JAMA : the journal of the American Medical Association
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Meta Analysis
Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature.
To quantify the efficacy of BCG vaccine against tuberculosis (TB). ⋯ On average, BCG vaccine significantly reduces the risk of TB by 50%. Protection is observed across many populations, study designs, and forms of TB. Age at vaccination did not enhance predictiveness of BCG efficacy. Protection against tuberculous death, meningitis, and disseminated disease is higher than for total TB cases, although this result may reflect reduced error in disease classification rather than greater BCG efficacy.
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Comparative Study
Outcome of out-of-hospital cardiac arrest in New York City. The Pre-Hospital Arrest Survival Evaluation (PHASE) Study.
To determine survival from out-of-hospital cardiac arrest in New York City and to compare this with other urban, suburban, and rural areas. ⋯ Survival from out-of-hospital cardiac arrest in New York City was poor. This was partly attributable to lengthy elapsed time intervals at every step in the chain of survival. However, examination of survival among arrests occurring after emergency medical services arrival suggests that other features may predispose residents of large cities to higher cardiac arrest mortality than individuals living in more suburban or rural settings. Since half the US population resides in large metropolitan areas, this represents a public health problem of considerable magnitude.
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Randomized Controlled Trial Clinical Trial
Predicting smoking cessation. Who will quit with and without the nicotine patch.
To identify predictors of smoking cessation success or failure with and without transdermal nicotine patch treatment. ⋯ Smoking status (abstinent or smoking) during the first 2 weeks of nicotine patch therapy, particularly week 2, was highly correlated with clinical outcome and can serve as a powerful predictor of smoking cessation. Early smoking behavior also predicted outcome among placebo patch users. Traditional measures of dependence are not consistently predictive of cessation success. Clinicians are advised to emphasize the importance of total abstinence after a quit attempt and to follow-up with patients within the first 2 weeks of quitting; smoking during this critical time should be assessed and treatment may be altered as appropriate.