Latest & greatest articles for pneumonia

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Top results for pneumonia

621. Nursing home-acquired pneumonia: outcomes from a clinical process improvement program

Nursing home-acquired pneumonia: outcomes from a clinical process improvement program Nursing home-acquired pneumonia: outcomes from a clinical process improvement program Nursing home-acquired pneumonia: outcomes from a clinical process improvement program Dempsey C L Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed (...) critical assessment on the reliability of the study and the conclusions drawn. Health technology Clinical process improvement programme for patients with nursing home-acquired pneumonia. Type of intervention Disease management Economic study type Cost-effectiveness analysis. Study population Patients with nursing home-acquired pneumonia. Setting Hospital, Chicago, USA. Dates to which data relate Effectiveness data are still being monitored. Resources related to 1992-93. Price dates were not specified

1995 NHS Economic Evaluation Database.

622. Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia

Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia Cook D J, Reeve B K, Scholes L C Authors' objectives To evaluate whether stress ulcer prophylaxis with histamine-2 (...) . Specific interventions included in the review Antacids, histamine-2-receptor antagonists, sucralfate, prostaglandins and pirenzepine. Participants included in the review Critically-ill patients. Outcomes assessed in the review Overt gastrointestinal bleeding, clinically-important bleeding, nosocomial pneumonia and mortality were assessed. How were decisions on the relevance of primary studies made? Two reviewers independently assessed titles and abstracts for each identified study. Assessment of study

1994 DARE.

623. Pharmacoeconomic analysis of cefmenoxime dual individualization in the treatment of nosocomial pneumonia

Pharmacoeconomic analysis of cefmenoxime dual individualization in the treatment of nosocomial pneumonia Pharmacoeconomic analysis of cefmenoxime dual individualization in the treatment of nosocomial pneumonia Pharmacoeconomic analysis of cefmenoxime dual individualization in the treatment of nosocomial pneumonia Paladino J A, Fell R A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Dual individualisation of cefmenoxime dosing in the treatment of nosocomial pneumonia. Type of intervention Treatment Economic study type Cost-effectiveness analysis Study population Patients with documented gram-negative nosocomial pneumonia, aged on average 70. Setting Hospital. The economic study was carried out in the USA. Dates to which data

1994 NHS Economic Evaluation Database.

624. Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. The PRIO Study Group. (Abstract)

Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. The PRIO Study Group. Pneumocystis carinii pneumonia and toxoplasmic encephalitis are frequent life-threatening opportunistic infections in patients with human immunodeficiency virus (HIV) infection. Primary prophylaxis against P. carinii pneumonia is now common, but there are few data on regimens for primary prophylaxis against (...) toxoplasmosis.We conducted a randomized trial that compared two prophylactic regimens: dapsone (50 mg per day) plus pyrimethamine (50 mg per week) was compared with aerosolized pentamidine (300 mg per month). The patients had symptomatic HIV infection, no history of P. carinii pneumonia or symptomatic toxoplasmosis, and CD4+ counts below 200 per cubic millimeter (0.2 x 10(9) per liter).In an intention-to-treat analysis, after a median follow-up of 539 days P. carinii pneumonia developed in 10 patients in each

1993 NEJM Controlled trial quality: uncertain

625. Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS. (Abstract)

Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS. Both trimethoprim-sulfamethoxazole and pentamidine are effective as treatments for Pneumocystis carinii pneumonia, but adverse effects frequently limit their use. Atovaquone (566C80) is a new hydroxynaphthoquinone with activity against P. carinii.We conducted a double-blind, multicenter study in patients with the acquired immunodeficiency syndrome and mild (...) or moderately severe P. carinii pneumonia. They were randomly assigned to 21 days of orally administered treatment three times daily with either atovaquone (750 mg) or trimethoprim (320 mg) plus sulfamethoxazole (1600 mg).Of the 322 patients with histologically confirmed P. carinii pneumonia, 160 received atovaquone and 162 received trimethoprim-sulfamethoxazole. Of those who could be evaluated for therapeutic efficacy, 28 of 138 patients given atovaquone (20 percent) and 10 of 146 patients given

1993 NEJM Controlled trial quality: uncertain

626. A controlled trial of aerosolized pentamidine or trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection. The Dutch AIDS Treatment Group. (Abstract)

