3ronchial hyperreactivity in systemic sclerosis patients: influence of associated Sjogren's syndrome

Abstract Objective-To determine the frequency and relative risk of bronchial hyperreactivity to methacholine in systemic sclerosis patients with or without associate

A composite methodology for supporting collaboration pattern discovery via semantic enrichment and multidimensional analysis

Classical process discovery approaches usually investigate logs generated by processes in order to mine and discovery corresponding process schemas. When the collaboration processes case is addressed, such approaches turn to be poorly effective, due to the fact that: (i) logs of collaboration processes are usually stored in heterogeneous data storages which also expose different data types; (ii) it is not easy and direct to derive a common analysis model from such logs. As a consequence, classical methodologies usually fail. In order to fulfill this gap, in this paper we describe a composite methodology that combines semantics-based techniques and multidimensional analysis paradigms to support effective and efficient collaboration process discovery from log data

A Composite Methodology for Supporting Collaboration Pattern Discovery via Semantic Enrichment and Multidimensional Analysis

Classical process discovery approaches usually investigate logs generated by processes in order to mine and discovery corresponding process schemas. When the collaboration processes case is addressed, such approaches turn to be poorly effective, due to the fact that: (i) logs of collaboration processes are usually stored in heterogenous data storages which also expose different data types; (ii) it is not easy and direct to derive a common analysis model from such logs. As a consequence, classical methodologies usually fail. In order to fulfill this gap, in this paper we describe a composite methodology that combines semantics-based techniques and multidimensional analysis paradigms to support effective and efficient collaboration process discovery from log data

Hydrocortisone infusion for severe community-acquired pneumonia: A preliminary randomized study

We hypothesize that hydrocortisone infusion in severe community-acquired pneumonia attenuates systemic inflammation and leads to earlier resolution of pneumonia and a reduction in sepsis-related complications. In a multicenter trial, patients admitted to the Intensive Care Unit (ICU) with severe community-acquired pneumonia received protocol-guided antibiotic treatment and were randomly assigned to hydrocortisone infusion or placebo. Hydrocortisone was given as an intravenous 200-mg bolus followed by infusion at a rate of 10 mg/hour for 7 days. Primary end-points of the study were improvement in Pa O2:FlO2 (PaO2:FlO2 \u3e 300 or ≥ 100 increase from study entry) and multiple organ dysfunction syndrome (MODS) score by Study Day 8 and reduction in delayed septic shock. Forty-six patients entered the study. At study entry, the hydrocortisone group had lower Pa O2:FlO2, and higher chest radiograph score and C-reactive protein level. By Study Day 8, treated patients had, compared with control subjects, a significant improvement in PaO2-FlO2 (P = 0.002) and chest radiograph score (p \u3c 0.0001), and a significant reduction in C-reactive protein levels (p = 0.01), MODS score (p = 0.003), and delayed septic shock (p = 0.001). Hydrocortisone treatment was associated with a significant reduction in length of hospital stay (p = 0.03) and mortality (p = 0.009)

Occupational exposure to respiratory irritants and chronic obstructive pulmonary disease

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Plasma sRAGE and N-(carboxymethyl) lysine in patients with CHF and/or COPD

BACKGROUND: Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 10th of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases. This article deals with how multiple comorbidities (co-existing chronic conditions) may be more effectively integrated into guidelines. METHODS: In this review we addressed the following topics and questions using chronic obstructive pulmonary disease (COPD) as an example. (1) How important are multiple comorbidities for guidelines? (2) How have other organizations involved in the development of guidelines for single chronic disease approached the problem of multiple comorbidities? (3) What are the implications of multiple comorbidities for pharmacological treatment? (4) What are the potential changes induced by multiple comorbidities in guidelines? (5) What are the implications of considering a population of older patients with multiple comorbidities in designing clinical trials? Our conclusions are based on available evidence from the published literature, experience from guideline developers, and workshop discussions. We did not attempt to examine all Clinical Practice Guidelines (CPGs) and relevant literature. Instead, we selected CPGs generated by prominent professional organizations and relevant literature published in widely read journals, which are likely to have a high impact on clinical practice. RESULTS AND CONCLUSIONS: A widening gap exists between the reality of the care of patients with multiple chronic conditions and the practical clinical recommendations driven by CPGs focused on a single disease, such as COPD. Guideline development panels should aim for multidisciplinary representation, especially when contemplating recommendations for individuals aged 65 years or older (who often have multiple comorbidities), and should evaluate the quality of evidence and the strength of recommendations targeted at this population. A priority area for research should be to assess the effect of multiple concomitant medications and assess how their combined effects are altered by genetic, physiological, disease-related, and other factors. One step that should be implemented immediately would be for existing COPD guidelines to add new sections to address the impact of multiple comorbidities on screening, diagnosis, prevention, and management recommendations. Research should focus on the possible interaction of multiple medications. Furthermore, genetic, physiological, disease-related, and other factors that may influence the directness (applicability) of the evidence for the target population in clinical practice guidelines should be examined