0 stringlengths 12 494 | embeddings listlengths 384 384 |
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deficiencies,\n\tand\tprevent\tcomplications\tand\tprogression\tof\tthe\tdisease.\tThe\tCF\tteam\tusually\tincludes\nmedical\tand\tnursing\tstaff;\trespiratory\ttherapists,\tphysical\ttherapists,\tregistered\tdietitian\nnutritionists;\tsocial\tworkers;\tand\tgenetic\tcounselors.\tImpairment\tof\tthe\trespiratory\tand | [
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gastrointestinal\tsystems\tis\tresponsible\tfor\tsignificant\tmortality\tand\tmorbidity.\tSinus\tinfection,\nglucose\tcontrol,\tnutritional\tstatus,\n\tand\tpsychosocial\tissues\tmust\tbe\tassessed\tand\tmanaged\tat\tregular\nintervals\t(\nFig.\t33.6\n).\nFIG.\t33.6\nAlgorithm\tfor\tdiagnosis\tand\tmanagement\tof\tcyst... | [
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CF\tmanagement\tis\tusually\tseparated\tinto\tchronic\tmaintenance\ttherapy\tand\tacute\texacerbation\tof\nthe\tdisease.\tChronic\ttherapy\tfocuses\ton\tprevention\tand\ttreatment\tof\tairway\tinfections\tand\nobstructions\tas\tCF\tpatients\tare\tprone\tto\trecurrent\tchest\tinfections.\tMedical\tmanagement\tconsists\t... | [
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chest\tphysiotherapy,\tnebulizer\ttherapy,\n\tantiinflammatory\tagents,\tpulmonary\thygiene,\tpneumococcal\nand\tinfluenza\tvaccinations,\tand,\tfrequently,\tchronic\tprophylactic\tantibiotic\tuse.\tA\tmajor\tstep\tforward\nin\tthe\ttreatment\tof\tCF\tcame\tin\t2011\twith\tthe\tinvention\tof\ta\tmedication\tthat\ttarge... | [
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the\tmutant\tCFTR\tfunction,\tIvacaftor\t(VX-770).\tIt\tis\ta\tsmall\tmolecular\tweight\toral\tdrug\tthat\tis\ndesigned\tspecifically\tto\ttreat\tpatients\twho\n\thave\ta\tG551D\tmutation\tin\tat\tleast\tone\tof\ttheir\tCFTR\ngenes.\tIvacaftor\tis\tthe\tfirst\tapproved\tCF\ttherapy\tthat\trestores\tthe\tfunctioning\tof... | [
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rather\tthan\ttrying\tto\ttarget\tone\tor\tmore\tof\tits\tdownstream\tconsequences\t(\nDavis,\t2011\n).\tIn\tclinical\ntrials,\tit\twas\tfound\tto\timprove\trespiratory\tstatus,\treduce\tpulmonary\texacerbations,\tenhance\tquality\nof\tlife,\tand\tpromote\tweight\tgain.\tCurrently,\n\tother\tdrugs\tare\tcoming\tonto\tt... | [
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other\tdrugs\tare\tcoming\tonto\tthe\tmarket\tthat\ttarget\tthe\nmutant\tCFTR\tfunction.\tIf\tthe\tCF\tpatient\tcontinues\tto\tdecline\tdespite\tmedical\ttherapy,\tbilateral\tlung\ntransplantation\tmay\tbe\tneeded.\tThe\tacute\tmanagement\tof\tCF\tsometimes\trequires\thospitalization,\nusually\tto\ttreat\tan\tinfection... | [
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0.040573... |
Because\tof\tthe\tPI,\t\npancreatic\tenzyme\treplacement\ttherapy\t(PERT)\n\tis\tan\timportant\tcomponent\nof\tthe\tmanagement\tfor\tCF\tpatients\tto\tadequately\tabsorb\tcarbohydrates,\tprotein,\tand\tfat.\tThe\npancreatic\tducts\tare\tobstructed\tin\tapproximately\t85%\tto\t90%\tof\tCF\tindividuals,\tand\tthis\tpreve... | [
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pancreatic\tenzymes\tsuch\tas\tlipase,\tamylase,\tand\tprotease\tfrom\tsecreting\tinto\tthe\tsmall\tintestine.\nThe\tbuild-up\tof\tthese\tenzymes\tin\tthe\tpancreas\tleads\tto\tauto\tdigestion\tof\n\tthe\tpancreas\tand\ndestruction\tof\tacinus.\tPancreatic\tacinus\tis\tthe\tsecretory\tunit\tof\texocrine\tpancreas,\twhe... | [
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juice\tis\tproduced.\tDestruction\tof\tpancreatic\tacinus,\tor\t\nacinar\n\tdestruction,\tresults\tin\timpaired\nsecretion\tof\tpancreatic\tjuice,\twhich\tresults\tin\tloose,\toily,\tfrequent\tstools\tand\tmalabsorption.\tThese\nindividuals\tneed\tPERT\tto\tcombat\tthe\tPI\tand\tmaintain\tadequate\tabsorption\tand\tdig... | [
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of\tnutrients\n(see\t\nFocus\tOn:\n\tPERT\n).\n\t\nFOCUS\tON\nPERT\nPancreatic\tenzyme\treplacement\ttherapy\t(PERT)\n\tis\tthe\tfirst\tstep\ttaken\tto\tcorrect\tmaldigestion\nand\tmalabsorption.\tThe\tmicrospheres,\tdesigned\tto\twithstand\tthe\tacidic\tenvironment\tof\tthe\nstomach,\trelease\tenzymes\tin\tthe\tduoden... | [
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Pharmaceutical\tadvancements\thave\timproved\tthe\tmedications.\tThe\tquantity\tof\tenzymes\tto\tbe\ntaken\twith\tfood\tdepends\ton\tthe\tdegree\tof\tpancreatic\tinsufficiency;\tthe\tquantity\tof\tfood\teaten;\tthe\nfat,\tprotein,\tand\tcarbohydrate\tcontent\tof\tfood\tconsumed;\tand\tthe\ttype\tof\tenzymes\tused. | [
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Enzyme\tdosage\tper\tmeal\tor\tsnack\tis\tadjusted\tempirically\tto\tcontrol\tgastrointestinal\tsymptoms,\nincluding\tsteatorrhea,\tand\n\tto\tpromote\tgrowth\tappropriate\tfor\tage.\tFollowing\tthe\tmanufacturer’s\ndirections\tabout\tstorage\tand\tadministration\tof\ta\tparticular\tbrand\tof\tenzyme\tis\timportant\tto | [
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emphasize.\tIf\tgastrointestinal\tsymptoms\tcannot\tbe\tcontrolled,\tenzyme\tdosage,\tpatient\tadherence,\nand\tenzyme\ttype\tshould\tbe\treevaluated.\tFecal\t\nelastase\n\t(protein-digesting\tenzyme\tsecreted\tby\tthe\npancreas\tand\tinvolved\tin\thydrolysis\tof\tpeptide\n\tbonds),\tfecal\tfat,\tor\tnitrogen\tbalance\... | [
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help\tto\tevaluate\tthe\tadequacy\tof\tenzyme\tsupplementation.\nThe\tacidic\tenvironment\tof\tthe\tstomach\tdoes\tnot\tallow\tthe\tenzymes\tof\tthe\tenteric\tcoated\tPERT\nto\tbe\tdegraded.\tThis\tnormally\toccurs\tonce\tthe\tpH\tis\tabove\t5.5,\tusually\twhen\tthe\tPERT\treaches\nthe\tduodenal\tjejunum.\tA\tcommon\tp... | [
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inhibitors\n\tin\torder\tto\tincrease\tthe\tduodenal\tpH\tby\tdecreasing\tgastric\tacid\tsecretion\t(\nRogers,\n2013\n).\nIntestinal\tabnormalities\tsuch\tas\tgastroesophageal\treflux\tdisease\t(GERD),\tmeconium\tileus\t(MI),\nand\t\ndistal\tintestinal\tobstruction\tsyndrome\t(DIOS)\n,\twhich\tis\tthe\tblockage\tof\tin... | [
