No abstract

An airflow in the first four generations of the tracheobronchial tree was simulated by the 1D model of incompressible fluid flow through the network of the elastic tubes coupled with 0D models of lumped alveolar components, which aggregates parts of the alveolar volume and smaller airways, extended with convective transport model throughout the lung and alveolar components which were combined with the model of oxygen and carbon dioxide transport between the alveolar volume and the averaged blood compartment during pathological respiratory conditions. The novel features of this work are 1D reconstruction of the tracheobronchial tree structure on the basis of 3D segmentation of the computed tomography (CT) data; 1D−0D coupling of the models of 1D bronchial tube and 0D alveolar components; and the alveolar gas exchange model. The results of our simulations include mechanical ventilation, breathing patterns of severely ill patients with the cluster (Biot) and periodic (Cheyne-Stokes) respirations and bronchial asthma attack. The suitability of the proposed mathematical model was validated. Carbon dioxide elimination efficiency was analyzed in all these cases. In the future, these results might be integrated into research and practical studies aimed to design cyberbiological systems for remote real-time monitoring, classification, prediction of breathing patterns and alveolar gas exchange for patients with breathing problems.

No abstract

Introduction: The goal of palliative care is the provision of the best quality of life (QOL) for terminally ill and dying patients. Advances in medical treatment has seen an increase in overall survival of all stages of malignant diseases. This includes advanced and/or inoperable malignancies where management is mainly palliative involving different modalities. Methods: We designed a cross-sectional descriptive study of surgical patients in a palliative care unit in a 1000-bedded teaching hospital in Kuantan, Malaysia. Objectives of this study are: to study the demographic characteristics and indications for admission of surgical patients in palliative care unit, to study the options of treatment modalities and their complications, to identify the barriers in decision making in surgical treatment and finally to objectively assess the quality of life of these patients by utilizing QUALITY OF LIFE (WHOQOL) –BREF –questionnaire. Results: One hundred and one eligible patients (53%) male, (47%) female of mean age of 54yrs, majority Malay and Chinese patients were included in the study. All patients had malignancies and they were Breast (30%), Lower gastrointestinal (GI) (24%), (18%) upper GI, (15%) hepato-biliary, and (7%) pancreatic cancers. Thirty two percents of patients had emergency treatment while the rest had supportive treatment. Barriers to decision making were mainly due to patient factors in 71%, while 12% was due to the disease presenting at an advanced stage and 15% due to limitation of care. The final results of overall quality of life rating were shown as poor (1%), neither poor nor good (42%), good (52%) and very good (2%). Conclusions: Palliative care and end of life decision making from surgical point of view is a delicate issue. Like all other fields in medicine, palliative care must be evidence-based with specific goal directed therapy. Our study shows that we are able to positively impact the quality of life in more than two thirds of our patients. Our aim is to achieve 100% success. As such, it is imperative to inculcate the goal of palliative care to all grades of health care personnel. ‘To cure sometimes, To relieve often, To comfort always’ should not be mere words.

No abstract