Sheldon R. Braun

Low-dose radiation pneumonitis

A case demonstrating fulminant radiation pneumonitis following a course of prophylactic whole lung irradiation at doses below 2000 rads, resulting in death, is presented. The importance of predisposing factors and the suspected “sensitizing” factor in this case are discussed.

Exercise training in patients with COPD.

Exercise is a useful therapeutic intervention for many COPD patients. The progressive stress test is the single most important means of clinical evaluation, although a thorough physical examination and preexercise ECG are also mandatory. The exercise program is prescribed according to duration of exercise and the maximal load reached by the patient during testing. As tolerance builds, exercise time, speed, and grade level are increased. Patients who exercise routinely should be watched carefully for problems, such as hypoxia, hypertension, abnormal right-sided cardiac function, and air tapping. Supplemental oxygen is required for those who are hypoxic.