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,\twhich\tis\tthe\tblockage\tof\tintestines\nresulting\tfrom\tstool\tand\tintussusceptions\t(obstructions),\tare\tsome\tof\tthe\tcomplications\tseen\tin\npatients\t(\nKatkin,\t2014\n).\nHepatobiliary\n\tproblems\tare\tseen\tmore\tcommonly\tnow\tin\tthis\tpopulation\tbecause\tof\tan\tincreased\nsurvival\trate.\tIn\tthe\... | [
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located\tin\tthe\tbiliary\tepithelium.\tBile\tproduced\tin\tpatients\twith\tCF\tis\tthick\tand\ttenacious,\tcausing\nblockage\tof\tthe\tintrahepatic\tbile\tducts.\tBlockage\tof\tthese\tducts\teventually\tleads\tto\tcirrhosis.\tUse\nof\tursodeoxycholic\n\tacid\t(UDCA)\tmay\tdelay\tthe\tprogression\tof\tliver\tdisease\t(... | [
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Kappler\tet\tal,\t2012\n)\n(see\t\nChapter\t28\n);\thowever,\ta\trecent\tCochrane\tReview\tfound\tlittle\tevidence\tto\tsupport\troutine\tuse\nof\tUDCA,\tciting\tthe\tsmall\tnumber\tof\ttrials\tassessing\tits\teffectiveness\t(\nCheng\tet\tal,\t2017\n).\tAt\tthis\ntime,\tthere\tis\tlittle\tevidence-based\tresearch\tfor\... | [
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persons\twith\tCF\t(\nPalanippan\tet\tal,\t2017\n).\nMedical\tnutrition\ttherapy\nMedical\tnutrition\ttherapy\t(MNT),\tcritical\tto\tmanagement\tof\tCF\tand\tall\tof\tits\tcomorbidities,\tis\tvital\tin\npromoting\tlongevity\tand\tpositive\toutcomes.\tMNT\tbegins\twith\tevaluation\tof\tthe\tnutritional\tstatus\tof\nthe\... | [
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the\tpatient\t(\nBaker\tet\tal,\t2013\n)\t(see\t\nChapters\t4\n\tand\t\n5\n).\tCF\tpatients\tfrequently\thave\tgrowth\tfailure,\nthe\tcause\tof\twhich\tis\tmultifactorial:\tmalabsorption,\tincreased\n\tenergy\tneeds,\tand\treduced\tappetite.\nNutritional\tstatus\tis\tclosely\tcorrelated\tto\tpulmonary\tfunction\tand\ts... | [
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attention\tto\tgrowth\tstatus\tin\tchildren\tshould\tbe\tmonitored;\tclinical\tcare\tguidelines\tfor\tinfants\tand\npreschoolers\thave\tbeen\tpublished\t(\nBorowitz\tet\tal,\t2009\n;\t\nLahiri\tet\tal,\t2016\n).\tAll\tpatients\twith\tCF\nshould\thave\tregular\tnutritional\tassessments\tfor\tearly\tdetection\n\tof\tnutr... | [
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of\tnutritional\tstatus\tdeterioration\n(see\t\nPathophysiology\tand\tCare\tManagement\tAlgorithm:\n\tCystic\tFibrosis\n).\tOlder\tchildren\tshould\tbe\nevaluated\tfor\tbone\tdensity,\tusing\tthe\tdual-energy\tx-ray\tabsorptiometry\t(DEXA)\t(see\t\nChapter\t23\n).\nCF\tis\ttypically\tassociated\twith\tmalnutrition;\tho... | [
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has\talso\tincreased\tin\tthis\tpopulation,\traising\tconcern\tfor\tthe\teffect\n\tof\texcess\tenergy\tintake\ton\tlung | [
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function.\tDietary\trecommendations\tshould\temphasize\ta\tbalanced\thealthy\tdiet\twith\tgood\texercise\nhabits.\nMajor\tgoals\tof\tnutritional\ttherapy\tare\tincreasing\tmuscle\tstrength,\tpromoting\toptimal\tgrowth\tand\nweight\tmaintenance,\tand\tenhancing\tthe\tquality\tof\tlife.\tTo\tachieve\tthese\tgoals,\tthe\t... | [
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treatment\tare\tto\tcorrect\tmaldigestion\tand\tmalabsorption\tand\tto\tprovide\n\tnutrients\tthat\tare\tcommonly\ndeficient.\nEnergy.\nEvidenced-based\tnutrition\tgoals\tfor\tindividuals\twith\tCF\tare\tbased\ton\tthe\tCystic\tFibrosis\tFoundation\nregistry\tdata\tanalysis\tfor\tage\tand\tsex:\n•\t\nNewborn\tto\t24\tm... | [
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and\tPrevention\t(CDC)\tgrowth\tcharts\n•\t\n2\tto\t20\tyears\told:\tBMI\t50th\tto\t85th\tpercentile,\tusing\tCDC\tgrowth\tcharts\n•\t\nAdult\tfemales:\tBMI\t22\tto\t27\tkg/m\n2\n•\t\nAdult\tmales:\tBMI\t23\tto\t27\tmg/km\n2\nThese\tweight\tgoals\tare\tassociated\twith\ta\tdesirable\tpulmonary\tfunction.\nA\tbroad\tran... | [
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150%\tof\trecommendations\tfor\tthe\tgeneral\tpopulation,\tdepending\ton\tthe\tCF\tmutation,\tthe\tpatient’s\nage,\tdegree\tof\tmalabsorption,\tpresence\tof\tpulmonary\texacerbation,\n\tpulmonary\tfunction,\tsex,\npubertal\tstatus,\tpresence\tof\tadditional\tmedical\tcomplications\t(CFRD,\tCF\tliver\tdisease),\tand\tth... | [
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0.05046297... |
current\tstate\tof\thealth\t(\nSchindler\tet\tal,\t2015\n).\nA\tchallenging\tissue\tis\tattaining\tan\tadequate\tenergy\tintake\twith\tan\tenergy\tdense\tdiet.\tThe\ndetermination\tto\tinitiate\tenteral\tfeedings\tis\tindividualized\tfor\tthose\twho\tare\tunable\tto\tconsume\nadequate\tcalories\tand\tprotein\tto\tmeet\... | [
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0.0950... |
growth/weight\tmaintenance\tgoals\tor\tthose\twith\tmoderate\tor\nsevere\tmalnutrition\t(\nSchwarzenberg,\t2016\n).\tTube\tfeeding\toptions\tinclude\tgastrostomy\ttube,\nnasogastric\ttube,\tand\tjejunostomy\ttube.\tThe\tmost\tcommon\tdelivery\toption\tis\tthe\tpercutaneous\nendoscopic\tgastrostomy\t(PEG)\ttube\t(see\t\... | [
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0.01... |
Chapter\t12\n).\tAppropriate\tPERT\tmanagement\tshould\tbe\nmaintained\twith\tgeneral\tguidelines\tbased\ton\tfat\tgrams\tprovided.\tIf\n\tthe\tpatient\tis\teating,\tPERT\tcan\nbe\tadministered\torally.\tFor\tthose\twho\tare\tnot\ttaking\tanything\tby\tmouth,\tPERT\tmay\tbe\tcrushed\n(depending\ton\tthe\ttype\tof\tPERT... | [
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0.08601820468902588,
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0.01063... |
as\tan\tenteral\tmedication.\tRecently\ta\tdigestive\tenzyme\tcartridge\tbecame\tavailable\tthat\tattaches\tto\nfeeding\ttube\tsets,\twhich\tsimplifies\tPERT\tadministration.\nVitamins\tand\tminerals.\nIn\tCF\tpatients,\tliver\tdisease\tand\tpancreatic\tdysfunction\tlead\tto\tfat\tmalabsorption,\twhich\tpredisposes | [
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these\tpatients\tto\tdeficiencies\tof\tfat-soluble\tvitamins\tA,\tD,\tE,\tand\tK\tand\tsome\tminerals\teven\twith\nPERT\tuse.\tVitamin\tlevels\tshould\tbe\tassessed\tat\tdiagnosis\t(except\tthe\tnewborn)\tand\tsupplemented\tas\nindicated.\tCF-specific\tvitamins\tcontain\tfat\tand\twater-soluble\tvitamins\tas\twell\tas\... | [
