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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 157 (1998), S. 215-220 
    ISSN: 1432-1076
    Keywords: Key words Respiratory syncytial virus infections ; Respiratory tract infections ; Hospitalization ; Length of stay ; Infant
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Respiratory syncytial virus (RSV) is a frequent cause of hospitalization among infants. To compare patient management in Europe, the United States, and Australia, we analyzed the charts of 1,563 pediatric patients hospitalized with laboratory-confirmed RSV lower respiratory infections during recent RSV seasons. Half of patients had been seen initially as outpatients. Median duration of hospitalization was 4 days in Australia, Finland, the United Kingdom, and the United States, and 8 or 9 days in Belgium, France, Germany, Italy, and the Netherlands. In a linear regression model that included clinical findings, underlying conditions, prematurity, and age, the leading variable associated with length of stay was “hospitalization in continental Europe”. This geographic factor conferred a 1.8-fold longer stay (95% CI: 1.7–1.9) than hospitalization elsewhere. Utilization of nine supportive therapies for RSV varied widely among hospitals, even within the same country. The individual hospital was strongly associated with the use of every therapy studied, independent of patient characteristics and clinical status. Conclusion Management of RSV patients varies markedly by country and hospital. Multicenter RSV trials that measure length of stay should standardize criteria for “readiness for discharge”. It may be appropriate to limit international trials to countries with similar median stays for RSV. Variability within multicenter trials could be further controlled by standardizing the use of other therapies and the diagnosis of complications.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To establish the lowest dose of cyclical dydrogesterone that protects against endometrial hyperplasia induced by continuous 2 mg 17β oestradiol, and to study the dose effect on vaginal bleeding and side effects.Design Double-blind, prospectively randomised dose-ranging study.Setting Menopause clinics in the UK and The Netherlands.Subjects Three hundred and seventy-one postmenopausal women with intact uteri, aged 40 to 60.Interventions Administration of six 28-day treatment cycles of continuous daily micronised 178 oestradiol with a randomly allocated dose of 5 to 20 mg of dydrogesterone added for the last 14 days of each.Main outcome measures Histological assessment of adequate progestational endometrial response, bleeding patterns and adverse effects.Results The study was completed by 320 subjects (86 %). Endometrial transformation occurred in over 94 % of those talung 5 mg of dydrogesterone, and in over 97 % of those on hgher doses, without significant differences between the 10, 15 and 20 mg groups. Acceptable bleeding patterns were found at all doses, with the incidence of withdrawal bleeding rising with increasing dose. The day of onset of bleeding was predictable from cycle to cycle, and occurred later in the 20 mg group than in the others. The incidence of noncyclic bleeding was about 6 % at all doses. Withdrawal occurred in 3-3% due to unacceptable bleeding and in 5-4% due to side effects. There was no relation with dose.Conclusions A dydrogesterone-17p oestradiol combination hormone replacement therapy confers endometrial protection with an acceptable bleeding pattern and few side effects. At least 10 mg of dydrogesterone for 14 days is required for acceptable endometrial protection.
    Type of Medium: Electronic Resource
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