Preventive and Clinical Medicine

In the past decade, there has been an alarming increase in the prevalence of obesity. Data from the National Health and Nutrition Examination Survey demonstrated that nearly two of three adults are overweight/obese (ie, body mass index [BMI], > 25 kg/m2), and that nearly one of three adults are obese (ie, BMI, > 30 kg/m2). []

Intractable Dyspnea Intractable profound dyspnea, disabling severe shortness of breath despite maximal treatment, is comparable to intractable pain from cancer. The ability of the patient to live a meaningful life is severely compromised. Conventional forms of treatment are directed toward decreasing the work cost of breathing by improving the mechanical performance of the lung, chest []

Subject Selection Thirteen healthy male and female volunteers whose ages ranged from 22 to 30 years were studied twice in paired studies separated by at least 12 days. Three other subjects were also admitted to the study but excluded from final data analysis for the reasons indicated below. The criteria for a subjects inclusion in []

Several studies have suggested that even after successful recanalization of the infarct-related coronary artery, some patients do not have complete myocardial reperfusion and remain at risk for large infarcts and more frequent mortality. Therefore, the early and simple identification of such high-risk patients is required. Our study demonstrated that in patients with inferior AMIs, larger []

There are no satisfactory animal models of the human disease bronchial asthma. There are, however, a number of animal species in which allergic bronchoconstriction can be reproducibly elicited and which have been used with some success to characterize various physiologic manifestations reminiscent of those seen in asthma and, where possible, to identify underlying mechanisms. Histamine []

Whereas all of the controlled studies have assessed acute clinical response, changes in bacterial numbers and products and long-term outcome have been monitored less consistently. Similarly, long-term clinical benefits (eg, time to next infection, rate of decline of lung function) are rarely reported, and any advantages have been modest There are few controlled studies of []

Treatment trials in CF There are many phase 2 studies that assess the responses to single antibiotics. These studies almost invariably show clinical benefit, with some improvement in lung function. The predominant organism in the sputum usually persists, and if eradicated returns within a few weeks. Recent reports have assessed bacterial load as numbers of []

The activity has been based on in vitro minimum inhibitory concentration (MIC) estimation rather than in vivo clinical efficacy, and in CF this simple approach may well be misleading. Factors that suggest that in vitro activities may not be reflected in vivo are listed in Table 2. Hypersensitivity reactions to all these drugs occasionally occur, []

Antimicrobial therapy for cystic fibrosis (CF) has developed empirically over the past 30 years, and controlled trials have usually followed rather than preceded the development of well-established treatment. As a result, although there are many drugs effective against the organisms commonly associated with CF, much doubt remains concerning indications for treatment, the best drugs to []

Indications for Antibiotic Treatment Most investigators give antibiotics directed against P aeruginosa only in the case of infectious exacerbations. However, the Danish group60 favors treatment every 3 months of patients harboring Pseudomonas for more than 6 months or who have more than two serum precipitins against Pseudomonas persisting for 14 days or more. They reported []

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Preventive and Clinical Medicine