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BACKGROUND A study was undertaken to evaluate the clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV) in immunocompetent patients with chronic obstructive pulmonary disease (COPD). METHODS A randomised controlled trial was carried out in 596 patients with COPD of mean (SD) age 65.8 (9.7) years, 298 of whom received PPV. The main(More)
BACKGROUND Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult. METHODS To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up(More)
Processes of care and adherence to guidelines have been associated with improved survival in community-acquired pneumonia (CAP). In sepsis, bundles of processes of care have also increased survival. We aimed to audit compliance with guideline-recommended processes of care and its impact on outcome in hospitalised CAP patients with sepsis. We prospectively(More)
The etiology, microbiologic findings, and management of 82 episodes of empyema treated by our unit over a period of 6 years were analyzed. Average patient age was 54 years. Eighty-two percent had underlying disease such as alcoholism (29 percent), malignancy (23 percent), and diabetes mellitus (20 percent). Sixty (73 percent) had an empyema develop(More)
BACKGROUND The new Global Initiative for Chronic Obstructive Lung Disease (GOLD) update includes airflow limitation, history of COPD exacerbations, and symptoms to classify and grade COPD severity. We aimed to determine their distribution in 11 well-defined COPD cohorts and their prognostic validity up to 10 years to predict time to death. METHODS(More)
The aim of this prospective study was to determine the rate of recurrence for spontaneous pneumothorax (SP) after tetracycline pleurodesis (TCP), using that of observation, tube thoracostomy alone, and thoracotomy as references. From 1985 to the end of 1991, 78 patients were treated with tetracycline pleurodesis and 135 patients served as control subjects.(More)
BACKGROUND FEV1 is universally used as a measure of severity in COPD. Current thresholds are based on expert opinion and not on evidence. OBJECTIVES We aimed to identify the best FEV1 (% predicted) and dyspnea (mMRC) thresholds to predict 5-yr survival in COPD patients. DESIGN AND METHODS We conducted a patient-based pooled analysis of eleven COPD(More)
Guidelines recommend defining chronic obstructive pulmonary disease (COPD) by airflow obstruction and other factors, but no studies have evaluated the ability of existing multicomponent indices to predict mortality up to 10 years. We conducted a patient-based pooled analysis. Survival analysis and C statistics were used to determine the best COPD(More)
INTRODUCTION Healthcare-associated pneumonia (HCAP) is actually considered a subgroup of hospital-acquired pneumonia due to the reported high risk of multidrug-resistant pathogens in the USA. Therefore, current American Thoracic Society/Infectious Diseases Society of America guidelines suggest a nosocomial antibiotic treatment for HCAP. Unfortunately, the(More)