Clinics in chest medicine
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Clinics in chest medicine · Mar 2003
ReviewPrevention and management of venous thromboembolism in pregnancy.
Pulmonary thromboembolism is a major cause of maternal mortality. DVT causes significant morbidity in pregnancy and in later life owing to the post-thrombotic syndrome. ⋯ Greater use of prophylaxis is needed after vaginal delivery. Because acute VTE is relatively uncommon, greater use of proposed guidelines [24,84,85] may be of value in improving management, but the involvement of clinicians with expertise in the management of these cases is also important.
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Clinics in chest medicine · Mar 2003
ReviewVenous thromboembolism prophylaxis in the medically ill patient.
All general medical patients should be assessed for clinical risk factors for VTE. The ACCP has recommended that general medical patients with clinical risk factors receive either LDUH twice or three times daily or once-daily LMWH. ⋯ The preferred strategy for prevention in the medically ill population at high to very high risk for VTE is LMWH. For patients who have a high to very high risk for bleeding, nonpharmacologic strategies such as ES or IPC devices are recommended.
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Clinics in chest medicine · Mar 2003
The evolution and impact of the American College of Chest Physicians consensus statement on antithrombotic therapy.
The evolution of the American College of Chest Physicians consensus on antithrombotic therapy is reviewed, specifically with regard to the prevention and treatment of venous thromboembolism and the rules of evidence applied. A perspective on the impact of the recommendations is offered.
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Clinics in chest medicine · Dec 2002
ReviewOccupational airways diseases from chronic low-level exposures to irritants.
Short-term, high-level exposures to dusts, gases, mists, fumes, and smoke that are irritating to the respiratory tract are capable of inducing asthma, the so-called reactive airways dysfunction syndrome. Such exposures, however, do not occur frequently; chronic or recurrent exposures to lower levels of irritants are much more common. This article reviews the evidence that supports the concept that low-level exposures to respiratory tract irritants can contribute to the development of chronic obstructive pulmonary disease and asthma.
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Clinics in chest medicine · Sep 2002
ReviewEpidemiology of human pulmonary infection with nontuberculous mycobacteria.
A great deal of study has gone into the assessment of the epidemiology of NTM infection and disease in many different parts of the world. Review of the available studies provides insight into the frequency of this clinical problem as well as important limitations in current data. Study methods have varied greatly, undoubtedly leading to differing biases. ⋯ Regardless, there are more than adequate data to conclude that NTM disease rates vary widely depending on population and geographic location. NTM disease is clearly a major problem in certain groups, including patients with underlying lung disease and also in individuals with impaired immunity. The rates of NTM infection and disease are increasing, so the problem will likely continue to grow and become a far more important issue than current rates suggest.