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pneumonia randomized controlled trial

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https://www.readbyqxmd.com/read/28622199/antifibrotic-drugs-as-treatment-of-nonidiopathic-pulmonary-fibrosis-interstitial-pneumonias-the-time-is-now
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28608496/stress-ulcer-prophylaxis-in-the-intensive-care-unit-trial-detailed-statistical-analysis-plan
#4
M Krag, A Perner, J Wetterslev, T Lange, M P Wise, M Borthwick, S Bendel, P Pelosi, F Keus, A B Guttormsen, J C Schefold, T S Meyhoff, S Marker, M H Møller
BACKGROUND: In this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The aim of the SUP-ICU trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (ICU). METHODS: The SUP-ICU trial is an investigator-initiated, international, multicentre, randomised, blinded, parallel-group trial of intravenously pantoprazole 40 mg once daily vs...
June 12, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28602602/pneumococcal-conjugate-vaccine-use-in-adults-addressing-an-unmet-medical-need-for-non-bacteremic-pneumococcal-pneumonia
#5
Heather L Sings
Streptococcus pneumoniae is a frequent cause of community acquired pneumonia (CAP), with the largest burden of disease attributed to non-bacteremic pneumonia. Due to the high persistent burden of disease, pneumococcal pneumonia, particularly non-bacteremic pneumococcal pneumonia, continues to be a major public health concern. There are currently two pneumococcal vaccines approved for use in adults in the United States (US) and other countries worldwide: a 23-valent pneumococcal simple polysaccharide vaccine (PPV23), and a 13-valent pneumococcal conjugate vaccine (PCV13)...
June 8, 2017: Vaccine
https://www.readbyqxmd.com/read/28587665/hospitalization-for-community-acquired-febrile-urinary-tract-infection-validation-and-impact-assessment-of-a-clinical-prediction-rule
#6
Janneke E Stalenhoef, Willize E van der Starre, Albert M Vollaard, Ewout W Steyerberg, Nathalie M Delfos, Eliane M S Leyten, Ted Koster, Hans C Ablij, Jan W Van't Wout, Jaap T van Dissel, Cees van Nieuwkoop
BACKGROUND: There is a lack of severity assessment tools to identify adults presenting with febrile urinary tract infection (FUTI) at risk for complicated outcome and guide admission policy. We aimed to validate the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE), a modified form of the pneumonia severity index, and to subsequentially assess its use in clinical practice. METHODS: A prospective observational multicenter study for model validation (2004-2009), followed by a multicenter controlled clinical trial with stepped wedge cluster-randomization for impact assessment (2010-2014), with a follow up of 3 months...
June 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28580433/limited-impact-of-neonatal-or-early-infant-schedules-of-7-valent-pneumococcal-conjugate-vaccination-on-nasopharyngeal-carriage-of-streptococcus-pneumoniae-in-papua-new-guinean-children-a-randomized-controlled-trial
#7
Celestine Aho, Audrey Michael, Mition Yoannes, Andrew Greenhill, Peter Jacoby, John Reeder, William Pomat, Gerard Saleu, Pioto Namuigi, Suparat Phuanukoonnon, Heidi Smith-Vaughan, Amanda J Leach, Peter Richmond, Deborah Lehmann
Streptococcus pneumoniae is a leading cause of pneumonia, the most common cause of childhood death. Papua New Guinean children experience high rates of nasopharyngeal pneumococcal colonization within weeks of birth, predisposing them to pneumococcal disease. In a trial to determine the safety and immunogenicity of early infant vaccination with 7-valent pneumococcal conjugate vaccine (7vPCV), we investigated the impact of early schedules on pneumococcal carriage. Infants were randomized at birth to receive 7vPCV in a 0-1-2-month (n = 101) or a 1-2-3-month (n = 105) schedule or no 7vPCV (n = 106)...
