The American journal of medicine
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To describe patients initiating nonsteroidal anti-inflammatory drug (NSAID) therapy with regard to gastrointestinal and cardiac risks and patterns of antisecretory agent use, and to explore the relation between therapy type and subsequent outcomes. ⋯ Although we found that COX-2 inhibitors were used more frequently than were traditional NSAIDs in certain groups of patients with varying cardiac or gastrointestinal risk, we did not find that their use resulted in reductions in clinical events, cotherapy with proton pump inhibitors, or costs, suggesting that a better understanding of the relation between NSAID treatment strategies and outcomes in patients with differing risk characteristics is needed.
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Clinical Trial Controlled Clinical Trial
Effect of short-term treatment with inhaled corticosteroid on airway wall thickening in asthma.
Computed tomography studies demonstrate thickening of the asthmatic airway wall and its relation to disease severity. We evaluated the effect of inhaled corticosteroid on this phenomenon. ⋯ Wall thickening of asthmatic central airways responds partially to inhaled corticosteroid therapy and may reflect an overall reduction in airway inflammation. "Unresponsive components," possibly involving structural changes, may increase in the absence of inhaled corticosteroid treatment, potentially leading to chronic airflow obstruction.
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To determine the effect of pulmonary fibrosis on survival in an unselected group of patients with hypersensitivity pneumonitis. ⋯ Pulmonary fibrosis is associated with diminished survival in patients with hypersensitivity pneumonitis.
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Review Meta Analysis
Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials.
To review the effectiveness of exercise-based cardiac rehabilitation in patients with coronary heart disease. ⋯ This review confirms the benefits of exercise-based cardiac rehabilitation within the context of today's cardiovascular service provision.
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Randomized Controlled Trial Clinical Trial
Effects of ACE gene insertion/deletion polymorphism on response to spironolactone in patients with chronic heart failure.
Angiotensin-converting enzyme (ACE) is involved in the pathophysiology of chronic heart failure, and its activity is determined in part by a polymorphism of the ACE gene. We hypothesized that the benefits of spironolactone, which inhibits downstream elements of ACE-mediated abnormalities, may depend on ACE genotype. ⋯ The effects of spironolactone treatment on left ventricular systolic function and remodeling may in part depend on ACE genotype.