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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/27912161/a-prospective-randomized-trial-of-tapered-cuff-endotracheal-tubes-with-intermittent-subglottic-suctioning-in-preventing-ventilator-associated-pneumonia-in-critically-ill-patients
#1
Ata Mahmoodpoor, Hadi Hamishehkar, Masoud Hamidi, Kamran Shadvar, Sarvin Sanaie, Samad Ej Golzari, Zahid Hussain Khan, Nader D Nader
BACKGROUND: Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube)...
November 14, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#2
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation-case-series-and-literature-review
#3
Minhyeok Lee, Seulgi Kim, Oh Jung Kwon, Ji Hye Kim, Inbeom Jeong, Ji Woong Son, Moon Jun Na, Yoo Sang Yoon, Hyun Woong Park, Sun Jung Kwon
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir...
November 30, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27895845/a-trial-of-a-7-valent-pneumococcal-conjugate-vaccine-in-hiv-infected-adults
#4
Neil French, Stephen B Gordon, Thandie Mwalukomo, Sarah A White, Gershom Mwafulirwa, Herbert Longwe, Martin Mwaiponya, Eduard E Zijlstra, Malcolm E Molyneux, Charles F Gilks
BACKGROUND: Streptococcus pneumoniae is a leading and serious coinfection in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. Prevention of this disease by vaccination with the current 23-valent polysaccharide vaccine is suboptimal. Protein conjugate vaccines offer a further option for protection, but data on their clinical efficacy in adults are needed. METHODS: In this double-blind, randomized, placebo-controlled clinical efficacy trial, we studied the efficacy of a 7-valent conjugate pneumococcal vaccine in predominantly HIV-infected Malawian adolescents and adults who had recovered from documented invasive pneumococcal disease...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27895134/vancomycin-and-the-risk-of-aki-a-systematic-review-and-meta-analysis
#5
Abhisekh Sinha Ray, Ammar Haikal, Kassem A Hammoud, Alan S L Yu
BACKGROUND AND OBJECTIVES: Vancomycin has been in use for more than half a century, but whether it is truly nephrotoxic and to what extent are still highly controversial. The objective of this study was to determine the risk of AKI attributable to intravenous vancomycin. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a systematic review of randomized, controlled trials and cohort studies that compared patients treated with intravenous vancomycin with a control group of patients given a comparator nonglycopeptide antibiotic and in which kidney function or kidney injury outcomes were reported...
November 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27894280/is-there-any-association-between-sarcoidosis-and-infectious-agents-a-systematic-review-and-meta-analysis
#6
Tiago Esteves, Gloria Aparicio, Vicente Garcia-Patos
BACKGROUND: During the last few years, investigators have debated the role that infectious agents may have in sarcoidosis pathogenesis. With the emergence of new molecular biology techniques, several studies have been conducted; therefore, we performed a meta-analysis in order to better explain this possible association. METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from the Cochrane collaboration guidelines...
November 28, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27893689/a-new-method-for-insertion-of-long-intestinal-tube-for-small-bowel-obstruction-nonendoscopic-over-the-wire-method-via-short-nasogastric-tube
#7
Kazuma Sekiba, Tomoya Ohmae, Nariaki Odawara, Makoto Moriyama, Sachiko Kanai, Mayo Tsuboi, Tomotaka Saito, Koji Uchino, Masatoshi Akamatsu, Makoto Okamoto
It is often difficult to insert a long intestinal tube (LT) in patients with small bowel obstruction (SBO). We developed a novel technique for inserting an LT without endoscopy called nonendoscopic over-the-wire method via short nasogastric tube (NEWSt). We evaluated the efficacy and safety of NEWSt.We performed a retrospective study of patients who underwent LT insertion for SBO without any indications of strangulation with either NEWSt (n = 16) or endoscopy (n = 17) between November 2011 and February 2015 at our hospital...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27890714/a-randomized-trial-of-the-amikacin-fosfomycin-inhalation-system-for-the-adjunctive-therapy-of-gram-negative-ventilator-associated-pneumonia-iasis-trial
#8
Marin H Kollef, Jean-Damien Ricard, Damien Roux, Bruno Francois, Eleni Ischaki, Zsolt Rozgonyi, Thierry Boulain, Zsolt Ivanyi, Gál János, Denis Garot, Firas Koura, Epaminondas Zakynthinos, George Dimopoulos, Antonio Torres, Wayne Danker, A Bruce Montgomery
BACKGROUND: Clinical failures in ventilator-associated pneumonia (VAP) caused by Gram-negative bacteria are common and associated with substantial morbidity, mortality, and resource utilization. METHODS: We assessed the safety and efficacy of the amikacin fosfomycin inhalation system (AFIS) for the treatment of Gram-negative bacterial VAP in a randomized double-blind, placebo-controlled, parallel group, phase 2 study between May 2013 and March 2016. We compared standard of care in each arm plus 300 mg amikacin/120 mg fosfomycin or placebo (saline), delivered by aerosol twice daily for 10 days (or to extubation if <10 days) via the investigational eFlow Inline System (PARI GmbH, Germany)...
