一個呼吸的距離

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)。
6MWT希望HR reversibiltiy在80%以上，但大多只有50~60%

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？
1. IPF
2. chronic HP

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。
2. 若接受whole brain R/T，則可以延長2~5個月。
3. brain MRI有67%較容易detect。

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！
Recommendation 1
大於等於60歲，SBP大於等於150 mmHg或DBP大於等於90 mmHg時，可給予藥物治療。目標是SBP/DBP小於150/90 mmHg. (Strong Recommendation – Grade A)

(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。
潮氣容積(tidal volume)在pressure-limited ventilation是變動的。它與inspiratory pressure level, compliance, airway resistance, and tubing resistance有關。Specifically, tidal volumes會變大：當the set inspiratory pressure level is high 或 there is good compliance, little airway resistance, or little resistance from the ventilator tubing.

(from uptodate-Modes of mechanical ventilation)
Volume-limited ventilation (also called volume-controlled or volume-cycled ventilation)
1. 需要設 peak flow rate, flow pattern, tidal volume, respiratory rate, positive end-expiratory pressure (applied PEEP), & FiO2

(引用自Uptodate-Overview of mechanical ventilation)
PEEP 
1. PEEP可以減少肺泡collapse。一開始我們可以用5cmH2O。如果遇到ARDS的病人，可以用超過20cm H2O。

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.
From:
http://www.ncbi.nlm.nih.gov/pubmed/22728033