Nursing Progress of Hypertonic Saline Inhalation in the Treatment of Infantile Bronchitis Based on Image Enhancement.

The onset of bronchiolitis is closely related to the anatomical characteristics of the bronchi in children of this age. This kind of injury is caused by epithelial necrosis, nasal mucosa, and mucosal edema caused by narrowing and blockage of the trachea. Children with this serious phenomenon will have respiratory and heart failure, which threatens the life of children to a large extent. In this paper, based on image enhancement technology, hypertonic saline aerosol inhalation treatment of pediatric bronchiolitis nursing care, through related cases, the application of image enhancement technology in hypertonic saline aerosol inhalation therapy and pediatric bronchiolitis is analyzed, and the tone mapping function is used. Tone mapping functions, hereditary arithmetics, and slope regimes for experimental field capture and detection were used for the objective of therapeutic approaches for the treatment of pediatric capillary pneumonia by hypertonic inhalation. Experimental results show that imaging technology hypertonic inhalation can control the main symptoms of bronchiolitis in infants and young children. Inhalation of 3% saline can shorten the course of moderately chronic children to half a year and can reduce the length of hospital stay by a quarter of the original requires hospitalization time, and the cure rate of pediatric bronchiolitis is increased to 93.7%.

Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative.

Acute bronchitis is a predominantly viral illness and, according to clinical practice guidelines, should not be treated with antibiotics. Despite clear guidelines, acute bronchitis continues to be the most common acute respiratory illness for which antibiotics are incorrectly prescribed. Although the national benchmark for antibiotic prescribing for adults with acute bronchitis is 0%, a preliminary record review before implementing the intervention at the project setting showed that 96% (N = 30) of adults with acute bronchitis in this setting were prescribed an antibiotic. This quality improvement project utilized a single-group, pre-post design. The setting for this project was a large urgent care network with numerous locations in central North Carolina. The purpose was to determine whether nurse practitioners and physician assistants, after participating in a multifaceted provider education session, would reduce inappropriate antibiotic prescribing for healthy adults with acute uncomplicated bronchitis. Twenty providers attended 1 of 4 training sessions offered in October and November 2015. The face-to-face interactive training sessions focused on factors associated with inappropriate antibiotic prescribing, current clinical practice guidelines, and patient communication skills. Retrospective medical record review of 217 pretraining and 335 posttraining encounters for acute bronchitis by 19 eligible participating providers demonstrated a 61.9% reduction in immediate antibiotic prescribing from 91.7% to 29.8%. Delayed prescribing, which accounted for a small percentage of the total prescriptions given, had a small but significant increase of 9.3% after training. Overall, this multifaceted, interactive provider training resulted in significant reductions in inappropriate prescriptions.

Asociación entre enfermedades respiratorias crónicas y Helicobacter pylori: un metaanálisis / Association between chronic respiratory diseases and helicobacter pylori: a meta-analysis

Antecedentes: La prevalencia de las enfermedades respiratorias crónicas (ERC), incluida la bronquitis crónica y la enfermedad pulmonar obstructiva crónica (EPOC), ha aumentado de manera significativa a lo largo de las últimas décadas. Varios estudios han sugerido que la infección por Helicobacter pylori puede estar relacionada con la aparición de las ERC, pero los resultados presentados no han sido uniformes. Con el objetivo de evaluar la posible asociación de la infección porH. pylori con las ERC, llevamos a cabo el presente metaanálisis. Métodos: Realizamos una búsqueda bibliográfica sistemática en PubMed, Embase, Ovid, Google Scholar y CNKI desde su inicio hasta el 31 de octubre de 2013. Los términos de búsqueda utilizados fueron los siguientes: «chronic respiratory disease», «chronic bronchitis», «chronic obstructive pulmonary disease» o «COPD» en combinación con «Helicobacter pylori» o «Campylobacter pylori». Según los criterios de inclusión establecidos, seleccionamos todos los artículos publicados elegibles y extrajimos los datos esenciales. Para evaluar la asociación deH. pylori con la bronquitis crónica y la EPOC se realizó un análisis global y se llevaron a cabo diversos análisis de subgrupos, respectivamente. Resultados: Finalmente se incluyeron en los análisis un total de 9 estudios de casos y controles en los que se incluyeron 782 casos y 815 controles. La OR combinada fue de 2,30 (IC 95%: 1,85-2,85) para el análisis global, de 2,90 (IC 95%: 2,04-4,13) para el análisis del subgrupo de bronquitis crónica y de 2,11 (IC 95%: 1,35-3,29) para el análisis del subgrupo de EPOC. Conclusiones: Los resultados del análisis global y de los análisis de subgrupos sugieren una asociación significativa entre H. pylori y ERC. Serán necesarios nuevos estudios para esclarecer los mecanismos patogénicos

