scholarly journals Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

2015 ◽  
Vol 47 (2) ◽  
pp. 420-428 ◽  
Author(s):  
J. Stuart Elborn ◽  
Scott C. Bell ◽  
Susan L. Madge ◽  
Pierre-Regis Burgel ◽  
Carlo Castellani ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Core Curriculum ◽  
Task Force ◽  
Clinical Care ◽  
Multidisciplinary Care ◽  
European Respiratory Society ◽  
Major Life ◽  
Psychological Burden ◽  
Number Of Patients ◽  
Respiratory Physician

The improved survival in people with cystic fibrosis has led to an increasing number of patients reaching adulthood. This trend is likely to be maintained over the next decades, suggesting a need to increase the number of centres with expertise in the management of adult patients with cystic fibrosis. These centres should be capable of delivering multidisciplinary care addressing the complexity of the disease, in addition to addressing the psychological burden on patients and their families. Further issues that require attention are organ transplantation and end of life management.Lung disease in adults with cystic fibrosis drives most of the clinical care requirements, and major life-threatening complications, such as respiratory infection, respiratory failure, pneumothorax and haemoptysis, and the management of lung transplantation require expertise from trained respiratory physicians. The taskforce therefore strongly reccommends that medical leadership in multidisciplinary adult teams should be attributed to a respiratory physician adequately trained in cystic fibrosis management.The task force suggests the implementation of a core curriculum for trainees in adult respiratory medicine and the selection and accreditation of training centres that deliver postgraduate training to the standards of the HERMES programme.

scholarly journals Medical oncology workload in Canada: infrastructure, supports, and delivery of clinical care

2018 ◽  
Vol 25 (3) ◽  
pp. 206 ◽  
Author(s):  
A. Fundytus ◽  
W.M. Hopman ◽  
N. Hammad ◽  
J.J. Biagi ◽  
R. Sullivan ◽  
...  
Keyword(s):  
Online Survey ◽  
Task Force ◽  
Clinical Care ◽  
Median Number ◽  
Models Of Care ◽  
Annual Number ◽  
Canadian Association ◽  
Level Of Activity ◽  
Medical Oncologists ◽  
Number Of Patients

Background In 2000, a Canadian task force recommended that medical oncologists (mos) meet a target of 160–175 new patient consultations per year. Here, we report the Canadian results of a global survey of mo workload compared with mo workload in other high-income countries (hics).Methods Using a snowball method, an online survey was distributed by national oncology societies to chemotherapy-prescribing physicians in 22 hics (World Bank criteria). The survey was distributed within Canada to all members of the Canadian Association of Medical Oncologists. Workload was measured as the annual number of new cancer patient consults per oncologist.Results The survey was completed by 782 oncologists from hics, including 58 from Canada. Median annual consults per mo were 175 in Canada compared with 125 in other hics. The proportions of mos having 100 or fewer consults or more than 300 consults per year were 3% (2/58) and 5% (3/58) in Canada compared with 31% (222/724) and 16% (116/724) in other hics (p < 0.001 and p = 0.023 respectively). The median number of patients seen in a full-day clinic was 15 in Canada and 25 in other hics (p = 0.220). Canadian mos reported spending a median of 55 minutes per new consultation; new consultations of 35 minutes were reported in other hics (p < 0.001). Median hours worked per week was 55 in Canada and 45 in other hics (p = 0.200).Conclusions Although the median annual clinical volume for Canadian mos aligns with recommended targets, half the respondents exceeded that level of activity. Health policymakers and educators have to consider mo workforce supply and alternative models of care in preparation for the anticipated surge in cancer incidence in the coming decade.

scholarly journals Health Human Resources Guidelines: Minimum Staffing Standards and Role Descriptions for Canadian Cystic Fibrosis Healthcare Teams

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ian D. McIntosh
Keyword(s):  
Cystic Fibrosis ◽  
Human Resources ◽  
Healthcare Workers ◽  
Clinical Care ◽  
Multidisciplinary Care ◽  
Site Visit ◽  
Hospital Administrators ◽  
Health Human Resources ◽  
National Accreditation ◽  
Healthcare Teams