December 2016: Vaccine Rep
https://www.readbyqxmd.com/read/28576451/elbasvir-plus-grazoprevir-in-patients-with-hepatitis-c-virus-infection-and-stage-4-5-chronic-kidney-disease-clinical-virological-and-health-related-quality-of-life-outcomes-from-a-phase-3-multicentre-randomised-double-blind-placebo-controlled-trial
#8
Annette Bruchfeld, David Roth, Paul Martin, David R Nelson, Stanislas Pol, Maria-Carlota Londoño, Howard Monsour, Marcelo Silva, Peggy Hwang, Jean-Marie Arduino, Michael Robertson, Bach-Yen Nguyen, Janice Wahl, Eliav Barr, Wayne Greaves
BACKGROUND: In the C-SURFER study, therapy with the all-oral elbasvir plus grazoprevir regimen for 12 weeks in patients with chronic hepatitis C virus (HCV) infection and stage 4-5 chronic kidney disease resulted in a high rate of virological cure compared with placebo. Here, we report sustained virological response (SVR), safety data, health-related quality-of-life (HRQOL), and virological resistance analyses in patients in C-SURFER who received immediate antiviral therapy or who received placebo before therapy...
May 30, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28575379/efficacy-of-oral-zinc-supplementation-in-radiologically-confirmed-pneumonia-secondary-analysis-of-a-randomized-controlled-trial
#9
Narendra Kumar Bagri, Neha Bagri, Manisha Jana, Arun Kumar Gupta, Nitya Wadhwa, Rakesh Lodha, Sushil Kumar Kabra, Aruna Chandran, Satinder Aneja, Mona K Chaturvedi, Jitender Sodhi, Sean Patrick Fitzwater, Jagdish Chandra, Bimbadhar Rath, Udaypal S Kainth, Savita Saini, Robert E Black, Mathuram Santosham, Shinjini Bhatnagar
Objective: To evaluate the effect of zinc as an adjuvant therapy in radiologically confirmed pneumonia in children 2-24 months of age. Patients and Methods: We analyzed data of 212 children with pneumonia for whom chest X-ray films were available at enrollment and at least two radiologists agreed on the diagnosis of pneumonia. We compared the time to recovery in the two groups ( n  = 121, zinc group and n  = 91, placebo group) using a Cox proportional hazards regression model...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28575286/efficacy-of-maternal-influenza-vaccination-against-all-cause-lower-respiratory-tract-infection-hospitalizations-in-young-infants-results-from-a-randomized-controlled-trial
#10
Marta C Nunes, Clare L Cutland, Stephanie Jones, Sarah Downs, Adriana Weinberg, Justin R Ortiz, Kathleen M Neuzil, Eric A F Simões, Keith P Klugman, Shabir A Madhi
Background: Influenza immunization of pregnant women protects their young infants against laboratory-confirmed influenza infection. Influenza infection might predispose to subsequent bacterial infections that cause severe pneumonia. In a secondary analysis of a randomized clinical trial (RCT), we evaluated the effect of maternal vaccination on infant hospitalizations for all-cause acute lower respiratory tract infection (ALRI). Methods: Infants born to women who participated in a double-blind placebo-controlled RCT in 2011 and 2012 on the efficacy of trivalent inactivated influenza vaccine (IIV) during pregnancy were followed during the first 6 months of life...
