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1.
Curr Opin Pulm Med ; 26(4): 321-325, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32427626

RESUMO

PURPOSE OF REVIEW: The current article reviews recent literature and summarizes the current understanding, diagnosis, risk, predictors, and management of radiation pneumonitis. RECENT FINDINGS: We discuss the different parameters that contribute to radiation toxicity, the potential biomarkers that predict the risk, and mitigators of radiation pneumonitis. SUMMARY: Radiotherapy aims to provide care and a better quality of life in cancer patients however with complications. Radiation pneumonitis is important to recognize to appropriately plan and care for this population.


Assuntos
Neoplasias Pulmonares/radioterapia , Qualidade de Vida , Pneumonite por Radiação/diagnóstico , Humanos , Pneumonite por Radiação/epidemiologia , Pneumonite por Radiação/etiologia , Tomografia Computadorizada por Raios X
2.
Curr Opin Pulm Med ; 25(4): 331-335, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31045904

RESUMO

PURPOSE OF REVIEW: This article reviews recent literature and experience in the diagnosis of nonresolving and slowly resolving pneumonia as it pertains to malignancy. RECENT FINDINGS: Malignancy must be considered as an important cause of pneumonia that resolves slowly or has incomplete resolution. Airway obstruction is more common than malignant infiltration as a cause of pneumonia that does not resolve appropriately. Infection due to resistant or unusual organisms must also be considered in the differential diagnosis. SUMMARY: Nonresolving pneumonia remains an important clinical challenge. Bronchoscopic evaluation in conjunction with computed tomography and PET scanning is still the most important technique for diagnosis.


Assuntos
Neoplasias Pulmonares , Pneumonia , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Pneumonia/diagnóstico , Pneumonia/etiologia , Pneumonia/terapia , Falha de Tratamento
3.
Curr Opin Pulm Med ; 23(4): 285-289, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28463856

RESUMO

PURPOSE OF REVIEW: Multiple pulmonary nodules are a common finding especially with the implementation of lung cancer screening. Available guidelines address the management of solitary pulmonary nodules. The management of the multiple pulmonary nodules would differ based on the characteristic of the nodules, their distribution, and the history of the patients as well. RECENT FINDINGS: Most of the recent publications on multiple pulmonary nodules consist of individual case reports or case series. Robust population studies are lacking. SUMMARY: In this article, we propose an approach for management of multiple pulmonary nodules which needs to be validated.


Assuntos
Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Gerenciamento Clínico , Detecção Precoce de Câncer , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Nódulos Pulmonares Múltiplos/diagnóstico , Nódulos Pulmonares Múltiplos/terapia
5.
Curr Opin Pulm Med ; 21(4): 322-6, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25978628

RESUMO

PURPOSE OF REVIEW: This article reviews the current literature for the purpose of developing a practical approach for the diagnosis and management of primary tracheal tumors. RECENT FINDINGS: Because of nonspecific symptoms, tracheal tumors remain a diagnostic challenge. Currently available management strategies are not being optimally utilized due to lack of physician awareness and knowledge. The use of newer diagnostic modalities has increased diagnostic accuracy resulting in earlier detection in recent years. This review describes currently available diagnostic modalities along with relatively newer ones such as virtual bronchoscopy, anatomic Optical Coherence Tomography, spectroscopic techniques, and endobronchial ultrasonography. We will review and discuss management strategies including surgical options, adjuvant therapies, and interventional pulmonary techniques including their role in palliation. SUMMARY: Early detection along with improved surgical and interventional pulmonology techniques has led to a decline in the death rates from tracheal cancer in recent years. However, further studies are required to define the role of chemotherapeutic agents, combination therapies, and novel techniques such as tracheal transplantation, in the management of primary tracheal tumors. More robust evidence-based studies are needed to provide evidence for clinical practice guidelines for the treatment of primary tracheal tumors.


