JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Clinical Trial
Methylnaltrexone for reversal of constipation due to chronic methadone use: a randomized controlled trial.
Constipation is the most common chronic adverse effect of opioid pain medications in patients who require long-term opioid administration, such as patients with advanced cancer, but conventional measures for ameliorating constipation often are insufficient. ⋯ Our data demonstrate that intravenous methylnaltrexone can induce laxation and reverse slowing of oral cecal-transit time in subjects taking high opioid dosages. Low-dosage methylnaltrexone may have clinical utility in managing opioid-induced constipation.
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Randomized Controlled Trial Clinical Trial
Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial.
Noninvasive ventilation (NIV) has been associated with lower rates of endotracheal intubation in populations of patients with acute respiratory failure. ⋯ These results indicate that transplantation programs should consider NIV in the treatment of selected recipients of transplantation with acute respiratory failure.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial.
Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However, these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. ⋯ In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable.