Association Between #Antipsychotic Agents and Risk of Acute #Respiratory Failure in Patients With Chronic Obstructive Pulmonary Disease
http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2595040
These findings suggest an acute risk of ARF from antipsychotic use in patients with chronic obstructive pulmonary disease, and future studies are required to confirm the observed association.
http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2595040
These findings suggest an acute risk of ARF from antipsychotic use in patients with chronic obstructive pulmonary disease, and future studies are required to confirm the observed association.
Jamanetwork
Antipsychotic Agents and Risk of Acute Respiratory Failure in COPD
This population-based case-crossover study uses the Taiwan National Health Insurance Research Database to determine whether the use of antipsychotics is associated with an increased risk of acute respiratory failure in patients with chronic obstructive pulmonary…
Acute #Respiratory Infection and Use of Nonsteroidal Anti-Inflammatory Drugs on Risk of Acute Myocardial #Infarction: A Nationwide Case-Crossover Study
https://academic.oup.com/jid/article-abstract/doi/10.1093/infdis/jiw603/2965358/Acute-Respiratory-Infection-and-Use-of?redirectedFrom=fulltext
Nonsteroidal anti-inflammatory drugs use during ARI episodes, especially parenteral NSAIDs, was associated with a further increased risk of AMI
https://academic.oup.com/jid/article-abstract/doi/10.1093/infdis/jiw603/2965358/Acute-Respiratory-Infection-and-Use-of?redirectedFrom=fulltext
Nonsteroidal anti-inflammatory drugs use during ARI episodes, especially parenteral NSAIDs, was associated with a further increased risk of AMI
Vitamin #D supplementation to prevent acute #respiratory tract infections: systematic review and meta-analysis of individual participant data
http://www.bmj.com/content/356/bmj.i6583
Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit
http://www.bmj.com/content/356/bmj.i6583
Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit
The BMJ
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant…
Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.
Design Systematic review and meta-analysis of individual participant data (IPD) from randomised…
Design Systematic review and meta-analysis of individual participant data (IPD) from randomised…
Effect of Oral #Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower #Respiratory Tract Infection A Randomized Clinical Trial
http://jamanetwork.com/journals/jama/article-abstract/2649201
Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence.
Among the 398 patients with baseline data (mean age, 47 SD, 16.0 years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range IQR, 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = .36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, −0.20; 95% CI, −0.40 to 0.00; P = .05 at an α = .001). No significant treatment effects were observed for duration or severity of other acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, or nonserious adverse events. There were no serious adverse events.
Conclusions and Relevance Oral corticosteroids should not be used for acute lower respiratory tract infection symptoms in adults without asthma because they do not reduce symptom duration or severity
http://jamanetwork.com/journals/jama/article-abstract/2649201
Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence.
Among the 398 patients with baseline data (mean age, 47 SD, 16.0 years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range IQR, 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = .36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, −0.20; 95% CI, −0.40 to 0.00; P = .05 at an α = .001). No significant treatment effects were observed for duration or severity of other acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, or nonserious adverse events. There were no serious adverse events.
Conclusions and Relevance Oral corticosteroids should not be used for acute lower respiratory tract infection symptoms in adults without asthma because they do not reduce symptom duration or severity
Jamanetwork
Effects of Oral Prednisolone on Symptom Duration in Lower Respiratory Tract Infection
This randomized trial compares the effect of prednisolone vs placebo on duration of moderately bad or worse cough and severity of symptoms in nonasthmatic adults with acute lower respiratory infections.
Preoperative #physiotherapy for the prevention of #respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial - postoperative pulmonary complications (PPCs)
http://www.bmj.com/content/360/bmj.j5916
The incidence of PPCs within 14 postoperative hospital days, including hospital acquired pneumonia, was halved (adjusted hazard ratio 0.48, 95% confidence interval 0.30 to 0.75, P=0.001) in the intervention group compared with the control group, with an absolute risk reduction of 15% (95% confidence interval 7% to 22%) and a number needed to treat of 7 (95% confidence interval 5 to 14). No significant differences in other secondary outcomes were detected.
