Chest
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COPD is a common comorbidity in heart failure. The efficacy of implantable cardioverter-defibrillator (ICD) therapy has not been determined in patients with heart failure and COPD. ⋯ Patients with COPD have a higher incidence of ICD shocks than those without COPD and appear to benefit from ICD therapy.
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Comparative Study
Pulmonary necrotizing granulomas of unknown cause: clinical and pathologic analysis of 131 patients with completely resected nodules.
The cause of pulmonary necrotizing granulomas is often unclear, even after histologic examination. Our aim was to determine the clinical significance of histologically unexplained necrotizing granulomas. ⋯ A cause, the most common being infection, can be established in many surgically resected pulmonary necrotizing granulomas that appear unexplained at the time of initial histologic diagnosis. Patients whose granulomas remain unexplained after a rigorous review have a favorable outcome. Most do not develop new nodules or progress clinically, even without medical therapy.
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The association between levels of acute kidney injury (AKI) during ICU admission and long-term mortality are not well defined. ⋯ Patients in whom AKI develops during ICU admission have significantly increased risks of death that extend beyond their high ICU mortality rates. These increased risks of death continue for at least 2 years after the index ICU admission.
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Comparative Study
Thromboprophylaxis and VTE Rates in Soldiers Wounded in Operation Enduring Freedom and Operation Iraqi Freedom.
US soldiers suffer catastrophic injuries during combat. We sought to define risk factors and rates for VTE in this population. ⋯ Patients who suffer traumatic injuries in combat overseas are at high risk for VTE during evacuation and recovery. Those with large resuscitations are at particularly high risk, and low-molecular-weight heparin is associated with a decrease in VTE.
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Comparative Study
Repair of lipopolysaccharide-induced acute lung injury in mice by endothelial progenitor cells, alone and in combination with simvastatin.
Endothelial progenitor cells (EPCs) are involved in endothelium repair of acute lung injury (ALI). Numerous studies have demonstrated that statins can promote EPC function in vitro and in vivo; therefore, the purpose of this study was to determine whether simvastatin enhances the function of EPCs participating in the repair of ALI. ⋯ The administration of simvastatin and EPC transplantation can reduce the severity of LPS-induced ALI in mice, and improvement is moderately enhanced in some respects when EPC transplantation is combined with simvastatin administration. The beneficial role of simvastatin on EPCs may be a component of its pleiotropic effects. Although the exact mechanism remains unknown, the combined administration of simvastatin and EPC transplantation may be a potentially important, cell-based, inflammation-mediated therapy for patients with ALI/ARDS.