Journal of the American Geriatrics Society
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Randomized Controlled Trial Multicenter Study Clinical Trial
A double-blind, placebo-controlled, multicenter study of Cerebrolysin for Alzheimer's disease.
To assess the efficacy and safety of Cerebrolysin over 4 weeks in patients with probable Alzheimer's disease (AD). ⋯ This study indicates that Cerebrolysin is a safe drug that improves the cognitive deficits and global function in patients with mild to moderate AD. Long-term efficacy and safety of Cerebrolysin in Alzheimer's patients should be evaluated in the future.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Pain and suffering in seriously ill hospitalized patients.
Previous studies had suggested a high prevalence of pain in hospitalized patients but had not specifically evaluated pain and other symptoms in seriously ill and older hospitalized patients. ⋯ Control of pain and other symptoms remains an important medical and ethical issue. Routine monitoring of pain and other symptoms should be linked to treatment strategies aimed at combinations of symptoms and tested to assuage concerns about side effects.
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Multicenter Study Clinical Trial
Blood transfusion administration in seriously ill patients: an evaluation of SUPPORT data. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.
Administration of blood transfusion in seriously ill patients is highly variable. Limited data are available to guide transfusion decisions. ⋯ Most transfusions occurred in patients with acute respiratory or multiorgan system failure. Few patients decide to forego transfusions. Additional investigation is necessary to evaluate blood transfusion practices in seriously ill patients.
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Multicenter Study
Prediction of survival for older hospitalized patients: the HELP survival model. Hospitalized Elderly Longitudinal Project.
To develop and validate a model estimating the survival time of hospitalized persons aged 80 years and older. ⋯ Accurate estimation of length of life for older hospitalized persons may be calculated using a limited amount of clinical information available from the medical chart plus a brief interview with the patient or surrogate. The accuracy of this model can be improved by including measures of the physician's perception of the patient's preferences for care and the physician's subjective estimate of prognosis.
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Multicenter Study Comparative Study Clinical Trial
Dying with lung cancer or chronic obstructive pulmonary disease: insights from SUPPORT. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.
Many are calling for patients with advanced chronic obstructive pulmonary disease (COPD) to receive hospice care, but the traditional hospice model may be insufficient. ⋯ Hospitalized patients with lung cancer or COPD preferred comfort-focused care, yet dyspnea and pain were problematic in both groups. Patients with COPD were more often treated with life-sustaining interventions, and short-term effectiveness was comparatively better than in patients with lung cancer. In caring for patients with severe COPD, consideration should be given to implementing palliative treatments more aggressively, even while remaining open to provision of life-sustaining interventions.