Should DBS be instituted earlier in the course of the disease?
Nevertheless, it seems reasonable to hypothesize that optimizing preload will improve outcome, particularly if the strategy is instituted early in the course of illness (e.g. during the first 6 hours after presentation).
A full understanding of the mechanisms that mediate lung injury may permit potential strategies directed at reducing the incidence of VILI-induced MOF to be instituted early in the course of illness.
These results highlight the need for selective non-toxic therapeutic intervention to attenuate cachexia and indicate that such interventions should be instituted early in the course of the disease.
In addition to the lung-protective strategy used in the management of patients with ALI, our data added to the understanding of the effects of mechanical forces in the lung and may permit possible strategies directed at preventing VILI to be instituted early in the course of the disease process.
Although ACEI has been shown to reduce the rate of progression of CKD in both diabetics and non-diabetics, [ 26- 28] and although it is identified that ACEI is more effective when instituted early in the course of the CKD, ACEI treatment prevalence in our cohort of CKD HMO enrollees was poor, as described in other settings [ 29- 31].
Lifestyle modifications, including weight loss, dietary changes, hypertension control, and changes in medication regimens, may provide adequate control of hyperuricemia in some patients, particularly when they are instituted early in the course of disease; they may also result in better control of gout in other patients when combined with drug therapy.
These studies raise the possibility that if aggressive treatment to induce remission is instituted very early in the course of RA, more conservative management strategies may be sufficient to maintain that remission.
Clinical features of leptospirosis are similar to dengue and many other tropical infectious diseases in Sri Lanka; thus early laboratory confirmation of the diagnosis will help guide clinicians to institute appropriate treatment early in the course of the illness and plan appropriate resource allocation, potentially preventing complications and death.
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