Assuntos
Neoplasias da Traqueia/diagnóstico , Neoplasias da Traqueia/terapia , Broncoscopia/métodos , Bases de Dados Factuais , Humanos , Pulmão/patologia
6.
Curr Opin Pulm Med ; 21(4): 333-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25978630

RESUMO

PURPOSE OF REVIEW: Despite the fact that primary pulmonary lymphoma (PPL) is a rare lung tumour, significant advances addressing clinical features, histological diagnosis, prognostic criteria and therapeutic management of this disease have been made within the past decade. RECENT FINDINGS: Monoclonality and phenotyping of alveolar lymphocytes are suggestive of mucosa-associated lymphoid tissue (MALT). Detection of MALT-1 gene rearrangements in bronchoalveolar fluid cells using fluorescence in-situ hybridization techniques helps to confirm the diagnosis of MALT PPL. Fine needle aspiration-computed tomography guided biopsies as well as transbronchial/cryobiopsies provide adequate tissue material for histological evaluation. Recent publications also provide a better appreciation of newer chemotherapeutic approaches, including fludarabine and mitoxantrone with or without ritubximab for the treatment of MALT, as well as complete surgical resection if local disease is present. Prognostic factors influencing survival and optimal therapy for MALT have not been well defined, but the use of tumour microvascular density appears promising. SUMMARY: This review outlines the implications of recent findings for clinical practice and research progress of PPL. Larger, multicentre and well designed studies are imperative to optimize the current diagnostic and therapeutic approach for this disease.


Assuntos
Neoplasias Pulmonares/patologia , Linfoma , Biópsia por Agulha Fina , Humanos , Neoplasias Pulmonares/terapia , Linfoma/diagnóstico , Linfoma/terapia , Prognóstico
7.
J Cardiopulm Rehabil Prev ; 40(6): 438-440, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925297

RESUMO

PURPOSE: Long-term oxygen therapy (LTOT) is widely used to treat chronic obstructive pulmonary disease (COPD) and other conditions with severe hypoxemia, imposing a large financial burden on the American health care system. METHODS: To better understand oxygen prescription and its use in a multiethnic community hospital, we completed a prospective, observational study with a survey design in our multicultural population to better recognize patient understanding of oxygen indications and utilization. RESULTS: The survey was conducted at three outpatient pulmonary clinics. Among the 94 respondents (42% men and 58% women; age 71.8 ± 13 yr), 64% were current or former smokers. Sixty-one percent had primary diagnoses other than COPD, most commonly interstitial lung disease and congestive heart failure. One-third used oxygen for <12 hr daily. Oxygen use was variable among those to whom it was prescribed. Thirty-two percent of patients described themselves as noncompliant with their prescribed therapy due to poor equipment ergonomics, burdensome machine weight, and negative self-image and social stigma when using oxygen. CONCLUSIONS: Chronic obstructive pulmonary disease represented <50% of LTOT patients who were surveyed. Our data suggest that more structured prescribing practices and patient education should be studied if compliance is to be increased.


Assuntos
Oxigênio , Serviços Urbanos de Saúde , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Cooperação do Paciente , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/terapia
8.
Chest ; 134(3): 507-513, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18641093

