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The Metabolic Medicine Postoperative Bariatric Surgery Consultation
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
However, if a patient requires steroids for their respiratory function, a strategy of reducing them to the lowest effective dose while controlling acid production with a PPI may be sufficient. A detailed discussion with the patient’s pulmonologist may be helpful in coordinating this effort.
Disorders of Keratinization and Other Genodermatoses
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Roselyn Stanger, Nanette Silverberg
Management: Neonates require care in the neonatal intensive care unit, as they are at high risk of temperature and electrolyte dysregulation, skin and respiratory infections, sepsis, and fluid loss. Several topical agents can be used to help heal the skin, including emollients, gentle exfoliants, and topical steroids; however, topical tacrolimus should be avoided due to increased absorption leading to potentially toxic systemic levels. Topical keratolytics may be too irritating. Patients with pruritus may be given antihistamines. Nutrition is essential to help mitigate the effects of failure to thrive, and patients may benefit from the help of a professional nutritionist. Patients with anaphylaxis or other atopic tendencies can be referred to an allergist and/or pulmonologist. Biologic agents that have recently been described to improve clinical features include secukinumab and dupilumab.
Elements of Case Analysis
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
Tonia Aiken, Phyllis ZaiKaner Miller, Marguerite Barbacci
When the symptoms persisted into the winter and became increasing worse, a dust allergy was diagnosed and more antihistamines prescribed. Two years after this patient was initially evaluated for fatigue and shortness of breath, she decompensated to the point that she could hardly climb a flight of stairs in her own home. She was referred to an allergist. The allergist determined the woman’s symptoms were likely not from allergies and referred her to a pulmonologist.
Asthma outcomes in pediatric patients with 30-day follow-up after an asthma hospitalization in a Medicaid-managed care program
Published in Journal of Asthma, 2023
Melissa C. Cole, Jean L. Raphael, Julie P. Katkin, Naga Jaya Smitha Yenduri, Maria C. Gazzaneo, Amee Revana, Aikaterini Anagnostou, Harold J. Farber
This study, as an observational study, carries the risk of selection bias and limited ability to control for potential confounding factors. It is possible that the patients who completed a post hospital follow-up had more severe asthma than those who did not. It is likely that patients followed by a pulmonologist had more severe disease than those who were not followed by pulmonologists. Our study was of a Medicaid-insured population in Southeastern Texas. Results may not be generalizable to commercially insured populations. Only outpatient medication dispensing data were captured. Medications dispensed from the hospital, ED, or medication samples from a physician’s office would not have been captured. Presence of an asthma diagnosis on the claim for payment submitted to the health plan does not necessarily mean that the provider addressed the asthma or provided asthma education. Our dataset would not differentiate whether the asthma follow-up visit was to address chronic asthma care or was for an acute asthma exacerbation. Our dataset does not include data on asthma severity apart from the presence of asthma hospitalization, nor the persistence or frequency of symptoms apart from the hospitalization. Lastly, our data does not include details about the care delivered at the outpatient follow-up visit, thus the content of the follow-up care delivered cannot be directly assessed from data.
Does omeprazole improve asthma-control in poorly-controlled asthmatic children with gastro-esophageal reflux
Published in Journal of Asthma, 2022
Abdelghani Yagoubi, Youcef Laid, Leila Smati, Keltoum Nafissa Benhalla, Fadila Benhassine
Patients were included gradually between May 2011 and May 2015, from pediatric pulmonologist consultations in Algiers city. Inclusion criteria were an age between 4 years and 16 years old; poorly controlled asthma defined by a childhood asthma control test (c-ACT) of less than 20 where diagnosis of asthma was done by a pediatric pulmonologist on a history of intermittent respiratory symptoms like coughing, wheezing, chest tightness and shortness of breath, triggered or aggravated by infections, stress or allergens with a favorable clinical response to bronchodilators; at least 3 months of regular use of adequate long-term asthma treatment assessed by a pulmonologist based on GINA guidelines; and GERD defined in pH-metry by a reflux index greater than 5% at pH < 4 according to NASPGHAN (7). Children were excluded if they had a personal history of esophageal or gastric surgery, neurologic disability or cardiac disease, and if they had used PPI during the previous month. Patients were also excluded during the study if they could not accept or tolerate endoscopy or esophageal pH monitoring.
Development of self-assessed work ability among middle-aged asthma patients—a 10 year follow-up study
Published in Journal of Asthma, 2021
Eveliina Hirvonen, Antti Karlsson, Maritta Kilpeläinen, Ari Lindqvist, Tarja Laitinen
The study population represent a subpopulation of the Finnish Chronic Obstructive Airway Disease (CAD) cohort. The cohort enrolled through the Pulmonary Clinics of Helsinki and Turku University Hospitals during the years 2005–2007 (17). The patients were identified using ICD10 code J44.8 or J45. All patients between 18 and 75 years of age were invited to join the study through a two-phase mailing campaign. Their asthma diagnosis, including lung function tests, age at onset, and possible co-morbidities, were carefully evaluated by a pulmonologist by using the participants’ medical records from all health care providers (hospitals, health care centers, outpatient clinics) that had treated the patient during the past 5 years. Social security numbers were used to combine the records from different data sources. All patients had given their informed consent for data collection and analysis.