Articles: disease.
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Multicenter Study
Sex-related differences in mortality, acute kidney injury, and respiratory failure among critically ill patients with COVID-19.
Although the number of deaths due to coronavirus disease 2019 (COVID-19) is higher in men than women, prior studies have provided limited sex-stratified clinical data. We evaluated sex-related differences in clinical outcomes among critically ill adults with COVID-19. Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units at 67 U. ⋯ Severe AKI occurred in 590 men (21.8%), and 239 women (15.5%), while respiratory failure occurred in 2255 men (80.7%) and 1234 women (76.5%). After adjusting for age, race/ethnicity and clinical variables, compared with women, men had a higher risk of death (OR, 1.50, 95% CI, 1.26-1.77), severe AKI (OR, 1.92; 95% CI 1.57-2.36), and respiratory failure (OR, 1.42; 95% CI, 1.11-1.80). In this multicenter cohort of critically ill adults with COVID-19, men were more likely to have adverse outcomes compared with women.
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Randomized Controlled Trial Multicenter Study
Behavioral interventions to reduce particulate matter exposure in patients with COPD.
Chronic obstructive pulmonary disease (COPD) is commonly affected by particulate matter (PM) exposure. In this study, we aimed to evaluate whether behavioral interventions to reduce PM exposure improve clinical outcomes in patients with COPD. ⋯ Given the harmful effect of air pollutants, individual-level interventions to reduce exposure may be significant. However, there is a lack of evidence on how effective such interventions are to date. This study will be able to provide physicians and patients with evidence-based strategies to reduce PM exposure in daily life.
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Randomized Controlled Trial Multicenter Study
Dupilumab in Children with Uncontrolled Moderate-to-Severe Asthma.
Children with moderate-to-severe asthma continue to have disease complications despite the receipt of standard-of-care therapy. The monoclonal antibody dupilumab has been approved for the treatment of adults and adolescents with asthma as well as with other type 2 inflammatory diseases. ⋯ Among children with uncontrolled moderate-to-severe asthma, those who received add-on dupilumab had fewer asthma exacerbations and better lung function and asthma control than those who received placebo. (Funded by Sanofi and Regeneron Pharmaceuticals; Liberty Asthma VOYAGE ClinicalTrials.gov number, NCT02948959.).
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Randomized Controlled Trial Multicenter Study
Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase.
At interim analysis in a phase 3, observer-blinded, placebo-controlled clinical trial, the mRNA-1273 vaccine showed 94.1% efficacy in preventing coronavirus disease 2019 (Covid-19). After emergency use of the vaccine was authorized, the protocol was amended to include an open-label phase. Final analyses of efficacy and safety data from the blinded phase of the trial are reported. ⋯ The mRNA-1273 vaccine continued to be efficacious in preventing Covid-19 illness and severe disease at more than 5 months, with an acceptable safety profile, and protection against asymptomatic infection was observed. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.).
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Randomized Controlled Trial Multicenter Study
Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial.
The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia (CAP) are unclear. ⋯ Among children with CAP discharged from an emergency department or hospital ward (within 48 hours), lower-dose outpatient oral amoxicillin was noninferior to higher dose, and 3-day duration was noninferior to 7 days, with regard to need for antibiotic re-treatment. However, disease severity, treatment setting, prior antibiotics received, and acceptability of the noninferiority margin require consideration when interpreting the findings.