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absorption.\tDeficiencies\tof\tvitamins\tA,\tD,\tE,\tand\tK,\twhich\tsignificantly\taffect\tCF\tpatients,\treduce\ntheir\tresponse\tto\tpulmonary\tinfections.\nBecause\tbone\tdisease\tis\tcommon\tin\tpatients\twith\tCF\tand\tprogresses\twith\tage\t(\nRana\tet\tal,\t2014\n),\nthe\tCystic\tFibrosis\tfoundation\trecommend... | [
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3\n).\tA\tdaily\nvitamin\tD\tdosage\tof\t1500\tto\t2000\tIU\tis\tsuggested\tby\tthe\tEndocrine\n\tSociety\twith\tdosages\tincreasing\nto\t10,000\tIU\tdaily\tfor\tCF\tpatients\t18\tor\tolder\t(\nRogers,\t2013\n).\nIt\tis\talso\trecommended\tthat\tthe\tCF\tpatient\tbe\tsupplemented\twith\tvitamin\tK.\tTaking\tat\tleast\t... | [
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0.000... |
Rogers,\t2013\n).\nFat-soluble\tvitamin\ttesting\tis\timportant\tin\tthe\tidentification\tof\tdeficiencies\tin\tCF\tpatients\twith\tPI.\nFat-soluble\tvitamins\tare\n\tsupplemented\troutinely\tand\tannually\tmonitored.\tPatients\tmay\tbe\nnoncompliant\twith\tvitamin\tsupplementation\tor\trequire\thigher\tdosages\t(\nRan... | [
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0.08... |
Rana\tet\tal,\t2014\n).\nSalt.\nExcessive\tsodium\tloss\tin\tperspiration\tin\tpatients\twith\tCF\tpredisposes\tthem\tto\thyponatremic\ndehydration\tunder\tconditions\tof\theat\tstress.\tMost\tpatients\tneed\tsupplementation\tof\tsodium\tchloride\nstarting\tin\tinfancy.\tThe\tamount\tof\tsalt\tsupplementation\n\tshould... | [
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0.02625335... |
should\tbe\tincreased\tunder\tcircumstances\nsuch\tas\thigh\ttemperature\tand\thumidity;\ta\tdry,\tdesert\tclimate;\tstrenuous\texercise\tin\thot\tweather;\nexcessive\tsweating;\tfever;\tand\tpresence\tof\tdiarrhea\tor\tvomiting.\nZinc.\nAdditional\tzinc\tis\trecommended\tif\ta\tdeficiency\tis\tsuspected\tin\tpatients\... | [
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0.071... |
in\tgrowth\tor\tappetite\tor\tthose\twith\tprolonged\tdiarrhea\t(\nSchindler\tet\tal,\t2015\n).\nAsthma\nAsthma\n\tis\ta\tchronic\tdisorder\tthat\taffects\tthe\tairways\tand\tis\tcharacterized\tby\tbronchial\thyper-\nreactivity,\treversible\tairflow\tobstruction,\tand\tairway\tremodeling.\tAsthmatic\tsymptoms\tinclude | [
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0.0... |
periodic\tepisodes\tof\tchest\ttightness,\tbreathlessness,\tand\twheezing.\tAsthma\thas\tbecome\tmore\nprevalent\tand\thas\tbeen\tincreasing\tat\tthe\trate\tof\t25%\tto\t75%\tevery\tdecade\tsince\t1960\tin\twesternized\ncountries\t(\nAllan\tand\tDevereux,\t2011\n).\tIt\taffects\tall\tage\tgroups.\nPathophysiology | [
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).\tIt\taffects\tall\tage\tgroups.\nPathophysiology\nAsthma\tis\tthe\tresult\tof\ta\tcomplex\tinteraction\tbetween\tenvironmental\texposures\tand\tgenetics.\tWhen\npeople\tare\tgenetically\tsusceptible,\tenvironmental\tfactors\texacerbate\tairway\thyper-responsiveness, | [
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airway\tinflammation,\tand\tatopy\t(tendency\tto\tdevelop\tallergic\treaction),\twhich\teventually\tleads\tto\nasthma.\nEnvironmental\tfactors\tthat\tare\tlinked\tto\tthe\tdevelopment\n\tof\tasthma\tinclude\tindoor\tallergies\t(dust\nmites,\tanimal\tallergies)\tand\toutdoor\tallergies\t(pollen\tand\tfungi),\texposure\t... | [
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0.0113076... |
pollution,\trecurring\trespiratory\tinfections,\tgastrointestinal\tesophageal\treflux,\tsulfites\tin\tfoods,\tand\nmedication\tsensitivities\t(\nFanta,\t2017\n).\tA\tyounger\tgestational\tage\tand\ta\thigher\tinfant\tweight\tgain\tare\nassociated\twith\tthe\tdevelopment\tof\tasthma\t(\nSonnenschein-van\tder\tVoort\tet\... | [
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0.010103... |
Sonnenschein-van\tder\tVoort\tet\tal,\t2014\n).\tLower\nsocioeconomic\tstatus\tmay\talso\tbe\tcorrelated\twith\tthe\tincidence\tof\tasthma\t(\nChen\tet\tal,\t2016\n).\nClinicians\tidentify\tthree\tkey\tareas\twhen\tdiagnosing\tasthma:\n1.\t\nAirflow\tobstruction\tthat\tis\tat\tleast\tpartially\treversible\n2.\t\nAirflo... | [
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-0.0... |
2.\t\nAirflow\tobstruction\tthat\trecurs\tin\tresponse\tto\ta\ttrigger\n3.\t\nSymptoms\tconsistent\twith\tasthma\nSymptoms\tsuch\tas\twheezing,\tcoughing,\tshortness\tof\tbreath,\tand\tchest\ttightness\n\toccur\tin\tmost\npatients,\tand\tsymptoms\tthat\tworsen\tat\tnight\tis\ta\tcommon\tfeature.\tAlthough\tallergic\tas... | [
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“extrinsic\tasthma”\tis\tdue\tto\tchronic\tallergic\tinflammation\tof\tthe\tairways,\t“intrinsic\tasthma”\tis\ntriggered\tby\tnonallergic\tfactors\tsuch\tas\texercise,\tcertain\tchemicals,\tand\textreme\temotions\t(\nChih–\nHung\tGuo\tet\tal,\t2012\n).\nA\tlife-threatening\tsituation\twith\tmarkedly\tnarrow\tairways,\t... | [
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0.02381700836122036,
0.0247592... |
asthmaticus,\tcan\tresult\nwhen\tasthma\thas\tnot\tbeen\ttreated\tproperly.\tCorticosteroid\ttherapy\tis\toften\tprescribed,\tbut\tchronic\nuse\tmay\tplace\tthe\tindividual\tat\trisk\tfor\t\nosteopenia\n\t(precursor\tto\tosteoporosis),\tbone\tfractures,\tor\nsteroid-induced\thyperglycemia\t(see\t\nAppendix\t13\n).\tSom... | [
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0.03418853... |
Appendix\t13\n).\tSome\tevidence\tsupports\tthe\teffectiveness\tof\nsublingual\timmunotherapy\tin\tthe\ttreatment\tof\tasthma\tand\trhinitis,\tbut\tmore\tstudies\n\tare\tneeded\ton\noptimal\tdosages\t(\nLin\tet\tal,\t2013\n).\nMedical\tmanagement\nThe\tessential\tcomponents\tof\tasthma\ttherapy\tare\troutine\tmonitorin... | [
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0.04... |
patient\teducation,\tcontrol\tof\tenvironmental\ttriggers,\tand\tpharmacotherapy.\nPharmacologic\ttreatment\tmust\tbe\ttailored\tto\tthe\tindividual\tpatient\tand\tis\tused\tin\ta\tstepwise\nmanner.\tThe\tmedications\tand\tthe\tregime\tchosen\tdepend\ton\tthe\n\tseverity\tof\tthe\tasthma,\twhich\tcan\tbe | [
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0.016... |
