Annals of internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Older age, aggressiveness of care, and survival for seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.
Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. ⋯ We found a modest independent association between patient age and short-term survival of serious illness. This age effect was not explained by the current practice of providing less aggressive care to elderly patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Azithromycin compared with penicillin G benzathine for treatment of incubating syphilis.
Preventive therapy is an important element of syphilis control efforts. No currently recommended, single-dose alternatives to penicillin G benzathine are available for treatment of incubating syphilis. ⋯ A single 1.0-g dose of azithromycin seems to be efficacious for prevention of syphilis in persons exposed to infected sexual partners.
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Randomized Controlled Trial Clinical Trial
Improving adherence to dementia guidelines through education and opinion leaders. A randomized, controlled trial.
Educational methods that encourage physicians to adopt practice guidelines are needed. ⋯ A multifaceted educational program can improve physician adoption of practice guidelines.
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Randomized Controlled Trial Clinical Trial
Persistence and boosting of bacille Calmette-Guérin-induced delayed-type hypersensitivity.
Bacille Calmette-Guérin (BCG) vaccination may induce persistent and booster purified protein derivative (PPD) responses that complicate tuberculosis screening efforts. ⋯ Previous BCG vaccination reduces the predictive value of serial PPD testing. The lowest PPD predictive values will occur in persons without known tuberculosis exposure who were vaccinated recently or many times with intradermal BCG. In addition, BCG-related persistence and boosting of delayed-type hypersensitivity responses correlate with other potential surrogate markers of protective mycobacterial immunity.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of nasogastric tube size on gastroesophageal reflux and microaspiration in intubated patients.
Little evidence exists to support the theory that small-bore nasogastric tubes prevent gastroesophageal reflux and microaspiration in intubated patients. ⋯ Small-bore nasogastric tubes in intubated patients do not reduce gastroesophageal reflux or microaspiration.