Revue médicale suisse
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Inhaled therapies play a significant role in the management of cystic fibrosis patients. Mucolytic and airway-rehydrating agents improve mucociliary clearance and respiratory functional status. Nebulized antibiotherapy achieve high local concentration, while reducing systemic toxicity. ⋯ The majority of treatments are only available in liquid formulations. Thus, nebulization is the most frequently used inhalation mode. Vibrating-mesh nebulizers have significantly reduced inhalation time.
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Interstitial lung disease (ILD) is found in up to 30% of patients with rheumatoid arthritis (RA) and is clinically manifest in 5 to 10%, resulting in significant morbidity and mortality. The most frequent histopathological forms are usual interstitial pneumonia and nonspecific interstitial pneumonia. ⋯ Smoking is a known risk factor of RA and may also play a role in the pathogenesis of RA-associated ILD, in combination with genetic and immunologic mechanisms. Several treatments of RA may also lead to drug-induced ILD.
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Revue médicale suisse · Nov 2011
Review[Postoperative pulmonary complications: how to anticipate and prevent the risk?].
Although less studied than cardiac complications, postoperative pulmonary complications are frequent and serious after major surgery. A close team working between primary care physician, surgeon, anesthesiologist, lung and heart physicians is essential to prevent and reduce postoperative pulmonary complications. Preoperative evaluation focused on clinical data and choice of surgical and anaesthetic adapted techniques are the key elements for a better control of these risks. Postoperative lung expansion techniques can minimize rate and severity of respiratory complications.
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Prevalence of COPD is under-estimated, and more so among non-smokers. Population studies relying on spirometry show a trend toward higher proportion of persons with COPD who never smoked. ⋯ Exposure to passive smoking, indoor air pollution or biological dusts may cause COPD. This review discusses COPD prevalence in never smokers and details associated risk factors.