Pulmonary pharmacology

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  • Care of the critically ill patient is truly multisystem management of highly complex patients who typically have numerous acute physiological derangements superimposed upon underlying medical ailments. Historically, the majority of patients admitted to intensive care units (particularly medical ICUs) have respiratory failure requiring mechanical ventilation, often along with other acute and chronic pulmonary problems.

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  • The Fourth Edition of Anesthesia is widely recognized as the most complete and thorough analysis and presentation available on the specialty of anesthesiology. The consulting editors and I examined the Fourth Edition carefully to ensure that the entire specialty of anesthesiology in the Fifth Edition is adequately addressed in a scholarly, thorough, and contemporary manner. Each author was instructed to revise his or her chapter in a manner that ensured its being a contemporary treatment of the subject matter being described.

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  • Venous thrombosis is the result of occlusive clot formation in the veins. It occurs mainly in the deep veins of the leg (deep vein thrombosis, DVT), from which parts of the clot frequently embolize to the lungs (pulmonary embolism, PE). Fewer than 5% of all venous thromboses occur at other sites (see "Thrombosis at Rare Sites," and "Superficial Thrombophlebitis," below). Venous thrombosis is common and often occurs spontaneously, but it also frequently accompanies medical and surgical conditions, both in the community and the hospital.

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  • Mechanisms of Dyspnea Respiratory sensations are the consequence of interactions between the efferent, or outgoing, motor output from the brain to the ventilatory muscles (feed-forward) and the afferent, or incoming, sensory input from receptors throughout the body (feedback), as well as the integrative processing of this information that we infer must be occurring in the brain (Fig. 33-1). A given disease state may lead to dyspnea by one or more mechanisms, some of which may be operative under some circumstances but not others. ...

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  • Influenza is an acute respiratory illness caused by infection with influenza viruses. The illness affects the upper and/or lower respiratory tract and is often accompanied by systemic signs and symptoms such as fever, headache, myalgia, and weakness. Outbreaks of illness of variable extent and severity occur nearly every winter. Such outbreaks result in significant morbidity in the general population and in increased mortality rates among certain high-risk patients, mainly as a result of pulmonary complications.

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  • This explicit step requires the program to seek explanations for unusually high or low outcomes on each indicator. The organization should establish a routine process for examining the findings from the latest outcome reports. For example, exhibit 11 compares outcomes for three family service units on one particular demographic characteristic. The two outlying values circled in the exhibit indicate unusual outcomes that a program manager will likely want to investigate.

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  • However, once initiated, swallowing is completed normally. Odynophagia means painful swallowing. Frequently, odynophagia and dysphagia occur together. Globus pharyngeus is the sensation of a lump lodged in the throat. However, no difficulty is encountered when swallowing is performed.Misdirection of food, resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, is characteristic of oropharyngeal dysphagia.

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  • Tuberculosis, one of the oldest diseases known to affect humans, is a major cause of death worldwide. This disease, which is caused by bacteria of the Mycobacterium tuberculosis complex, usually affects the lungs, although other organs are involved in up to one-third of cases. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within 5 years in 50–65% of cases.

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  • Once COPD has been diagnosed, goals of treatment and management include relieving symptoms; preventing and treating disease progression, complications, and exacerbations; improving exercise tolerance, daily activity, and health status; monitoring nutritional needs; and reducing premature mortality (8).

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