Harefuah
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Idiopathic pulmonary fibrosis (IPF) is a devastating lung disease of unknown cause. The clinical course is unpredictable, but the disease is usually progressive with a median survival of 2-5 years as a result of advanced respiratory failure. ⋯ Despite better understanding of the pathogenesis, there is no effective therapy for the disease. In this review, we present the positive results of recently published clinical trials regarding therapy for IPF, with emphasis on pirfenidone and nintedanib.
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Obesity has become a "global pandemic" in the modern world. One of the anesthetic challenges associated with obesity is securing the patients' airway. ⋯ In this review, we describe the specific reasons for difficulty in securing the airway in the obese patient population. We present the complications and the typical problems that the anesthesiologist may encounter in each stage of anesthesia and suggest ways to solve them.
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Pregnancy related carpal tunnel syndrome (PRCTS) is the most frequent mononeuropathy during pregnancy. The reported incidence of PRCTS varies widely and ranges from 0.8% to 70% depending on the diagnostic method and the physician. The etiology for PRCTS is related to hormonal fluctuations, fluid accumulation, glucose level fluctuations, median nerve hypersensitivity etc. ⋯ Treatment of PRCS is mostly conservative, and if there is lack of improvement local intracarpal injection of a steroid is indicated. Intracarpal injections have demonstrated a significant decrease in symptoms and low recurrence in comparison to the general population, and do not put the fetus or his mother at risk. A surgical intervention is rarely indicated during pregnancy.
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For the last 20 years the classic treatment for relapsing remitting multiple sclerosis was based on injectable disease-modifying drugs, interferon-β and glatiramer acetate (copaxone). Currently, new disease-modifying drugs have been added to the clinician's arsenal with similar and even improved efficacy and safety profiles. Some of these drugs are given orally and are recommended as first line treatment. In this review we will discuss the various innovative and emerging disease-modifying drugs including the method of administration, mechanism of action, efficacy, safety and major side effects.
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Chest ultrasonography was considered hampered and deficient but it is now taking a prominent role as a bedside tool for the diagnosis of lung ailments. Technological development has made it accurate, fast and reliable to the extent that it is gradually replacing the traditional chest X-ray and sometimes also the computed tomography scan. In this article we review and display in a few images the diagnostic possibilities of the thoracic ultrasound examination in a diverse range of maladies such as pneumonia, pulmonary congestion, pleural effusion and other conditions.