JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Hydrocortisone therapy for patients with multiple trauma: the randomized controlled HYPOLYTE study.
The role of stress-dose hydrocortisone in the management of trauma patients is currently unknown. ⋯ In intubated trauma patients, the use of an intravenous stress-dose of hydrocortisone, compared with placebo, resulted in a decreased risk of hospital-acquired pneumonia.
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Review Meta Analysis
Association of episodic physical and sexual activity with triggering of acute cardiac events: systematic review and meta-analysis.
Evidence has suggested that physical and sexual activity might be triggers of acute cardiac events. ⋯ Acute cardiac events were significantly associated with episodic physical and sexual activity; this association was attenuated among persons with high levels of habitual physical activity.
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Although troponin assays have become increasingly more sensitive, it is unclear whether further reductions in the threshold of detection for plasma troponin concentrations will improve clinical outcomes in patients with suspected acute coronary syndrome (ACS). ⋯ In patients with suspected ACS, implementation of a sensitive troponin assay increased the diagnosis of MI and identified patients at high risk of recurrent MI and death. Lowering the diagnostic threshold of plasma troponin was associated with major reductions in morbidity and mortality.