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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/28730887/a-systematic-review-and-meta-analysis-of-pneumonia-associated-with-thin-liquid-vs-thickened-liquid-intake-in-patients-who-aspirate
#1
Asako Kaneoka, Jessica M Pisegna, Hiroki Saito, Melody Lo, Katey Felling, Nobuhiko Haga, Michael P LaValley, Susan E Langmore
OBJECTIVE: To investigate whether drinking thin liquids with safety strategies increases the risk for pneumonia as compared with thickened liquids in patients who have demonstrated aspiration of thin liquids. DATA SOURCES: Seven electronic databases, one clinical register, and three conference archives were searched. No language or publication date restrictions were imposed. Reference lists were scanned and authors and experts in the field were contacted. REVIEW METHODS: A blind review was performed by two reviewers for published or unpublished randomized controlled trials and prospective non-randomized trials comparing the incidence of pneumonia with intake of thin liquids plus safety strategies vs...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28729019/safety-reactogenicity-and-immunogenicity-of-two-investigational-pneumococcal-protein-based-vaccines-results-from-a-randomized-phase-ii-study-in-infants
#2
Roman Prymula, Leszek Szenborn, Sven-Arne Silfverdal, Jacek Wysocki, Piotr Albrecht, Magali Traskine, Asparuh Gardev, Yue Song, Dorota Borys
INTRODUCTION: Vaccination with formulations containing pneumococcal protein antigens such as pneumolysin toxoid (dPly) and histidine-triad protein D (PhtD) may extend serotype-related protection of pneumococcal conjugate vaccines (PCVs) against Streptococcus pneumoniae. METHODS: This phase II, multi-center, observer-blind trial conducted in Europe (NCT01204658) assessed 2 investigational vaccines containing 10 serotype-specific polysaccharide conjugates of PHiD-CV and either 10 or 30µg of dPly and PhtD each...
July 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28722167/assisted-autogenic-drainage-in-infants-and-young-children-hospitalized-with-uncomplicated-pneumonia-a-pilot-study
#3
Lieselotte Corten, Jennifer Jelsma, Anri Human, Sameer Rahim, Brenda M Morrow
BACKGROUND AND PURPOSE: Pneumonia is the most important respiratory problem in low-to-middle income countries. Airway clearance therapy continues to be used in children with pneumonia and secretion retention; however, there is lack of evidence to support or reject this treatment. This study aimed to investigate the feasibility of a randomized controlled trial (RCT) on the efficacy and safety of assisted autogenic drainage (AAD) compared to standard nursing care in children hospitalized with uncomplicated pneumonia...
July 19, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28720674/tracheal-tube-design-and-ventilator-associated-pneumonia
#4
REVIEW
Anahita Rouzé, Emmanuelle Jaillette, Julien Poissy, Sébastien Préau, Saad Nseir
Microaspiration of contaminated oropharyngeal and gastric secretions is the main mechanism for ventilator-associated pneumonia (VAP) in critically ill patients. Improving the performance of tracheal tubes in reducing microaspiration is one potential means to prevent VAP. The aim of this narrative review is to discuss recent findings on the impact of tracheal tube design on VAP prevention. Several randomized controlled studies have reported that subglottic secretion drainage (SSD) is efficient in VAP prevention...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28714745/long-term-use-of-inhaled-corticosteroids-and-risk-of-upper-respiratory-tract-infection-in-chronic-obstructive-pulmonary-disease-a-meta-analysis
#5
Mingjin Yang, Hong Chen, Yan Zhang, Yuejun Du, Ying Xu, Ping Jiang, Zhibo Xu
Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months...
