The American journal of medicine
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Single-dose intravenous therapy with pamidronate for the treatment of hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosages.
To determine the efficacy, dose-response relationship, and safety of 30, 60, and 90 mg of a single intravenous dose of an aminobisphosphonate, pamidronate (APD), for the treatment of moderate to severe hypercalcemia of malignancy. ⋯ A single-dose infusion of 60 to 90 mg of pamidronate was highly effective and well tolerated and normalized corrected serum calcium in nearly all patients (61% to 100%) with hypercalcemia of malignancy.
-
Randomized Controlled Trial Clinical Trial
Prophylaxis of urinary tract infection in persons with recent spinal cord injury: a prospective, randomized, double-blind, placebo-controlled study of trimethoprim-sulfamethoxazole.
To determine the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) for prophylaxis of urinary tract infection in persons with recent spinal cord injury, during the first 4 months of intermittent catheterization. ⋯ Prophylaxis with TMP-SMX significantly reduces bacteriuria and symptomatic urinary tract infection in persons with recent acute spinal cord injury during bladder retraining using intermittent catheterization. However, adverse reactions attributable to TMP-SMX are common in this population. Colonization and breakthrough bacteriuria with TMP-SMX-resistant organisms are frequent and may seriously limit the usefulness of this strategy, particularly in an institutional setting.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A controlled trial of two forms of self-management education for adults with asthma.
Excess morbidity and mortality due to asthma, aggravated by demonstrably poor patient self-management practices, suggest the need for formal patient education programs. Individual and group asthma education programs were developed and evaluated to determine their cognitive, behavioral, and clinical effects. ⋯ Carefully designed asthma education programs for adults can improve patients' understanding of their condition and its treatment and increase their motivation and confidence that the condition can be controlled, thereby increasing their adherence to the treatment regimen and management of symptoms, and, in turn, improving control of symptoms. Both small-group education and individual education were associated with significant benefits, but the group program was simpler to administer, better received by patients and educators, and more cost-effective. The results show promise for improving clinical outcomes, through well-designed educational programs, for patients with asthma and other chronic health problems.
-
Randomized Controlled Trial Clinical Trial
Gastrointestinal side effects of intravenous erythromycin: incidence and reduction with prolonged infusion time and glycopyrrolate pretreatment.
To determine the frequency of gastrointestinal toxicity due to intravenous (IV) erythromycin and to attempt to decrease this toxicity by prolonging the infusion time of erythromycin and/or pretreating with the peripheral anticholinergic, glycopyrrolate 0.1 mg IV. ⋯ Gastrointestinal toxicity associated with the IV infusion of erythromycin is common and is more likely to occur in younger patients. A 1-hour infusion of erythromycin combined with pretreatment with glycopyrrolate, 0.1 mg IV, is effective in reducing this toxicity.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Single-dose oral temafloxacin versus parenteral ceftriaxone in the treatment of gonococcal urethritis/cervicitis.
Temafloxacin is an oral fluoroquinolone with potent in vitro activity against Neisseria gonorrhoeae. The efficacy and safety of a single dose of temafloxacin were compared with ceftriaxone, the current treatment of choice for gonorrhea, in a randomized, multicenter study. A total of 421 patients with uncomplicated gonococcal urethritis or cervicitis were randomly assigned to receive a single oral dose of temafloxacin 200 mg (n = 63) or 400 mg (n = 175), or a single intramuscular injection of ceftriaxone 250 mg (n = 183). ⋯ Corresponding clinical cure rates were 93.6% and 94.6%, respectively. Both regimens were well tolerated. A single oral dose of temafloxacin appears to be as safe and effective as injectable ceftriaxone in the treatment of uncomplicated gonococcal urethritis or cervicitis.