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The Pulmonology Clinic at Nicosia General Hospital plays a critical role in both public and private healthcare sectors, particularly concerning severe respiratory conditions. It serves as a reference centre and provides care for the most critical cases of respiratory diseases, offering essential and irreplaceable services, considering the absence of a Pulmonology Clinic in the private sector.
With its dedicated staff, the Pulmonology Clinic delivers high-level care to seriously ill patients who require specialised treatments like High Flow Oxygen and non-invasive mechanical ventilation. It also provides treatment to those with other severe respiratory conditions, such as pneumonia, pulmonary embolism, respiratory infections, pleural effusion, interstitial lung diseases, pulmonary arterial hypertension, respiratory failure/obesity, lung cancer, asthma exacerbations, chronic obstructive pulmonary disease (COPD), bronchiectasis, and haemoptysis. Both the medical professionals and the supporting staff work diligently, combining expertise and genuine concern for the well-being of their patients.
Following the establishment of the new Nicosia General Hospital in 2006, the “Clinic of Chest Diseases”, operating at the old hospital of Nicosia since 1949, was relocated to a modern space called “Pulmonary Clinic”. The Pulmonary Clinic, as a department for the treatment of patients with diseases of the respiratory system, started its operation on December 17, 2009. It has 23 beds for the treatment of patients and a V. I. P. treatment room for the treatment of distinguished persons. It is the first pancyprian Pulmonary Clinic in both the private and public sectors and is staffed by well-trained medical personnel and has modern scientific equipment.
Visitors:
THE VISITING HOURS AND UPDATES ON PATIENT’S CONDITION BY THE ATTENDING DOCTORS WILL BE BETWEEN 13.00-14.00.
Activities and services provided by the Pulmonary Clinic
1. Patient care department
Patients with respiratory diseases are treated in the patient care department of the Pulmonary Clinic. The department is on daily duty, 365 days a year, 24 hours a day. In addition to the admissions made by the clinic’s doctors, there are transfers from other hospitals, for patients who require specialised follow-up due to respiratory diseases.
2. Application of clinical protocols by the Pulmonary Clinic
The Pulmonary Clinic of the General Hospital of Nicosia implements clinical protocols for the treatment of community-acquired pneumonia, pulmonary embolism, COPD exacerbations, pleural effusion, right heart catheterisation and bronchoscopy. These are protocols that determine the sequence of tasks and interventions that should be performed by the various professional teams of the clinic (doctors, nurses, physiotherapists), in a standardised manner, for patients who have the same diagnosis. The implementation of clinical protocols has been shown to improve the quality of patient care and increase staff and patient satisfaction. Protocols also bring a more cost-effective management of various cases by reducing hospitalisation time and limiting diagnostic tests.
3. Outpatient clinics department
Patients who are referred by other specialties, as well as patients suffering from chronic respiratory diseases, are examined daily in the outpatient clinics of the Pulmonary Clinic. For the most adequate treatment based on international clinical protocols, the patients are grouped according to their disease and are referred to the corresponding clinic with scheduled appointments:
At Nicosia General Hospital’s Pulmonology Clinic, we operate the only specialised and organised centre for Pulmonary Arterial Hypertension (PAH) in Cyprus, offering comprehensive care to patients, from diagnosis to treatment. For the past 15 years, the organised clinic has monitored all severe PAH cases nationwide. Additionally, for the past two years, we have been able to perform subcutaneous and intravenous drug administration pumps in collaboration with an overseas centre, and from this year, autonomously in Cyprus. At the centre, the investigation of PAH is comprehensive, with diagnosis through right heart catheterization performed by Pulmonologists, followed by monitoring and treatment. We provide continuous support to our patients for all their needs, including informative material, emergency guidelines, and assistance with specialised medication requests.
Individuals experiencing shortness of breath, fatigue, and exhibit cardiac ultrasound findings indicative of PAH should be referred to the specialised Pulmonary Hypertension Centre at Nicosia General Hospital’s Pulmonology Clinic.
