JAMA : the journal of the American Medical Association
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Results from several studies conducted in the early 1990s showed that the majority of US methadone maintenance programs did not use treatment practices that met established standards for the care of heroin users. Effective treatment for heroin users is critical given the upsurge in heroin use and the continued role of injection drug use in the human immunodeficiency virus and hepatitis C epidemics. ⋯ Efforts to improve methadone treatment practices appear to be making progress, but many patients are still receiving substandard care.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.
Septic shock may be associated with relative adrenal insufficiency. Thus, a replacement therapy of low doses of corticosteroids has been proposed to treat septic shock. ⋯ In our trial, a 7-day treatment with low doses of hydrocortisone and fludrocortisone significantly reduced the risk of death in patients with septic shock and relative adrenal insufficiency without increasing adverse events.