JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Effect of Escitalopram on All-Cause Mortality and Hospitalization in Patients With Heart Failure and Depression: The MOOD-HF Randomized Clinical Trial.
Depression is frequent in patients with heart failure and is associated with adverse clinical outcomes. Long-term efficacy and safety of selective serotonin reuptake inhibitors in these patients are unknown. ⋯ In patients with chronic heart failure with reduced ejection fraction and depression, 18 months of treatment with escitalopram compared with placebo did not significantly reduce all-cause mortality or hospitalization, and there was no significant improvement in depression. These findings do not support the use of escitalopram in patients with chronic systolic heart failure and depression.
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Diarrheal disease is commonly encountered in clinical practice. Persistent diarrhea (≥14 days) can be caused by pathogens that differ from those commonly seen in acute illness; proper etiologic diagnosis is important for appropriate therapeutic management. This review provides an overview of the epidemiology, etiology, diagnosis, and management of persistent diarrhea caused by infectious agents in immunocompetent individuals worldwide. ⋯ Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms.
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Randomized Controlled Trial
Standardized Rehabilitation and Hospital Length of Stay Among Patients With Acute Respiratory Failure: A Randomized Clinical Trial.
Physical rehabilitation in the intensive care unit (ICU) may improve the outcomes of patients with acute respiratory failure. ⋯ Among patients hospitalized with acute respiratory failure, SRT compared with usual care did not decrease hospital LOS.