Plos One
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Randomized Controlled Trial Multicenter Study Comparative Study
Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment.
The optimal treatment duration for ventilator-associated pneumonia is based on one study dealing with late-onset of the condition. Shortening the length of antibiotic treatment remains a major prevention factor for the emergence of multiresistant bacteria. ⋯ Our results suggest that an 8-day course of antibiotic therapy is safe for early-onset ventilator-associated pneumonia in intubated patients.
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Randomized Controlled Trial Multicenter Study
A randomized, double blind, placebo-controlled trial of pioglitazone in combination with riluzole in amyotrophic lateral sclerosis.
Pioglitazone, an oral anti-diabetic that stimulates the PPAR-gamma transcription factor, increased survival of mice with amyotrophic lateral sclerosis (ALS). ⋯ Pioglitazone has no beneficial effects on the survival of ALS patients as add-on therapy to riluzole.
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Multicenter Study
Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.
The impact of diuretic usage and dosage on the mortality of critically ill patients with acute kidney injury is still unclear. ⋯ Higher time-varying 3-day accumulative diuretic dose predicts mortality in postsurgical critically ill patients requiring acute dialysis. Higher diuretic doses are associated with hypotension and a lower intensity of dialysis. Caution should be employed before loop diuretics are administered to postsurgical patients during the acute dialysis period.
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Multicenter Study
Readmissions and death after ICU discharge: development and validation of two predictive models.
Early discharge from the ICU is desirable because it shortens time in the ICU and reduces care costs, but can also increase the likelihood of ICU readmission and post-discharge unanticipated death if patients are discharged before they are stable. We postulated that, using eICU® Research Institute (eRI) data from >400 ICUs, we could develop robust models predictive of post-discharge death and readmission that may be incorporated into future clinical information systems (CIS) to assist ICU discharge planning. ⋯ Our models for death and readmission after ICU discharge showed good to excellent discrimination and good calibration. Although prospective validation is warranted, we speculate that these models may have value in assisting clinicians with ICU discharge planning.
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Multicenter Study
Derivation and validation of a scoring system to identify patients with bacteremia and hematological malignancies at higher risk for mortality.
The aim of this study was to develop and validate a reliable clinical prediction rule that could be employed to identify patients at higher likelihood of mortality among those with hematological malignancies (HMs) and bacterial bloodstream infections (BBSIs). ⋯ The risk index accurately identifies patients with HMs and BBSIs at high risk for mortality; a better initial predictive approach may yield better therapeutic decisions for these patients, with an eventual reduction in mortality.