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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/29343141/novel-%C3%AE-lactam-%C3%AE-lactamase-inhibitors-versus-alternative-antibiotics-for-the-treatment-of-complicated-intra-abdominal-infection-and-complicated-urinary-tract-infection-a-meta-analysis-of-randomized-controlled-trials
#1
Mengmeng Chen, Minjie Zhang, Peixian Huang, Qiongyu Lin, Cheng Sun, Hongke Zeng, Yiyu Deng
OBJECTIVES: The aim of this study is to compare the efficacy and safety of novel BL/BLIs with alternative antibiotics for the treatment of Complicated intra-abdominal infection (cIAI) and complicated urinary tract infection (cUTI). METHODS: We performed a systematic review and meta-analysis of all randomized controlled trials comparing novel β-lactam/β-lactamase inhibitors (BL/BLIs) with other antibiotics for the treatment of cIAI and cUTI. The primary outcome included clinical and microbiological treatment success...
January 18, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29337171/is-early-tracheostomy-better-for-severe-traumatic-brain-injury-a-meta-analysis
#2
Qin Lu, Yonglin Xie, Xunchen Qi, Xinwei Li, Shuxu Yang, Yirong Wang
OBJECTIVE: Tracheotomy have been proven to be benefit for the patients requiring prolonged mechanical ventilation. However, whether early tracheotomy (less than 10 days) could also improve the outcome of severe traumatic brain injury (TBI) patient (GCS≤8) remains controversial. The aim of this study was trying to clarify this question. METHODS: We searched four databases (PubMed, Web of Science, Elsevier and Cochrane Library) for articles comparing the outcome of early tracheostomy with late tracheostomy or prolonged intubation on the severe TBI patients...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29324986/the-impact-of-the-13-valent-pneumococcal-conjugate-vaccine-on-pneumococcal-carriage-in-the-community-acquired-pneumonia-immunization-trial-in-adults-capita-study
#3
Anna M M van Deursen, Marlies A van Houten, Chris Webber, Michael Patton, Daniel Scott, Scott Patterson, Qin Jiang, William C Gruber, Beate Schmoele-Thoma, Diederick E Grobbee, Marc J M Bonten, Elisabeth A M Sanders
Background: The impact of pneumococcal conjugate vaccination on the prevalence of nasopharyngeal carriage with pneumococci and other bacteria in adults is unknown. The direct effects of the 13-valent pneumococcal conjugate vaccine (PCV13) in community dwelling older adults was investigated as part of the randomized controlled Community Acquired Pneumonia immunization Trial in Adults (CAPiTA). Methods: We determined the carriage of S. pneumoniae, S. aureus, H. influenzae, and M...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29315968/cuffed-endotracheal-tubes-in-infants-less-than-3-kg-a-retrospective-cohort-study
#4
Rebecca E Thomas, Shripada C Rao, Corrado Minutillo, Bruce Hullett, Max K Bulsara
BACKGROUND: Cuffed endotracheal tubes are being increasingly used in infants; however, current evidence in the literature mostly includes infants ≥ 3-kg weight. AIMS: The aim of this observational study was to compare the short-term outcomes with the use of Microcuff® cuffed vs uncuffed endotracheal tubes in neonates < 3 kg. METHODS: We performed a retrospective cohort study in a single-centre, tertiary children's hospital neonatal intensive care unit...
January 9, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29288963/antioxidant-reserve-of-the-lungs-and-ventilator-associated-pneumonia-a-clinical-trial-of-high-dose-selenium-in-critically-ill-patients
#5
Ata Mahmoodpoor, Hadi Hamishehkar, Sarvin Sanaie, Nazila Behruzizad, Afshin Iranpour, Evin Koleini, Nader D Nader
PURPOSE: To evaluate the effect of supplemental selenium administration on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients. METHODS: Ninety-nine mechanically ventilated patients were randomized to receive either selenium or isotonic saline infusion for 10days. The primary endpoint was serum glutathione peroxidase-3 (GPX-3) activity and secondary endpoints were development of VAP or death, ICU stay and vasopressor requirement. Serum concentrations of selenium and GPX-3 were measured on Day-1, Day-4 and Day-10...
December 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29288590/combined-electrical-stimulation-and-exercise-for-swallow-rehabilitation-post-stroke-a-pilot-randomized-control-trial
#6
Lise Sproson, Sue Pownall, Pam Enderby, Jenny Freeman
BACKGROUND: Dysphagia is common after stroke, affecting up to 50% of patients initially. It can lead to post-stroke pneumonia, which causes 30% of stroke-related deaths, a longer hospital stay and poorer health outcomes. Dysphagia care post-stroke generally focuses on the management of symptoms, via modified oral intake textures and adapted posture, rather than direct physical rehabilitation of the swallowing function. Transcutaneous neuromuscular electrical stimulation (NMES) is a promising rehabilitation technology that can be used to stimulate swallowing; however, findings regarding efficacy have been conflicting...
