JAMA internal medicine
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JAMA internal medicine · Jun 2013
Multicenter Study Comparative StudyProvision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.
Previous studies report associations between medical utilization at the end-of-life (EoL) and religious coping and spiritual support from the medical team. However, the influence of clergy and religious communities on EoL outcomes is unclear. ⋯ Terminally ill patients who are well supported by religious communities access hospice care less and aggressive medical interventions more near death. Spiritual care and EoL discussions by the medical team may reduce aggressive treatment, highlighting spiritual care as a key component of EoL medical care guidelines.
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JAMA internal medicine · Jun 2013
Randomized Controlled Trial Comparative StudyAggressive fluid and sodium restriction in acute decompensated heart failure: a randomized clinical trial.
The benefits of fluid and sodium restriction in patients hospitalized with acute decompensated heart failure (ADHF) are unclear. ⋯ Aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at 3 days and is associated with a significant increase in perceived thirst. We conclude that sodium and water restriction in patients admitted for ADHF are unnecessary.
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JAMA internal medicine · Jun 2013
Multicenter Study Comparative StudyPerioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery.
Single-site studies have described an association between use of selective serotonin reuptake inhibitors (SSRIs) and adverse outcomes of surgery. Multicenter studies including a broad range of surgical procedures that explore rare outcomes, such as bleeding and mortality, and that account for indications for administration of SSRIs are needed. ⋯ Receiving SSRIs in the perioperative period is associated with a higher risk for adverse events. Determining whether patient factors or SSRIs themselves are responsible for elevated risks requires prospective study.