The Annals of pharmacotherapy
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This commentary explores the influence of industry funding and offers suggestions for overcoming some of the problems. First, it is difficult to obtain funding from some sources for research with limited commercial value. Second, lack of communication among researchers can impede scientific progress. ⋯ Next, suppressed or delayed publication of data may bias the results of meta-analyses, resulting in incorrect risk-benefit profiles for drugs. Finally, commercially funded clinical research is more likely to yield positive results than when funding comes from other sources. Possible solutions are explored.
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To review the use of erythropoietin for anemia in heart failure (HF). ⋯ In selected patients with severe, chronic HF, erythropoietin may be considered for functional improvement. However, routine use of this treatment strategy is not recommended until more data are available.
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To present a single case of sulbactam/ampicillin-induced chronic cholestasis and a literature review of antibiotic-associated chronic cholestasis. ⋯ Sulbactam/ampicillin, one of the most widely used antibiotics, may cause chronic cholestatic hepatitis. Clinicians should be aware of this adverse affect and consider it during diagnostic workup of liver injury.
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To review the current efficacy and safety evidence for the use of intramuscular olanzapine in the management of acute agitation. ⋯ Additional studies comparing intramuscular olanzapine with combination antipsychotic/benzodiazepine therapy in more severely ill patients and patients with concomitant medical illnesses are needed to determine the most effective dosing regimen, use of adjunctive medications, and to obtain a comprehensive safety profile.
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Comparative Study
Impact of prophylactic postoperative beta-blockade on post-cardiothoracic surgery length of stay and atrial fibrillation.
Previous studies have shown that post-cardiothoracic surgery atrial fibrillation (AF) increases the risk of hospital length of stay (LOS), overall mortality, pulmonary edema, and need for a balloon pump. A meta-analysis of 2 previous trials showed a nonsignificant reduction in LOS with postoperative beta-blockers but only encompassed 1200 patients, with few valve surgery patients, and neither study used a hospital within the US. ⋯ In this observational cohort study, prophylactic postoperative beta-blocker use was associated with shorter hospital LOS by an average of 2.2 days and a 17.3% lower incidence of AF. It may also be associated with reductions in overall mortality, pulmonary edema, and need for an IABP.