Articles: outcome.
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Interact Cardiovasc Thorac Surg · Mar 2004
Low dose (renal dose) dopamine in the critically ill patient.
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether low dose (renal dose) dopamine in the critically ill patient prevents acute renal failure. ⋯ The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that there is no evidence to support the use of low-dose dopamine to treat acute renal failure in critically ill patients.
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To assess the association of diagnostic predictors available in the emergency department (ED) with the outcome diagnosis of severe acute respiratory syndrome (SARS). ⋯ Two components of the World Health Organization case definition - fever and contact exposure - are helpful for ED decision-making, but respiratory symptoms do not discriminate well between SARS and non-SARS. Emergency physicians should consider the presence of diarrhea, chest x-ray findings, the absolute lymphocyte count and the platelet count as significant modifiers of disease likelihood. Prospective validation of these findings in other clinical settings is desirable.
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This was a pilot study to test the potential effectiveness of intradiscal restorative injection therapy and compare with intradiscal electrothermal therapy (IDET). Thirty-five patients for intradiscal injection and seventy-four for IDET took part in the study. All patients had intractable chronic discogenic low back pain, confirmed by discogram study. ⋯ However, the duration of pain flare-up was notably shorter for restorative injections (8.6 days) than for IDET (33.1 days). Biochemical intradiscal restorative injections may be useful to reduce pain and disability in patients with chronic discogenic low back pain, and have clinically similar efficacy to IDET, but with improved cost-benefit ratio. The results of this study indicate that controlled random prospective comparative studies need to be performed to establish the efficacy of this treatment.
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To evaluate the pattern and flow of epidural contrast in fluoroscopically guided lumbar interlaminar steroid injections. ⋯ Thirty six percent of the injections observed in the study revealed ventral contrast flow. Bilateral contrast flow occurred in 16% of the injections. Caudad contrast flow is less than cephalad. The observed contrast flows need to be studied clinically to determine if this can affect clinical outcome.
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The objective of this study was to assess the usability and safety of BION injectable neuromuscular microstimulators for therapeutic electrical stimulation (TES) to treat two conditions involving disuse atrophy: poststroke shoulder subluxation in hemiplegic subjects and knee osteoarthritis. Clinicians were provided with PC-based software to track implants and to design the exercise programs. Subjects self-administered TES (3 sessions/day, 10-30 min/session) for 6 or 12 weeks. ⋯ The devices did not migrate and did not cause inflammation or pain. Thresholds were stable over time. We conclude that the use of BION implants to exercise atrophic muscles was well-accepted and provided effective rehabilitation in these two clinical conditions.