The American journal of medicine
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Multicenter Study
Respiratory virus infections in bone marrow transplant recipients: the European perspective.
The role of respiratory viruses in severe complications following bone marrow transplantation was examined in a survey of selected transplant centers in Europe belonging to the European Group for Blood and Marrow Transplantation. Information was collected on 57 cases of infections with respiratory viruses, including adenoviruses. In two centers that had conducted prospective studies of bone marrow recipients with respiratory symptoms, the frequency of these infections was 7.1% and 4%, respectively. ⋯ Influenza infections progressed to fatal pneumonia in 17% of cases. Results of antiviral therapy varied. As the results of our survey showed, respiratory virus infections are not infrequent after bone marrow transplantation and are associated with significant morbidity and mortality.
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Multicenter Study Comparative Study
Pain during hospitalization is associated with continued pain six months later in survivors of serious illness. The SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.
To determine the level of pain reported by survivors of serious illness 2 and 6 months after study enrollment and to identify variables associated with later pain. ⋯ Survivors of the serious and common illnesses that we studied have a high level of pain during hospitalization and up to 6 months after hospitalization. Level of hospital pain was most strongly associated with later pain. Better pain control both during hospitalization and after discharge should be given a high priority. Pain during hospitalization should trigger future inquiries about pain and its treatment.
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Comparative Study
Body mass index as a correlate of postoperative complications and resource utilization.
To describe the relationship of body mass index (BMI) with postoperative complications and resource utilization. ⋯ Overall, BMI was not significantly correlated with postoperative complications or length of stay. However, overweight patients who underwent abdominal or gynecologic procedures had higher wound infection rates, and patients with the highest and lowest BMIs had significantly higher adjusted total costs.
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Comparative Study
Reversible hypercapnia in chronic obstructive pulmonary disease: a distinct pattern of respiratory failure with a favorable prognosis.
Hypercapnia is regarded as a poor prognostic indicator in chronic obstructive pulmonary disease (COPD), but many patients hospitalized with hypercapnia associated with an acute exacerbation of COPD revert to normocapnia during recovery. We wished to determine if this reversible hypercapnia represents a distinct pattern of respiratory failure in COPD, or simply a stage in the progression to chronic hypercapnia. We therefore compared the long-term clinical progression and survival of COPD patients with reversible hypercapnic respiratory failure (defined as type 2.1) to those with normocapnic (PaCO2 < 50 mm Hg; type 1) and also to those patients with chronic hypercapnic (PaCO2 > 50 mm Hg) respiratory failure (defined as type 2.2). ⋯ The data support reversible hypercapnia being a distinct manifestation of respiratory failure in COPD, with a similar prognosis to that of normocapnic respiratory failure.