Articles: mortality.
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Randomized Controlled Trial Clinical Trial
Effect of phenobarbital on seizure frequency and mortality in childhood cerebral malaria: a randomised, controlled intervention study.
Seizures commonly complicate cerebral malaria and are associated with an increased risk of death and neurological sequelae. We undertook a randomised study to assess the efficacy of intramuscular phenobarbital in preventing seizures in childhood cerebral malaria. ⋯ In children with cerebral malaria, phenobarbital 20 mg/kg provides highly effective seizure prophylaxis but is associated with an unacceptable increase in mortality. Use of this dose cannot, therefore, be recommended.
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Health services research · Feb 2000
Associations among hospital capacity, utilization, and mortality of US Medicare beneficiaries, controlling for sociodemographic factors.
To explore whether geographic variations in Medicare hospital utilization rates are due to differences in local hospital capacity, after controlling for socioeconomic status and disease burden, and to determine whether greater hospital capacity is associated with lower Medicare mortality rates. ⋯ Residence in areas of greater hospital capacity is associated with substantially increased use of the hospital, even after controlling for socioeconomic characteristics and illness burden. This increased use provides no detectable mortality benefit.
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Despite recent advances in technology, the mortality rate for patients suffering from adult respiratory distress syndrome remains in the range of 40-50%. This high mortality rate may be in part related to complications from ventilator management, such as ventilator-induced lung injury. In these patients, adjunct therapies aiming at ameliorating ventilator-induced lung injury are being developed. This article discusses the rationale for use of pharmacologic adjunct therapies, including inhaled nitric oxide, surfactant replacement therapy, antioxidants, prostaglandins, and corticosteroids, in patients with acute lung injury, and reviews the effectiveness of these agents in human clinical trials to date.
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To assess the safety of pediatric procedural sedation performed by emergency physicians working within a structured sedation protocol. ⋯ Emergency physicians using a structured sedation protocol can safely perform ED pediatric procedural sedation. Where intravenous access is not already present, intramuscular ketamine, administered in the doses described, is a safe and effective agent for pediatric sedation.