Chest
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Review Meta Analysis
Efficacy and tolerability of treatments for chronic cough: a systematic review and meta-analysis.
Understanding the comparative effectiveness of treatments for patients with unexplained or refractory cough is important to increase awareness of proven therapies and their potential adverse effects in this unique population. ⋯ Although evidence is limited, opioid and certain nonopioid and nonanesthetic antitussives demonstrated efficacy for treating chronic cough in adults. There is a need for further studies in patients with unexplained or refractory cough as well as for more systematic study designs, assessment of patient-centered outcomes, and reporting.
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Randomized Controlled Trial Multicenter Study
Development of a novel composite stroke and bleeding risk score in patients with atrial fibrillation: The AMADEUS study.
The aim of the current analysis was to identify independent predictors of the overall clinical outcome of patients with atrial fibrillation (AF), including both stroke/thromboembolism and/or major bleeding. Given the overlap between stroke and bleeding risk factors, a composite risk-stratification score for stroke/thromboembolism or bleeding could potentially be developed. ⋯ We have developed and validated two novel composite scores for stroke/thromboembolism/bleeding that offer good discriminatory and predictive performance. However, these composite risk scores did not perform better than the easier and more practical "traditional" stroke and bleeding risk scores that are currently in use, which allow greater practicality and a more personalized balancing of risks.
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Randomized Controlled Trial
A randomized controlled trial of balance training during pulmonary rehabilitation for individuals with COPD.
Deficits in balance are increasingly recognized among the important secondary impairments in COPD. The purpose of this study was to investigate the effect of a balance-training program on measures of balance and physical function in patients with COPD enrolled in pulmonary rehabilitation (PR). ⋯ Our results support the feasibility and effectiveness of balance training as part of PR for improving balance performance, muscle strength, and self-reported physical function in patients with moderate to severe COPD.
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The increasing frequency of ventilator-associated pneumonia (VAP) caused by colistin-only susceptible (COS) gram-negative bacteria (GNB) is of great concern. Adjunctive aerosolized (AS) colistin can reportedly increase alveolar levels of the drug without increasing systemic toxicity. Good clinical results have been obtained in patients with cystic fibrosis, but conflicting data have been reported in patients with VAP. ⋯ Our results suggest that AS colistin might be a beneficial adjunct to IV colistin in the management of VAP caused by COS GNB.
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Comparative Study
Quality Gaps and Comparative Effectiveness in Lung Cancer Staging: The impact of test sequencing on outcomes.
Evidence-based guidelines recommend mediastinal sampling as the first invasive test in patients with suspected lung cancer and mediastinal adenopathy. The goal of this study was to assess practice patterns and outcomes of diagnostic strategies in this patient population. ⋯ Quality gaps in lung cancer staging in patients with mediastinal adenopathy are common and lead to unnecessary testing and increased complications. In patients with suspected lung cancer without distant metastatic disease with mediastinal adenopathy, EBUS-TBNA should be the first test.