July 17, 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28701844/effect-of-calories-delivered-on-clinical-outcomes-in-critically-ill-patients-systemic-review-and-meta-analysis
#6
Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
INTRODUCTION: International guidelines are promoting early enteral nutrition (EN) as a means of feeding critically ill adult patients to improve clinical outcomes. The question of how much calorie intake is enough to improve the outcomes still remained inconclusive. Therefore, we carried out a meta-analysis to evaluate the effect of low calorie (LC) versus high calorie (HC) delivery on critically ill patients' outcomes. METHODS: We included randomized clinical trials (RCTs) that compared LC EN with or without supplemental parenteral nutrition with HC delivery in this meta-analysis irrespective of the site of nutritional delivery in the gastrointestinal tract...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28685042/comprehensive-review-of-the-evidence-regarding-the-effectiveness-of-community-based-primary-health-care-in-improving-maternal-neonatal-and-child-health-4-child-health-findings
#7
Paul A Freeman, Meike Schleiff, Emma Sacks, Bahie M Rassekh, Sundeep Gupta, Henry B Perry
BACKGROUND: This paper assesses the effectiveness of community-based primary health care (CBPHC) in improving child health beyond the neonatal period. Although there has been an accelerated decline in global under-5 mortality since 2000, mortality rates remain high in much of sub-Saharan Africa and in some south Asian countries where under-5 mortality is also decreasing more slowly. Essential interventions for child health at the community level have been identified. Our review aims to contribute further to this knowledge by examining how strong the evidence is and exploring in greater detail what specific interventions and implementation strategies appear to be effective...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28679413/double-carbapenem-as-a-rescue-strategy-for-the-treatment-of-severe-carbapenemase-producing-klebsiella-pneumoniae-infections-a-two-center-matched-case-control-study
#8
Gennaro De Pascale, Gennaro Martucci, Luca Montini, Giovanna Panarello, Salvatore Lucio Cutuli, Daniele Di Carlo, Valentina Di Gravio, Roberta Di Stefano, Guido Capitanio, Maria Sole Vallecoccia, Piera Polidori, Teresa Spanu, Antonio Arcadipane, Massimo Antonelli
BACKGROUND: Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical impact of such a regimen in critically ill patients. METHODS: This case-control (1:2), observational, two-center study involved critically ill adults with a microbiologically documented CR-Kp invasive infection treated with the DC regimen matched with those receiving a standard treatment (ST) (i...
July 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28669365/incidence-of-pneumonia-in-nursing-home-residents-with-dementia-in-the-netherlands-an-estimation-based-on-three-differently-designed-studies
#9
T P Zomer, T VAN DER Maaden, A B VAN Gageldonk-Lafeber, S C DE Greeff, J T VAN DER Steen, L Verhoef
Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia...
July 3, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28666965/individualizing-duration-of-antibiotic-therapy-in-community-acquired-pneumonia
#10
Stefano Aliberti, Julio Ramirez, Fabio Giuliani, Timothy Wiemken, Giovanni Sotgiu, Sara Tedeschi, Manuela Carugati, Vincenzo Valenti, Marco Marchioni, Marco Camera, Roberto Piro, Manuela Del Forno, Giuseppe Milani, Paola Faverio, Luca Richeldi, Martina Deotto, Massimiliano Villani, Antonio Voza, Eleonora Tobaldini, Mauro Bernardi, Andrea Bellone, Matteo Bassetti, Francesco Blasi
International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration...
June 27, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28655326/treatment-of-severe-hospital-acquired-and-ventilator-associated-pneumonia-a-systematic-review-of-inclusion-and-judgment-criteria-used-in-randomized-controlled-trials
#11
Emmanuel Weiss, Wafa Essaied, Christophe Adrie, Jean-Ralph Zahar, Jean-François Timsit
BACKGROUND: Hospital-acquired and ventilator-associated pneumonia (HAP/VAP) are often selected for randomized clinical trials (RCTs) aiming at new drug approval. Guidelines for the design of such RCTs have been repeatedly updated by regulatory agencies. We hypothesized that large variability in the enrolled populations, the endpoints assessed and the HAP/VAP definition criteria may impact the results of these studies, and addressed this through a systematic review of HAP/VAP RCTs. METHODS: A search (Pubmed-Embase-ICAAC-ECCMID) of all RCTs published between 1994 and 2016 comparing antimicrobial treatment for HAP/VAP in the intensive care unit was conducted...
June 27, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28652535/clinical-application-of-ghrelin-for-chronic-respiratory-failure
#12
Nobuhiro Matsumoto, Hironobu Tsubouchi, Yoshifumi Imazu, Yasuji Arimura, Shigehisa Yanagi, Hirotoshi Iiboshi, Masamitsu Nakazato
Chronic respiratory failure, which is often caused by chronic obstructive pulmonary disease, chronic lower respiratory tract infection, or interstitial pneumonia, often leads to cachexia with disease progression. Patients who have chronic respiratory failure with cachexia exhibit increased morbidity. Although cachectic status is an important clinical problem, there are no effective therapies for cachexia. Ghrelin has various effects, including increasing food intake, attenuating sympathetic nerve activity, inhibiting inflammation, increasing cardiac output, and controlling fat utilization...
2017: Endocrine Journal
https://www.readbyqxmd.com/read/28648859/ceftriaxone-versus-ceftriaxone-plus-a-macrolide-for-community-acquired-pneumonia-in-hospitalized-patients-with-hiv-aids-a-randomized-controlled-trial
#13
Claudia Figueiredo-Mello, Pontus Naucler, Marinella D Negra, Anna S Levin
OBJECTIVES: Evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome when compared with monotherapy with ceftriaxone, in hospitalized patients with HIV/AIDS with community-acquired pneumonia (CAP). METHODS: Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one of two regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (Brazilian Clinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondary outcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation, time to clinical stability and length of hospitalization...