In cystic fibrosis clinics across Canada, the most common barrier that healthcare workers face when providing care to their patients is having too little time. The Health Human Resources Guidelines were developed to define specifically what amounts of time should be allocated for each discipline of cystic fibrosis clinical care and to provide a description of all the roles involved, reinforcing how these work together to provide comprehensive multidisciplinary care. With involvement from all cystic fibrosis clinics in Canada, through the use of a tailored survey, the Health Human Resources Guidelines are an exclusively Canadian document that has been developed for implementation across the country. The guidelines have been incorporated into a national Accreditation Site Visit program for use in evaluating and improving care across the country and have been distributed to all Canadian cystic fibrosis clinics. The guidelines provide hospital administrators with clear benchmarks for allocating personnel resources to the cystic fibrosis clinics hosted within their institutions.

scholarly journals Echocardiographic Probability of Pulmonary Hypertension in Myeloproliferative Neoplasms Patients in Chiang-Mai University

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5390-5390
Author(s):  
Yanika Jindamai ◽  
Ekarat Rattarittamrong ◽  
Arintaya Phrommintikul ◽  
Lalita Yongsmith ◽  
Thanawat Rattanathammethee ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Conflicts Of Interest ◽  
Task Force ◽  
Myeloproliferative Neoplasms ◽  
White Blood Cells ◽  
Philadelphia Chromosome ◽  
University Hospital ◽  
Chiang Mai ◽  
European Respiratory Society ◽  
Number Of Patients

Introduction: Pulmonary hypertension (PHT) is an emerging complication of myeloproliferative neoplasms (MPNs). The aim of this study was to determine the prevalence and risk factors of high echocardiographic probability of PHT according to 2015 The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) Guideline. The echocardiographic probability of PHT was assessed by peak tricuspid regurgitation velocity (TRV max) and echocardiographic signs suggesting PHT. Methods: This was a cross-sectional study conducted in Chiang-Mai University Hospital during January 2019 and July 2019. Patients aged 18 years or older with Philadelphia chromosome negative MPNs including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) were eligible after obtaining informed consents. Patients who were known to have a preexisting PHT from any causes were excluded. All enrolled patients had an echocardiography performed by a cardiologist for evaluating the probability of PHT according to 2015 ESC/ERS guideline. Primary outcome of the study was the prevalence of MPNs patients who had high echocardiographic probability of PHT. Secondary outcomes were risk factor of high echocardiographic probability of PHT. Results: A total of 23 patients with a median age of 64 years (range 45-87) were enrolled. There were 14 PV (60.9%), 8 ET (34.8%), 1 MF (4.3%) patients included. There were13 male patients (56.5%). The most common driver mutation was JAK2V617F mutation (19 patients, 82.6%). Common co-morbid diseases were hypertension (26.1%), combined hypertension and dyslipidemia (13%), and combined hypertension and diabetes (8.7%), respectively. The majority of patients (73.9%) did not have history of thrombosis. However, 57.2% and 62.5% of PV and ET patients were classified as high risk of thrombosis. Twenty two patients (95.6%) received both antiplatelets and cytoreductive agents with 9 patients (39.1%) also underwent phlebotomy. Hydroxyurea was only cytoreductive drug prescribed in this study. The median time from diagnosis to echocardiogram evaluation was 66 months (range 9-6,242 months). Median (range) hemoglobin was 11.7 g/dl (9.7-16.8), median white blood cells count was 7.5x109/L (4.0-24.1), and median platelet count was 374x109/L (171-931). No patient with high echocardiographic probability of PHT was detected. One patient (4.3%) patient had intermediate probability and 22 (95.7%) patients had low probability. The median value of TRV max was 2.42 m/s (range 1.93-2.90). Conclusions: No MPNs patients (0/23) with high echocardiographic probability of PHT detected in this study. Further study with higher number of patients is warrant for determine the prevalence of PHT in Thai MPN patients. Table Disclosures No relevant conflicts of interest to declare.

scholarly journals ERS/EAACI statement on severe exacerbations in asthma in adults: facts, priorities and key research questions

