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Respiratory Infections PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Azithromycin (AZ) is a macrolide that has shown increased survival in patients with community-acquired pneumonia and bacteremic pneumococcal pneumonia. Immunomodulatory properties are claimed to be associated with the beneficial effects of macrolides. However, limited data are available about the clinical efficacy in patients with severe sepsis. Our aim was to assess the efficacy of AZ in addition to standard of care (SOC) therapy compared to SOC antimicrobial therapy in a pilot randomized controlled trial (RCT) in critically ill patients with severe sepsis. ⋯ Marcos Restrepo: Grant monies (from sources other than industry): NIH/NHLBI K23HL096054 The following authors have nothing to disclose: Paola Faverio, Alejandro Arango, Oriol Sibila, Eric Mortensen, Grant Waterer, Richard Wunderink, Antonio AnzuetoNo Product/Research Disclosure Information.
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COPD QVA149 PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Current COPD treatment guidelines recommend long-acting β2-agonist/inhaled corticosteroids (LABA/ICS) for severe COPD patients with a history of exacerbations. The 26-week ILLUMINATE study in moderate-to-severe COPD patients showed superiority of QVA149 versus the LABA/ICS salmeterol/fluticasone combination (SFC) in lung function. A novel study design to evaluate the effect of QVA149 versus SFC on COPD exacerbations in more severe patients with a history of exacerbations is presented. ⋯ Jadwiga Wedzicha: Consultant fee, speaker bureau, advisory committee, etc.: JW has received speaking fee and/or for advisory boards from GlaxoSmithKline, AstraZeneca, Novartis, Bayer, Boehringer Ingelheim, Nycomed. Chiesi and Respifor as well as travel reimbursements from Boehringer Ingelheim. JW has received research grants from GlaxoSmithKline, AstraZeneca, Chiesi and Novartis. Nicola Gallagher: Employee: Novartis employee Donald Banerji: Employee: Novartis employee The following authors have nothing to disclose: Jørgen VestboClinical trial results of QVA149, combination of two approved products indacaterol and glycopyrronium, will be presented, QVA is in the late stage phase 3 trials prior to approval.
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PleuralSESSION TYPE: Slide PresentationsPRESENTED ON: Sunday, March 23, 2014 at 04:15 PM - 05:15 PMPURPOSE: Study objective: To evaluate the role of rigid medical thoracoscopy in the management of patients with undiagnosed exudative pleural effusion. ⋯ The following authors have nothing to disclose: Essam Hassanein, Eman Hatata, Suzan Helal, Emad Ibrahim, Ayman BaessNo Product/Research Disclosure Information.
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ILD Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: The cryptogenic organizing pneumonia (COP) is a disease characterized by impairment of alveolar ducts and terminal bronchioles with inflammation. It was previously known as bronchiolitis obliterans organizing pneumonia (BOOP). It affects men and women with the same incidence and may be secondary to infections, drugs or be a primary manifestation. This case report presents a patient with COP whose approach dispensed, in accordance with the patient, lung biopsy for diagnosis. Only clinical data,laboratorial and image exams were used to define the conduct. ⋯ The patient improved dramatically after introduction of corticosteroid therapy, which has been decreasing gradually in posology. This case expresses an opportunity for choice by the patient, along with the physician and scientific evidence, to a personal approach for this disease.Reference #1: Vasu TS, Cavallazzi R, Hirani A, Sharma D, Weibel SB, Kane GC. Clinical and radiologic distinctions between secondary bronchiolitis obliterans organizing pneumonia and cryptogenic organizing pneumonia. Respir Care. 2009.Reference #2: Oymak FS, Demirbas HM, Mavili E, et al. Bronchiolitis obliterans organizing pneumonia. Clinical and roentgenological features in 26 cases. Respiration. 2005;723:254-262Reference #3: Sveinsson OA, Isaksson HJ, Sigvaldason A, Yngvason F, Aspelund T, Gudmundsson G. Clinical features in secondary and cryptogenic organising pneumonia. Int J Tuberc Lung Dis. 2009DISCLOSURE: The following authors have nothing to disclose: Gilmar Zonzin, Christian Boechat, Gabriela de Souza, Silvio Guerra, Priscila das Virgens, Jamile Abdalla, Vinícius AgostinhoNo Product/Research Disclosure Information.
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The modern medical record is not only used by providers to record nuances of patient care, but also is a document that must withstand the scrutiny of insurance payers and legal review. Medical documentation has evolved with the rapid growth in the use of electronic health records (EHRs). The medical software industry has created new tools and more efficient ways to document patient care encounters and record results of diagnostic testing. ⋯ Policies to guide provider documentation in EHRs have been developed by institutions and payers with the goal of reducing patient care risks as well as preventing fraud and abuse. In this article, we describe the major content-importing technologies that are commonly used in EHR documentation as well as the benefits and risks associated with their use. We have also reviewed a number of institutional policies and offer some best practice recommendations.