Chest
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Tracheostomy tube malposition is a barrier to weaning from mechanical ventilation. We determined the incidence of tracheostomy tube malposition, identified the associated risk factors, and examined the effect of malposition on clinical outcomes. ⋯ Tracheostomy tube malposition appears to be a common and important complication in patients who are being weaned from mechanical ventilation. Surgical expertise may be an important factor that impacts this complication.
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Despite a variety of benefits brought by pulmonary rehabilitation to patients with COPD, it is unclear whether these patients are more active during daily life after the program. ⋯ If one aims at changing physical activity habits in the daily life of COPD patients, the contribution of long-lasting programs might be important.
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To identify predictors of 30-day mortality and hospital costs in patients with ventilator-associated pneumonia (VAP) attributed to potentially antibiotic-resistant Gram-negative bacteria (PARGNB) [Pseudomonas aeruginosa, Acinetobacter species, and Stenotrophomonas maltophilia]. ⋯ These data suggest that inappropriate initial antibiotic therapy of microbiologically confirmed VAP attributed to PARGNB is associated with greater 30-day mortality. High rates of VAP attributed to antibiotic-resistant bacteria (eg, Acinetobacter species) may require changes in the local empiric antibiotic treatment of VAP in order to optimize the prescription of appropriate initial therapy.
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High-resolution CT (HRCT) scan data on primary ciliary dyskinesia (PCD) related lung disease are scarce. ⋯ PCD patients show significantly lower pulmonary HRCT scan scores than CF patients. The PCD total and bronchiectasis scores correlate with spirometry findings. The PCD HRCT scan score might be used for longitudinal assessment and/or represent an outcome surrogate in future studies.
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Sleep bruxism (SB) is a stereotyped movement disorder that is characterized by rhythmic masticatory muscle activity (RMMA) and tooth grinding. Evidence has suggested that SB is associated with sleep arousals and that most RMMA episodes are preceded by physiologic changes occurring in sequence, namely, a rise in autonomic sympathetic-cardiac activity followed by a rise in the frequency of EEG and suprahyoid muscle activity. In the present study, we hypothesize that an increase in respiration also characterizes the onset of SB within the arousal sequence. ⋯ To our knowledge, this is the first report showing that RMMA-SB muscle activity is associated with a rise in respiration within arousal.