JAMA : the journal of the American Medical Association
-
Most medical interventions have modest effects, but occasionally some clinical trials may find very large effects for benefits or harms. ⋯ Most large treatment effects emerge from small studies, and when additional trials are performed, the effect sizes become typically much smaller. Well-validated large effects are uncommon and pertain to nonfatal outcomes.
-
Previous studies have examined the associations of individual clinical risk factors with risk of peripheral artery disease (PAD), but the combined effects of these risk factors are largely unknown. ⋯ Among men in this cohort, smoking, hypertension, hypercholesterolemia, and type 2 diabetes account for the majority of risk associated with development of clinically significant PAD.
-
Lung-protective mechanical ventilation with the use of lower tidal volumes has been found to improve outcomes of patients with acute respiratory distress syndrome (ARDS). It has been suggested that use of lower tidal volumes also benefits patients who do not have ARDS. ⋯ Among patients without ARDS, protective ventilation with lower tidal volumes was associated with better clinical outcomes. Some of the limitations of the meta-analysis were the mixed setting of mechanical ventilation (intensive care unit or operating room) and the duration of mechanical ventilation.
-
Norovirus outbreaks are common among vulnerable, elderly populations in US nursing homes. ⋯ Norovirus outbreaks were associated with significant concurrent increases in all-cause hospitalization and mortality in nursing homes.