GolniÅ¡ki simpozij 2011 Zbornik povzetkov

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Pulmonary rehabilitation program – our results Tomaæ Hafner, Jurij Øorli University Clinic of Respiratory and Allergic Diseases Golnik Background Chronic obstructive pulmonary disease (COPD) is a chronic disease which through systemic inflammation and physical inactivity because of dyspnea leads to muscle wasting and atrophy. Rehabilitation improves patients’ physical performance and consequently their ability to perform everyday tasks and their quality of life. That is why physical rehabilitation of COPD patients is very important in long term management of COPD. In our hospital we have four week long pulmonary rehabilitation program (PRP) for COPD patients. Methods We retrospectively searched through medical records of patients who underwent our PRP from years 2006-2010 for results of maximal inspiratory and expiratory pressure (MIP & MEP), distance walked on shuttle and 6 minute walk tests (SWT & 6MWT) before and after PRP. Not all patients performed all tests. Data are presented as mean, standard deviation and p value from paired-samples T test. We wondered how efficient our PRP was and how much patients physically improved. Results 71 patients (46 man and 25 women) with average age of 65,8 +/- 9,0 years were included in this study. They were mostly COPD stage 3 and 4 according to GOLD with average FEV1 33,8% +/- 14,1%. Average MIP before PRP was 62,8 +/- 22,2 cm H2O. After PRP increased to 73,9 +/- 22,4 cm H2O which reached statistical significance with p 0,024. Average MEP before PRP was 107,4 +/- 47,4 cm H2O. After PRP increased to 126,0 +/- 46,5 cm H2O with p 0,009. Achieved walking distance on SWT before PRP was 224,3 +/ -120,3 m. After PRP increased to 263,5 +/- 139,0 m with p 0,000. Achieved walking distance on 6MWT before PRP was 287,6+/-124,8m. After PRP increased to 353,3 +/- 133,6 m with p 0,000. Conclusions Physical rehabilitation of COPD patients importantly increases their measurable physical performance which consequently improves their everyday functionality and quality of life. 30
Videothoracoscopic resection of giant emphysema bullae Katja Adamiœ 1 , Nika Lalek 1 , Tomaæ Øtupnik 2 1 University Clinic of Respiratory and Allergic Diseases Golnik 2 Clinical Department of Thoracic Surgery, University Medical Centre Ljubljana Background The most common indications for resection of giant emphysema bullae (GEB - large bulla occupying at least 30 percent of the hemithorax) are severe dyspnoea, compression of the surrounding normal lung and secondary spontaneous pneumothorax. Excision of a GEB reduces airway resistance, functional residual capacity and physiologic dead space. Physiologic outcome after surgery is determined mostly by the size of the bulla (preferably > 50% of the hemithorax) and the severity of the underlying emphysema as the patients with severe generalized emphysema tend to have a worse outcome. The surgical risk is increased when forced expiratory volume in first second (FEV1) is less than 40% of the predicted (FEV1 < 20% is an absolute contraindication for surgery) (1, 2). GEB can be removed using open or videothoracoscopic technique (VATS). VATS is technically more complex, but provides the best preservation of lung function in early postoperative period, thus it is most beneficial for patients with reduced pulmonary reserve (3). Methods In 2010, we have used the three-incision VATS technique on two patients with GEB. All bullae were opened longitudinally and resected at their base using a 60 mm long endoscopic stapler. Clinical case 1. A 57-year old male with a non-small cell lung cancer in the left upper lobe (cT2bN1M0) and a GEB in the apex of the right upper lobe (FEV1 61%, forced vital capacity (FVC) 101%) had undergone an uncomplicated VATS left upper lobectomy Several months later the GEB grew to almost 50% of the hemithorax and the patient became severely dyspnoeic (Medical