severity\tof\tthe\tasthma,\twhich\tcan\tbe\nclassified\tas\tan\tacute\tattack,\tintermittent,\tmild\tpersistent,\tmoderate\tpersistent,\tor\tsevere\tpersistent.\nQuick-relief\tand\tlong-term\tcontroller\tmedications\tare\tused\tas\ttherapy\tfor\tasthma.\tAlthough\tquick-\nrelief\tmedications\tinclude\tshort-acting\tbet... | [
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0.043995738... |
controller\tmedications\tinclude\tinhaled\tcorticosteroid,\n\tlong-acting\tbeta\tagonists,\tand\tleukotriene\nmodifiers.\tLong-acting\tanticholinergics\tare\tnow\tconsidered\tas\tadditional\ttherapy\tin\tthose\tnot\ncontrolled\twith\tinhaled\tcorticosteroids\t(\nSobieraj\tet\tal,\t2018\n). | [
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0.12399796396493912,
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0.012033959850668907,
0.03112... |
controlled\twith\tinhaled\tcorticosteroids\t(\nSobieraj\tet\tal,\t2018\n).\nInhaled\tcorticosteroids\tare\tthe\tcornerstone\tof\tpharmacologic\tmanagement\twith\tpersistent\tasthma.\nSome\tpatients\twith\trefractory\tasthma\tneed\tmaintenance\tdoses\tof\tsystemic\tsteroids.\tBecause\tsteroids | [
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0.06960748881101608,
0.10358422994613647,
-0.019710896536707878,
0.019704557955265045,
0.0312596... |
change\tbone\tmetabolism\tand\tthe\tdevelopment\tof\tosteoporosis,\tthese\tpatients\tbenefit\tfrom\tincreased\ncalcium\tintake.\tTherapies\tdeveloped\tover\tthe\tpast\tdecade\tfor\tsevere\tasthmatics\tfocus\ton\nimmunotherapy:\tantiimmunoglobulin\tE\t(anti-IgE),\tantiinterleukin-5\t(anti-IL-5)\tantibodies,\ttumor | [
-0.015054687857627869,
0.0023459335789084435,
0.04731810465455055,
-0.021822713315486908,
-0.05745484307408333,
0.006474991329014301,
0.05975152552127838,
0.07250308990478516,
-0.02508244849741459,
0.04544119909405708,
0.016413407400250435,
0.03348206356167793,
0.006777661386877298,
0.0044... |
necrosis\tfactor-alpha\t(TNF-α)\tinhibitors,\tand\tmacrolide\tantibiotics.\nAntibiotics\tfor\texacerbation\tof\tasthma\tare\tnot\n\trecommended\tby\tcurrent\tclinical\tpractice\nguidelines,\tbecause\trespiratory\tinfection\ttriggering\tasthma\tattacks\tare\tmore\toften\tviral\trather\tthan\nbacterial.\nMedical\tnutriti... | [
0.011249478906393051,
-0.05974859744310379,
0.04651718586683273,
-0.03758234530687332,
-0.06650912016630173,
0.020888280123472214,
0.05253083258867264,
0.04753057286143303,
-0.07571064680814743,
0.09541646391153336,
0.09478426724672318,
-0.057591818273067474,
0.012182904407382011,
0.079724... |
bacterial.\nMedical\tnutrition\ttherapy\nWhen\ttreating\tasthma,\tthe\tdietitian\tnutritionist\taddresses\tdietary\ttriggers,\tcorrects\tenergy\tand\nnutrient\tdeficiencies\tand\texcesses\tin\tthe\tdiet,\teducates\tthe\tpatient\ton\ta\tpersonalized\tdiet\tthat\nprovides\toptimal\tlevels\n\tof\tnutrients,\tmonitors\tgro... | [
0.01340832281857729,
-0.06633909791707993,
0.030680213123559952,
-0.03413977473974228,
-0.06481348723173141,
0.06502335518598557,
0.08758646994829178,
0.09032926708459854,
-0.10783564299345016,
0.06727762520313263,
0.0953281819820404,
-0.05463440343737602,
0.021937333047389984,
0.083807103... |
interactions.\nModulation\tof\tantioxidant\tintake\twith\tnutritional\tsupplementation\thas\ta\tbeneficial\teffect\ton\tthe\nseverity\tand\tprogression\tof\tasthma\t(\nFabian\tet\tal,\t2013\n).\tAlthough\ta\tslight\tinverse\tassociation\twas\nseen\tbetween\ta\tlow\tvitamin\tE\tintake\tand\twheezing\tsymptoms,\tno\tasso... | [
0.011598638258874416,
-0.07669263333082199,
0.04713666811585426,
0.03702988103032112,
-0.08272819966077805,
0.029776236042380333,
0.07727159559726715,
0.013772734440863132,
0.0009943011682480574,
0.03951718658208847,
0.11524392664432526,
-0.05933626368641853,
0.0019764977041631937,
0.04558... |
vitamin\tE\tand\tasthma.\tFurther\n\tstudies\tare\trequired\tto\tunderstand\tthe\tmechanism\tof\tvitamin\tE\ton\tthe\ninflammation\tof\tthe\timmune\tsystem\t(\nFabian\tet\tal,\t2013\n).\tLow\tblood\tcarotenoid\tlevels\talso\thave\tbeen\nlinked\twith\tasthma.\tA\tdiet\trich\tin\tantioxidants\tand\tmonounsaturated\tfats\... | [
-0.031644608825445175,
-0.015388406813144684,
0.037467729300260544,
-0.024573687463998795,
-0.07266589999198914,
0.04037057235836983,
0.12255106121301651,
0.012281432747840881,
-0.0477396659553051,
0.07620108127593994,
0.1316346973180771,
-0.07656782120466232,
0.009890601970255375,
-0.0131... |
effect\ton\tchildhood\tasthma\tby\tcounteracting\toxidative\tstress\t(\nGarcia-Marcos\tet\tal,\t2013\n).\tThe\nrelationship\tbetween\tselenium\tstatus\n\tand\tthe\tincidence\tand\tseverity\tof\tasthma\thas\tbeen\tinconsistent\nin\thumans\tso\tselenium\tsupplementation\tis\tnot\trecommended\t(\nNorton\tet\tal,\t2012\n). | [
-0.01467335969209671,
0.03137655183672905,
0.07673940807580948,
0.03773845359683037,
-0.020661167800426483,
0.05240413546562195,
0.035184528678655624,
0.03248181566596031,
-0.02442779578268528,
0.03655765578150749,
0.1513971984386444,
-0.05300050601363182,
-0.008984833024442196,
-0.0138759... |
Norton\tet\tal,\t2012\n).\nIn\tthe\tchildhood\tasthma\tprevention\tstudy\tomega-3\tpolyunsaturated\tfatty\tacid\t(PUFA)\tfish\toil\twas\nsupplemented\tthroughout\tchildhood,\tand\twheezing\twas\treduced.\tThis\teffect\tdid\tnot\tcontinue\tinto\nlater\tchildhood.\tSupplementation\tof\tvitamin\tC\tand\tzinc\talso\thave\n... | [
-0.035142410546541214,
-0.03857233002781868,
0.025652313604950905,
-0.04983888193964958,
-0.061647240072488785,
0.0013928565895184875,
0.1233610138297081,
0.011057407595217228,
-0.009369458071887493,
0.03504304587841034,
0.07989884167909622,
-0.038585979491472244,
0.08610457926988602,
0.03... |
been\treported\tto\timprove\tasthma\nsymptoms\tand\tlung\tfunction\t(\nAllan\tand\tDevereux,\t2011\n).\nConflicting\tresults\ton\tthe\tefficacy\tof\tvitamin\tD\tsupplementation\thave\tbeen\treported.\tIn\tone\tstudy\nan\tinsufficient\tserum\tlevel\tof\tless\tthan\t30\tng/dL\tof\tvitamin\tD\twas\tassociated\twith\tan\ti... | [
0.021670034155249596,
-0.00022305063612293452,
0.10052192211151123,
-0.054675035178661346,
-0.0787036344408989,
0.018454905599355698,
0.10098803043365479,
0.007208035793155432,
-0.03743690997362137,
0.06988445669412613,
0.09837806224822998,
-0.01665513962507248,
0.03493727743625641,
0.0129... |
