break through project in NCM with ma'am Faceronda,RN

8/8/2019 break through project in NCM with ma'am Faceronda,RN

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Submitted To: Mrs. Rosadel Faceronda, RN

Submitted By: BSN 3D 2010

Respiratory System

Current Trends and Discoveries


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Current Trends And Discoveries 2 | P a g e

New Trends in Mechanical Ventilation

By Bercadez, Hemerson

FOCUS: Journal for Respiratory Care & Sleep Medicine, Sept-Oct,

2008 by Stephanie Richardson

With the advent of new technology, manufacturers are developing

innovative mechanical ventilators that are helping patients and respiratory

therapists breathe easier when it comes to administering care. But with new

software and functionality upgrades available all the time, what are some of the

most recent trends?

Small wonders

Pending clearance by the Food and Drug Administration, two "palmtop"

ventilators will be hitting hospitals soon. These two devices promise ICU-level

care in any area of a hospital. Weighing in at about the same size as a

continuous positive airway pressure device, these ventilators are of the smallest

available.

Each palmtop ventilator contains a gas delivery system with active

exhalation valve. They provide a complete selection of modes, full graphics and

integrated spontaneous breathing trials that simplify weaning. Endotracheal

tubes are optional, and each ventilator can provide noninvasive ventilation withautomatic leak compensation. Additionally, an internal battery provides up to

four hours of power needed during patient moves.

While one of the palmtops is designed for high-acuity applications, the

other is a mid-acuity system. The high-acuity palmtop ventilator features a

nebulizer and touch screen, and its batteries can be hot swapped without any

disruption in patient care. The mid-acuity device uses a simple LED interface to

provide patient data and provides external active exhalation.

What's new for sub-acute care?

Currently, sub-acute care is one of the fastest growing services in health

care. While most patients requiring sub-acute care don't require the intensive

procedures associated with the ICU, a ventilator may be needed for certain

invasive procedures. However, clinicians have struggled finding a ventilator that

can easily move with a patient from room to room and adapt to changing care

requirements.


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A new device that received FDA clearance in June is enhancing the way

respiratory therapists and sub-acute care patients give and receive mechanical

ventilation. Providing invasive and noninvasive ventilation, this machine's

flexibility allows RTs to address a wide range of respiratory challenges for adult

and pediatric patients.

This machine helps to simplify ventilation with a system that featuresautomatic leak compensation and automatic termination criteria. The ventilator

can synchronize ventilation to a patient's breathing requirements, even in the

presence of erratic breathing patterns and mask leaks. A trigger function

minimizes the patient's work of breathing, while an automatic ramp adjustment

optimizes the patient's the inflation pattern to his or her changing comfort levels

during care.

Additionally, this ventilator features PC-BIPAP/SIMV, allowing the patient

to breathe spontaneously. This helps RTs better tailor ventilation for each

patient and increase patient comfort.

Because this ventilator can operate independent of a high-pressure gas

system, it is also well-suited for emergency rooms and general hospital wards. It

has an integrated oxygen blender for the use of 21-percent to 100-percent

oxygen concentrations. In situations where compressed oxygen is not available,

the ventilator's low-pressure oxygen inlet allows it to be connected to an oxygen

concentrator or liquid oxygen cylinder.

An added benefit to this sub-acute care ventilator is that it is available in ahome edition. For patients leaving sub-acute care and moving to long-term

patient care at home, the home version runs quietly and has a small footprint. It

also features an extended battery life that gives the patient appropriate

ventilation even during power outages. Finally, its similar design gives patients a

seamless transition from hospital to home care.

Another new hospital and sub-acute care ventilator can transition from

invasive to noninvasive ventilation for adult, pediatric and infant patients. Using

dual control adaptive breath management, the ventilator combines volume

target pressure control and volume target pressure support. With this mode, theventilator automatically applies the lowest pressure possible within the set

pressure limit in order to reach the patient's targe tidal volume. Adjustable

slope/rise and expiratory threshold controls give RTs the tools to decrease a

patient's work of breathing and improve synchrony while expediting the weaning

process.


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This ventilator also comes with a calculated and trended Rapid Shallow

Breathing Index and a measured, imposed work of breathing value to help guide

weaning decisions.

Noninvasive ventilation

Another innovation in sub-acute care lies in the realm of noninvasiveventilation. The latest trends in noninvasive ventilation surround bi-level

therapy. These simple and versatile systems have been designed to be

accurate, reliable and easily upgraded. One ventilator offers a low-cost

alternate form of sub-acute therapy for patients and may eliminate the need for

intubation in appropriate candidates. The integrated display screen uses real-

time graphics in waveforms or bar scale format to provide enhanced monitoring

for caregivers. It also ensures optimal sensitivity despite changing breathing

patterns or circuit leaks.

CPAP and S/T modes are available for sub-acute care patients that needto maintain airway patency and pressure support ventilation. Additional

proportional assist ventilation/timed mode help promote improved patient

comfort and enhanced patient-ventilator synchrony. This is due to the

independent adjustment of volume and flow assist based on a patient's disease

state.

Another noninvasive ventilator has been developed specifically for

hospitals to provide ventilatory assistance to stable, lower acuity patients with

respiratory insufficiency or failure. The machine ensures optimal triggering andcycle sensitivity during changing breathing patterns and leaks. It also eliminates

the need for a perfect seal of the patient interface and constant adjustment

while increasing patient-ventilator synchrony.

His bi-level ventilator's integrated back-up battery system maintains

patient ventilation in the event of an interruption in power. This safety feature

also provides a convenient method for intra-hospital patient transport from one

care area to another with uninterrupted ventilator care.

Other innovations

At minimum, the most advanced ventilators on the market operate with

proportional solenoid (PSOL) valves. These valves help improve synchrony by

taking active control of exhalation, which ensures precision and flexible breath

delivery.


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Online ventilator systems are also becoming popular as hospitals find the

need to centralize patient data. One ventilator on the market contains a web

server that can display the ventilator's settings, monitoring, and alarms on

computers, hospital networks or the Internet using Windows[R] software.

Another common problem for ventilator patients also has been addressed

by a ventilator manufacturer: speaking. By integrating a speaking mode, thispositive pressure ventilator enables speech without the addition of an external

one-way speaking valve. An RT only needs to deflate the patient's trach tube cuff

and activate the software. The ventilator controls the exhalation valve and

forces exhaled gas to the vocal chords to allow speech. The ventilator also

responds to occlusions to return to the patient's normal settings.

Stephanie Richardson is a freelance medical writer based in Philadelphia.

Bibliography:

http://findarticles.com/p/articles/mi_hb4758/is_2008_Sept-Oct/ai_n30960965/


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Reaction:

Ventilation is the movement of air in and out of the lungs. Well ventilated is

very important for us to breath normally. Ventilation is used to remove

unpleasant smells and excessive moisture, introduce outside air, to keep

interior building air circulating, and to prevent stagnation of the interior

air. Natural ventilation is the ventilation of a building with outside air without the

use of a fan or other mechanical system. Mechanical or forced ventilation:

through an air handling unit or direct injection to a space by a fan . A local

exhaust fan can enhance infiltration or natural ventilation, thus increasing the

ventilation air flow rate. But when it comes to situation that natural ventilation

and mechanical ventilation is not useful there are new trends that are available

now in enhancing the ventilation of our patients.

These new trends of mechanical ventilation focuses on the critical

situations where in the client can't breathe or not breathing because of anydisease. As i have read this article i was amazed with the equipments that are

being used in ventilation of patients. Even though these equipments are very

expensive but when it comes to life for me money is nothing.

As i continued reading the articles i was thinking how these equipments

were created by a human being only?,, there persons that are very intelligent

that even our imaginations will come true. Now by using these equipments early

access and early survival of patient i think can be guaranteed.


