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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/29138583/efficacy-of-intravenous-tigecycline-in-patients-with-acinetobacter-complex-infections-results-from-14-phase-iii-and-phase-iv-clinical-trials
#1
Hal Tucker, Michele Wible, Ashesh Gandhi, Alvaro Quintana
Background: Acinetobacter infections, especially multidrug-resistant (MDR) Acinetobacter infections, are a global health problem. This study aimed to describe clinical outcomes in patients with confirmed Acinetobacter spp. isolates who were treated with tigecycline in randomized clinical trials. Materials and methods: Data from 14 multinational, randomized (open-label or double-blind), and active-controlled (except one) Phase III and IV studies were analyzed using descriptive statistics...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29128525/respiratory-rehabilitation-in-multiple-sclerosis-a-narrative-review-of-rehabilitation-techniques
#2
REVIEW
J Levy, H Prigent, D Bensmail
BACKGROUND: Respiratory disorders in multiple sclerosis (MS) are an important issue. They can occur early during the course of the disease, are associated with the neurological impairment, and can lead to pneumonia and respiratory failure, which are the main causes of death in advanced MS. Prevailing impaired expiratory muscles and cough abilities has been demonstrated in this population and might constitute a specific target for rehabilitation interventions. However, international guidelines lack recommendations regarding respiratory rehabilitation in MS...
November 8, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#3
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29112181/vitamin-d-supplementation-in-respiratory-diseases-evidence-from-rct
#4
Carolien Mathyssen, Ghislaine Gayan-Ramirez, Roger Bouillon, Wim Janssens
Pulmonary diseases are one of the most important causes for morbidity and mortality. Although vitamin D is best known for its role in calcium, phosphorus and bone homeostasis, in the recent years vitamin D has gained attention because of a wide range of extra-skeletal effects including its immunomodulatory and antibacterial potential. Vitamin D deficiency is highly prevalent in chronic pulmonary diseases such as Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis, tuberculosis and asthma and several clinical studies have been conducted investigating the effect of vitamin D supplementation on disease outcomes...
November 2, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29108950/amoxicillin-for-acute-lower-respiratory-tract-infection-in-primary-care-subgroup-analysis-by-bacterial-and-viral-etiology
#5
Robin Bruyndonckx, Beth Stuart, Paul Little, Niel Hens, Margareta Ieven, Christopher C Butler, Theo Verheij, Herman Goossens, Samuel Coenen
OBJECTIVE: We aimed to assess the effects of amoxicillin treatment in adult patients presenting to primary care with a lower respiratory tract infection (LRTI) who are infected with a potential bacterial, viral, or mixed bacterial/viral infection. METHODS: The multicenter randomized controlled trial focused on adults with LRTI not suspected for pneumonia. Patients were randomized to receive either antibiotic (amoxicillin 1g) or placebo three times daily for seven consecutive days using computer-generated random numbers (follow-up 28 days)...
November 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29104871/smoking-gender-and-overweight-are-important-influencing-factors-on-monocytic-hla-dr-before-and-after-major-cancer-surgery
#6
Gunnar Lachmann, Clarissa von Haefen, Johannes Kurth, Fatima Yuerek, Klaus-Dieter Wernecke, Claudia Spies
Background: Monocytic human leukocyte antigen D related (mHLA-DR) is essential for antigen-presentation. Downregulation of mHLA-DR emerged as a general biomarker of impaired immunity seen in patients with sepsis and pneumonia and after major surgery. Influencing factors of mHLA-DR such as age, overweight, diabetes, smoking, and gender remain unclear. Methods: We analyzed 20 patients after esophageal or pancreatic resection of a prospective, randomized, placebo-controlled, double-blind trial (placebo group)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29097339/comparable-outcomes-among-trial-and-non-trial-participants-in-a-clinical-trial-of-antibiotics-for-childhood-pneumonia-a-retrospective-cohort-study
#7
Ambrose Agweyu, Jacquie Oliwa, David Gathara, Naomi Muinga, Elizabeth Allen, Richard J Lilford, Mike English
OBJECTIVE: We compared characteristics and outcomes of children enrolled in a randomized controlled trial (RCT) comparing oral amoxicillin and benzyl penicillin for the treatment of chest indrawing pneumonia versus children who received routine care to determine the external validity of the trial results. STUDY DESIGN AND SETTING: We undertook a retrospective cohort study of children aged 2 - 59 months admitted in six Kenyan hospitals. Data for non-trial participants were extracted from inpatient records upon conclusion of the RCT...
