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Corticosteroids in the Critically Ill Patient: Benefits and Risks for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia

Corticosteroids are among the most commonly prescribed medications. Because of their wide use and vast influence on various aspects of homeostasis, it is not surprising that steroids may be beneficial in some clinical scenarios and deleterious in others. The interplay between nosocomial pneumonias and steroids represents one of the most remarkable intersections between a drug and a disease. Corticosteroids may influence the risk of a hospitalized patient developing pneumonia, but they may ultimately be necessary if a patient develops catecholamine-resistant septic shock or if overt bronchospasm is present. In addition, prolonged inappropriate use of corticosteroids is likely to increase negative side effects (including myopathy) and decrease the immediate benefit received from the medicati...

Exercise Intolerance in Pulmonary Hypertension

Synopsis: Exercise intolerance and blunted cardiac output response to exercise in pulmonary hypertension is related to an impaired right ventricular exertional contractile reserve. Source: Spruijt OA, Man FS, Groepenhoff H, et al. The effects of exercise on right ventricular contractility and right ventricular-arterial coupling in pulmonary hypertension. Am J Respir Crit Care Med. 2015; 191:1050-1057. (Source: Clinical Pulmonary Medicine)

E-cigarettes declared 95% less harmful than tobacco by UK health body

Publication date: Available online 31 August 2015 Source:The Lancet Respiratory Medicine Author(s): Tony Kirby (Source: The Lancet Respiratory Medicine)

Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Jordan

Between 26 and 28 August 2015, the National IHR Focal Point of Jordan notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. All these cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city. Contact tracing of household contacts and healthcare contacts is ongoing for these cases. The National IHR Focal Point of Jordan informed the National IHR Focal Point for the Kingdom of Saudi Arabia about the index case to trace contacts in Saudi Arabia. (Source: WHO Disease Outbreaks)

Physiological impairment in mild COPD

Abstract Chronic obstructive pulmonary disease (COPD) is a common and often progressive inflammatory disease of the airways, alveoli and microvasculature that is both preventable and treatable. It is well established that smokers with mild airway obstruction, as spirometrically defined, represent the vast majority of patients with COPD, yet this population has not been extensively studied. An insidious preclinical course means that mild COPD is both underdiagnosed and undertreated. In this context, recent studies have confirmed that even patients with mild COPD can have extensive physiological impairment, which contributes to poor perceived health status compared with non‐smoking healthy controls. This review describes the heterogeneous pathophysiology that can exist in COPD patients wit...

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