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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/28315586/sucralfate-versus-histamine-2-receptor-antagonists-for-stress-ulcer-prophylaxis-in-adult-critically-ill-patients-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#1
Mustafa Alquraini, Fayez Alshamsi, Morten Hylander Møller, Emilie Belley-Cote, Saleh Almenawer, Roman Jaeschke, Robert MacLaren, Waleed Alhazzani
PURPOSE: To determine the impact of using sucralfate versus H2RAs for SUP on patient important outcomes. MATERIALS AND METHODS: We searched CENTRAL, MEDLINE, EMBASE, ACPJC, clinical trials registries, and conference proceedings through June 2016 for randomized controlled trials (RCTs) comparing sucralfate to H2RAs for SUP in adult critically ill patients. RESULTS: 21 RCTs enrolling 3121 patients met inclusion criteria. There was no significant difference between sucralfate compared to H2RAs in the risk of clinically important GI bleeding (risk ratio [RR] 1...
March 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#2
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28301676/deprescribing-versus-continuation-of-chronic-proton-pump-inhibitor-use-in-adults
#3
REVIEW
Taline A Boghossian, Farah Joy Rashid, Wade Thompson, Vivian Welch, Paul Moayyedi, Carlos Rojas-Fernandez, Kevin Pottie, Barbara Farrell
BACKGROUND: Proton pump inhibitors (PPIs) are a class of medications that reduce acid secretion and are used for treating many conditions such as gastroesophageal reflux disease (GERD), dyspepsia, reflux esophagitis, peptic ulcer disease, and hypersecretory conditions (e.g. Zollinger-Ellison syndrome), and as part of the eradication therapy for Helicobacter pylori bacteria. However, approximately 25% to 70% of people are prescribed a PPI inappropriately. Chronic PPI use without reassessment contributes to polypharmacy and puts people at risk of experiencing drug interactions and adverse events (e...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#4
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28292280/the-impact-of-community-acquired-pneumonia-on-the-health-related-quality-of-life-in-elderly
#5
Marie-Josée J Mangen, Susanne M Huijts, Marc J M Bonten, G Ardine de Wit
BACKGROUND: The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. METHODS: In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i...
March 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28284468/the-influence-of-tracheostomy-timing-on-outcomes-in-trauma-patients-a-meta-analysis
#6
Shi-Qi Cai, Jun-Wu Hu, Dong Liu, Xiang-Jun Bai, Jie Xie, Jia-Jun Chen, Fan Yang, Tao Liu
OBJECTIVE: This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia. METHOD: A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI). RESULT: 20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group...
February 24, 2017: Injury
https://www.readbyqxmd.com/read/28282701/vitamin-a-supplementation-for-preventing-morbidity-and-mortality-in-children-from-six-months-to-five-years-of-age
#7
REVIEW
Aamer Imdad, Evan Mayo-Wilson, Kurt Herzer, Zulfiqar A Bhutta
BACKGROUND: Vitamin A deficiency (VAD) is a major public health problem in low- and middle-income countries, affecting 190 million children under five years of age and leading to many adverse health consequences, including death. Based on prior evidence and a previous version of this review, the World Health Organization has continued to recommend vitamin A supplementation for children aged 6 to 59 months. There are new data available from recently published randomised trials since the previous publication of this review in 2010, and this update incorporates this information and reviews the evidence...
March 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28273084/vitamin-d-deficiency-predicts-infections-in-young-north-indian-children-a-secondary-data-analysis
#8
Ranadip Chowdhury, Sunita Taneja, Nita Bhandari, Bireshwar Sinha, Ravi Prakash Upadhyay, Maharaj Kishan Bhan, Tor A Strand
BACKGROUND: Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this paper, we examined the extent to which vitamin-D deficiency (<10 ng/ml) predicts ALRI, clinical pneumonia and diarrhea among 6 to 30 months old children. METHODS: We used data from a randomized controlled trial (RCT) of daily folic acid and/or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India...
2017: PloS One
https://www.readbyqxmd.com/read/28267808/gastric-tube-versus-whole-stomach-esophagectomy-for-esophageal-cancer-a-systematic-review-and-meta-analysis
#9
Wenxiong Zhang, Dongliang Yu, Jinhua Peng, Jianjun Xu, Yiping Wei
OBJECTIVES: To conduct a systematic review and meta-analysis of studies comparing the gastric-tube vs. whole-stomach for esophageal cancer in order to determine the optimal surgical technique of esophagectomy. METHODS: A comprehensive literature search was performed using PubMed, EMBASE, ScienceDirect, Ovid MEDLINE, Cochrane Library, Web of Science, Google Scholar, and Scopus. Clinical trials that compared the gastric-tube versus whole-stomach for esophageal cancer were selected...
