Chest
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Case Reports
Successful aeromedical transport using inhaled prostacyclin for a patient with life-threatening hypoxemia.
Our aim was to describe the technique and results of using inhaled prostacyclin (iPGI(2)) to enable the safe interhospital helicopter transport of a patient with ARDS complicated by life-threatening hypoxemia. The case describes a 32-year-old women with ARDS complicated by life-threatening hypoxemia who was referred to our ARDS referral center for further management. ⋯ After the administration of iPGI(2), oxygen saturation improved significantly, enabling the transport to occur safely by medevac helicopter. iPGI(2) is a valuable adjunct for the medical transport team to enable the safe transport of critically ill patients with severe hypoxemia. The simple, lightweight, and portable delivery system makes it ideal for use during all forms of aeromedical transport.
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To determine the trends in the prevalence of overweight and obese individuals among patients with myocardial infarction (MI), and to assess the association between weight and outcomes after MI. ⋯ The prevalence of overweight and obese individuals among patients with MI is high and increased over time. Despite a higher prevalence of other cardiovascular risk factors among patients with excess weight, these patients did not experience worse outcomes, underscoring the need to further study the paradoxical relation between weight and post-MI outcomes.
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To validate the APACHE (acute physiology and chronic health evaluation) III unadjusted and similar hospital mortality estimate models on 30-day mortality, and to propose a simple approach to modeling local 30-day in-hospital mortality of critically ill hospitalized adults for quality management and risk-adjusted monitoring. ⋯ For quality audit, 30-day in-hospital mortality can be used as an alternative outcome to survival to hospital discharge. New logistic regression models provide evidence that local models, possessing good calibration and discrimination, may be built from a few explanatory variables.
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To identify factors associated with a misclassification of the true disease stage by comparing the differences between the clinical and pathologic stage of patients with early-stage non-small cell lung cancer (NSCLC). ⋯ A lower lobe tumor location in patients with early-stage NSCLC appears to be associated with upstaging after surgery. We conclude that a tumor location in a lower lobe deserves special attention.
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Clinical Trial
Increased responses to inhaled oxitropium bromide in asthmatic patients with active hepatitis C virus infection.
The interaction between chronic hepatitis C virus (HCV) infection and bronchial asthma is of considerable interest. This study was designed to examine whether differences in airway responses to an inhaled anticholinergic agent exist between asthmatic patients with and without active HCV infection. ⋯ In patients with asthma, active HCV infection is associated with increased bronchodilator responses to inhaled oxitropium bromide. HCV infection may modulate acetylcholine-mediated airway tone.