RESUMO
Lung injury related to mesalamine (5-aminosalicylic acid) has rarely been reported in patients with inflammatory bowel diseases. Patients present with progressive respiratory symptoms and radiographic abnormalities whose genesis may occur from days to years after initiation of therapy. Although pathologic features overlap with other pulmonary disorders, findings of chronic interstitial pneumonia and poorly formed nonnecrotizing granulomas should prompt consideration of mesalamine-related lung disease in a patient receiving this medication. The authors describe the clinical, radiographic, and pathologic manifestations of mesalamine-related lung disease in three patients and review the literature related to this topic.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológico , Doenças Pulmonares Intersticiais/induzido quimicamente , Mesalamina/efeitos adversos , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Hipersensibilidade a Drogas/patologia , Feminino , Humanos , Masculino , Mesalamina/uso terapêuticoRESUMO
Computerized physician-order entry (CPOE) is a system of hardware and software through which a physician enters orders directly into a computer rather than writing them on paper. The advantages of CPOE include order legibility, improved response time, reduction in adverse drug reactions, reduced cost of care, and improved patient outcomes. The maturation of mobile computing platforms, graphical user interfaces, and wireless technologies are making CPOE more practical for both outpatient and inpatient care. Significant barriers to the implementation of CPOE include the reluctance of physicians to change existing practices, doubt about the possible benefits, increased front-end time to enter orders, and system cost.
Assuntos
Sistemas de Informação Hospitalar , Sistemas Computadorizados de Registros Médicos , Interface Usuário-Computador , Sistemas Computacionais , Redução de Custos , Sistemas de Informação Hospitalar/economia , Humanos , Erros Médicos/prevenção & controle , SoftwareRESUMO
We assessed whether trivalent live, cold-adapted influenza virus (CAIV-T) vaccine provides added protection when co-administered with trivalent inactivated influenza virus vaccine (TVV) in patients with chronic obstructive pulmonary disease (COPD). Subjects (N=2215) were randomly assigned to receive either TVV intramuscularly (IM) and CAIV-T intranasally (TC), or TVV and placebo (TP). The vaccines were well-tolerated. Efficacy of TC compared to TP was not statistically significant and was 0.16 for any influenza virus strain (95% confidence limit (CL): -0.22, 0.43), 0.26 for A (H3N2) virus (95% CL: -0.17, 0.53), and -0.05 for type B virus (95% CL: -1.13, 0.48). However, there was a possible advantage for TC over TP in reducing respiratory consequences of an influenza season measured by pulmonary function and symptoms at end of study.