2017: PloS One
https://www.readbyqxmd.com/read/28249572/efficacy-and-safety-of-de-escalation-therapy-to-ertapenem-for-treatment-of-infections-caused-by-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-an-open-label-randomized-controlled-trial
#10
Pinyo Rattanaumpawan, Peerawong Werarak, Anupop Jitmuang, Pattarachai Kiratisin, Visanu Thamlikitkul
BACKGROUND: Carbapenem antibiotics are considered the treatment of choice for serious extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria (GNB) infections. The study objectives were to evaluate efficacy and safety of de-escalation therapy to ertapenem for treatment of infections caused by extended-spectrum-β-lactamase-producing Enterobacteriaceae. METHODS: We conducted a randomized controlled trial of adult patients with documented ESBL-producing Enterobacteriaceae infections who had received any group 2 carbapenem for less than 96 h...
March 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28243749/sivelestat-sodium-and-mortality-in-pneumonia-patients-requiring-mechanical-ventilation-propensity-score-analysis-of-a-japanese-nationwide-database
#11
Miwa Kishimoto, Hayato Yamana, Satoki Inoue, Tatsuya Noda, Tomoya Myojin, Hiroki Matsui, Hideo Yasunaga, Masahiko Kawaguchi, Tomoaki Imamura
PURPOSE: Sivelestat is widely used in Japan for the treatment of acute respiratory distress syndrome caused by pneumonia. Although the efficacy of sivelestat was reported in several Japanese studies in the early 2000 s, a multinational randomized control trial did not support these findings. We therefore conducted the present study to examine the association between the use of sivelestat and mortality in pneumonia patients requiring mechanical ventilation. METHODS: We conducted a retrospective observational study using the Diagnosis Procedure Combination database, a national inpatient database in Japan...
February 27, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28229893/safety-and-efficacy-of-natalizumab-in-patients-with-acute-ischaemic-stroke-action-a-randomised-placebo-controlled-double-blind-phase-2-trial
#12
Jacob Elkins, Roland Veltkamp, Joan Montaner, S Claiborne Johnston, Aneesh B Singhal, Kyra Becker, Maarten G Lansberg, Weihua Tang, Ih Chang, Kumar Muralidharan, Sarah Gheuens, Lahar Mehta, Mitchell S V Elkind
BACKGROUND: In animal models of acute ischaemic stroke, blocking of the leukocyte-endothelium adhesion by antagonism of α4 integrin reduces infarct volumes and improves outcomes. We assessed the effect of one dose of natalizumab, an antibody against the leukocyte adhesion molecule α4 integrin, in patients with acute ischaemic stroke. METHODS: In this double-blind, phase 2 study, patients with acute ischaemic stroke (aged 18-85 years) from 30 US and European clinical sites were randomly assigned (1:1) to 300 mg intravenous natalizumab or placebo with stratification by treatment window and baseline infarct size...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28228106/long-term-treatment-with-ruxolitinib-for-patients-with-myelofibrosis-5-year-update-from-the-randomized-double-blind-placebo-controlled-phase-3-comfort-i-trial
#13
Srdan Verstovsek, Ruben A Mesa, Jason Gotlib, Vikas Gupta, John F DiPersio, John V Catalano, Michael W N Deininger, Carole B Miller, Richard T Silver, Moshe Talpaz, Elliott F Winton, Jimmie H Harvey, Murat O Arcasoy, Elizabeth O Hexner, Roger M Lyons, Ronald Paquette, Azra Raza, Mark Jones, Deanna Kornacki, Kang Sun, Hagop Kantarjian
BACKGROUND: The randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial evaluated the JAK1/JAK2 inhibitor ruxolitinib in patients with intermediate-2/high-risk myelofibrosis. The primary and planned 3-year analyses of COMFORT-I data demonstrated that ruxolitinib-the first myelofibrosis-approved therapy-reduced splenomegaly and prolonged overall survival versus placebo. Here, we present the final 5-year results. METHODS: Patients managed in Australia, Canada, and the USA were randomized centrally (interactive voice response system) 1:1 to oral ruxolitinib twice daily (15 or 20 mg per baseline platelet counts) or placebo...
February 22, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28221010/high-sensitivity-cardiac-troponin-t-predicts-mortality-after-hospitalization-for-community-acquired-pneumonia
#14
Stefan M T Vestjens, Simone M C Spoorenberg, Ger T Rijkers, Jan C Grutters, Jurriën M Ten Berg, Peter G Noordzij, Ewoudt M W Van de Garde, Willem Jan W Bos
BACKGROUND AND OBJECTIVE: Mortality after hospitalization with community-acquired pneumonia (CAP) is high, compared with age-matched controls. Available evidence suggests a strong link with cardiovascular disease. Our aim was to explore the prognostic value of high-sensitivity cardiac troponin T (cTnT) for mortality in patients hospitalized with CAP. METHODS: CTnT level on admission was measured (assay conducted in 2015) in 295 patients hospitalized with CAP who participated in a randomized placebo-controlled double-blind trial on adjunctive dexamethasone treatment...
