Chest
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Observational Study
Diaphragm Excursion-Time Index: A New Parameter Using Ultrasonography to Predict Extubation Outcome.
The diaphragmatic response to increased mechanical load following withdrawal of mechanical ventilation is critical in determining the outcome of extubation. Using ultrasonography, we aimed to evaluate the performance of the excursion-time (E-T) index-a product of diaphragm excursion and inspiratory time, to predict the outcome of extubation. ⋯ Diaphragm E-T index measured during SBT may help predict the outcome of extubation. Maintenance or increase in diaphragm E-T index between A/C and SBT increases the likelihood of successful extubation.
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A 38-year-old right-handed woman presented to the hospital with subtle right facial palsy and global aphasia of 4 days' duration. She found that she had aphasia when she suddenly woke up at midnight and reported a headache lasting for several hours. ⋯ She was not taking any medication and was a nondrinker and nonsmoker. She had no other significant medical background and family history.
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Exacerbations of COPD (ECOPD) are a major cause of mortality and morbidity. Continuous cyclic azithromycin (CC-A) reduces the exacerbation rate, but it is unknown whether it remains effective and safe beyond the first year. ⋯ LT-CC-A therapy over a 24- to 36-month period in patients with COPD (Global Initiative for Chronic Obstructive Lung Disease grade D) achieved sustained reductions in ECOPD and hospitalizations of > 50% with few adverse events, although macrolide resistance increased.