[Bronchogenic carcinoma after lung transplantation: a case report and literature review]

Extracorporeal membrane oxygenation (ECMO) for acute exacerbations of chronic obstructive pulmonary disease: care modalities, experience, and precautions

PURPOSE

The aim of this study was to summarize the care modalities, experiences, and corresponding precautions of ECMO for acute exacerbations of chronic obstructive pulmonary disease (COPD).

METHODS

Seventy-three patients with acute exacerbations of COPD were enrolled, of whom 38 were treated with ECMO (experimental group) and 35 received conventional low-flow oxygen therapy, management of metabolic acidosis, infection control, bronchodilators for quick relief from severe spasms, and glucocorticoid-mediated suppression of inflammation (control group). The improvement in the patient's pulmonary ventilation and the incidence of complications were recorded.

RESULTS

PaCO₂ is lower in patients using ECMO, FEV1, FEV1/FVC, and FEV1% are significantly higher in the experimental group than in the control group, and the respiratory rate, heart rate, and CO₂ saturation are significantly lower in patients in the experimental group (i.e., the experimental group) after oxygenation than in the control group, pH and O₂ saturation are significantly higher in experimental group than in the control group, and the incidence of complications in experimental group is significantly higher than in the control group.

CONCLUSION

ECMO significantly improves gas exchange in patients, but also increases the incidence of complications with the extension of usage, so the duration of ECMO support should be monitored and the complications should be prevented.

Is pimecrolimus cream (1%) an appropriate therapeutic agent for the treatment of external ear atopic dermatitis?

Background

In recent years, pimecrolimus 1% cream has been demonstrated to reduce symptoms of atopic dermatitis in patients when applied topically.

Material/Methods

In our study we compared the therapeutic effects of local 1% pimecrolimus to 1% hydrocortisone, and to a control group in a mouse model with atopic dermatitis in the external ear canals. Atopic dermatitis was created by application of Dinitrochlorobenzene in the external ear canals of mice. The development of atopic dermatitis was detected by clinical observation score and determination of total serum IgE levels. Pimecrolimus and hydrocortisone cream were topically applied to the external ear canal skin once a day for 14 days.

Results

There was no significant difference between the hydrocortisone and the pimecrolimus therapy groups, while there was a statistically significant difference between these 2 groups and the control group (p<0.05) Assessment of the clinical observation scoring carried out on the 14th day of therapy revealed that there was no difference between the hydrocortisone and pimecrolimus groups. Biopsies were taken on the 14^th day following treatment. Tissue samples were histologically evaluated; contact dermatitis was observed microscopically in the control group, but in the therapy groups only minimal evidence of contact dermatitis was found.

Conclusions

The results of our study reveal that the therapeutic efficacy of 1% pimecrolimus was equivalent to 1% hydrocortisone treatment in the artificially developed atopic dermatitis model in external ear canals of mice. These results clearly demonstrate that 1% pimecrolimus cream can be an effective alternative therapeutic agent in cases where steroid treatment proves to be insufficient or in cases where treatment must be discontinued due to its adverse effects.