November 24, 2016: Chest
https://www.readbyqxmd.com/read/27889723/vitamin-d-supplementation-for-treatment-and-prevention-of-pneumonia-in-under-five-children-a-randomized-double-blind-placebo-controlled-trial
#9
Piyush Gupta, Pooja Dewan, Dheeraj Shah, Nisha Sharma, Nidhi Bedi, Iqbal R Kaur, Ajay Kumar Bansal, S V Madhu
OBJECTIVE: To evaluate the efficacy of single oral mega-dose of Vitamin D3 for treatment and prevention of pneumonia in under-five children. DESIGN: Randomized, double blind, placebo-controlled trial. SETTING: Tertiary-care hospital. PARTICIPANTS: 324 children (of 980 assessed) between 6 mo-5 y age (median (IQR): 12 (7,19.8) mo) with WHO-defined severe pneumonia. Of these, 126 (39%) were vitamin D deficient (serum 25(OH)D <12 ng/mL)...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27884765/efficacy-of-clarithromycin-naproxen-oseltamivir-combination-in-the-treatment-of-patients-hospitalized-for-influenza-a-h3n2-infection-an-open-label-randomized-controlled-phase-2b-3-trial
#10
Ivan Fn Hung, Kelvin Kw To, Jasper Fw Chan, Vincent Cc Cheng, Kevin Sh Liu, Anthony Tam, Tuen-Ching Chan, Anna Jinxia Zhang, Patrick Li, Tin-Lun Wong, Ricky Zhang, Michael Ks Cheung, William Leung, Johnson Yn Lau, Manson Fok, Honglin Chen, Kwok-Hung Chan, Kwok-Yung Yuen
BACKGROUND: Influenza causes excessive hospitalizations and deaths. Single agent treatment with oseltamivir in severe influenza might be insufficient. The study assessed the efficacy and safety of oseltamivir-clarithromycin-naproxen combination for treatment of serious influenza. METHODS: From February to April 2015, we conducted a prospective open-label randomized-controlled trial. Adult patients hospitalized for A(H3N2) influenza were randomly assigned to a 2-day combination of clarithromycin 500mg, naproxen 200mg and oseltamivir 75mg twice daily, followed by 3 days of oseltamivir; or oseltamivir 75mg twice daily without placebos for 5 days as control (1:1)...
November 21, 2016: Chest
https://www.readbyqxmd.com/read/27864038/a-systematic-review-with-meta-analysis-of-fluticasone-furoate-vilanterol-combination-for-the-treatment-of-stable-copd
#11
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Current guidelines recommend the use of inhaled corticosteroids/long-acting beta2-agonists as first-line therapy for COPD patients at risk for acute exacerbations and/or severe airflow limitation. This systematic review assesses available evidence on the efficacy and safety of fluticasone furoate/vilanterol (FF/VI) combination versus each alone, for the treatment of patients with severe to very severe stable COPD. METHODS: Randomized, placebo-controlled trials of >8 weeks of duration were included...
November 15, 2016: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27856954/coolist-cooling-for-ischemic-stroke-trial-a-multicenter-open-randomized-phase-ii-clinical-trial
#12
Marjolein Geurts, Jesper Petersson, Marco Brizzi, Stefan Olsson-Hau, Gert-Jan Luijckx, Ale Algra, Diederik W J Dippel, L Jaap Kappelle, H Bart van der Worp
BACKGROUND AND PURPOSE: Animal studies suggest that cooling improves outcome after ischemic stroke. We assessed the feasibility and safety of surface cooling to different target temperatures in awake patients with acute ischemic stroke. METHODS: A multicenter, randomized, open, phase II, clinical trial, comparing standard treatment with surface cooling to 34.0°C, 34.5°C, or 35.0°C in awake patients with acute ischemic stroke and an National Institutes of Health Stroke Scale score of ≥6, initiated within 4...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27846240/efficacy-and-safety-of-adjunctive-corticosteroids-therapy-for-severe-community-acquired-pneumonia-in-adults-an-updated-systematic-review-and-meta-analysis
#13
Jirui Bi, Jin Yang, Ying Wang, Cijiang Yao, Jing Mei, Ying Liu, Jiyu Cao, Youjin Lu
BACKGROUND: Adjunctive corticosteroids therapy is an attractive option for community-acquired pneumonia (CAP) treatment. However, the effectiveness of adjunctive corticosteroids on mortality of CAP remains inconsistent, especially in severe CAP. We performed a meta-analysis to evaluate the efficacy and safety of adjunctive corticosteroids in severe CAP patients. METHODS: Three databases of PubMed, EMBASE and Cochrane Library were searched for related studies published in English up to December, 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27836310/effects-of-perioperative-supplementation-with-pro-synbiotics-on-clinical-outcomes-in-surgical-patients-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#14
Xiang-Dong Wu, Meng-Meng Liu, Xi Liang, Ning Hu, Wei Huang
BACKGROUND & AIMS: The Potential benefits and possible risks of perioperative supplementation with probiotics/synbiotics in surgical patients are not fully understood. Recent evidence has rapidly evolved and conveys conflicting results. Thus, we undertook a meta-analysis of randomized controlled trials (RCTs) to valuate the effectiveness, safety, cost-effectiveness and quality of life of perioperative supplementation with pro-/synbiotics. METHODS: We systematically searched PubMed, Embase and the Cochrane Library through October 2015 to identify RCTs that assessed the effects of perioperative supplementation with pro-/synbiotics in surgical patients...