October 30, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29066586/mechanical-insufflation-exsufflation-versus-conventional-chest-physiotherapy-in-children-with-cerebral-palsy
#8
Rasintra Siriwat, Jitladda Deerojanawong, Suchada Sritippayawan, Sumalee Hantragool, Prapasri Cheanprapai
BACKGROUND: The cough mechanism is often impaired in children with quadriplegic spastic cerebral palsy, accounting for the high prevalence of pneumonia and atelectasis requiring prolonged hospitalization. Conventional chest physiotherapy (CPT) is a current technique recommended at the onset of lower-respiratory infections in cerebral palsy. Previous studies have demonstrated the usefulness of mechanical insufflation-exsufflation (MI-E) in children with neuromuscular disease. To date, there has been no study of MI-E in children with quadriplegic spastic cerebral palsy...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29062279/probiotics-for-preventing-ventilator-associated-pneumonia-in-mechanically-ventilated-patients-a-meta-analysis-with-trial-sequential-analysis
#9
Hong Weng, Jian-Guo Li, Zhi Mao, Ying Feng, Chao-Yang Wang, Xue-Qun Ren, Xian-Tao Zeng
Background and Objective: Ventilator-associated pneumonia (VAP) is still an important cause of morbidity and mortality in mechanically ventilated patients. The efficacy of the probiotics for preventing VAP is still controversial. Present study was conducted to comprehensively evaluate the effect of probiotics on VAP prevention in mechanically ventilated patients. Methods: PubMed, Embase, and CENTRAL were searched up to September 2016. Eligible trials designed with randomized controlled trials (RCTs) comparing probiotics with control in mechanically ventilated patients were included...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29061311/efficacy-of-high-doses-of-penicillin-versus-amoxicillin-in-the-treatment-of-uncomplicated-community-acquired-pneumonia-in-adults-a-non-inferiority-controlled-clinical-trial
#10
Carl Llor, Almudena Pérez, Eugenia Carandell, Anna García-Sangenís, Javier Rezola, Marian Llorente, Salvador Gestoso, Francesc Bobé, Miguel Román-Rodríguez, Josep M Cots, Silvia Hernández, Jordi Cortés, Marc Miravitlles, Rosa Morros
INTRODUCTION: Community-acquired pneumonia (CAP) is treated with penicillin in some northern European countries. OBJECTIVES: To evaluate whether high-dose penicillin V is as effective as high-dose amoxicillin for the treatment of non-severe CAP. DESIGN: Multicentre, parallel, double-blind, controlled, randomized clinical trial. SETTING: 31 primary care centers in Spain. PARTICIPANTS: Patients from 18 to 75 years of age with no significant associated comorbidity and with symptoms of lower respiratory tract infection and radiological confirmation of CAP were randomized to receive either penicillin V 1...
