Книги: "Non-invasive treatment"

1

K, Simonds Anita, ed. Non-invasive respiratory support. London: Chapman & Hall Medical, 1996.

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2

Klicpera, Martin. Chronic aortic regurgitation: Prognostic parameters for patients with chronic aortic regurgitation undergoing aortic valve replacement : value of invasive and non-invasive methods and pharmacological interventions (systemic vasodilation). Wien: Facultas Universitätsverlag, 1985.

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3

Baker-Price, Laura. Trans-cerebral magnetic (TCM) therapy: An effective and non-invasive treatment for depression and epileptic spectrum disorder (ESD) following brain trauma. Sudbury, Ont: Laurentian University, School of Graduate Studies, 2005.

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4

Simonds, Anita K. Non-Invasive Respiratory Support. Taylor & Francis Group, 2007.

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5

Masip, Josep, Kenneth Planas, and Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0025.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.

6

Masip, Josep, Kenneth Planas, and Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_001.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.

7

Masip, Josep, Kenneth Planas, and Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_002.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.

8

Masip, Josep, Kenneth Planas, and Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_003.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, immunocompromised or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure, bilevel pressure support ventilation and more recently, high flow nasal cannula. Whereas non-invasive pressure support ventilation requires a ventilator, the other two techniques are simpler and can be easily used in non-equipped areas by less experienced teams, including the pre-hospital setting. The success of non-invasive ventilation is related to an adequate timing, proper selection of patients and interfaces, close monitoring as well as the achievement of a good adaptation to patients’ demand.

9

Simonds, Anita K. Non-Invasive Respiratory Support: A Practical Handbook. 2nd ed. A Hodder Arnold Publication, 2001.

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10

Bard, Robert L. Prostate Cancer Decoded: Non-Invasive Breakthrough Treatments. Morgan James Publishing, 2007.

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11

Esquinas, Antonio M. Non-Invasive Mechanical Ventilation Complications: Essentials for Treatment and Prevention. Nova Science Publishers, Incorporated, 2021.

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12

Esquinas, Antonio M. Non-Invasive Mechanical Ventilation Complications: Essentials for Treatment and Prevention. Nova Science Publishers, Incorporated, 2021.

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13

(Editor), Aydin Arici, and Emre Seli (Editor), eds. Non- Invasive Management of Gynecologic Disorders. Informa Healthcare, 2008.

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14

Arici, Aydin, and Emre Seli. Non-Invasive Management of Gynecologic Disorders. Taylor & Francis Group, 2008.

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15

Arici, Aydin, and Emre Seli. Non-Invasive Management of Gynecologic Disorders. Taylor & Francis Group, 2008.

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16

Kubli, F. Breast Diseases: Breast-Conserving Therapy Non-Invasive Lesions, Mastopathy. Springer-Verlag, 1990.

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17

Breast diseases: Breast-conserving therapy, non-invasive lesions, mastopathy. Berlin: Springer-Verlag, 1989.

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18

Kadosh, Roi Cohen. Stimulated Brain: Cognitive Enhancement Using Non-Invasive Brain Stimulation. Elsevier Science & Technology Books, 2018.

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19

Kadosh, Roi Cohen. Stimulated Brain: Cognitive Enhancement Using Non-Invasive Brain Stimulation. Elsevier Science & Technology Books, 2014.

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20

Kadosh, Roi Cohen. Stimulated Brain: Cognitive Enhancement Using Non-Invasive Brain Stimulation. Elsevier Science & Technology Books, 2014.

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21

Badakhshi, Harun. Image-Guided Stereotactic Radiosurgery: High-Precision, Non-invasive Treatment of Solid Tumors. Springer, 2018.

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22

Badakhshi, Harun. Image-Guided Stereotactic Radiosurgery: High-Precision, Non-Invasive Treatment of Solid Tumors. Springer London, Limited, 2016.

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23

Badakhshi, Harun. Image-Guided Stereotactic Radiosurgery: High-Precision, Non-invasive Treatment of Solid Tumors. Springer, 2016.

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24

Esquinas, Antonio M. Non-Invasive Ventilation: A Practical Handbook for Understanding the Causes of Treatment Success and Failure. Nova Science Publishers, Incorporated, 2019.

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25

Chang, Sam S. Diagnosis, Evaluation, and Treatment of Non-Muscle Invasive Bladder Cancer: An Update, an Issue of Urologic Clinics. Elsevier - Health Sciences Division, 2013.

