Articles: bronchodilator-agents-adverse-effects.
-
Am. J. Respir. Crit. Care Med. · May 2020
Observational StudyInhaled Steroids, Circulating Eosinophils, Chronic Airway Infection and Pneumonia Risk in Chronic Obstructive Pulmonary Disease: A Network Analysis.
Rationale: Treatment of chronic obstructive pulmonary disease (COPD) with inhaled corticosteroids (ICS) is controversial, because it can reduce the risk of future exacerbations of the disease at the expense of increasing the risk of pneumonia. Objectives: To assess the relationship between the presence of chronic bronchial infection (CBI), reduced number of circulating eosinophils, ICS treatment, and the risk of pneumonia in patients with COPD. Methods: This was a post hoc long-term observational study of an historical cohort of 201 patients with COPD (Global Initiative for Chronic Obstructive Lung Disease II-IV) who were carefully characterized (including airway microbiology) and followed for a median of 84 months. ⋯ During follow-up, 38.8% of patients suffered one or more episodes of pneumonia, with CBI (hazard ratio [HR], 1.635) and <100 eosinophils/μl (HR, 1.975) being independently associated with the risk of pneumonia, particularly when both coexist (HR, 3.126). ICS treatment increased the risk of pneumonia in those patients with <100 eosinophils/μl and CBI (HR, 2.925). Conclusions: Less than 100 circulating eosinophils/μl combined with the presence of CBI increase the risk of pneumonia in patients with COPD treated with ICS.
-
Anisocoria may be physiological or seen in fatal conditions, such as intracranial hemorrhage. Newly developing anisocoria may cause confusion and diagnostic difficulty in the emergency department (ED). A 35-year-old female was admitted to the ED with an asthma attack and dyspnea. ⋯ A pilocarpine test can be used to differentiate pharmacological anisocoria from other causes, such as third nerve palsy and Adie's pupil. Through the awareness of emergency physicians and the use of the pilocarpine test, a diagnosis can be made without engaging in time-consuming and costly analyses. In addition, this complication can be prevented using masks that better fit the face, as well as protective goggles or eye patches, during treatment.
-
J. Matern. Fetal. Neonatal. Med. · Mar 2019
Risk factors for necrotizing enterocolitis in very preterm infants: a case-control study in southwest China.
The objective of this study is to investigate perinatal risk factors for necrotizing enterocolitis (NEC) in very preterm infants. ⋯ Neonatal septicemia and intravenous aminophylline use are risk factors associated with NEC development in very preterm infants.
-
Pediatric emergency care · May 2018
Safety of Terbutaline for Treatment of Acute Severe Pediatric Asthma.
The use of continuous intravenous terbutaline treatment in severe asthma attacks has been hampered by the lack of well-powered clinical trials where effects of such treatment are described in detail. Here, we aimed to provide a descriptive report on the largest cohort of severe pediatric asthma patients treated with terbutaline. ⋯ The results indicate that overall, terbutaline infusion was well tolerated without irreversible adverse effects of the treatment. Although hemodynamic and metabolic disturbances occurred, these were clinically easily managed and posed little risk in emergency department or pediatric intensive care unit.