Arch Intern Med
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To determine the effect of location within the hospital and preexisting electrocardiographic rhythm on the outcome of cardiopulmonary resuscitation, the cardiopulmonary resuscitation records for a 3-year period, including 668 hospitalized patients, were retrospectively reviewed. ⋯ Futile resuscitative efforts are routinely performed in part because physicians and patients are unaware of outcome results and factors that influence survival. A wider recognition of the limitations of cardiopulmonary resuscitation should lead to advanced directives that reflect this awareness, with substantially more patients choosing not to have cardiopulmonary resuscitation.
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Randomized Controlled Trial Clinical Trial
Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.
Switch therapy is defined as the early transition from intravenous to oral antibiotics during treatment of infection. This study was designed to evaluate the clinical outcome and length of stay of hospitalized patients with community-acquired pneumonia treated with an early switch from intravenous to oral third-generation cephalosporins. ⋯ This investigation demonstrated that an early switch to oral cefixime may be reasonable in hospitalized patients with community-acquired pneumonia who have already shown a good clinical and laboratory response to therapy with intravenous third-generation cephalosporins. This approach is clinically effective and minimizes hospital stay.
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To determine whether blacks in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study remained at increased risk for cerebral infarction after adjusting for stroke risk factors and sociodemographic factors. ⋯ These results indicate that much of the increased risk for cerebral infarction experienced by blacks can be explained by their higher prevalence of stroke risk factors, especially diabetes, hypertension, and lower educational attainment. Younger blacks, however, may still be at increased risk after adjusting for stroke risk factors.
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While there has been extensive research on interventions designed to increase knowledge of research methods in the setting of journal clubs, little is known regarding other features that are of potential importance. To my knowledge, no research to date has described the attributes of journal clubs associated with high resident attendance and the avoidance of periodic abandonment. I sought to determine how journal clubs in postgraduate programs in internal medicine are organized and to identify the features associated with high attendance and continuous existence. ⋯ If residency journal club success is defined as having high attendance or long, continuous existence, then success is associated with smaller residency programs, making attendance mandatory, promoting a journal club independent of faculty, providing formal teaching of critical appraisal skills, making food available, and emphasizing original research articles. Residency programs in internal medicine seeking to establish journal clubs with long, continuous existence or high attendance should focus on these attributes.