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A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
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A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a

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  • 1. DEBBIE KENNEDY, SPECIALIST ASPERGILLOSIS NURSE NATIONAL ASPERGILLOSIS CENTRE UHSM MANCHESTER Support Meeting for Aspergillosis Patients Fungal Research Trust
  • 2.  
  • 3. A Clinic Visit 4 th November 2010 Patient Support Meeting ERC by Debbie Kennedy Aspergillosis Specialist Nurse
  • 4. Your Clinic Visit <ul><li>Where </li></ul><ul><li>National Aspergillosis Centre based in the North West Lung Centre at University Hospital Manchester </li></ul><ul><li>When </li></ul><ul><li>Monday am Wednesday pm Friday am </li></ul><ul><li>Who </li></ul><ul><li>Foreground - Doctors, Specialist Nurses, Administration Manager, Physiotherapists, </li></ul><ul><li>Background - Specialist Laboratory staff, Researchers, Website Information Architect </li></ul><ul><li>Why </li></ul><ul><li>Nationally Commissioned Specialist Service to deliver all aspects of Aspergillosis Care </li></ul><ul><li>How </li></ul><ul><li>Face to face Multidisciplinary Team approach </li></ul><ul><li>Nurse driven telephone support service </li></ul>
  • 5. Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Welcomed </li></ul><ul><li>Weight </li></ul><ul><li>MRC Dyspnoea (breathlessness) score </li></ul><ul><li>Quality of Life Questionnaire </li></ul><ul><li>History </li></ul><ul><li>Chest Examination </li></ul><ul><li>Chest X-ray </li></ul><ul><li>CT Scan </li></ul><ul><li>Lung Function Studies </li></ul><ul><li>Bronchoscopy </li></ul><ul><li>Specialist Aspergillus Tests </li></ul><ul><li>Information Giving </li></ul><ul><li>Avoidance </li></ul>
  • 6. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  • 7. MRC Breathlessness Scale
  • 8. History – Past & Recent Who gets Aspergillosis Inhalation of aspergillus spores is a common daily occurrence. A healthy immune system would normally remove the spores and no symptoms or infection would occur. In individuals whose immune system may be suppressed either because of illness e.g. AIDS, cancer patients or drugs, spores may germinate and resulting tissue or systemic aspergillus invasion can result. Individuals with allergies such as asthma, can also be vulnerable to aspergillus disease.
  • 9. History <ul><li>Signs and Symptoms </li></ul><ul><li>Weight loss 16 / 18 (89%) </li></ul><ul><li>Cough 15 / 18 (83%) </li></ul><ul><li>Shortness of breath 9 / 18 (50%) </li></ul><ul><li>Haemoptysis 9 / 18 (50%) </li></ul><ul><li>Fatigue / malaise 5 / 18 (28%) </li></ul><ul><li>Chest pain 3 / 18 (17%) </li></ul><ul><li>Sputum production ++ 3 / 18 (17%) </li></ul><ul><li>Fever 2 / 18 (11%) </li></ul>Denning DW et al, Clin Infect Dis 2003; 37:S265
  • 10. Chest Examination
  • 11. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  • 12. Chest X-ray
  • 13. Chest Xray Aspergilloma Fungal Ball
  • 14. Chest CT scan Fungal Ball
  • 15. Lung Function Studies
  • 16. Lung Function Studies
  • 17. Bronchoscopy
  • 18. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  • 19. Specialist Aspergillus Tests <ul><li>Sputum test </li></ul><ul><li>Fungal Culture and Sensitivity </li></ul><ul><li>Sputum PCR </li></ul>
  • 20. Sputum Fungal Culture
  • 21. Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Blood tests </li></ul><ul><ul><li>Liver Function test </li></ul></ul><ul><ul><li>Kidney function test </li></ul></ul><ul><ul><li>Glucose </li></ul></ul><ul><ul><li>Full Blood Count – anaemia, infection </li></ul></ul><ul><ul><li>Immune system </li></ul></ul><ul><ul><li>Inflammatory markers </li></ul></ul><ul><ul><li>Allergy Levels </li></ul></ul><ul><ul><li>Drug Monitoring Levels </li></ul></ul><ul><ul><li>Vitamin D Levels </li></ul></ul><ul><ul><li>Research Bloods </li></ul></ul>
  • 22. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  • 23. Specialist Aspergillus Tests <ul><li>Blood test </li></ul><ul><li>Aspergillus precipitins (IgG) and titre </li></ul><ul><li>Total Immunoglobulin E (IgE) </li></ul><ul><li>Aspergillus specific IgE (RAST) </li></ul><ul><li>Drug Monitoring Levels </li></ul>
  • 24. Information <ul><li>Contact Information </li></ul><ul><li>Information Leaflets </li></ul><ul><li>Website Information </li></ul><ul><li>Smoking Cessation </li></ul><ul><li>Physiotherapist Advice </li></ul><ul><li>Aspergillus Avoidance </li></ul>
  • 25. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  • 26. How to avoid Aspergillus <ul><li>Pulmonary infections can be prevented by </li></ul><ul><ul><li>Avoid smoking </li></ul></ul><ul><ul><li>Do not use bedside humidifiers </li></ul></ul><ul><li>Sources of Aspergillus spores </li></ul><ul><ul><li>animal stables </li></ul></ul><ul><ul><li>Hay </li></ul></ul><ul><ul><li>Mulch </li></ul></ul><ul><ul><li>rotten plants, </li></ul></ul><ul><ul><li>compost piles, </li></ul></ul><ul><ul><li>wood chips </li></ul></ul><ul><ul><li>construction sites </li></ul></ul>
  • 27. Where is Aspergillosis <ul><li>Sources of Infection? </li></ul><ul><li>Aspergillus species are found in: </li></ul><ul><ul><li>Soil </li></ul></ul><ul><ul><li>Air; spores may be inhaled </li></ul></ul><ul><ul><li>Water / storage tanks in hospitals etc </li></ul></ul><ul><ul><li>Food </li></ul></ul><ul><ul><li>Compost and decaying vegetation </li></ul></ul><ul><ul><li>Fire proofing materials </li></ul></ul><ul><ul><li>Bedding, pillows </li></ul></ul><ul><ul><li>Ventilation and air conditioning systems </li></ul></ul><ul><ul><li>Computer fans </li></ul></ul>
  • 28. www.aspergillus.org.uk
  • 29. Thank you

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