Prevention of COPD requires appropriate patient education, especially of adolescents, as well as the establishment of an effective national health policy. The new GOLD guidelines represent the current standard of knowledge on the management of chronic, progressive, obstructive pulmonary diseases. It points out that COPD is avoidable and treatable,and hence, there is no reason for therapeutic nihilism. Chronic bronchitis preceding a progressive respiratory obstruction cannot be improved with the presently available respiratory therapeutics. For this reason, therapeutic measures concentrate on the avoidance of exacerbations, which are primarily responsible for the severity of the course of COPD.
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Hepatology
November 2024
Department of Medicine Huddinge, Karolinska Institutet, Huddinge, Stockholm, Sweden.
It has proven difficult to establish robust evidence for significant clinical benefits of medical treatment in primary sclerosing cholangitis (PSC). For ursodeoxycholic acid, clinical practice guidelines only offer vague recommendations, leading to a situation of variable prescription rates depending on local reimbursement policies and physician preference. The difficulty in drug development in PSC is partly related to a poor understanding of critical disease processes with failure to identify relevant mechanisms of action of putative drugs.
View Article and Find Full Text PDFCirculation
November 2024
Faculté de Médecine, Inserm UMR_S 999, HPPIT, Service de Pneumologie et Soins Intensifs Respiratoires, ERN-LUNG, Hôpital Bicêtre (Assistance Publique-Hôpitaux de Paris), Université Paris-Saclay, Le Kremlin-Bicêtre, France (M.H.).
Epilepsy Behav
November 2024
Department of Neurology, Division of Neurocritical Care, University of Florida College of Medicine, Gainesville, FL 32611, USA.
Clin Geriatr Med
November 2024
Division of Geriatrics, Spencer Fox Eccles School of Medicine, Center on Aging, University of Utah, 30 North Mario Capecchi Drive, 2nd Floor North, Salt Lake City, UT 84112, USA. Electronic address:
The focus of antihypertensive therapy in older adults should be on lowering the systolic blood pressure (SBP) to the patient's "optimal" benefit-based target goal. Applying benefit-based therapy to the majority of adults aged 65 years or older who are at high cardiovascular disease or cognitive impairment risk favors an SBP goal of less than 130 mm Hg, and for some, a goal of 120 mm Hg may be considered.
View Article and Find Full Text PDFAnn Am Thorac Soc
September 2024
Cleveland Clinic Foundation, Pulmonary, Allergy andCritical Care, Cleveland, Ohio, United States;
Alpha-1 antitrypsin deficiency (AATD) is an under-recognized condition with only a small minority of affected individuals detected, long delays between initial symptoms and diagnosis, and evidence that affected individuals may see many physicians with suggestive symptoms before an initial diagnosis is made. In the context that failure to detect AATD confers harm and that specific therapy is currently available, there is a clear need for enhanced detection. Impediments to enhanced detection include inadequate knowledge about AATD by physicians caring for at-risk patients, inattention to guidelines which endorse testing, a sense of therapeutic nihilism among some physicians (i.
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