Annals of internal medicine
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Randomized Controlled Trial Clinical Trial
Excess body weight is not independently associated with outcome in mechanically ventilated patients with acute lung injury.
Despite an epidemic of obesity among adults, the effect of excess body weight on outcome from critical illness is not well studied. ⋯ After risk adjustment, overweight and obese patients with acute lung injury have outcomes similar to those of patients with normal BMI. The lack of interaction between ventilator protocol assignment and BMI suggests that patients with normal, overweight, or obese BMI benefit from lower tidal volume ventilation for acute lung injury.
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Randomized Controlled Trial Clinical Trial
Graded activity for low back pain in occupational health care: a randomized, controlled trial.
Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. ⋯ Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain.
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Randomized Controlled Trial Clinical Trial
Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial.
Leech therapy was commonly used in traditional medicine for treating localized pain. Clinically significant pain relief after leech therapy for osteoarthritis of the knee has been demonstrated by preliminary data. ⋯ Leech therapy helps relieve symptoms in patients with osteoarthritis of the knee. The potential of leech therapy for treating osteoarthritis and the pharmacologic properties of leech saliva remain to be clarified.
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Randomized Controlled Trial Clinical Trial
Association of hospital procedure volume and outcomes in patients with colon cancer at high risk for recurrence.
Studies that use registry data have demonstrated superior long-term overall survival after curative surgical resection of colon cancer at hospitals where the volume of such surgeries is high. However, because such administrative data lack information on cancer recurrence, the true nature of this relation remains uncertain. ⋯ According to prospectively recorded data from a large clinical trial, patients whose colon cancer was resected at low-volume hospitals experienced a higher risk for long-term mortality; however, this increased mortality was not attributable to differences in colon cancer recurrences.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Extended oral anticoagulant therapy after a first episode of pulmonary embolism.
The optimal duration of oral anticoagulant treatment after a first episode of pulmonary embolism remains uncertain. ⋯ Patients with pulmonary embolism have a substantial risk for recurrence after discontinuation of oral anticoagulation, regardless of treatment duration. Physicians should try to identify patients who are at high risk for recurrent venous thromboembolism and are therefore potential candidates for indefinite oral anticoagulant therapy.