A controlled trial of aerosolized pentamidine or trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection. The Dutch AIDS Treatment Group. Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) is recommended for patients with human immunodeficiency virus (HIV) infection if their CD4 cell counts are below 200 per cubic millimeter (0.2 x 10(9) per liter). Either aerosolized pentamidine

1992 NEJM Controlled trial quality: uncertain

627. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021. (Abstract)

A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021. Pneumocystis carinii pneumonia (PCP) continues to be the most common index diagnosis in the acquired immunodeficiency syndrome (AIDS), but it is not clear which of several available agents is the most effective in preventing a recurrence of PCP.We conducted

1992 NEJM Controlled trial quality: predicted high

628. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. (Abstract)

Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. Secondary pneumonia in patients requiring mechanical ventilation has a high morbidity and mortality. Diagnosis is difficult and treatment failure common; therefore, preventive measures are important. In a double-blind, placebo-controlled trial, we evaluated selective decontamination of the oropharynx with polymyxin B sulfate, neomycin sulfate (...) , and vancomycin hydrochloride (PNV) in 52 patients requiring mechanical ventilation during a 3- to 34-day period (mean, 10 days). Either PNV or placebo was administered six times daily in the oropharynx. During the first 12 days of intubation, tracheobronchial colonization by gram-negative bacteria and Staphylococcus aureus, as well as pneumonia, occurred less frequently in the PNV than in the placebo group (16% vs 78%; P less than .0001). Hospital mortality was not different, but systemic antibiotics were

1991 JAMA Controlled trial quality: predicted high

629. A controlled study of inhaled pentamidine for primary prevention of Pneumocystis carinii pneumonia. (Abstract)

A controlled study of inhaled pentamidine for primary prevention of Pneumocystis carinii pneumonia. Current recommendations for prophylaxis of Pneumocystis carinii pneumonia (PCP) are based on data from patients who have had at least one episode of PCP (secondary prevention). We designed a study to determine the efficacy and side effects of inhaled pentamidine in the primary prevention of PCP.Two hundred twenty-three patients sero-positive for human immunodeficiency virus (HIV) who had (...) analyses showed a significant difference in the occurrence of PCP, with 8 cases in pentamidine group and 23 in the placebo group (nominal P value = 0.0021). There were no deaths within 60 days of the diagnosis of PCP and no significant differences in survival between groups. Approximately 53 inhalations were needed to prevent one episode of pneumonia. Thirty-eight of 114 patients given pentamidine (33 percent) and 7 of 109 given placebo (6 percent) had moderate-to-severe coughing during inhalations

1991 NEJM

630. Primary prophylaxis for Pneumocystis carinii pneumonia in HIV-infected people with CD4 counts below 200/mm3: a cost-effectiveness analysis

Primary prophylaxis for Pneumocystis carinii pneumonia in HIV-infected people with CD4 counts below 200/mm3: a cost-effectiveness analysis Primary prophylaxis for Pneumocystis carinii pneumonia in HIV-infected people with CD4 counts below 200/mm3: a cost-effectiveness analysis Primary prophylaxis for Pneumocystis carinii pneumonia in HIV-infected people with CD4 counts below 200/mm3: a cost-effectiveness analysis Freedberg K A, Tosteson A N, Cohen C J, Cotton D J Record Status (...) are illustrative and require confirmation from an ongoing trial. 6) The sensitivity analysis was not adequate. Bibliographic details Freedberg K A, Tosteson A N, Cohen C J, Cotton D J. Primary prophylaxis for Pneumocystis carinii pneumonia in HIV-infected people with CD4 counts below 200/mm3: a cost-effectiveness analysis. Journal of Acquired Immune Deficiency Syndromes 1991; 4(5): 521-531 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Acquired Immunodeficiency Syndrome /complications

