• Title/Summary/Keyword: respiratory management

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Pneumothorax

  • Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.99-104
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    • 2014
  • Pneumothorax-either spontaneous or iatrogenic-is commonly encountered in pulmonary medicine. While secondary pneumothorax is caused by an underlying pulmonary disease, the spontaneous type occurs in healthy individuals without obvious cause. The British Thoracic Society (BTS, 2010) and the American College of Chest Physicians (ACCP, 2001) published the guidelines for pneumothorax management. This review compares the diagnostic and management recommendations between the two societies. Patients diagnosed with primary spontaneous pneumothorax (PSP) may be observed without intervention if the pneumothorax is small and there are no symptoms. Oxygen therapy is only discussed in the BTS guidelines. If intervention is needed, BTS recommends a simple aspiration in all spontaneous and some secondary pneumothorax cases, whereas ACCP suggests a chest tube insertion rather than a simple aspiration. BTS and ACCP both recommend surgery for patients with a recurrent pneumothorax and persistent air leak. For patients who decline surgery or are poor surgical candidates, pleurodesis is an alternative recommended by both BTS and ACCP guidelines. Treatment strategies of iatrogenic pneumothorax are very similar to PSP. However, recurrence is not a consideration in iatrogenic pneumothorax.

A Case of Bronchoscopic Treatment of a Bronchopleural Fistula Accompanied by Pneumonia (폐렴에 합병된 기관지 늑막강루에서 기관지 내시경을 이용한 비침습적 치료 -1예 보고)

  • Kim, Hyoungrae
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.507-510
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    • 2007
  • A bronchopleural fistula (BPF) is traditionally treated by surgery, but currently various noninvasive forms of management, particularly the use of bronchoscopy, have been utilized. The substances and methods for noninvasive management of a BPF differ with individual clinicians. This case describes the use of flexible bronchoscopic treatment of a BPF complicating pneumoniausing embolization coils and intraluminally injected fibrin glue. If the BPF is small and is located on the peripheral bronchus, this minimal invasive maneuver could be recommended for the treatment of a BPF.

Current Diagnosis and Management of Hypersensitivity Pneumonitis

  • Leone, Paolo Maria;Richeldi, Luca
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.122-131
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    • 2020
  • Hypersensitivity Pneumonitis (HP) one of the most common interstitial lung diseases (ILDs) is characterized by exposure to an inhaled inciting antigen that leads to a host immunologic reaction determining interstitial inflammation and architectural distortion. The underlying pathogenetic mechanisms are unclear. The absence of international shared diagnostic guidelines and the lack of a "gold-standard" test for HP combined with the presence of several clinical and radiologic overlapping features makes it particularly challenging to differentiate HP from other ILDs, also in expert contests. Radiology is playing a more crucial role in this process; recently the headcheese sign was recognized as a more specific for chronic-HP than the extensive mosaic attenuation. Several classification proposals and diagnostic models have been advanced by different groups, with no prospective validation. Therapeutic options for HP have been limited to antigen avoidance and immunosuppressant drugs over the last decades. Several questions about this condition remain unanswered and there is a need for more studies.

The Association between Serotonin Reuptake Inhibitors and Obstructive Sleep Apnea in People with Epilepsy-A Retrospective Analysis

  • Cheng, Jocelyn Y.
    • Journal of Sleep Medicine
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    • v.15 no.2
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    • pp.43-47
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    • 2018
  • Objectives: Obstructive sleep apnea (OSA) is common in people with epilepsy (PWE), and confers medical and seizure-related consequences when untreated. Positive airway pressure, the gold-standard for OSA management, is limited by tolerability. As serotonin is involved respiratory control and amelioration of seizure-induced respiratory events, this study aims to determine whether serotonin reuptake inhibitors (SRIs) may represent a potential therapeutic option. Methods: A retrospective study of 100 PWE and OSA ${\geq}18$ years of age was conducted. The primary outcome measure was OSA severity as function of SRI use, with rapid eye movement (REM)-related OSA as a secondary outcome. Results: Older age and depression were more common in those taking an SRI. There was no association between SRIs and OSA severity. However, the SRI group was less likely to have REM-related OSA. Conclusions: In PWE and OSA, SRI use is associated with reduced risk of REM-related OSA, and may represent a potential management strategy.