May 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28567215/comparison-of-postoperative-infection-related-complications-between-cemented-and-cementless-hemiarthroplasty-in-elderly-patients-a-meta-analysis
#11
Byung-Ho Yoon, Jeong Gook Seo, Kyung-Hoi Koo
BACKGROUND: The purpose of this review was to assess the risk of infection-related complications following cemented and cementless hemiarthroplasty in elderly patients. METHODS: We searched PubMed, EMBASE, and Cochrane Library databases for published randomized clinical trials comparing cemented hemiarthroplasty with cementless hemiarthroplasty in patients with a femoral neck fracture and more than 65 years of age. Eight randomized controlled trials were available for analysis...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28559467/effect-of-ards-severity-and-etiology-on-short-term-outcomes
#12
Haitham El-Haddad, Hyejeong Jang, Wei Chen, Ayman O Soubani
BACKGROUND: We evaluated the outcome of subjects with ARDS in relation to etiology and severity in a retrospective cohort study of the ARDS Network randomized controlled trials. The primary outcome was 28-d mortality. The secondary outcomes were 60-d mortality and ventilator- and ICU-free days. For severity of ARDS, subjects were stratified according to PaO2/FIO2. The etiology of ARDS was classified into sepsis, pneumonia, aspiration, trauma, and others. RESULTS: A total of 2,914 subjects were included in these trials...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#13
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28552074/heat-and-moisture-exchangers-hmes-and-heated-humidifiers-hhs-in-adult-critically-ill-patients-a-systematic-review-meta-analysis-and-meta-regression-of-randomized-controlled-trials
#14
Maria Vargas, Davide Chiumello, Yuda Sutherasan, Lorenzo Ball, Antonio M Esquinas, Paolo Pelosi, Giuseppe Servillo
BACKGROUND: The aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients...
May 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28545041/effect-of-early-measles-vaccine-on-pneumococcal-colonization-a-randomized-trial-from-guinea-bissau
#15
Nadja Skadkær Hansen, Stine Byberg, Lars Hervig Jacobsen, Morten Bjerregaard-Andersen, Aksel Karl Georg Jensen, Cesario Martins, Peter Aaby, Jørgen Skov Jensen, Christine Stabell Benn, Hilton Whittle
BACKGROUND: Measles vaccine (MV) may have non-specific beneficial effects for child health and particularly seems to prevent respiratory infections. Streptococcus pneumoniae is the leading cause of bacterial pneumonia among children worldwide, and nasopharyngeal colonization precedes infection. OBJECTIVE: We investigated whether providing early MV at 18 weeks of age reduced pneumococcal colonization and/or density up to 9 months of age. METHOD: The study was conducted in 2013-2014 in Guinea-Bissau...
2017: PloS One
https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#16
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28532398/clinical-outcomes-of-linezolid-and-vancomycin-in-patients-with-nosocomial-pneumonia-caused-by-methicillin-resistant-staphylococcus-aureus-stratified-by-baseline-renal-function-a-retrospective-cohort-analysis
#17
Ping Liu, Blair Capitano, Amy Stein, Ali A El-Solh
BACKGROUND: The primary objective of this study is to assess whether baseline renal function impacts treatment outcomes of linezolid and vancomycin (with a dose-optimized regimen) for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. METHODS: We conducted a retrospective cohort analysis of data generated from a prospective, randomized, controlled clinical trial (NCT 00084266). The analysis included 405 patients with culture-proven MRSA pneumonia. Baseline renal function was stratified based on creatinine clearance...
May 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28524027/-effect-of-chest-physiotherapy-in-patients-undergoing-mechanical-ventilation-a-prospective-randomized-controlled-trial
#18
Hui Zeng, Zhen Zhang, Yuan Gong, Miao Chen
OBJECTIVE: To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28494088/peripheral-nerve-blocks-for-hip-fractures
#19
REVIEW
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra Kopp
BACKGROUND: Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. OBJECTIVES: This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards...
May 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28493877/co2-driven-endotracheal-tube-cuff-control-in-critically-ill-patients-a-randomized-controlled-study
#20
Gennaro De Pascale, Mariano Alberto Pennisi, Maria Sole Vallecoccia, Giuseppe Bello, Riccardo Maviglia, Luca Montini, Valentina Di Gravio, Salvatore Lucio Cutuli, Giorgio Conti, Massimo Antonelli
BACKGROUND: To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). METHODS: This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE) and serious AE (SAE) as a result of using AnapnoGuard (AG) 100 during mechanical ventilation...
2017: PloS One
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