Thorax
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Urban air pollution can trigger asthma exacerbations, but the effects of long-term exposure to traffic-related air pollution on lung function or onset of airway disease and allergic sensitisation in children is less clear. ⋯ The results of this study suggest that residential traffic-related air pollution exposure is associated with reduced expiratory flows in schoolchildren.
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Randomized Controlled Trial Multicenter Study
Nocturnal non-invasive nasal ventilation in stable hypercapnic COPD: a randomised controlled trial.
Sleep hypoventilation has been proposed as a cause of progressive hypercapnic respiratory failure and death in patients with severe chronic obstructive pulmonary disease (COPD). A study was undertaken to determine the effects of nocturnal non-invasive bi-level pressure support ventilation (NIV) on survival, lung function and quality of life in patients with severe hypercapnic COPD. ⋯ Nocturnal NIV in stable oxygen-dependent patients with hypercapnic COPD may improve survival, but this appears to be at the cost of worsening quality of life.
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Multicenter Study
Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia.
Prognostic scales provide a useful tool to predict mortality in community-acquired pneumonia (CAP). However, the inflammatory response of the host, crucial in resolution and outcome, is not included in the prognostic scales. ⋯ Adding CRP levels to PSI, CURB65 and CRB65 scales improves the 30-day mortality prediction. The highest predictive value is reached with a combination of two scales and CRP. Further validation of that improvement is needed.
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Multicenter Study
Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia.
The aim of this study was to identify key factors on admission predicting the development of complicated parapneumonic effusion or empyema in patients admitted with community-acquired pneumonia. ⋯ This study has identified seven clinical factors predicting the development of complicated parapneumonic effusion or empyema. Independent validation is needed.
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The 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) guidelines defined severe community-acquired pneumonia (CAP) and recommended intensive care unit (ICU) admission when patients fulfilled three out of nine minor criteria. These criteria have not been validated. ⋯ These findings support the use of the IDSA/ATS minor criteria to predict hospital mortality and guide ICU admission in inpatients with CAP who do not require emergency mechanical ventilation or vasopressors.