asthma\texacerbation\tin\tthe\tform\tof\temergency\troom\t(ER)\tvisits\tand\thospitalizations\t(\nBrehm\tet\tal,\n2010\n).\tIn\tanother,\n\thigh\tdoses\tof\tvitamin\tD\tsupplementation\twere\tnot\tshown\tto\thave\tany\tprotective\neffect\t(\nLitonjua\tet\tal,\t2014\n).\tDue\tto\tthe\tconflicting\tresults\tof\tthese\tst... | [
0.015185724012553692,
-0.02682853676378727,
0.06774431467056274,
-0.042655233293771744,
-0.038662608712911606,
0.02250629849731922,
0.11652130633592606,
0.01006312109529972,
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0.04056941717863083,
0.08179987221956253,
0.01940893940627575,
0.07404281944036484,
0.02797207... |
vitamin\tD\tsupplementation\tshould\tnot\tbe\trecommended\tat\tthis\ttime\tas\ttherapy\tfor\tasthma\t(\nJiao\tand\nCastro,\t2015\n).\nOther\tnutritional\tinterventions\tcould\tpotentially\tinclude\tuse\tof\tprobiotics,\toral\tmagnesium,\tand\tthe\nMediterranean\tdiet.\tReduced\tdiversity\tor\taberrant\tcomposition\tof\... | [
0.00929640419781208,
-0.05253471061587334,
0.0381990447640419,
-0.022438503801822662,
-0.08419347554445267,
0.011119882576167583,
0.06749876588582993,
0.013652378693223,
-0.041464485228061676,
0.06991399079561234,
0.11921313405036926,
-0.04771667718887329,
-0.0004028360126540065,
0.0185627... |
associated\twith\tthe\tdevelopment\tof\tasthma\tin\tlater\tlife,\tso\tbreastfeeding\tis\trecommended\tto\tensure\ngrowth\tof\thealthy\tmicrobiota\t(\nMilani\tet\tal,\t2017\n;\t\nHendaus\tet\tal,\t2016\n).\tA\tnutritionally\thealthy\tdiet\nsuch\tas\tthe\tMediterranean\tdiet\tmay\thelp\tprevent\tasthma\tduring\tchildhood... | [
0.025213049724698067,
0.021740568801760674,
0.02793906070291996,
-0.0676683560013771,
-0.09677956998348236,
0.046875908970832825,
0.0004753734392579645,
-0.027440454810857773,
-0.029855703935027122,
0.07485201954841614,
0.21645429730415344,
-0.06088672950863838,
0.021656421944499016,
0.018... |
Hendaus\tet\tal,\t2016\n).\tIn\na\tsmall\tstudy\tof\t55\tmales\tand\tfemales\twith\tmild\tto\tmoderate\tasthma,\tsupplementing\twith\t340\tmg\nmagnesium/\tday\t(in\ttwo\tdivided\tdoses\tof\t170\tmg)\tfor\t6\tmonths\treduced\tbronchial\treactivity\tand\nimproved\tpulmonary\tfunction\ttests\t(\nKazaks\tet\tal,\t2010\n). | [
-0.035201285034418106,
-0.030641237273812294,
0.016377147287130356,
-0.05701122060418129,
-0.05726082623004913,
-0.03403102979063988,
0.06519056856632233,
0.04747695103287697,
-0.027890266850590706,
0.04006383568048477,
0.11181118339300156,
-0.013601443730294704,
0.008839501067996025,
0.06... |
improved\tpulmonary\tfunction\ttests\t(\nKazaks\tet\tal,\t2010\n).\nA\thigher\tthan\tdesirable\tBMI\tduring\tchildhood\tis\tassociated\twith\ta\tsignificant\tincrease\tin\tthe\ndevelopment\tof\tasthma.\tInstitution\tof\tdiets\tthat\thelp\twith\n\tweight\tloss\tin\tasthmatic\tobese\tchildren | [
0.008511084131896496,
0.002245586598291993,
0.12234260886907578,
-0.016642238944768906,
-0.12049306184053421,
0.006371966563165188,
0.0966171994805336,
-0.009267675690352917,
-0.1021503284573555,
0.08363670855760574,
0.10898535698652267,
-0.0455770306289196,
0.0220908522605896,
-0.02301768... |
weight\tloss\tin\tasthmatic\tobese\tchildren\nseem\tto\tshow\timprovements\twith\tthe\tcontrol\tof\tasthma,\tstatic\tlung\tfunction,\tand\timproved\tquality\tof\nlife\t(\nGibson\tet\tal,\t2013\n).\tHowever,\ta\tlarge\tstudy\tof\tadult\tobese\tasthmatics\tfound\tthat\tthe\tdegree\tof\nweight\tloss\tneeded\tto\timprove\t... | [
-0.04880834370851517,
-0.010936258360743523,
0.04902675375342369,
-0.027561277151107788,
-0.11687564104795456,
-0.007552525028586388,
0.08142713457345963,
-0.0029249507933855057,
-0.013881649821996689,
0.07789391279220581,
0.11019858717918396,
-0.08377788215875626,
0.034959446638822556,
0.... |
control\t(\nMa\tet\tal,\t2015\n).\nGastroesophageal\treflux\tdisease\t(GERD)\n\tand\tfood\tallergens\tare\tthe\ttwo\tmost\tcommon\tdietary\ntriggers\tfor\tasthma.\tGERD\tis\thighly\tprevalent\tin\tasthmatic\tpatients.\tA\tcritical\tcomponent\tof\tMNT\tfor\nasthmatic\tpatients\tis\ta\tdiet\tfree\tof\tknown\tirritants\ts... | [
-0.00398112740367651,
-0.03969324380159378,
0.012103461660444736,
-0.0051149362698197365,
-0.10710139572620392,
0.006652862299233675,
0.08859949558973312,
0.04798087850213051,
-0.01589086465537548,
0.03855312988162041,
0.12432298064231873,
-0.01969725824892521,
0.05605071783065796,
0.01954... |
foods\t(see\t\nChapter\t26\n).\tLimiting\tthe\tintake\tof\thigh\tfat\tfoods\tand\tportion\tcontrol\tcan\tprevent\tgastric\nsecretions,\twhich\texacerbate\tGERD.\nFood\tallergens\tand\tfood\tadditives\tare\tother\tpotential\tdietary\ttriggers\tfor\tasthma.\tAn\tIgE-mediated\nreaction\tto\ta\tfood\tprotein\tcan\tlead\tto... | [
0.005288122221827507,
-0.06007225066423416,
0.057958174496889114,
0.011662478558719158,
-0.04841776192188263,
0.02194209210574627,
0.09526199102401733,
0.0064448406919837,
-0.05509967356920242,
0.03163041174411774,
0.13118302822113037,
-0.040381673723459244,
0.006822620984166861,
-0.023433... |
protein\tis\tthe\tonly\tdietary\ttreatment\tcurrently\tavailable\tfor\tfood\tallergies.\tSome\tsulfites,\tsuch\tas\npotassium\tmetabisulfite\tand\tsodium\tsulfide,\tused\tin\tthe\tprocessing\tof\tfoods\thave\tbeen\tfound\tto\tbe\ta\ntrigger\tfor\tasthmatics\t(\nGaur\tet\tal,\t2013\n)\nSome\tasthma\tpatients\tneed\tmain... | [
-0.009929710067808628,
-0.09844838827848434,
0.0314672589302063,
-0.04944242909550667,
-0.06025150790810585,
0.010849657468497753,
0.06019652634859085,
0.05568680912256241,
-0.02551380544900894,
0.015602768398821354,
0.12217557430267334,
-0.015798037871718407,
0.015373372472822666,
0.04959... |
drug-nutrient\tinteraction\tproblems.\tDue\tto\trisk\tof\tdeveloping\tosteoporosis\twhile\ton\tlong-term\nsteroids,\tintakes\tof\t1000\tmg\tcalcium/day\tand\t600\tIU\tVitamin\tD\tis\tsuggested\tfor\tchildren\tages\t4-17\n(\nBuckley,\t2017\n).\nChronic\tobstructive\tpulmonary\tdisease\nChronic\tobstructive\tpulmonary\td... | [
-0.04663962125778198,
-0.05242065340280533,
0.03318783640861511,
-0.07371766120195389,
-0.09515617787837982,
0.011410431936383247,
0.049415841698646545,
0.08858000487089157,
-0.048689648509025574,
0.05427330359816551,
0.0851072147488594,
-0.054992325603961945,
0.03316112607717514,
0.073094... |
