Annals of internal medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Ciprofloxacin or trimethoprim-sulfamethoxazole as initial therapy for travelers' diarrhea. A placebo-controlled, randomized trial.
The efficacy of ciprofloxacin was compared with that of trimethoprim-sulfamethoxazole in a placebo-controlled trial of the 5-day treatment of acute diarrhea among 181 adults recently arrived in Guadalajara, Mexico. Both antimicrobial agents were significantly (p less than 0.0001) more efficacious than placebo in the treatment of diarrhea, with the average duration of diarrhea being 29, 20, and 81 hours, respectively, in the ciprofloxacin, trimethoprim-sulfamethoxazole, and placebo treatment groups. ⋯ Both antimicrobials were effective in treating mild-to-moderate and moderate-to-severe disease, and both were well tolerated. Ciprofloxacin appears to be a logical alternative to trimethoprim-sulfamethoxazole in the initial treatment of acute travelers' diarrhea.
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Randomized Controlled Trial Clinical Trial
Bicarbonate therapy in severe diabetic ketoacidosis.
Twenty-one adult patients with severe diabetic ketoacidosis entered a randomized prospective protocol in which variable doses of sodium bicarbonate, based on initial arterial pH (6.9 to 7.14), were administered to 10 patients (treatment group) and were withheld from 11 patients (control group). During treatment, there were no significant differences in the rate of decline of glucose or ketone levels or in the rate of increase in pH or bicarbonate levels in the blood or cerebrospinal fluid in either group. Similarly, there were no significant differences in the time required for the plasma glucose level to reach 250 mg/dL, blood pH to reach 7.3, or bicarbonate level to reach 15 meq/L. We conclude that in severe diabetic ketoacidosis (arterial pH 6.9 to 7.14), the administration of bicarbonate does not affect recovery outcome variables as compared with those in a control group.
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Randomized Controlled Trial Clinical Trial
Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest.
The amplitude of ventricular fibrillation found initially in 394 patients was compared to clinical and logistical findings at the time of cardiac arrest. Peak-to-peak amplitude averaged 0.55 +/- 0.25 mV; a very low amplitude (0.2 mV or less) or "fine" fibrillation was present in 66 patients (17%). ⋯ Patient outcome related to amplitude even after adjusting for clinical history and logistical delays (p less than 0.005). We conclude that fine ventricular fibrillation is in part the result of delay in initiation of treatment, and that fibrillation amplitude is a powerful indicator of outcome after cardiac arrest.
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Randomized Controlled Trial Clinical Trial
Verapamil for control of ventricular rate in paroxysmal supraventricular tachycardia and atrial fibrillation or flutter: a double-blind randomized cross-over study.
The effectiveness of verapamil in controlling ventricular rate was evaluated in 20 patients with atrial fibrillation or flutter with a rapid ventricular response (Group 1) and 30 patients with paroxysmal supraventricular tachycardia (Group 2). In Group 1 low-dose verapamil (0.075 mg/kg body weight) decreased the mean ventricular rate from 146 to 114 beats/min (p < 0.01) compared to a decrease of 145 to 132 beats/min (p < 0.01) after placebo. In Group 2, 14 of 29 patients converted to sinus rhythm after low-dose verapamil, nine of 15 after high-dose verapamil (0.15 mg/kg body weight), and one of 24 after placebo (p < 0.01). We conclude that verapamil results in a clinically significant slowing of the ventricular response in atrial fibrillation or atrial flutter and is superior to placebo for conversion of paroxysmal supraventricular tachycardia to sinus rhythm.
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Randomized Controlled Trial Clinical Trial
Prednisone therapy of acute alcoholic hepatitis. Report of a controlled trial.