Conclusion In a general population of patients listed for elective upper abdominal surgery, a 30 minute preoperative physiotherapy session provided within existing hospital multidisciplinary preadmission clinics halves the incidence of PPCs and specifically hospital acquired pneumonia. Further research is required to investigate benefits to mortality and length of stay.
http://www.bmj.com/content/360/bmj.j5916
The incidence of PPCs within 14 postoperative hospital days, including hospital acquired pneumonia, was halved (adjusted hazard ratio 0.48, 95% confidence interval 0.30 to 0.75, P=0.001) in the intervention group compared with the control group, with an absolute risk reduction of 15% (95% confidence interval 7% to 22%) and a number needed to treat of 7 (95% confidence interval 5 to 14). No significant differences in other secondary outcomes were detected.
Conclusion In a general population of patients listed for elective upper abdominal surgery, a 30 minute preoperative physiotherapy session provided within existing hospital multidisciplinary preadmission clinics halves the incidence of PPCs and specifically hospital acquired pneumonia. Further research is required to investigate benefits to mortality and length of stay.
The BMJ
Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded…
Objective To assess the efficacy of a single preoperative physiotherapy session to reduce postoperative pulmonary complications (PPCs) after upper abdominal surgery.
Design Prospective, pragmatic, multicentre, patient and assessor blinded, parallel group…
Design Prospective, pragmatic, multicentre, patient and assessor blinded, parallel group…
High Frequency of Systemic #Corticosteroid Use for Acute #Respiratory Tract Illnesses in Ambulatory Settings
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2673299?redirect=true
Clinical practice guidelines do not recommend systemic steroids in the treatment of acute respiratory tract infections (ARTIs).1 While some studies have shown earlier symptom resolution with steroids given for pharyngitis,2 clinical trials show no efficacy of systemic steroids for sinusitis3 and bronchitis.4 Adverse events can develop within 30 days of short-term steroid use, which raises concern about the safety of systemic steroids for ARTIs.5 We conducted the present study to examine the frequency of steroid use for ARTIs in Louisiana and nationally and to examine factors associated with this clinical practice
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2673299?redirect=true
Clinical practice guidelines do not recommend systemic steroids in the treatment of acute respiratory tract infections (ARTIs).1 While some studies have shown earlier symptom resolution with steroids given for pharyngitis,2 clinical trials show no efficacy of systemic steroids for sinusitis3 and bronchitis.4 Adverse events can develop within 30 days of short-term steroid use, which raises concern about the safety of systemic steroids for ARTIs.5 We conducted the present study to examine the frequency of steroid use for ARTIs in Louisiana and nationally and to examine factors associated with this clinical practice
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Short-term Elevation of Fine #Particulate Matter Air Pollution and Acute Lower #Respiratory Infection
https://www.atsjournals.org/doi/10.1164/rccm.201709-1883OC
Nearly 60% of U.S. children live in counties with PM2.5 concentrations above air quality standards. Understanding the relationship between ambient air pollution exposure and health outcomes informs actions to reduce exposure and disease risk. Objectives: To evaluate the association between ambient PM2.5 levels and healthcare encounters for acute lower respiratory infection (ALRI). Methods: Using an observational case-crossover design, subjects (N=146,397) were studied if they had an ALRI diagnosis and resided on Utah’s Wasatch Front. PM2.5 air pollution concentrations were measured using community-based air quality monitors between 1999 and 2016. Odds ratios (OR) for ALRI healthcare encounters were calculated after stratification by ages 0-2, 3-17, and 18+ years. Measurements and Main Results: Approximately 77% (n=112,467) of subjects were 0-2 years of age. The odds of ALRI encounter for these young children increased within 1 week of elevated PM2.5 and peaked after 3 weeks with a cumulative 28-day OR= 1.15 per +10 μg/m3 (95% CI= 1.12, 1.19). ALRI encounters with diagnosed and laboratory-confirmed RSV and influenza increased following elevated ambient PM2.5 levels. Similar elevated odds for ALRI were also observed for older children, although the number of events and precision of estimates were much lower.
Conclusions: In this large sample of urban/suburban patients, short-term exposure to elevated PM2.5 air pollution was associated with greater healthcare utilization for ALRI in both young children, older children, and adults. Further exploration is needed of causal interactions between PM2.5 and ALRI.
