Annals of internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial.
Optimal management of patients who are clinically suspected of having ventilator-associated pneumonia remains open to debate. ⋯ Compared with a noninvasive management strategy, an invasive management strategy was significantly associated with fewer deaths at 14 days, earlier attenuation of organ dysfunction, and less antibiotic use in patients suspected of having ventilator-associated pneumonia.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease. A randomized, controlled trial.
Pulmonary hypertension is a progressive and often fatal complication of the scleroderma spectrum of disease for which no treatment has been proven effective in a randomized trial. ⋯ Continuous epoprostenol therapy improves exercise capacity and cardiopulmonary hemodynamics in patients with pulmonary hypertension due to the scleroderma spectrum of disease.
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Randomized Controlled Trial Clinical Trial
Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A randomized, controlled trial.
Few investigations include both subjective and objective measurements of the effectiveness of treatments for osteoarthritis of the knee. Beneficial interventions may decrease the disability associated with osteoarthritis and the need for more invasive treatments. ⋯ A combination of manual physical therapy and supervised exercise yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention.
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Randomized Controlled Trial Comparative Study Clinical Trial
Chlorhexidine compared with povidone-iodine as skin preparation before blood culture. A randomized, controlled trial.
Chlorhexidine is better than povidone-iodine for care of catheter sites, but it is not known whether chlorhexidine is superior in reducing blood culture contamination. ⋯ Skin preparation with alcoholic chlorhexidine is more efficacious than skin preparation with aqueous povidone-iodine in reducing contamination of blood cultures.
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Randomized Controlled Trial Clinical Trial
Effect of clinician communication skills training on patient satisfaction. A randomized, controlled trial.
Although substantial resources have been invested in communication skills training for clinicians, little research has been done to test the actual effect of such training on patient satisfaction. ⋯ "Thriving in a Busy Practice: Physician-Patient Communication," a typical continuing medical education program geared toward developing clinicians' communication skills, is not effective in improving general patient satisfaction. To improve global visit satisfaction, communication skills training programs may need to be longer and more intensive, teach a broader range of skills, and provide ongoing performance feedback.