Annals of internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Use of tunneled femoral catheters to prevent catheter-related infection. A randomized, controlled trial.
The risk for catheter-related infection seems higher with femoral catheters than with catheters inserted at other sites. ⋯ The incidence of femoral catheter-related infections in critically ill patients can be reduced by using subcutaneous tunneling.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Oral montelukast, inhaled beclomethasone, and placebo for chronic asthma. A randomized, controlled trial. Montelukast/Beclomethasone Study Group.
Oral leukotriene receptor antagonists have been shown to have efficacy in chronic asthma. ⋯ Although beclomethasone had a larger mean effect than montelukast, both drugs provided clinical benefit to patients with chronic asthma. This finding is consistent with the use of these agents as controller medications for chronic asthma.
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Randomized Controlled Trial Clinical Trial
Effect of inhaled nitric oxide on gas exchange in patients with congestive heart failure. A randomized, controlled trial.
Conventional vasodilators increase ventilation-perfusion mismatch and do not improve gas exchange even though they reduce pulmonary hypertension. However, the effects of nitric oxide inhalation on ventilatory and gas exchange values in patients with congestive heart failure are not known. ⋯ Because nitric oxide inhalation improved gas exchange, it may be used as a supportive therapy when other conventional vasodilators worsen gas exchange.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial.
In patients with acute exacerbations of chronic obstructive pulmonary disease, mechanical ventilation is often needed. The rate of weaning failure is high in these patients, and prolonged mechanical ventilation increases intubation-associated complications. ⋯ Noninvasive pressure support ventilation during weaning reduces weaning time, shortens the time in the intensive care unit, decreases the incidence of nosocomial pneumonia, and improves 60-day survival rates.
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Randomized Controlled Trial Clinical Trial
Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation. The Stroke Prevention in Atrial Fibrillation Investigators Committee on Echocardiography.
Transesophageal echocardiography (TEE) visualizes potential sources of embolism in patients with atrial fibrillation, but the clinical significance of TEE findings has not been prospectively established. ⋯ In high-risk patients with atrial fibrillation, subsequent rates of thromboembolism are correlated with dense spontaneous echocardiographic contrast, thrombus of the atrial appendage, and aortic plaque. Adjusted-dose warfarin reduces the rate of stroke among patients with dense contrast and complex plaque. In patients with atrial fibrillation, the pathogenesis of stroke is multifactorial, and warfarin seems effective for the diverse mechanisms.