RESUMO

BACKGROUND: Prior case series have shown promising diagnostic sensitivity for CT scan-guided bronchoscopy. METHODS: This was a prospective randomized trial comparing CT scan-guided bronchoscopy vs conventional bronchoscopy for the diagnosis of lung cancer in peripheral lesions and mediastinal lymph nodes. All procedures were performed using a protocolized number of passes for forceps, transbronchial needles, and brushes. Cytologists and pathologists were blinded as to bronchoscopy type. Patients with negative results underwent open surgical biopsy (for nodules or lymph nodes) or were observed for > or = 2 years if they had a nodule < 1 cm in size. RESULTS: Fifty patients were enrolled into the study (CT scan-guided bronchoscopy, 26 patients; conventional bronchoscopy, 24 patients). Two patients, one from each arm, dropped out of the study. Ultimately, 36 patients were proven to have cancer, and 27 of these patients (75%) had their diagnosis made by bronchoscopy. The sensitivity for malignancy of CT scan-guided bronchoscopy vs conventional bronchoscopy for peripheral lesions was similar (71% vs 76%, respectively; p = 1.0). The sensitivity for malignancy of CT guided bronchoscopy vs conventional bronchoscopy for mediastinal lymph nodes was higher (100% vs 67%, respectively) but did not reach statistical significance (p = 0.26). On a per-lymph-node basis, there was a trend toward higher diagnostic accuracy with CT scan guidance (p = 0.09). The diagnostic yield was higher in larger lesions (p = 0.004) and when CT scanning confirmed target entry (p = 0.001). CONCLUSION: We failed to demonstrate a significant difference between CT scan-guided bronchoscopy and conventional bronchoscopy for the diagnosis of lung cancer in peripheral lesions and mediastinal lymph nodes. Further study of improved steering methods combined with CT scan guidance for the diagnosis of lung cancer in peripheral lesions is warranted.


Assuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Broncoscopia/métodos , Fluoroscopia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Tomografia Computadorizada por Raios X , Idoso , Biópsia , Broncoscopia/tendências , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/patologia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Metástase Linfática , Masculino , Mediastino/patologia , Pessoa de Meia-Idade , Sensibilidade e Especificidade
9.
J Gen Physiol ; 126(2): 151-9, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16043775

RESUMO

Plasma membrane wound repair is an important but poorly understood process. We used femtosecond pulses from a Ti-Sapphire laser to make multiphoton excitation-induced disruptions of the plasma membrane while monitoring the membrane potential and resistance. We observed two types of wounds that depolarized the plasma membrane. At threshold light levels, the membrane potential and resistance returned to prewound values within seconds; these wounds were not easily observed by light microscopy and resealed in the absence of extracellular Ca(2+). Higher light intensities create wounds that are easily visible by light microscopy and require extracellular Ca(2+) to reseal. Within a few seconds the membrane resistance is approximately 100-fold lower, while the membrane potential has depolarized from -80 to -30 mV and is now sensitive to the Cl(-) concentration but not to that of Na(+), K(+), or H(+). We suggest that the chloride sensitivity of the membrane potential, after wound resealing, is due to the fusion of chloride-permeable intracellular membranes with the plasma membrane.


Assuntos
Permeabilidade da Membrana Celular , Cloretos/metabolismo , Fusão de Membrana , Oócitos/metabolismo , Animais , Ânions , Cloreto de Cálcio/farmacologia , Cátions Bivalentes , Membrana Celular/metabolismo , Membrana Celular/efeitos da radiação , Permeabilidade da Membrana Celular/efeitos dos fármacos , Permeabilidade da Membrana Celular/efeitos da radiação , Técnicas In Vitro , Membranas Intracelulares/metabolismo , Transporte de Íons , Lasers , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/efeitos da radiação , Oócitos/patologia , Oócitos/efeitos da radiação , Técnicas de Patch-Clamp , Estrelas-do-Mar , Membrana Vitelina/efeitos da radiação
10.
Clin Occup Environ Med ; 5(1): 1-7, vii, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16446250

RESUMO

The use of tobacco can be traced back to ancient times. Its popularity grew exponentially during the twentieth century, surging during wartime and with the advent of mass media. The tobacco industry in the United States has been under constant legal pressure during the past 40 years. Despite the well-known and continually increasing morbidity and mortality related to smoking, it continues to be a prominent feature in worldwide culture and health.