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26

Zehnder, Pascal, and George N. Thalmann. Muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0078.

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In the United Kingdom, >4,000 people die of bladder cancer every year. This reflects around one-third of affected patients and occurs in those with primary metastatic disease, with invasion at presentation, and in persons whose tumour progresses to invasion from non-invasive disease. The outcome from invasive cancers has not dramatically altered over the last 30 years, due to a lack of screening programmes, a lack of advances in treatment, and the fact that many patients present with tumours at an advanced stage. Around 50% of patients with invasive disease die from bladder cancer despite radical treatment, suggesting the disease is metastatic at presentation. Cure is rarely possible in patients with locally advanced tumours and lymph node metastases. Therapeutic options include systemic chemotherapy and salvage radical treatment for responders or palliation. Following radical cystectomy for cancer, patients require lifelong follow-up for both oncologic and functional reasons.

27

Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0046.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatment, including antithrombotic therapy with dual antiplatelet therapy (aspirin plus one P2Y12 inhibitor) and parenteral anticoagulation, anti-ischaemic treatment, and preventative therapies. After the initial medical therapy is established, an invasive strategy, consisting of coronary angiography with coronary revascularization (either percutaneous coronary intervention or coronary bypass graft surgery), as appropriate, should be decided. The timing of the invasive strategy should be adjusted, according to the patient’s risk. Given the high event rate of patients with non-ST-segment elevation acute coronary syndromes after hospital discharge, an aggressive long-term preventative therapy should be put in place to improve prognosis.

28

Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0046_update_001.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatment, including antithrombotic therapy with dual antiplatelet therapy (aspirin plus one P2Y12 inhibitor) and parenteral anticoagulation, anti-ischaemic treatment, and preventative therapies. After the initial medical therapy is established, an invasive strategy, consisting of coronary angiography with coronary revascularization (either percutaneous coronary intervention or coronary bypass graft surgery), as appropriate, should be decided. The timing of the invasive strategy should be adjusted, according to the patient’s risk. Given the high event rate of patients with non-ST-segment elevation acute coronary syndromes after hospital discharge, an aggressive long-term preventative therapy should be put in place to improve prognosis.

29

Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0046_update_002.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatment, including antithrombotic therapy with dual antiplatelet therapy (aspirin plus one P2Y12 inhibitor) and parenteral anticoagulation, anti-ischaemic treatment, and preventative therapies. After the initial medical therapy is established, an invasive strategy, consisting of coronary angiography with coronary revascularization (either percutaneous coronary intervention or coronary bypass graft surgery), as appropriate, should be decided. The timing of the invasive strategy should be adjusted, according to the patient’s risk. Given the high event rate of patients with non-ST-segment elevation acute coronary syndromes after hospital discharge, an aggressive long-term preventative therapy should be put in place to improve prognosis.

30

Stowell, Janet, and Ronan Breen. Pulmonary disease caused by non-tuberculous mycobacteria. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0014.

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This chapter describes a case of Mycobacterium malmoense in a male ex-smoker with chronic obstructive pulmonary disease. The approaches to a diagnosis of pulmonary non-tuberculous mycobacterial disease are discussed, including key laboratory features and associated radiological changes. The factors influencing the decision to treat and treatment regimen selected are reviewed, along with evidence from landmark trials regarding drug combinations and the role of surgery in managing non-tuberculous mycobacterial disease. This case was complicated by a secondary diagnosis of invasive aspergillosis, and the challenges of treating non-tuberculous mycobacteria and Aspergillus concurrently are highlighted. Non-tuberculous mycobacterial infection in HIV-positive patients can behave differently to non-tuberculous mycobacterial disease in immunocompetent individuals. Restoring immunocompetence is key to the success of non-tuberculous mycobacterial treatment in these individuals, but beware Mycobacterium avium complex-related immune restoration inflammatory syndrome.

31

Iqbal, Muhammad Waqas, Michael E. Lipkin, and Glenn M. Preminger. Prevention of other non-calcium stones. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0016.

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Urolithiasis is a worldwide problem with an increase in incidence and prevalence affecting the quality of life of millions of people. While there have been significant advances in minimally invasive and endourological techniques to treat urinary stones, stone recurrence remains a substantial medical problem posing considerable social and financial burdens. Although debate continues on optimal metabolic workup in stone formers, identification of metabolic risk factors and medical preventive therapy is known to decrease stone recurrence. Specific treatment measures include targeted medical therapy tailored to individual stone types. In this chapter we discuss the current specific as well as non-specific measures to prevent non-calcium-based stones.

