Respiratory care
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Comparative Study Observational Study
Comparison of Bronchoscopic and Nonbronchoscopic Methods of Airway Culturing in Tracheostomized Children.
Distal airway secretions can be sampled by bronchoscopic bronchoalveolar lavage (B-BAL), blind protected BAL (BP-BAL), and tracheal aspiration (TA). We quantitatively compared the cultures of distal airway secretions from BP-BAL, B-BAL, and TA specimens, and assessed the efficacy of the three above methods in diagnosing bronchitis in tracheostomized children. ⋯ BP-BAL allows for more accurate sampling of lower airway secretions in tracheostomized children and is more accurate in the diagnosis of bronchitis in this group.
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In March 2013, the first patient infected with the avian influenza A H7N9 virus was identified in China. The infection progressed rapidly, and the patient died of ARDS. ⋯ When the viral infection was identified, strict procedures for disinfection and protection were carried out. None of the health care workers involved in the management of the patient were infected.
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Review Meta Analysis
Corticosteroid therapy for severe community-acquired pneumonia: A meta-analysis.
The debate about the efficacy of corticosteroids in the treatment of severe community-acquired pneumonia (CAP) is still a longstanding dilemma. We performed a meta-analysis including 4 randomized controlled trials (RCTs) to evaluate the effect of corticosteroids on the treatment of severe CAP in adults. ⋯ On the basis of the current limited evidence, we suggest that, although corticosteroid therapy may reduce mortality and improve the prognosis of adult patients with severe CAP, the results should be interpreted with caution due to the instability of pooled estimates. Reliable treatment recommendations will be raised only when large sufficiently powered multi-center RCTs are conducted.
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Observational Study
CRP, PCT, CPIS AND PNEUMONIA SEVERITY SCORES IN NURSING HOME ACQUIRED PNEUMONIA.
Patients with nursing home acquired pneumonia (NHAP) present a distinct group of lower respiratory track infections with different risk factors, clinical presentation, and mortality rates. ⋯ CPIS, procalcitonin, and C-reactive protein are reliable for the diagnosis of NHAP. Procalcitonin and CURB-65 are accurate in predicting in-patient mortality in NHAP.