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Airway clearance therapy: finding the evidence.

Authors: Volsko TA Abstract Disease processes can impair ciliary function, alter secretion production and mucus rheology, and interfere with the cough reflex. Airway clearance therapy has been a cornerstone of therapy aimed at minimizing the devastating effects of airway obstruction, infection, and inflammation due to mucus stasis on the conducting airways and lung parenchyma. Although challenges to performing clinical studies evaluating the effectiveness of airway clearance therapeutic modalities exist, resources are available in the literature. In addition to device evaluations and original clinical research, the expert opinion, systematic reviews, and evidence-based practice guidelines can be found. These tools can be used to develop protocols and pathways to guide our practice....

Evidence for oxygen use in the hospitalized patient: is more really the enemy of good?

Authors: Blakeman TC Abstract Oxygen in arguably one of the most frequently utilized drugs in modern healthcare, but is often administered to patients at caregivers' discretion with scant evidence as to its efficacy or safety. Although oxygen is administered for varied medical conditions in the hospital setting, published literature supports the use of oxygen to reverse hypoxemia, for trauma victims with traumatic brain injury and hemorrhagic shock, for resuscitation during cardiac arrest, and for carbon monoxide poisoning. Oxygen should be titrated to target an SpO2 of 94-98%, except with carbon monoxide poisoning (100% oxygen), ARDS (88-95%), those at risk for hypercapnia (SpO2 88-92%), and premature infants (SpO2 88-94%). Evidence for use with other conditions for which oxygen i...

Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection and Guidance for the Public, Clinicians, and Public Health Authorities, 2012–2013

(Source: CDC Morbidity and Mortality Weekly Report)

It’s flu season again!

With flu season kicking into high gear, it is important for infection preventionists (IPs) to engage patients and their families in the fight against influenza—not only health care personnel. IPs know that the influenza vaccine is the best way to prevent the virus, along with good hand hygiene and respiratory etiquette. This year’s International Infection Prevention Week (IIPW), October 20-26, puts a special emphasis on public awareness of infection prevention. Do your part to help ensure that patients and their families know how to protect themselves from infection, including the flu. (Source: American Journal of Infection Control)

Effects of Respiratory Motion on Passively Scattered Proton Therapy Versus Intensity Modulated Photon Therapy for Stage III Lung Cancer: Are Proton Plans More Sensitive to Breathing Motion?

Purpose: To quantify and compare the effects of respiratory motion on paired passively scattered proton therapy (PSPT) and intensity modulated photon therapy (IMRT) plans; and to establish the relationship between the magnitude of tumor motion and the respiratory-induced dose difference for both modalities.Methods and Materials: In a randomized clinical trial comparing PSPT and IMRT, radiation therapy plans have been designed according to common planning protocols. Four-dimensional (4D) dose was computed for PSPT and IMRT plans for a patient cohort with respiratory motion ranging from 3 to 17 mm. Image registration and dose accumulation were performed using grayscale-based deformable image registration algorithms. The dose–volume histogram (DVH) differences (4D-3D [3D = 3-dimensional]...

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