Background: The prevalence of chronic respiratory diseases (CRDs), including chronic bronchitis and chronic obstructive pulmonary disease (COPD), has increased significantly over the past decades. Several studies suggest that Helicobacter pylori infection may be related to the development of CRDs, but the results were not consistent. We carried out a meta-analysis to evaluate the potential association of H. pylori infection with CRDs. Methods: We conducted a systematic literature search in PubMed, Embase, Ovid, Google Scholar and CNKI from inception to October 31, 2013. The following search terms were used: "chronic respiratory disease", "chronic bronchitis," "chronic obstructive pulmonary disease" or "COPD" in combination with "Helicobacter pylori" or "Campylobacter pylori". According to established inclusion criteria, we selected all eligible published papers and then extracted essential data. To evaluate the association of H. pylori with chronic bronchitis and COPD, an overall analysis and subgroup analyses were conducted. Results: A total of 9 case-control studies comprising 782 cases and 815 controls were included in the study. Pooled ORs were 2.30 (95% CI: 1.85-2.85) in the overall analysis, 2.90 (95% CI: 2.04-4.13) in the chronic bronchitis subgroup, and 2.11 (95% CI: 1.35-3.29) in the COPD subgroup. Conclusions: The results of the overall analysis and subgroup analyzed suggest a significant association between H. pylori and CRDs. Further studies are needed to clarify the pathogenetic mechanisms involved

Evidence-based diagnosis and management of acute bronchitis.

Acute bronchitis is a common respiratory infection seen in primary care settings. This article examines the current evidence for diagnosis and management of acute bronchitis in adults and provides recommendations for primary care clinical practice.

Acute bronchitis: Evaluation and management.

Acute bronchitis affects millions of individuals, significantly impacting patient health and the healthcare industry. Understanding evaluation and treatment guidelines for acute bronchitis allows the nurse practitioner to practice comprehensive care for patients. This article reviews evidence-based practices when caring for the patient with acute bronchitis, promoting optimization of healthy outcomes.

Helium:oxygen versus air:oxygen noninvasive positive-pressure ventilation in patients exposed to sulfur mustard.

Exposure to sulfur mustard (SM) causes a variety of respiratory symptoms, such as chronic bronchitis and constrictive bronchiolitis. This study assessed the effectiveness of noninvasive positive-pressure ventilation, adjunct with 79:21 helium:oxygen instead of 79:21 air:oxygen, in 24 patients with a previous exposure to SM presenting with acute respiratory failure. Both air:oxygen and helium:oxygen significantly decreased systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse rate, respiratory rate, dyspnea, and increased oxygen saturation (P values: .007, .029, .002, <.001, <.001, <.001, and .002 for air:oxygen, respectively, and <.001, .020, .001, <.001, <.001, <.001, and .002, for helium:oxygen, respectively). Moreover, helium:oxygen more potently improved systolic pressure, mean arterial pressure, pulse rate, respiratory rate, and dyspnea (P values: .012, .048, <.001, <.001, and .012, respectively). The results of our study support the benefit of using helium:oxygen adjunct with noninvasive positive-pressure ventilation in patients exposed to SM with acute respiratory decompensation.

Cuidados a un paciente crítico con insuficiencia respiratoria aguda / Care of the critically-ill patient with acute respiratory failure

En este artículo se presenta un caso clínico de un paciente con una bronquitis crónica, que ingresó en la unidad de cuidados intensivos (UCI) con un cuadro de insuficiencia respiratoria aguda, debido a una neumonía bilateral originada tras un traumatismo torácico. Se presenta el plan de cuidados llevado a cabo en el momento del ingreso y a los cinco días del mismo; las dos fases de la evolución del paciente son realizadas desde el punto de vista enfermero. Se puede observar que inicialmente los problemas que predominan son los de colaboración y las intervenciones enfermeras de suplencia, como consecuencia de la situación de compromiso vital del paciente. Posteriormente, a medida que la situación clínica evoluciona favorablemente, aparecen diagnósticos enfermeros que requieren intervenciones de ayuda y apoyo educativo. Como guía para la valoración del paciente se han utilizado los patrones de respuesta humana por considerar que permiten obtener una visión global de la situación del paciente, al contemplar tanto respuestas fisiológicas como psicosociales, lo que posibilita un enfoque integral en el cuidado del paciente crítico (AU)

The judicious use of antibiotic agents in common childhood respiratory illness.

Increased bacterial resistance is caused most frequently by the widespread use of antimicrobial agents. Antimicrobial agents are often used inappropriately to treat common respiratory illnesses in children. This article discusses the judicious use of antimicrobials in the common cold, otitis media, acute sinusitis, pharyngitis, and bronchitis.

