一個呼吸的距離

1. second primary lung cancer (SPLC) 的定義:

何謂第二個原發癌症(Second primary lung cancer, SPLC)呢？就是另一個獨立的惡性腫瘤，它必須是非第一個癌症轉移、非復發、非鄰近腫瘤蔓延過來。第二原發癌可分為同時性(synchronous)與異時性(metachronous)。同時性第二原發癌，是指在第一個癌症診斷後6個月內被發現的原發癌﹔而異時性第二原發癌，是指第一個癌症診斷後6個月後才發現的原發癌。

若DLCO<60%, 看6 minute walking test是否可以到350m以上。

若運動後FVC明顯下降(比較前後的肺功能)，可能是因為air-trapping (hyperdynamic compression)。

Pirfendone為anti-fibrotic drug, 針對IPF來治療，目前為phase III trial中。

何時會有UIP的情況？

某次蔡總教練在meeting上分享：

1. NSCLC於第一次診斷時，約有10~20%的病人會有brain mets或是leptomeningeal carcinomatosis。

結果今年內專就考了，果然CV已經進入GDMT (guideline directed management therapy)的時代了。

上複習班時，學長覺得JNC8的參考性較低，而且我也沒看，所以我也沒寫對，所以就把recommendations寫上來吧！

(轉錄自uptodate; FROM UPTODATE-MODES OF MECHANICAL VENTILATOR)

CONTINUOUS POSITIVE AIRWAY PRESSURE — Continuous positive airway pressure (CPAP) refers to the delivery of a continuous level of positive airway pressure (持續給予呼吸道正壓). It is functionally similar to PEEP (基本上有點像PEEP). The ventilator does not cycle during CPAP, no additional pressure above the level of CPAP is provided, and patients must initiate all breaths (病人需啟始所有呼吸).

(from uptodate-modes of mechanical ventilator)

PRESSURE-LIMITED VENTILATION — Pressure-limited ventilation (also called pressure-cycled ventilation)需要設定inspiratory pressure level, I:E ratio, respiratory rate, applied PEEP, and FiO₂ 。吸氣停止於delivery of the set inspiratory pressure後。

(from uptodate-Modes of mechanical ventilation)

Volume-limited ventilation (also called volume-controlled or volume-cycled ventilation)

(引用自Uptodate-Overview of mechanical ventilation)

PEEP 

From FDA, Olmesartan would induce sprue-like enteropathy. The clinical symptoms/signs are long-term sever diarrhea combined with decreased body weight. The condition would be relieved if stopping this medication.

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