Abstract:
:The psychosocial assessment of applicants to the Toronto Lung Transplant Program provides the team with a variety of information including coping style; adjustment to illness; presence and management of psychiatric disorders; ability to adhere to medical recommendations; and available social support. This information facilitates the organization of resources to match each patient's strengths and vulnerabilities. The period of awaiting transplantation may be prolonged, and is often associated with high levels of anxiety. A support group, brief individual and family psychotherapies, and pharmacologic interventions have each been useful in ameliorating symptoms of stress during this time. A physical rehabilitation program is prescribed to most candidates and contributes to improved physical endurance as well as emotional well-being. Postoperative delirium has commonly occurred in lung transplant recipients, and appears to be associated with prolonged cardiopulmonary bypass when used, the administration of cyclosporine, and other nonspecific factors. Delirium has been managed with preoperative psychologic preparation and a routine postoperative protocol using intravenously administered haloperidol. Other immunosuppressant-associated organic mental disorders have also occurred in recipients. Postoperative recovery and rehabilitation are facilitated by both the preoperative exercise program and a postoperative exercise regimen. Recovery following transplant may require abrupt adjustment to new activity levels and reintegration into social and vocational roles. After 7 months, over 50% of surviving recipients have returned to employment and most report high satisfaction with physical and emotional well-being.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Craven JL,Bright J,Dear CLsubject
Has Abstractpub_date
1990-06-01 00:00:00pages
247-57issue
2eissn
0272-5231issn
1557-8216journal_volume
11pub_type
杂志文章,评审abstract::Inhaled particles are cleared from the airways by ciliary transport of a discontinuous mucous layer. The effectiveness of this process depends on the viscoelastic properties of the secretion, which in turn depend on the composition and interaction of the glycoprotein constituents. In human airways, two major cell type...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-06-01 00:00:00
abstract::This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome. The authors first present the conventional strategies of mechanical ventilation: volume-limited mechanical ventilation with positive end-expiratory pressure (PEEP) at normal inspiratory-expirato...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::A comprehensive assessment is the foundation of a successful pulmonary rehabilitation programme. There is a broad selection of outcome measures that tend to be categorized into measures of exercise performance (including measures of strength) quality of life (health status), psychological well-being, nutritional statu...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2014.02.010
更新日期:2014-06-01 00:00:00
abstract::An older smoker tends to be asked less often to quit although he or she has much to gain from achieving a nonsmoking status. Multiple barriers may interfere with attempting to quit including nicotine withdrawal, doubted self-efficacy, other smokers in one's environment, or misperceptions of little gain from quitting. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::To conclude, impairment ratings differ among various diseases and compensation programs. It therefore is important to note, at the outset, which compensation program the patient is eligible for because the requirements of the different programs may vary. The physician report must clearly state an opinion using termino...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70395-6
更新日期:1997-09-01 00:00:00
abstract::A number of different imaging modalities can be used in the assessment of pleural disease. Although ultrasound has been the more traditional method, CT has found increasing utility for the assessment of the empyema and loculated pleural fluid collections prior to drainage and the evaluation of benign and malignant ple...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70076-9
更新日期:1998-06-01 00:00:00
abstract::Patients with MAC-PD and pre-existing lung disease are a distinct group from the more common and recently recognized group of predominantly middle- to older-aged women without pre-existing lung disease. Those with pre-existing disease are expected to have more sputum positivity and slower conversion of sputum with tre...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(02)00022-9
更新日期:2002-09-01 00:00:00
abstract::Recent progress in medical therapies has diminished the role of transplantation in the management of PPH during the past decade. Drug therapy is not effective in some patients, responses to therapy are not sustained over time in others, and drug side effects eventually limit the benefits of treatment in a few more. Lu...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70293-8
更新日期:2001-09-01 00:00:00
abstract::This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leadi...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Inhaled corticosteroids (ICSs), when used in combination with long-acting bronchodilators, reduce the risk of exacerbations and improve health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with bronchodilator or ICS therapy alone. Potential side effects of ICSs include ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2020.05.006
更新日期:2020-09-01 00:00:00
abstract::Hypersensitivity pneumonitis (HP) represents a group of immunologically mediated lung disorders provoked by recurrent exposure to various environmental agents. HP is multifaceted and may mimic almost any interstitial lung disease, some infectious diseases,and even bronchiolar disorders. In the absence of a diagnostic ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2004.04.001
更新日期:2004-09-01 00:00:00
abstract::Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for whic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2010.10.007
更新日期:2011-03-01 00:00:00
abstract::The features of cardiovascular and pulmonary disease in exercise testing are described. In general, ventilatory limitation is the most common factor in lung disease. An early anaerobic threshold and a decreased VO2 mix in the absence of ventilatory limitation is the usual feature of severe heart disease. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::The authors attempt to demonstrate those circumstances for which perfusion scintigraphy, by itself, or in combination with ventilation scintiscanning, offers the best adjunctive information in excluding or confirming the presence of pulmonary embolism. They then identify those circumstances in which scintiscanning doe...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1984-09-01 00:00:00