October 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29059253/a-novel-electronic-algorithm-using-host-biomarker-point-of-care-tests-for-the-management-of-febrile-illnesses-in-tanzanian-children-e-poct-a-randomized-controlled-non-inferiority-trial
#11
RANDOMIZED CONTROLLED TRIAL
Kristina Keitel, Frank Kagoro, Josephine Samaka, John Masimba, Zamzam Said, Hosiana Temba, Tarsis Mlaganile, Willy Sangu, Clotilde Rambaud-Althaus, Alain Gervaix, Blaise Genton, Valérie D'Acremont
BACKGROUND: The management of childhood infections remains inadequate in resource-limited countries, resulting in high mortality and irrational use of antimicrobials. Current disease management tools, such as the Integrated Management of Childhood Illness (IMCI) algorithm, rely solely on clinical signs and have not made use of available point-of-care tests (POCTs) that can help to identify children with severe infections and children in need of antibiotic treatment. e-POCT is a novel electronic algorithm based on current evidence; it guides clinicians through the entire consultation and recommends treatment based on a few clinical signs and POCT results, some performed in all patients (malaria rapid diagnostic test, hemoglobin, oximeter) and others in selected subgroups only (C-reactive protein, procalcitonin, glucometer)...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29050992/the-impact-of-13-valent-pneumococcal-conjugate-vaccination-on-virus-associated-community-acquired-pneumonia-in-elderly
#12
Susanne M Huijts, Frank E J Coenjaerts, Marieke Bolkenbaas, Cornelis H van Werkhoven, Diederick E Grobbee, Marc J M Bonten
OBJECTIVES: Our objective was to evaluate whether vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) prevents the incidence of community-acquired pneumonia (CAP) caused by influenza (Influenza-Associated CAP, IA-CAP) or other respiratory viruses in elderly. METHODS: This analysis was part of the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA); a double blind, randomized, placebo-controlled trial in 84,496 immunocompetent individuals aged ≥65 years...
October 16, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29049353/should-preventive-antibiotics-be-used-in-patients-with-acute-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
REVIEW
Feng Zheng, Niklas von Spreckelsen, Xintong Zhang, Pantelis Stavrinou, Marco Timmer, Christian Dohmen, Roland Goldbrunner, Fang Cao, Qiang Zhang, Qishan Ran, Gang Li, Ruiming Fan, Shengtao Yao, Boris Krischek
BACKGROUND: Infection is a common complication in acute stroke. Whether or not preventive antibiotics reduce the risk of infection or even lead to a favorable outcome and reduction of mortality after a stroke still remains equivocal. This review was performed to update the current knowledge on the effect and possible benefits of prophylactic antibiotic therapy in patients with stroke. METHODS: A systematic review and meta-analysis of preventive antibiotics`effect on the incidence of infection, favorable outcome (mRS≤2) and mortality in patients with acute stroke is performed with relevant randomized controlled trials...
2017: PloS One
https://www.readbyqxmd.com/read/29037481/surgical-outcomes-among-elderly-women-with-endometrial-cancer%C3%A2-treated-by-laparoscopic-hysterectomy-a-nrg-gynecologic-oncology-group-study
#14
Erin A Bishop, James J Java, Kathleen N Moore, Nick M Spirtos, Michael L Pearl, Oliver Zivanovic, David M Kushner, Floor Backes, Chad A Hamilton, Melissa A Geller, Jean Hurteau, Cara Mathews, Robert M Wenham, Pedro T Ramirez, Susan Zweizig, Joan L Walker
OBJECTIVE: Tolerance of and complications caused by minimally invasive hysterectomy and staging in the older endometrial cancer population is largely unknown despite the fact that this is the most rapidly growing age group in the United States. The objective of this retrospective review was to compare operative morbidity by age in patients on the Gynecologic Oncology Group Laparoscopic Surgery or Standard Surgery in Treating Patients With Endometrial Cancer or Cancer of the Uterus (LAP2) trial...
October 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#15
REVIEW
Timothy E Albertson, Susan Murin, Mark E Sutter, James A Chenoweth
The Salford Lung Study (SLS) of patients with asthma and chronic obstructive pulmonary disease (COPD) is a practical, community-based, randomized, open-label pragmatic study on the efficacy and safety of the once-daily dry powder inhaler that combines the inhaled corticosteroid fluticasone furoate (FF) with the long-acting beta2 agonist vilanterol (VI). The asthma component of the SLS is not yet reported but the COPD component, done over a 12-month period, found a statistically significant 8.4% reduction in COPD exacerbations when compared to usual care...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29028980/influenza-among-young-children-in-bangladesh-clinical-characteristics-and-outcomes-from-a-randomized-clinical-trial
#16
Elizabeth Rotrosen, K Zaman, Jodi Feser, Justin R Ortiz, Doli Goswami, Amina Tahia Sharmeen, Mustafizur Rahman, Kristen D C Lewis, Md Ziaur Rahman, Burc Barin, W Abdullah Brooks, Kathleen M Neuzil
Background: Influenza causes substantial morbidity in children worldwide, although influenza vaccine is seldom used in low-resource settings. More information on the clinical presentation of influenza and the efficacy of vaccine is needed to inform policy. Methods: In 2013 we conducted a randomized, placebo-controlled clinical trial of live attenuated influenza vaccine (LAIV) in children aged 24-59 months in Bangladesh (N = 1761). If participants met prespecified specimen collection criteria, we collected nasopharyngeal washes for testing by singleplex reverse-transcription polymerase chain reaction (RT-PCR) for laboratory-confirmed influenza virus infection (LCI)...