Assuntos
Regulamentação Governamental , Indústria do Tabaco/legislação & jurisprudência , Tabagismo/epidemiologia , Publicidade , Humanos , Meios de Comunicação de Massa , Fumar/efeitos adversos , Fumar/epidemiologia , Prevenção do Hábito de Fumar , Abandono do Uso de Tabaco , Tabagismo/complicações , Tabagismo/prevenção & controle , Estados Unidos
11.
J Gen Physiol ; 121(5): 441-9, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12719484

RESUMO

The experiments reported here were designed to answer the question of whether inositol 1,4,5-trisphosphate (IP3)-induced calcium release is necessary for generating the entire light response of Limulus ventral photoreceptors. For this purpose the membrane-permeable IP3 receptor antagonist 2-aminoethoxydiphenyl borate (2APB) (Maruyama, T., T. Kanaji, S. Nakade, T. Kanno, and K. Mikoshiba. 1997. J. Biochem. (Tokyo). 122:498-505) was used. Previously, 2APB was found to inhibit the light activated current of Limulus ventral photoreceptors and reversibly inhibit both light and IP3 induced calcium release as well as the current activated by pressure injection of calcium into the light sensitive lobe of the photoreceptor (Wang, Y., M. Deshpande, and R. Payne. 2002. Cell Calcium. 32:209). In this study 2APB was found to inhibit the response to a flash of light at all light intensities and to inhibit the entire light response to a step of light, that is, both the initial transient and the steady-state components of the response to a step of light were inhibited. The light response in cells injected with the calcium buffer 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) was reversibly inhibited by 2APB, indicating that these light responses result from IP3-mediated calcium release giving rise to an increase in Cai. The light response obtained from cells after treatment with 100 microM cyclopiazonic acid (CPA), which acts to empty intracellular calcium stores, was reversibly inhibited by 2APB, indicating that the light response after CPA treatment results from IP3-mediated calcium release and a consequent rise in Cai. Together these findings imply that IP3-induced calcium release is necessary for generating the entire light response of Limulus ventral photoreceptors.


Assuntos
Cálcio/metabolismo , Caranguejos Ferradura/fisiologia , Inositol 1,4,5-Trifosfato/metabolismo , Luz , Células Fotorreceptoras de Invertebrados/fisiologia , Animais , Compostos de Boro/farmacologia , Cálcio/fisiologia , Canais de Cálcio , Sinalização do Cálcio , Técnicas In Vitro , Inositol 1,4,5-Trifosfato/fisiologia , Receptores de Inositol 1,4,5-Trifosfato , Técnicas de Patch-Clamp , Células Fotorreceptoras de Invertebrados/efeitos dos fármacos , Receptores Citoplasmáticos e Nucleares/antagonistas & inibidores , Visão Ocular
13.
JAMA ; 294(6): 706-15, 2005 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-16091573

RESUMO

CONTEXT: Patients with venous thromboembolism (VTE) are susceptible to recurrent events, but whether prolonging anticoagulation is warranted in patients with VTE remains controversial. OBJECTIVE: To review the available evidence and quantify the risks and benefits of extending the duration of anticoagulation in patients with VTE. DATA SOURCES: PubMed, EMBase Pharmacology, the Cochrane database, clinical trial Web sites, and a hand search of reference lists. STUDY SELECTION: Included studies were randomized controlled trials with results published from 1969 through 2004 and evaluating the duration of anticoagulation in patients with VTE that measured recurrent VTE. Excluded studies were those enrolling only pure populations of high-risk patients. Two independent reviewers assessed each article for inclusion and exclusion criteria, with adjudication by a third reviewer in cases of disagreement. Fifteen of 67 studies were included in the analysis. DATA EXTRACTION: Two independent reviewers performed data extraction using a standardized form, with adjudication by the remainder of the investigators in cases of disagreement. Data regarding recurrent VTE, major bleeding, person-time at risk, and study quality were extracted. DATA SYNTHESIS: If patients in the long-term therapy group remained receiving anticoagulation, the risk of recurrent VTE with long- vs short-term therapy was reduced (weighted incidence rate, 0.020 vs 0.126 events/person-year; rate difference, -0.106 [95% confidence interval {CI}, -0.145 to -0.067]; P<.001; pooled incidence rate ratio [IRR], 0.21 [95% CI, 0.14 to 0.31]; P<.001). If anticoagulation in the long-term therapy group was discontinued, the risk reduction was less pronounced (weighted incidence rate, 0.052 vs 0.072 events/person-year; rate difference, -0.020 [95% CI, -0.039 to -0.001]; P = .04; pooled IRR, 0.69 [95% CI, 0.53 to 0.91]; P = .009). The risk of major bleeding with long- vs short-term therapy was similar (weighted incidence rate, 0.011 vs 0.006 events/person-year; rate difference, 0.005 [95% CI, -0.002 to 0.011]; P = .14; pooled IRR, 1.80 [95% CI, 0.72 to 4.51]; P = .21). CONCLUSIONS: Patients who receive extended anticoagulation are protected from recurrent VTE while receiving long-term therapy. The clinical benefit is maintained after anticoagulation is discontinued, but the magnitude of the benefit is less pronounced.


