8 research outputs found
Uloga plućne rehabilitacije prije i nakon transplantacije
Pulmonary rehabilitation is the key component in treating patients with chronic respiratory diseases. In lung transplantation program it plays an important role as an individualized program for every patient before and after surgery. In these patients reduced ability to exercise is an important predictor of outcome and survival after surgery so feature of pulmonary rehabilitation is immenesely important. The intensity of exercise and training regimen depend on the underlying disease. Pretransplant rehabilitation helps optimize and maintain patient’s functional status and supplies important interdisciplinary information about the following surgery. It also includes psychosocial support to patients and their caregivers with the goal to reduce stress and improve adjustment while waiting for operation. Posttransplantation rehabilitation starts in the first 24-48 hours after surgery and it is oriented to optimal lung expansion, airway hygene, efficient breathing, extremity activation and walking. Educational component of the posttransplantation rehabilitation includes teaching recipients about desired health behaviors, risks, adequate medical regimen and healthy diet. Psychosocial support after transplantation involves: helping recipients to recover lost social and family roles, counseling, adapting to new organ and ongoing medical necessities, long-term moderation of their expectations and careing about their psychological wellbeing.Plućna rehabilitacija ključna je komponenta u liječenju osoba s kroničnim bolestima dišnog sustava, a u programu transplantacije pluća igra važnu ulogu u smislu individulanog programa za svakog bolesnika prije i nakon transplantacije. Kod ovih je pacijenata nemogućnost vježbanja snažan predskazatelj ishoda operacije i preživljenja, stoga je baš ovo obilježje plućne rehabilitacije od iznimne važnosti. Intenzitet i režim vježbanja određen je karakteristikama bolesti od koje je pacijent bolovao prije transplantacije. Pretransplantacijska plućna rehabilitacija bolesnicima pomaže u optimiziranju i održavanju funkcionalnog statusa prije operacije uz pružanje interdisciplinarnih informacija važnih za predstojeću operaciju i oporavak. Također uključuje psihosocijalnu potporu za pacijenta i članove obitelji radi umanjivanja stresa i povećanja prilagodbe u periodu čekanja transplantacije. Posttransplantacijska rehabilitacija započinje u prvih 24-48 sati nakon operacije i usmjerena je na optimalno širenje pluća i toaletu dišnih putova, učinkovito disanje, aktivaciju ekstremiteta i hod. Edukacijska komponenta posttransplantacijske rehabilitacije uključuje poučavanje o željenom zdravstvenom ponašanju, rizicima, adekvatnom režimu uzimanja lijekova i zdravoj prehrani. Psihosocijalna potpora odnosi se na pomoć u ponovnom preuzimanju izgubljenih socijalnih i obiteljskih životnih uloga, savjetovanje, prilagodbu na novi organ i daljnje medicinske potrebe, dugoročno moderiranje očekivanja te brigu o psihičkoj dobrobiti pacijenta
Mnenje za spremljanje bolnikov po preboleli covidni pljučnici
Pljučnica je najpogostejši vzrok za težji potek okužbe z virusom SARS-CoV-2 in s hospitalizacijo. Potek covidne pljučnice je lahko različen; infiltrati, vidni na rentgenski sliki, se lahko resorbirajo spontano, včasih pa je potrebno zdravljenje s sistemskimi glukokortikoidi. Ob odpustu iz bolnišnice zdravljenje običajno še ni končano, zato je Združenje pulmologov Slovenije v želji po enotnem obravnavanju bolnikov s covidno pljučnico izdelalo mnenje za obravnavo in sledenje bolnikov po odpustu iz bolnišnice. Zavedamo se, da ob novi bolezni ne gre za dokončno mnenje, saj bodo nova spoznanja o covidni pljučnici zanesljivo zahtevala obnavljanje mnenj
Presaditev pljuč v Sloveniji – izkušnje prvih treh let
Izhodišča: Presaditev pljuč je zahtevna metoda zdravljenja za izbrane bolnike z napredovalo pljučno boleznijo. Naraščanje števila primernih kandidatov in standarizacija posega sta v letu 2018 omogočila vzpostavitev transplantacijskega centra v UKC Ljubljana. Prispevek poroča o prvih rezultatih.
Metode: Opravili smo analizo lastnega registra bolnikov. Rezultate smo primerjali s skupino bolnikov, ki so jim pred tem opravili presaditev v AKH Dunaj.
