Chest
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Multicenter Study
Viral infection in adults hospitalized with community-acquired pneumonia: prevalence, pathogens, and presentation.
The potential role of respiratory viruses in the natural history of community-acquired pneumonia (CAP) in adults has not been well described since the advent of nucleic amplification tests (NATs). ⋯ Viral infections are common in adults with pneumonia. Easily transmissible viruses such as influenza, hMPV, and RSV were the most common, raising concerns about infection control. Routine testing for respiratory viruses may be warranted for adults who have been hospitalized with pneumonia.
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Randomized Controlled Trial
Cardiac effects of continuous and bilevel positive airway pressure for patients with heart failure and obstructive sleep apnea: a pilot study.
Obstructive sleep apnea (OSA) is prevalent in patients with heart failure. Treatment with continuous positive airway pressure (CPAP) improves systolic function in patients with heart failure. Bilevel positive airway pressure (PAP) is another treatment modality for OSA. The intermediate-term effect of bilevel PAP on left ventricular ejection fraction (LVEF) in patients with stable heart failure and OSA has not been compared to the effect of CPAP. ⋯ This pilot randomized controlled trial suggests that bilevel PAP is superior to CPAP in improving LVEF in patients with systolic dysfunction and OSA. Larger trials are required to evaluate the mechanism behind this effect.
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Childhood idiopathic bronchiectasis (IB) unrelated to cystic fibrosis (CF) or known immunodeficiency remains a common problem among indigenous populations in developed and developing countries. The physical and transport properties of sputum among children with IB have not been described, and these properties may suggest therapies that would be particularly effective for this group of children. ⋯ The physical and transport properties of sputum from children with IB who are stable in the outpatient setting are substantially different and lead to improved cough transportability compared to sputum from children with CF or adults with CB. Therapies that focus on cough may be sufficient to improve airway mucus clearance in children with IB. Sputum properties may explain in part the different clinical course of children with IB compared to children with CF.
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Smoking is the single most important risk factor for COPD, yet there is still disagreement about the differences in the effect of smoking between white and African-American people. We hypothesized that the results of spirometry between smokers of the two races are equivalent if reference equations and lower limits of normal appropriate for each race are used. ⋯ There are no differences in spirometry findings between African Americans and whites when abnormality is defined appropriately using reference equations and lower limits of normal for each race. By using either percentage cutoffs for abnormality, or by adjusting for African-American equations only appropriate for whites, we were able to mimic with our data conflicting results in the literature.