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The article offers information that the b-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease study found that metoprolol was associated with a higher risk of severe exacerbation. It also discusses that Metoprolol was linked to a decreased lung function early on in the course of therapy, however these effects were minor and short-lived.

The physiological causes of dyspnea, shortness of breath, are poorly understood and may involve various signals in the nervous system. Studying the causes of dyspnea is difficult because no single stimulus causes the sensation. Dyspnea is often accompanied by a sense that greater muscular effort is required to breathe, due to weakened respiratory muscles or an external stress. Dyspnea may also be caused high levels of carbon dioxide in the blood or, though less likely, low oxygen levels. Receptors in the chest muscles, airways, and lungs may cause dyspnea by detecting muscle stretch, airway distortion, or congestion. The mechanisms of dyspnea probably vary with the underlying disease. Attempts at treating dyspnea include treatment of the underlying disease, strengthening respiratory muscles, various breathing techniques, and administration of opioid drugs.

Provides information on acute respiratory distress syndrome (ARDS). Definition of ARDS; Details on the epidemiology and pathogenesis of the disease; Management of the syndrome.

Instillation into the urinary tract of the bacillus Calmette-Guérin (BCG), a strain of Mycobacterium bovis, is associated only rarely with severe side effects. We report here two cases of culture-proven pulmonary infection due to therapy with BCG. The first patient, who was seropositive for the human immunodeficiency virus, developed bilateral interstitial pneumonitis after instillation of BCG into the bladder. The second patient developed a right-lower-lobe infiltrate and empyema after instillation of BCG into the right renal pelvis. The clinical isolates from these two patients and from a third patient with a psoas abscess following intravesical instillation were analyzed with use of pulsed field gel electrophoresis (PFGE) to resolve chromosomal restriction fragment polymorphisms. The clinical isolates were confirmed to be BCG by comparison with known vaccine strains that differed from M. bovis isolates. We conclude that the potential for subsequent dissemination be considered prior to the intravesical administration of BCG. Analysis with PFGE may be useful for identifying species of the Mycobacterium tuberculosis complex. [ABSTRACT FROM PUBLISHER]