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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A subcommitte was appointed by the Joint Tuberculosis Committee of the British Thoracic Society to review and bring up to date guidelines on control measures for tuberculosis. The updated code of practice emphasises that all cases of tuberculosis must be notified. A minority of patients need admission, and those with positive sputum smears should be regarded as infectious until they have received two weeks of chemotherapy. NHS staff at risk should be protected, and evidence of infectious tuberculosis should be sought as routine among certain prospective NHS employees, schoolteachers, and others. Contact tracing should be vigorously pursued, and all entrants to Britain from countries where tuberculosis is common should be screened. BCG vaccination should be offered in selected instances, and local organisation of tuberculosis services should be extended.
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PMID:Control and prevention of tuberculosis in Britain: an updated code of practice. Subcommittee of the Joint Tuberculosis Committee of the British Thoracic Society. 236 69

Chronic obstructive pulmonary disease is a common, smoking-related respiratory disease. It is responsible for considerable morbidity and mortality and accounts for a large amount of NHS resources. Despite this, it is underdiagnosed, often poorly managed and its impact on patients is underestimated (British Thoracic Society (BTS), 2001). The first step is to make an accurate diagnosis at as early a stage as possible. This article explores the prevalence, impact and presentation of the disease and how it can be identified and diagnosed.
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PMID:Chronic obstructive pulmonary disease: importance of diagnosis. 1528 52

Chronic obstructive pulmonary disease (COPD) affects 600,000 people in the UK (British Thoracic Society, 2001) and costs the NHS more than 800m pounds a year (Guest, 1999). While this data is useful for health economists and service providers, it does not tell us about the devastating impact COPD has on quality of life. The disease is commonly associated with varying degrees of breathlessness, cough and loss of exercise capacity. These symptoms can play a significant role in limiting a patient's ability to carry out simple, day-to-day activities.
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PMID:Understanding the benefits of pulmonary rehabilitation. 1549 67

Thoracic surgical services for one cancer network in London are based at one NHS Trust. Approximately 80% of the surgery performed in the period January-December 2003 was for the diagnosis, palliation or treatment of cancer. The range of different patient groups and needs is very wide, ranging from teenagers undergoing metastatectomy to adults and older adults undergoing resections or palliative surgery. An audit of lung cancer resections performed in 2001 on behalf of the Network lung tumour board indicated that the service was fragmented and there were several bottlenecks in the lung cancer pathway, causing patient delays and a feeling of dissatisfaction amongst referrers and patients. A clinician with oncology experience was appointed in 2002. Immediate action to track patients and ensure referrers knew the outcome of surgery and histology was taken. As part of the NHS Modernisation agenda, the local Cancer Services Collaborative then facilitated mapping the pathway for lung cancer, identifying problems and ways of tackling them. Changes from this, subsequent initiatives and adopting a collaborative approach have also had a positive impact on the lung cancer service. These strategies have been adapted to all thoracic surgery pathways for cancer or suspected cancer. Examples include decreased wait time, sector-wide patient information, multiprofessional working practice and educational initiatives.
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PMID:Redesign of thoracic surgical services within a cancer network-using an oncology focus to inform change. 1577 43

This NIV audit was conducted across the North Central London network area, for a 3-month period in 2003. Five trusts participated (on 6 hospital sites) and 141 audit forms were returned, allowing data analysis for individual hospitals and for comparisons between hospitals. The results are discussed in line with the British Thoracic Society guidelines on NIV [British Thoracic Society Guideline. Non-invasive ventilation in acute respiratory failure. Thorax 2002;57:192-211] and the Modernisation Agency document [Critical Care Programme. Weaning and Long Term Ventilation. NHS Modernisation Agency; 2002]. Key areas for future work have been identified to facilitate service improvement.
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PMID:Non-invasive ventilation (NIV). An audit across the North Central London Critical Care Network (NCLCCN). 1603 62

This article aimed to: (1) review the work carried out in Lanarkshire between 1996 and 1999 on a Scottish Executive funded project and (2) to discuss the situation from 1999 to 2006. (1) This 3-year project led to the successful development and implementation of over 100 integrated care pathways in an urban teaching hospital (Glasgow) and a district general hospital (Lanarkshire) and was the first in-depth study of integrated care pathways to be undertaken in Scotland. The main report on the project was produced in 1999 (Clinical Audit and Quality using Integrated Pathways of Care) and reported increased adherence to British Thoracic Society and Scottish Intercollegiate Guidelines Network guidelines and multiple best practice statements, and improved standards of documentation. The general findings were that process indicators were improved by integrated care pathway use and there was some suggestion of improved length of stay with no apparent effect on outcome. Evidence was found that integrated care pathways have made a difference for both patients and staff. (2) This provides an update of integrated care pathway development in a changing environment within NHS Lanarkshire and examines some of the key factors for success.
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PMID:A decade on: has the use of integrated care pathways made a difference in Lanarkshire? 1700 61

Thoracic surgical procedures account for only a small fraction of all surgery undertaken in the NHS. Thoracic surgery is performed in specialist centres as patients often suffer serious co-morbidities and require vigilant care and observation by staff involved in their treatment. Anaesthesia for thoracic surgery challenges the theoretical and practical experience of all involved. This review briefly summarises the anaesthetic skills and knowledge required to deliver a safe and professional service to patients with thoracic pathology.
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PMID:Theoretical and practical aspects of anaesthesia for thoracic surgery. 1842 31

Non-tuberculous mycobacteria are opportunist pathogens increasingly recognised as a cause of pulmonary and extrapulmonary disease. Treatment is complicated, prolonged and potentially toxic, and due to a limited evidence base, potentially contentious and idiosyncratic. This is a retrospective review of non-tuberculous mycobacteria cases in the NHS Borders Health Board between 1992 and 2010. We consider incidence, species identified, drug sensitivity testing and treatment outcome with reference to the British and American Thoracic Society guidelines. Thirty-eight cases of non-tuberculous mycobacteria isolates were identified; 84.21% were pulmonary and 42.11% were Mycobacterium avium complex. Incidence rose from 1.92/100,000 in 1993 to 4.43/100,000 in 2010. The British Thoracic Society guidelines were followed in 45.45% of cases. A total of 36.36% were successfully treated with another 36.36% still being treated with antimicrobials. There is a clear need for more research on treatment for this group of 'emerging pathogens' and it remains to be seen if concordance with current guidelines will improve treatment outcomes.
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PMID:Non-tuberculous mycobacterial infections in the Scottish Borders: identification, management and treatment outcomes--a retrospective review. 2244 Oct 76

The importance of providing patients with high-quality information is highlighted in several government reports. The aim of this project was to develop written information specifically designed for patients with non-cystic fibrosis bronchiectasis who are prescribed nebulised colistimethate sodium. This involved evaluating current literature and best practice, which was achieved through multidisciplinary collaboration. The leaflet produced meets the recommendations of the British Thoracic Society and Department of Health, as well as NHS trusts' legal obligations to promote equality and diversity. It is available as a printed document in a variety of formats and languages, and can be downloaded from the hospital website.
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PMID:Patient information on nebulised antibiotics. 2268 57

The British Thoracic Society and Scottish Intercollegiate Guidelines Network recommend that children up to the age of five should use a pressurised metered dose inhaler with a spacer device to deliver inhaled steroids. However, large-volume spacers can be cumbersome, which is why I designed a smaller, more portable device to encourage spacer use. After prototypes were made, the idea was presented to the local NHS innovations department. With its advice and assistance, a collapsible spacer device has been developed. This article describes the product development process.
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PMID:The development process for a new spacer device. 2349 81


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