Articles: prospective-studies.
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The detrimental effects of post-thoracotomy pain syndrome is experienced worldwide; however, an effective treatment regimen remains elusive. ⋯ Although the data are limited, in the aforesaid case report, post-thoracotomy syndrome was effectively treated with the use of PNfS. This resulted in a significant pain perception reduction, increased quality of life and mobility, as well as decreased usage of oral pain medications. This adds to the accumulating case report and case series data that suggest PNfS is showing great promise as a pain reduction modality. Further, it is minimally invasive, can be trialled prior to implantation, and is reversible. Large prospective studies will be required in the future to further evaluate its efficacy before it can be widely accepted and adopted.
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Rev Bras Ter Intensiva · Sep 2010
Outcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury.
Critically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury. ⋯ The present study demonstrates that intensive care units admission and advanced life-support should be considered in selected critically ill cancer patients with kidney injury.
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J Bronchology Interv Pulmonol · Jul 2010
Utility of semirigid thoracoscopy in the diagnosis of pleural effusions: a systematic review.
Pleural effusion of undetermined etiology (PEUE), where blind pleural aspirate/biopsy fails to yield an answer, often needs histologic study for a definitive diagnosis. Several studies have shown the potential utility of medical thoracoscopy (MT) in PEUE; results, however, are not uniform and a majority are available for rigid thoracoscopy. We sought to determine the diagnostic accuracy of the relatively new technique of semirigid thoracoscopy in PEUE through this systematic review. ⋯ Semirigid thoracoscopy seems to be a safe, simple, and accurate tool for undiagnosed pleural effusions. It is well tolerated and is devoid of major complications. Further studies with sound methodology will further help to define the future role of this procedure.
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By a prospective database analysis of patients with an injury to the chest admitted to the University Medical Center Utrecht between 2000 and 2004 were studied. All patients with a blood gas analyses were included. Absolute BD was used for analyses. Clinical outcome parameters were recorded. ⋯ Admission BD is a predictive factor in thoracic trauma patients for mortality and chest related complications. Furthermore it is a predictive factor for ICU admission, required ventilation and hospital stay. The use of BD in thoracic trauma patients can potentially identify patients who require additional monitoring or early aggressive therapy.
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The Lotrach endotracheal tube has a unique low-volume, low-pressure (LVLP) cuff, which has been designed to prevent pressure injury to the tracheal wall. We aimed to estimate the pressure exerted on the tracheal wall by the LVLP cuff and a conventional cuff in a bench-top, clinical and radiological study. ⋯ The bench-top and clinical studies both demonstrated that the LVLP cuff exerted approximately 30 cmH2O of pressure on the tracheal wall. These results are supported by our radiological study. We conclude that the LVLP cuff exerts an acceptable amount of pressure on the tracheal wall when it is operated at the recommended intracuff pressure.