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Pneumocystis jirovecii dihydropteroate synthase (DHPS) gene mutations are well-reported. Although sulfa prophylaxis generally is associated with DHPS mutant infection, whether mutant infection is associated with poorer clinical outcomes is less clear. The differing definitions of sulfa prophylaxis and the different mortality endpoints used in these studies(More)
BACKGROUND The combination antiretroviral therapy (ART) era (1996 to the present) has been associated with improved survival among HIV-infected outpatients, but ICU data from 2000 to the present are limited. METHODS We conducted a retrospective study of HIV-infected adults who had been admitted to the ICU at San Francisco General Hospital (from 2000 to(More)
OBJECTIVE To measure the impact of a national propofol shortage on the duration of mechanical ventilation. DESIGN Before-after study. SETTING Three, noncardiac surgery, adult intensive care units at a 320-bed academic medical center. PATIENTS Consecutive patients requiring mechanical ventilation ≥48 hrs, administered a continuously infused sedative(More)
BACKGROUND Respiratory failure remains the leading indication for admission to the intensive care unit (ICU) and a leading cause of death for HIV-infected patients in spite of overall improvements in ICU mortality. It is unclear if these improvements are due to combination anti-retroviral therapy, low tidal volume ventilation for acute lung injury, or both.(More)
BACKGROUND Successful application of noninvasive ventilation (NIV) for acute respiratory failure (ARF) requires patient cooperation and comfort. The efficacy and safety of early IV dexmedetomidine when added to protocolized, as-needed IV midazolam and fentanyl remain unclear. METHODS Adults with ARF and within 8 h of starting NIV were randomized to(More)
Acknowledgements We would like to thank a number of people without whom we would not have been able to complete this project: Judge Jill Rangos, for her incredibly generous hospitality and keen insight into the drug court system. Ms. Penny Howe, for her help in organizing our visits to the Allegheny Courthouse and willingness to speak with us about drug(More)
We explored the relative strength of environmental and social factors associated with pediatric asthma in middle class families and considered the efficacy of recruitment for an educational study at a science museum. Eligibility criteria were having a child aged 4-12 and English fluency. Our questionnaire included information on demographics, home(More)
BACKGROUND Cardiac dysfunction is one of many causes for unsuccessful weaning from mechanical ventilation. Although cardiac dysfunction can be detected via direct measurement of cardiac output during weaning, available methods are not feasible. OBJECTIVE To investigate the role of noninvasive monitoring of cardiac output during weaning and determine if a(More)
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