1991 NHS Economic Evaluation Database.

631. Cost and benefit of secondary prophylaxis for Pneumocystis carinii pneumonia

Cost and benefit of secondary prophylaxis for Pneumocystis carinii pneumonia Cost and benefit of secondary prophylaxis for Pneumocystis carinii pneumonia Cost and benefit of secondary prophylaxis for Pneumocystis carinii pneumonia Castellano A R, Nettleman M D Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical (...) assessment on the reliability of the study and the conclusions drawn. Health technology Trimethoprim-sulfamethoxazole (TMS) and aerosolised pentemidine (AP). Secondary prophylaxis against Pneumocystis carinii pneumonia (PCP) for HIV-infected people. Type of intervention Secondary prevention. Economic study type Costs-effectiveness analysis. Study population HIV-infected people. Setting The study was carried out in the USA. Dates to which data relate It seems that price related to 1991. Source

1991 NHS Economic Evaluation Database.

632. Corticosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A double-blind, placebo-controlled trial. (Abstract)

Corticosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A double-blind, placebo-controlled trial. Preliminary reports suggest that patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia may benefit from the addition of corticosteroid treatment to antibiotic therapy.We conducted a double-blind, placebo-controlled trial to assess the efficacy of adjunctive corticosteroids in patients (...) with AIDS and severe P. carinii pneumonia. Patients with marked abnormalities in gas exchange who had been treated with antibiotics for less than 72 hours were randomly assigned to receive either methylprednisolone (40 mg) or placebo every 6 hours for 7 days, in addition to treatment for 21 days with trimethoprim-sulfamethoxazole. The primary outcome measures were survival until hospital discharge and the development of respiratory failure.Twenty-three patients were enrolled in the study; there were

1990 NEJM Controlled trial quality: predicted high

633. A controlled trial of early adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. California Collaborative Treatment Group. Full Text available with Trip Pro

A controlled trial of early adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. California Collaborative Treatment Group. Pneumocystis carinii pneumonia remains a common cause of serious morbidity and mortality in patients with the acquired immunodeficiency syndrome (AIDS). The extensive lung injury that accompanies pneumocystis-associated respiratory failure and the reports of clinical benefit from the use of adjunctive (...) corticosteroids provided the rationale for this prospective multicenter trial.A total of 333 patients with AIDS and pneumocystis pneumonia received standard treatment and were randomly assigned to receive either corticosteroids (beginning with the equivalent of 40 mg of prednisone twice daily) or no additional therapy. The primary end points in this unblinded trial were the occurrence of respiratory failure (hypoxemia ratio [partial pressure of arterial oxygen divided by fraction of inspired oxygen] less than

1990 NEJM Controlled trial quality: predicted high

634. Aerosolized pentamidine for prophylaxis against Pneumocystis carinii pneumonia. The San Francisco community prophylaxis trial. (Abstract)

Aerosolized pentamidine for prophylaxis against Pneumocystis carinii pneumonia. The San Francisco community prophylaxis trial. Pneumocystis carinii pneumonia (PCP) is the most frequent life-threatening opportunistic infection associated with human immunodeficiency virus (HIV) infection. To assess the possible value of aerosolized-pentamidine prophylaxis in different doses, a controlled clinical trial was begun in 1987 with 408 subjects at 12 treatment centers. The participants were randomly

1990 NEJM Controlled trial quality: uncertain

635. Oral therapy for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A controlled trial of trimethoprim-sulfamethoxazole versus trimethoprim-dapsone. (Abstract)

Oral therapy for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A controlled trial of trimethoprim-sulfamethoxazole versus trimethoprim-dapsone. Antimicrobial drugs that can be taken orally are needed for the treatment of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). Preliminary data indicate that dapsone with trimethoprim may be an effective alternative to trimethoprim-sulfamethoxazole, which is frequently toxic.In (...) a double-blind trial, 60 patients with AIDS and mild-to-moderately-severe first episodes of P. carinii pneumonia (partial pressure of oxygen in arterial blood, greater than 60 mm Hg while breathing room air) were randomly assigned to 21 days of treatment with either trimethoprim-sulfamethoxazole (20 and 100 mg per kilogram of body weight per day, respectively) or trimethoprim-dapsone (20 mg per kilogram per day and 100 mg per day).The orally administered treatment failed because of progressive

1990 NEJM Controlled trial quality: uncertain

636. Prevention of Pneumocystis carinii pneumonia relapse by pentamidine aerosol in zidovudine-treated AIDS patients. (Abstract)

