ABSTRACT
Non-invasive ventilation [NIV] has been widely supported in the past two decades as an effective application in avoiding the need for endotracheal intubation [ETI] and reducing associated mortality in acute hypoxemic respiratory failure [AHRF] patients. However, the efficacy of NIV in AHRF patients, non-related to chronic obstructive pulmonary disease [COPD] and trauma is still controversial in the field of medical research. This retrospective study aimed to evaluate the efficacy of NIV as an adjunctive therapy in non-COPD and non-traumatic AHRF patients. Data of 11 randomized control trials [RCTs], which were conducted between 1990 and 2010 to determine the efficacy of NIV in non-COPD and non-traumatic AHRF patients, were reviewed from the PUBMED, MEDLINE, Cochrane Library, and EMBASE databases. Parameters monitored in this study included the ETI rate, fatal complications, mortality rate of patients, and their ICU and hospital duration of stay. Overall results showed a statistically significant decrease in the rate of ETI, mortality, and fatal complications along with reduced ICU and hospital length of stay in non-COPD and non-trauma AHRF patients of various etiologies. This systematic review suggests that non-COPD and non-trauma AHRF patients can potentially benefit from NIV as compared with conventional treatment methods. Observations from various cohort studies, observational studies, and previously published literature advocate on the efficacy of NIV for treating non-COPD and non-traumatic AHRF patients. However, considering the diversity of studied populations, further studies and more specific trials on less heterogeneous AHRF patient groups are needed to focus on this aspect
ABSTRACT
We conducted this national survey to quantitatively assess sleep medicine services in the Kingdom of Saudi Arabia [KSA] and to identify obstacles that specialists and hospitals face, precluding the establishment of this service. A self-administered questionnaire was designed to collect the following: General information regarding each hospital, information regarding sleep medicine facilities [SFs], the number of beds, the number of sleep studies performed and obstacles to the establishment of SFs. The questionnaire and a cover letter explaining the study objectives were mailed and distributed by respiratory care practitioners to 32 governmental hospitals and 18 private hospitals and medical centers in the KSA. The survey identified 18 SFs in the KSA. The estimated per capita number of beds/year/100,000 people was 0.11 and the per capita polysomnography [PSG] rate was 18.0 PSG/year/100,000 people. The most important obstacles to the progress of sleep medicine in the KSA were a lack of trained sleep technologists and a lack of sleep medicine specialists. The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA
Subject(s)
Humans , Specialization , Residence Characteristics , Medicine/trends , Health Surveys , Surveys and Questionnaires , Sleep Medicine SpecialtyABSTRACT
This multicenter phase II study was designed to assess the efficacy and tolerability of the combination of irinotecan with bolus 5-FU and calcium leucovorin [LV] as a front line therapy for advanced colorectal cancer [CRC]. Patients with histologically proven advanced CRC and at least one measurable lesion, with age range 18-75 years, with a performance status of <2, normal baseline biochemical values and no prior chemotherapy [apart from adjuvant] were selected. The treatment regimen was formed of weekly CPT-11 [125 mg/m2] i.v. infusion, 5-FU [500 mg/m2] bolus i.v. and LV [20 mg/m2] i.v. for four weeks [two weeks, followed by two weeks rest, this constitute one cycle]. Treatment continued till either complete remission or disease progression or failure