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Current Trends in Immunosuppression for Lung

Transplantation

By Bueno, Ben Nicole

Timothy Floreth, Sangeeta M. Bhorade Division of Pulmonary and Critical Care

Medicine, Department of Medicine, University of Chicago Medical Center,

Chicago, Illinois

ABSTRACT

Lung transplant has become an established therapy in the treatment of

end-stage lung disease. Many of the advances in the modern

immunosuppression regimen have provided more quality and quantity of life to

transplant patients. Immunosuppression agents target various aspects of the

immune system to maximize graft tolerance while minimizing medication

toxicities and side effects. Lung transplant regimens follow typical protocols but

are always tailored to the individual patient based upon previous and current

medical problems. Despite the various advances, acute and chronic rejections

still occur in the majority of all lung transplants. For these reasons, long-term

lung transplantation success remains a challenge. Further improvement in

immunosuppression will be geared toward minimizing rejection and infection as

well as being tailored to the individual patient. This review details the current

armamentarium of immunosuppression medications and the current body of

evidence supporting the current trends of usage.

Bibliography:

https://www.thieme-connect.com/DOI/DOI10.1055/s-0030-1249112


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Reaction:

In our modern world today, it shows that most of the nations are

technologically advance and it have endow with a more quality and quantity of

life to transplant patients. Although there is lung transplantation as a new trend

in those who are respiratory distress, there are still chances that it will be

rejected because it is possible for infections to enter the lungs and complicate

the disease. And so, they must create a medicine that would increase the

immunity of the client so that more chances of success in lung transplantation. I

recommend that further study should be done and tested in order to assure the

safety of the people who will be undergoing this. Health care professionals

should also understand thoroughly this study to avoid any further complications.


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Anticoagulation In Pulmonary Arterial Hypertension: A

Qualitative Systematic Review

By Castro, Bryan Dave

Abstract

BACKGRUND:

Thrombotic arteriopathy has been implicated in the pathophysiology of

pulmonary arterial hypertension (PAH). However, the role of anticoagulants in

the treatment of PAH is uncertain. Through a qualitative systematic review of

epidemiological studies, the effectiveness of anticoagulation therapy with

warfarin on survival was evaluated in patients with PAH.

METHODS:

MEDLINE (1966 to November 2005), EMBASE (1966 to November 2005),

bibliographies of included studies and published reviews were searched without

language restriction. Epidemiological studies evaluating the effectiveness of

warfarin in PAH were included. Studies had to report mortality as an outcome.

RESULTS:

Seven observational studies evaluating the effectiveness of warfarin

comprising 488 patients were identified. Five studies support the effectivenessof anticoagulation therapy, whereas two do not.

CONCLUSIONS:

Data from observational studies suggest that anticoagulation therapy may

be an effective intervention in pulmonary arterial hypertension. However, given

the methodological limitations and the small number of existing observational

studies, a randomised controlled trial is needed in order to definitively address

this important clinical issue.

Bibliography:

http://erj.ersjournals.com/content/28/5/999.abstract


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Current Trends And Discoveries 10 |

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Reaction:

The study is about the role of anticoagulants in the treatment of arterial

pulmonary hypertension or PAH. For me, as a nursing student, this study could

greatly help me in caring for patients with PAH. This research could provide me

added information and knowledge about the disease which could help me in

assessing patients with PAH better. This study could really help nurses

especially in giving medications to patients with PAH. The research abstract

made me aware of the effect of anticoagulants to PAH. Having knowledge about

the medications that we give to our patients could greatly help us to avoid

accidents and could also help us to provide the needed interventions to our

patients. This study is very significant therefore I recommend that they further

continue the research about the effects of anticoagulants to PAH. I also suggest

that they also research about other drugs which could also provide treatment to

PAH. The role of anticoagulants in the treatment of PAH is still uncertain so they

must also provide more test to further evaluate the effectiveness of the drug.


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Tomato Juice Prevents Emphysema In Animal Models

By Lanzar, Eric John

Related topics: Research, Antioxidants, carotenoids, Phytochemicals, plant

extracts, Respiratory health

Drinking tomato juice completely prevented emphysema in mice exposed

to tobacco smoke, report researchers from Japan.

The results suggest smokers and non-smokers exposed to second-hand smoke

could benefit from daily intake of tomato juice although expert advice is clearly

to avoid tobacco smoke altogether.

Smoking causes most cases of emphysema, a progressive and incurable

disease. The alveoli in the lungs gradually lose their elasticity, making it more

and more difficult for sufferers to force air in and out of their lungs.There are over 1 billion smokers worldwide with 80 per cent of these people

living in low and middle-income countries. Ten million people are diagnosed with

emphysema in the US alone, with an estimated 14 million people not aware they

have the disease.

The researchers, from the Juntendo University School of Medicine in

Tokyo, exposed the mice models to short periods of tobacco smoke to induce

emphysema over an eight-week period. A group of mice also had its water

supply replaced by tomato juice (5 mg lycopene, 52.6 mg vitamin A).

Significant destruction of the alveoli in the lungs of the mice not given tomato juice indicated the development of emphysema. The ingestion of tomato juice

produced convincing results.

"Smoke-induced emphysema was completely prevented by concomitant

ingestion of lycopene given as tomato juice," wrote lead author Satoshi Kasagi

in the American Journal of Physiology - Lung Cellular and Molecular Physiology

(published online October 2005).

Lycopene, a potent antioxidant, can be extracted from tomatoes and is

considered to the most efficient natural carotenoid for stopping reactive oxygen.

The balance between oxidant stress and antioxidant defences in the lungs is

proposed to be a possible process that leads to emphysema. Therefore, intake

lycopene could restore the natural oxidant-antioxidant balance.

Lycopene was detected in both serum and lung tissue samples of the test

group, leading the researchers to propose, "lycopene modulates the oxidant-

antioxidant balance perturbed by chronic tobacco smoke exposure."


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However the researchers were unable to specify if the antioxidant effects

were due solely to lycopene or from a combination of compounds found

naturally in tomatoes.

"Since mice were given tomato juice instead of pure lycopene

preparation, we cannot exclude a possibility that other ingredients contained intomato juice affected the results," wrote Kasagi.

Bibliography:

http://www.nutraingredients.com/Research/Tomato-juice-prevents-

emphysemain-animal-models By Stephen Daniells, 10-Jan-2006


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Reaction:

For me, it all comes to the basic nursing intervention, encouraging clients

to eat plenty of fruits and vegetable. As you can see, still the best prevention of a

certain disease is through healthy leaving, proper nutrition and exercise. Nature

has its answers to our problems but its us who over uses it. In the treatment ofemphysema, it is always the task of the pharmacological agents to do, but

certainly this research has proven that during the exposure to nicotine

containing pollutants specimen was able to combat the disease and that natural.

It does not say that this will be the answer for the long time problem, but it

do give us promising results and this will greatly help the people of science to

make another breakthrough out of this.


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BREATHE EAZY

By Matutina, Allen Mark

A combination of 14 Herbs and natural

ingredients in specific composition has been formulated by us. Our herbal formulation

BREATHE EAZY is an International Standard

Organization ISO 9002 accredited product. It

is perhaps the only ISO 9002 qualified herbal

formulation for asthma. BREATHE EAZY

herbal formulation dilates the respiratory

tract making you breath easy. It prevents the

occurrence of hyper sensitivity reaction.

They build up a strong immunity against

allergy. Thus effecting a near complete cureto asthma, allergy, edema (collection of fluids

mucous in lungs), Eosinophilia attacks, breathing disorders, sinusitis and

rhinitis. The decrease in IgE levels (Immunoglobulin E ) which is the indication of

allergic reaction in the body will measurably and markedly come down. The

herbal formulation is completely safe and is without any side effects.

Bibliography:

http://www.healasthma.com


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Reaction:

Taking herbal medicines that prescribe by the doctor and approved by the

International Organization for Standardization is safe. The formulation of this

drug is 2 tablets taken 2 times a day after meals. And it also within 4-5 days of

taking the BREATHE EAZY formulation you will find the respiratory tract dilating

and will feel light. Over the course of the BREATHE EAZY herbals you will find

the choking feeling in the chest and the difficulty in breathing slowly diminishing.

The ever nagging phlegm and mucous in the respiratory tract will be clearing

out. By these formulation, and taking this religiously you can prevent asthma

attacks.


