Chest
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Multicenter Study
Video-assisted thoracoscopic surgery in the treatment of complicated parapneumonic effusions or empyemas: outcome of 234 patients.
To review our experience in treatment of complicated parapneumonic effusion and pleural empyema by video-assisted thoracoscopic surgery (VATS). ⋯ VATS is safe and effective for treatment of complicated parapneumonic effusion and pleural empyema. Earlier intervention with VATS can produce better clinical results. A prospective study should be done to identify optimal timing and settings for VATS treatment for both complicated parapneumonic effusion and pleural empyema.
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Multicenter Study Clinical Trial
A pilot study of the safety and efficacy of tobramycin solution for inhalation in patients with severe bronchiectasis.
To evaluate the efficacy and safety of tobramycin solution for inhalation (TSI) in patients with severe bronchiectasis. ⋯ TSI therapy resulted in significant improvements in respiratory symptoms and health-related quality of life in subjects with severe bronchiectasis, but some subjects did not tolerate TSI therapy. Bronchiectasis patients receiving this therapy should be monitored for signs of intolerance.
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Randomized Controlled Trial Clinical Trial
Effects of N-acetylcysteine on microalbuminuria and organ failure in acute severe sepsis: results of a pilot study.
The level of microalbuminuria is thought to reflect the severity of inflammation-induced systemic vascular permeability and may have prognostic value with regard to organ dysfunction and survival. N-acetylcysteine (NAC) has been shown to decrease capillary leakage in experimental sepsis. The present study investigated the effect of early treatment with NAC on microalbuminuria and organ dysfunction in severe clinical sepsis. ⋯ Early NAC administration does not influence the course of MACR in severe clinical sepsis, suggesting that NAC might not attenuate endothelial damage in this condition. NAC treatment even aggravated sepsis-induced organ failure, in particular cardiovascular failure.
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To investigate the associations of maternal and grandmaternal smoking before, during, and after pregnancy with childhood asthma. ⋯ Maternal and grandmaternal smoking during pregnancy may increase the risk of childhood asthma.
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Multicenter Study
Indications, timing, and techniques of tracheostomy in 152 French ICUs.
To investigate the current practice of tracheostomy in French ICUs, focusing on the frequency, timing, indications, and techniques. ⋯ There is much heterogeneity in the reported practices of tracheostomy in French ICUs. Three fourths of physicians considered that a randomized study comparing prolonged translaryngeal intubation and early tracheostomy in patients expected to receive prolonged MV would be necessary to clarify those issues.