The American journal of medicine
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Randomized Controlled Trial Clinical Trial
Third heart sound and elevated jugular venous pressure as markers of the subsequent development of heart failure in patients with asymptomatic left ventricular dysfunction.
To determine the independent prognostic value of a third heart sound (S(3)) and elevated jugular venous pressure in patients with asymptomatic left ventricular dysfunction. ⋯ The physical examination provides prognostic information among patients with asymptomatic or minimally symptomatic left ventricular dysfunction.
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To evaluate the predictors of and time taken for the translation of highly promising basic research into clinical experimentation and use. ⋯ Even the most promising findings of basic research take a long time to translate into clinical experimentation, and adoption in clinical practice is rare.
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The National Asthma Education and Prevention Program (NAEPP) recommends pulmonary function testing as part of asthma evaluation. The objectives of this study were to determine the use of spirometry in patients with asthma by primary care physicians and asthma specialists, and to identify barriers to use of spirometry. ⋯ Pulmonary function testing is underutilized by physicians, with rates of utilization lowest among primary care physicians. Providing primary care physicians with better access to spirometry, through provision of a machine and appropriate training in its use and interpretation, may improve compliance with the NAEPP recommendations.
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Clinical Trial Controlled Clinical Trial
The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults.
We sought to determine whether a multicomponent hospital-based intervention targeted toward risk factors for delirium had any effect on patient outcomes 6 months later. ⋯ In the group as a whole, we were unable to identify a lasting beneficial effect of the multicomponent intervention, although further efforts to identify appropriate subgroups for targeted interventions may be worthwhile. Other strategies are needed after hospital discharge to deter deterioration in susceptible elderly people.