Short-term Elevation of Fine #Particulate Matter Air Pollution and Acute Lower #Respiratory Infection
https://www.atsjournals.org/doi/10.1164/rccm.201709-1883OC
Nearly 60% of U.S. children live in counties with PM2.5 concentrations above air quality standards. Understanding the relationship between ambient air pollution exposure and health outcomes informs actions to reduce exposure and disease risk. Objectives: To evaluate the association between ambient PM2.5 levels and healthcare encounters for acute lower respiratory infection (ALRI). Methods: Using an observational case-crossover design, subjects (N=146,397) were studied if they had an ALRI diagnosis and resided on Utah’s Wasatch Front. PM2.5 air pollution concentrations were measured using community-based air quality monitors between 1999 and 2016. Odds ratios (OR) for ALRI healthcare encounters were calculated after stratification by ages 0-2, 3-17, and 18+ years. Measurements and Main Results: Approximately 77% (n=112,467) of subjects were 0-2 years of age. The odds of ALRI encounter for these young children increased within 1 week of elevated PM2.5 and peaked after 3 weeks with a cumulative 28-day OR= 1.15 per +10 μg/m3 (95% CI= 1.12, 1.19). ALRI encounters with diagnosed and laboratory-confirmed RSV and influenza increased following elevated ambient PM2.5 levels. Similar elevated odds for ALRI were also observed for older children, although the number of events and precision of estimates were much lower.
Conclusions: In this large sample of urban/suburban patients, short-term exposure to elevated PM2.5 air pollution was associated with greater healthcare utilization for ALRI in both young children, older children, and adults. Further exploration is needed of causal interactions between PM2.5 and ALRI.
Risk Factors Associated With Acute #Respiratory Distress Syndrome and Death in Patients With #Coronavirus Disease 2019 Pneumonia in Wuhan, China
https://2medical.news/2020/03/22/risk-factors-associated-with-acute-respiratory-distress-syndrome-and-death-in-patients-with-coronavirus-disease-2019-pneumonia-in-wuhan-china/
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated.. ..Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, …
https://2medical.news/2020/03/22/risk-factors-associated-with-acute-respiratory-distress-syndrome-and-death-in-patients-with-coronavirus-disease-2019-pneumonia-in-wuhan-china/
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated.. ..Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, …
Reducing #Antibiotic Prescribing in Primary Care for #Respiratory Illness
https://2medical.news/2020/08/15/reducing-antibiotic-prescribing-in-primary-care-for-respiratory-illness/
One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program’s effectiveness for reducing outpatient antibiotic prescribing for ARTI visits.. In this stepped-wedge clinical trial run from November 2015 to June 2018, we randomly assigned 19 pediatric practices belonging to the Pediatric Research in Office Settings Network or the NorthShore University HealthSystem to 4 wedges. Visits …
https://2medical.news/2020/08/15/reducing-antibiotic-prescribing-in-primary-care-for-respiratory-illness/
One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program’s effectiveness for reducing outpatient antibiotic prescribing for ARTI visits.. In this stepped-wedge clinical trial run from November 2015 to June 2018, we randomly assigned 19 pediatric practices belonging to the Pediatric Research in Office Settings Network or the NorthShore University HealthSystem to 4 wedges. Visits …
Effectiveness of #honey for symptomatic relief in upper #respiratory tract infections: a systematic review and meta-analysis
https://2medical.news/2020/08/25/effectiveness-of-honey-for-symptomatic-relief-in-upper-respiratory-tract-infections-a-systematic-review-and-meta-analysis/
Antibiotic over prescription for upper respiratory tract infections (URTIs) in primary care exacerbates antimicrobial resistance. There is a need for effective alternatives to antibiotic prescribing. Honey is a lay remedy for URTIs, and has an emerging evidence base for its use. Honey has antimicrobial properties, and guidelines recommended honey for acute cough in children.. ..We identified 1345 unique records, and 14 studies were included. Overall …
https://2medical.news/2020/08/25/effectiveness-of-honey-for-symptomatic-relief-in-upper-respiratory-tract-infections-a-systematic-review-and-meta-analysis/
