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Debate over the cardiovascular effects of COX-2 inhibitors has raged
for more than a year since a special communication was published in
JAMA last August suggesting an increase in cardiovascular events with
rofecoxib (Vioxx). Now a large retrospect, the cohort study from the
Tennessee Medicaid program seems to confirm the prothrombotic effects
of rofecoxib, at least in high dose.
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MRC/BHF Heart Protection Study of Antioxidant Vitamin Supplementation
in 20,536 High-Risk Individuals; Prolonged Erections Produced by
Dihydrocodeine & Sildenafil; Effect of Magnesium Supplementation of
Blood Pressure; Homocysteine-Lowering Therapy with Folic Acid,
Vitamins, and Clinical Outcome after Percutaneous Coronary
Intervention; Effect of Cataract Surgery on Motor Vehicle Accidents in
Older Adults; Inflammatory Biomarkers, Hormone Replacement Therapy, and
Incident Coronary Heart Disease
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Intensive care is part of a continuum of progressive patient care, and a significant number of research groups are now focusing their attention on ways to improve the organization of the ICU and its place in the continuum of care. An important aspect of this process is the evaluation of ICU discharge policies and their consequences.
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Intravascular catheters are an essential component of the practice of critical care medicine. These devices are used to deliver life-sustaining intravenous fluids, antibiotics, parenteral nutrition, blood, and blood products, and to monitor the hemodynamic status of critically ill patients.
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With the health care penny being squeezed dry its not unexpected that nurses report they are unable to provide quality of care consistent with professional standards in todays hospitals, says Julie Sochalski, RN, PhD, professor of nursing at the University of Pennsylvania School of Nursing.
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In this randomized, double-blind study, 256 patients with submassive pulmonary embolism (PE) were treated with either heparin or heparin plus alteplase, a thrombolytic agent.
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Health care providers are understandably concerned about the legal climate in which they live, observes Marshall B. Kapp, JD, MPH, professor in the department of community health at Wright State University School of Medicine in Dayton, Ohio. But ICU physicians can rest easier than many. Even though malpractice cases abound, the reality is that very few medical malpractice claims or other adverse legal actions happen due to thoughtful decisions to withhold or withdraw treatment for dying patients in the ICU.
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