Chest
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The diagnosis of ventilator-associated pneumonia (VAP) can be difficult. Soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) has been reported to be elevated in BAL fluid from patients with VAP. ⋯ sTREM-1 is detectable in EVC and may be useful in establishing or excluding the diagnosis of VAP.
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Atrial fibrillation (AF) that occurs as a frequent complication of myocardial infarction (MI) is associated with a poor clinical outcome. It nonetheless remains uncertain whether AF that occurs transiently during MI is associated with a subsequent increased risk of the development of AF and ischemic stroke. ⋯ Transient AF complicating acute inferior MI is associated with an increased future risk of AF occurrence and ischemic stroke in patients with preserved LVEF, despite the use of antiplatelet therapy.
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Comparative Study
The quality of chest compressions during cardiopulmonary resuscitation overrides importance of timing of defibrillation.
We address the quality of chest compressions and the impact on initial defibrillation or initial chest compressions after sudden death. ⋯ In this animal model of cardiac arrest, it was the quality of the chest compressions, rather then the priority of either initial defibrillation or initial chest compressions, that was the predominant determinant of successful resuscitation.
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Diffuse alveolar damage (DAD) is a relatively common histopathologic finding at autopsy, particularly in patients dying with ARDS, and can result from a variety of causes. The spectrum of causes and associated prognostic implications for DAD diagnosed by surgical lung biopsy are unclear. ⋯ Our study showed that infections and acute interstitial pneumonia are the most common causes of DAD diagnosed by surgical lung biopsy. Hospital mortality rate associated with DAD may vary depending on the underlying cause.