Chest
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Review Case Reports
Movement disorders associated with withdrawal from high-dose intravenous haloperidol therapy in delirious ICU patients.
Intravenous haloperidol is recommended as the drug of choice to treat delirium in ICU patients. Movement disorders and other adverse events commonly occur with oral haloperidol use but are rarely seen with IV haloperidol use, and withdrawal symptoms have not been reported with short-term ICU use. We describe self-limited dyskinesia during withdrawal of high-dose continuous IV haloperidol therapy in five ICU patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of inhaled albuterol and ipratropium bromide on autonomic control of the cardiovascular system.
Systemic administration of beta-agonist and anticholinergic drugs markedly impair normal autonomic heart rate control. The purpose of this study was to quantify and compare the effects of therapeutic doses of inhaled albuterol and ipratropium on autonomic control of the cardiovascular system. ⋯ Inhalation of four puffs of albuterol (400 microg) or ipratropium (80 microg) does not alter the autonomic control of the cardiovascular system in young, healthy male subjects.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pressure vs flow triggering during pressure support ventilation.
Adult mechanical ventilators have traditionally been pressure- or time-triggered. More recently, flow triggering has become available and some adult ventilators allow the choice between pressure or flow triggering. Prior studies have supported the superiority of flow triggering during continuous positive airway pressure, but few have compared pressure and flow triggering during pressure support ventilation (PSV). The purpose of this study was to compare pressure and flow triggering during PSV in adult mechanically ventilated patients. ⋯ For this group of patients, flow triggering was not superior to pressure triggering at -0.5 cm H2O during PSV.
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Multicenter Study Comparative Study
Assessment of the prognosis of coronary patients: performance and customization of generic severity indexes.
To assess the prognostic performance of general severity systems (APACHE II [acute physiology and chronic health evaluation], simplified acute physiology score [SAPS II], and mortality probability models [MPM II]) in coronary patients and to derive new customized indexes for coronary patients using a reduced number of variables. ⋯ Prognostic indexes developed for multidisciplinary patients show good performance when applied to patients with acute myocardial infarction, but customization can reduce the number of variables necessary to compute them without a loss of, and a possible improvement in, prognostic accuracy.
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Revisions in stage grouping of the TNM subsets (T=primary tumor, N=regional lymph nodes, M=distant metastasis) in the International System for Staging Lung Cancer have been adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. These revisions were made to provide greater specificity for identifying patient groups with similar prognoses and treatment options with the least disruption of the present classification: T1N0M0, stage IA; T2N0M0, stage IB; T1N1M0, stage IIA; T2N1M0 and T3N0M0, stage IIB; and T3N1M0, T1N2M0, T2N2M0, T3N2M0, stage IIIA. The TNM subsets in stage IIIB-T4 any N M0, any T N3M0, and in stage IV-any T any N M1, remain the same. Analysis of a collected database representing all clinical, surgical-pathologic, and follow-up information for 5,319 patients treated for primary lung cancer confirmed the validity of the TNM and stage grouping classification schema.