Arch Intern Med
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Review Meta Analysis Comparative Study
Rate vs rhythm control in patients with atrial fibrillation: a meta-analysis.
The 2 fundamental approaches to the management of atrial fibrillation (AF) are reestablishing and maintaining sinus rhythm (rhythm control) and controlling ventricular rate with atrioventricular node blocking agents (rate control). We performed a meta-analysis of randomized controlled trials comparing these strategies in patients with AF to add precision to the relative merits of both strategies on the risk of all-cause mortality and to evaluate the consistency of the results between trials. ⋯ In patients with persistent AF or with AF that is likely to be recurrent, a strategy of ventricular rate control, in combination with anticoagulation in appropriate patients, appears to be at least equivalent to a strategy of maintaining sinus rhythm by using currently available antiarrhythmic drugs in preventing clinical outcomes.
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Review Meta Analysis Comparative Study
Vasopressin for cardiac arrest: a systematic review and meta-analysis.
The current guidelines for cardiopulmonary resuscitation recommend vasopressin as an alternative to epinephrine for the treatment of adult shock-refractory ventricular fibrillation. The objective of this study was to determine the effectiveness of vasopressin in the treatment of cardiac arrest. ⋯ There is no clear advantage of vasopressin over epinephrine in the treatment of cardiac arrest. Guidelines for Advanced Cardiac Life Support should not recommend vasopressin in resuscitation protocols until more solid human data on its superiority are available.
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Review Meta Analysis
A systematic review and meta-analysis of studies comparing readmission rates and mortality rates in patients with heart failure.
Heart failure is the leading cause of hospitalization and readmission in many hospitals worldwide. We performed a meta-analysis to evaluate the effectiveness of multidisciplinary heart failure management programs on hospital admission rates. ⋯ This systematic review suggests that specific heart failure-targeted interventions significantly decrease hospital readmissions but do not affect mortality rates.
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Review Meta Analysis
A systematic review and meta-analysis of studies comparing readmission rates and mortality rates in patients with heart failure.
Heart failure is the leading cause of hospitalization and readmission in many hospitals worldwide. We performed a meta-analysis to evaluate the effectiveness of multidisciplinary heart failure management programs on hospital admission rates. ⋯ This systematic review suggests that specific heart failure-targeted interventions significantly decrease hospital readmissions but do not affect mortality rates.
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Infectious diseases may rival cancer, heart disease, and chronic lung disease as sources of morbidity and mortality from smoking. We reviewed mechanisms by which smoking increases the risk of infection and the epidemiology of smoking-related infection, and delineated implications of this increased risk of infection among cigarette smokers. ⋯ The clinical implications of our findings include emphasizing the importance of smoking cessation as part of the therapeutic plan for people with serious infectious diseases or periodontitis, and individuals who have positive results of tuberculin skin tests. Controlling exposure to secondhand cigarette smoke in children is important to reduce the risks of meningococcal disease and otitis media, and in adults to reduce the risk of influenza and meningococcal disease. Other recommendations include pneumococcal and influenza vaccine in all smokers and acyclovir treatment for varicella in smokers.