Chest
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Review Meta Analysis
Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis.
This study compares, by meta-analysis, the use of anterior-posterior chest radiography (CR) with transthoracic ultrasonography for the diagnosis of pneumothorax. ⋯ The meta-analysis indicated that bedside ultrasonography performed by clinicians had higher sensitivity and similar specificity compared with CR in the diagnosis of pneumothorax, but the accuracy of ultrasonography in the diagnosis of pneumothorax depended on the skill of the operators.
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COPD is a preventable and treatable disease characterized by airflow limitation that is not fully reversible. The diagnosis of COPD is based on spirometric evidence of airways obstruction following bronchodilator administration. Although it used to be commonly believed that patients with COPD have largely irreversible airflow obstruction, evidence now suggests that a considerable proportion of patients exhibit clinically significant bronchodilator reversibility. ⋯ Although bronchodilator reversibility commonly is defined based on thresholds for improvement in FEV(1), lung volume-based measures of pulmonary function may be of particular importance in patients with severe COPD. The usefulness of acute reversibility to short-acting bronchodilators in predicting a patient's long-term response to bronchodilator maintenance therapy is also unclear, although most studies suggest that a lack of acute response to short-acting bronchodilators does not preclude a beneficial long-term response to maintenance bronchodilator treatment. This review outlines recent findings about the prevalence and usefulness of bronchodilator reversibility in patients with COPD based on the available literature and proposes areas of future research.
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Multicenter Study
Pancreatic stone protein: a marker of organ failure and outcome in ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is the most common hospital-acquired, life-threatening infection. Poor outcome and health-care costs of nosocomial pneumonia remain a global burden. Currently, physicians rely on their experience to discriminate patients with good and poor outcome. However, standardized prognostic measures might guide medical decisions in the future. Pancreatic stone protein (PSP)/regenerating protein (reg) is associated with inflammation, infection, and other disease-related stimuli. The prognostic value of PSP/reg among critically ill patients is unknown. The aim of this pilot study was to evaluate PSP/reg in VAP. ⋯ Serum PSP/reg is a biomarker related to organ failure and outcome in patients with VAP.