Annals of internal medicine
-
Randomized Controlled Trial Clinical Trial
Acetazolamide in the treatment of acute mountain sickness: clinical efficacy and effect on gas exchange.
To determine the efficacy of acetazolamide in the treatment of patients with acute mountain sickness and the effect of the drug on pulmonary gas exchange in acute mountain sickness. ⋯ In established cases of acute mountain sickness, treatment with acetazolamide relieves symptoms, improves arterial oxygenation, and prevents further impairment of pulmonary gas exchange.
-
To review the literature on the appropriateness of red blood cell transfusion and current physician practice, with emphasis on the physiologic and symptomatic implications of elective transfusion in the treatment of anemia. ⋯ Despite the recent decline in red blood cell use because of concerns about infection, current transfusion practice remains variable because physicians have disparate views about its appropriateness. The remarkable human tolerance of anemia suggests that clinicians can accept hemoglobin levels above 70 g/L (7 g/dL) in most patients with self-limited anemia. In patients with impaired cardiovascular status or with anemias that will not resolve spontaneously, however, the data are insufficient to determine minimum acceptable hemoglobin levels, and therapy must be guided by the clinical situation. Several therapeutic strategies and pharmacologic interventions are available in the perioperative and non-operative settings to further reduce red blood cell use.
-
Multicenter Study Clinical Trial
Treatment of Mycobacterium avium complex bacteremia in AIDS with a four-drug oral regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. The California Collaborative Treatment Group.
To determine the quantitative microbiologic response and the clinical response of patients with Mycobacterium avium complex bacteremia and AIDS to an oral antimycobacterial regimen. ⋯ A rapid reduction in symptoms and bacteremia can be achieved as early as week 2 of therapy using an oral regimen of rifampin, ethambutol, clofazimine, and ciprofloxacin. Colony counts rose dramatically after therapy was discontinued, suggesting that more prolonged periods of therapy are necessary to eradicate systemic infection.
-
Clinical Trial
Evaluation of syncope by upright tilt testing with isoproterenol. A nonspecific test.
To determine the proportion of patients with syncope of unknown etiology who have a positive response to upright tilt testing and to determine the specificity of this test as a marker for vasodepressor syncope. ⋯ The rate of positive tilt testing in patients with syncope is equivalent to that in controls without a history of syncope. The low specificity of this test makes its use as a marker for vasodepressor syncope questionable.
-
To assess the effect of a structured analgesic regimen on hospital use by patients with sickle cell disease. ⋯ A pain-control program modeled on regimens used to treat chronic cancer pain reduced hospital use by adult patients with sickle cell pain.