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Parent Initiated Prednisolone for Acute Asthma in Children

Of School Age: Randomised Controlled Crossover Trial

By Naldoza, Shan Rey

Abstract

Objective

To evaluate the efficacy of a short course of parent initiated oral prednisolone

for acute asthma in children of school age.

Design Double blind, randomised, placebo controlled, crossover trial in which

episodes ofasthma, rather than participants, were randomised to treatment.

Setting The Barwon region of Victoria, Australia.

Participants Children aged 5-12 years with a history of recurrent episodes of

acute asthma.

Intervention

A short course of parent initiated treatment with prednisolone (1 mg/kg a day)

or placebo.

Main outcome measures The primary outcome measure was the mean daytime

symptom score over seven days. Secondary outcome measures were mean

night time symptom score over seven days, use of health resources, and school

absenteeism.

Results

230 children were enrolled in the study. Over a three year period, 131 (57%) of

the participants contributed a total of 308 episodes of asthma that required

parent initiated treatment: 155 episodes were treated with parent initiated

prednisolone and 153 with placebo. The mean daytime symptom score was 15%

lower in episodes treated with prednisolone than in those treated with placebo

(geometric mean ratio 0.85, 95% CI 0.74 to 0.98; P=0.023). Treatment with

prednisolone was also associated with a 16% reduction in the night time

symptom score (geometric mean ratio 0.84, 95% CI 0.70 to 1.00; P=0.050), areduced risk of health resource use (odds ratio 0.54, 95% CI 0.34 to 0.86;

P=0.010), and reduced school absenteeism (mean difference 0.4 days, 95% CI

0.8 to 0.0 days; P=0.045).


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Conclusion

A short course of oral prednisolone initiated by parents when their child

experiences an episode of acute asthma may reduce asthma symptoms, health

resource use, and school absenteeism. However, the modest benefits of this

strategy must be balanced against potential side effects of repeated short

courses of an oral corticosteroid.

Bibliography:

http://www.bmy.com/cgi/content/abstract/340/mar01_1/c843


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Reaction:

This research has a great help in our society especially to the mothers

whose problem is how to manage the asthma attack of their children.

This will lessen their burden because prednisolone can reduce asthma

symptoms, health resource use, and school absenteeism. As well as it will

lessen the suffering of their children. As a student nurse, this will serve as new

information to my study. I can do some health teachings to my fellow neighbors

and those who are in need of education.


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SSCCIIEENNTTIISSTTSSGGRROOWWNNEEWWLLUUNNGGSSUUSSIINNGG''SSKKEELLEETTOONNSS'' OOFFOOLLDDOONNEESS

By Rute, Sherwin

ScienceDaily (June 28, 2010) For someone with a severe, incurable

lung disorder such as cystic fibrosis or chronic obstructive pulmonary disease,

a lung transplant may be the only chance for survival. Unfortunately, it's oftennot a very good chance. Matching donor lungs are rare, and many would-be

recipients die waiting for the transplants that could save their lives.

Such deaths could be prevented if it were possible to use stem cells to

grow new lungs or lung tissue. Specialists in the emerging field of tissue

engineering have been hard at work on this for years. But they've been

frustrated by the problem of coaxing undifferentiated stem cells to develop into

the specific cell types that populate different locations in the lung.

Now, researchers from the University of Texas Medical Branch at

Galveston have demonstrated a potentially revolutionary solution to thisproblem. As they describe in an article published electronically ahead of print by

the journal Tissue Engineering Part A, they seeded mouse embryonic stem cells

into "acellular" rat lungs -- organs whose original cells had been destroyed by

repeated cycles of freezing and thawing and exposure to detergent.

The result: empty lung-shaped scaffolds of structural proteins on which

the mouse stem cells thrived and differentiated into new cells appropriate to

their specific locations.

"In terms of different cell types, the lung is probably the most complex ofall organs -- the cells near the entrance are very different from those deep in the

lung," said Dr. Joaquin Cortiella, one of the article's lead authors. "Our natural

matrix generated the same pattern, with tracheal cells only in the trachea,

alveoli-like cells in the alveoli, pneumocytes only in the distal lung, and definite

transition zones between the bronchi and the alveoli."

Such "site-specific" cell development has never been seen before in a

natural matrix, said professor Joan Nichols, another of the paper's lead authors.

The complexity gives the researchers hope that the concept could be scaled up

to produce replacement tissues for humans -- or used to create models to testtherapies and diagnostic techniques for a variety of lung diseases.

"If we can make a good lung for people, we can also make a good model

for injury," Nichols said. "We can create a fibrotic lung, or an emphysematous

lung, and evaluate what's happening with those, what the cells are doing, how

well stem cell or other therapy works. We can see what happens in pneumonia,


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or what happens when you've got a hemorrhagic fever, or tuberculosis, or

hantavirus -- all the agents that target the lung and cause damage in the lung."

The researchers have already begun work on large-scale experiments,

"decellularizing" pig lungs with an eye toward using them to produce larger

samples of lung tissue that could lead to applications in humans. They're also

taking on the challenge of vascularization -- stimulating the growth of bloodvessels that will enable the engineered tissues to survive outside the special

bioreactors that the researchers now use to keep them alive by bathing them in

a life-sustaining cocktail of nutrients and oxygen.

"People ask us why we're doing the lung, because it's so hard," Cortiella

said. "But the potential is so great, and the technology is here. It's going to take

time, but I think we're going to create a system that works."

Bibliography:

http://www.sciencedaily.com/releases/2009/11/091123083650.htm


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REACTION:

This research is about growing new lung through skeletons of old ones.

This article states that researchers are trying to make fibrotic lungs as a model,

for them to test therapies and diagnostic techniques for variety of lung disease.This model will be a big help in the field of medication, now that cases of lung

diseases are increasing. It will be easier to try new therapies and medications

using this model because we can tell if that kind of therapy and medication is

effective or not. As a student nurse, I can say that this research will be a great

help if in case it will be fully accomplished. It will also be new breakthrough in

the society and surely give knowledge and skills not only for me but also for all.


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Potential Blood Test for Chronic Sinusitis Identified

By Abelita, Mary Dominique

Science Daily (Apr. 15, 2008) A protein profile has been identified in the

blood of chronic sinusitis sufferers that may enable physicians to objectively

diagnosed and treat the disease, researchers say.

They used a sophisticated research tool that rapidly assesses expression

of large numbers of proteins and found among 96 chronic sinusitis patients a

profile missing in 38 healthy controls.

We can diagnose this disease with a totally objective test that does not depend

on symptoms or observations, says Dr. Stilianos E. Kountakis, vice chair of the

Department of Otolaryngology-Head and Neck Surgery in the Medical College of

Georgia School of Medicine. He is corresponding author on the study published

in the March/April issue of American Journal of Rhinology.

Diagnosing this chronically irritating disease, characterized by dripping

noses, sinus pressure, congestion and difficulty breathing, currently is rather

subjective. Patients talk about symptoms and doctors look at their sinuses with

an endoscope and probably a computerized tomography scan. overall

management of (chronic sinusitis) is still hampered by the lack of quantifiable,

molecular and genetic markers to aid in screening, researchers write.

To be classified chronic, the misery has to continue for at least 12 weeks.

Causes include bacterial infections, respiratory inflammation, sinus polyps andmucosal disease. Some causes, such as polyps and asthma, have a genetic

predisposition. You may have bacterial infections, allergies, mechanical

problems, Dr. Kountakis says. There are numerous genes that control

respiratory function. Any of these things can go wrong to predispose the patient

to develop chronic sinusitis.

Treating it isnt much more straightforward. Surgery can help correct

anatomical causes such as deviated septums or polyps. However, there are no

FDA-approved drugs specifically to treat chronic sinusitis. Instead, physicians

use drugs that treat symptoms: steroid sprays for inflammation, mucus thinners,saline irrigation, etc. Its difficult to show drugs are effective because its

difficult to group patients together and measure their disease, says Dr.

Kountakis.

He hopes further studies will enable both, revealing signature protein

profiles for different types of chronic sinusitis as well as the degree of disease.


