Respirology : official journal of the Asian Pacific Society of Respirology
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Comparative Study
Health care-associated pneumonia in haemodialysis patients: clinical outcomes in patients treated with narrow versus broad spectrum antibiotic therapy.
Although the 2005 American Thoracic Society/Infectious Disease Society of America antibiotic guidelines classify pneumonia occurring in patients receiving chronic haemodialysis as health care-associated pneumonia (HCAP), and thus recommend treatment with broad-spectrum antibiotics for these patients, little data support this classification. We compared clinical outcomes in haemodialysis patients hospitalized with pneumonia, who were treated with broad-spectrum antibiotics versus narrow-spectrum antibiotics. ⋯ This study is the first to our knowledge to describe clinical outcomes in patients with haemodialysis as their only HCAP risk factor. Narrow-spectrum antibiotics may be safe in haemodialysis patients with no other HCAP risk factors. HCAP therapy delayed de-escalation to oral antibiotics was associated with increased duration of intravenous antibiotics and length of stay.
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Weaning from invasive mechanical ventilation (IMV) in specialized weaning units has been demonstrated to be safe and cost-effective. Success rates and outcomes vary widely, probably relating to patient factors and unit expertise. ⋯ High rates of weaning success with infrequent complications and low mortality were achieved in this specialized non-intensive care unit-based weaning unit. The VWU may provide a useful template for the development of similar units elsewhere.
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Respiratory inductive plethysmography is a non-invasive technique for measuring respiratory function. However, there are challenges associated with using linear methods for calibration of respiratory inductive plethysmography. In this study, we developed two nonlinear models, artificial neural network and adaptive neuro-fuzzy inference system, to estimate respiratory volume based on thoracoabdominal movements, and compared these models with routine linear approaches, including qualitative diagnostic calibration and multiple linear regression. ⋯ These results indicate that the nonlinear methods can be adapted to closely simulate variable conditions and used to study the patterns of volume changes during normal and asynchronous breathing.
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Meta Analysis
Obstructive sleep apnoea and the risk of type 2 diabetes: a meta-analysis of prospective cohort studies.
There has been increasing recognition that obstructive sleep apnoea (OSA) is associated with incident type 2 diabetes. The aim of this study was to assess the association between the severity of OSA and the risk of type 2 diabetes by performing a meta-analysis of all available prospective cohort studies. ⋯ This meta-analysis indicates that moderate-severe OSA is associated with an increased risk of type 2 diabetes, and this appears to be an independent risk factor for the development of diabetes.