abstract::With the rare exceptions of PAH associated with antiphospholipid antibodies, genetic platelet dysfunction, or inherited deficiencies of antithrombotic pathways, the thrombotic lesions are secondary, but frequently occurring, in most cases of primary or secondary PAH. Pulmonary arterial hypertension is associated with ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70283-5
更新日期:2001-09-01 00:00:00
abstract::Our ability to define appropriate molecular targets for preclinical development and develop better methods needs to be improved, to determine the clinical value of novel acute respiratory distress syndrome (ARDS) agents. Clinical trials must have realistic sample sizes and meaningful end points and use the available o...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2014.08.009
更新日期:2014-12-01 00:00:00
abstract::The Hispanic population in the United States is diverse in many respects. Although there is marked variation in the prevalence, morbidity, and mortality of asthma among Hispanic subgroups in the United States, these differences are poorly understood. Future stu-dies of asthma should include large samples of Hispanic s...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2006.04.004
更新日期:2006-09-01 00:00:00
abstract::Many different therapeutic compounds are associated with pulmonary toxicity. Although the mechanism of injury for many of these compounds is poorly defined, several compounds are believed to produce alterations in normal lung biochemistry. These mechanisms of injury in both clinical and experimental models are discuss...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::The long-term ventilated patient is at high risk for developing nosocomial pneumonia or tracheobronchitis. In general, the frequency of infection increases with the duration of mechanical ventilation, but the risk appears to be greatest in the first week of intubation. Although these types of infection are common and ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70026-5
更新日期:2001-03-01 00:00:00
abstract::Rheumatoid arthritis (RA) is commonly associated with pulmonary disease that can affect any anatomic compartment of the thorax. The most common intrathoracic manifestations of RA include interstitial lung disease, airway disease, pleural disease, rheumatoid nodules, and drug-induced toxicity. Patients with RA with tho...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.05.003
更新日期:2019-09-01 00:00:00
abstract::As recently as the 1992 Report of the American Thoracic Society Workshop on Lung Transplantation, no QOL facts were given and no knowledge gaps related to QOL outcomes were cited. Even at the present time, the information in that area is based on a relatively small set of preliminary reports. Current information indic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70387-7
更新日期:1997-06-01 00:00:00
abstract::Non-small cell lung cancer with very limited extent of metastatic spread commonly is termed, oligometastatic disease (OMD), and typically described as no more than 3 to 5 lesions. Definitive local therapy potentially leads to significant improvement in progression-free survival and overall survival. OMD may occur de n...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2020.02.004
更新日期:2020-06-01 00:00:00
abstract::The last decade has heralded a paradigm shift in the evaluation and treatment of advanced non-small cell lung cancer (NSCLC). No longer are patients with NSCLC considered a homogeneous population treated in the same way; rather, clinical characteristics, histology, and an expanding array of molecular markers are incre...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2011.08.017
更新日期:2011-12-01 00:00:00
abstract::Millions of people worldwide engage in leisure or occupational activities in extreme environments. These environments entail health risks even for normal subjects. The presence of lung disease, or other conditions, further predisposes to illness or injury. Patients who have lung conditions should, but often do not, co...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2005.05.006
更新日期:2005-09-01 00:00:00
abstract::After half a century of clinical experience and research, management of pulmonary arterial hypertension remains a challenge. Currently, data to support the use of standard therapies for pulmonary arterial hypertension (oxygen supplementation, diuretics, digoxin, anticoagulation, and calcium channel blockers) are mostl...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2006.12.003
更新日期:2007-03-01 00:00:00
abstract::Bullectomy for giant bullae, lung volume reduction surgery, and lung transplantation are three surgical therapies that may benefit highly selected patients with advanced chronic obstructive pulmonary disease. In this article, each procedure is reviewed, with an emphasis on guidelines for patient selection and clinical...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2007.05.004
更新日期:2007-09-01 00:00:00
abstract::This article focuses on thoracoscopy for pleural procedures, both diagnostic and therapeutic, and discusses whether there is a difference between pleuroscopy and thoracoscopy or video-assisted thoracic surgery. How thinking should be structured regarding the management of pleural disease in the modern context of avail...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2012.12.002
更新日期:2013-03-01 00:00:00
abstract::In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all sit...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Pulmonary complications occur in 40% to 60% of recipients of bone marrow trans-plants, account for more than 90% of mortality, and develop during identifiable phases. Phase 1 (Days 1-30) includes pulmonary edema; diffuse alveolar hemorrhage; and various bacterial, fungal, and viral infections; Phase 2 (Days 31-100) us...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/S0272-5231(03)00121-7
更新日期:2004-03-01 00:00:00
abstract::Thoracic imaging is widely used to detect lower respiratory tract infections, identify their complications, and aid in differentiating infectious from noninfectious thoracic disease. Less commonly, the combination of imaging findings and a clinical setting can favor infection with a specific organism. This confluence ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2015.02.005
更新日期:2015-06-01 00:00:00