Assuntos
Anticoagulantes/administração & dosagem , Tromboembolia/tratamento farmacológico , Humanos , Medição de Risco , Prevenção Secundária , Fatores de Tempo
14.
Drugs ; 63(14): 1481-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12834365

RESUMO

In acute exacerbation of chronic obstructive pulmonary disease (AECOPD), short-acting inhaled bronchodilators, such as salbutamol (albuterol) and ipratropium bromide, have proven useful. In patients who are refractory to these agents, intravenous aminophylline should be considered. Corticosteroids should also be used, either in the outpatient or inpatient setting. The duration of corticosteroids should probably not exceed 2 weeks and the optimum dosage is yet to be determined. Antibacterials, especially in patients with purulent or increased sputum, should be used, guided by the local antibiogram of the key microbes. Controlled oxygen therapy improves outcome in hypoxaemic patients and arterial blood gases should be performed to ensure hypercarbia is not becoming excessive. Should patients be in distress despite the above measures or if there is acidaemia or hypercarbia, noninvasive positive pressure ventilation could be used to improve outcomes without resorting to invasive mechanical ventilation. Mucous-clearing drugs and chest physiotherapy have no proven beneficial role in AECOPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Corticosteroides/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Broncodilatadores/uso terapêutico , Humanos , Oxigenoterapia/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia
15.
Chest ; 122(2): 517-23, 2002 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12171825

RESUMO

BACKGROUND: Non-ICU telemetry monitoring has proven to be a valuable resource for patients suspected of having an acute myocardial infarction. While a significant number of patients are admitted to these units, the actual incidence of events or interventions is low. OBJECTIVE: To identify a subset of patients in whom telemetry monitoring does not alter management. DESIGN: Prospective observational study. SETTING: Large tertiary care facility. PATIENTS: A total of 414 patients consecutively admitted from the emergency department for suspected acute coronary syndromes were studied. Patients were excluded if they presented with ST-segment elevations, were revascularized on hospital admission, were admitted to a surgical service, were transferred from another floor or unit, or remained in the emergency department for the course of the stay. OUTCOMES: Events were defined as development of myocardial infarction, episodes of chest pain, new or rapid atrial arrhythmias, ventricular arrhythmias, any form of AV nodal block, and asystole. Intervention or change in management was any increase, decrease, or change in medication, cardioversion, electrophysiology study, or transfer to the ICU. RESULTS: Patients who had atypical chest pain and normal ECG findings were significantly less likely to have both intervention and events (4 interventions vs 23 interventions [p < 0.0001], 12 events vs 45 events [p < 0.0001]), compared to those with typical chest pain and abnormal ECG findings. When normal laboratory values were added, only four telemetry events were observed. CONCLUSION: Patients with atypical chest pain and normal ECG findings represent a subset of patients with low risk for life-threatening arrhythmia. Use of telemetry monitoring in this subset of patients should be reevaluated.