32

Lam, Raymond W. Somatic treatments. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199692736.003.0008.

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• Wake therapy, exercise and light therapy are non-invasive and clinically useful treatments.• Electroconvulsive therapy remains an effective, safe and well-tolerated treatment for patients with severe, psychotic or medication-resistant depression.• Repetitive transcranial magnetic stimulation is an emerging treatment with evidence for acute efficacy, but with limited data about long-term management....

33

Clark, Caroline, Jeffrey Cole, Christine Winter, and Geoffrey Grammer. Transcranial Magnetic Stimulation Treatment of Posttraumatic Stress Disorder. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190205959.003.0005.

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Symptoms of post-traumatic stress disorder (PTSD) often fail to resolve with psychotherapy, pharmacotherapy, or integrative medicine treatments. Given these limitations, there is a continued push to discover treatment methods utilizing novel mechanisms of action. Transcranial magnetic stimulation (TMS) offers a non-invasive and safe method of brain stimulation that modulates neuronal activity in a focal area to achieve excitation or inhibition, and may have utility for patients suffering from PTSD, although, to date, evidence of efficacy is limited. The TMS treatment can be varied to suit the needs of the patient by altering the selection of the specific treatment parameters, such as pulse frequency or stimulation intensity. The weight of evidence to date supports treatment of either the right dorsolateral prefrontal cortex or the medical prefrontal cortex. Coupling treatment with script based exposure therapies may also assist with potentiation of the extinction response. Ultimately, stimulation parameters may be related to secondary downstream effects, and thus current targets may indirectly reverse the underlying neuronal pathophysiology. Given that PTSD is a complex illness with a poorly understood pathophysiology, it often exists with other psychiatric comorbidities or TBI. As such, TMS could be an effective part of a comprehensive treatment program.

34

Glannon, Walter. Psychiatric Neuroethics II. Edited by John Z. Sadler, K. W. M. Fulford, and Werdie (C W. ). van Staden. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780198732372.013.31.

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I discuss ethical issues relating to interventions other than intracranial surgery and psychopharmacology for psychiatric disorders. I question the distinction between “invasive” and “non-invasive” techniques applying electrical stimulation to the brain, arguing that this should be replaced by a distinction between more and less invasive techniques. I discuss electroconvulsive therapy (ECT); it can be a relatively safe and effective treatment for some patients with depression. I consider transcranial magnetic stimulation (TMS) and transcranial current stimulation (tCS); the classification of these techniques as non-invasive may lead to underestimation of their risks. I discuss how placebos can justifiably be prescribed non-deceptively and even deceptively in clinical settings. An analysis of neurofeedback as the neuromodulating technique most likely to promote autonomy/control for some conditions follows. Finally, I examine biomarkers identified through genetic screening and neuroimaging; they might contribute to more accurate prediction and diagnosis, more effective treatment, and possibly prevention of psychiatric disorders.

35

Warris, Adilia. Fungal infections in neonates. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0035.

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Fungal infections in the neonatal population are caused predominantly by Candida species and invasive fungal disease mainly affects extremely low birth weight infants. The vast majority of Candida infections are due to C. albicans and C. parapsilosis, while the more fluconazole-resistant Candida species are only sporadically observed. Invasive candidiasis typically occurs during the first month of life and presents with non-specific signs of sepsis. Despite antifungal treatment, 20% of neonates developing invasive candidiasis die and neurodevelopmental impairment occurs in nearly 60% of survivors. Antifungal prophylaxis reduces the incidence in neonatal intensive care units with high rates of invasive candidiasis (>10%). Amphotericin B, fluconazole, micafungin, and caspofungin can be used to treat neonatal candidiasis, although optimal dosing for fluconazole and the two echinocandins has not yet been established.

36

Pittman, Marcus, and Adrian Williams. Central sleep apnoea. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0005.

