The American journal of the medical sciences
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Review Comparative Study
Reporting of adherence to medication in recent randomized controlled trials of 6 chronic diseases: a systematic literature review.
International recommendations such as the CONSORT and International Conference on Harmonisation statements recognize patient adherence to prescribed treatment as an important aspect of a treatment's evaluation, but this issue is little assessed. ⋯ There is important variability in the assessment and reporting of medication adherence in published RCTs of pharmacological treatments of selected chronic diseases, for a given disease and across diseases. Standardization is advisable to allow for comparisons among studies.
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The prevalence of diabetes in the U. S. Hispanic population has grown to epidemic proportions. ⋯ Diabetes is diagnosed at an earlier age, and, for a multiplicity of reasons, Hispanics suffer from higher rates of diabetic complications and mortality. The etiology for the higher prevalence of diabetes and its complications is not clear, but it is thought to be related to genetic and environmental factors. In this manuscript, we review recent epidemiologic information on the prevalence, pathophysiology, and complications of diabetes, as well as the recommendations for the management of Hispanics with type 2 diabetes.
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Clinical Trial
Polymyxin B-immobilized fiber hemoperfusion with the PMX-05R column in elderly patients suffering from septic shock.
Direct hemoperfusion with the polymyxin B-immobilized fiber (PMX-20R) column has a positive effect on outcome in patients with sepsis or septic shock. The PMX-05R column has a low priming volume and has been used in pediatric patients with septic shock. The aim of the present study was to determine whether PMX-F treatment with the PMX-05R column is effective in elderly patients with septic shock. ⋯ Direct hemoperfusion with the PMX-05R column is effective in ameliorating clinical and laboratory abnormalities in elderly septic shock patients.
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Multicenter Study
Mechanical ventilation management by pulmonologists and surgeons in patients with adult respiratory distress syndrome.
Treatment of patients with acute respiratory distress syndrome (ARDS) is complex, and management by a specialist with expertise in pulmonary mechanics may improve outcomes. We compared mechanical ventilation management of patients with ARDS by pulmonologists and surgeons. ⋯ We found that patients who survived with ARDS spent fewer days on mechanical ventilation, and there was a trend for spending fewer days in the ICU when mechanical ventilation is managed by a pulmonologist compared with a surgeon. There was a lower mortality rate in the pulmonologist group, although this did not reach statistical significance. A small sample size and the retrospective design limit our findings. Further study using a multicenter design to determine if a disease specific specialist improves efficiency of care is needed because if our findings are confirmed, it would translate into significant cost savings.
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Cisplatin is a major antineoplastic drug for the treatment of solid tumors, but it has dose-dependent renal toxicity. ⋯ Understanding the mechanisms of injury has led to multiple approaches to prevention. Furthermore, the experimental approaches in these studies with cisplatin are potentially applicable to other drugs causing renal dysfunction.