Annals of internal medicine
-
To review the clinical use of noninvasive positive pressure ventilation, including its efficacy with acute and chronic forms of respiratory failure, its mechanism of action, and its implementation. ⋯ Noninvasive positive pressure ventilation is effective in the treatment of chronic respiratory failure due to restrictive thoracic diseases. The routine use of such treatment for chronic respiratory failure due to chronic obstructive pulmonary disease and for acute respiratory failure needs to be studied in randomized controlled trials in better-defined patient subsets.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Nosocomial pneumonia in mechanically ventilated patients receiving antacid, ranitidine, or sucralfate as prophylaxis for stress ulcer. A randomized controlled trial.
To assess three anti-stress ulcer prophylaxis regimens in mechanically ventilated patients for bacterial colonization, early- and late-onset nosocomial pneumonia, and gastrointestinal bleeding. ⋯ Stress ulcer prophylaxis with sucralfate reduces the risk for late-onset pneumonia in ventilated patients compared with antacid or ranitidine.
-
To introduce guidelines for the conduct, reporting, and critical appraisal of meta-analyses evaluating diagnostic tests and to apply these guidelines to recently published meta-analyses of diagnostic tests. ⋯ Meta-analysis is potentially important in the assessment of diagnostic tests. Those reading meta-analyses evaluating diagnostic tests should critically appraise them; those doing meta-analyses should apply recently developed methods. The conduct and reporting of primary studies on which meta-analyses are based require improvement.
-
A strategy is proposed for attracting trainees to careers in general internal medicine coupled with a program that attracts a smaller number of trainees to research careers without attracting trainees into careers in the practice of the subspecialties. A novel training track analogous to the Medical Scientist Training Program, the Specialty Training and Academic Research (STAR) Program has been established. It is anticipated that within the next 5 years, 80% of the trainees in the department of medicine at the University of California, Los Angeles, Medical Center will be training for practice in general internal medicine; the remaining 20% will be enrolled in the STAR Program.