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Community-acquired pneumonia (CAP) is a major global disease. Parapneumonic effusions often complicate CAP and range from uninfected (simple) to infected (complicated) parapneumonic effusions and empyema (pus). CAP patients who have a pleural effusion at presentation are more likely to require hospitalization, have a longer length of stay and higher mortality than those without an effusion. Conventional management of pleural infection, with antibiotics and chest tube drainage, fails in about 30% of cases. Several randomized controlled trials (RCT) have evaluated the use of corticosteroids in CAP and demonstrated some potential benefits. Importantly, steroid use in pneumonia has an acceptable safety profile with no adverse impact on mortality. A RCT focused on pediatric patients with pneumonia and a parapneumonic effusion demonstrated shorter time to recovery. The effects of corticosteroid use on clinical outcomes in adults with parapneumonic effusions have not been tested. We hypothesize that parapneumonic effusions develop from an exaggerated pleural inflammatory response. Treatment with systemic steroids may dampen the inflammation and lead to improved clinical outcomes. The steroid therapy and outcome of parapneumonic pleural effusions (STOPPE) trial will assess the efficacy and safety of systemic corticosteroid as an adjunct therapy in adult patients with CAP and pleural effusions.
Pubmed ID: 31651842
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Commercial instrument supplier for human activity monitors. ActiGraph devices are used by researchers and clinicians in hundreds of universities and research organizations in more than 56 countries. ActiGraph activity monitors are the most validated and widely used devices of their kind. ActiGraph activity monitors use triaxial accelerometers and our validated proprietary filtering algorithms to accurately measure the amount and intensity of human activity. They are powered by rechargeable lithium ion batteries, and battery charging and communication are accomplished via a standard USB connection. All ActiGraph activity monitors can be worn at the waist or wrist and are suitable for subjects of all ages. ActiGraph devices have been used in hundreds of research studies in nearly 60 countries around the world since 1992. Leading research facilities including the U.S. National Institute of Health (NIH), the Institute of Child Health in the UK, and Karolinska Institutet in Sweden rely on our products to provide objective activity measurement in dozens of areas including obesity, diabetes, sleep, elderly behavior, and athletics. ActiGraph often works with scientific organizations to develop and implement software and hardware features that reflect the evolving needs of the research community. ActiGraph devices are well recognized as some of the most accurate activity measurement products on the market. Extensive research has confirmed our accuracy against the VO2 and doubly labeled water (DLW) methods of estimating energy expenditure. Keywords: Device, Researcher, Clinician, University, Research, Organization, Obesity, Diabetes, Sleep, Elderly, Behavior, Athletics, Scientific, Activity monitor, Physical, Measurement, Human, Activity,
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