Antibiotic over prescription for upper respiratory tract infections (URTIs) in primary care exacerbates antimicrobial resistance. There is a need for effective alternatives to antibiotic prescribing. Honey is a lay remedy for URTIs, and has an emerging evidence base for its use. Honey has antimicrobial properties, and guidelines recommended honey for acute cough in children.. ..We identified 1345 unique records, and 14 studies were included. Overall …
Effect of convalescent #blood products for patients with severe acute #respiratory infections of #viral etiology: a systematic review and meta-analysis
https://2medical.news/2020/10/03/effect-of-convalescent-blood-products-for-patients-with-severe-acute-respiratory-infections-of-viral-etiology-a-systematic-review-and-meta-analysis/
To determine whether convalescent blood products (CBPs) could offer a survival advantage for patients with severe acute respiratory infections (SARI) of viral etiology.. ..According to observational studies, the cases received CPBs showed a decline of all-cause mortality compared with cases without using (OR 0.36, 95% CI 0.23 to 0.56, P < 0.00001). The all-cause mortality in the randomized controlled trials (RCTs) showed no difference between the interventional …
https://2medical.news/2020/10/03/effect-of-convalescent-blood-products-for-patients-with-severe-acute-respiratory-infections-of-viral-etiology-a-systematic-review-and-meta-analysis/
To determine whether convalescent blood products (CBPs) could offer a survival advantage for patients with severe acute respiratory infections (SARI) of viral etiology.. ..According to observational studies, the cases received CPBs showed a decline of all-cause mortality compared with cases without using (OR 0.36, 95% CI 0.23 to 0.56, P < 0.00001). The all-cause mortality in the randomized controlled trials (RCTs) showed no difference between the interventional …
Delayed #antibiotic prescribing for #respiratory tract infections: individual patient data meta-analysis
http://2medical.news/2021/04/30/delayed-antibiotic-prescribing-for-respiratory-tract-infections-individual-patient-data-meta-analysis/
http://2medical.news/2021/04/30/delayed-antibiotic-prescribing-for-respiratory-tract-infections-individual-patient-data-meta-analysis/
2Medical.News
Delayed #antibiotic prescribing for #respiratory tract infections: individual patient data meta-analysis
To assess the overall effect of delayed antibiotic prescribing on average symptom severity for patients with respiratory tract infections in the community, and to identify any factors modifying thi…
The relationship between duration and quality of #sleep and upper #respiratory tract infections: a systematic review
https://2medical.news/2021/05/27/the-relationship-between-duration-and-quality-of-sleep-and-upper-respiratory-tract-infections-a-systematic-review/
https://2medical.news/2021/05/27/the-relationship-between-duration-and-quality-of-sleep-and-upper-respiratory-tract-infections-a-systematic-review/
2Medical.News
The relationship between duration and quality of #sleep and upper #respiratory tract infections: a systematic review
Upper respiratory tract infections (URTIs) are common, mostly self-limiting, but result in inappropriate antibiotic prescriptions. Poor sleep is cited as a factor predisposing to URTIs, but the evi…
#Zinc for the prevention or treatment of acute viral #respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials
https://2medical.news/2021/11/03/zinc-for-the-prevention-or-treatment-of-acute-viral-respiratory-tract-infections-in-adults-a-rapid-systematic-review-and-meta-analysis-of-randomised-controlled-trials/
https://2medical.news/2021/11/03/zinc-for-the-prevention-or-treatment-of-acute-viral-respiratory-tract-infections-in-adults-a-rapid-systematic-review-and-meta-analysis-of-randomised-controlled-trials/
2Medical.News
#Zinc for the prevention or treatment of acute viral #respiratory tract infections in adults: a rapid systematic review and meta…
To evaluate the benefits and risks of zinc formulations compared with controls for prevention or treatment of acute viral respiratory tract infections (RTIs) in adults. Method Seventeen English and…
#Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower #Respiratory Tract Infection
https://2medical.news/2024/04/17/antibiotics-not-associated-with-shorter-duration-or-reduced-severity-of-acute-lower-respiratory-tract-infection/
https://2medical.news/2024/04/17/antibiotics-not-associated-with-shorter-duration-or-reduced-severity-of-acute-lower-respiratory-tract-infection/
2Medical.News
#Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower #Respiratory Tract Infection
BackgroundAntibiotic use remains common for the treatment of lower respiratory tract infections. The objective of this study was to evaluate the impact of antibiotic use on the duration and severit…