Isr Med Assoc J
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Randomized Controlled Trial
Efficacy of nebulized fluticasone propionate in adult patients admitted to the emergency department due to bronchial asthma attack.
Locally delivered steroids by inhalers or nebulizers have been shown in small trials to be effective in acute asthma attack, but evidence-based data are insufficient to establish their place as routine management of adult asthma attacks. ⋯ Our study cohort showed the advantage of nebulized steroid fluticasone versus systemic corticosteroids in adult asthmatics managed in the ED following an acute attack. Both these and previous results suggest that nebulized steroids should be used, either alone or in combination with systemic steroids, to treat adults suffering acute asthma attack.
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Randomized Controlled Trial
Comparison of 4 and 6 French catheters for coronary angiography: real-world modeling.
Femoral artery vascular complications are the most common adverse events following cardiac catheterization. Smaller diameter introducer sheaths and catheters are likely to lower the puncture site complication rate but may hinder visualization. ⋯ Patients catheterized with 4F have fewer complications compared with 6F diagnostic catheters even when ambulated earlier. Although 4F had a reduced quality compared to 6F angiographies, they were evaluated as satisfactory or excellent in quality 85% of the time. 4F catheters have a potential for reduced hospitalization stay and are a good option for primary catheterization in patients not anticipated to undergo coronary intervention.
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Randomized Controlled Trial
Insulin therapy of hyperglycemia in intensive care.
Hyperglycemia is common among patients admitted to intensive care units, and carries the risk for complications and prolonged ICU stay. With intensive insulin control of blood glucose, morbidity and mortality can be reduced. ⋯ Intensive insulin treatment did not affect the mortality or morbidity rates in ICU patients. The increased insulin dosage of conventional insulin treatment was attributable to the group's higher prevalence of diabetes. Future studies should address this bias and determine the optimal glucose target.
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Randomized Controlled Trial Comparative Study
Comparison of the quality of life after minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: a prospective randomized study.
Earlier studies comparing minilaparotomy cholecystectomy with laparoscopic cholecystectomy did not find significant differences between the MC and the LC groups in operating times and patients' recovery. ⋯ The results of this study showed that the MC procedure is a good alternative to the LC procedure, when postoperative quality of life is measured.
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Randomized Controlled Trial Comparative Study
Hypertonic saline/epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years experience.
We recently published preliminary evidence on the effectiveness of hypertonic saline in infants with viral bronchiolitis. ⋯ This second-year experience and our 2 year pooled data analysis strengthen the evidence that the combination of 3% saline/1.5 mg epinephrine benefits hospitalized infants with viral bronchiolitis.