Annals of internal medicine
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Students should have contact with faculty members in internal medicine throughout their medical education. Faculty internists should play a role in admission of students, in the basic science courses of the first year of medical school, and in the introductory course to clinical medicine and pathophysiology of the second year of medical school. ⋯ The advanced medicine experience should give students at least a glimpse of the mastery of the discipline of internal medicine. For students entering internal medicine, the fourth year of medical school and first year of residency could be combined to improve the content and quality of both.
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Randomized Controlled Trial Clinical Trial
Clinical and metabolic efficacy of glutamine-supplemented parenteral nutrition after bone marrow transplantation. A randomized, double-blind, controlled study.
To determine whether glutamine-supplemented parenteral nutrition improves nitrogen retention and reduces hospital morbidity compared with standard parenteral nutrition after bone marrow transplantation. ⋯ Patients receiving glutamine-supplemented parenteral nutrition after bone marrow transplantation had improved nitrogen balance, a diminished incidence of clinical infection, lower rates of microbial colonization, and shortened hospital stay compared with patients receiving standard parenteral nutrition. These effects occurred despite no differences between groups in the incidence of fever, antibiotic requirements, or time to neutrophil engraftment.
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Randomized Controlled Trial Clinical Trial
Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position.
To determine if the semirecumbent position (45-degree angle) decreases aspiration of gastric contents to the airways in intubated and mechanically ventilated patients. ⋯ We conclude that the supine position and length of time the patient is kept in this position are potential risk factors for aspiration of gastric contents. Elevating the head of the bed for patients who can tolerate the semirecumbent position may be a simple, no-cost prophylactic measure.
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Multicenter Study Clinical Trial
Treatment of Mycobacterium avium complex bacteremia in AIDS with a four-drug oral regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. The California Collaborative Treatment Group.
To determine the quantitative microbiologic response and the clinical response of patients with Mycobacterium avium complex bacteremia and AIDS to an oral antimycobacterial regimen. ⋯ A rapid reduction in symptoms and bacteremia can be achieved as early as week 2 of therapy using an oral regimen of rifampin, ethambutol, clofazimine, and ciprofloxacin. Colony counts rose dramatically after therapy was discontinued, suggesting that more prolonged periods of therapy are necessary to eradicate systemic infection.