São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room.
Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s. ⋯ Inhaled ciclesonide was not inferior to systemic hydrocortisone for managing acute asthma exacerbations, and it improved both clinical and spirometric parameters.
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For critically ill patients, physicians tend to administer sufficient or even excessive oxygen to maintain oxygen saturation at a high level. However, the credibility of the evidence for this practice is unclear. ⋯ It is not necessary to use liberal oxygen therapy strategies to pursue a higher level of peripheral oxygen saturation for mechanically ventilated ICU patients. Conservative oxygen therapy was not associated with any statistically significant reduction in mortality.
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Multicenter Study
Management strategies for implementing a multicenter cross-sectional study: lessons from the ADHERE Brazil study.
Epidemiological studies involving large samples usually face financial and operational challenges. ⋯ http://clinicaltrials.gov/ on October 10, 2013; NCT02066935.
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Observational Study
Association between frailty and depression among hemodialysis patients: a cross-sectional study.
Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. ⋯ Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.
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The high number of patients with end-stage kidney disease (ESRD) on hemodialysis makes it necessary to conduct studies aimed at improving their quality of life. ⋯ It can be suggested that changes to cerebral compliance in individuals with ESRD occur frequently and that a good-quality hemodialysis session (Kt/V > 1.2) may be effective for normalizing the patient's cerebral compliance.