Chest
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Comparative Study
Diagnostics of spontaneous cough in childhood asthma: results of continuous tracheal sound recording in the homes of children.
Spontaneous cough is a symptom with diffuse diagnostic significance for childhood asthma. Information on the interrelations between presence/frequency of cough and other symptoms of asthma are not available to the physician. Tracheal sounds were continuously recorded in the homes of 60 children with and 30 without asthma, at 72 and 24 h, respectively. ⋯ Three children did not cough during exacerbations. Persistent, isolated cough was observed in two children. It was concluded that spontaneous cough is modestly predictive of asthmatic exacerbations, but not of a diagnosis of asthma or severity of asthma.
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The treatment of small cell lung cancer (SCLC) has evolved significantly over the past 3 decades. Single-agent and combination chemotherapies given with radiotherapy have greatly improved response rates and median survival. Combination regimens such as cisplatin/etoposide, carboplatin/etoposide, ifosfamide/carboplatin/etoposide, cyclophosphamide/doxorubicin/vincristine, and etoposide/ifosfamide/cisplatin have all achieved good response rates. ⋯ New agents showing good preliminary single-agent activity in untreated SCLC include paclitaxel, vinorelbine, gemcitabine, topotecan, and teniposide. Results obtained with single-agent docetaxel and CPT-11 are thus far inconclusive. Studies evaluating response and survival rates of these new agents in combination with agents of known activity are underway.
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Comparative Study
Salbutamol delivery from a hydrofluoroalkane pressurized metered-dose inhaler in pediatric ventilator circuits: an in vitro study.
The aim of our study was to determine the in vitro delivery of salbutamol from a pressurized metered-dose inhaler (pMDI) containing hydrofluoroalkane (HFA) propellant through various delivery devices to four models of a pediatric lung. ⋯ Salbutamol from an HFA pMDI is delivered efficiently through inline holding chambers with reduced static in pediatric ventilator settings. A large holding chamber has no advantage over a small holding chamber. In addition, salbutamol delivery is more efficient through a holding chamber than through a nonchamber device.
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To assess the utilization of venous thromboembolism (VTE) prophylaxis in a medical-surgical ICU. ⋯ Eighty-six percent of the medical-surgical patients included in this study received VTE prophylaxis. The utilization of VTE prophylaxis described in this study is higher compared to previously published data. The nature of physician coverage in our medical-surgical ICU (closed unit), consistent practice patterns of a designated ICU staff, and a continuing medical education program involving VTE prophylaxis are the factors believed to be responsible for these results.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A 1-year community-based health economic study of ciprofloxacin vs usual antibiotic treatment in acute exacerbations of chronic bronchitis: the Canadian Ciprofloxacin Health Economic Study Group.
To evaluate the costs, consequences, effectiveness, and safety of ciprofloxacin vs standard antibiotic care in patients with an initial acute exacerbation of chronic bronchitis (AECB) as well as recurrent AECBs over a 1-year period. ⋯ Treatment with ciprofloxacin tended to accelerate the resolution of all AECBs compared to usual care; however, the difference was not statistically significant. Further, usual care was found to be more reflective of best available care rather than usual first-line agents such as amoxicillin, tetracycline, or trimethoprim-sulfamethoxazole as originally expected. Despite the similar antimicrobial activities and broad-spectrum coverage of both ciprofloxacin and usual care, the trends in clinical outcomes and all quality of life measurements favor ciprofloxacin. In patients suffering from an AECB with a history of moderate to severe chronic bronchitis and at least four AECBs in the previous year, ciprofloxacin treatment offered substantial clinical and economic benefits. In these patients, ciprofloxacin may be the preferred first antimicrobial choice.