Arch Intern Med
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Metoclopramide hydrochloride, a neuroleptic dopamine receptor antagonist used to treat gastric ailments, is reported to cause extrapyramidal movement disorders. The goals of this study were (1) to determine the prevalence and severity of tardive dyskinesia and acute extrapyramidal movement syndromes including akathisia, acute dystonia, and drug-induced parkinsonism in metoclopramide-treated patients and (2) to compare the prevalence and severity of tardive dyskinesia in metoclopramide-treated diabetics and nondiabetics. ⋯ Metoclopramide use is associated with a significantly increased prevalence and severity of several extrapyramidal movement disorders.
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We examined the relationship between workplace smoking policies and smoking prevalence and cigarette consumption. ⋯ Employees in smoke-free workplaces have a lower smoking prevalence and, among continuing smokers, lower cigarette consumption than individuals working where smoking is permitted. We estimate cigarette consumption among employees indoors is 21% below that if there were no smoking restrictions in California workplaces. Furthermore, if all California workplaces were smoke-free, cigarette consumption among employees would be 41% below that if there were no workplace smoking restrictions, approximately a $406 million annual loss in sales to the tobacco industry. This study supports the hypothesis that smoke-free workplace policies are an effective public health measure for decreasing smoking prevalence and cigarette consumption among continuing smokers.
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Randomized Controlled Trial Clinical Trial
High-molecular-weight hydroxypropylmethylcellulose. A cholesterol-lowering agent.
We assessed the efficacy of a high-molecular-weight hydroxypropylmethylcellulose (K8515) as a cholesterol-lowering agent, the dose-response profile of its action, and the ability of adult subjects to tolerate its ingestion at effective doses. ⋯ These results suggest a role for high-molecular-weight hydroxypropylmethylcellulose in the clinical treatment of mild hypercholesterolemia.
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Review
Results of cardiopulmonary resuscitation. Failure to predict survival in two community hospitals.
The use of closed chest cardiopulmonary resuscitation (CPR) has, since its initial description in 1960, expanded greatly. Recently, much energy has focused on identifying patients' probabilities of responding to CPR. The goal of this study was to determine the current rate of successful CPR in two community teaching hospitals and to identify patient characteristics associated with the likelihood of successful resuscitation. ⋯ Other than the length of resuscitation, easily accessible clinical variables provided limited predictive information about CPR results.
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To assess the determinants of communication about resuscitation between persons with acquired immunodeficiency syndrome (AIDS) and their physician. ⋯ A majority of persons with AIDS in this study had not discussed their preferences for life-sustaining care with their physician, despite the desire to do so. Interventions to improve patient-physician communication about resuscitation for nonwhites and other groups at risk of inadequate discussion might lead to clinical decisions that are more consistent with patient preferences.