Cleveland Clinic journal of medicine
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Beta-blockers, long considered contraindicated in heart failure, improve left ventricular function in this disease by improving the biology of cardiac myocytes. Whether they improve survival remains to be determined.
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The variety of devices for administering supplemental oxygen and aerosolized drugs for hospital inpatients allows physicians to tailor the therapy to patient's needs, but presents a challenge in determining which device is best for the individual patient. We describe the selection process, appropriate use, and the advantages and disadvantages of various devices.
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When Jehovah's Witnesses refuse blood, they regularly ask their physicians to explore and provide all other medically and scientifically based alternatives, even when these alternatives may not be as effective and may carry risk of failure that could lead to physical disabilities or death. An awareness of the values at stake and of other cases from personal experience and the literature can help physicians, patients, and their families to move toward ethically responsible decisions and actions.