Effect of nursing on postoperative respiratory function and mental health of lung cancer patients

BACKGROUND Both pulmonary rehabilitation training and psychological care have been shown to have a positive effect on the postoperative recovery of patients with lung cancer.However,few studies have combined the two to explore their combined effect.Therefore,this study aimed to investigate the effects of pulmonary rehabil-itation training combined with psychological care on postoperative respiratory function and mental health in lung cancer patients.AIM To investigate effect of nursing on postoperative respiratory function and mental health of lung cancer patients.METHODS 122 cases of lung cancer patients who underwent surgical treatment in our hospital and were treated in our department from January 2022 to April 2023 were selected and randomly divided into the control group and observation group.The control group performed the routine care intervention.The obser-vation group was given pulmonary rehabilitation training and psychological care based on conventional nursing interventions.Forced expiratory volume,forced vital capacity.Maximum ventilatory volume(MVV)in one second was measured,and the patient's 6-min walking distance and dyspnoea index scale were used to assess the patient's respiratory condition.The Connor-Davidson resilience scale(CD-RISC),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were used to evaluate the mental health of the patients.RESULTS There was no difference between the two groups regarding age,gender,education level,surgical procedure,type of pathology,and treatment(P>0.05).After treatment,MVV,6-min walking distance,toughness,strength,optimism,and total CD-RISC scores were significantly higher in the observation group(P<0.05),dyspnoea scores,SAS,and SDS scores were substantially lower in the control group compared to the observation group(P<0.05).CONCLUSION Pulmonary rehabilitation training combined with psychological care for patients after lung cancer resection could improve lung function,enhance daily activities,effectively relieve negative emotions such as anxiety and depression,and reduce complications.

Cortical activity in patients with high-functioning ischemic stroke during the Purdue Pegboard Test:insights into bimanual coordinated fine motor skills with functional near-infrared spectroscopy

After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation.Therefore,incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes.The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.

Analysis of the Effect of Extracorporeal Diaphragmatic Pacing Combined with Noninvasive Ventilator on the Respiratory Function and Prognosis of COPD Patients

Objective: To investigate the effect of extracorporeal diaphragmatic pacing combined with noninvasive ventilators on the respiratory function and prognosis of chronic obstructive pulmonary disease (COPD) patients. Methods: A total of 50 COPD patients were selected between January 2023 to December 2023 and randomly grouped into an observation group and a control group, with 25 cases. The observation group was given extracorporeal diaphragm pacing combined with a noninvasive ventilator, while the control group was given a conventional treatment mode. After the treatment, the results of each index in the two groups were compared. Results: Compared with the diaphragm function indexes of the two groups, the data of the observation group were more dominant (P < 0.05). The rehospitalization rate of the observation group was lower than that of the control group (P < 0.05). The COPD assessment test (CAT) and mMRC (Modified Medical Research Council) Dyspnoea scale scores after treatment between the two groups were significantly different (P < 0.05). Compared with the control group, the lung function indexes of the observation group were more dominant (P < 0.05). Conclusion: Extracorporeal diaphragmatic pacing combined with a noninvasive ventilator promoted the improvement of the patient’s prognosis and improved their respiratory function.

Respiratory Tract, Ventilation, and Pulmonary Functions Tests

Breathing is considered the common factor that links studying,sleeping,and activities.It is one of the primary indicators that is frequently considered when determining whether or not an unconscious individual is still alive.The evolution and development process of the respiratory system that occurs in a foetus is primarily from head to tail(cephalocaudal).Many changes occur throughout this period until the 28th week of pregnancy at which the foetus^respiratory system will attain adequate development for the rest of his or her life.The respiratory system comprises of the lungs and the encompassing thoracic wall,which includes the thoracic cages,midriff(diaphragm),and the abdominal wall.Spirometry is a procedure used for estimating air volumes that enter and exit the pulmonary system with the aid of a spirometer.The various pulmonary parameters that reflect pulmonary ventilation are of great significance in diagnosing respiratory diseases.The respiratory system will be discussed in more detail in this article.

Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer

BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Values of high-resolution computed tomography and pulmonary function tests in managements of patients with chronic hepatitis C virus infection

AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.

Measurement of hepatic functional mass by means of ^(13)C-methacetin and ^(13)C-phenylalanine breath tests in chronic liver disease: Comparison with Child-Pugh score and serum bile acid levels

AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels.METHODS: One hundred and forty patients (50 HCV-related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated.RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids.Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test.CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients.