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The bottom line is we want to group patients according to their disease rather

than just the general term chronic sinusitis, Dr. Kountakis says. If we can find

a way to classify patients, group them together based on the specific disease

they have, maybe we can get better outcomes and treat patients with better

efficiency.

These objective measures should allow monitoring the effectiveness ofcurrent therapies and objectively reviewing new ones, he says.

In fact, even getting a handle on disease incidence is tough. The National Health

Interview Survey, based on self-reports, says 14 to 16 percent of people in the

United States have chronic sinusitis. A population-based study of the Olmsted

County, Minnesota published in 2004 in Archives of Otolaryngology-Head &

Neck Surgery put the incidence at 2 percent.

For this study, researchers analyzed protein expression in the blood using

surface enhanced laser desorption ionization time-of-flight mass spectroscopy

or SELDI-TOF-MS. The test is about 88 percent accurate.

Bibliography:

Science Daily. Retrieved September 5, 2010,

from http://www.sciencedaily.com /releases/2008/04/080414145649.htm

http://www.sciencedaily.com


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Reaction:

Sinusitis is an inflammation of sinuses. Patients may suffer different signs

and symptoms and it is remarkably uncomfortable. Treating can be

uncomfortable too because it uses different instrument in visualization of

sinuses to note the extent of damage for the classification of the disease toeither chronic or acute. Medications given to the patients do not directly treat

the disease itself; rather it treated only the underlying signs and symptoms to

lessen the effect or the complications if not treated. The patients need to

undergo days to week of treatment and another days for observation if the signs

and symptoms becomes severe or not. This method of treatment is time

consuming.

This research enable to diagnosed sinusitis through the use of blood test.

Presence of protein profile in the blood of sinusitis sufferers enable the

physicians to diagnosed the disease without depending on the signs nad

symptoms and to the observations. This will help patients to be treated in a way

that they are comfortable and without too much of their time were consumed.

This research is 88 percent accurate.

As a student nurse, this trend in treating sinusitis helps me to encourage

my patient with this disease to undergo this treatment by stating them how the

procedure is done and what are their differences with the routine way of

diagnosing sinusitis.

Moreover, proper hygiene is still the best way to prevent sinusitis.

Avoidance to any allergens is another way to prevent the occurrence of this

disease. It is indeed true that prevention is better than cure.


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New Trends in Mechanical Ventilation

By Aguillion, Czarina

Currently, sub-acute care is one of the fastest growing services in health

care. While most patients requiring sub-acute care don't require the intensive

procedures associated with the ICU, a ventilator may be needed for certaininvasive procedures. However, clinicians have struggled finding a ventilator that

can easily move with a patient from room to room and adapt to changing care

requirements.

A new device that received FDA clearance in June is enhancing the way

respiratory therapists and sub-acute care patients give and receive mechanical

ventilation. Providing invasive and noninvasive ventilation, this machine's

flexibility allows RTs to address a wide range of respiratory challenges for adult

and pediatric patients.

This machine helps to simplify ventilation with a system that features automatic

leak compensation and automatic termination criteria. The ventilator can

synchronize ventilation to a patient's breathing requirements, even in the

presence of erratic breathing patterns and mask leaks. A trigger function

minimizes the patient's work of breathing, while an automatic ramp adjustment

optimizes the patient's the inflation pattern to his or her changing comfort levels

during care.

Additionally, this ventilator features PC-BIPAP/SIMV, allowing the patient tobreathe spontaneously. This helps RTs better tailor ventilation for each patient

and increase patient comfort.

Because this ventilator can operate independent of a high-pressure gas system,

it is also well-suited for emergency rooms and general hospital wards. It has an

integrated oxygen blender for the use of 21-percent to 100-percent oxygen

concentrations. In situations where compressed oxygen is not available, the

ventilator's low-pressure oxygen inlet allows it to be connected to an oxygen

concentrator or liquid oxygen cylinder.

An added benefit to this sub-acute care ventilator is that it is available in a home

edition. For patients leaving sub-acute care and moving to long-term patient

care at home, the home version runs quietly and has a small footprint. It also

features an extended battery life that gives the patient appropriate ventilation

even during power outages. Finally, its similar design gives patients a seamless

transition from hospital to home care.


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Another new hospital and sub-acute care ventilator can transition from invasive

to noninvasive ventilation for adult, pediatric and infant patients. Using dual

control adaptive breath management, the ventilator combines volume target

pressure control and volume target pressure support. With this mode, the

ventilator automatically applies the lowest pressure possible within the set

pressure limit in order to reach the patient's target tidal volume. Adjustableslope/rise and expiratory threshold controls give RTs the tools to decrease a

patient's work of breathing and improve synchrony while expediting the weaning

process.

This ventilator also comes with a calculated and trended Rapid Shallow

Breathing Index and a measured, imposed work of breathing value to help guide

weaning decisions.

Bibliography

http://findarticles.com/p/articles/mi_hb4758/is_2008_Sept-Oct/ai_n30960965/


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Reaction:

Just to give you a little background about the ventilation. The ventilation

defines as the exchange of air between the lungs and the atmosphere so that

oxygen can be exchanged for carbon dioxide in the alveoli (the tiny air sacs in

the lungs). A ventilator is a machine which mechanically assists patients in theexchange of oxygen and carbon dioxide (sometimes referred to as artificial

respiration). So what is the importance of the ventilator in a person who has

difficulty in breathing? By the use of a ventilator, it can help in the breathing and

the patient can have more comfort.

In the hospital setting, many doctors have difficulty in providing ventilation

to a patient especially during invasive procedures because of its availability and

accessibility. It is difficult because ventilator cannot be transfer to room to room

or in any department on the hospital.

Now, it is nice to know that there is a newly invented device that can help

in problems of medical practioner. It has many benefits like it is enhance the

way respiratory therapists and sub-acute care patients give and receive

mechanical ventilation. The ventilator can synchronize ventilation to a patient's

breathing requirements, even in the presence of erratic breathing patterns and

mask leaks. It allows the patient to breathe spontaneously. This helps

Respiratory Tract better tailor ventilation for each patient and increase patient

comfort. The ventilator can operate independent of a high-pressure gas system;

it is also well-suited for emergency rooms and general hospital wards. It has anintegrated oxygen blender for the use of 21-percent to 100-percent oxygen

concentrations. It is also available in a home edition so patients leaving sub-

acute care and moving to long-term patient care at home, the home version runs

quietly and has a small footprint. It also features an extended battery life that

gives the patient appropriate ventilation even during power outages. And it is

nice to know that it is similar design gives patients a seamless transition from

hospital to home care.

So as a student nurse, by these benefits we can ensure that it is so helpful

in the patient and we can focus more in providing comfort to a person and wecan attend in the needs of the patient.


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Lagundi herbal medicinal shrub from the Philippines

By Biyo, Mae Hope

Lagundi (scientific name: Vitex negundo 1) Shrub or Five-leaf Chaste Tree one of

the most popular (from generation to generation) Philippine traditional medicine

or alternative remedy to treat various health concerns (Fever, body pains,asthma, and cough 3). 2 Lagundi Shrub found in the Mt. Banahaw (National Park

of the Philippines 10). 11 The leaves of the Five-leaf Tree appear like fingers of

the hand and shrub extends approximately five meter in height. 3 The Vitex

negundo belongs to the Vertbenaceae family (Small tough attractive plants:

About 75 genera and 3000 species worldwide 8) of botanical plants. Lagundi is

the eighth registered and licensed herb (1996) by the Department of Health in

the Philippines. Philippine Government received from German Government and

the Geneva Consul in Switzerland a silver certificate awards for research and

development of Lagundi.

In the United States more than 20 million people have asthma.4 "Asthma is

now the leading cause of disease and disability in children and teens from two to

17 years old. It is increasing in older people (40) years or older) as well.

