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PulmonaryMedicine

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Controversies of Thrombolytics for Pulmonary Embolism - emdocs

Pulmonary embolism (PE) is a disease process associated with significant morbidity and mortality. The benefits of thrombolytics for massive PE has been established in the literature. But what does the evidence say about the use of thrombolytics for submassive PE? What are the current guidelines and recommendations? As emergency physicians how should we apply the current evidence for the use of thrombolytics in submassive PE?   
emdocs.net
about 3 years ago
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Diagnosis and Management of Community-Acquired Pneumonia in Adults - American Family Physician

Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients. Initial outpatient therapy should include a macrolide or doxycycline. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. Patients with severe community-acquired pneumonia or who are admitted to the intensive care unit should be treated with a beta-lactam antibiotic, plus azithromycin or a respiratory fluoroquinolone. Those with risk factors for Pseudomonas should be treated with a beta-lactam antibiotic (piperacillin/tazobactam, imipenem/cilastatin, meropenem, doripenem, or cefepime), plus an aminoglycoside and azithromycin or an antipseudomonal fluoroquinolone (levofloxacin or ciprofloxacin). Those with risk factors for methicillin-resistant Staphylococcus aureus should be given vancomycin or linezolid. Hospitalized patients may be switched from intravenous to oral antibiotics after they have clinical improvement and are able to tolerate oral medications, typically in the first three days. Adherence to the Infectious Diseases Society of America/American Thoracic Society guidelines for the management of community-acquired pneumonia has been shown to improve patient outcomes. Physicians should promote pneumococcal and influenza vaccination as a means to prevent community-acquired pneumonia and pneumococcal bacteremia.  
aafp.org
about 3 years ago
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Glasgow has highest lung disease death rate in Britain - BBC News

Scotland's urban areas, particularly around Glasgow, have the highest lung disease mortality rates in Britain, according to a new report.  
bbc.co.uk
about 3 years ago
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Dr Heimlich saves choking woman with manoeuvre he invented - BBC News

The 96-year-old man behind the Heimlich manoeuvre has used the technique to save a woman choking at his retirement home.  
bbc.co.uk
about 3 years ago
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Severe Acute Respiratory Infections in Arizona

What is the main cause of severe acute respiratory infections on the US-Mexico border? Read the disease surveillance data here.  
medscape.com
about 3 years ago
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Pneumonia Mimics: Pearls and Pitfalls - emdocs

Pneumonia is an illness frequently seen in our emergency departments.  But, are all presentations actually pneumonia?  Are we missing other illnesses that present similarly to pneumonia?  Which ones pose significant morbidity and mortality risk to our patients?  What clues are out there that will aid us in making an alternative and critical diagnosis?  
emdocs.net
over 3 years ago
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Nonpharmacologic Treatments for COPD

A range of nonpharmacologic treatments for COPD can provide alternatives to medication and relief for patients.  
medscape.com
over 3 years ago
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Worldwide Trends in Occupational Allergy and Asthma

How has the occurrence of work-related allergy and asthma changed in recent years? This new article examines the worldwide trends.  
medscape.com
over 3 years ago
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Quality of Life Changes Over Time in Patients With COPD

What are the impacts of this disease on health-related quality of life in these patients?  
medscape.com
over 3 years ago
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Supraglottoplasty Effective for Children With Laryngomalacia

Supraglottoplasty relieves obstructive sleep apnea (OSA) in children with laryngomalacia, but residual disease is common, according to a new meta-analysis of four studies.  
medscape.com
over 3 years ago
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Over-the-Counter Allergic Rhinitis Treatments: Navigating the Maze CME/CE

This activity is intended for physicians, nurses, and pharmacists in primary care, allergy, clinical immunology, and pediatrics.  
medscape.org
over 3 years ago
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Early Exposure to Dogs, Farm Animals Reduces Childhood Asthma

Could exposure to dogs at an early age help prevent asthma in children?  
medscape.com
over 3 years ago
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Combo May Help Stave Off Acute Respiratory Distress Syndrome

Early intervention in the emergency department improves outcomes for patients with hypoxemia, who are at high risk for acute respiratory distress syndrome, new research shows.  
medscape.com
over 3 years ago
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Life Threatening Asthma

LIFE THREATENING ASTHMA #FOAMed https://t.co/HPxDhliaT9 @ketaminh @Anaesthesia_AGB @ParaACP @FOAMEMS pic.twitter.com/LWQaP32gvi— David Lyness (@Gas_Craic) April 21, 2016 //platform.twitter.com/widgets.js  
prehospitalmed.com
over 3 years ago
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Percutaneous Cricothyroid Jet Ventilation Using Repetitive Airway Obstruction: A quick and simple way to ventilate the “impossible” airway

Percutaneous Cricothyroid Jet Ventilation Using Repetitive Airway Obstruction: A quick and simple way to ventilate the “impossible” airway  
prehospitalmed.com
over 3 years ago
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Acquired Resistance in Lung Cancer: When to Switch Agents

Rociletinib and osimertinib appear to be on the verge of approval. Dr Mark Kris discusses how their arrival may affect clinical decisions at the time of acquired resistance in lung cancer.  
medscape.com
over 3 years ago
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Echo Case: Diagnose Dyspnea From the Doppler

Dr Wharton keeps something hidden from the patient's history. Can you make the diagnosis?  
medscape.com
over 3 years ago
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Non-COPD Lung Disease Still Spells Trouble for Smokers

Even when lung function does not meet criteria for COPD, smokers can still have functional impairment and exacerbations.  
medscape.com
over 3 years ago
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Imaging Case of the Week 205

This frontal chest x-ray is from a 27 year old with a cough. What chronic pathology can be noted?Answer will be posted on 18/05/16.  
emergucate.com
over 3 years ago
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Prolyl Isomerase Pin1 Expression in Lung Adenocarcinoma

The findings of this study suggest that inhibition of Pin1 activity could be a novel strategy for lung cancer treatment.  
medscape.com
over 3 years ago