Annals of internal medicine
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Randomized Controlled Trial Clinical Trial
Effects of naloxone infusions in patients with the pruritus of cholestasis. A double-blind, randomized, controlled trial.
To determine whether endogenous opioids contribute to the pruritus of cholestasis by studying the effect of the opiate antagonist naloxone on the perception of pruritus and on scratching activity in patients with this form of pruritus. ⋯ Naloxone administration is associated with amelioration of the perception of pruritus and reduction of scratching activity in cholestatic patients. Because of the opioid receptor specificity of the action of naloxone, these findings support the hypothesis that a mechanism underlying the pruritus of cholestasis is modulated by endogenous opioids and suggest that opiate antagonists may have a role in the management of this complication of cholestasis.
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Randomized Controlled Trial Clinical Trial
Mechanical ventilation with or without 7-day circuit changes. A randomized controlled trial.
To determine whether a practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with an increased incidence of nosocomial pneumonia. ⋯ The elimination of routine ventilator circuit changes can reduce medical care costs without increasing the incidence of nosocomial pneumonia in patients who require prolonged mechanical ventilation.