JAMA : the journal of the American Medical Association
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Comparative Study
Effects of organizational change in the medical intensive care unit of a teaching hospital: a comparison of 'open' and 'closed' formats.
To compare the effects of change from an open to a closed intensive care unit (ICU) format on clinical outcomes, resource utilization, teaching, and perceptions regarding quality of care. ⋯ Based on comparison of actual to predicted mortality, changing from an open to a closed ICU format improved clinical outcome. Although patients in the closed ICU had greater severity of illness, resource utilization did not increase.
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Comparative Study
Cross-national epidemiology of major depression and bipolar disorder.
To estimate the rates and patterns of major depression and bipolar disorder based on cross-national epidemiologic surveys. ⋯ There are striking similarities across countries in patterns of major depression and of bipolar disorder. The differences in rates for major depression across countries suggest that cultural differences or different risk factors affect the expression of the disorder.
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To determine the incidence, predictors, and cost of atrial fibrillation and flutter (AFIB) following coronary artery bypass graft (CABG) surgery. ⋯ Postoperative AFIB is common after CABG surgery and has a significant effect on both intensive care unit and overall hospital length of stay. In addition to expected demographic factors, certain surgical practices increase the risk of postoperative AFIB. Randomized controlled trials are necessary to determine if modification of these surgical practices, especially in patients at high risk, would decrease the incidence of postoperative AFIB.
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Randomized Controlled Trial Clinical Trial
Intranasal lidocaine for treatment of migraine: a randomized, double-blind, controlled trial.
To evaluate the effectiveness of intranasal lidocaine for treatment of acute migraine headache. ⋯ Intranasal lidocaine provides rapid relief of headache in approximately 55 percent of ambulatory patients with migraine. Relapse of headache is common and occurs early after treatment.