The differentiation of chronic obstructive pulmonary disease from asthma: a review of current diagnostic and treatment recommendations.

Aim: Global and regional data have shown that chronic airway diseases such as chronic obstructive pulmonary disease (COPD) and asthma are increasing in incidence and prevalence, with detrimental consequences to healthcare resources and the quality of life of patients. A firm diagnosis of COPD or asthma is important because the natural history, treatment, and outcomes differ between the two respiratory diseases. The aim of this review is to provide nurse practitioners (NPs) with the requisite facts to understand and improve the diagnosis and treatment of affected individuals.

Hyperinflation and intrinsic positive end-expiratory pressure: less room to breathe.

Clinically, the symptoms and limited exercise capabilities of patients with chronic obstructive pulmonary disease (COPD) correlate better with changes in lung volumes than with airflow measurements. The realization of the clinical importance of hyperinflation has been overshadowed for decades by the use of forced expiratory volume during 1 s (FEV(1)) and the ratio of the FEV(1) to the forced expiratory vital capacity (FEV(1)/FVC) to categorize the severity and progression of COPD. Hyperinflation is defined as an elevation in the end-expiratory lung volume or functional residual capacity.

Silicone embolism syndrome: a case report, review of the literature, and comparison with fat embolism syndrome.

Liquid silicone is an inert material that is utilized for cosmetic procedures by physicians as well as illegally by nonmedical personnel. We present a case report and collated clinical findings of 32 other patients who were hospitalized after illegal silicone injections. Symptoms and signs of the "silicone syndrome" included dyspnea, fever, cough, hemoptysis, chest pain, hypoxia, alveolar hemorrhage, and altered consciousness.

Pulmonary artery rupture induced by a pulmonary artery catheter: a case report and review of the literature.

Placement and use of pulmonary artery catheters (PACs) carry potential risks. The authors describe a case of a patient who developed massive hemoptysis after placement of a PAC that caused a rupture of the pulmonary artery with pseudoaneurysm formation. Treatment was successfully achieved with transcatheter coil embolization.

Pulmonary complications of pregnancy.

Pregnancy induces significant physiologic stresses on the pulmonary and cardiovascular systems that may precipitate respiratory compromise. In addition, certain disease states that are unique to the pregnant woman, such as amniotic fluid emboli syndrome, may be associated with respiratory failure. The physiologic changes that affect the pregnant woman are reviewed.

When wheezing may not mean asthma. Other common and uncommon causes to consider.

Establishing that wheezing is not due to asthma requires attention to the patient's history, physical examination results, and response to therapy. If the diagnosis of asthma is questionable, appropriate pulmonary function tests should be performed to firmly establish or refute that the wheezing is due to asthma. If asthma is not the cause, other entities need to be considered so that inappropriate therapy is not prescribed.