Estimated medical costs are $6.2 billion per year, including $1.1 billion for

medicines, $295 million in emergency room visits, and $345 million in lost work

time." During an asthmatic allergic reaction: Leukotrienes (Immune cells in the

body release inflammatory molecules.7), and histamine (released in the body 5),

constrict the bronchial tubes and inflame the mucus membrane causing

wheezing. Scientific analysis proves Lagundi functions as anti - histamine(contains Chrysoplenol D. A (12), a smooth muscle relaxant 15) and anti

inflammatory herb, treats asthma and related symptoms including coughing.

Lagundi compared to prescribed medicines Bromohexine (for cough) and

Theophylline (a bronchodilato), results were virtually identical, during double

blind studies. Langundi is available in spray (treat mild mucus, breathing

difficulties and coughing), and capsule treat asthma. 6 The Food and Drug

Administration (USA) approved the usage of Lagundi. The herbal product is

available in herbal tea products. And other packaged usage (Syrup, tables, and

capsules). 13 Astral Natural supplier of supplements (800 - 653 - 6047), first U.S.

company to sell Lagundi ("120 vegicaps, 450 mg; 2 oz liquid with sprayer since1994" 14). In the Philippines the Bureau of Food and Drugs recognize Lagundi as

herbal registered medicine. 9 In 1988, former President Corazon C. Aquino

inaugurated.


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Reaction:

Lagundi (scientific name: Vitex negundo) is a shrub that grows in the

Philippines. It is one ten herbal medicines endorsed by the Philippine

Department of Health as an effective herbal medicine with proven therapeutic

value. lagundi has been clinically tested to be effective in the treatment of colds,

flu, bronchial asthma, chronic bronchitis, and pharyngitis. Studies have shown

that Lagundi can prevent the body's production of leukotrienes, which are

released during an asthma attack. Lagundi contains Chrysoplenol D, a

substance with anti-histamine and muscle relaxant properties. Lagundi is

becoming recognized as an effective herbal medicine, especially since

researches have shown that it contains properties that make it an expectorant

and it has been reported to function as a tonic as well. More than that, most of

the parts of the lagundi plant have medicinal value. Lagundi leaves, root,

flowers, and seeds are believed to have medicinal value. Lagundi concoction is

prepared by boiling, steeping, and then straining various parts such as lagundileaves, roots, flowers and seeds. So, we as Pilipino must know this idea because

we can prevent this kind of problem and also regarding in the financial matter,

we can save our money because lagundi are abundant here in the Philippines.

Bibliography:

http://www.helium.com/knowledge/148069-lagundi-herbal-medicinal-shrub-

from-the-philippines


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Molecular Diagnosis of Respiratory Viruses

By Cagas, Marilla

Abstract

Respiratory tract viral infections are responsible for an incredible amountof morbidity and mortality throughout the world. Older diagnostic methods, such

as tissue culture and serology, have been replaced with more advanced

molecular techniques, such as PCR and reverse-transcriptase PCR, nucleic acid

sequence-based amplification and loop-mediated isothermal amplification.

These techniques are faster, have greater sensitivity and specificity, and are

becoming increasingly accessible. In the minds of most, PCR has replaced

tissue culture and serology as the gold standard for detection of respiratory

viruses owing to its speed, availability and versatility. PCR/reverse-

transcriptase PCR has been used in a variety of detection platforms, in multiplex

assays (detecting multiple pathogens simultaneously) and in automated systems

(sample inanswer out devices). Molecular detection has many proven

advantages over standard virological methods and will further separate itself

through increased multiplexing, processing speed and automation. However,

tissue culture remains an important method for detecting novel viral mutations

within a virus population, for detecting novel viruses and for phenotypic

characterization of viral isolates.

Introduction

Respiratory viruses are one of the most important causes of morbidity and

mortality throughout the world.[1,101] Over 100 million people have been killed by

influenza virus in the last century alone. The majority of this burden befalls

children and the elderly.[102] While it is true that respiratory viruses place a

greater burden on people in developing countries, these viruses still create

numerous problems in the developed world.[101] Classically, viral detection in

patient samples employed tissue culture, which can take a long time to obtain

results (average 35 days). Modern molecular technologies are more sensitive,

more dependable and more rapid than classical tests. For this reason they have

joined tissue culture as a gold standard for respiratory virus diagnosis and aremore useful for rapid diagnosis.

There are many important reasons to rapidly diagnose respiratory

viruses.[2] One is to properly direct antiviral therapy. Some antivirals are only

effective if administered in the early stages of infection. Understanding the true


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cause of disease also serves to decrease the unnecessary use of antibiotics,

which are often prescribed to patients infected with respiratory viruses.[2,3]

Patients infected with respiratory viruses will gain little relief from their

symptoms with antibiotic treatment while simultaneously increasing the

likelihood that antibiotic resistance will occur in any bacteria that may be

present. Rapid molecular detection of respiratory viruses improves our

understanding of virus natural history and pathophysiology, which allowsphysicians to better understand potential complications that may arise with

these types of infections. In addition, appropriate personal protective equipment

and measures, such as quarantine of infected patients, can be implemented to

minimize spread. Equally important is preventing unnecessary isolation (often at

great expense) of uninfected individuals. This is particularly important with

newly emerging or re-emerging pathogens, including severe acute respiratory

syndrome coronavirus, highly pathogenic avian influenza and swine-origin

influenza virus H1N1 (S-OIV H1N1). Understanding the epidemiology of

respiratory viruses can also be aided by early diagnosis. Accurateepidemiological studies allow clinicians to identify at-risk populations and

determine which populations should consider vaccination (if a suitable vaccine

exists).[4] Finally, rapid viral diagnosis significantly decreases length of hospital

stays and unnecessary laboratory testing.

For these reasons, molecular diagnostics are more commonly used as

gold standards than tissue culture in respiratory virus diagnosis. While it is

critical to maintain facilities capable of tissue culture and other biological virus

amplification methodologies, it is to everyone's benefit for clinical facilities to

switch to more rapid, cost-effective molecular diagnostics.[6] This article brieflydescribes the most common community-acquired respiratory viruses in addition

to the methods currently available to detect them.

Source:

Eric T Beck; Kelly J Henrickson

Medscape.com


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Consent Forms For Research: Have They Improved In 25

Years?

By Cereneche, Ma. Doretti

ScienceDaily (May 31, 2010)

A study in IRB: Ethics & Human Research examined the changes over a quartercentury in the accuracy and length of research consent forms used for 215

studies by one department in a major academic center. The review, by

researchers at the University of Pennsylvania Law School and Columbia

University, revealed two trends with potentially opposite effects on

comprehensibility.

One trend is that the information in the consent forms became more

accurate over time, as measured by discrepancies in the description of risks in

the consent forms compared with the descriptions in the study protocolsthemselves. In the early consent forms evaluated in the study, which dated back

to 1978, more than 54 percent had such discrepancies, mainly with the consent

forms understating the actual risk. But by 2002, there were no discrepancies.

On the other hand, the consent forms became much longer, growing from an

average of a paragraph or two to more than four and a half pages. The

increased length could interfere with comprehension: the authors cite data

showing that consent forms that are longer than four pages "are unlikely to be

read, perhaps in part because of the time involved."

"Our findings highlight the inherent paradox in attempting to use consent forms to convey ever-more-complete information to potential research

subjects," the authors write. "Greater information is associated with increased

length of consent forms, and studies have shown an inverse relationship

between length and individuals' comprehension of the information provided."

They conclude that innovative approaches are needed -- possibly including

supplementary booklets or computer-based disclosures -- to achieve genuinely

informed consent.

Bibliography:

The Hastings Center (2010, May 31). Consent forms for research: Have they

improved in 25 years?. ScienceDaily. Retrieved September 7, 2010, from

http://www.sciencedaily.com/releases/2010/05/100528210732.htm


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Reaction:

The consent forms that people sign before participating in research are

widely considered difficult to understand and sometimes inaccurate in the past

years. In an informed consent form, the procedure or activity must be clearly

explained in language that the person can understand. It is a process of

communication between a patient and physician that that results in the patients

authorization or agreement to undergo a specific medical treatment. Efforts

have been made to improve the forms, but how effective are they? Lately, some

researchers noticed that the form is not that complete and accurate, that is why

they had decided to improve the form in order to give more information to

patients who will undergo a certain procedure. The consent became longer and

more specific. It is very important to give the patient comprehensive and correct

information in order for them to decide properly. Thats why an informed

consent is considered as a part of surgical interventions because it is a lawful

requirement of the medical profession before a surgery. As a student nurse, thisinformation or study is important to in the future. Because a nurse is a part of a

medical team and is also liable in the any procedure she is present.


