Annals of internal medicine
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Randomized Controlled Trial
Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial.
It is not known whether rigorous intraoperative glycemic control reduces death and morbidity in cardiac surgery patients. ⋯ Intensive insulin therapy during cardiac surgery does not reduce perioperative death or morbidity. The increased incidence of death and stroke in the intensive treatment group raises concern about routine implementation of this intervention.
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Randomized Controlled Trial
Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study.
Polysomnography (PSG), despite limited availability and high cost, is currently recommended for diagnosis of obstructive sleep apnea and titration of effective continuous positive airway pressure (CPAP). ⋯ In the initial management of patients with a high probability of obstructive sleep apnea, PSG confers no advantage over the ambulatory approach in terms of diagnosis and CPAP titration. The ambulatory approach may improve adherence to treatment. When access to PSG is inadequate, the ambulatory approach can be used to expedite management of patients most in need of treatment.