions; vascular access techniques; daily management of the circuit and patient; guidance regarding the weaning and decannulation process and recommendations for crisis management and rehabilitation related to ECLS. Extracorporeal Life Support for Adults is ideal reading for practicing physicians, nurses, perfusion specialists, therapists and critical care trainees who are considering whether to refer their patients for ECLS or are already providing ECLS and are seeking a practical reference to best practices and updated information.
Download or read book Atlas of Procedures in Neonatology written by Mhairi G. MacDonald and published by Lippincott Williams & Wilkins. This book was released on 2012-10-08 with total page 449 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Atlas of Procedures in Neonatology, Fifth Edition, provides detailed, step-by-step instructions on procedures performed in the neonatal intensive care nursery. In an easy-to-follow outline format, with more than 450 drawings and clinical photographs, the book presents clear, current information on indications, preparation, technique, precautions, and how to avoid potential complications. New for this edition: New chapters covering: Brain and Whole Body Coolling; Bubble CPAP; Educational Principles of Simulation Based Procedure Training to help you stay updated on the latest technology and information Access to free online companion website that includes fully searchable text, image bank and videos so you can access the content anytime, anywhere Video collection has been expanded to include: lumbar puncture, intraosseous infusion, bubble CPAP and pericardiocentesis for both commonly performed procedures and vital emergency procedures
Download or read book Neonatal Encephalopathy and Cerebral Palsy written by American College of Obstetricians and Gynecologists. Task Force on Neonatal Encephalopathy and Cerebral Palsy and published by American College of Obstetricians and Gynecologists Women's Health Care Physicians. This book was released on 2003 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: This monograph explores the mechanisms and timing of possible etiologic events that contribute to fetal and neonatal neurologic injury. the report presents evidence that most cases of cerebral palsy are a result of multifactorial and unpreventable causes that occur during fetal development or in the newborn after delivery, and not a result of an isolated intrapartum hypoxic event. the report contains a set of criteria that may be used to define (or rule out) an acute intrapartum hypoxic event sufficient to cause or suggest cerebral palsy.
Download or read book Bibliography on Smoking and Health written by and published by . This book was released on 1982 with total page 590 pages. Available in PDF, EPUB and Kindle. Book excerpt: Annual cummulation of Smoking and Health Bulletin, -1988.
Download or read book Limitations Neurologiques Des Op rations A riennes written by North Atlantic Treaty Organization. Advisory Group for Aerospace Research and Development. Aerospace Medical Panel. Symposium and published by . This book was released on 1996 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Critical Care Ultrasonography written by Alexander Levitov and published by McGraw Hill Professional. This book was released on 2009-09-04 with total page 399 pages. Available in PDF, EPUB and Kindle. Book excerpt: A complete, hands-on guide to successful image acquisition and interpretation at the bedside Written by top practitioners in the field, this comprehensive book is filled with practical guidance that helps you master clinical ultrasonography in a critical care environment. Here, you’ll learn exactly how to utilize diagnostic ultrasound as part of the physical exam, as the book examines current evidence supporting its use in the critically ill adult and child. Organized by body system, Critical Care Ultrasonography features self-contained chapters that can be used as individual reference guides for a range of interventions, from transthoracic echocardiography to echocardiagraphic evaluation of cardiac trauma. Through this in-depth coverage, you’ll get a sense of how this essential technology supports the cross-disciplinary nature of critical care. The book’s authoritative content is reinforced throughout by a full-color presentation and hundreds of concept-clarifying illustrations, figures, and images. Features Comprehensive coverage of the fundamentals of ultrasound use in critical care Guidance on ultrasound procedures enables practitioners to use ultrasound for vascular and axial procedures, improving safety and ensuring that nationally recognized compliance standards are upheld Cardiac ultrasound chapters help you assess and monitor the patient’s cardiopulmonary status non-invasively Chapter on Neck and Upper Respiratory Ultrasound offers an overview of little-known techniques that have not been comprehensively described in any other source Full-color presentation, with 495 illustrations that emphasize the basic skills required to visualize anatomic structures and interpret findings
Download or read book Pulmonary Infection written by Mieczyslaw Pokorski and published by Springer. This book was released on 2015-06-16 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The respiratory tract is a frequent target of infections caused by a wide range of organisms. The book provides reader-friendly information on aspects of pulmonary infections, including comprehensive accounts of bacterial and viral diseases, therapeutic approaches, molecular and classical culture-related techniques of diagnosis and explaining the basic cell biological mechanism. The role of oxidative stress, both helpful in fighting invading pathogens and detrimental in yielding to infection is detailed as it is often undervalued and needs focus. The chapters encompass latest developments and applications in bacteriology and virology, preventive and therapeutic tips, and raise attention to implementation of proper antibiotic policies by medical institutions to decrease resistance to antimicrobials. The perennial problem of low influenza vaccination coverage rate is rationalized. The volume will be of interest to both clinicians and biomedical researchers engaged in this exciting field.
Download or read book Sleep Medicine written by Sudhansu Chokroverty and published by Springer. This book was released on 2015-09-22 with total page 552 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume provides a balanced and easily readable account of the rise of modern sleep medicine, its history and developmental milestones. Authored by an international group of experts, the remarkable progress and fascinating evolution from rudimentary concepts of the ancient prehistoric and early classical periods to our contemporary knowledge are covered in detail. These examples and their relationship to modern therapies offer neurologists, psychiatrists, respiratory specialists, clinicians, researchers and those interested in sleep medicine an important perspective to the origins of current practice.
Download or read book Treatment of Tuberculosis written by World Health Organization and published by . This book was released on 1993 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Surgical Site Infection written by Andrew Welsh and published by . This book was released on 2008 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.
