Annals of internal medicine
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Randomized Controlled Trial Clinical Trial
Combination therapy with oral sildenafil and inhaled iloprost for severe pulmonary hypertension.
Inhalation of the stable prostacyclin analogue iloprost is being studied for treatment of pulmonary hypertension. The selective phosphodiesterase-5 inhibitor sildenafil has been reported to cause pulmonary vasodilatation. ⋯ Although limited by the small sample and lack of long-term observations, the study shows that oral sildenafil is a potent pulmonary vasodilator that acts synergistically with inhaled iloprost to cause strong pulmonary vasodilatation in both severe pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.
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Randomized Controlled Trial Clinical Trial
Efficacy of resident training in smoking cessation: a randomized, controlled trial of a program based on application of behavioral theory and practice with standardized patients.
New educational programs must be developed to improve physicians' skills and effectiveness in counseling patients about smoking cessation. ⋯ A training program in smoking cessation administered to physicians that was based on behavioral theory and practice with standardized patients significantly increased the quality of physicians' counseling, smokers' motivation to quit, and rates of abstinence from smoking at 1 year.
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Randomized Controlled Trial Clinical Trial
Recovery rate and prognosis in older persons who develop acute lung injury and the acute respiratory distress syndrome.
The incidence of acute respiratory failure requiring mechanical ventilation increases 10-fold from the ages of 55 to 85 years, yet the rate of recovery and outcomes in older persons who develop acute lung injury are poorly defined. ⋯ Although the survival rate among patients 70 years of age or older was high, these patients were twice as likely to die of acute lung injury compared with their younger counterparts, even after adjustment for covariates. Older survivors recovered from respiratory failure and achieved spontaneous breathing at the same rate as younger patients but had greater difficulty achieving liberation from the ventilator and being discharged from the intensive care unit.
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Randomized Controlled Trial Clinical Trial
Summaries for patients. Prednisone for rheumatoid arthritis.
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Randomized Controlled Trial Clinical Trial
Estrogen in the prevention of atherosclerosis. A randomized, double-blind, placebo-controlled trial.
Although observational studies suggest that estrogen replacement therapy (ERT) reduces cardiovascular morbidity and mortality in postmenopausal women, use of unopposed ERT for prevention of coronary heart disease in healthy postmenopausal women remains untested. ⋯ Overall, the average rate of progression of subclinical atherosclerosis was slower in healthy postmenopausal women taking unopposed ERT with 17beta-estradiol than in women taking placebo. Reduction in the progression of subclinical atherosclerosis was seen in women who did not take lipid-lowering medication but not in those who took these medications.