7 research outputs found
European Respiratory Society guidelines for the management of adult bronchiectasis
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes
Migration von /sw vom AFS ins DCE/DFS
/sw ist eine verteilte Softwarebereitstellung mit dem Ziel, jedem Benutzer Software zentral zur VerfĂŒgung zu stellen, ohne daĂ er sich darum kĂŒmmern muĂ, woher er seine Software bekommt. FĂŒr eine AuĂenstehenden ergibt sich somit das Bild eines groĂen Softwarepools, aus dem er sich fertig installierte Software fĂŒr seine Plattform herunterladen kann.
Voraussetzung dafĂŒr ist, daĂ ein Benuzter an seiner Workstation ĂŒber AFS (Andrew File System), DFS (Distributed File System) oder ftp verfĂŒgt. Zur Zeit werden vom /sw fĂŒr 18 verschiedenen Unix-Plattformen 594 Programme in 1024 verschiedenen Installationen angeboten. Die meisten Architekturen vom /sw liegen im AFS, bis auf die Architekturen DEC ALPHA, IRIX 4.0 und Linux, die im NFS liegen.
In Zukunft wird es fĂŒr die gesamte /sw Software nur noch eine Quelle geben, das DFS. Mit der Migration von /sw aus dem AFS ins DFS entfĂ€llt dann die Trennung von /sw in einen AFS-Teil und einem NFS-Teil und damit auch der AFS/NFS-Translators, der recht unstabil lĂ€uft. Die gesamte Software von /sw wurde aus dem AFS bzw. NFS ins DFS migriert, so daĂ fĂŒr alle vom /sw unterstĂŒtzten Architekturen nur noch eine Quelle zur VerfĂŒgung steht, die Stuttgarter DCE-Zelle. Jeder AFS-Klient hat ĂŒber den AFS/DFS-Translator Zugriff auf /sw und fĂŒr die NFS-Klienten wird das /sw-Fi-lesystem exportiert, so daĂ jeder NFS-Klient die Möglichkeit hat das DFS-Filesystem /sw zu mounten. Eine Workstation kann sowohl AFS- als auch DCE/DFS-Klient sein
Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.
BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden
Diaphragm motion and lung function prediction in patients operated for lung cancer â a pilot study on 27 patients
ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe
European Respiratory Society Guideline on various aspects of quality in lung cancer care
This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available
European Respiratory Society Guideline on various aspects of quality in lung cancer care.
This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available