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Alternative medicine
\"Alternative Medicine: Opposing Viewpoints is the leading source for libraries and classrooms in need of current-issue materials. The viewpoints are selected from a wide range of highly respected sources and publications\"-- Provided by publisher.
Book
Frailty in Older Adults
Assessing older patients for frailty enables clinicians to tailor clinical care, including decisions about stressful treatments. The authors review the assessment, pathophysiology, and management of frailty.
Journal Article
The nocebo effect : overdiagnosis and its costs
\"The Nocebo Effect documents the transformation of normal problems into medical ones and brings out the risks of this inflationary practice. One notable risk is that people labeled as sick may find themselves living up to their label through the alchemy of the nocebo effect\"-- Provided by publisher.
Book
Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma
In patients with subdural hematoma and an indication for surgical evacuation, middle meningeal artery embolization plus surgery led to a lower risk of reoperation for recurrence or progression within 90 days than surgery alone.
Journal Article
Alternative therapies
Presents essays and articles offering multiple, often conflicting opinions on the subject of alternative medical treatments.
BOOK
Key Issues as Wearable Digital Health Technologies Enter Clinical Care
The authors address the issues that must be confronted if we are to integrate the use of wearable digital health technologies into clinical care in a way that provides an enduring benefit to patients.
Journal Article
Benefits, Limits, and Risks of GPT-4 as an AI Chatbot for Medicine
Chatbots are computer programs with which one can have a conversation. In this article, the authors describe how the GPT-4 chatbot, which has been given a general education, could affect the practice of medicine.
Journal Article
Hydrocortisone in Severe Community-Acquired Pneumonia
Whether the antiinflammatory and immunomodulatory effects of glucocorticoids may decrease mortality among patients with severe community-acquired pneumonia is unclear.
In this phase 3, multicenter, double-blind, randomized, controlled trial, we assigned adults who had been admitted to the intensive care unit (ICU) for severe community-acquired pneumonia to receive intravenous hydrocortisone (200 mg daily for either 4 or 7 days as determined by clinical improvement, followed by tapering for a total of 8 or 14 days) or to receive placebo. All the patients received standard therapy, including antibiotics and supportive care. The primary outcome was death at 28 days.
A total of 800 patients had undergone randomization when the trial was stopped after the second planned interim analysis. Data from 795 patients were analyzed. By day 28, death had occurred in 25 of 400 patients (6.2%; 95% confidence interval [CI], 3.9 to 8.6) in the hydrocortisone group and in 47 of 395 patients (11.9%; 95% CI, 8.7 to 15.1) in the placebo group (absolute difference, -5.6 percentage points; 95% CI, -9.6 to -1.7; P = 0.006). Among the patients who were not undergoing mechanical ventilation at baseline, endotracheal intubation was performed in 40 of 222 (18.0%) in the hydrocortisone group and in 65 of 220 (29.5%) in the placebo group (hazard ratio, 0.59; 95% CI, 0.40 to 0.86). Among the patients who were not receiving vasopressors at baseline, such therapy was initiated by day 28 in 55 of 359 (15.3%) of the hydrocortisone group and in 86 of 344 (25.0%) in the placebo group (hazard ratio, 0.59; 95% CI, 0.43 to 0.82). The frequencies of hospital-acquired infections and gastrointestinal bleeding were similar in the two groups; patients in the hydrocortisone group received higher daily doses of insulin during the first week of treatment.
Among patients with severe community-acquired pneumonia being treated in the ICU, those who received hydrocortisone had a lower risk of death by day 28 than those who received placebo. (Funded by the French Ministry of Health; CAPE COD ClinicalTrials.gov number, NCT02517489.).
Journal Article