Respiratory medicine
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Respiratory medicine · Apr 2007
Risk factors for pulmonary complications after emergency abdominal surgery.
Pulmonary complications are common after abdominal surgery. Although a variety of risk factors have been described for these complications, studies so far have focused on elective interventions. The aim of this study was to determine the incidence and predictors of pulmonary complications following emergency abdominal surgery. ⋯ Pulmonary complications are frequent among patients undergoing abdominal emergency surgery and lead to increased length of hospital stay and death rate. Older age, abnormal BMI, upper or upper/lower abdominal incision and multiple procedures are predictors of PPC in this setting.
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Respiratory medicine · Apr 2007
Variability in the organisation and management of hospital care for COPD exacerbations in the UK.
Previous smaller UK audits have demonstrated wide variation in organisation, resources, and process of care for acute chronic obstructive pulmonary disease (COPD) admissions. Smallest units appeared to do less well. UK acute hospitals supplied information on (1) resources and organisation of care, (2) clinical data on process of care and outcomes for up to 40 consecutive COPD admissions. ⋯ Those receiving specialist input are more likely to be offered interventions of proven effect. Management guidelines alone are insufficient to address inequalities of care and a clear statement of minimum national standards for resource provision and organisation of COPD care are required. This study provides a unique insight into the current state of care for patients admitted with COPD exacerbations in the UK.
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Respiratory medicine · Apr 2007
Clinical TrialAntifungal treatment in sarcoidosis--a pilot intervention trial.
Sarcoidosis is generally treated with corticosteroids that are not always an effective therapy. ⋯ It is suggested that treatment with antifungal drugs may be useful, at least in certain cases of sarcoidosis.
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Respiratory medicine · Apr 2007
Incidence and risk factors for ventilator-associated pneumonia in a developing country: where is the difference?
Latin America exhibits a wide range of differences, compared to developed nations, in genetic background, health services, and clinical research development. It is valid to hypothesize that the incidence and risk factors for ventilator-associated pneumonia (VAP) in our setting may be substantially different of those reported elsewhere. We conducted a study to determine the incidence and risk factors for VAP in a University Hospital from Medellin, Colombia. ⋯ The epidemiologic profile of VAP in terms of incidence, length of stay and clinical course resembles the general pattern described everywhere. Surprisingly, we could not identify any potentially modifiable risk factor for VAP. A comprehensive multicenter study is warranted. It should provide deep insight about the specific microbiological, genetic and clinic features of VAP in our setting.
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Respiratory medicine · Apr 2007
Case ReportsSevere vocal cord dysfunction resistant to all current therapeutic interventions.
Vocal cord dysfunction (VCD) is characterised by paradoxical vocal cord adduction during inspiration or throughout the respiratory cycle, it results in wheeze, stridor, cough and dyspnoea. Although asthma and VCD can coexist, patients with VCD are frequently misdiagnosed with refractory asthma. It can severely restrict an individual's level of activity and effective therapeutic control can be difficult to achieve. We report the case of a patient who was treated with all available therapeutic interventions, including intralaryngeal botulinum toxin injection, but failure resulted in a permanent trachesotomy.