October 26, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27826955/vitamin-d-supplementation-for-preventing-infections-in-children-under-five-years-of-age
#15
REVIEW
Mohammad Y Yakoob, Rehana A Salam, Farhan R Khan, Zulfiqar A Bhutta
BACKGROUND: Vitamin D is a micronutrient important for bone growth and immune function. Deficiency can lead to rickets and has been linked to various infections, including respiratory infections. The evidence on the effects of supplementation on infections in children has not been assessed systematically. OBJECTIVES: To evaluate the role of vitamin D supplementation in preventing pneumonia, tuberculosis (TB), diarrhoea, and malaria in children under five years of age...
November 9, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27814776/lower-versus-higher-dose-of-enteral-caloric-intake-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis
#16
Hasan M Al-Dorzi, Abdullah Albarrak, Mazen Ferwana, Mohammad Hassan Murad, Yaseen M Arabi
BACKGROUND: There is conflicting evidence about the relationship between the dose of enteral caloric intake and survival in critically ill patients. The objective of this systematic review and meta-analysis is to compare the effect of lower versus higher dose of enteral caloric intake in adult critically ill patients on outcome. METHODS: We reviewed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from inception through November 2015...
November 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27811559/rib-fractures-in-trauma-patients-does-operative-fixation-improve-outcome
#17
Peter Majak, Pål A Næss
PURPOSE OF REVIEW: Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. RECENT FINDINGS: Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27809338/cost-effectiveness-of-histamine2-receptor-antagonists-versus-proton-pump-inhibitors-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#18
Drayton A Hammond, Niranjan Kathe, Anuj Shah, Bradley C Martin
STUDY OBJECTIVE: To determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (H2RA) versus proton pump inhibitors (PPI) in critically ill and mechanically ventilated adults. DESIGN: A decision analytic model estimating the costs and effectiveness of stress ulcer prophylaxis (with H2RAs and PPIs) from a health care institutional perspective. PATIENTS: Adult, mixed intensive care unit (ICU) population who received an H2RA or PPI for up to 9 days...
November 3, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27807279/design-and-implementation-of-pharyngeal-electrical-stimulation-for-early-de-cannulation-in-tracheotomized-phast-trac-stroke-patients-with-neurogenic-dysphagia-a-prospective-randomized-single-blinded-interventional-study
#19
Rainer Dziewas, Satish Mistry, Shaheen Hamdy, Jens Minnerup, Ingeborg Van Der Tweel, Wolf Schäbitz, Philip M Bath
RATIONALE: Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) of tracheotomized dysphagic stroke patients regained sufficient control of airway management allowing tracheotomy tube removal (decannulation) 24-72 h after pharyngeal electrical stimulation (PES) compared to controls who received standard therapy over the same time period (20%)...
November 2, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27796647/clinical-outcomes-of-extended-versus-intermittent-administration-of-piperacillin-tazobactam-for-the-treatment-of-hospital-acquired-pneumonia-a-randomized-controlled-trial
#20
H Bao, Y Lv, D Wang, J Xue, Z Yan
The purpose of this study was to assess the pharmacokinetic (PK) characteristics, clinical efficiency, and pharmacoeconomic parameters of piperacillin/tazobactam administered by extended infusion (EI) or intermittent infusion (II) in the treatment of hospital-acquired pneumonia (HAP) in critically ill patients with low illness severity in China. Fifty patients completed the study, with 25 patients receiving 4/0.5 g piperacillin/tazobactam over 30 min as the II group and 25 patients receiving 4/0.5 g piperacillin/tazobactam over 3 h every 6 h as the EI group...
October 28, 2016: European Journal of Clinical Microbiology & Infectious Diseases
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