Annals of internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of a second-generation venous catheter impregnated with chlorhexidine and silver sulfadiazine on central catheter-related infections: a randomized, controlled trial.
Central venous catheter-related infections are a significant medical problem. Improved preventive measures are needed. ⋯ The second-generation chlorhexidine-silver sulfadiazine catheter is well tolerated. Antiseptic coating appears to reduce microbial colonization of the catheter compared with an uncoated catheter.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Exenatide versus insulin glargine in patients with suboptimally controlled type 2 diabetes: a randomized trial.
Physicians may use either insulin or exenatide injections for patients with type 2 diabetes mellitus who have poor glycemic control despite taking oral blood glucose-lowering drugs. ⋯ Exenatide and insulin glargine achieved similar improvements in overall glycemic control in patients with type 2 diabetes that was suboptimally controlled with oral combination therapy. Exenatide was associated with weight reduction and had a higher incidence of gastrointestinal adverse effects than insulin glargine.
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Multicenter Study
The Wells rule does not adequately rule out deep venous thrombosis in primary care patients.
Using data from secondary care outpatients, Wells and colleagues developed a diagnostic rule to estimate the probability of the presence of deep venous thrombosis (DVT). The accuracy of the Wells rule has not been properly validated for use in primary care patients in whom DVT is suspected. ⋯ The Wells rule, alone or in combination with D-dimer testing, does not guarantee accurate estimation of risk in primary care patients in whom DVT is suspected.
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Multicenter Study
Patient safety concerns arising from test results that return after hospital discharge.
Failure to relay information about test results pending when patients are discharged from the hospital may pose an important patient-safety problem. Few data are available on the epidemiology of test results pending at discharge or on physician awareness of these results. ⋯ Many patients are discharged from hospitals with test results still pending, and physicians are often unaware of potentially actionable test results returning after discharge. Further work is needed to design better follow-up systems for test results returning after hospital discharge.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial.
Randomized clinical trials have not yet demonstrated the mortality benefit of smoking cessation. ⋯ Smoking cessation intervention programs can have a substantial effect on subsequent mortality, even when successful in a minority of participants.