is\tnow\tthe\tthird\tmost\tcommon\tcause\tof\tdeath\tin\nthe\tworld\tand\tis\tpredicted\tto\tbe\tthe\tfifth\tmost\tcommon\tcause\tof\tdisability\tby\t2020\t(\nBurney\tet\tal,\n2014\n).\tSmoke\tfrom\tcigarettes\tis\ta\tmajor\trisk\tfactor,\talong\twith\tthat\tfrom\tbiomass\tfuel\tused\tfor\ncooking\tand\theating\tin\tru... | [
0.003886620979756117,
0.008738765493035316,
0.02821163460612297,
-0.06625119596719742,
-0.07560427486896515,
-0.016903512179851532,
0.07374429702758789,
-0.014453312382102013,
-0.013513359241187572,
0.08128146082162857,
0.06752005219459534,
-0.03251653537154198,
0.09406773746013641,
0.0179... |
and\tgenetic\tfactors\tare\talso\tfactors\tin\tthe\tdevelopment\n\tof\tCOPD\t(\nTable\t33.1\n).\tPatients\twith\tCOPD\nsuffer\tfrom\tdecreased\tfood\tintake\tand\tmalnutrition\tthat\tcauses\trespiratory\tmuscle\tweakness,\nincreased\tdisability,\tincreased\tsusceptibility\tto\tinfections,\tand\thormonal\talterations.\n... | [
0.0071153114549815655,
-0.023713814094662666,
0.0409926101565361,
-0.0059411185793578625,
-0.06848923116922379,
-0.006498491391539574,
0.09109988808631897,
0.06891007721424103,
-0.043252356350421906,
0.0476919449865818,
0.12407734990119934,
-0.019338279962539673,
0.0037977402098476887,
0.0... |
TABLE\t33.1\nRisk\tFactors\tfor\tChronic\tObstructive\tPulmonary\tDisease\t(COPD)\nDefinite\nProbable\nTobacco\tsmoking\nOccupational\texposure\nExposure\tto\tbiomass\tfuel\tsmoke\nEnvironmental\ttobacco\tsmoke\nPulmonary\ttuberculosis\nRepeated\tlower\trespiratory\tinfection\tduring\tchildhood\nPoorly\ttreated\tasthma | [
0.00913655012845993,
-0.03301069140434265,
0.026111533865332603,
-0.010717072524130344,
-0.09521615505218506,
-0.010814385488629341,
0.03566312789916992,
0.016259415075182915,
-0.03623654693365097,
0.09480727463960648,
0.10777747631072998,
-0.11395647376775742,
0.03901093825697899,
0.06032... |
Poorly\ttreated\tasthma\nAdapted\tfrom\tGupta\tD,\tet\tal:\tGuidelines\tfor\tdiagnosis\tand\tmanagement\tof\tchronic\tobstructive\tpulmonary\tdisease:\tJoint\tICS/NCCP\t(I)\nrecommendations,\t\nLung\tIndia\n\t30:228,\t2013.\nPathophysiology\nCOPD\n\tis\ta\tterm\tthat\tencompasses\t\nchronic\tbronchitis\n\t(a\tlong-term... | [
-0.00745222857221961,
-0.038199085742235184,
0.09202343970537186,
-0.015266504138708115,
-0.1426968276500702,
-0.038118716329336166,
0.022318800911307335,
0.05933339148759842,
-0.031148571521043777,
0.05451077222824097,
0.07397949695587158,
-0.03933775797486305,
0.02376973070204258,
0.0596... |
chronic\tbronchitis\n\t(a\tlong-term\tcondition\n\tof\tCOPD\tin\twhich\ninflamed\tbronchi\tlead\tto\tmucus,\tcough,\tand\tdifficulty\tbreathing)\tand\t\nemphysema\n\t(a\tform\tof\tlong-\nterm\tlung\tdisease\tcharacterized\tby\tthe\tdestruction\tof\tlung\tparenchyma\twith\tlack\tof\telastic\trecoil).\nThese\tconditions\... | [
0.019619744271039963,
-0.0514310821890831,
0.06167842075228691,
0.004723734222352505,
-0.09544555842876434,
0.02386690117418766,
0.08254262059926987,
0.034618351608514786,
-0.016850272193551064,
0.039783913642168045,
0.07475116103887558,
0.028940895572304726,
0.06055464595556259,
0.0469755... |
Fig.\t33.7\n\tshows\nthe\toverlap\tbetween\tthese\tthree\tconditions:\tasthma,\tchronic\tbronchitis,\tand\temphysema.\n\tAsthma-\nCOPD\toverlap\tsyndrome\t(ACOS)\tis\ta\tnew\tentity\tthat\tentails\tthose\twho\thave\tfeatures\tof\tboth\tCOPD\nand\tasthma.\tACOS\twas\trecognized\tin\t2015\tby\tthe\tGlobal\tInitiative\tfo... | [
-0.006052360404282808,
0.006594743113964796,
0.06999409198760986,
-0.01977895200252533,
-0.09115469455718994,
0.011365815997123718,
0.06011408567428589,
-0.006931068375706673,
-0.02035563811659813,
0.10108595341444016,
0.11985284090042114,
-0.09313040971755981,
0.00703171594068408,
0.03036... |
Disease\t(GOLD)\tand\tGlobal\tInitiative\tfor\tAsthma\t(GINA). | [
-0.027719596400856972,
0.01991541124880314,
0.04539141058921814,
0.05423487350344658,
-0.11977076530456543,
0.00611375505104661,
0.13968198001384735,
0.014064818620681763,
-0.02464291825890541,
0.06408718228340149,
0.10057798027992249,
-0.09194562584161758,
-0.06801308691501617,
0.00300387... |
FIG.\t33.7\nThe\toverlap\tof\tasthma,\tchronic\tbronchitis,\tand\temphysema\tmaking\tup\tchronic\tobstructive\tpulmonary\ndisease\t(COPD).\nPatients\twith\tprimary\temphysema\tsuffer\tfrom\tgreater\tdyspnea\tand\tcachexia.\tOn\tthe\tother\thand\npatients\twith\tbronchitis\thave\thypoxia,\t\nhypercapnia\n\t(increased\ta... | [
-0.004055388737469912,
-0.055400487035512924,
0.054582927376031876,
-0.014788230881094933,
-0.09213163703680038,
-0.013043655082583427,
0.05618095397949219,
0.057304393500089645,
-0.028101330623030663,
0.0710102841258049,
0.08989496529102325,
-0.01137958001345396,
0.045209381729364395,
0.0... |
hypercapnia\n\t(increased\tamount\tof\tCO\n2\n),\tand\tcomplications\nsuch\tas\tpulmonary\thypertension\tand\tright\theart\tfailure\t(\nPapaioannou\tet\tal,\t2013\n).\nAlpha-1\tantitrypsin\tdeficiency\tis\tpresent\tin\t1%\tto\t2%\tof\tCOPD\tpatients\tand\tis\tlikely\nunderrecognized.\tCOPD\texacerbations\tcan\tbe\tcaus... | [
0.03136400505900383,
-0.057156629860401154,
0.017130501568317413,
0.04839479923248291,
-0.07194282114505768,
-0.0072633083909749985,
0.10404136776924133,
0.053211111575365067,
-0.018908744677901268,
-0.004457779228687286,
0.07221639901399612,
-0.02863929606974125,
0.04432857036590576,
0.06... |
Haemophilus\tinfluenzae\n,\t\nMoraxella\ncatarrhalis\n,\t\nStreptococcus\tpneumonia\n,\trhinovirus,\tcoronavirus,\tand\tto\ta\tlesser\tdegree,\torganisms\nsuch\tas\t\nP.\taeruginosa\n,\t\nS.\taureus\n,\tMycoplasma\tspp.,\tand\t\nChlamydia\tpneumoniae\n.\tAllergies,\tsmoking,\ncongestive\theart\tfailure,\tpulmonary\n\te... | [
-0.017113562673330307,
-0.01783842220902443,
-0.0004520621441770345,
-0.03411403298377991,
-0.04731544479727745,
0.005740564316511154,
0.037436001002788544,
0.04201505333185196,
-0.014655745588243008,
0.08717913925647736,
0.10437296330928802,
-0.024024177342653275,
0.06326187402009964,
0.0... |
embolism,\tpneumonia,\tand\tsystemic\tinfections\tare\tthe\treason\tfor\n20%\tto\t40%\tof\tCOPD\texacerbations\t(\nNakawah\tet\tal,\t2013\n).\nProlonged\ttobacco\tuse\tis\tassociated\twith\tan\tincreased\trisk\tof\thaving\tCOPD\tbesides\tother\nrespiratory\tdisorders\t(\nLiu\tet\tal,\t2015\n).\tOsteoporosis\tin\tCOPD\t... | [
-0.010617046616971493,
-0.012847025878727436,
