The American journal of medicine
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This article reviews the rationale for and the benefits from a pulmonary rehabilitation approach to the treatment of chronic obstructive pulmonary disease (COPD). Key clinical trials, meta-analyses, and national guidelines or statements on pulmonary rehabilitation were identified. ⋯ It works, in part, through reducing nonpulmonary comorbidity. We conclude that patients with COPD-who are commonly managed in primary care settings-may benefit from multiple components of pulmonary rehabilitation.
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Patients with a history of penicillin allergy pose a treatment dilemma. Unnecessary avoidance of this relatively nontoxic class of drugs exposes the patient to potentially more toxic drugs, increases health care costs, and contributes to the development of antibiotic resistance. Yet for those who truly have allergy or other serious adverse reactions to beta-lactams, the use of alternate drugs is a must. This article reviews current management strategies to determine which patients are good candidates for reintroduction of beta-lactams and which patients should continue avoidance.
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There is a paucity of comprehensive study in status epilepticus in central nervous system infections. This observational study evaluated the response to antiepileptic drugs in patients with status epilepticus and central nervous system infection. ⋯ Of patients with status epilepticus and central nervous system infection, 24.3% had a refractory status that was associated with a high mortality. Their response to an antiepileptic drug in encephalitis was insignificantly poorer.