Revue des maladies respiratoires
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The optimal course of oral anticoagulant therapy is determined according to the risk of recurrent venous thromboembolism after stopping therapy and the risk of anticoagulant-related bleeding. Clinical risk factors appear to be important in predicting the risk of recurrence whereas the influence of biochemical and morphological tests is uncertain. The risk of recurrent venous thromboembolism is low when the initial episode was provoked by a reversible major risk factor (surgery): 3 months of anticoagulation is sufficient. ⋯ Lastly, if pulmonary embolism occurred in association with cancer, anticoagulation should be conducted for 6 months or more if the cancer is active or treatment is on going. Despite an increasing knowledge of the risk factors for recurrent venous thromboembolism, a number of issues remain unresolved. Randomised trials comparing different durations of anticoagulation are needed.
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Review Comparative Study
[Diaphragm and skeletal muscle dysfunction in COPD].
Chronic obstructive pulmonary disease (COPD) is often accompanied by skeletal muscle alterations, resulting in enhanced morbidity and mortality. ⋯ The current review introduces the alterations observed in the quadriceps and diaphragm in the context of COPD and suggests possible signaling pathways involved in the development of muscle dysfunction.
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Most admissions for asthma are preventable. The objective of this study was to describe readmissions for asthma. ⋯ The rate of readmission of asthma patients is a relevant indicator for monitoring asthma and, more specifically, the clinical management of the disease. In the future, the accumulation of data from consecutive years and the linkage of admission data to asthma medication claims data can be expected to improve our understanding of severe asthma in France.
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Coccidioidomycosis is a fungal infection endemic in the south west of the United States. Sixty percent of infected individuals remain asymptomatic. Symptomatic disease manifests itself with variable signs such as pneumonia, pleural effusion, empyema or acute respiratory distress syndrome. ⋯ The diagnosis of pulmonary Coccidioidomycosis was made after surgical resection. One year later, the patient is asymptomatic and well. This review focuses on the most common clinical manifestations, the diagnostic strategy and the treatment and management of pulmonary Coccidioidomycosis.
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Lung cancer is a frequently occurring disease among elderly people. The objective of this study was to search for a relationship between multimodal geriatric assessment and a decision-making in the treatment of patients with this condition. ⋯ Geriatric assessment should be integrated into treatment decision-making for patients with primary lung cancer aged more than 70 years, particularly those where frailty is a concern. Folstein's MMSE was predictive in our study for changes in decision-making.