2019 ◽  
Vol 54 (3) ◽  
pp. 1900900 ◽  
Author(s):  
Arnaud Bourdin ◽  
Leif Bjermer ◽  
Christopher Brightling ◽  
Guy G. Brusselle ◽  
Pascal Chanez ◽  
...  
Keyword(s):  
Task Force ◽  
European Respiratory Society ◽  
Psychological Burden ◽  
Major Health ◽  
European Academy ◽  
Control Asthma ◽  
Research Questions ◽  
Set Up ◽  
Definition Of ◽  
Urgent Action

Despite the use of effective medications to control asthma, severe exacerbations in asthma are still a major health risk and require urgent action on the part of the patient and physician to prevent serious outcomes such as hospitalisation or death. Moreover, severe exacerbations are associated with substantial healthcare costs and psychological burden, including anxiety and fear for patients and their families. The European Academy of Allergy and Clinical Immunology (EAACI) and the European Respiratory Society (ERS) set up a task force to search for a clear definition of severe exacerbations, and to also define research questions and priorities. The statement includes comments from patients who were members of the task force.

scholarly journals European Respiratory Society guideline on long-term management of children with bronchopulmonary dysplasia

2019 ◽  
Vol 55 (1) ◽  
pp. 1900788 ◽  
Author(s):  
Liesbeth Duijts ◽  
Evelien R. van Meel ◽  
Laura Moschino ◽  
Eugenio Baraldi ◽  
Magda Barnhoorn ◽  
...  
Keyword(s):  
Lung Function ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Period ◽  
Task Force ◽  
Clinical Care ◽  
Supplemental Oxygen ◽  
Target Range ◽  
European Respiratory Society ◽  
Assessment Development ◽  
Systemic Corticosteroids

This document provides recommendations for monitoring and treatment of children in whom bronchopulmonary dysplasia (BPD) has been established and who have been discharged from the hospital, or who were >36 weeks of postmenstrual age. The guideline was based on predefined Population, Intervention, Comparison and Outcomes (PICO) questions relevant for clinical care, a systematic review of the literature and assessment of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. After considering the balance of desirable (benefits) and undesirable (burden, adverse effects) consequences of the intervention, the certainty of the evidence, and values, the task force made conditional recommendations for monitoring and treatment of BPD based on very low to low quality of evidence. We suggest monitoring with lung imaging using ionising radiation in a subgroup only, for example severe BPD or recurrent hospitalisations, and monitoring with lung function in all children. We suggest to give individual advice to parents regarding daycare attendance. With regards to treatment, we suggest the use of bronchodilators in a subgroup only, for example asthma-like symptoms, or reversibility in lung function; no treatment with inhaled or systemic corticosteroids; natural weaning of diuretics by the relative decrease in dose with increasing weight gain if diuretics are started in the neonatal period; and treatment with supplemental oxygen with a saturation target range of 90–95%. A multidisciplinary approach for children with established severe BPD after the neonatal period into adulthood is preferable. These recommendations should be considered until new and urgently needed evidence becomes available.

scholarly journals European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

2016 ◽  
Vol 49 (1) ◽  
pp. 1601090 ◽  
Author(s):  
Jane S. Lucas ◽  
Angelo Barbato ◽  
Samuel A. Collins ◽  
Myrofora Goutaki ◽  
Laura Behan ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Primary Ciliary Dyskinesia ◽  
High Speed ◽  
Task Force ◽  
Clinical Care ◽  
Beat Frequency ◽  
Diagnostic Methods ◽  
Future Research ◽  
European Respiratory Society ◽  
Ciliary Dyskinesia

The diagnosis of primary ciliary dyskinesia is often confirmed with standard, albeit complex and expensive, tests. In many cases, however, the diagnosis remains difficult despite the array of sophisticated diagnostic tests. There is no “gold standard” reference test. Hence, a Task Force supported by the European Respiratory Society has developed this guideline to provide evidence-based recommendations on diagnostic testing, especially in light of new developments in such tests, and the need for robust diagnoses of patients who might enter randomised controlled trials of treatments. The guideline is based on pre-defined questions relevant for clinical care, a systematic review of the literature, and assessment of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. It focuses on clinical presentation, nasal nitric oxide, analysis of ciliary beat frequency and pattern by high-speed video-microscopy analysis, transmission electron microscopy, genotyping and immunofluorescence. It then used a modified Delphi survey to develop an algorithm for the use of diagnostic tests to definitively confirm and exclude the diagnosis of primary ciliary dyskinesia; and to provide advice when the diagnosis was not conclusive. Finally, this guideline proposes a set of quality criteria for future research on the validity of diagnostic methods for primary ciliary dyskinesia.