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Central sleep apnoea and Cheyne-Stokes respiration are common forms of sleep-disordered breathing, particularly in patients with co-morbidities such as cardiac and renal disease which, however, often do not require specific treatment. Physicians may encounter such patients in their outpatient clinics or as ward referrals in hospital. A typical case is presented to aid the approach to such patients, including how to make an accurate diagnosis, which of the various treatment modalities to use, and what to do if a treatment fails. The evidence for the different interventions is explored, including oxygen, modes of non-invasive positive airway pressure, and drug treatments, with particular attention to groundbreaking studies.

37

Adam, Sheila, Sue Osborne, and John Welch. Cardiovascular problems. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0005.

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The cardiovascular chapter discusses the physiology, assessment, and treatment of cardiovascular disorders in the critically ill patient. It gives an in-depth explanation of non-invasive and invasive monitoring procedures (such as ECG, pulse oximetry, oesophageal Doppler, and pulmonary artery catheterization). It includes the measurement of oxygen delivery and consumption, and explains diagnostic techniques such as echocardiography. The chapter includes the management and optimization of goal-directed therapies for specific conditions including coronary heart disease (such as myocardial infarction and angina), shock, valvular heart disease, and heart failure. Interventional treatment and specific drug therapy are discussed, including percutaneous coronary intervention, cardiac pacing, and electrical conversion.

38

Meehleis, Mr Tony H. Autism Wellness Resources: Understanding the Causes and the Latest Non-Invasive Treatments. Tony Meehleis, 2018.

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39

Schelenz, Silke. Fungal diseases of the gastrointestinal tract. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0026.

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Fungal diseases of the gastrointestinal (GI) tract can occur because of an overgrowth of yeast in the gut, exposure to contaminated food and water, or as part of disseminated invasive fungal infections from other sites. The extent of the disease depends on the underlying risk factors, such as diabetes or immunosuppression, and ranges from colonization, localized infection, or fungaemia, to aggressive life-threatening GI tract infections. Candida spp. are the commonest cause of mucosal infection, although mould infections are increasingly reported. Serious invasive mould infections are difficult to diagnose as symptoms are often non-specific. Early recognition, prompt antifungal treatment, and surgical intervention can be lifesaving.

40

Brunoni, Andre Russowsky, Bernardo de Sampaio Pereira Júnior, and Izio Klein. Neuromodulatory approaches for bipolar disorder: current evidences and future perspectives. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0028.

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Bipolar disorder is a prevalent condition, with few therapeutic options and a high degree of refractoriness. This justifies the development of novel non-pharmacological treatment strategies, such as the non-invasive techniques of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), as well as the invasive techniques of deep brain stimulation (DBS) and vagus nerve stimulation (VNS). In this chapter, we provide a summary of the development of the techniques as well as the studies carried out with patients with bipolar disorder. Although many promising results regarding the efficacy of theses techniques were described, the total number of studies is still low, highlighting the need of further studies in larger samples as to provide a definite picture regarding the use of clinical neuromodulation in bipolar disorder.

41

Schirmer, Uwe, and Andreas Koster. Anaesthesia for cardiac surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0056.

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Cardiac anaesthesia continues to develop as a specialized discipline within the wide field of clinical anaesthesia. A comprehensive knowledge of cardiovascular physiology and its improved monitoring with modern invasive and non-invasive devices is the basis for the pharmacological treatment of complex cardiovascular disorders. Excellent skills in intraoperative transoesophageal echocardiography have become essential. Rapid developments in cardiopulmonary bypass techniques and surgical devices have resulted in the speedy introduction of new surgical techniques which anaesthesia has to embrace. The developments in the field of (left) ventricular assist devices are expansive. By changing the paradigm of the indication of implantation from ‘bridging to heart transplantation’ to ‘destination therapy’, particularly in the large group of elderly patients with end-stage heart failure, these complex operations are no longer restricted to the small group of heart centres performing heart transplantation. This chapter provides a comprehensive review of modern cardiac anaesthesia in the contemporary world of quickly evolving cardiac surgery. The basics of anaesthesia management for the ‘cardiac’ patient are described and principles of extracorporeal circulation as well as diagnostic and treatment strategies of disturbances of the haemostatic system are highlighted. Pharmacological strategies to treat left- and right-heart failure and strategies for temporary mechanical support are outlined. Further areas of focus are the anaesthetic implications of modern less or minimally invasive procedures such as off-pump coronary artery bypass grafting and minimally invasive valve implantation/surgery and anaesthesia for implantation of ventricular assist devices and heart transplantation.