Big Data Research on Severe Asthma

  • Sang Hyuk Kim;Youlim Kim
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.213-220
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    • 2024
  • The continuously increasing prevalence of severe asthma has imposed an increasing burden worldwide. Despite the emergence of novel therapeutic agents, management of severe asthma remains challenging. Insights garnered from big data may be helpful in the effort to determine the complex nature of severe asthma. In the field of asthma research, a vast amount of big data from various sources, including electronic health records, national claims data, and international cohorts, is now available. However, understanding of the strengths and limitations is required for proper utilization of specific datasets. Use of big data, along with advancements in artificial intelligence techniques, could potentially facilitate the practice of precision medicine in management of severe asthma.

Relationships between Respiratory Diseases and Safety of Pediatric Dental Sedation (소아의 호흡기 질환과 안전한 치과진정법의 연관성)

  • Chung, Woojin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.327-330
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    • 2015
  • The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

Pediatric advanced life support and sedation of pediatric dental patients

  • Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.1
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    • pp.9-15
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    • 2016
  • Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

New Era of Management Concept on Pulmonary Fibrosis with Revisiting Framework of Interstitial Lung Diseases

  • Azuma, Arata;Richeldi, Luca
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.195-200
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    • 2020
  • The disease concept of interstitial lung disease with idiopathic pulmonary fibrosis at its core has been relied on for many years depending on morphological classification. The separation of non-specific interstitial pneumonia with a relatively good prognosis from usual interstitial pneumonia is also based on the perception that morphology enables predict the prognosis. Beginning with dust-exposed lungs, initially, interstitial pneumonia is classified by anatomical pathology. Diagnostic imaging has dramatically improved the diagnostic technology for surviving patients through the introduction of high-resolution computed tomography scan. And now, with the introduction of therapeutics, the direction of diagnosis is turning. It can be broadly classified into to make known the importance of early diagnosis, and to understand the importance of predicting the speed of progression/deterioration of pathological conditions. For this reason, the insight of "early lesions" has been discussed. There are reports that the presence or absence of interstitial lung abnormalities affects the prognosis. Searching for a biomarker is another prognostic indicator search. However, as is the case with many chronic diseases, pathological conditions that progress linearly are extremely rare. Rather, it progresses while changing in response to environmental factors. In interstitial lung disease, deterioration of respiratory functions most closely reflect prognosis. Treatment is determined by combining dynamic indicators as faithful indicators of restrictive impairments. Reconsidering the history being classified under the disease concept, the need to reorganize treatment targets based on common pathological phenotype is under discussed. What is the disease concept? That aspect changes with the discussion of improving prognosis.

Association among Lifestyle and Risk Factors with SARS-CoV-2 Infection

  • Yi Ko;Zi-Ni Ngai;Rhun-Yian Koh;Soi-Moi Chye
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.102-110
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    • 2023
  • Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.

Usage of Bojungiki-tang to Maintain and Treat Asthmatic Patients (천식(喘息)환자의 유지치료를 위한 보중익기탕(補中益氣湯)의 효과)

  • Sul, Mu-Chang;Kim, Do-Sun;Kim, Do-Hyun;Jang, Ha-Ryeon;Kim, Jin-Ju;Jung, Hee-Jae;Jung, Sung-Ki
    • The Journal of Internal Korean Medicine
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    • v.32 no.4
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    • pp.497-503
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    • 2011
  • Objectives : To assess the effect of Bojungiki-tang for symptomatic management in stable asthmatic patients after initial treatment. Methods : Outcome measures of asthmatic patients were recorded using patient's charts and inquiry. Compared with the patient's state right after they got their treatment, "Excellent" was if it was almost the same state, "Good" was if the patient's state was maintained for almost 70%, "Fair" was for 50%, "Poor" was for under 50% or if the patient required another treatment. Results : Of 25 patients, 21 used Bojungiki-tang for more than one month and 20 maintained a stable state, that is, feeling more than 70% of symptom control compared with previous best status. Conclusions : Bojungiki-tang has a good effect for maintaining asthma after treatment.