The American journal of medicine
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Comparative Study
Value of initial chest radiographs for predicting clinical outcomes in patients with severe acute respiratory syndrome.
To determine whether the initial chest radiograph is helpful in predicting the clinical outcome of patients with severe acute respiratory syndrome (SARS). ⋯ Frontal chest radiographs on presentation may have prognostic value in patients with SARS.
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Community-acquired pneumonia (CAP) is the sixth most common cause of death in the United States and the leading cause of death from infectious diseases. It is associated with significant morbidity and mortality, and poses a major economic burden to the healthcare system. Streptococcus pneumoniae is the leading cause of CAP. ⋯ Increasing resistance to a variety of antimicrobial agents has been documented in S. pneumoniae and is common in H. influenzae as well. Successful empiric therapy is paramount to the management of CAP to avoid treatment failure and subsequent associated costs. Given that resistance is increasing among respiratory pathogens, and S. pneumoniae is the most common etiologic agent identified in CAP, strategies for antimicrobial therapy should be based on the likely causative pathogen, the presence of risk factors for infection with resistant bacteria, and local resistance patterns.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Differences in treatment outcome for hepatitis C among ethnic groups.
Studies of interferon-based therapies for hepatitis C virus (HCV)-infected patients have documented variable response rates according to ethnicity. However, these studies enrolled low numbers of ethnic minorities. ⋯ Sustained response rates to interferon and ribavirin therapy differ among ethnic groups. Ethnicity appears to be associated with treatment outcomes, even in a model that adjusts for other factors that influence response to therapy.
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Comparative Study
Effects of weekend admission and hospital teaching status on in-hospital mortality.
The effect of reduced hospital staffing during weekends on in-hospital mortality is not known. We compared mortality rates between patients admitted on weekends and weekdays and whether weekend-weekday variation in rates differed between patients admitted to teaching and nonteaching hospitals in California. ⋯ Patients admitted to hospitals on weekends experienced slightly higher risk-adjusted mortality than did patients admitted on weekdays. While overall mortality was similar for patients admitted to all hospital categories, the weekend effect was larger in major teaching hospitals and is cause for concern.