Chest
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Randomized Controlled Trial Multicenter Study Comparative Study
Prognostic and pathogenetic value of combining clinical and biochemical indices in patients with acute lung injury.
No single clinical or biologic marker reliably predicts clinical outcomes in acute lung injury (ALI)/ARDS. We hypothesized that a combination of biologic and clinical markers would be superior to either biomarkers or clinical factors alone in predicting ALI/ARDS mortality and would provide insight into the pathogenesis of clinical ALI/ARDS. ⋯ A combination of biomarkers and clinical predictors is superior to clinical predictors or biomarkers alone for predicting mortality in ALI/ARDS and may be useful for stratifying patients in clinical trials. From a pathogenesis perspective, the degree of acute inflammation and alveolar epithelial injury are highly associated with the outcome of human ALI/ARDS.
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Randomized Controlled Trial Multicenter Study Comparative Study
Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU.
Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members. ⋯ Families demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms.
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial.
Optimal dosing of the recombinant tissue-type plasminogen activator (rt-PA) is important in treating pulmonary thromboembolism (PTE). The aim of this study was to compare the efficacy and safety of a 50 mg/2 h rt-PA regimen with a 100 mg/2 h rt-PA regimen in patients with acute PTE. ⋯ Compared with the 100 mg/2 h regimen, the 50 mg/2 h rt-PA regimen exhibits similar efficacy and perhaps better safety in patients with acute PTE. These findings support the notion that optimizing rt-PA dosing is worthwhile when treating patients with PTE.
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Multicenter Study Comparative Study
Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation.
Contemporary clinical risk stratification schemata for predicting stroke and thromboembolism (TE) in patients with atrial fibrillation (AF) are largely derived from risk factors identified from trial cohorts. Thus, many potential risk factors have not been included. ⋯ Our novel, simple stroke risk stratification schema, based on a risk factor approach, provides some improvement in predictive value for TE over the CHADS(2) schema, with low event rates in low-risk subjects and the classification of only a small proportion of subjects into the intermediate-risk category. This schema could improve our approach to stroke risk stratification in patients with AF.
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Multicenter Study Comparative Study
Multiplex molecular detection of respiratory pathogens in children with asthma exacerbation.
Up to 80% of asthma exacerbations in white children are associated with viral upper respiratory infections. The relative importance of different respiratory pathogens and relevant microbiological data in Asian children are unclear. This study elucidated the epidemiology of respiratory infections in Hong Kong children with asthma exacerbation. ⋯ Respiratory viral infections are commonly found in children with asthma exacerbation, with HRV being the most important pathogen in our patients. Respiratory viral infection is a triggering factor for asthma exacerbation but does not correlate with its severity.