Abnormal liver function tests associated with severe rhabdomyolysis

Rhabdomyolysis is a syndrome of skeletal muscle injury with release of cellular constituents such as potassium,phosphate,urate and intracellular proteins such as myoglobin into the circulation,which may cause complications including acute kidney injury,electrolyte disturbance and cardiac instability.Abnormal liver function tests are frequently observed in cases of severe rhabdomyolysis.Typically,there is an increase in serum aminotransferases,namely aspartate aminotransferase and alanine aminotransferase.This raises the question of liver injury and often triggers a pathway of investigation which may lead to a liver biopsy.However,muscle can also be a source of the increased aminotransferase activity.This review discusses the dilemma of finding abnormal liver function tests in the setting of muscle injury and the potential implications of such an association.It delves into some of the clinical and experimental evidence for correlating muscle injury to raised aminotransferases,and discusses pathophysiological mechanisms such as oxidative stress which may cause actual liver injury.Serum aminotransferases lack tissue specificity to allow clinicians to distinguish primary liver injury from muscle injury.This review also explores potential approaches to improve the accuracy of our diagnostic tools,so that excessive or unnecessary liver investigations can be avoided.

Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU

BACKGROUND: Prognostic value of cortisol and thyroid function tests(TFTs) has previously been evaluated in medical ICUs. We aimed to evaluate prognostic efficacy of cortisol and TFTs in critically ill poisoned patients admitted to toxicology intensive care unit(ICU).METHODS: In a prospective study of consecutively enrolled subjects admitted to the toxicology ICU, lab analyses included TFTs(total T3 and T4 as well as TSH) and cortisol levels drawn between 8 am–10 am during period of the first 24 hours post-ingestion/exposure. Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) were recorded. All scores were compared to detect the best prognostic factor. Type of poisoning was also included.RESULTS: In 200 patients evaluated, 129 were male and mean age was 31 years. In general, SAPS Ⅱ, T4, and cortisol could prognosticate death. After regression analysis, only cortisol had such efficacy(P=0.04; OR=1.06; 95%CI=1.05–1.08; cut-off=42 μg/d L; sensitivity=70%; specificity=82%). Between aluminium phosphide(ALP)-and non ALP-poisoned patients, level of consciousness, mean arterial pressure, and cortisol level could prognosticate death in ALP poisoning(all Ps<0.001 in both uni and multivariate analyses). Median(interquartile range; IQR) GCS was 7(6, 10) and 15(8, 15) in non-ALP and ALP-poisoned patients(P<0.003). SAPS Ⅱ and APACHE Ⅱ could not prognosticate death at all.CONCLUSION: Cortisol best prognosticated outcomes for subjects admitted to the toxicology ICU. Its level is higher in ALP-poisoned patients probably due to the higher stress while they remain conscious till the final stages of toxicity and are aware of deterioration of their clinical condition or may be due to their significantly lower blood pressures.

Sperm function tests after vasovasostomy

Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasovasostomy groups and between these 3 groups and the controls. With triple-stain, the percentage of normalacrosome reaction was significantly lower in Group A as compared with the controls, but not in Groups B and C. Therewere no significant differences in the results of CMPT between the vasovasostomy groups and the controls. However,the number of 'poor' type was significantly higher in Groups A and C than in the controls; the percentage of 'nega-tive' type were higher in Groups A and B than in the controls. Conclusion: After vasovasostomy a lower level ofHOST remained for one year and gradually recovered after one year. Six months after vasectomy reversal, the percent-age of acrosome reaction could be changed from lower level to normal range. The data of AO indicated that the geneticmaterial (double-stranded DNA) in spermatozoa was not affected by vasovasostomy. To evaluate the result of CMPTafter vasectomy reversal, not only the normal results but also the abnormal results ('poor' and 'negative' types)should also be considered.Aim: To evaluate the sperm function after vasovasostomy. Methods: Semen samples from 42 subjects aftervasovasostomy (Group A: 1-6 months, Group B: 6-12 months; Group C: 12-18 months after vasectomy rever-sal) were investigated. Semen from 34 normal fertile men was used as controls. Sperm function tests, including hypo-osmotic swelling test (HOST), acridine orange (AO) fluorescence, acrosome reaction (triple-stain), cervical mucuspenetration test (CMPT), etc were done. Results: After vasectomy reversal, the percentage of HOST was signifi-cantly lower than that of the normal fertile men. In regard to AO, there were no significant differences between thethree vasov

Could quantitative liver function tests gain wide acceptance among hepatologists?