February 21, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28203436/chest-physiotherapy-in-mechanically-ventilated-patients-without-pneumonia-a-narrative-review
#15
REVIEW
Herbert D Spapen, Jouke De Regt, Patrick M Honoré
A beneficial adjuvant role of chest physiotherapy (CPT) to promote airway clearance, alveolar recruitment, and ventilation/perfusion matching in mechanically ventilated (MV) patients with pneumonia or relapsing lung atelectasis is commonly accepted. However, doubt prevails regarding the usefulness of applying routine CPT in MV subjects with no such lung diseases. In-depth narrative review based on a literature search for prospective randomized trials comparing CPT with a non-CPT strategy in adult patients ventilated for at least 48 h...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28182741/etiology-of-severe-pneumonia-in-ecuadorian-children
#16
Sivani Jonnalagadda, Oswaldo Rodríguez, Bertha Estrella, Lora L Sabin, Fernando Sempértegui, Davidson H Hamer
BACKGROUND: In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. METHODS: This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction...
2017: PloS One
https://www.readbyqxmd.com/read/28169243/efficacy-of-compound-kushen-injection-plus-radiotherapy-on-nonsmall-cell-lungcancer-a-systematic-review-and-meta-analysis
#17
REVIEW
Shanshan Wang, Xiaobo Lian, Miaomiao Sun, Lei Luo, Lizhong Guo
OBJECTIVE: To evaluate the benefits of compound Kushen injection (CKI) combined with radiotherapy for nonsmall cell lung cancer. MATERIALS AND METHODS: We searched nine electronic databases and six gray literature databases comprehensively until June 2015. Two reviewers independently selected and assessed the included trials according to the inclusion and exclusion criteria. The risk of bias tool from the Cochrane Handbook version 5.1.0, the Review Manager 5.3 software was employed for data analysis...
October 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28157810/bayes-to-the-rescue-continuous-positive-airway-pressure-has-less-mortality-than-high-flow-oxygen
#18
Vicent Modesto I Alapont, Robinder G Khemani, Alberto Medina, Pablo Del Villar Guerra, Alfred Molina Cambra
OBJECTIVES: The merits of high-flow nasal cannula oxygen versus bubble continuous positive airway pressure are debated in children with pneumonia, with suggestions that randomized controlled trials are needed. In light of a previous randomized controlled trial showing a trend for lower mortality with bubble continuous positive airway pressure, we sought to determine the probability that a new randomized controlled trial would find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure through a "robust" Bayesian analysis...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28143414/impact-of-oral-hygiene-involving-toothbrushing-versus-chlorhexidine-in-the-prevention-of-ventilator-associated-pneumonia-a-randomized-study
#19
Claudia Fernanda de Lacerda Vidal, Aurora Karla de Lacerda Vidal, José Gildo de Moura Monteiro, Aracele Cavalcanti, Ana Paula Trindade Henriques, Márcia Oliveira, Michele Godoy, Mirella Coutinho, Pollyanna Dutra Sobral, Claudia Ângela Vilela, Bárbara Gomes, Marta Amorim Leandro, Ulisses Montarroyos, Ricardo de Alencar Ximenes, Heloísa Ramos Lacerda
BACKGROUND: Nosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP). METHODS: The study design was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilatior-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0...
January 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28139405/idelalisib-or-placebo-in-combination-with-bendamustine-and-rituximab-in-patients-with-relapsed-or-refractory-chronic-lymphocytic-leukaemia-interim-results-from-a-phase-3-randomised-double-blind-placebo-controlled-trial
#20
Andrew D Zelenetz, Jacqueline C Barrientos, Jennifer R Brown, Bertrand Coiffier, Julio Delgado, Miklós Egyed, Paolo Ghia, Árpád Illés, Wojciech Jurczak, Paula Marlton, Marco Montillo, Franck Morschhauser, Alexander S Pristupa, Tadeusz Robak, Jeff P Sharman, David Simpson, Lukáš Smolej, Eugen Tausch, Adeboye H Adewoye, Lyndah K Dreiling, Yeonhee Kim, Stephan Stilgenbauer, Peter Hillmen
BACKGROUND: Bendamustine plus rituximab is a standard of care for the management of patients with relapsed or refractory chronic lymphocytic leukaemia. New therapies are needed to improve clinically relevant outcomes in these patients. We assessed the efficacy and safety of adding idelalisib, a first-in-class targeted phosphoinositide-3-kinase δ inhibitor, to bendamustine plus rituximab in this population. METHODS: For this international, multicentre, double-blind, placebo-controlled trial, adult patients (≥18 years) with relapsed or refractory chronic lymphocytic leukaemia requiring treatment who had measurable lymphadenopathy by CT or MRI and disease progression within 36 months since their last previous therapy were enrolled...
January 27, 2017: Lancet Oncology
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