All trials should address a research question of importance. However, it is easier to perform a clinical trial comparing similar strategies that may exert only a small impact on practice than to perform a trial comparing very different strategies, even though results from the latter could produce large shifts in practice. Some research questions of fundamental importance have never been satisfa...

Sarcoidosis is a rare granulomatous disease of unknown etiology that can affect any organ. Cardiac involvement, although uncommon, has a wide spectrum of clinical manifestations and is potentially fatal. Although there is no agreement upon a strategy for the diagnosis (which is difficult to make based on clinical information alone), the introduction of newer technology is promising and may be u...

OBJECTIVE To examine factors that influence the natural history of asthma, such as genetics, atopy, air pollution and environmental tobacco smoke, gastroesophageal reflux, and infection, to promote early identification and treatment of patients at risk for persistent asthma. DATA SOURCES Journal articles published in English involving human subjects with asthma. STUDY SELECTION Studies were...

The clinical course was followed for 10 years in 521 patients whose coronary arteriograms did not show any severe obstruction. Coronary disease had been suspected in all patients before arteriography. Two of 357 patients thought to have normal arteriograms died from coronary disease and two of 101 patients died who had less than 30% estimated narrowing of at least one coronary artery. Ten death...

OBJECTIVE To follow and analyze the clinical course and quality of life of Pandemrix H1N1-vaccine-related narcolepsy (pNT1). METHODS Twenty-six drug-naïve confirmed pNT1 subjects completed Epworth Sleepiness Scale (ESS), Ullanlinna Narcolepsy Scale (UNS), Swiss Narcolepsy Scale (SNS), Rimon's Brief Depression scale (RDS), and WHO-5 Well-being index questionnaires near the disease onset and in...

BACKGROUND Dementia is a leading cause of death in the United States but is underrecognized as a terminal illness. The clinical course of nursing home residents with advanced dementia has not been well described. METHODS We followed 323 nursing home residents with advanced dementia and their health care proxies for 18 months in 22 nursing homes. Data were collected to characterize the residen...

conclusions although, successful implementation of high reliability organizations is based on knowledge of managers and supervisors, the effectiveness of this model is still in the maturity and readiness phase. results after holding high reliability model training course, 52.2% of respondents expressed obtaining a keen knowledge of high reliability organizations model. compared to knowledge of ...

rheumatoid arthritis (ra) is an inflammatory progressive disease which in the absence of appropriate treatment can lead to joint destruction and disability. prognosis of ra may be predicted based on the presence of some clinical and laboratory evidences.new criteria for classification of ra provides opportunity for earlier treatment. initiation of treatment particularly by combination of dmards...