Research Council dyspnea score (MRC) 4, FEV1 46%, FVC 61%). The bulla was resected eight months after the lobectomy without any further complications. Two weeks after surgery, the patient was capable of normal efforts (MRC 1, FEV1 65%, FVC 79%). Clinical case 2. A 53-year old female presented with the first spontaneous pneumothorax and was initially treated with a chest tube. Computed tomography revealed severe centrilobular emphysema and two GEBs in the left upper and lower lobe. Two weeks after discharge the pneumothorax recurred. Chest tube was inserted to relieve severe dyspnoea and she was scheduled for surgery two days later. Both GEBs were resected using the VATS technique and a mechanical pleurodesis was performed. Postoperative recovery was uneventful. A month after surgery, she is capable of normal efforts (MRC 1) with improved pulmonary function: FEV1 from 25% to 50% and FVC from 51% to 60%. 31
Page 1 and 2: Golnik Symposium 2011 Congress Bled
Page 3 and 4: Content Oral presentations Kadivec
Page 5: Turnøek N, Mohorœiœ K, Neutropen
Page 9 and 10: Coordination of discharge in COPD S
Page 11 and 12: pensing should be undertaken in ord
Page 13 and 14: References 1. Plebani M. Errors in
Page 15 and 16: of lung fibrosis. In more detail, m
Page 17 and 18: Apart from the proliferation of fib
Page 19 and 20: POSTER PRESENTATIONS 19
Page 21 and 22: Licensing of medical laboratories i
Page 23 and 24: The intervention group had a signif
Page 25 and 26: Implementation of a medication reco
Page 27 and 28: Communication in palliative care: c
Page 29: tients with OHS were treated with C
Page 33 and 34: Electrocardiogram analysis of patie
Page 35 and 36: of COPD but not in the severity of
Page 37 and 38: Examination of resistance of bacter
Page 39 and 40: Pneumococcal bacteriemia in adults
Page 41 and 42: Aspergillosis Tina Jeriœ, Izidor K
Page 43 and 44: Carriage rate of extended-spectrum
Page 45 and 46: Screening of persons after contact
Page 47 and 48: many years correctional facilities
Page 49 and 50: Conclusions The collaboration of di
Page 51 and 52: Conclusions NTM are not very often
Page 53 and 54: more serious measures in pre-analyt
Page 55 and 56: Nation-wide evaluation of three mol
Page 57 and 58: NSE and negative for cytokeratins a
Page 59 and 60: Videothoracoscopic lung lobectomy i
Page 61 and 62: Quantitative Methylation Profiles o
Page 63 and 64: Anti-angiogenic miRNAs let-7b and m
Page 65 and 66: MDR1 polymorphisms G2677T/A and C34
Page 67 and 68: Topoisomerase IIa in small cell lun
Page 69 and 70: tients with FN received antibiotic
Page 71 and 72: ing 45,9%, elevated liver enzymes 5
Page 73 and 74: stress and lipid status showed pote
Page 75 and 76: The significance of PET CT in diagn
Page 77 and 78: Peripheral invariant NKT cells and
Page 79 and 80: Allergy in patients with vocal fold
Page 81 and 82:
ORMDL3 gene polymorphism is associa
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Baseline serum tryptase is not asso
Page 85 and 86:
Rhinitis symptoms caused by grass p
Page 87 and 88:
Conclusions We provide a protocol o
Page 89:
Association analysis of polymorphis
Page 92 and 93:
Organizirajoœa pljuœnica - histop
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Organizirajoœa pljuœnica - spekte
Page 96 and 97:
Organizirajoœa pljuœnica - klini
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Notes: 98
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Notes: 100
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Notes: 102
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Notes: 104
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PARTNERS Congress was supported by
Page 109:
Najbolj predpisovano zdravilo za vz
Page 112 and 113:
z b f 160 µg/4,5 µg/odmerek
Page 114 and 115:
320 µg/9 µg/odmerek
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SAMO ZA STROKOVNO JAVNOST.
Page 118 and 119:
^AS ZA ŽIVLJENJE. DOKAZANO PODALJ
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