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Meta-Analysis: Radiotherapy Variants Improve Survival in

Non-Metastatic Lung Cancer

By Dalen, Rhenia Joy

ScienceDaily (Apr. 30, 2010) A new meta-analysis reported at the

second European Lung Cancer Conference shows that patients with both non-small-cell lung cancer and small-cell lung cancer benefit in terms of overall

survival when treated with hyperfractionated or accelerated radiotherapy.

Patients treated with hyperfractionated or accelerated radiotherapy

regimens are given their treatments more frequently, and over a shorter period

of time. The benefit of doing this has been in question as different randomized

trials have given contradictory results.

Dr Cecile Le Pechoux and colleagues from Institut Gustave Roussy in

Villejuif, France analyzed 10 trials including 2,279 patients with non-metastaticlung cancer. They found that in the eight trials dealing with non-small-cell lung

cancer, modified fractionation of the radiotherapy improved overall survival

compared to conventional radiotherapy, resulting in an absolute benefit of 3%

after 5 years, meaning that 3% more of the patients were alive after 5 years in

the modified fractionation groups.

"The clinical benefit we found was small, but comparable to the benefit

found in other meta-analyses concerning non-small-cell lung cancer," Dr Le

Pechoux said.

Lung cancer remains a major cause of death worldwide with more than

1.1 million deaths per year. Non-small-cell lung cancer (NSCLC) represents

more than 80% of all lung tumors and small-cell lung cancer (SCLC) less than

20%. Approximately 35% of patients with NSCLC, and less than a third of SLSC

patients, present with locally advanced, non-metastatic disease. The standard

treatment for these patients is combined radio-chemotherapy.

In small-cell lung cancer, which is a less common form of the disease,

similar results were found, although the difference in survival between thestandard and modified radiotherapy regimens was not statistically significant

because of lack of power.

These results could encourage further work to determine how best to

deliver radiotherapy for lung cancer patients, Dr Le Pechoux said. "Interest in

modified fractionation was uncertain before the meta-analysis, but the current

results will lead to renewed interested in this research field."


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"In the most recent meta-analysis evaluating the best way to combine

radiotherapy and chemotherapy in NSCLC, the results showed that concomitant

chemo-radiation (5-year survival rate of 15.1%) is superior to sequential chemo-

radiation (5-year survival rate of 10.6%) and the best results shown in

randomized trials in small-cell lung cancer limited disease show 5-year survival

rates of 20-25%. Thus there is need for improvements of both radiotherapy and

chemotherapy," Dr Le Pechoux said.

Bibliography:

www.sciencedaily.com/news/health_medicine/lung_cancer/4/


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Reaction:

Lung cancer is a major cause of death worldwide. It is a lung disease

which can lead to death if not treated immediately. The cause of lung cancer

was due to cigarette smoking, and exposure to certain industrial substances

such as asbestos particularly in those who smoke. Early detection of cancer canbe a way of preventing of worsening and metastizing of cancer to the organ and

parts of the body. Diagnostic test can also be one way to detect the severity if

cancer. It may include chest X-ray, sputum cytology test, and fiberoptic

bronchoscopy. Management of the lung cancer may include the following:

LOBECTOMY (surgical excision of a lobe.), PNEUMONECTOMY (surgical

procedure to remove a lung), and WEDGE RESECTION (to remove a triangle-

shaped slice of tissue). Radiation and chemotherapy are also best suggested

treatment. These Procedure are common choice in treating cancer and few

cancer patients survive even they undergo those treatment.

Nowadays because of advancing technology and much research being

created to treat certain disease researchers have found out that there is other

alternative treatment for treating lung cancer. Not only radiation therapy,

chemotherapy and surgical management can treat lung cancer. Researchers

found out the effect of Radiotherapy Variants Improve Survival in Non-Metastatic

Lung Cancer. These studies become successful because the study have been

proved and have a good effect to cancer patients. It gives hope to cancer

patient to live long. Through the used of technology and brilliant mind of

individual treating severe condition is now possible.


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Doxycycline Is a Cost-effective Therapy for Hospitalized

Patients With Community-Acquired Pneumonia

By Dellero, Sarah Joy

Reba K. Ailani, MD; Gautami Agastya, MD; Rajesh K. Ailani, MD; Beejadi N.

Mukunda, MD; Raja Shekar, MDArch Intern Med. 1999;159:266-270.

Background Doxycycline has a high degree of activity againstmany

common respiratory pathogens and has been used in the

outpatientmanagement of lower respiratory tract infections,

includingpneumonia.

Objective To evaluate the efficacy of intravenous doxycycline as empirical

treatment in hospitalized patients with mild tomoderately severe community-

acquired pneumonia.

Patients and Methods We conducted a randomized prospective trial to

compare the efficacy of intravenous doxycycline withother routinely used

antibiotic regimens in 87 patients admittedwith the diagnosis of community-

acquired pneumonia. Forty-threepatients were randomized to receive 100 mg of

doxycycline intravenouslyevery 12 hours while 44 patients received other

antibiotic(s)(control group). The 2 patient groups were comparable in

theirclinical and laboratory profiles.

Results The mean SD interval between startingan antibiotic and theclinical response was 2.21 2.61 days in the doxycycline group compared with

3.84 6.39days in the control group (P = .001). The mean SD lengthof

hospitalization was 4.14 3.08 days in the doxycycline group compared with

6.14 6.65 days in the control group(P = .04). The median cost of hospitalization

was $5126 in thedoxycycline group compared with $6528 in the control group

(P= .04). The median cost of antibiotic therapy in the doxycycline-

treatedpatients ($33) was significantly lower than in the control group($170.90)

(P


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Reaction:

The study was about the drug doxycycline which is cost effective therapy

for patient with Community Acquired Pneumonia. Doxycycline is an anti-

infection drug which inhibits the growth of microorganisms and other causative

agent that destroys the bodys cell. It has been proven that this drug is effective

and inexpensive drug therapy for patient with CAP.

As a student nurse it is our responsibility to inform the patient about the

medication that we give to them because it is their right to know what drug they

are taking for. It is also our responsibility to familiarize drugs that is commonly

used in the hospital. We should be knowledgeable enough about the drugs that

we are administering; therefore we should study first the drug before giving to

the patient or client. We should familiarize and understand the actions, adverse

reaction and side effect of the certain drug.

Doxycycline is not a new drug it has been used for more than a decade,before giving this drug we should understand its action and how it will help to

the condition of the patient or client.

Drug administration as one of the job description of a nurse, so we should

be careful in giving drugs to patient because we are dealing with human life.

Bibliography:

http://archinte.ama-assn.org/cgi/content/abstract/159/3/266


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Asthma: Recent trends in diagnosis and management

By Dequito, Ilona Mae

Abstract

Asthma is an inflammatory disease of the airways that results in airway

hyperreactivity and episodic airway narrowing. The prevalence of asthma in the

United States is increasing, as are the rates of morbidity and mortality

associated with the disease. Environmental and psychosocialfactors may be

responsible for these disturbing trends and should be modified when possible.

Psychiatrists should be able to diagnose and to manage uncomplicated cases of

asthma because of certain risk factors such as cigarette smoke, emotional

distress, and severe psychiatric illness. Anti-inflammatory and bronchodilator

medications are the foundation of pharmacologic treatment. To increase

compliance, patient education is critical. The clinician should encourage carefulself-monitoring and use of a home peak flow meter. Every attempt should be

made to modify adverse environmental factors. Recent cellular and molecular

research has led to a better understanding of the pathophysiology of asthma. As

a result of this increasing understanding, newer medications are being

developed and tested. The new antimediator agents, which appear to be

effective and safe for the treatment of asthma, are particularly promising.