4. Consultation for patients treated in other clinics
Pulmonologists are consulted for patients who are being treated in other clinics and have lung problems or are about to undergo surgery. For these patients, the necessary recommendations are made for the treatment of the respiratory problem or, where necessary, the patients are transferred to the Pulmonary Clinic for further treatment.
5. Laboratories and examinations
5.1 Spirometry with a portable spirometer for patients with respiratory diseases or those who are about to undergo surgery and require preoperative pulmonary evaluation.
5.2 Functional investigation of the respiratory system
The Pulmonary Clinic has a state-of-the-art laboratory for the comprehensive assessment of respiratory function. The static and dynamic volumes of the lungs as well as the diffusion capacity and the respiratory muscles are assessed.
5.3 Allergy skin tests
They are carried out in the context of investigating atopy. The test includes 13 types of airborne allergens.
5.4 Methacholine challenge test
Patients being examined for asthma undergo a Methacholine challenge test.
5.5 Sleep study lab to diagnose sleep apnoea syndrome and other sleep disorders
Scheduled sleep studies are performed every night. At the same time, patients suffering from sleep apnoea syndrome are monitored at the Sleep Disorders Clinic. In this clinic, patients are specially trained in the use of non-invasive ventilation devices (c-pap, bi-pap) and the devices are checked regularly with modern software, for their proper operation and usage by patients.
5.6 Cardiopulmonary Exercise Testing (CPET) Laboratory
The Pulmonary Clinic operates a state-of-the-art Cardiopulmonary Exercise Testing laboratory to which patients are referred from both the public and the private sector. In clinical practice it is used to diagnose, assess disability or ability to exercise, assess the severity and prognosis of various conditions, but also to evaluate the effectiveness of medication. The laboratory examines patients who are candidates for heart transplant and patients with Chronic Obstructive Pulmonary Disease before and after the Pulmonary Rehabilitation Program.
5.7 Bronchoscopy
The flexible bronchoscope was introduced in the public healthcare sector in 1993. The endoscopy laboratory and laboratory of invasive Pulmonology operate on the first floor of Nicosia General Hospital, and provide the following examinations:
Conventional Transbronchial needle aspiration (TBNA) for biopsy of mediastinal lymph nodes and / or mediastinal masses
Endobronchial Ultrasound Guided Transbronchial needle aspiration (TBNA) for mediastinal lymph nodes and / or mediastinal masses biopsies (EBUS-TBNA), offered since 2012
Sampling bronchial secretions for various examinations
Bronchoalveolar lavage (BAL) examination
Cytology brush
Autofluorescence Bronchoscopy (AFB)
Removal of malignant obstruction of the trachea, bronchi (use of electrocautery, argon plasma coagulation APC) ND-YAG Laser, Cryotherapy
Treatment of benign / malignant stenosis of trachea, bronchi, placement of tracheobronchial stent
Closure of bronchopleural fistula – endotracheal valves in patients with severe emphysema
The clinic also has a model in place for training of resident doctors in the use of the bronchoscope.
Endoscopic evaluation of swallowing in patients with swallowing disorders, neurological diseases, frequent aspirations
5.8 Minimally invasive medical thoracoscopy
The Pulmonary Clinic of Nicosia General Hospital has been applying thoracoscopy since 2012. It is a method of examination of the pleural cavity for investigating pleural effusion. It is also applied where reduction and fixation of rib fractures is required. It is performed utilising a flexible thoracoscope.
6. Other activities
6.1 Schools for bronchial asthma and chronic obstructive pulmonary disease (COPD)
In the Pulmonary Clinic of Nicosia General Hospital, the schools of bronchial asthma and COPD have been operating since 2008. These schools are educational spaces for patients and relatives of patients with bronchial asthma and COPD.
