The American journal of the medical sciences
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of 24 vs 72-hour octreotide infusion in acute esophageal variceal hemorrhage - a multi-center, randomized clinical trial.
Current guidelines lack clarity about the optimal duration of octreotide therapy for patients with esophageal variceal hemorrhage (EVH). To address this lack of evidence, we conducted a randomized clinical trial (RCT) of 24-hr versus 72-hr continuous infusion of octreotide for patients with EVH. ⋯ A 24-hr infusion is non-inferior to a 72-hr infusion of octreotide for prevention of re-bleeding in patients with EVH. We propose that shortened octreotide duration may help reduce hospital stay and related costs in these patients.
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Randomized Controlled Trial
Optimizing Oral Immune Tolerance to Type II Collagen in Patients with Rheumatoid Arthritis: The Importance of Dose, Interfering Medication and Genetics.
Oral immune tolerance (OT) is a complex process with unknown genetic regulation. Our aim is to explore possible genetic control of OT in patients with rheumatoid arthritis (RA). ⋯ The ROT1 region plays a role in the control of IFNγ production after oral dosing of auto-antigens, thereby determining if oral tolerance to that antigen will develop.
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Letter Randomized Controlled Trial
Non-invasive ventilatory support accelerates the oxygen uptake and heart rate kinetics and improves muscle oxygenation dynamics in COPD-HF patients.
The aim of this study was to explore the effects of non-invasive positive pressure ventilation (NIPPV) associated with high-intensity exercise on heart rate (HR) and oxygen uptake (V̇O2) recovery kinetics in in patients with coexistence of chronic obstructive pulmonary disease (COPD) and heart failure (HF). ⋯ NIPPV applied during high-intensity dynamic exercise can effectively improve exercise tolerance, accelerate HR and V̇O2 kinetics, improve respiratory and peripheral muscle oxygenation in COPD-HF patients. These beneficial results from the effects of NIPPV may provide evidence and a basis for high-intensity physical training for these patients in cardiopulmonary rehabilitation programs.
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Randomized Controlled Trial
The impact of inspiratory pressure level on prevention of ventilator-associated pneumonia: A double-blind, randomized clinical trial.
Atelectasis and pneumonia are highly prevalent in patients under mechanical ventilation. Studies indicate that using ventilation with an open lung concept improves recovery, decreases ventilator-related pneumonia, decreases mortality and leads to faster weaning from the ventilator. Therefore, this study investigated the effect of higher airway pressure on ventilator-associated pneumonia. ⋯ High-pressure levels can decrease ventilator-associated pneumonia and organ failure. It is recommended that the study be repeated with a larger, more diverse population.
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Randomized Controlled Trial
Satisfaction with modes of telemedicine delivery during COVID-19: A randomized, single-blind, parallel group, noninferiority trial.
Little is known about satisfaction with different modes of telemedicine delivery. The objective of this study was to determine whether patient satisfaction with phone-only was noninferior to video visits. ⋯ Among a group of diverse, established older or underserved patients, the satisfaction rate for phone-only was noninferior to video visits. These findings could impact practice and policies governing telemedicine.