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Traumatic brain injury (TBI) is a major cause of disability and death in most Western nations and consumes an estimated $100 billion annually in the United States alone. In the last 2 decades, the management of TBI has evolved dramatically, as a result of a more thorough understanding of the physiologic events leading to secondary neuronal injury as well as advances in the care of critically ill patients. However, it is likely that many patients with TBI are not treated according to current treatment principles. This article presents an overview of the current management of patients with TBI.
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s: Consensus guidelines for the empirical treatment of community-acquired pneumonia (CAP) have been published. We investigated the following factors: (1) the degree of adherence to American Thoracic Society (ATS) and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) guidelines; and (2) the influence of adhering to these guidelines on mortality and length of hospitalization. ⋯ Adherence was higher to ATS guidelines than to SEPAR guidelines. Severe CAP had a significantly higher mortality when the guidelines (both ATS and SEPAR) were not followed. Length of hospitalization was similar irrespective of adherence to either set of guidelines.
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Quality of life (QOL) following video-assisted thoracic surgery (VATS) major lung resection has not been systematically studied. This study was designed to evaluate the intermediate to long-term QOL in patients with lung cancer following resection, comparing VATS with thoracotomy. ⋯ This study showed that lung cancer patients with resectable disease following surgical treatment without recurrence have good QOL and high levels of functioning on intermediate to long-term follow-up, with no significant differences between the VATS and open groups.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Mask proportional assist vs pressure support ventilation in patients in clinically stable condition with chronic ventilatory failure.
To compare the short-term physiologic effects of mask pressure support ventilation (PSV) and proportional assist ventilation (PAV) in patients in clinically stable condition with chronic ventilatory failure (CVF). ⋯ In resting, awake patients in clinically stable condition with CVF caused by either COPD or RCWD, noninvasive application of PAV, set at the patient's comfort, was not superior to PSV either in increasing VT and E or in unloading the inspiratory muscles. We failed to find any difference in patient/ventilator interaction between ventilatory modes.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Using quality of life to predict hospitalization and mortality in patients with obstructive lung diseases.
Condition-specific measures of quality of life (QOL) for patients with COPD have been demonstrated to be highly reliable and valid, but they have not conclusively been shown to predict hospitalization or death. ⋯ Lower QOL is a powerful predictor of hospitalization and all-cause mortality. Brief, self-administered instruments such as the SOLDQ may provide an opportunity to identify patients who could benefit from preventive interventions.