June 22, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28648477/time-to-antibiotics-administration-and-outcome-in-community-acquired-pneumonia-secondary-analysis-of-a-randomized-controlled-trial
#14
Christophe Marti, Gregor John, Daniel Genné, Virginie Prendki, Olivier T Rutschmann, Jérôme Stirnemann, Nicolas Garin
BACKGROUND: The association between early antibiotic administration and outcomes remains controversial in patients hospitalized for community-acquired pneumonia. METHODS: We performed a secondary analysis of a randomized controlled trial comparing two antibiotic treatment strategies for patients hospitalized for moderately severe CAP. The univariate and multivariate associations between time to antibiotic administration (TTA) and time to clinical stability were assessed using a Cox proportional hazard model...
June 22, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28640148/restrictive-versus-liberal-transfusion-strategies-for-red-blood-cell-transfusion-after-hip-or-knee-surgery-a-systematic-review-and-meta-analysis
#15
REVIEW
Tianli Mao, Fuqiang Gao, Jun Han, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: Red blood cell (RBC) transfusions are commonly used in surgical patients, but accompanied by many risks such as metabolic derangement, and allergic and febrile reactions. Indications for transfusion in patients after hip or knee surgery have not been definitively evaluated and remain controversial. We performed a meta-analysis to compare the benefits and harms of restrictive versus liberal transfusion strategies in patients after hip or knee surgery. METHODS: The PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies through September 2015...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639502/rituximab-as-first-line-treatment-for-acquired-thrombotic-thrombocytopenic-purpura
#16
Haifei Chen, Ailin Fu, Jing Wang, Tianqin Wu, Zhengyang Li, Jieqing Tang, Hongshi Shen, Jingjing Zhu, Jie Li, Qian Zhu, Longmei Qing
Objective To investigate the efficacy and safety of rituximab (RTX) as first-line treatment of acquired thrombotic thrombocytopenic purpura (aTTP). Methods Twenty-five patients with acute aTTP and/or severe a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) deficiency were admitted to our centre from April 2009 to March 2015. Fourteen patients received RTX plus standard therapy (plasma exchange and corticosteroids) at acute episodes. Haemoglobin, platelet count, schistocytes, lactate dehydrogenase levels, ADAMTS13 activity and its inhibitors, and the ratio of B lymphocytes in the peripheral blood, were monitored...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28639080/the-use-of-statins-and-risk-of-community-acquired-pneumonia
#17
REVIEW
Mohammed A Batais, Abdur Rahman Khan, Aref A Bin Abdulhak
PURPOSE OF THE REVIEW: Community-acquired pneumonia (CAP) is still associated with a large burden and causes significant morbidity and mortality. Besides universal vaccination and antibiotic treatment, statins as adjunctive therapy may also have a beneficial role in the prevention and treatment of CAP. Our goal from this review is to discuss the epidemiology of CAP, and role of statins as adjunctive therapy in the development of CAP. RECENT FINDINGS: Statins are lipid-lowering medications characterized by their ability to control hypercholesterolemia in addition to other pleiotropic effects that could explain their role in the pathogenesis of CAP...
June 21, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28622199/antifibrotic-drugs-as-treatment-of-nonidiopathic-pulmonary-fibrosis-interstitial-pneumonias-the-time-is-now
#18
Michael Kreuter, Julia Wälscher, Jürgen Behr
PURPOSE OF REVIEW: Therapeutic advances in the management of idiopathic pulmonary fibrosis (IPF) has led to improved outcomes with the use of the antifibrotic agents pirfenidone and nintedanib, with a number of randomized studies demonstrating benefits in slowing disease progression in IPF. However, treatment of other fibrosing interstitial lung diseases (ILD) remains challenging. RECENT FINDINGS: Observational and uncontrolled studies investigating pirfenidone and nintedanib in non-IPF ILDs suggest potential benefits, although the data is weak...
June 15, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#19
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28615010/internet-based-perioperative-exercise-program-in-patients-with-barrett-s-carcinoma-scheduled-for-esophagectomy-ipep-study-a-prospective-randomized-controlled-trial
#20
Daniel Pfirrmann, Suzan Tug, Oana Brosteanu, Matthias Mehdorn, Martin Busse, Peter P Grimminger, Florian Lordick, Torben Glatz, Jens Hoeppner, Hauke Lang, Perikles Simon, Ines Gockel
BACKGROUND: Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy...
June 14, 2017: BMC Cancer
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