Articles: chronic.
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Curr Opin Anaesthesiol · Feb 2014
ReviewBronchoscopic treatment of end-stage chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a progressive, debilitating disease that in its final stages cripples the patient. The disappointing results of the National Emphysema Treatment Trial study led to a decrease in the acceptance of lung volume reduction surgery as a therapy. Thus, it became clear that debilitated COPD patients would need innovative alternative nonsurgical procedures to potentially alleviate their symptoms. This review will address the various techniques of bronchoscopic lung volume reduction (BLVR). ⋯ BLVR appears to be safer than surgery and presents an attractive alternative for the treatment of COPD patients. Unfortunately, the outcome data to date are inconclusive; the procedures remain experimental and any benefits unproven. However, the data that are emerging continue to appear promising.
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Addiction to alcohol and illicit drugs occurs in approximately 10% of the Canadian population and thus likely affects numerous perioperative patients. Provision of perioperative analgesia to these patients is challenging for physiological and behavioural reasons. Seven electronic databases were searched to identify papers addressing the perioperative management of analgesia in addicted patients. ⋯ Perioperative analgesic management of addicted patients remains poorly understood. Most clinical trials specifically exclude addicted patients. Suggestions for management are provided.
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Review Case Reports
Acquired pharmaco-dynamic opioid tolerance: a concept analysis.
To report an analysis of the concept of acquired pharmaco-dynamic opioid tolerance. ⋯ Untangling the antecedents, empirical referents and consequences of tolerance help healthcare professionals understand its complexities. Improved knowledge may ultimately influence patient outcomes through the construction of better monitoring systems. This concept analysis may also provide insights for policy change and give empirical direction for future research.
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The purpose of this article is to review the literature and to highlight current practice regarding the management of the chronic pain patient presenting for surgery. ⋯ Successful management of the complex pain patient requires knowledge of the art and science of perioperative medicine.
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Jordanian cancer patients' information needs and information-seeking behaviour: a descriptive study.
Cancer diagnosis can leave patients with uncertainty and anxiety that can be reduced by providing timely information and effective communication. Despite information provision being highly important in improving the quality of provided care, no study had been conducted to assess the information needs of Jordanian cancer patients. ⋯ Many factors may cause variations in patients' information-seeking behaviour. Therefore, a notational policy for information provision is needed to satisfy different patients' information needs. Healthcare providers should be aware that cancer patients' will continue to need information at all stages.