Resp Care
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Case Reports
Pulmonary zygomycosis in a non-neutropenic patient with myelodysplastic syndrome on lenalidomide.
Pulmonary zygomycosis is an uncommon infection that occurs mostly in immunocompromised patients. We report the case of a 75-year-old man with myelodysplastic syndrome, treated with lenalidomide for 3 months, who developed respiratory failure and a rapidly progressive left upper lobe consolidation. ⋯ This unique case illustrates the potential risks of lenalidomide therapy in patients with myelodysplastic syndrome and the difficulties in diagnosing pulmonary zygomycosis. To our knowledge this is the first report of a diagnostic in situ post-mortem transbronchial lung biopsy.
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Chest x-ray (CXR) is widely used for diagnosing and screening pulmonary tuberculosis (PTB), yet its validity is debatable and its costs are relatively high. This study aimed to determine the validity of CXR screening in detecting radiological findings compatible with active PTB or with old healed tuberculosis (OHTB). ⋯ CXR is a valid and cost-saving tool for screening active PTB in immigrants originating in high-burden countries, and is beneficial in detecting OHTB in immigrants who are at a higher risk for developing active PTB.
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Randomized Controlled Trial Comparative Study
The measurement of lung volumes using body plethysmography: a comparison of methodologies.
The statement of the American Thoracic Society and European Respiratory Society on the measurement of static lung volumes (SLV) suggests a preferred and alternate method for measuring and calculating SLV. ⋯ Differences in FRC, VC, RV, and TLC obtained using the preferred and alternate measurement methodologies exist in the clinical setting in select classification groups and individuals. Differing calculation methods dependent on measurement method used may be unnecessary.
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Randomized Controlled Trial Comparative Study
Short-term effects of using pedometers to increase daily physical activity in smokers: a randomized trial.
In adults it is recommended that the minimum of 10,000 steps/day should be performed in order to consider an individual as active. The pedometer, a small device that counts steps, has been used to monitor and/or motivate physical activity in various populations. ⋯ Physically inactive smokers improve their daily physical activity level by using a simple tool (pedometer), and larger improvement occurs in subjects with the lowest levels of physical activity.
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Inhaled corticosteroids (ICSs) are the mainstay of anti-inflammatory treatment in subjects with asthma and COPD. This review evaluates the role of nebulizers as an alternative to inhalers for delivering ICSs in asthma and COPD. I selected 16 randomized, placebo-controlled, blinded, long-term studies, mostly carried out in asthma (n = 14) and COPD. ⋯ The practices of mixing nebulized ICSs with bronchodilators and using nebulized ICSs in acute settings are promising, but require further confirmations, and at present cannot be recommended. I conclude that nebulizers may be considered as an effective alternative to inhalers for delivering ICSs and can be recommended to asthmatic and COPD subjects who are unwilling or unable to use inhalers. Newer formulations could possibly offer a relevant advance for a more efficient nebulization of ICSs.