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OBJECTIVE To analyze the effect on clinical outcomes of prophylactic positive end expiratory pressure in nonhypoxemic ventilated patients. DESIGN Multicenter randomized controlled clinical trial. SETTING One trauma and two general intensive care units in two university hospitals. PATIENTS One hundred thirty-one mechanically ventilated patients with(More)
An increase in the number of new cases of tuberculosis (TB) combined with poor clinical outcome was identified among HIV-infected injecting drug users attending a large HIV unit in central Lisbon. A retrospective epidemiological and laboratory study was conducted to review all newly diagnosed cases of TB from 1995 to 1996 in the HIV unit. Results showed(More)
BACKGROUND Detection of small (10-20%) increases in lung water may be relevant to detect incipient pulmonary edema but no clinically usable method has demonstrated this capability to date. METHODS In six pigs weighing 28 to 35 kg, we performed 18 determinations of extravascular lung water (EVLW; transpulmonary thermodilution method) before and immediately(More)
The human immunodeficiency virus replication cycle begins by sequential interactions between viral envelope glycoproteins with CD4 molecule and a member of the seven-transmembrane, G-protein-coupled, receptors' family (coreceptor). In this report we focused on the contribution of CCR8 as alternative coreceptor for HIV-1 and HIV-2 isolates. We found that(More)
OBJECTIVE To study the minimum assistance level during proportional assist ventilation (PAV) to decrease the work of breathing to physiological limits (0.6 j/l) and the relationship between breathing pattern changes and respiratory effort at different PAV levels. DESIGN Prospective cohort study. SETTING Polyvalent intensive care unit of a teaching(More)
Bacillary angiomatosis and bacillary peliosis are opportunistic infections caused by Bartonella henselae and Bartonella quintana, which occur in patients with late-stage infection. We report a case of bacillary angiomatosis in an HIV-infected patient with skin, bone, and probably liver involvement, The identification of the agent (B quintana ) was done by(More)
Few actions taken by intensivists are as effective and inexpensive as application of positive end-expiratory pressure (PEEP). However, the use of this ventilatory modality is highly susceptible to fashions and trends that are rarely supported by scientific evidence. Prophylactic PEEP can be considered an exception, in that there is scientific evidence that(More)
We report a case of atypical bullous pyoderma gangrenosum associated with acute myeloid leukaemia in which we found atypical myeloid cells within the skin lesion. Although there have been many reported cases of leukaemia-associated pyoderma gangrenosum, the finding of myeloblasts in the skin has rarely been described.
Reported here is the case of a patient with a superficial bladder tumor who developed pancytopenia, miliary nodular pattern pneumonitis and noncaseating granuloma in bone marrow after receiving intravesical Bacillus Calmette-Gu rin (BCG) instillations. Late detection of Mycobacterium tuberculosis complex-deoxyribonucleic acid (MTC-DNA) in a respiratory(More)
This article provides a broad overview of microbial pathogens associated with marine and fresh water aquatic animals, including Vibrio species, Escherichia coli, Streptococcus iniae, Salmonella species, and Edwardsiella tarda. Historically, cultured fish were not considered important vectors of human pathogens. This situation is changing, partly due to(More)