0.046272195875644684,
-0.006632516626268625,
-0.07576648145914078,
0.004469160921871662,
0.0475553423166275,
0.06896544247865677,
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0.03225583955645561,
0.11440619826316833,
-0.010749798268079758,
0.017106477171182632,
0.049... |
).\tOsteoporosis\tin\tCOPD\tpatients\tnot\tonly\tpredisposes\tpatients\nto\tpainful\tvertebral\tfractures\tbut\talso\taffects\tlung\tfunction\tby\taltering\tthe\tconfiguration\n\tof\tthe\tchest\nwall.\tFrequent\tacute\texacerbations\tin\tCOPD\tpatients\tincrease\tthe\tseverity\tof\tchronic\tsystem | [
0.02333195134997368,
-0.01757667399942875,
0.057440657168626785,
0.01350044272840023,
-0.12325330823659897,
0.014016817323863506,
0.08415673673152924,
0.014858531765639782,
0.0014094409998506308,
0.0034471270628273487,
0.09961531311273575,
-0.02209012396633625,
0.0359051488339901,
0.019173... |
inflammation.\tThis\tleads\tto\tbone\tloss\tby\tinhibiting\tbone\tmetabolism.\tLack\tof\tsun\texposure\tand\nphysical\tactivity\twith\tCOPD\tleads\tto\ta\tlack\tof\t25-hydroxy\tvitamin\tD\t(25[OH]D),\twhich\tregulates\tbone\nmetabolism\tby\tpromoting\tthe\tabsorption\tof\tcalcium\t(\nXiaomei\tet\tal,\t2014\n).\nFactors... | [
-0.0005922768032178283,
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0.053378790616989136,
-0.0065437788143754005,
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0.0007432503043673933,
0.07662319391965866,
0.08138111978769302,
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0.06146213412284851,
0.0276515930891037,
0.003445466049015522,
0.07723410427570343,
0.10... |
Xiaomei\tet\tal,\t2014\n).\nFactors\tthat\tinfluence\n\tthe\tprognosis\tof\tCOPD\tare\tthe\tseverity\tof\tdisease,\tgenetic\tpredisposition,\nnutritional\tstatus,\tenvironmental\texposures,\tand\tacute\texacerbations.\nMedical\tmanagement\nIn\tgeneral,\tCOPD\ttherapies\thave\ta\tlimited\teffect\tcompared\twith\ttherapi... | [
0.026991846039891243,
-0.03274873271584511,
0.08486194163560867,
0.007033524569123983,
-0.0298109482973814,
0.035523783415555954,
0.08111395686864853,
0.009063600562512875,
-0.02517767623066902,
0.052866529673337936,
0.16497944295406342,
-0.04178355261683464,
0.06529548019170761,
0.0314633... |
exception\tof\tsmoking\tcessation,\tno\tdisease-modifying\tmedications\texist\tthat\tcan\tchange\tthe\nprogression\tof\tairway\tobstruction\tin\tCOPD.\n\tThe\tairflow\tobstruction\tin\tCOPD\tis\tirreversible.\nInhaled\tbronchodilators\tremain\tthe\tmainstay\tof\ttreatment\tfor\tCOPD\tpatients.\tUsually\tthese\tare | [
-0.026370400562882423,
0.014836562797427177,
0.017882635816931725,
-0.03728649765253067,
-0.06161031499505043,
0.030733859166502953,
0.07559402287006378,
0.07755547016859055,
0.010954238474369049,
0.012049886398017406,
0.058269090950489044,
-0.0028053103014826775,
0.0730498805642128,
-0.01... |
given\tby\tmetered\tdose\tinhalers\t(MDI),\tbut\tfor\tsevere\tdyspnea\tor\tthose\tunable\tto\tuse\tinhalers\t(i.e.,\narthritis,\tcognitive\tdysfunction),\tthey\tmay\tbe\tadministered\tin\ta\tnebulized\tform.\tAnticholinergic\nmedications\tsuch\tas\tipratropium\tbromide\tor\tSpiriva\t(tiotropium\n\tbromide),\ta\tlong-ac... | [
0.03419801592826843,
-0.054761871695518494,
0.03832573443651199,
-0.024763163179159164,
-0.1095704659819603,
-0.006154615432024002,
0.034427281469106674,
0.0702633336186409,
-0.062327925115823746,
0.03506993502378464,
0.07161558419466019,
0.004561505280435085,
0.06686767190694809,
0.088683... |
bromide),\ta\tlong-acting\nanticholinergic\tagent\twith\tspecificity\tfor\tmuscarinic\treceptors,\tcan\tbe\tadded\tto\tthe\ttreatment.\nTheophylline\tcontinues\tto\tbe\tused\tbut\tless\toften\tdue\tto\tassociated\ttoxicity.\tInhaled\tsteroids\tand\ta\ntrial\tof\toral\tsteroids\tmay\tbe\trequired\tfor\tsome\tpatients.\t... | [
0.03908141702413559,
-0.07029659301042557,
0.032672539353370667,
-0.06660626083612442,
-0.10770420730113983,
0.026308244094252586,
0.06725706160068512,
0.0337446890771389,
0.023778581991791725,
0.052375081926584244,
0.13659100234508514,
-0.04160275682806969,
0.010445314459502697,
0.0268261... |
exacerbation\tis\tconsidered\tto\tbe\tdue\tto\tbacterial\tinfection.\nAcute\texacerbation\n\tof\tCOPD\tis\tassociated\twith\tadverse\teffects\tsuch\tas\tdeclining\tlung\tfunction,\nreduced\tquality\tof\tlife,\tand\tincreased\tmortality.\tIn\tmany\tinstitutions,\treducing\tearly\t(≤30\tdays) | [
0.005990339443087578,
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0.0602230429649353,
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0.009649076499044895,
0.0753498300909996,
0.07140590995550156,
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0.07637962698936462,
0.12716898322105408,
-0.005097274202853441,
0.02483247220516205,
0.0656353... |
readmission\tfor\tCOPD\thas\tbecome\ta\thealth\tcare\tpolicy\tgoal.\tIdentifying\treasons\tfor\treadmissions\tare\nimportant.\tSome\tof\tthese\treasons\tinclude\tdepression,\tsmoking,\tanxiety,\tGERD,\treduced\tfunctional\nstatus,\tunwillingness\tto\tuse\n\toxygen,\tand\tmalnutrition.\nPulmonary\thypertension\tis\ta\tr... | [
0.013291174545884132,
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0.03472292423248291,
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0.014757662080228329,
0.10156035423278809,
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0.0688820630311966,
0.09213406592607498,
-0.01570543460547924,
0.05106070637702942,
0.027... |
COPD.\tThe\tfirst\tstep\tin\ttreating\tpulmonary\thypertension\tin\tpatients\twith\tCOPD\tis\tappropriate\nmedical\tmanagement\tof\ttheir\tobstructive\tlung\tdisease,\tas\tmentioned\tearlier.\nPatients\twith\tlow\toxygen\tlevels\t(hypoxemic)\tneed\tsupplemental\toxygen.\tPulmonary\trehabilitation\nmay\tbe\thelpful | [
-0.023535458371043205,
-0.009833761490881443,
0.033187832683324814,
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0.014014750719070435,
0.07785611599683762,
0.07519643008708954,
0.0062797702848911285,
0.026209833100438118,
0.11615344882011414,
-0.005240205209702253,
0.03923680633306503,
0.... |
may\tbe\thelpful\n\tin\tadvanced\tCOPD.\tPatients\twith\tsevere\tCOPD\tmay\tsuffer\trespiratory\tfailure\trelated\nto\tcomplications\tsuch\tas\tpneumothorax,\tpneumonia,\tand\tcongestive\theart\tfailure,\tor\tdue\tto\nuncontrolled\tadministration\tof\thigh-dose\toxygen\tor\tnarcotic\tsedatives.\tThe\tpatients\tin\tresp... | [