December 30, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29241762/eltrombopag-for-advanced-myelodysplastic-syndromes-or-acute-myeloid-leukaemia-and-severe-thrombocytopenia-aspire-a-randomised-placebo-controlled-phase-2-trial
#7
Moshe Mittelman, Uwe Platzbecker, Boris Afanasyev, Sebastian Grosicki, Raymond S M Wong, Achilles Anagnostopoulos, Benjamin Brenner, Claudio Denzlinger, Giuseppe Rossi, Arnon Nagler, Regina Garcia-Delgado, Maria Socorro O Portella, Zewen Zhu, Dominik Selleslag
BACKGROUND: Thrombocytopenia is a life-threatening complication in patients with advanced myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML). In this study (ASPIRE), we aimed to assess eltrombopag, an oral thrombopoietin receptor agonist, for thrombocytopenia (grade 4) treatment in adult patients with advanced MDS or AML. METHODS: ASPIRE consisted of an open-label, double-blind phase for 8 weeks and a randomised, double-blind phase (parts 1 and 2, reported here) for 12 weeks, and an open-label extension (part 3)...
December 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29232988/does-antibiotic-treatment-duration-affect-the-outcomes-of-exacerbations-of-asthma-and-copd-a-systematic-review
#8
Marie Stolbrink, Jack Amiry, John D Blakey
Asthma and chronic obstructive pulmonary disease (COPD) cause significant morbidity and mortality worldwide, primarily through exacerbations. Exacerbations are often treated with antibiotics but their optimal course duration is uncertain. Reducing antibiotic duration may influence antimicrobial resistance but risks treatment failure. The objective of this article is to review published literature to investigate whether shorter antibiotic therapy duration affects clinical outcomes in the treatment of asthma and COPD exacerbations...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#9
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#10
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210011/n-of-1-randomized-trials-of-ultra-micronized-palmitoylethanolamide-in-older-patients-with-chronic-pain
#11
Federico Germini, Anna Coerezza, Luca Andreinetti, Alessandro Nobili, Paolo Dionigi Rossi, Daniela Mari, Gordon Guyatt, Maura Marcucci
BACKGROUND: Ultra-micronized palmitoylethanolamide (um-PEA) represents an attractive option for chronic pain control in complex older patients at higher risk of adverse effects with traditional analgesics. OBJECTIVE: The aim of this study was to determine the effectiveness of um-PEA versus placebo on chronic pain intensity and function in individual geriatric patients. DESIGN: We performed randomized, blinded N-of-1 trials with two 3-week um-PEA versus placebo comparisons, separated by 2-week washout periods...
December 5, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29206767/prevention-of-ventilator-associated-and-early-postoperative-pneumonia-through-tapered-endotracheal-tube-cuffs-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Bert Maertens, Koen Blot, Stijn Blot
OBJECTIVE: Microaspiration of subglottic secretions is considered a major pathogenic mechanism of hospital-acquired pneumonia, either early postoperative or ventilator-associated pneumonia. Tapered endotracheal tube cuffs have been proposed to provide a better seal of the extraluminal airway, thereby preventing microaspiration and possibly hospital-acquired pneumonia. We performed a systematic review and meta-analysis to assess the value of endotracheal tubes with tapered cuffs in the prevention of hospital-acquired pneumonia...
December 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29201115/effect-of-vitamin-d-supplementation-on-procalcitonin-as-prognostic-biomarker-in-patients-with-ventilator-associated-pneumonia-complicated-with-vitamin-d-deficiency
#13
Amir Ebrahim Miroliaee, Jamshid Salamzadeh, Shervin Shokouhi, Alireza Fatemi, Seyed Hossein Ardehali, Mohammad Reza Hajiesmaeili, Zahra Sahraei
Ventilator-associated pneumonia (VAP) is a common and serious problem that develops after more than 48 h of mechanical ventilation. Improving the activity of immune system with vitamin D, and its consequent impact on prognostic biomarkers of VAP was studied in the current study. A randomized double blind placebo controlled clinical trial was designed. A total of 46 patients with VAP, who were suffering from vitamin D deficiency, were randomly allocated into the study groups of placebo (n=22) and treatment (n=24) The treatment group received 300,000 units of intramuscular vitamin D...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/29199388/efficacy-and-safety-of-stress-ulcer-prophylaxis-in-critically-ill-patients-a-network-meta-analysis-of-randomized-trials
#14
REVIEW
Waleed Alhazzani, Fayez Alshamsi, Emilie Belley-Cote, Diane Heels-Ansdell, Romina Brignardello-Petersen, Mustafa Alquraini, Anders Perner, Morten Hylander Møller, Mette Krag, Saleh Almenawer, Bram Rochwerg, Joanna Dionne, Roman Jaeschke, Mohammed Alshahrani, Adam Deane, Dan Perri, Lehana Thebane, Awad Al-Omari, Simon Finfer, Deborah Cook, Gordon Guyatt
PURPOSE: Stress ulcer prophylaxis (SUP) is commonly prescribed in the intensive care unit. However, data from systematic reviews and conventional meta-analyses are limited by imprecision and restricted to direct comparisons. We conducted a network meta-analysis of randomized clinical trials (RCTs) to examine the safety and efficacy of drugs available for SUP in critically ill patients. METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2017 for randomized controlled trials that examined the efficacy and safety of proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), and sucralfate for SUP in critically ill patients...
