Archives of internal medicine
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Accurate estimation of favorable neurological survival after in-hospital cardiac arrest could provide critical information for physicians, patients, and families. ⋯ Among successfully resuscitated patients with an in-hospital cardiac arrest, a simple, bedside prediction tool provides robust estimates of the probability of favorable neurological survival. This tool permits accurate prognostication after cardiac arrest for physicians, patients, and families.
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The history of pulmonary embolism (PE) provides a fascinating portrait of a well-established diagnosis and standard of care treatment moving into the age of evidence-based medicine. ⋯ Trials of newer anticoagulants and longer durations of anticoagulation have not yielded real improvements over heparin, inviting doubts regarding its efficacy. Thus, PE is the quintessential diagnosis of medicine not because it represents our greatest success, but because it captures all the complexity of medicine in the evidence-based era. It may serve as a metaphor for many other conditions in medicine, including coronary artery disease. New trials in the field continue to test trivialities, whereas fundamental questions are unanswered.
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Randomized Controlled Trial
A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT).
Dyspnea on exertion (DOE) is a major symptom of chronic obstructive pulmonary disease (COPD) and is difficult to control. This study was performed to determine whether acupuncture is superior to placebo needling in improving DOE in patients with COPD who are receiving standard medication. ⋯ This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing DOE in patients with COPD.