American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2020
Use of Hydrocortisone, Ascorbic Acid, and Thiamine in Adults with Septic Shock.
Rationale: In December 2016, a single-center study describing significant improvements in mortality among a small group of patients with severe sepsis and septic shock treated with hydrocortisone, high-dose ascorbic acid, and thiamine (HAT therapy) was published online. Objectives: This study aims to describe the administration of HAT therapy among U. S. adults with septic shock before and after study publication and to compare outcomes between patients who received and did not receive HAT therapy. ⋯ Receipt of early HAT was associated with higher hospital mortality (28.2% vs. 19.7%; P < 0.001; adjusted odds ratio, 1.17 [95% CI, 1.02-1.33]; primary propensity-matched model adjusted odds ratio, 1.19 [95% CI, 1.02-1.40]). Conclusions: Publication of a single-center retrospective study was associated with significantly increased administration of HAT. Among patients with early septic shock, receipt of HAT was not associated with mortality benefit.
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Am. J. Respir. Crit. Care Med. · Dec 2020
Impact of Effective Global Tuberculosis Control on Health and Economic Outcomes in the United States.
Rationale: Most U. S. residents who develop tuberculosis (TB) were born abroad, and U. S. ⋯ The total U. S. economic burden of TB (including the value of averted TB deaths) would be 21% (95% uncertainty interval, 16-28%) lower (18 billion dollars [95% uncertainty level, 8-32 billion dollars]). Conclusions: In addition to producing major health benefits for high-burden countries, strengthened efforts to achieve effective global TB control could produce substantial health and economic benefits for the United States.