Articles: cations.
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As seen in this CME online activity (available at http://copdcme.elsevierresource.com/, COPD is characterized by pulmonary airflow obstruction that is not completely reversible. COPD presents clinically with diverse phenotypes ranging from relatively asymptomatic people to patients with severe chronic cough, abnormal sputum production, and dyspnea with exertion. Exacerbations accelerate the downward cycle of breathing difficulties, activity avoidance, and physical decline that characterizes progressive COPD. ⋯ Evidence-based education that addresses individualized maintenance regimens are needed to improve long-term outcomes in COPD. Within this CME/CE Snapshot educational series, an expert pulmonologist and a primary care educator discuss how to best longitudinally evaluate patients with COPD and incorporate the principles of pulmonary rehabilitation to maximize patient function and quality of life. They explain therapeutic tailoring over the course of disease and describe the importance of engaging patients in shared decision-making to promote acceptance of the diagnosis, appropriate physical activity, and treatment adherence.
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Patients resuscitated from cardiac arrest commonly develop an inflammatory response called post-cardiac arrest syndrome that clinically resembles septic shock.Procalcitonin and presepsin are associated with inflammation. We hypothesized that these biomarkers reflect the severity of post-cardiac arrest syndrome and predict short-term hemodynamical instability and long-term neurological outcome after cardiac arrest. ⋯ Elevated procalcitonin is associated with hemodynamical instability and worsened long-term outcome in OHCA patients. The association is not strong enough for it to be used as a single predictor. Presepsin did not provide clinically relevant information for risk stratification after OHCA.
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We wanted to assess the awareness of the nursing staff to therapeutic communications on improving the welcoming experience of patients in the operating room for outpatient surgery. ⋯ This preliminary study shows a mild improvement of the patients' comfort and satisfaction after therapeutic communication. A controlled randomized trial is needed to confirm those results.