Chest
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effects of 24 weeks of lansoprazole therapy on asthma symptoms, exacerbations, quality of life, and pulmonary function in adult asthmatic patients with acid reflux symptoms.
Difficult-to-control asthma has been associated with gastroesophageal acid reflux. Acid-suppressive treatment has been inconsistent in improving asthma control. ⋯ In adult patients with moderate-to-severe persistent asthma and symptoms of acid reflux, treatment with 30 mg of lansoprazole bid for 24 weeks did not improve asthma symptoms or pulmonary function, or reduce albuterol use. However, this dose significantly reduced asthma exacerbations and improved asthma quality of life, particularly in those patients receiving more than one asthma-control medication.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Anticoagulant therapy for idiopathic pulmonary fibrosis.
To evaluate the effect of anticoagulant therapy on the survival of patients with idiopathic pulmonary fibrosis (IPF). ⋯ Our data suggested that plasma d-dimer levels are associated with mortality in patients with an acute exacerbation of IPF, and that anticoagulant therapy has a beneficial effect on survival in patients with IPF.
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Multicenter Study Clinical Trial
Deep venous thrombosis in patients with acute pulmonary embolism: prevalence, risk factors, and clinical significance.
To determine the prevalence of lower-limb deep venous thrombosis (DVT) that can be detected by compression ultrasonography (CUS) in patients with symptomatic pulmonary embolism (PE) diagnosed with spiral CT pulmonary angiography (CTPA); and to explore the risk factors for positive CUS results and the prognostic significance of such findings. ⋯ These results do not support screening for DVT in patients with CTPA-proven symptomatic PE; however, they suggest that CUS might prove especially efficient and safe as a frontline test in elderly patients with suspected PE. Further studies are needed before these conclusions can be translated into clinical recommendations.
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Multicenter Study Clinical Trial
Thoracic ultrasound for diagnosing pulmonary embolism: a prospective multicenter study of 352 patients.
Pulmonary embolism (PE) continues to be a major challenge in terms of diagnosis, as evidenced by the fact that many patients die undiagnosed and/or untreated. The aim of this multicenter study was to determine the accuracy of thorax ultrasound (TUS) in the diagnosis of PE (TUSPE). ⋯ TUS is a noninvasive method to diagnose peripheral PE. In the absence of CTPA, TUS is a suitable tool to demonstrate a PE at the bedside and in the emergency setting.
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Multicenter Study
Hospital volume-outcome relationships among medical admissions to ICUs.
Positive relationships between hospital volume and outcomes have been demonstrated for several surgeries and medical conditions. However, little is known about the volume-outcome relationship in patients admitted to medical ICUs. ⋯ Associations between ICU volume and risk-adjusted mortality were significant for patients with GI diagnoses and for sicker patients with respiratory diagnoses. However, associations were not significant for patients with neurologic diagnoses. The lack of a consistent volume-outcome relationship may reflect unmeasured patient complexity in higher-volume hospitals, relative standardization of care across ICUs, or lack of efficacy of some accepted ICU processes of care.