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除染廃棄物の焼却灰 容積減らす新施設完成

福島県内の除染廃棄物を燃やして出る、汚染の程度が高い灰の容積を減らすための新しい施設が、福島第一原発の周辺にある中間貯蔵施設の用地に完成しました。

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Management of invasive aspergillosis in patients with COPD: rational use of voriconazole.

著者 Ader F , Bienvenu AL , Rammaert B , Nseir S この記事をPubMed上で見るPubMedで表示
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Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de La Croix-Rousse, Lyon, France. florence.ader@univ-lyon1.fr

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Invasive pulmonary aspergillosis (IPA) is an important cause of mortality in patients with hematologic malignancies. The reported incidence of IPA in the context of chronic obstructive pulmonary disease (COPD) seems to increase. Approximately 1%-2% of overall fatal cases of IPA occur in COPD patients. The combination of factors such as lung immune imbalance, long-term corticosteroid use, increasing rate of bacterial exacerbations over time, and malnutrition are responsible for the emergence of IPA in these patients. The diagnosis of IPA is difficult to establish, which explains the delay in implementing accurate antifungal therapy and the high mortality rate. Persistent pneumonia nonresponsive to appropriate antibiotic treatment raises the concern of an invasive fungal infection. Definite diagnosis is obtained from tissue biopsy evidencing Aspergillus spp. on microscopic examination or in culture. Culture and microscopy of respiratory tract samples have a sensitivity and specificity of around 50%. Other diagnostic tools can be useful in documenting IPA: computed tomography (CT) scan, nonculture-based tests in serum and/or in bronchoalveolar lavage such as antibody/antigen tests for Aspergillus spp. More recent tools such as polymerase chain reaction or [1-->3]-beta-D-glucan have predictive values that need to be further investigated in COPD patients. Antifungal monotherapy using azole voriconazole is recommended as a first-line treatment of IPA. This review assesses the use of voriconazole in COPD patients.
PMID: 19684861 [PubMed - indexed for MEDLINE]
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