The diagnosis of pulmonary embolism (PE) remains a challenge. CT pulmonary angiography (CTPA) for suspected PE has become the primary imaging modality, but concerns regarding overutilization, overdiagnosis, radiation, and costs have led to algorithms that combine a clinical decision rule (CDR) and highly sensitive d-dimer to identify patients in whom PE can be safely excluded… Continue reading Underuse of Clinical Decision Rules and d-#Dimer in Suspected Pulmonary #Embolism: A Nationwide Survey of the Veterans Administration Health Care System
Category: Pneumology
Comparisons of exacerbations and mortality among regular inhaled therapies for patients with stable chronic obstructive pulmonary disease: Systematic review and Bayesian network meta-analysis
..Compared with placebo, all drug classes significantly reduced the total exacerbations and moderate to severe exacerbations. ICS/LAMA/LABA was the most efficacious treatment for reducing the exacerbation risk (odds ratio [OR] = 0.57; 95% credible interval [CrI] 0.50–0.64; posterior probability of OR > 1 [P(OR > 1)] < 0.001). In addition, in contrast to the other… Continue reading Comparisons of exacerbations and mortality among regular inhaled therapies for patients with stable chronic obstructive pulmonary disease: Systematic review and Bayesian network meta-analysis
Clinical presentation, treatment, and short-term outcomes of #lung injury associated with e-cigarettes or #vaping: a prospective observational cohort study
..33 (55%) of 60 were admitted to an intensive care unit (ICU). 53 (88%) of 60 patients presented with constitutional symptoms, 59 (98%) with respiratory symptoms, and 54 (90%) with gastrointestinal symptoms. 54 (90%) of 60 were given antibiotics and 57 (95%) were given steroids. Six (10%) of 60 patients were readmitted to an ICU… Continue reading Clinical presentation, treatment, and short-term outcomes of #lung injury associated with e-cigarettes or #vaping: a prospective observational cohort study
A Screening Algorithm for Obstructive Sleep #Apnea in #Pregnancy
Obstructive sleep apnea (#OSA) is common in pregnancy and associated with maternal and fetal complications. Early detection of OSA may have important implications for maternal-fetal well-being. A screening tool combining several methods of assessment may better predict OSA among pregnant women compared with tools that rely solely on self-reported information.. Participants’ mean age was 27.4 ± 7.0… Continue reading A Screening Algorithm for Obstructive Sleep #Apnea in #Pregnancy
C-Reactive Protein Testing to Guide Antibiotic Prescribing for #COPD Exacerbations
Point-of-care testing of C-reactive protein (#CRP) may be a way to reduce unnecessary use of antibiotics without harming patients who have acute exacerbations of chronic obstructive pulmonary disease (COPD). A lower percentage of patients in the CRP-guided group than in the usual-care group received an antibiotic prescription at the initial consultation (47.7% vs. 69.7%, for… Continue reading C-Reactive Protein Testing to Guide Antibiotic Prescribing for #COPD Exacerbations
#Metoprolol for the Prevention of Acute Exacerbations of #COPD
Observational studies suggest that beta-blockers may reduce the risk of exacerbations and death in patients with moderate or severe chronic obstructive pulmonary disease (COPD), but these findings have not been confirmed in randomized trials. .. There was no significant between-group difference in the median time until the first exacerbation, which was 202 days in the… Continue reading #Metoprolol for the Prevention of Acute Exacerbations of #COPD
Fatty #Airways: Implications for #Obstructive Disease
Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway pathology ..BMI ranged from 15 to 45 (kg·m−2) and was greater in NFA (p<0.05). Adipose tissue was… Continue reading Fatty #Airways: Implications for #Obstructive Disease
Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses
Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma. Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning… Continue reading Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses
Single inhaler extrafine triple therapy in uncontrolled asthma (TRIMARAN and TRIGGER): two double-blind, parallel-group, randomised, controlled phase 3 trials
..extrafine combination of beclometasone dipropionate (BDP; inhaled corticosteroid), formoterol fumarate (FF; long-acting β 2 agonist), and glycopyrronium (G; long-acting muscarinic antagonist) with the combination of BDP with FF ..Compared with the BDP/FF group, week 26 predose FEV 1 improved in the BDP/FF/G group by 57 mL (95% CI 15–99; p=0·0080) in TRIMARAN and by 73… Continue reading Single inhaler extrafine triple therapy in uncontrolled asthma (TRIMARAN and TRIGGER): two double-blind, parallel-group, randomised, controlled phase 3 trials
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