Articles: prospective-studies.
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Am. J. Obstet. Gynecol. · Jun 2000
Comparative StudyAcceptability of suction curettage and mifepristone abortion in the United States: a prospective comparison study.
We sought to compare the acceptability of suction curettage abortion with that of medical abortion with mifepristone and misoprostol in American women. ⋯ Women receiving mifepristone and misoprostol were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. Failure of a medical abortion and increased anxiety during surgical abortion were associated with preference for the alternative technique in a future procedure.
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To review human thermoregulation and the pathophysiology and management of induced and accidental hypothermia. ⋯ Operative hypothermia reduces ischaemic injury during cardiac and neurosurgical procedures. Hypothermia induced following tissue injury has not yet been shown to be of benefit. Management of accidental hypothermia requires passive and active warming methods, the indication of each depending on the availability of the method and severity of hypothermia.
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Recent reports suggest a short series of cardiac troponin (cTnT) testing effectively identifies patients at risk for cardiac events. However, there are few studies validating this strategy. The purpose of this study was to determine the ability of cTnT levels to predict short- and long-term outcomes in low-risk patients with suspected acute coronary syndromes. ⋯ Determination of troponin T levels has a low sensitivity and high specificity for predicting outcomes in low-risk patients evaluated for suspected acute coronary syndromes. This study does not support a strategy of relying solely on troponin testing for disposition decisions. [Peacock WF IV, Emerman CL, McErlean ES, Deluca SA, van Lente F, Rao JS, Nissen SE: Prediction of short- and long-term outcomes by troponin T levels in low-risk patients evaluated for acute coronary syndromes. Ann Emerg Med. March 2000;35:213-220.].
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Place of care in advanced cancer: a qualitative systematic literature review of patient preferences.
It is commonly written that more patients wish to die at home than currently achieve this. However, the evidence for preferences for place of terminal care and death has not been systematically reviewed. ⋯ Home care is the most common preference, with inpatient hospice care as second preference in advanced illness. Meeting these preferences could be important outcomes for services. Study designs in this area need to be improved.
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Since 1982 an emergency ambulance manned by a physician and two emergency medical technicians has been operated in the Reykjavik area. The physicians have followed guidelines from the American Heart Association (AHA). Until 1986 the AHA guidelines had bicarbonate and in some instances calcium as first line treatment in cardiopulmonary resuscitation (CPR). ⋯ When sudden cardiorespiratory arrest is witnessed the probability of survival is multiplied. We conclude that the results of ACLS outside the hospital in Reykjavik and surrounding area continue to be among the best. Changes in ACLS guidelines do not appear to have increased survival.