Pulmonology

Pulmonary Hypertension A rare but important cause of dyspnoea

Pulmonary Hypertension A rare but important cause of dyspnoea

Pulmonary hypertension can be a devastating disease that is easily missed in the early stages because of its typically nonspecific presentation with gradually increasing dyspnoea, and may coexist with other sources of dyspnoea. With advances in management, most forms of pulmonary hypertension are treatable with medication. Early diagnosis and treatment are key to improving functional and haemodynamic outcomes and survival.

Modern Medicine – Issue 5 2020

October 20, 2020 by Pulmonology

Managing Asthma and COVID-19 Risk

Managing Asthma and COVID-19 Risk

In the face of unchartered territory and unprecedented times, there remains uncharted much to be learned about the impact of asthma on the course of SARS-CoV-2 virus infection. Although adult data suggest that asthma is a risk factor for COVID-19 morbidity and mortality, such a risk in children is unclear. Differentiating COVID- 19 from worsening asthma, or an asthma exacerbation, is challenging. There is broad consensus that asthma exacerbations should be treated aggressively and in keeping with current guideline recommendations.

Modern Medicine – Issue 4 2020

August 14, 2020 by Asthma COVID Pulmonology

Continuous Airways: Allergic and Nonallergic Associations Between the Nose and Lungs

Continuous Airways: Allergic and Nonallergic Associations Between the Nose and Lungs

Rhinitis is a common chronic illness with a lifetime annual incidence of
at least seven per 1000 people. Over 80% of patients with asthma
have rhinitis and 10 to 40% of patients with rhinitis have asthma.
Both allergic and nonallergic rhinitis are independent risk factors for the
development of asthma. Treatment of rhinitis can influence asthma
outcomes. Aspirin-exacerbated respiratory disease occurs in more
than 14% of patients with severe asthma.

Modern Medicine – July 2017

August 1, 2017 by Pulmonology

Improving Long-term Outcomes Following Acute Pulmonary Embolism

Improving Long-term Outcomes Following Acute Pulmonary Embolism – MM1701

Acute pulmonary embolism (PE) can result in complications many years after the initial event. An understanding of the long-term outcomes in patients following a PE is important to improve their management. Chronic thromboembolic pulmonary hypertension should be considered in patients with previous PE or VTE who present with ongoing or unexplained dyspnoea, exercise intolerance, atypical chest pain, syncope or peripheral oedema. There is increasing evidence of persistent functional and right ventricular impairment among long-term survivors of submassive PE. Patients who have had a PE have been found to have a threefold increase in 30-year mortality compared with controls, even after adjustment for comorbidities.

Modern Medicine – January 2017

January 27, 2017 by Embolism Pulmonology

Identifying Ventilator-Associated Pneumonia Early is Key

Identifying Ventilator-Associated Pneumonia Early is Key – MM1611

When critically ill patients experience a life-threatening illness, they are also vulnerable to contracting ventilator-associated pneumonia, which increases morbidity and likely mortality as well as the cost of health care. Ventilator associated pneumonia is very difficult to diagnosis as there are no ‘golden rules’ for doctor’s to use as a diagnostic tool. Mortality is reduced with early diagnosis and treatment of VAP. Drug resistant VAP is becoming more prevalent.

Modern Medicine – November 2016

December 8, 2016 by Pneumonia Pulmonology

Pneumonia: Who is at Risk?

Pneumonia: Who is at Risk? – MM1610

Risk factors for pneumonia include age, smoking and presence of chronic diseases, such as lung disease, heart disease and diabetes. Preventive measures include influenza and pneumococcal vaccination and smoking cessation. GPs are at the front line of management of patients with pneumonia, starting empirical outpatient antibiotic therapy and referring those who are very ill or at risk of deterioration to hospital. A chest x-ray is important for diagnosis of pneumonia. Most patients respond to empirical antibiotic therapy with amoxycillin, doxycycline or an appropriate macrolide antibiotic. Patients with nonresolving pneumonia require reassessment to confirm the diagnosis, identify the pathogen and look for complications or underlying disease such as malignancy.

Modern Medicine – October 2016

October 31, 2016 by Pneumonia Pulmonology

Asthma – COPD Overlap Syndrome | A merger of 2 distinct spectrums of inflammatory airway diseases

Asthma – COPD Overlap Syndrome | A merger of 2 distinct spectrums of inflammatory airway diseases – MM1609

Most practising doctors are familiar with the diseases of Asthma and Chronic Obstructive Pulmonary Disease (COPD). Within the cohort of these two disease entities, there are patients that do not completely satisfy the criteria to be diagnosed convincingly as either asthma or COPD. While the semantics of these diseases are far more important for research purposes than the diagnostic dilemma they pose, there have been several advances in both asthma and COPD that make the distinction or recognition of an asthma COPD Overlap Syndrome (ACOS) as a clinical entity more pertinent.

Modern Medicine – September 2016

October 6, 2016 by Asthma COPD Pulmonology

Reducing Croup Severity Cuts Hospital Readmission

Reducing Croup Severity Cuts Hospital Readmission – MM1606

Croup is characterised by the abrupt onset, most commonly at night, of a barking cough, inspiratory stridor, hoarseness and respiratory distress due to upper airway obstruction and must be differentiated from acute epiglottitis, bacterial tracheitis, or an inhaled foreign body. Croup affects about 3% of children a year, usually between the ages of six months and three years and 75% of infections are caused by Parainfluenza virus. Symptoms usually resolve within 48 hours. Severe infection rarely leads to pneumonia or to respiratory failure and arrest.

Modern Medicine – June 2016

June 30, 2016 by Paediatrics Pulmonology

Putting COPD Medications into Perspective

Putting COPD Medications into Perspective – MM1601

Over the past few years, new drugs have been added to the bronchodilators and inhaled corticosteroids used for treating COPD. There is no strong evidence to say that one drug within a class is better than another and the decision about which drugs to use is mainly about patient preference, although multiple drugs from the same class should not be used in the same patient.

Modern Medicine – January 2016

January 14, 2016 by COPD Pulmonology
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