Chest
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Randomized Controlled Trial Multicenter Study Comparative Study
Early microbiological response to linezolid vs vancomycin in ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus.
Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of ventilator-associated pneumonia (VAP). This prospective, open-label, multicenter clinical trial compared the early microbiological efficacy of linezolid (LZD) therapy with that of vancomycin (VAN) therapy in patients with MRSA VAP. ⋯ Early microbiological cure rates were not statistically significantly higher with LZD therapy than with VAN therapy despite trends in all secondary clinical outcomes favoring LZD therapy. These results suggest that any beneficial effect of LZD therapy may be due to factors other than increased bacterial clearance.
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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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Multicenter Study
Differences in hospital mortality among critically ill patients of Asian, Native Indian, and European descent.
It is unclear whether race/ethnicity influences survival for acute critical illnesses. We compared hospital mortality among patients of Asian (originating from Asia or Southeast Asia), Native Indian, and European descent admitted to the ICU. ⋯ Patients of Asian and Native Indian descent with acute critical illness did not have an increased mortality after adjusting for differences in case mix.
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Multicenter Study Comparative Study
Outcomes of emergency department patients treated for primary spontaneous pneumothorax.
International guidelines for the management of primary spontaneous pneumothorax (PSP) vary, and there is growing opinion that more patients could be successfully managed with observation alone. There is little published evidence detailing the outcomes of emergency department (ED) patients who have been treated for PSP. The aim of this study was to describe the clinical outcomes for patients with PSP. ⋯ These data suggest that observation alone is an effective initial treatment strategy for selected patients with PSP. They support the inclusion of an observation arm in planned prospective studies comparing different management approaches.
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Randomized Controlled Trial Multicenter Study
Alendronate once weekly for the prevention and treatment of bone loss in Canadian adult cystic fibrosis patients (CFOS trial).
Patients with cystic fibrosis (CF) are at risk for early bone loss, and demonstrate increased risks for vertebral fractures and kyphosis. A multicenter, randomized, controlled trial was conducted to assess the efficacy, tolerability, and safety of therapy with oral alendronate (FOSAMAX; Merck; Whitehouse Station, NJ) in adults with CF and low bone mass. ⋯ Alendronate therapy was well tolerated and produced a significantly greater increase in BMD over 12 months compared with placebo.