Cleveland Clinic journal of medicine
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Mortality from asthma is increasing, raising questions about the goals and adequacy of treatment. It is important to understand the pathophysiology of asthma and the rationale and options for treatment. ⋯ Appropriate medical therapy includes treatment with compounds that specifically suppress airway inflammation. The best approach to treatment may be an anti-inflammatory agent--preferably by inhalation--along with an inhaled direct bronchodilator, with objective measures of airflow limitation to assess disease severity.
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Valve repair is the best operation currently available for patients with mitral valve disease. However, repair is technically more difficult than valve replacement and has a risk of early and late failure. ⋯ Preoperative echocardiography, including Doppler color flow mapping to evaluate intracardiac flow, is used to assess the feasibility of repair. Intraoperatively, epicardial and transesophageal echocardiography are used to monitor surgical results immediately after repair, ensuring successful outcome of surgery.