0.045877207070589066,
-0.020198296755552292,
0.05986393615603447,
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0.08376523107290268,
0.05330032482743263,
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0.05438539385795593,
0.11245296150445938,
-0.0128181679174304,
0.09412376582622528,
0.0763138... |
FIG.\t33.8\nAn\tintensive\tcare\tunit\t(ICU)\tpatient\ton\tventilator.\nIn\taddition\tto\tfacing\tmajor\tphysical\timpairment\tand\tchronic\tdyspnea,\tCOPD\tpatients\tare\tat\tan\nincreased\trisk\tof\tdeveloping\tdepression\tthat\tshould\tbe\tidentified\tand\ttreated.\nMedical\tnutrition\ttherapy | [
-0.01612250693142414,
-0.006191244348883629,
0.0843956246972084,
-0.037097133696079254,
-0.0781753659248352,
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0.10359128564596176,
0.036289677023887634,
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0.020855804905295372,
0.10281716287136078,
-0.05121895298361778,
0.038900312036275864,
0.039... |
Medical\tnutrition\ttherapy\nMalnutrition\tis\ta\tcommon\tproblem\tassociated\twith\tCOPD,\twith\tprevalence\trates\tof\t30%\tto\t60%\tdue\nto\tthe\textra\tenergy\trequired\tby\n\tthe\twork\tof\tbreathing\tand\tfrequent\tand\trecurrent\trespiratory\ninfections.\tBreathing\twith\tnormal\tlungs\texpends\t36\tto\t72\tkcal... | [
0.004394210409373045,
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0.056243911385536194,
0.013902979902923107,
-0.07197476923465729,
0.010163416154682636,
0.13253603875637054,
0.07915147393941879,
-0.0340145081281662,
-0.0010262937285006046,
0.08459492027759552,
-0.009318364784121513,
0.06913631409406662,
0.0523... |
with\tCOPD\t(\nHill\tet\tal,\t2013\n).\tInfection\twith\tfever\tincreases\tmetabolic\trate\teven\tfurther\t(see\t\nChapter\n2\n).\tMalnourished\tpatients,\tidentified\tas\tthose\thaving\tdecreased\tbody\tweight,\treduced\tfat-free\tbody\nmass,\tor\ta\tBMI\t≤20\tkg/m\n2\n,\tare\tlikely\n\tto\thave\tmore\tCOPD\texacerbat... | [
-0.027408523485064507,
0.009847283363342285,
0.043641649186611176,
0.007537096738815308,
-0.071981281042099,
0.00031825152109377086,
0.04032861068844795,
0.009292569011449814,
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-0.005662534385919571,
0.11527333408594131,
-0.07113965600728989,
0.044739846140146255,
0.00... |
than\tthose\twho\tare\twell-nourished\t(\nItoh\tet\tal,\t2013\n).\tIncreasing\tenergy\tintake\tcan\tmaintain\tor\nimprove\tmuscle\tstrength\tand\texercise\ttolerance\tin\tthese\tpatients\t(\nItoh\tet\tal,\t2013\n).\nLow\tbody\tweight\tis\tdue\tto\tpoor\tnutritional\tintake,\tan\tincreased\tmetabolic\trate,\tor\tboth.\t... | [
-0.008827999234199524,
0.0018641505157575011,
0.07314471155405045,
0.006268531084060669,
-0.08668630570173264,
0.0028680867981165648,
0.11253803968429565,
-0.0008596928091719747,
-0.05897156521677971,
-0.01654840260744095,
0.10184021294116974,
-0.04054275155067444,
0.04639330878853798,
0.0... |
food\tintake\tand\tpoor\tappetite\tare\tthe\tprimary\ttargets\tfor\n\tintervention\tin\tpatients\twith\tCOPD.\tThese\ntwo\tissues\tare\tthe\treasons\tCOPD\tpatients\tstruggle\tto\tmeet\ttheir\tnutritional\tneeds.\tDepletion\tof\nprotein\tand\tvital\tminerals\tsuch\tas\tcalcium,\tmagnesium,\tpotassium,\tand\tphosphorus\... | [
-0.016365934163331985,
-0.00786070991307497,
0.04810541868209839,
-0.007290949113667011,
-0.052900493144989014,
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0.13854020833969116,
0.039235129952430725,
-0.021353065967559814,
0.03463580831885338,
0.10626393556594849,
-0.03103242628276348,
0.028322290629148483,
0.0... |
respiratory\tmuscle\tfunction\timpairment.\tIn\tsevere\tmalnutrition\tinadequate\telectrolyte\trepletion\nduring\taggressive\tnutrition\trepletion\tcan\tlead\tto\tsevere\tmetabolic\tconsequences\n\trelated\tto\trefeeding\nsyndrome\t(see\t\nChapter\t12\n).\nThere\tare\ttwo\tmain\tgoals\tin\tmanaging\tthe\thypermetabolis... | [
-0.006757688242942095,
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0.03829028457403183,
-0.02761712856590748,
-0.13504889607429504,
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0.09623470902442932,
0.05855085328221321,
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0.04265493154525757,
0.1008387878537178,
-0.008819679729640484,
0.0564238540828228,
0.05661... |
prevention\tof\tweight\tloss\tand\t(2)\tthe\tprevention\tof\tthe\tloss\tof\tlean\tbody\tmass\t(LBM).\tThese\tgoals\tcan\nbe\tachieved\tby\tensuring\tthe\tfollowing:\n•\t\nSmall\tfrequent\tmeals\tthat\tare\tnutritionally\tdense\n•\t\nThe\tpatient\teats\tthe\tmain\tmeal\twhen\tenergy\tlevel\tis\tat\tits\thighest\n• | [
0.008026674389839172,
0.005309779662638903,
0.06814330816268921,
0.013711937703192234,
-0.07806248962879181,
0.026854215189814568,
0.08917368203401566,
0.0382126048207283,
-0.0653599426150322,
0.012944081798195839,
0.10350063443183899,
0.0035796761512756348,
0.0462387353181839,
0.046010673... |
The\tpatient\teats\tthe\tmain\tmeal\twhen\tenergy\tlevel\tis\tat\tits\thighest\n•\t\nAdequate\tcalories,\tprotein,\tvitamins,\tand\tminerals\tto\tmaintain\ta\tdesirable\tweight—a\tBMI\tof\n20\tto\t24\tkg/m\n2\n•\t\nAvailability\tof\tfoods\tthat\trequire\tless\tpreparation\tand\tcan\tbe\theated\teasily\tin\ta\tmicrowave... | [
0.02600850537419319,
-0.04592209309339523,
0.03149277716875076,
0.01833917945623398,
-0.10563994944095612,
-0.011227644979953766,
0.0870090126991272,
0.06305037438869476,
-0.04125702753663063,
-0.004532128106802702,
0.12790295481681824,
-0.0257060918956995,
0.06456027925014496,
0.025932377... |
oven\tif\tpatients\tprepare\ttheir\town\tfood\n•\t\nLimitation\tof\talcohol\tto\tfewer\tthan\t2\tdrinks/day\t(30\tg\talcohol)\n•\t\nA\tperiod\tof\trest\tbefore\tmealtimes\nPeople\twith\tCOPD\tsuffer\ta\tpoor\tprognosis\twhen\n\tthey\thave\tmalnutrition\tthat\tpredisposes\tthem\tto\ninfections.\tThe\tability\tto\tproduc... | [
0.037528228014707565,
0.011842254549264908,
0.04874708503484726,
0.04816044121980667,
-0.06999987363815308,
0.0391022227704525,
0.0952812135219574,
0.04093161225318909,
-0.05667395144701004,
-0.0077214594930410385,
0.09898696839809418,
-0.03689700365066528,
0.05765373259782791,
0.021029608... |
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