Assuntos
Dor no Peito/diagnóstico , Monitorização Fisiológica , Infarto do Miocárdio/diagnóstico , Telemetria , Doença Aguda , Idoso , Arritmias Cardíacas/diagnóstico , Dor no Peito/epidemiologia , Eletrocardiografia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Monitorização Fisiológica/estatística & dados numéricos , Infarto do Miocárdio/epidemiologia , Estudos Prospectivos , Fatores de Risco , Telemetria/estatística & dados numéricos
16.
Chest ; 126(1): 100-7, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15249449

RESUMO

STUDY OBJECTIVES: To evaluate the impact of a multifactorial intervention to improve the quality, efficiency, and patient understanding of care for community-acquired pneumonia. DESIGN: Times series cohort study. SETTING: Four academic health centers in the New York City metropolitan area. PATIENTS OR PARTICIPANTS: All consecutive adults hospitalized for pneumonia during a 5-month period before (n = 1,013) and after (n = 1,081) implementation of an inpatient quality improvement (QI) initiative. INTERVENTIONS: A multidisciplinary team of opinion leaders developed evidence-based treatment guidelines and critical pathways, conducted educational sessions with physicians, distributed pocket reminder cards, promoted standardized orders, and developed bilingual patient education materials. MEASUREMENTS AND RESULTS: The average age was 71.4 years, and 44.1% of cases were low risk, 36.8% were moderate risk, and 19.2% were high risk. The preintervention and postintervention groups were well matched on age, sex, race, nursing home residence, pneumonia severity, initial presentation, and most major comorbidities. The intervention increased the use of guideline-recommended antimicrobial therapy from 78.1 to 83.4% (p = 0.003). There was also a borderline decrease in the proportion of patients being discharged prior to becoming clinically stable, from 27.0 to 23.5% (p = 0.06). However, there were no improvements in the other targeted indicators, including time to first dose of antibiotics, proportion receiving antibiotics within 8 h, timely switch to oral antibiotics, timely discharge, length of stay, or patient education outcomes. CONCLUSIONS: This real-world QI program was able to improve modestly on some quality indicators, but not effect resource use or patient knowledge of their disease. Changing physician and organizational behavior in academic health centers will require the development and implementation of more intensive, system-oriented strategies.


Assuntos
Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Hospitalização , Pneumonia/tratamento farmacológico , Garantia da Qualidade dos Cuidados de Saúde/métodos , Idoso , Infecções Comunitárias Adquiridas/classificação , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Educação de Pacientes como Assunto , Pneumonia/classificação , Índice de Gravidade de Doença
17.
Med Clin North Am ; 88(6): 1391-7, ix, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15464103

RESUMO

The use of tobacco can be traced back to ancient times. Its popularity grew exponentially during the twentieth century, surging during wartime and with the advent of mass media. The tobacco industry in the United States has been under constant legal pressure during the past 40 years. Despite the well-known and continually increasing morbidity and mortality related to smoking, it continues to be a prominent feature in worldwide culture and health.


Assuntos
Fumar/tendências , Feminino , Humanos , Masculino , Fumar/efeitos adversos , Fumar/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudência , Tabaco sem Fumaça/efeitos adversos , Estados Unidos
18.
Postgrad Med ; 113(1): 79-82, 85-8, 91-2, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12545594

RESUMO

Pneumonia that fails to resolve after 10 to 14 days of antibiotic therapy can lead physicians to call for consultation or unnecessary invasive diagnostic procedures. Understanding the infectious and noninfectious causes of pneumonia and their normal times to resolution is enormously helpful in the judicious evaluation of and timely intervention in this very challenging condition.


Assuntos
Resistência Microbiana a Medicamentos , Pneumopatias/diagnóstico , Pneumopatias/etiologia , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/microbiologia , Pneumonia/diagnóstico , Pneumonia/microbiologia , Fatores Etários , Idoso , Infecções Comunitárias Adquiridas/microbiologia , Árvores de Decisões , Humanos , Pneumopatias/diagnóstico por imagem , Infecções Oportunistas/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Radiografia , Fatores de Tempo , Procedimentos Desnecessários
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