Thorax
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Randomized Controlled Trial Clinical Trial
Pigtail drainage in the treatment of tuberculous pleural effusions: a randomised study.
Tuberculous pleurisy can result in obvious clinical symptoms, pleural fibrosis, and pleural thickening. Some studies of tuberculous pleurisy have suggested that symptomatic improvement and minimisation of sequelae can be achieved by completely draining the effusion during treatment, although the results have not been conclusive. ⋯ The addition of pigtail drainage to an effective anti-TB regimen is not clinically relevant and does not reduce the level of RPT.
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Comparative Study
Radiological versus histological diagnosis in UIP and NSIP: survival implications.
High resolution computed tomography (HRCT) has an important diagnostic role in idiopathic interstitial pneumonia (IIP). We hypothesised that the HRCT appearance would have an impact on survival in patients with IIP. ⋯ Patients with a typical HRCT appearance of UIP experience the highest mortality. A surgical lung biopsy is indicated for patients without an HRCT appearance of UIP to differentiate between histological UIP and NSIP.
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The management of severe pulmonary hypertension associated with right ventricular failure is reviewed and its relevance to adults with acute respiratory distress syndrome (ARDS) is discussed.
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Exacerbations of chronic obstructive pulmonary disease (COPD) are a leading cause of admission to hospital among men in many countries, although the factors causing exacerbations are largely unknown. The association between readmission for a COPD exacerbation and a wide range of modifiable potential risk factors, after adjusting for sociodemographic and clinical factors, has been assessed. ⋯ This is the first study to show a strong association between usual physical activity and reduced risk of readmission to hospital with COPD, which is potentially relevant for rehabilitation and other therapeutic strategies.
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The influence of genetic polymorphisms of interleukin (IL)-10, tumour necrosis factor (TNF)-alpha, and IL-6 gene promoters on severity of systemic inflammatory response syndrome (SIRS) associated with community acquired pneumonia (CAP) was studied. ⋯ A polymorphism affecting IL-10 expression may influence the severity of illness in patients with CAP.