Reference:

MD Andrew J. Cutler,

(Psychiatric Medicine Program, Florida Hospital, Orlando, Florida, USA)


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Reaction:

Asthma is a common disorder of the airways that is characterized by typical

symptoms arising from a complex interplay between chronic inflammation and

disordered airway function. Worldwide disease prevalence continues to rise

steadily and the condition contributes to significant morbidity and preventable

mortality. The goals of treatment in asthma are to achieve control of symptoms

and to prevent exacerbations. Thats why non-pharmacological measures is

important for the patient to be followed including patient education, avoidance

of triggers and smoking cessation.Also Pharmacological management that

involves the stepwise titration of -agonist bronchodilators and inhaled

corticosteroids according to symptoms. . As a result of this increasing

understanding, newer medications are being developed and tested. The new

antimediator agents, which appear to be effective and safe for the treatment of

asthma, are particularly promising.Nurses must be aware of alternative

therapies for the patient with bronchial asthma.


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Mangosteen Asthma

Breakthrough Treatment for Asthma Relief

By Dolloso, Eunee Kem

Asthma is a common chronic inflammation of the airways characterized

by swelling and bronchospasm. The inflammation leads to narrowing of the

bronchial tubes, either totally or partially. The result is difficulty in breathing

(dyspnea). Asthma affects seven percent of the population of the United States

and approximately 300 million people worldwide. The disease is prevalent but

the mortality rate is relatively low. It is responsible for 4,000 deaths per year in

the U.S. and 250,000 deaths per year across the globe.

When the bronchial tubes are chronically inflamed, they tend to be more

sensitive to allergens or irritants. In such cases, the airways become highly

irritable and may remain in a state of heightened sensitivity which is also knownas bronchial hyperreactivity (BHR). Experts say that there is a certain degree of

bronchial hyperreactivity in all individuals but apparently asthmatics have a

higher degree when compared to nonasthmatic people. Sensitive individuals are

more likely to experience swelling and constriction of the bronchial tubes when

exposed to allergens and other triggers such as cigarette smoke, dust or

exercise. Among asthmatics, some may have severe BHR and chronic

symptoms while others may only have mild BHR and no symptoms. Evidently,

people are affected differently by asthma. Each individual has a unique reaction

to various allergens and environmental triggers. This significantly influences the

specific type and dose of medication which may also vary from one person to

another.

Asthma Symptoms

Because of the difference in severity among asthmatics, some patients

rarely experience symptoms, whereas others may have severe airflow

obstruction at all times. Therefore, the symptoms of asthma vary greatly from

person to person and in any patient from time to time. It is important to note that

the most of the symptoms can be relatively mild and may appear similar to thoseobserved in other diseases. In general, there are four major symptoms of

asthma. First is shortness of breath (SOB) which is normally seen with physical

exertion or at night. Next is wheezing which is characterized by a whistling

sound upon exhalation. Third is coughing which is typically worse at night or

early in the morning. Coughing can be chronic and it may be triggered by

exposure to cold air or exercise. The last one is tightness of the chest which may


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occur with or without the other aforementioned symptoms.

Note that all of the symptoms mentioned above can be present in other

respiratory, and sometimes, in cardiac diseases. This possible confusion

highlights the importance of determining the particular settings in which the

symptoms take place. Moreover, diagnostic testing plays a crucial role in

identifying this disorder.

Asthma Treatment

The treatment protocol primarily focuses on relaxing bronchospasm with

the use of bronchodilators, or reducing inflammation with the help of

corticosteroids. These medications are divided into two types: quick-relief

medications used to treat acute asthma attacks and long-term control

medications used to prevent exacerbation of the disease. Quick relief

medications include beta2-adrenoceptor agonists such as bitolterol,levalbuterol, salbutamol and terbutaline); adrenergic agonists such as inhaled

epinephrine and ephedrine tablets; and anticholinergic medications such as

ipratropium bromide. These medications must be taken with caution as they may

have adverse side effects. For instance, beta2-adrenoceptor agonists may cause

tremor and hypertension. They must not be used too often as their efficacy may

decline, creating desensitization resulting into exacerbation of symptoms which

may eventually lead to refractory asthma and even death. As for long-term

control medications, they include inhaled glucocorticoids and long-acting 2-

agonists.

Mangosteen Help for Asthma

For a lot of asthmatics who have grown sick and tired of steroids and their

harmful side effects, it is but natural to seek relief from natural sources. This is

where mangosteen comes into the picture and its quite likely that most

asthmatics have already heard or have been taking this wonder fruit as a dietary

supplement. However, the hype about the benefits offered by mangosteen to

asthmatics is not mere hearsay. Mangosteen has grown in popularity among

asthma sufferers because it delivers positive results without any accompanying

adverse reactions.

The key to mangosteens remarkable benefits is the presence of a group of

compounds called xanthones. These are powerful anti-inflammatories, and as

previously mentioned, inflammation of the airways is a major problem about

asthma. Mangosteens truckload of xanthones can easily address this problem,

allowing the patient to breath normally. Xanthones also have anti-viral properties


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which is important in reducing the risk of pulmonary infections. Note that when

the airways are inflamed, there is a tendency for overproduction and

accumulation of mucus. This leaves the patient susceptible to infection because

bacteria and viruses grow and multiply in the mucus that lines the bronchial

passageways. With xanthones anti-inflammatory and anti-viral properties, these

problems are easily eliminated. Xanthones are also potent antioxidants that help

to counteract the free radical damage caused by exposure to polluted air.Finally, xanthones have been shown to have anti-allergy effects which greatly

reduce the risk of having an acute asthma attack.

Bibliography:

http://www.naturalhomecures.com


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Reaction:

One of the newest, hottest topics in health food supplements today is

mangosteen.

The whole fruit of a mangosteen contains its primary nutrient compound,

xanthones, naturally occurring, high-potency antioxidants found primarily in the

peel/hull of the fruit.

Mangosteen has been revered for centuries as Asia's Queen of Fruits.

It has been proven that mangosteen can help us in treating different kind

of illness. According to that study that many had tested this kind of fruit and is

proven effectively.

It can boost energy, reduced and diminish pain, fight inflammation lose

weight, improve digestion and your stomach condition, fight muoth sore and

eliminate bad breath, fight cancer, fight infectious and a lot more. So it is

recommended for us to try mangosteen for us also to protect ourselves fromillness. We should be aware also that we should not really depend because too

much of intake of this may result to toxicity that may lead us for a specific illness.

Nevertheless, mangosteen is a good source of food supplementation for our

health.


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When Seconds Count: Interventional Radiology Treatment

for Pulmonary Embolism Saves Lives

By Elizada, Kristine Joy

Catheter-directed therapy should be considered a first-line treatment

option for massive blood clots in the lungs, according to study of nearly 600patients in Journal of Vascular and Interventional Radiology

FAIRFAX, Va.Catheter-directed therapy or catheter-directed thrombolysisan

interventional radiology treatment that uses targeted image-guided drug

delivery with specially designed catheters to dissolve dangerous blood clots in

the lungssaves lives and should be considered a first-line treatment option for

massive pulmonary embolism, note researchers in the November Journal of

Vascular and Interventional Radiology.

"Modern catheter-directed therapy for acute pulmonary embolism saveslives, and we need to raise awareness about its safety and effectiveness not only

among the general public but also within the medical community. It's a matter of

life and death," said William Kuo, M.D., an interventional radiologist who is

assistant professor and fellowship director of vascular and interventional

radiology in the Department of Radiology at Stanford University Medical Center

in Stanford, Calif. "In our study, we conclude that modern catheter-directed

therapy is a relatively safe and effective treatment for acute massive pulmonary

embolism and should be considered as a first-line treatment option," he added.

Pulmonary embolism occurs when one or more arteries in the lungs become

blocked from blood clots that break free and travel there. These clots most oftenbegin as deep vein thrombosis (DVT) or blood clots within the deep leg veins.