42

Shaw, Christopher M., Akin Cil, and Lyle J. Micheli. Upper extremity and trunk injuries. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0044.

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As the rate and level of youth athletic participation continues to rise, so does the frequency of injury to the trunk and upper extremities in these young athletes. Injuries are varied in severity and frequency. Additionally, injury patterns are unique to the growing musculoskeletal system and specific to the demands of the sport. The treatment of these injuries is also varied, ranging from preventative, to non-operative, to operative. Recognition of injury patterns with early activity modification and the initiation of efficacious treatment can potentially prevent invasive treatments, future deformity, or disability, and return the young athlete to sport. This chapter discusses the diagnosis and management of common upper extremity and trunk injuries in the paediatric athlete, including joint injuries, fractures, repetitive microtrauma, tendonitis, ligament injuries, and back pain.

43

Chan, Kin-Sang, Doris M. W. Tse, and Michael M. K. Sham. Dyspnoea and other respiratory symptoms in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0082.

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Dyspnoea is prevalent among palliative care patients with increased severity over time. There are two patterns of dyspnoea-breakthrough dyspnoea and constant dyspnoea-and three separate qualities of dyspnoea-air hunger, work or effort, and tightness. The measurement of dyspnoea includes three domains: sensory-perceptual experience, affective distress, and symptom impact. The management of dyspnoea includes specific disease management, non-pharmacological intervention, pharmacological treatment, and palliative non-invasive ventilation. Cough is prevalent and disturbing in patients with cancer and chronic lung diseases, and is often associated with airway hypersecretion and impaired mucociliary clearance. Management includes specific treatments for underlying non-cancer and cancer-related causes, symptomatic treatment by antitussives, mucoactive agents, and airway clearance techniques for expectoration and reduction in mucus production. Anticholinergics may be indicated for death rattles to facilitate a peaceful death. Haemoptysis occurs in 30-60% of lung cancer patients and initial management of haemoptysis includes airway protection and volume resuscitation. Localization of the site and source of bleeding may determine the choice of treatment. If a life-threatening haemoptysis occurs, sedation should be given as soon as possible. Support should be given to the family, and debriefing provided to team members.

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Provan, Drew, Trevor Baglin, Inderjeet Dokal, Johannes de Vos, and Hassan Al-Sader. Haematopoietic stem cell transplantation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199683307.003.0009.

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Haemopoietic stem cell transplantation (SCT) - Indications for haemopoietic SCT - Allogeneic SCT - Autologous STC - Investigations for BMT/PBSCT - Pretransplant investigation of donors - Bone marrow harvesting - Peripheral blood stem cell mobilization and harvesting - Microbiological screening for stem cell cryopreservation - Stem cell transplant conditioning regimens - Infusion of cryopreserved stem cells - Infusion of fresh non-cryopreserved stem cells - Blood product support for SCT - Graft-versus-host disease (GvHD) prophylaxis - Acute GvHD - Chronic GvHD - Veno-occlusive disease (syn. sinusoidal obstruction syndrome) - Invasive fungal infections and antifungal therapy - CMV prophylaxis and treatment - Post-transplant vaccination programme and foreign travel - Longer term effect post-transplant - Treatment of relapse post-allogeneic SCT - Discharge and follow-up

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Cosyns, Bernard, and Bernard Paelinck. Pericardial disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0021.

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The ability of ultrasound to elucidate the functional and structural abnormalities of pericardial disease is powerful. Due to multimodality imaging possibilities and to its portability, echocardiography is the technique of choice for the diagnosis of pericardial disease. Although other non-invasive technologies have been developed to provide information about the pericardium, echocardiography remains the first and often only diagnostic method needed to make a definitive diagnosis and guide appropriate treatment in patients with pericardial effusion, cardiac tamponade, or constrictive pericarditis. It allows differential diagnosis with restrictive cardiomyopathy and can easily be performed for guiding pericardiocentesis.

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Herbert, Lara, and Bruce McCormick. Respiratory disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719410.003.0005.

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This chapter describes the anaesthetic management of the patient with respiratory disease. It describes the assessment of respiratory function and preoperative respiratory investigations, and ventilatory strategies to reduce pulmonary complications. Common respiratory conditions covered include respiratory tract infection, smoking, asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea, sarcoidosis, restrictive pulmonary disease, and the patient with a transplanted lung. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. Recommendations for the patient who may require post-operative respiratory support (e.g. non-invasive ventilation) are provided.

