Articles: treatment.
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Scand J Trauma Resus · Nov 2014
Multicenter StudyEvaluation of pre-hospital transport time of stroke patients to thrombolytic treatment.
Effective treatment of stroke is time dependent. Pre-hospital management is an important link in reducing the time from occurrence of stroke symptoms to effective treatment. The aim of this study was to evaluate time used by emergency medical services (EMS) for stroke patients during a five-year period in order to identify potential delays and evaluate the reorganization of EMS in Copenhagen in 2009. ⋯ This study shows an unchanged alarm-to-door time of 41 minutes over a five-year period. Response time, but not total alarm-to-door time, was reduced during the five years. On-scene time constituted nearly half of the total alarm-to-door time and is thus a point of focus for improvement.
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Critical care medicine · Nov 2014
Multicenter StudyLow-Dose Corticosteroid Treatment in Septic Shock: A Propensity-Matching Study.
Given conflicting data and current guidelines, low-dose corticosteroids are often used in the treatment of septic shock. To evaluate the therapeutic benefit of early low-dose corticosteroid in patients with septic shock. ⋯ Early administration of low-dose corticosteroid is not associated with decreased mortality when it is administered to unselected patients with septic shock. A beneficial effect of low-dose corticosteroid on mortality may exist in patients with the highest severity of illness. Future trials of low-dose corticosteroid in septic shock should consider restricting the study population to this cohort.
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Critical care medicine · Nov 2014
Multicenter Study Observational StudyICU Physician-Based Determinants of Life-Sustaining Therapy During Nights and Weekends: French Multicenter Study From the Outcomerea Research Group.
Patient- and organization-related factors are the most common influences affecting the ICU decision-making process. Few studies have investigated ICU physician-related factors and life-sustaining treatment use during nights and weekends, when staffing ratios are low. Here, we described patients admitted during nights/weekends and looked for physician-related determinants of life-sustaining treatment use in these patients after adjustment for patient- and center-related factors. ⋯ Patients admitted during nights/weekends were younger and had fewer comorbidities. Age, specialty, ICU experience, and religious beliefs of the physicians were significantly associated life-sustaining treatments used.
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Multicenter Study
The First Postoperative Day: Prospective Evaluation of Pain in Adult Otorhinolaryngologic Surgery.
The aim of the study was to assess postoperative pain within the first 24 hours after otorhinolaryngologic surgery and to identify factors influencing postoperative pain. ⋯ Analgesia and perioperative pain management in otorhinolaryngologic surgery seems to be highly variable. After otorhinolaryngologic surgery many patients seem to receive less analgesia than needed or ineffective analgesic drug regimes.
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Randomized Controlled Trial Multicenter Study Comparative Study
Epidural Steroid Injections, Conservative Treatment, or Combination Treatment for Cervical Radicular Pain: A Multicenter, Randomized, Comparative-effectiveness Study.
Cervical radicular pain is a major cause of disability. No studies have been published comparing different types of nonsurgical therapy. ⋯ For the primary outcome measure, no significant differences were found between treatments, although combination therapy provided better improvement than stand-alone treatment on some measures. Whereas these results suggest an interdisciplinary approach to neck pain may improve outcomes, confirmatory studies are needed.