Chest
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Randomized Controlled Trial Clinical Trial
Effects of cigarette reduction on cardiovascular risk factors and subjective measures.
To assess the effect of continued smoking and smoking reduction on cardiovascular biomarkers (eg, WBC count, cholesterol concentrations, BP, heart rate). ⋯ These results show the availability of reliable and dose-sensitive biomarkers and that reduction in smoking can lead to significant but only modest changes in cardiovascular risk factors in healthy smokers. It is not known whether the reductions in cardiovascular risk factors observed after smoking reduction are also associated with reduced disease risk. Additional research is necessary to address this issue.
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Multicenter Study
Use of the pulmonary artery catheter is not associated with worse outcome in the ICU.
In critically ill patients, the impact of pulmonary artery catheter (PAC) use on outcome is debatable. We investigated the epidemiology of PAC use in European ICUs and its relation to outcome. ⋯ This observational study suggests that PAC use is not associated with increased mortality in this heterogeneous population.
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Multicenter Study
Development and validation of The Cystic Fibrosis Questionnaire in the United States: a health-related quality-of-life measure for cystic fibrosis.
The Cystic Fibrosis Questionnaire (CFQ) is a disease-specific instrument that measures health-related quality of life (HRQOL) for adolescents and adults with cystic fibrosis (CF) > or = 14 years, consisting of 44 items on 12 generic and disease-specific scales. Versions of the CFQ are also available for children with CF and their parents. This study evaluated the psychometric properties of the CFQ in a national study at 18 CF centers in the United States. ⋯ The results demonstrated that the CFQ-teen/adult is a reliable and valid measure of HRQOL for individuals with CF. It may be utilized in clinical trials to assess the effects of new therapies, to document the progression of disease, and to inform clinical practice.
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This study applies a stochastic or probability search and display model to prospectively predict outcome and to evaluate therapeutic effects in a consecutively monitored series of 396 patients with severe thoracic and thoracoabdominal injuries. ⋯ Noninvasive hemodynamic monitoring with an information system provided a feasible approach to early outcome predictions and therapeutic decision support.
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Postresuscitation syndrome is a state of myocardial dysfunction after the restoration of circulation by successful resuscitation. Despite several advances in the field of resuscitation, the management of out-of-hospital cardiac arrest is still suboptimal. The high fatality rate shortly after successful resuscitation is mainly related to postresuscitation myocardial dysfunction. ⋯ By modifying the conventional modalities of resuscitation together with new promising agents, the rescuers will be able to salvage the jeopardized postresuscitation myocardium and prevent its progression to the dismal stony heart. Community awareness and staff education are crucial to shorten resuscitation time and improve short-term and long-term outcomes. There is an urgent need to revise the guidelines for cardiopulmonary resuscitation in community setting, but how? It is a matter of where and when it is of enough value to be efficacious and cost-effective.