Prevention of Pneumocystis carinii pneumonia relapse by pentamidine aerosol in zidovudine-treated AIDS patients. To examine the efficacy and tolerance of pentamidine aerosol in the prevention of Pneumocystis carinii pneumonia (PCP) relapse in patients with the acquired immunodeficiency syndrome (AIDS) being treated with zidovudine, 51 patients who had had an episode of PCP in the previous 5 months were enrolled in a randomised controlled study. 25 patients (group I) received pentamidine

1989 Lancet Controlled trial quality: uncertain

637. Safety and efficacy of sulfamethoxazole and trimethoprim chemoprophylaxis for Pneumocystis carinii pneumonia in AIDS. (Abstract)

Safety and efficacy of sulfamethoxazole and trimethoprim chemoprophylaxis for Pneumocystis carinii pneumonia in AIDS. The safety and efficacy of sulfamethoxazole and trimethoprim in the prevention of Pneumocystis carinii pneumonia associated with the acquired immunodeficiency syndrome (AIDS) were evaluated. Sixty patients with a new diagnosis of Kaposi's sarcoma and no history of opportunistic infections were randomly assigned to receive 800 mg of sulfamethoxazole and 160 mg of trimethoprim (...) twice per day or no therapy. None of the 30 patients receiving sulfamethoxazole and trimethoprim developed P carinii pneumonia. Sixteen of the 30 patients receiving no suppressive therapy developed P carinii pneumonia. Development of P carinii pneumonia was associated with the stage of Kaposi's sarcoma, B subtype disease, and the presence of 0.20 X 10(9)/L (200/mm3) or fewer CD4 cells at study entry. The proportion of patients surviving and the mean length of survival were significantly greater

1988 JAMA Controlled trial quality: uncertain

638. Trial of co-trimoxazole versus procaine penicillin with ampicillin in treatment of community-acquired pneumonia in young Gambian children. (Abstract)

Trial of co-trimoxazole versus procaine penicillin with ampicillin in treatment of community-acquired pneumonia in young Gambian children. 134 Gambian children under 5 years of age with severe pneumonia (as defined by the World Health Organisation classification of acute respiratory infections) were given either oral co-trimoxazole for 5 days, or a single intramuscular dose of fortified procaine penicillin and 5 days of oral ampicillin. At 2 weeks, there was no significant difference in outcome (...) between the two groups. Co-trimoxazole is much less expensive than ampicillin or procaine penicillin, requires only twice-daily administration, and can be given by health-care staff with little training. The results support the use of co-trimoxazole as the antibiotic of first choice in outpatient management of young children with pneumonia in developing countries.

1988 Lancet

639. Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. The role of gastric colonization. (Abstract)

Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. The role of gastric colonization. Gram-negative nosocomial pneumonia may result from retrograde colonization of the pharynx from the stomach, and this may be more likely when the gastric pH is relatively high. We studied the rate of nosocomial pneumonia among 130 patients given mechanical ventilation in an intensive care unit who were receiving as prophylaxis for stress ulcer (...) ) in gastric aspirates, pharyngeal swabs, and tracheal aspirates than did patients in the antacid-H2-blocker group. The rate of pneumonia was twice as high in the antacid-H2 group as in the sucralfate group (95 percent confidence interval, 0.89 to 4.58; P = 0.11). Gram-negative bacilli were isolated more frequently from the tracheal aspirates of patients with pneumonia who were receiving antacids or H2 blockers. Mortality rates were 1.6 times higher in the antacid-H2 group than in the sucralfate group (95

1987 NEJM Controlled trial quality: uncertain

640. Cost effectiveness of vaccination against pneumococcal pneumonia: an update

Cost effectiveness of vaccination against pneumococcal pneumonia: an update Cost effectiveness of vaccination against pneumococcal pneumonia: an update Cost effectiveness of vaccination against pneumococcal pneumonia: an update Sisk J E, Riegelman R K Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment (...) on the reliability of the study and the conclusions drawn. Health technology Vaccination for pneumococcal pneumonia. Type of intervention Primary prevention. Economic study type Cost-utility analysis. Study population Persons aged 65 years and over. Setting The study was carried out in the USA. Dates to which data relate Prices related to 1983. Source of effectiveness data Published studies. Modelling Epidemiological cohort model (model of survival and disease). Measure of benefits used in the economic analysis

1986 NHS Economic Evaluation Database.