October 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29025270/design-of-a-randomized-clinical-trial-of-a-colorectal-cancer-screening-decision-aid-to-promote-appropriate-screening-in-community-dwelling-older-adults
#17
Christine E Kistler, Carol Golin, Carolyn Morris, Alexandra F Dalton, Russell P Harris, Rowena Dolor, Renée M Ferrari, Noel T Brewer, Carmen L Lewis
BACKGROUND: Appropriate colorectal cancer screening in older adults should be aligned with the likelihood of net benefit. In general, patient decision aids improve knowledge and values clarity, but in older adults, they may also help patients identify their individual likelihood of benefit and foster individualized decision-making. We report on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. This report includes a description of the baseline characteristics of participants...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29020404/colistin-vs-ceftazidime-avibactam-in-the-treatment-of-infections-due-to-carbapenem-resistant-enterobacteriaceae
#18
David van Duin, Judith J Lok, Michelle Earley, Eric Cober, Sandra S Richter, Federico Perez, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Vance G Fowler, David L Paterson, Robert A Bonomo, Scott Evans
Background: The efficacy of ceftazidime-avibactam - a cephalosporin-β-lactamase inhibitor combination with in vitro activity against Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE) - as compared to colistin remains unknown. Methods: Patients initially treated with either ceftazidime-avibactam or colistin for CRE infections were selected from the Consortium on resistance against carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE), a prospective, multicenter, observational study...
September 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29020323/corticosteroids-in-patients-hospitalized-with-community-acquired-pneumonia-systematic-review-and-individual-patient-data-meta-analysis
#19
Matthias Briel, Simone M C Spoorenberg, Dominic Snijders, Antoni Torres, Silvia Fernandez-Serrano, G Umberto Meduri, Albert Gabarrús, Claudine A Blum, Marco Confalonieri, Benjamin Kasenda, Reed A C Siemieniuk, Wim Boersma, Willem Jan W Bos, Mirjam Christ-Crain
Background: We aimed to evaluate the benefits and harms of adjunctive corticosteroids in adults hospitalized with community-acquired pneumonia (CAP) using individual patients' data of randomized placebo-controlled trials and to explore subgroup differences. Methods: We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and trial registers (all until July 2017) for eligible trials. Data from 1,506 individual patients in six trials were analyzed using uniform outcome definitions...
September 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29017280/immunogenicity-of-the-13-valent-pneumococcal-conjugate-vaccine-in-older-adults-with-and-without-comorbidities-in-the-community-acquired-pneumonia-immunization-trial-in-adults-capita
#20
Anna M M van Deursen, Marlies A van Houten, Chris Webber, Michael Patton, Daniel A Scott, Scott Patterson, Mohinder Sidhu, Wayne Drews, William C Gruber, Emilio A Emini, Diederick E Grobbee, Marc J M Bonten, Elisabeth A M Sanders
Background: In the randomized controlled Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) against first episodes of vaccine-type community-acquired pneumonia in adults aged ≥65 years was 46%. The long-term immunogenicity of PCV13 in pneumococcal vaccine-naive older adults was investigated as part of CAPiTA. Methods: We determined the immune responses to PCV13 before and at 1, 12, and 24 months after vaccination in 1006 PCV13 recipients and 1005 controls with 3 age-stratified study participant cohorts...
September 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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