Annals of internal medicine
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Review Meta Analysis
Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
The prevalence, efficacy, and risk for addiction for persons receiving opioids for chronic back pain are unclear. ⋯ Opioids are commonly prescribed for chronic back pain and may be efficacious for short-term pain relief. Long-term efficacy (> or =16 weeks) is unclear. Substance use disorders are common in patients taking opioids for back pain, and aberrant medication-taking behaviors occur in up to 24% of cases.
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Meta Analysis
Meta-analysis: efficacy and safety of inhaled insulin therapy in adults with diabetes mellitus.
Injection insulin therapy is not readily accepted by patients and many health care providers; therefore, less invasive options for insulin therapy are desirable. ⋯ Inhaled insulin offers an alternative noninvasive option for premeal insulin administration, with glycemic efficacy slightly less than subcutaneous regular insulin and increased patient acceptability. Until long-term safety data are available, inhaled insulin should be reserved for nonpregnant adults with diabetes who are opposed to injections and who would otherwise delay appropriate and timely therapy with insulin.
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Meta Analysis Historical Article
Meta-analysis: convalescent blood products for Spanish influenza pneumonia: a future H5N1 treatment?
Studies from the Spanish influenza era reported that transfusion of influenza-convalescent human blood products reduced mortality in patients with influenza complicated by pneumonia. Treatments for H5N1 influenza are unsatisfactory, and convalescent human plasma containing H5N1 antibodies could be an effective therapy during outbreaks and pandemics. ⋯ Patients with Spanish influenza pneumonia who received influenza-convalescent human blood products may have experienced a clinically important reduction in the risk for death. Convalescent human H5N1 plasma could be an effective, timely, and widely available treatment that should be studied in clinical trials.
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Conflicting reports have caused controversy on whether cysticidal drugs modify the natural course of neurocysticercosis. ⋯ Cysticidal drug therapy results in better resolution of colloidal and vesicular cysticerci, lower risk for recurrence of seizures in patients with colloidal cysticerci, and a reduction in the rate of generalized seizures in patients with vesicular cysticerci.
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Protein and energy undernutrition is common in older people, and further deterioration may occur during illness. ⋯ Oral nutritional supplements can improve nutritional status and seem to reduce mortality and complications for undernourished elderly patients in the hospital. Current evidence does not support routine supplementation for older people at home or for well-nourished older patients in any setting.