The American journal of medicine
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To develop a test that will be administered by nonphysician office staff to screen elderly persons seen in ambulatory settings for problems commonly contributing to functional disability. ⋯ The screening instrument is relatively inexpensive and brief and easy to use in the ambulatory setting. It is good validity and reliability when compared to the assessment of a geriatrician. We are currently conducting a randomized trial to assess the effectiveness of the screen among older persons seen in community physicians' offices.
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Physicians lack objective outcome data to define the medically appropriate length of stay (LOS) for patients hospitalized with acute upper gastrointestinal hemorrhage (UGIH), resulting in wide variations in resource utilization and quality of care. A clinical practice guideline with the ability to assign relative risk for adverse events is proposed. ⋯ The proposed clinical practice guideline may safely reduce hospital LOS for selected low-risk patients with acute UGIH. Moreover, it also may reduce premature discharge of high-risk patients prone to life-threatening events.
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Randomized Controlled Trial Comparative Study Clinical Trial
Isoetharine versus albuterol for acute asthma: greater immediate effect, but more side effects.
To compare the magnitudes of the immediate effects of the nebulized beta-agonists isoetharine and albuterol in the treatment of acute severe asthma. ⋯ Both medications were equally effective in alleviating bronchospasm. The immediate effect of isoetharine was significantly greater, but equalized that of albuterol within an hour after treatment. There were more side effects with isoetharine.
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Randomized Controlled Trial Clinical Trial
Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults.
To assess the efficacy, dose stability, safety, and abuse potential of long-term, nightly benzodiazepine treatment of chronic disorders of disrupted nocturnal sleep. ⋯ Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep resulted in sustained efficacy in most cases, with low risk of dosage tolerance, adverse effects, or abuse. Data from this study on the treatment of chronic, severe insomnia (a small subset of all insomnia) are not generalizable to the typical insomnia patient.