It has been emphasized that the assessment of residual liver function is of paramount importance to determine the following： severity of acute or chronic liver diseases independent of etiology; long-term prognosis; step-bystep disease progression; surgical risk; and efficacy of antiviral treatment. The most frequently used tools are the galactose elimination capacity to asses hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, and antipyrine clearance to estimate microsomal activity. However, a widely accepted liver test （not necessarily a laboratory one） to assess quantitative functional hepatic reserve still needs to be established, although there have been various proposals. Furthermore, who are the operators that should order these tests？ Advances in analytic methods are expected to allow quantitative liver function tests to be used in clinical practice.

High-resolution computed tomography findings in humoral primary immunodeficiencies and correlation with pulmonary function tests

AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.

Effects of C2 hemisection on respiratory and cardiovascular functions in rats

High ce rvical spinal co rd injuries induce permanent neuromotor and autonomic deficits.These injuries impact both central respiratory and cardiovascular functions through modulation of the sympathetic nervous system.So far,cardiovascular studies have focused on models of complete contusion or transection at the lower cervical and thoracic levels and diaphragm activity evaluations using invasive methods.The present study aimed to evaluate the impact of C2 hemisection on different parameters representing vital functions(i.e.,respiratory function,cardiovascular,and renal filtration parameters)at the moment of injury and 7 days post-injury in rats.No ventilatory parameters evaluated by plethys mography were impacted during quiet breathing after 7 days post-injury,whereas permanent diaphragm hemiplegia was observed by ultrasound and confirmed by diaphragmatic electromyography in anesthetized rats.Interestingly,the mean arterial pressure was reduced immediately after C2 hemisection,with complete compensation at 7 days post-injury.Renal filtration was unaffected at 7 days post-injury;however,remnant systolic dysfunction chara cterized by a reduced left ventricular ejection fraction persisted at 7 days post-injury.Taken together,these results demonstrated that following C2 hemisection,diaphragm activity and systolic function are impa cted up to 7 days post-injury,whereas the respiratory and cardiovascular systems display vast ada ptation to maintain ventilatory parameters and blood pressure homeostasis,with the latter likely sustained by the remaining descending sympathetic inputs spared by the initial injury.A better broad characterization of the physiopathology of high cervical spinal cord injuries covering a longer time period post-injury could be beneficial for understanding evaluations of putative therapeutics to further increase cardiorespiratory recovery.

Liver function tests: Association with cardiovascular outcomes

An association between nonalcoholic fatty liver disease and cardiovascular disease has been repeatedly rep orted. Several studies have focused on levels of gammaglutamyltransferase (GGT) and alanine aminotransferase (ALT) in relation to cardiovascular outcomes. Evidence indicates that GGT may have a potential role for cardiovascular risk stratifi cation while the role of ALT for cardiac prognosis remains controversial. A conceptual framework that includes not only GGT and ALT but also markers of hepatocyte apoptosis such as cytokeratin-18 fragments should be developed.

Correlation between the Six-Minute Walk Test and Subjective Functional Class in Patients with Heart Failure

Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.

Analysis of the impact of ERAS-based respiratory function training on older patients’ability to prevent pulmonary complications after abdominal surgery

BACKGROUND In China,as the population grows older,the number of elderly people who have died from respiratory problems has increased.AIM To investigate whether enhanced recovery after surgery(ERAS)-based respiratory function training may help older patients who had abdominal surgery suffer fewer pulmonary problems,shorter hospital stays,and improved lung function.METHODS The data of 231 elderly individuals having abdominal surgery was retrospectively analyzed.Based on whether ERAS-based respiratory function training was provided,patients were divided into ERAS group(n=112)and control group(n=119).Deep vein thrombosis(DVT),pulmonary embolism(PE),and respiratory tract infection(RTI)were the primary outcome variables.Secondary outcome variables included the Borg score Scale,FEV1/FVC and postoperative hospital stay.RESULTS The percentage of 18.75%of ERAS group participants and 34.45%of control group participants,respectively,had respiratory infections(P=0.007).None of the individuals experienced PE or DVT.The ERAS group’s median postoperative hospital stay was 9.5 d(3-21 d)whereas the control groups was 11 d(4-18 d)(P=0.028).The Borg score decreased on the 4th d following surgery in the ERAS group compared to the 2nd d prior(P=0.003).The incidence of RTIs was greater in the control group than in the ERAS group among patients who spent more than 2 d in the hospital before surgery(P=0.029).CONCLUSION ERAS-based respiratory function training may reduce the risk of pulmonary complications in older individuals undergoing abdominal surgery.

Research on the intelligent internet nursing model based on the child respiratory and asthma control test scale for asthma management of preschool children

BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.

Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique(FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in preschool children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyperresponsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.