Annals of internal medicine
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Methylprednisolone therapy in patients with severe alcoholic hepatitis. A randomized multicenter trial.
To determine the efficacy of a corticosteroid in reducing the short-term mortality of patients with severe alcoholic hepatitis. ⋯ Methylprednisolone therapy decreases short-term mortality in patients with severe alcoholic hepatitis manifested either by spontaneous hepatic encephalopathy or a markedly elevated discriminant function value.
-
Randomized Controlled Trial Clinical Trial
Training physicians in counseling about smoking cessation. A randomized trial of the "Quit for Life" program.
To test whether physicians who receive a continuing education program ("Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients who smoke. ⋯ This continuing education program substantially changed the way physicians counseled smokers. As a result, a few more patients who wanted to quit smoking achieved long-term abstinence.
-
Randomized Controlled Trial Clinical Trial
Effect of a geriatric consultation team on functional status of elderly hospitalized patients. A randomized, controlled clinical trial.
To evaluate the impact of a geriatric consultation team on the functional status of hospitalized elderly patients. ⋯ Among elderly patients entering an acute-care hospital, approximately 60% had some degree of, and one third had serious functional disability. Such patients are at risk for further decline during hospitalization. A geriatric consultation team was unable to alter the degree of functional decline. Geriatric units or consultation teams may have to offer direct preventive or restorative services in addition to advice if improvements are to be made.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Ibuprofen interferes with the efficacy of antihypertensive drugs. A randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen.
To assess the effects of ibuprofen on blood pressure control in patients being treated with antihypertensive drugs. ⋯ In the ibuprofen group, the mean increase from baseline after 3 weeks of treatment was significant in the average supine diastolic blood pressure (6.4 mm Hg; 95% confidence interval [CI], 1.05 to 11.75; p = 0.0239); supine mean arterial pressure (6.6 mm Hg; 95% CI, 1.25 to 11.95; p = 0.0205); and sitting mean arterial pressure (5.8 mm Hg; 95% CI, 1.57 to 10.04; p = 0.0123). The mean increase in blood pressure variables in the ibuprofen group was significantly different compared with the mean increase in the variables in the placebo group after 3 weeks of treatment: supine systolic blood pressure (7.1 mm Hg compared with -4.5 mm Hg; 95% CI for the difference in means, 2.5 to 20.6; p = 0.0133); supine diastolic pressure (6.4 mm Hg compared with 0.0; 95% CI for difference in means, 0.87 to 12.4; p = 0.0250); supine mean arterial pressure (6.6 mm Hg compared with -1.5; 95% CI for difference in means, 2.0 to 14.2; p = 0.0110); sitting systolic pressure (6.8 mm Hg compared with -3.7; 95% CI for difference in means, 2.0 to 19.0; p = 0.0169); sitting diastolic pressure (5.3 mm Hg compared with -1.1; 95% CI for difference in means, 0.76 to 12.1; p = 0.0273); and sitting mean arterial pressure (5.8 mm Hg compared with -2.0; 95% CI for difference in means, 1.5 to 14.1; p = 0.0169).(ABSTRACT TRUNCATED AT 400 WORDS)
-
Randomized Controlled Trial Clinical Trial
Computerized display of past test results. Effect on outpatient testing.
To determine the effect of displaying previous results of diagnostic tests on the ordering of selected outpatient tests. ⋯ Presenting physicians with previous test results reduced the ordering of those tests. The actual effect may have been greater than 13%, because there were reductions in study tests ordered for both intervention and control patients during the intervention period when compared with the pre-intervention period, and both tended to rise after the intervention, or display, was turned off.