The clinical respiratory journal
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Treatment of chronic obstructive pulmonary disease (COPD) is evolving specially with triple inhaler therapy. ⋯ Among patients with moderate-to-severe COPD, triple inhaler therapy was associated with a reduction of moderate-to-severe COPD exacerbations, improved lung function and improved quality of life when compared to dual inhaler therapy but with an increased pneumonia risk.
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Thoracoscopy in the endoscopy suite, has a high diagnostic yield of undiagnosed pleural effusions with minimal and mild complications. Whereas relatively minimal invasive techniques, such as thoracentesis, image-guided pleural biopsy or blind pleural biopsy, can yield sufficient cell or tissue material to establish the diagnosis of the underlying condition, more definite invasive diagnostic and therapeutic procedure, such as thoracoscopy, may be required for accurate sampling and diagnosis, and further provide real-time treatment options in same procedure. If thoracoscopy is considered the gold standard for the diagnosis is a fact in case. The current review aims to provide informations on thoracoscopy indications in benign pleural diseases according to up to date publications.
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Comparative Study
Comparing severity scores in exacerbations of chronic obstructive pulmonary disease.
Prognostic scores help identify patients at a high risk of mortality in exacerbations of chronic obstructive pulmonary disease (COPD). The Dyspnoea, Eosinopaenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) score has been reported to perform better than other severity scores in predicting mortality from exacerbations of COPD in studies including patients with pneumonia. ⋯ In patients hospitalised with exacerbations of COPD without pneumonia, simple clinical scores that rely on fewer laboratory measures perform at least as well as DECAF in predicting early mortality.
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Comparative Study
Chest physiotherapy with early mobilization may improve extubation outcome in critically ill patients in the intensive care units.
Extubation failure can lead to a longer intensive care unit (ICU) stay, higher mortality rate, and higher risk of requiring tracheostomy. Chest physiotherapy (CPT) can help patients in reducing the accumulation of airway secretion, preventing collapsed lung, improving lung compliance, and reducing comorbidities. Much research has investigated the correlation between CPT and respiratory system clearance. However, few studies have investigated the correlation between CPT and failed ventilator extubation. Therefore, this study aimed to investigate the use of CPT for reducing the rate of failed removal from mechanical ventilators. ⋯ The results indicate that intensive chest physiotherapy could decrease extubation failure in mechanically ventilated patients in the ICU. In addition, chest physiotherapy could also significantly improve the rapid shallow breathing index score.
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Comparative Study
The association between Cytomegalovirus co-infection with Pneumocystis pneumonia and mortality in immunocompromised non-HIV patients.
Impact of Cytomegalovirus (CMV) co-infection pneumonia in non-HIV patients with Pneumocystis jirovecii pneumonia (PCP) is unclear. ⋯ The risk of mortality appears to be increased in the setting of CMV and PCP co-infection in HIV-uninfected immunocompromised patients. PCP prophylaxis use was lower than expected, suggesting low physician awareness of the risks of PCP in this population.