What's new, what's different

Find out about screening and management changes and how to educate patients in self-care.     

If what matters most is what's to come

As a means of thanking nurses who supported her during the final months of her imminent death, this best-selling French-Canadian author reveals her fears and her need to be understood. Her article, published posthumously, attempts to help caregivers understand what clients live through in situations such as hers and explains why they need to be merciful in their care.     

常见呼吸系统疾病气管插管机械通气指征

机械通气是治疗各种类型严重呼吸衰竭的有效手段。掌握机械通气指征,及时气管插管是提高严重呼吸衰竭机械通气治疗成功率的关键。各种疾病导致呼吸衰竭的气管插管指征有所不同。具备呼吸停止或呼吸微弱、意识障碍、血流动力学不稳定、严重缺氧、严重酸中毒、严重呼吸肌疲劳等条件之一是呼吸衰竭患者气管插管机械通气的通常指征。对于呼吸衰竭较严重而又一时无法确认是否行气管插管机械通气时,在严密观察下可以试行非机械通气治疗或无创正压通气。对治疗1～2h病情无改善或加重者,则应及时气管插管机械通气。ARDS患者行无创正压通气效果欠佳,应及时气管插管机械通气。     

Artificial intelligence in echocardiography is here and more to come

The International Journal of Cardiovascular Imaging -     

Application and indication of psychotropic drugs for respiratory diseases

Respiratory symptoms are induced not only by the organic stimulation of air tract but also by emotional irritation. Symbolic respiratory reactions and symptoms like a cough and dyspnea may develop when human's eomotion is affected by a psychosocial stressor. It is important to differentiate so-called psychosomatic disorders of respitratory system because it may easily take the chronic course and may become difficult to improve unless a precise diagnosis and treatment is not performed. Anxiety disorder and depressive state often merges the condition, and the patients with respiratory diseases sometimes may benefit from a antianxiety agents and antidepressant therapy when significant depressive symptoms are present. Specific psychotherapy may be applicable when symptom is aggravated by remarkable psychologic factors.     

Antiviral drugs for HBV liver disease

INTRODUCTION: Chronic hepatitis B (CHB) virus infection affects about 400 million people around the globe and is among the world's leading causes of death. The management of CHB has evolved rapidly, several therapeutic options are now available to prevent both progression of liver disease and anticipated liver morbidity and mortality. AREAS COVERED: Current treatment modalities for CHB patients, together with suggestions from our own experience are summarized. The most relevant works published in recent years on pegylated interferon, nucleos(t)ides analogues (NUC) and the 2009 update of the American Association for the Study of Liver Diseases Practice Guidelines and the 2009 European Association for the Study of the Liver (EASL) Clinical Practice Guidelines on the management of chronic hepatitis B are discussed. EXPERT OPINION: Pegylated interferon and NUC have advantages and limitations, as short-term interferon treatment induces a sustained virological response in a third of patients, whereas long-term suppressive therapy by NUC rapidly inhibits HBV replication in most patients but drug resistance and safety in the long-term will remain the most important unresolved questions. Careful evaluation of patient history, staging of liver disease and virological factors should guide the start of treatment and the choice to the most appropriate individualized treatment strategy in all CHB patients.     

Antiviral drugs in the immunocompetent host: part II. Treatment of influenza and respiratory syncytial virus infections

Family physicians should be familiar with the various drugs available for treating and preventing viral infections. Part II of this two-part article focuses on agents used to manage influenza and respiratory syncytial virus. Rimantadine and amantadine traditionally have been used to prevent and treat influenza type A infections. The neuraminidase inhibitors zanamivir and oseltamivir have a broadened spectrum of activity in the treatment and prevention of influenza types A and B. Ribavirin has been used in some high-risk infants to treat respiratory syncytial virus infections, and palivizumab can be used for prophylaxis.