Rezultati: Med 15. 9. 2018 in 15. 9. 2021 smo opravili 37 presaditev pljuč (od tega pri 13 ženskah). Indikacije so bile KOPB (n = 13, 35 %), pljučne fibroze (n = 7, 19 %), cistična fibroza (n = 5, 14 %), kovidna pljučnica (n = 4, 11 %), bronhiektazije (n = 3, 8 %), pljučna hipertenzija (n = 2, 5 %), limfangioleiomiomatoza (n = 1, 3 %), pomanjkanje alfa-1-antitripsina (n = 1, 3 %) in bronhiolitis (n = 1, 3 %). V primerjavi s prejšnjo skupino bolnikov, napotenih v AKH Dunaj (71 bolnikov, od tega 35 žensk), je bil delež bolnikov s KOPB višji (35 % in 16 %, p = 0,019), bolniki pa so bili starejši (mediana [razpon], 59 [14–68] in 43 [4–58] let, p = 0,001). 76 % darovanih pljuč ni ustrezalo standardnim merilom (30 % darovalcev je bilo starejših od 55 let, 22 % jih je imelo infiltrate na rentgenogramu pljuč, 24 % pa ni izpolnjevalo enega od ostalih meril), v 43 % pa je bila potrebna redukcija velikosti, kar pa ni vplivalo na primarno odpoved presadka. Kratkoročno preživetje je bili podobno v obeh skupinah (1-letno preživetje v UKC Ljubljana 89 % [95 % CI 78–99 %] in v AKH Dunaj 83 % [95 % CI 74–92 %]).
Zaključek: Prvi rezultati kažejo, da so zgodnji izidi po presaditvi pljuč primerljivi pri bolnikih, ki so imeli presaditev v UKC Ljubljana ali v AKH Dunaj
Position on the follow-up of patients after a bout of COVID-19 pneumonia
Pljučnica je najpogostejši vzrok za težji potek okužbe z virusom SARS-CoV-2 in s hospitalizacijo. Potek covidne pljučnice je lahko različeninfiltrati, vidni na rentgenski sliki, se lahko resorbirajo spontano, včasih pa je potrebno zdravljenje s sistem-skimi glukokortikoidi. Ob odpustu iz bolnišnice zdravljenje običajno še ni končano, zato je Združenje pulmologov Slovenije v želji po enotnem obravnavanju bolnikov s covidno pljučnico izdelalo mnenje za obravnavo in sledenje bolnikov po od-pustu iz bolnišnice. Zavedamo se, da ob novi bolezni ne gre za dokončno priporočilo, saj bodo nova spoznanja o covidni pljučnici zanesljivo zahtevala obnavljanje priporočil.Pneumonia is the most common complication of SARS-CoV-2 infection. Covid 19 - pneumonia is a serious illness and can lead to respiratory failure. Pulmonary infiltrates often resorb spontaneouslyhowever, sometimes treatment with systemic glucocorticoids is required. Upon discharge from the hospital, treatment is usually not yet completed. The Slovenian Respiratory society made suggestions for the treatment and follow-up of patients with covid 19 pneumonia after discharge from hospital. We are aware that with new findings we will need to update these recommendations
Complexes of Eu(III), Tb(III) and Cu(II) with proton transfer compound between 2,6-pyridinedicarboxylic acid and 2-aminobenzothiazole: characterization of the structures and physical properties
Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine
We report a case of 73-year-old man with massive hyperostosis of the cervical spine associated with diffuse idiopathic skeletal hyperostosis (DISH), resulting in dysphagia, hoarseness and acute respiratory insufficiency. An emergency operation was performed, which involved excision of osteophytes at the level of C6–C7, compressing the trachea against enlarged sternoclavicular joints, also affected by DISH. Approximately 3 years later, the patient sustained a whiplash injury in a low impact car accident, resulting in a C3–C4 fracture dislocation, which was not immediately diagnosed because he did not seek medical attention after the accident. For the next 6 months, he had constant cervical pain, which was growing worse and eventually became associated with dysphagia and dyspnoea, ending once again in acute respiratory failure due to bilateral palsy of the vocal cords. The patient underwent a second operation, which comprised partial reduction and combined anteroposterior fixation of the fractured vertebrae. Twenty months after the second operation, mild hoarseness was still present, but all other symptoms had disappeared. The clinical manifestations, diagnosis and treatment of the two unusual complications of DISH are discussed