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1.
Paediatr Respir Rev ; 42: 23-28, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34215541

RESUMEN

There has been growing interest in telemedicine for cystic fibrosis over recent years based largely on convenience for patients and/or increasing the frequency of surveillance and early detection which, it is assumed, could improve treatment outcomes. During 2020, the covid-19 pandemic catalysed the pace of development of this field, as CF patients were presumed to be at high risk of infection. Most clinics adapted to digital platforms with provision of lung function monitoring and sample collection systems. Here, we present the views of multidisciplinary team members at a large paediatric CF centre on what has worked well and what requires further optimisation in the future. In response to the question posed, 'Do we still need face to face clinics?' our answer is 'Yes, but not every time, and not for everyone'.


Asunto(s)
Fibrosis Quística , Telemedicina , COVID-19 , Niño , Fibrosis Quística/diagnóstico , Fibrosis Quística/epidemiología , Fibrosis Quística/terapia , Humanos , Pandemias
2.
Paediatr Respir Rev ; 42: 43-48, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33773928

RESUMEN

The COVID-19 pandemic has led to a rapid escalation in use of home monitoring and video consultations in children with a variety of chronic respiratory conditions. Our department set up a home spirometry service from scratch once it became evident that we needed to keep patients away from hospital clinics whenever possible. We faced a number of challenges but now have around 400 children using home spirometers. There are a number of portable spirometers available, some with online platforms. The technology, particularly the software/apps interface, has been improved by the companies in response to issues that have arisen. We believe the use of home monitoring is here to stay.


Asunto(s)
Asma , COVID-19 , Espirometría , Niño , Humanos , Pandemias
3.
Lung ; 196(2): 231-238, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29368042

RESUMEN

PURPOSE: Primary ciliary dyskinesia (PCD) is characterised by repeated upper and lower respiratory tract infections, neutrophilic airway inflammation and obstructive airway disease. Different ultrastructural ciliary defects may affect lung function decline to different degrees. Lung clearance index (LCI) is a marker of ventilation inhomogeneity that is raised in some but not all patients with PCD. We hypothesised that PCD patients with microtubular defects would have worse (higher) LCI than other PCD patients. METHODS: Spirometry and LCI were measured in 69 stable patients with PCD. Age at testing, age at diagnosis, ethnicity, ciliary ultrastructure, genetic screening result and any growth of Pseudomonas aeruginosa was recorded. RESULTS: Lung clearance index was more abnormal in PCD patients with microtubular defects (median 10.24) than those with dynein arm defects (median 8.3, p = 0.004) or normal ultrastructure (median 7.63, p = 0.0004). Age is correlated with LCI, with older patients having worse LCI values (p = 0.03, r = 0.3). CONCLUSION: This study shows that cilia microtubular defects are associated with worse LCI in PCD than dynein arm defects or normal ultrastructure. The patient's age at testing is also associated with a higher LCI. Patients at greater risk of obstructive lung disease should be considered for more aggressive management. Differences between patient groups may potentially open avenues for novel treatments.


Asunto(s)
Cilios/ultraestructura , Trastornos de la Motilidad Ciliar/complicaciones , Enfermedades Pulmonares/etiología , Pulmón/fisiopatología , Pulmón/ultraestructura , Microtúbulos/ultraestructura , Depuración Mucociliar , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Trastornos de la Motilidad Ciliar/genética , Trastornos de la Motilidad Ciliar/patología , Trastornos de la Motilidad Ciliar/fisiopatología , Femenino , Volumen Espiratorio Forzado , Humanos , Lactante , Recién Nacido , Enfermedades Pulmonares/patología , Enfermedades Pulmonares/fisiopatología , Masculino , Flujo Espiratorio Medio Máximo , Microscopía Electrónica de Transmisión , Factores de Riesgo , Espirometría , Adulto Joven
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