December 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29198820/resveratrol-improves-efficacy-of-oral-amoxicillin-against-childhood-fast-breathing-pneumonia-in-a-randomized-placebo-controlled-double-blind-clinical-trial
#15
Li Qiang, Yunfei Di, Zhilan Jiang, Juanjuan Xu
Childhood pneumonia has been considered as a major cause of child morbidity and mortality worldwide. We aimed to investigate the effect of resveratral in synergizing with oral amoxicillin to improve the treatment outcome of oral amoxicillin administration against childhood fast breathing pneumonia. 647 children diagnosed fast breathing pneumonia were recruited and randomized to receive oral amoxicillin plus either resveratrol (AX + RV) or placebo (AX + placebo). The primary outcome was defined as treatment failure up to day 3, while the secondary outcome was defined as treatment failure at day 6 and 12 upon follow up...
November 30, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29197407/low-tidal-volume-mechanical-ventilation-against-no-ventilation-during-cardiopulmonary-bypass-heart-surgery-mecano-study-protocol-for-a-randomized-controlled-trial
#16
Lee S Nguyen, Messaouda Merzoug, Philippe Estagnasie, Alain Brusset, Jean-Dominique Law Koune, Stephane Aubert, Thierry Waldmann, Jean-Michel Grinda, Hadrien Gibert, Pierre Squara
BACKGROUND: Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery...
December 2, 2017: Trials
https://www.readbyqxmd.com/read/29184589/comparing-the-effect-of-echinacea-and-chlorhexidine-mouthwash-on-the-microbial-flora-of-intubated-patients-admitted-to-the-intensive-care-unit
#17
Mehdi Safarabadi, Ehsanollah Ghaznavi-Rad, Abdolghader Pakniyat, Korosh Rezaie, Ali Jadidi
Background: Providing intubated patients admitted to the intensive care units with oral healthcare is one of the main tasks of nurses in order to prevent Ventilator-Associated Pneumonia (VAP). This study aimed at comparing the effects of two mouthwash solutions (echinacea and chlorhexidine) on the oral microbial flora of patients hospitalized in the intensive care units. Materials and Methods: In this clinical trial, 70 patients aged between18 and 65 years undergoing tracheal intubation through the mouth in three hospitals in Arak, were selected using simple random sampling and were randomly divided into two groups: the intervention group and the control group...
November 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29183931/early-low-energy-versus-high-energy-enteral-nutrition-support-in-patients-with-traumatic-intracerebral-haemorrhage-protocol-for-a-randomised-controlled-trial
#18
Yanfei Shen, Xuping Cheng, Manzhen Ying, Weimin Zhang, Xuandong Jiang, Kailei Du
BACKGROUND: Early enteral nutrition (EN) is associated with shorter hospital stay and lower infection and mortality rates in patients with intracerebral haemorrhage. However, high-energy support always causes clinical complications, such as diarrhoea and aspiration pneumonia, and the true benefit of high-energy support in these patients has not been investigated. The appropriate amount of energy support still needs further investigation. Therefore, we are performing a randomised controlled trial to investigate whether early low-energy EN can decrease mortality and feeding-related complications and improve neurological outcomes as compared with high-energy EN in traumatic intracerebral haemorrhage (TICH) patients...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29183382/a-proposal-for-the-withdrawal-of-inhaled-corticosteroids-in-the-clinical-practice-of-chronic-obstructive-pulmonary-disease
#19
REVIEW
Marc Miravitlles, Borja G Cosío, Aurelio Arnedillo, Myriam Calle, Bernardino Alcázar-Navarrete, Cruz González, Cristóbal Esteban, Juan Antonio Trigueros, José Miguel Rodríguez González-Moro, José Antonio Quintano Jiménez, Adolfo Baloira
According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting β2 agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy.Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations...
November 28, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29183037/efficacy-of-a-new-post-mouthwash-intervention-wiping-plus-oral-nutritional-supplements-for-preventing-aspiration-pneumonia-in-elderly-people-a-multicenter-randomized-comparative-trial
#20
Takashi Higashiguchi, Hiroshi Ohara, Yayoi Kamakura, Takeshi Kikutani, Masafumi Kuzuya, Hiromi Enoki, Hiromi Sanada, Masami Matsuzaki, Michio Maruyama
BACKGROUND/AIMS: Aspiration pneumonia is a common cause of death among the elderly (≥90-year-old) in nursing homes. Studies suggest that its incidence could be reduced by oral care interventions. We aimed to evaluate the efficacy of a new oral care intervention: wiping plus oral nutritional supplements (ONS). METHODS: This prospective observational study was conducted in 252 patients (age 88.0 ± 6.5 years) in 75 nursing homes, rehabilitation hospitals, and other care facilities...
November 28, 2017: Annals of Nutrition & Metabolism
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