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An atypical cause of respiratory failure

A 70 year old woman was admitted to the general medical ward (from the emergency department) with a three week history of progressive shortness of breath, which was worse on exertion, and a non-productive cough. She took amlodipine 5 mg for hypertension and lansoprazole 30 mg for gastro-oesophageal reflux disease. She had also been taking immunosuppressive therapy with mycophenolate mofetil 1.5 g twice daily for nine months to treat her lichen planus. She was allergic to tramadol, codeine, and co-trimoxazole. She had received influenza vaccine within the previous 12 months. She was normally active and went on regular five mile walks.  
feeds.bmj.com
almost 5 years ago
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1
22

A man with fever, a productive cough, and a striking chest radiograph

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day.  
feeds.bmj.com
almost 5 years ago
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0
0

An atypical cause of respiratory failure

A 70 year old woman was admitted to the general medical ward (from the emergency department) with a three week history of progressive shortness of breath, which was worse on exertion, and a non-productive cough. She took amlodipine 5 mg for hypertension and lansoprazole 30 mg for gastro-oesophageal reflux disease. She had also been taking immunosuppressive therapy with mycophenolate mofetil 1.5 g twice daily for nine months to treat her lichen planus. She was allergic to tramadol, codeine, and co-trimoxazole. She had received influenza vaccine within the previous 12 months. She was normally active and went on regular five mile walks.  
feeds.bmj.com
almost 5 years ago
Preview
0
0

An atypical cause of respiratory failure

A 70 year old woman was admitted to the general medical ward (from the emergency department) with a three week history of progressive shortness of breath, which was worse on exertion, and a non-productive cough. She took amlodipine 5 mg for hypertension and lansoprazole 30 mg for gastro-oesophageal reflux disease. She had also been taking immunosuppressive therapy with mycophenolate mofetil 1.5 g twice daily for nine months to treat her lichen planus. She was allergic to tramadol, codeine, and co-trimoxazole. She had received influenza vaccine within the previous 12 months. She was normally active and went on regular five mile walks.  
feeds.bmj.com
almost 5 years ago
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0
7

Unexpected rapid weight gain in a patient with HIV and anorexia

A 45 year old man presented to outpatients in January 2015 with unexplained weight gain and shortness of breath. He was HIV positive (diagnosed in the early 1990s) and was on combination antiretroviral therapy (tenofovir, emtricitabine, and darunavir boosted with ritonavir). His HIV infection was well controlled with an undetectable HIV viral load and a CD4 count of 497×106/L.  
feeds.bmj.com
almost 5 years ago
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0
7

Unexpected rapid weight gain in a patient with HIV and anorexia

A 45 year old man presented to outpatients in January 2015 with unexplained weight gain and shortness of breath. He was HIV positive (diagnosed in the early 1990s) and was on combination antiretroviral therapy (tenofovir, emtricitabine, and darunavir boosted with ritonavir). His HIV infection was well controlled with an undetectable HIV viral load and a CD4 count of 497×106/L.  
feeds.bmj.com
almost 5 years ago
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0
6

Unexpected rapid weight gain in a patient with HIV and anorexia

A 45 year old man presented to outpatients in January 2015 with unexplained weight gain and shortness of breath. He was HIV positive (diagnosed in the early 1990s) and was on combination antiretroviral therapy (tenofovir, emtricitabine, and darunavir boosted with ritonavir). His HIV infection was well controlled with an undetectable HIV viral load and a CD4 count of 497×106/L.  
feeds.bmj.com
almost 5 years ago
Preview
0
6

Unexpected rapid weight gain in a patient with HIV and anorexia

A 45 year old man presented to outpatients in January 2015 with unexplained weight gain and shortness of breath. He was HIV positive (diagnosed in the early 1990s) and was on combination antiretroviral therapy (tenofovir, emtricitabine, and darunavir boosted with ritonavir). His HIV infection was well controlled with an undetectable HIV viral load and a CD4 count of 497×106/L.  
feeds.bmj.com
almost 5 years ago
Preview
0
0

Unexpected rapid weight gain in a patient with HIV and anorexia

A 45 year old man presented to outpatients in January 2015 with unexplained weight gain and shortness of breath. He was HIV positive (diagnosed in the early 1990s) and was on combination antiretroviral therapy (tenofovir, emtricitabine, and darunavir boosted with ritonavir). His HIV infection was well controlled with an undetectable HIV viral load and a CD4 count of 497×106/L.  
feeds.bmj.com
almost 5 years ago
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5

Ticagrelor and Science: Is the Dyspnea Really Worth It?

Dr Melissa Walton-Shirley reports on the presentation about the long-term tolerability of ticagrelor in PEGASUS vs the results of her experience with the drug.  
medscape.com
almost 5 years ago
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Dyspnea, Minor Bleeds Led Causes for Stopping Ticagrelor in Trial

"As clinicians we shouldn't underestimate the impact on patients of nosebleeds and bruising," said a PEGASUS TIMI 54 researcher, so before treatment patients should hear about even nonmajor risks.  
medscape.com
over 4 years ago
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ECG Challenge: Palpitation Puzzle

An older man in the ED complains of palpitations and shortness of breath. What does his ECG show?  
medscape.com
over 4 years ago
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6

Management of chronic refractory cough

Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.  
feeds.bmj.com
over 4 years ago
Www.bmj
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Management of chronic refractory cough

Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.  
feeds.bmj.com
over 4 years ago
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1

A Healthy Young Man with Sudden Onset of Dyspnea and Chest Pain CME

It is important that patients with pulmonary embolism (PE) are diagnosed and treated effectively. The goal of this program is to provide practical advice regarding treating patients with PE.  
medscape.org
over 4 years ago
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Lab Case 86

A 70 year old female presents with generalised weakness and shortness of breath. On examination she has a low grade temperature and is pale looking.  
emergucate.com
over 4 years ago
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Exercise induced bronchoconstriction in adults: evidence based diagnosis and management

EIB is commonly misdiagnosed because its symptoms (such as shortness of breath, chest tightness, wheezing, and cough) are neither sensitive nor specific  
feeds.bmj.com
over 4 years ago
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0
3

Exercise induced bronchoconstriction in adults: evidence based diagnosis and management

EIB is commonly misdiagnosed because its symptoms (such as shortness of breath, chest tightness, wheezing, and cough) are neither sensitive nor specific  
feeds.bmj.com
over 4 years ago
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0
0

Exercise induced bronchoconstriction in adults: evidence based diagnosis and management

EIB is commonly misdiagnosed because its symptoms (such as shortness of breath, chest tightness, wheezing, and cough) are neither sensitive nor specific  
feeds.bmj.com
over 4 years ago
Preview
0
1

Exercise induced bronchoconstriction in adults: evidence based diagnosis and management

EIB is commonly misdiagnosed because its symptoms (such as shortness of breath, chest tightness, wheezing, and cough) are neither sensitive nor specific  
feeds.bmj.com
over 4 years ago