When the clots break free, circulate and become trapped in the lungs, they can

block the oxygen supply, cause heart failure and result in death. About 600,000

cases of acute pulmonary embolism are diagnosed each year in the United

States, and an estimated 300,000 patients die, noted Kuo. "If initiated early,

minimally invasive catheter-directed therapy could save many of those lives,"

added the lead author of the study, "Catheter-directed Therapy for the

Treatment of Massive Pulmonary Embolism: Systematic Review and Meta-

analysis of Modern Techniques."

During the treatment, an interventional radiologist inserts specially

designed catheters (thin plastic tubes) through a tiny incision into one's blood

vessels and guides the catheters using real-time imaging without traditional

open surgery. This allows an interventional radiologist to deliver a clot-busting

medicine directly into the clot. The catheters may also be used to mechanically


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break up clots and suction them away. This treatment offers less pain and less

recovery time than traditional open surgery, said Kuo.

Stanford University researchers conducted a meta-analysis of the treatment on

594 patients in 18 countries who were treated between 1990 and 2008. The

treatment was lifesaving in 86.5 percent of the cases studied and had only a 2.4

percent chance of major complications. Researchers found that not only was

the treatment effective, but it also appeared much safer than the historicalcomplication rates reported from injecting high-dose clot-busting medicine

systemically or directly into the blood stream where the drug can circulate

throughout the body and cause major bleeding in up to 20 percent of patients.

Kuo began this study three years ago after he was asked to assist with a 62-

year-old woman who had collapsed at home and was rushed to the emergency

room with massive blood clots in her lungs. The patient had been given a large-

dose intravenous infusion of clot-busing medicine, a treatment called systemic

thrombolysis, but that had failed.

While Kuo was initially consulted to place a special filter to prevent more

clots from traveling from the legs to the lungs, he knew it would do little to save

her. "I could see that she was quickly dying and there was no time to waste. I

remember telling the staff, 'We can do more than just insert a filter. We can go

after these clots using specially designed catheters,'" said Kuo. After obtaining

consent from the family, Kuo made a tiny incision into the patient's neck and

inserted a catheter into the vein. He then used X-ray images (fluoroscopy) to

guide the catheter, navigating through the heart and finally reaching the blood

clots within the lungs. He injected a clot-busting drug directly into the clots and

then used the catheter to mechanically break up the clots before suctioningthem out. "The results were immediate, and the treatment saved her life," said

Kuo. "That experience inspired me to initiate further studies and to raise

awareness of this emerging life-saving procedure," he added.

According to Kuo, the study addressed the use of catheter-directed

therapy for treating the most severe or life-threatening form of pulmonary

embolism known as "massive" pulmonary embolism. Additional studies are

needed to see if the treatment should be initiated in those patients with less

severe or "sub-massive" pulmonary embolism, he added. To answer these

questions and to analyze further treatment outcomes, Kuo's team is initiating the

multicenter PERFECT (Pulmonary Embolism Response to Fragmentation,

Embolectomy and Catheter Thrombolysis) registry. In the meantime, the

Stanford researchers advocate the use of catheter-directed therapy for massive

pulmonary embolism "as both an early and alternative treatment option at

centers with the appropriate expertise," said Kuo.

###


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"Catheter-directed Therapy for the Treatment of Massive Pulmonary

Embolism: Systematic Review and Meta-analysis of Modern Techniques" is

published in the November Journal of Vascular and Interventional Radiology.

Co-authors are William T. Kuo, M.D.; John D. Louie, M.D.; Jarrett K. Rosenberg,

Ph.D.; Daniel Y. Sze, M.D., Ph.D.; Lawrence V. Hofmann, M.D., all Division of

Vascular and Interventional Radiology, Department of Radiology, Stanford

University Medical Center, Stanford, Calif., and Michael K. Gould, M.D., M.S.,Pulmonary and Critical Care Division, Department of Medicine, Stanford

University Medical Center, Stanford, Calif., and Pulmonary and Critical Care

Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif.

Bibliography:

http://www.eurekalert.org/pub_releases/2009-11/soir-wsc111109.php


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Reaction:

Interventional radiologists are physicians who specialize in minimally

invasive, targeted treatments. They offer the most in-depth knowledge of the

least invasive treatments available coupled with diagnostic and clinical

experience across all specialties. They use X-ray, MRI and other imaging to

advance a catheter in the body, such as in an artery, to treat at the source of the

disease internally. As the inventors of angioplasty and the catheter-delivered

stent, which were first used in the legs to treat peripheral arterial disease,

interventional radiologists pioneered minimally invasive modern medicine.

Today, interventional oncology is a growing specialty area of interventional

radiology. Interventional radiologists can deliver treatments for cancer directly

to the tumor without significant side effects or damage to nearby normal tissue.

Many conditions that once required surgery can be treated less invasively by

interventional radiologists. Interventional radiology treatments offer less risk,

less pain and less recovery time compared to open surgery.

Interventional radiologists' unique blend of skills fosters innovation and

enables them to quickly adapt their imaging expertise to pioneer nonsurgical

treatments that are guided by imaging. They adapt a technique proven to work

for one problem and apply it to another. When it comes to the best practices for

safely performing minimally invasive treatments, interventional radiologists

pioneered the procedures and the standards for safety and quality. Patient

safety is incorporated into the development of these advances because

interventional radiology and diagnostic radiology training programs include

radiation safety, radiation physics, the biological effects of radiation and injury

prevention.

The Society of Interventional Radiology (SIR) publishes guidelines for

minimally invasive treatments, including criteria for adequate training for

specific interventional procedures, as well as expected success and

complication rates. For many years, surgery was the only treatment available for

many conditions. Today, interventional radiology treatments are first-line care

for a wide variety of conditions. It is important to get a second opinion and know

all of your treatment options before consenting to any procedure or surgery.


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Impact of Oseltamivir Treatment on Influenza-Related Lower

Respiratory Tract Complications and Hospitalizations

By Espiritu, Ma. Kristina Cassandra

Laurent Kaiser, MD; Cynthia Wat, MBBS, MRCP; Tracy Mills, MSc; Paul Mahoney,

MSc; Penelope Ward, MBBS; Frederick Hayden, MD

Arch Intern Med. 2003;163:1667-1672.

Background

Influenza causes lower respiratory tract complications (LRTCs),

particularly bronchitis and pneumonia, in both otherwise healthy adults and

those with underlying conditions. The aimof this study was to assess the effectof oseltamivir treatment on the incidence of LRTCs leading to antibiotic

treatment andhospitalizations following influenza illness.

Methods We analyzed prospectively collected data on LRTCsand antibiotic use

from 3564 subjects (age range, 13-97 years)with influenzalike illness enrolled in

10 placebo-controlled,double-blind trials of oseltamivir treatment.

Results

In adults and adolescents with a proven influenza illness, oseltamivir

treatment reduced overall antibiotic use for any reason by 26.7% (14.0% vs

19.1% with placebo; P


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Conclusion

Oseltamivir treatment of influenza illness reduces LRTCs, antibiotic use,

and hospitalization in both healthyand "at-risk" adults.

Reference:

From the Hpital Cantonal de Genve, Geneva, Switzerland (Dr Kaiser);

Roche Global Development, Welwyn, England (Drs Wat and Ward, Ms Mills, and

Mr Mahoney); and University of Virginia, Charlottesville (Dr Hayden). Dr Wat, Ms

Mills, and Mr Mahoney are employees of F. HoffmanLa Roche Ltd. Dr Ward was

employed by F. HoffmannLa Roche Ltd when this research was conducted. Dr

Hayden has served as a paid consultant to F. HoffmannLa Roche Ltd according

to the guidelines of the University of Virginia School of Medicine.


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Reaction:

It is always said that prevention is better than cure. Influenza virus can

always be prevented before it can further lead to lower respiratory infection

which could be more complicated and fatal. One prevention is the universal

precaution which was hand washing. Through it, we can further prevent the

spread of infection. Then, the covering of nose and mouth during sneeze andcough. That is to avoid the spread of microorganisms to the environment and to

other people. Lastly, maintaining clean environment and avoidance to allergens

would be a major help.

In the abstract, they used Oseltamivir for the treatment of people having

lower respiratory tract complications

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