Annals of internal medicine
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Physicians in intensive care units have withdrawn life support in incapacitated patients who lack surrogate decision makers and advance directives, yet little is known about how often this occurs or under what circumstances. ⋯ Incapacitated patients without surrogates accounted for approximately 1 in 20 deaths in intensive care units. Most life-support decisions were made by physicians without institutional or judicial review.
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Randomized Controlled Trial Multicenter Study
Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial.
Adalimumab, a fully human tumor necrosis factor (TNF) antagonist, is an effective treatment for patients with Crohn disease who are naive to the chimeric TNF antagonist, infliximab. No anti-TNF agent has been evaluated prospectively in patients with Crohn disease who had responded to another anti-TNF agent and then lost that response or were intolerant of the agent. ⋯ Adalimumab induces remissions more frequently than placebo in adult patients with Crohn disease who cannot tolerate infliximab or have symptoms despite receiving infliximab therapy. For more information on adalimumab in Crohn disease, click here. ClinicalTrials.gov registration number: NCT00105300.
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Randomized Controlled Trial Multicenter Study
Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial.
Advice and exercise are widely recommended for subacute low back pain, but the effectiveness of these interventions is unclear. ⋯ In participants with subacute low back pain, physiotherapist-directed exercise and advice were each slightly more effective than placebo at 6 weeks. The effect was greatest when the interventions were combined. At 12 months, the only effect that persisted was a small effect on participant-reported function. AUSTRALIAN CLINICAL TRIALS REGISTRY REGISTRATION NUMBER: 12605000039684.
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Randomized Controlled Trial Multicenter Study
The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial.
Few studies have tested the effects of a depression intervention on the risk for death associated with depression. ⋯ Older primary care patients with major depression in practices that implemented depression care management were less likely to die over a 5-year period than were patients with major depression in usual care practices. The effect seemed to be limited to deaths due to cancer. The mechanism for such an effect is unclear and warrants further investigation. ClinicalTrials.gov registration number: NCT00000367.
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Randomized Controlled Trial Multicenter Study
A sustained mortality benefit from screening for abdominal aortic aneurysm.
Longer-term mortality benefit and cost-effectiveness for abdominal aortic aneurysm (AAA) screening are uncertain. ⋯ These results from a large, pragmatic randomized trial show that the early mortality benefit of screening ultrasonography for AAA is maintained in the longer term and that the cost-effectiveness of screening improves over time. International Standard Randomized Controlled Trial registration number: ISRCTN37381646.