The American journal of medicine
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Review Meta Analysis
Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis.
To assess the efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia. ⋯ Subglottic secretion drainage appears effective in preventing early-onset ventilator-associated pneumonia among patients expected to require >72 hours of mechanical ventilation.
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Exacerbations of chronic obstructive pulmonary disease (COPD) have a profound effect on the patient's health status and decline in lung function; they also impose a significant burden on healthcare resource utilization. Prevention and treatment of exacerbations is listed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as among the major objectives of COPD management, and it is therefore an important outcome measure when studying any new agent. This article discusses pharmacologic therapy and other measures for preventing exacerbations and hospitalizations due to exacerbations of COPD.
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Review
Availability of large-scale evidence on specific harms from systematic reviews of randomized trials.
To assess how frequently systematic reviews of randomized controlled trials convey large-scale evidence on specific, well-defined adverse events. ⋯ Systematic reviews can convey useful large-scale information on adverse events. Acknowledging the importance and difficulties of studying harms, reporting of adverse effects must be improved in both randomized trials and systematic reviews.
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Review Meta Analysis
Application of U.S. guidelines in other countries: aspirin for the primary prevention of cardiovascular events in Japan.
Clinical guidelines developed in the United States are used frequently in other countries without assessment of their appropriateness in non-U.S. populations. We explored the relevance of recent U.S. guidelines for the use of aspirin for the primary prevention of cardiovascular events in the Japanese population. ⋯ The thresholds of antiplatelet therapy for Asian populations should be two to five times higher than those for the U.S. population because of higher risks of hemorrhagic complications. The assumptions and implications of U.S. guidelines should be evaluated before use in other countries.