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Herbert, Lara, and Bruce McCormick. Respiratory disease. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198719410.003.0005_update_001.

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This chapter describes the anaesthetic management of the patient with respiratory disease. It describes the assessment of respiratory function and preoperative respiratory investigations, and ventilatory strategies to reduce pulmonary complications. Common respiratory conditions covered include respiratory tract infection, smoking, asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea, sarcoidosis, restrictive pulmonary disease, and the patient with a transplanted lung. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. Recommendations for the patient who may require post-operative respiratory support (e.g. non-invasive ventilation) are provided.

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Leaver, Susannah, and Timothy Evans. Hypoxaemia in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0085.

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Hypoxaemia is a reduction in the partial pressure of oxygen in the blood below 8 kPa/60 mmHg. Hypoxaemia results from one, or several, or a combination of causes. Calculating the alveolar–arterial gradient can help to delineate the cause. Acute respiratory failure manifests in a number of ways, the most sensitive indicator being an increased respiratory rate. Diagnosis is dependent on a comprehensive history, examination in combination with appropriate blood tests, and imaging. Hypoxaemia is the final common pathway of a number of conditions and the exact cause may not be immediately apparent. Despite this, the same management principles apply. A trial of non-invasive ventilation can be used to support patients during respiratory failure who do not require immediate endotracheal intubation. However, it is recommended that this is instituted for a preset trial period (e.g. 1–2 hours) in an HDU/ICU setting where facilities for definitive airway management are available. Invasive ventilation aims to facilitate treatment of the underlying condition whilst minimizing side effects through lung protective ventilatory strategies.

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Nava, Stefano, and Luca Fasano. Ventilator Liberation Strategies. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0039.

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The weaning process should ideally begin as soon as the patient is intubated and continue through the treatment of the cause inducing acute respiratory failure. Weaning includes the assessment of readiness to extubate, extubation, and post-extubation monitoring; it also includes consideration of non-invasive ventilation which has been shown to reduce the duration of invasive mechanical ventilation in selected patients. Weaning accounts for approximately 40% of the total time spent on mechanical ventilation and should be achieved rapidly, since prolonged mechanical ventilation is associated with increased risk of complications and mortality and with increased costs. During mechanical ventilation, medical management should seek to correct the imbalance between respiratory load and ventilatory capacity (reducing the respiratory and cardiac workload, improving gas exchange and the ventilatory pump power). Ventilator settings delivering partial ventilatory pump support may help prevent ventilator-induced respiratory muscles dysfunction. Daily interruption of sedation has been associated with earlier extubation. Critically ill patients should be repeatedly and carefully screened for readiness to wean and readiness to extubate, and objective screening variables should be fully integrated in clinical decision making.

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Sampson, Brett G., and Andrew D. Bersten. Therapeutic approach to bronchospasm and asthma. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0111.

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The optimal management of bronchospasm and acute asthma is reliant upon confirmation of the diagnosis of asthma, detection of life-threatening complications, recognition of β‎2 agonist toxicity, and exclusion of important asthma mimics (such as vocal cord dysfunction and left ventricular failure). β‎2 agonists, anticholinergics, and corticosteroids are the mainstay of treatment. β‎2 agonists should be preferentially administered by metered dose inhaler via a spacer, and corticosteroids by the oral route, reserving nebulized (and intravenous) salbutamol, as well as intravenous hydrocortisone, for situations when these routes are not possible. A single intravenous dose of magnesium may be of benefit in severe asthma, but repeat dosing is likely to cause serious side effects. Parenteral administration of adrenaline may prevent the need for intubation in the patient in extremis. Aminophylline has an unfavourable side effect profile and has not been shown to offer additional benefit in adults. However, it does have a role in paediatric asthma. Unproven medical therapies with potential benefit include ketamine, heliox, inhalational anaesthetics, and leukotriene antagonists. The need for ventilatory support is usually preceded by worsening dynamic hyperinflation, exhaustion, hypoxia, reduced conscious state, or a combination of these. While non-invasive ventilation may have a temporizing role to allow time for response to medical therapy, there is insufficient evidence for its use, and should not delay invasive ventilation. If invasive ventilation is indicated, a strategy of hypoventilation and permissive hypercapnoea, minimizes barotrauma and dynamic hyperinflation. Extracorporeal support may have a role as a rescue therapy.

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