Systemische Sklerose - eine systematische Übersicht

VASA ◽  
2011 ◽  
Vol 40 (1) ◽  
pp. 6-19 ◽  
Author(s):  
Klein-Weigel ◽  
Opitz ◽  
Riemekasten
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Task Force ◽  
Systemische Sklerose ◽  
Systematische Übersicht ◽  
European Respiratory Society ◽  
High Association ◽  
Microscopic Features ◽  
European Society Of Cardiology ◽  
Genetic Burden

Due to its high association with Raynaud’s phenomenon systemic sclerosis (SSc) is probably the most common connective tissue disease seen by vascular specialists. In part 1 of our systematic overview we summarize classification concepts of scleroderma disorders, the epidemiologic and genetic burden, the complex pathophysiologic background, and the clinical features and the stage-dependent capillary microscopic features of SSc. Furthermore, we address the diagnostic recommendations propagated by the German Network for Systemic Sclerosis and the Task Force for Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology, the European Respiratory Society, and the International Society of Heart and Lung Transplantation.

scholarly journals Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go

2019 ◽  
Vol 8 (4) ◽  
pp. 555 ◽  
Author(s):  
Cátia Caneiras ◽  
Cristina Jácome ◽  
Sagrario Mayoralas-Alises ◽  
José Ramon Calvo ◽  
João Almeida Fonseca ◽  
...  
Keyword(s):  
Clinical Research ◽  
Patient Experience ◽  
Clinical Care ◽  
Research Priorities ◽  
Specific Patient ◽  
Quality Healthcare ◽  
Body Of Knowledge ◽  
Number Of Patients ◽  
Patient Reported ◽  
System Sustainability

The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.

scholarly journals Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

2021 ◽  
Vol 81 (04) ◽  
pp. 390-397
Author(s):  
Maritta Kühnert ◽  
Sven Kehl ◽  
Ulrich Pecks ◽  
Ute Margaretha Schäfer-Graf ◽  
Tanja Groten ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B ◽  
Task Force ◽  
Clinical Care ◽  
Diagnostic Procedures ◽  
Routine Clinical Care ◽  
Prenatal Counselling ◽  
Hepatitis Infection ◽  
Birth Planning ◽  
In Pregnancy

AbstractThese statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.

scholarly journals Cystic fibrosis in disguise – the wolf in sheep’s clothing, a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Friederike Wilbert ◽  
Sarah C. Grünert ◽  
Andrea Heinzmann ◽  
Sebastian F. N. Bode
Keyword(s):  
Cystic Fibrosis ◽  
Systemic Disease ◽  
Gastrointestinal Symptoms ◽  
Chloride Concentration ◽  
Failure To Thrive ◽  
Sweat Test ◽  
Upper Airways ◽  
Inborn Errors ◽  
Hepatic Involvement ◽  
Number Of Patients

Abstract Background Childhood hypoglycemia in combination with hepatomegaly is suspicious for inborn errors of metabolism. Cystic fibrosis typically presents with failure to thrive, pulmonary and gastrointestinal symptoms. Hepatic involvement and hypoglycemia can occur in a significant number of patients, although hepatomegaly is uncommon. Case presentation A 28 months old boy was presented with recurrent upper airways infections, progressive lethargy and weight loss. Clinically hepatomegaly was the main presenting feature and hypoglycemia (minimum 1.4 mmol/l) was noted as were elevated transaminases. The patient did not produce enough sweat to analyze it. Infectious causes for hepatitis were excluded and a broad metabolic work-up initiated. A therapy with starch was initiated to control hypoglycemia. In further course loose stools were reported and pancreatic elastase was found to be reduced. A further sweat test yielded pathological chloride concentration and genetic testing confirmed the diagnosis of cystic fibrosis. Conclusions Cystic fibrosis is a systemic disease and less common presentations need to be considered. Even in the age of CF-newborn screening in many countries CF needs to be ruled out in typical and atypical clinical presentations and diagnostics need to be repeated if inconclusive.

Sign in / Sign up

Export Citation Format

Share Document