Fisioterapia respiratoria en geriatría / Respiratory Physiotherary in geriatrics

En el presente trabajo se justifica la actuación de la Fisioterapia en el paciente Geriátrico con problemas respiratorios, estableciéndose objetivos y pautas de actuación en distintos ámbitos (preventivo y terapéutico). De igual forma y partiendo de la premisa de una necesaria y vital comunicación fisioterapeuta- enfermero, se describen una serie de técnicas específicas (drenaje postural, ventilación dirigida, percusión o clappin, vibraciones, expansiones, ... ) que forman parte del tratamiento fisioterápico respiratorio y que necesitan de la participación activa del enfermero para facilitar, de esa forma, la adhesión del paciente al tratamiento y la obtención de mejores resultados en la evolución del proceso respiratorio del anciano (AU)

Vias aéreas inferiores e a poluçao / Lower Airway an polution

Objetivo. O estudo visa demostrar a prevalencia de doenças de vias aéreas inferiores en crianças expostas a poluentes ambientales provenientes de fontes distintas. Métodos. Um estudo epidemiológico ( através de un enquérito) foi realizado no Estado de Sao paulo com 3 grupos (100 crianças em cada grupo): na regiao da Grande Sao paulo, poluiçao urbana; em Piracicaba, poluiçao da queimada da palha da cana de açicar; Tupa e Batatais, zona rural livre de poluiçao. Resultados. Com relaçao à asma/bronquite e/o pneumonia, as crianças de Piracicaba e Sao paulo apresentaram índices de 14 porcento e 11 porcento respectivamente, em comparçao a 10 porcento en Tupa ou Batatais. O índice de abstenteísmo na escola foi de 17 porcento em Piracicaba, 11 porcento em Sao Paulo e 9 porcento em Tupa e Batatais. O índice de hospitalizaçoes devido a complicaóes de doenças respiratorias (asma7bronquite e/o pneumonia) foi de 4 porcento em Sao Paulo, 3 porcento em Piracicaba e 2 porcento em Tupa e Batatais. Todos os resultados citados demostraram alta significância estatística (p<0,005). Conclusoes. a alta prevalência de infecçoes e complicaçoes das vias aéres inferiores nos grupos de crianças expostas a poluentes de diferentes origenes do ar artmosférico demostra a necesidade de medidas mais eficazes no controle da poluiçao ambiental.

Effects of guided imagery in patients with chronic bronchitis and emphysema.

Together, chronic bronchitis and emphysema (CBE) ranks as one of the top five leading health problems in the United States. Few nursing interventions have been tested that improve symptom management, functional status, and quality of life. This study tested the effects of guided imagery and maximal inspiratory muscle training (MITT) in a group of 10 males and 9 females, 56-75 years old, with moderate CBE. The research tested whether the independent variables, guided imagery and MITT, have significant independent and/or interaction effects on the dependent variables functional status, fatigue, dyspnea, depression, mastery, quality of life, perceived health status, and inspiratory muscle strength. Results showed that the psychologic intervention of guided imagery significantly improved subjects' perceived quality of life. The physiologic intervention of MITT could not be tolerated by subjects, which precluded testing the effects on the dependent variables. Application of study findings to clinical practice and the need for further research are discussed.

Bronquite crônica, enfisema e asma: aspectos fisiopatológicos e intervençöes de enfermagem frente a estas enfermidades / Chronics bronchitis, emphysema and asthma: physiopatology and nursing orientations

As autoras fazem uma breve revisäo sobre a fisiopatologia das doenças pulmonares, bronquite crônica, enfisema e asma, enfocando as intervençöes de enfermagem necessárias para o controle destas enfermidades.

Perceived uncertainty, physical symptoms, and negative mood in hospitalized patients with chronic obstructive pulmonary disease.

OBJECTIVE: To determine whether perceived uncertainty and physical symptoms were related to negative mood in hospitalized patients with chronic bronchitis and/or emphysema. DESIGN: Descriptive correlational. SETTING: Five large teaching hospitals in a city in central Canada. SUBJECTS: The sample consisted of 15 men and 11 women ranging in age from 53 to 86 years. INSTRUMENTS: Mishel Uncertainty in Illness Scale; Somatic Scale of the Bronchitis Emphysema Symptom Checklist; and Tension, Depression and Anger Subscales of the Profile of Mood States. RESULTS: Only the variable of physical symptoms contributed to the negative mood of the subjects with chronic obstructive pulmonary disease, explaining 21% of the variance (p < 0.02). Of the four symptom categories measured (fatigue, dyspnea, congestion, and peripheral-sensory disturbance), only fatigue was a significant predictor (p < 0.006) of negative mood, accounting for 28% of the variance. CONCLUSION: Negative mood is evidence of impaired coping. The finding that fatigue contributed to negative mood provides support for the theoretic prediction that low energy interferes with an individual's ability to cope with a stressful situation.