6.2 Pulmonary rehabilitation for patients with COPD and other chronic lung diseases such as pulmonary fibrosis
The Pulmonary Rehabilitation Program was initiated on November 9, 2010. The programme includes various interventions for the treatment of patients with COPD in order to improve their general condition and their quality of life. It is the first rehabilitation centre for COPD patients in both the public and private sectors.
6.3 6-minute walking test 6MWT
The six-minute walking test is a test performed by the patient in an available corridor outside the laboratory of the pulmonology clinic with special wearable modern equipment. During the test, the distance travelled by the patient walking fast for six minutes, is measured. The test is attended by a pulmonologist and records arterial blood oxygen saturation, heart rate and respiratory rate.
6.4 Transthoracic ultrasound
Lung ultrasound is the fastest, most direct, non-invasive means of diagnosing a patient, without complications and radiation, and at a lower cost compared to other diagnostic methods. Lung ultrasound is used as a diagnostic tool in Pulmonology for the control of diseases of the chest and pleural cavity but also for safe aspiration
7. Anti-tuberculosis program
The Pulmonary Clinic is represented in the National Tuberculosis Committee. The committee meets regularly for the central planning of the anti-tuberculosis programme with the participation of all competent bodies and the implementation of the guidelines of the World Health Organization. Patients in Nicosia General Hospital are monitored at the Tuberculosis Clinic with regular appointments.
8. Residency in Pulmonology training programme
Training of resident doctors
The Pulmonary Clinic staff has extensive experience in providing effective training of resident doctors, facilitated by the state-of-the-art equipment of the clinic. It demonstrates significant educational work according to the standards of the European Respiratory Society (ERS). The Pulmonary Clinic is the only clinic in Cyprus that provides a complete residency programme in Pulmonology.
The Pulmonology Clinic also offers education in the Specialty of Pulmonology to resident General Practitioners and Anaesthesiologists. The educational programme includes courses, training in imaging examination of the respiratory system, in performing and reading spirometry, in the daily examination of patients with respiratory diseases and practice in the clinical laboratory.
Education of Medical Students
The Pulmonary Clinic also trains medical students from both public and private universities.
9. Outreach – Educating the public
In the context of public outreach and raising awareness about respiratory system diseases, the Pulmonary Clinic started in 2007 publishing and distributing free of charge, relevant leaflets. These leaflets, written in layman’s terms, cover bronchial asthma, COPD, sleep apnoea syndrome, community pneumonia, bronchoscopy, pulmonary rehabilitation, asthma and COPD schools, quitting smoking, pulmonary embolism, thoracoscopy, lung transplant, oxygen therapy, physiotherapy and rehabilitation as well as all the services provided by the Pulmonary Clinic.
10. Teleconference system
In 2012, a pilot teleconferencing system was installed, which provides the opportunity to discuss cases and participate in educational activities with Pulmonary Clinics abroad.
11. Future projects
Establishment of a research centre for respiratory diseases for the development of research activities in Pulmonology. The research centre will carry out genetic testing for respiratory diseases and will apply cellular and molecular biology techniques.
12. Initiatives
1. The doctors of the Pulmonary Clinic support the “Pancyprian Association of Lung Patients and Friends”. The purpose of this association is to provide assistance and any kind of support to patients with respiratory conditions and their families while informing and raising public awareness on the matter. The association has open membership for anyone who wishes to join.
2. Doctors of the Pulmonary Clinic have established and actively participate in the Non-Profit Foundation under the name “Cyprus Institute of Respiratory Diseases – K.I.A.NOS.” The purpose of the Foundation is to promote research and education, health and a healthy environment in matters of respiratory diseases and to support respiratory disease patients.
RIGHT HEART CATHETERISATION In collaboration with a specialist Anaesthesiologist, the Pulmonary Clinic within the Pulmonary Arterial Hypertension Clinic performs Right Heart Catheterization, an examination which is considered necessary for the diagnosis, the staging of the disease but also its treatment. It is the only nationwide specialised and organised centre for Pulmonary Arterial Hypertension for the comprehensive treatment of patients.
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