Reviews on recent clinical trials
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Malignant pleural effusion, which is a common clinical problem in patients with cancer, may be due to both primary thoracic tumours or to a metastatic spread in the chest and constitutes the first sign of disease in approximately 10% of patients. Almost all cancers can potentially produce a pleural effusion. The presence of malignant tumour cells in the pleural fluid is generally indicative of advanced disease and is associated with high morbidity and mortality with reduced therapeutic options. Dyspnoea during mild physical activity or at rest is generally the typical sign of restrictive respiratory failure. ⋯ Despite progress in therapeutic options, the prognosis remains severe, and the average survival is 4-9 months from the diagnosis of malignant pleural effusion. Moreover, mortality is higher for patients with malignant pleural effusion compared with those with metastatic cancer but no malignant pleural effusion. Therefore, the prognosis of these patients primarily depends on the underlying disease and the extension of a primary tumour. This review focuses on the most relevant updates in the management of malignant pleural effusion.
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Rev Recent Clin Trials · Jan 2019
Randomized Controlled TrialDexmedetomidine versus Midazolam-Fentanyl in Procedural Analgesia Sedation for Reduction of Anterior Shoulder Dislocation: A Randomized Clinical Trial.
Shoulder joint dislocation is the most common dislocation of joints in the body. To reduce the anterior shoulder dislocation, it is necessary to have analgesia and sedation. ⋯ The findings of this study show that dexmedetomidine provides a higher level of analgesia than midazolam-fentanyl. Moreover, it was also shown that dexmedetomidine causes quicker procedural sedation than midazolam-fentanyl.
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Rev Recent Clin Trials · Jan 2019
High Flow Through Nasal Cannula in Stable and Exacerbated Chronic Obstructive Pulmonary Disease Patients.
High-Flow through Nasal Cannula (HFNC) is a system delivering heated humidified air-oxygen mixture at a flow up to 60 L/min. Despite increasing evidence in hypoxemic acute respiratory failure, a few is currently known in chronic obstructive pulmonary disease (COPD) patients. ⋯ Though evidence of superiority still lacks and further studies are necessary, HFNC might play a role in the treatment of both stable and exacerbated COPD patients.