Chest
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Aortic root abscess is a common complication of aortic valve endocarditis. However, aortic root abscess and formation of a fistula from the aortic root to the right ventricular outflow tract in the setting of a native aortic valve and previous repair of an aortic dissection with a Dacron graft is an uncommon event. Transesophageal echocardiography is superior to transthoracic echocardiography for the diagnosis of aortic root abscess. To our knowledge, no studies have compared the diagnostic value of cardiac MRI with transesophageal echocardiography for this condition.
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To identify the relative contribution of hydrostatic and permeability mechanisms to the development of human neurogenic pulmonary edema. ⋯ Many of our patients had a hydrostatic mechanism for neurogenic pulmonary edema. This is a novel observation in humans since prior clinical case reports have emphasized increased permeability as the usual mechanism for neurogenic pulmonary edema. These findings are consistent with pulmonary venoconstriction or transient elevation in left-sided cardiovascular pressures as contributing causes to the development of human neurogenic pulmonary edema.
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Randomized Controlled Trial Clinical Trial
The effect of salmeterol on nocturnal symptoms, airway function, and inflammation in asthma.
To determine the efficacy of salmeterol alone in a group of patients with moderate asthma with nocturnal worsening of symptoms. ⋯ Salmeterol alone improves the number of nocturnal awakenings and supplemental 24-h beta 2-agonist use in nocturnal asthma without significantly altering lung function and airway inflammation.
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To determine an effective means of improving compliance with nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA). ⋯ Attendance in a group clinic designed to encourage patient compliance with CPAP therapy provided a simple and effective means of improving treatment of OSA.
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To determine the relative importance of clinically recognized cardiac dysfunction and unrecognized cardiac injury to hospital mortality. ⋯ Among critically ill medical patients, clinically recognized cardiac dysfunction is an independent determinant of hospital mortality. The identification of unrecognized cardiac injury, using serial measurements of cardiac troponin I, did not independently contribute to the prediction of hospital mortality.