Annals of internal medicine
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Previous studies suggest that specialty care is more costly but may produce improved outcomes for patients with acute cardiac illnesses. ⋯ In this observational study of patients hospitalized with congestive heart failure, cardiologist care was associated with greater costs and resource use and no difference in survival at 30 days of follow-up. Whether the trend toward better survival at longer follow-up represents differences in care or unadjusted illness severity is uncertain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Older age, aggressiveness of care, and survival for seriously ill, hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.
Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. ⋯ We found a modest independent association between patient age and short-term survival of serious illness. This age effect was not explained by the current practice of providing less aggressive care to elderly patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Use of tunneled femoral catheters to prevent catheter-related infection. A randomized, controlled trial.
The risk for catheter-related infection seems higher with femoral catheters than with catheters inserted at other sites. ⋯ The incidence of femoral catheter-related infections in critically ill patients can be reduced by using subcutaneous tunneling.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Oral montelukast, inhaled beclomethasone, and placebo for chronic asthma. A randomized, controlled trial. Montelukast/Beclomethasone Study Group.
Oral leukotriene receptor antagonists have been shown to have efficacy in chronic asthma. ⋯ Although beclomethasone had a larger mean effect than montelukast, both drugs provided clinical benefit to patients with chronic asthma. This finding is consistent with the use of these agents as controller medications for chronic asthma.
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Patient age may influence decisions to withhold life-sustaining treatments, independent of patients' preferences for or ability to benefit from such treatments. Controversy exists about the appropriateness of using age as a criterion for making treatment decisions. ⋯ Even after adjustment for differences in patients' prognoses and preferences, older age was associated with higher rates of decisions to withhold ventilator support, surgery, and dialysis.