12 15 Several severity scores have been developed and validated widely, with the aim of guiding the initial site of treatment (eg, home vs hospital; hospital ward vs intensive care unit (ICU)) and appropriate level of intervention, including choice and route of administration of antibiotics.
Current questions relate to whether this improved response rate translates to improved survival and if it does, the balance of standard vs intensive treatment may alter and necessitate a specific randomised comparison.
These studies showed that in patients with CKD stages III-V intensive blood pressure lowering (< 130/80 mmHg versus < 140/90 mmHg) was not beneficial on the progression of CKD, defined as decline in renal function or time until the start of dialysis, transplantation, death and/or doubling of serum creatinine.
In adjusted stratified analyses, the mean UAER was 40.2 mg/24 h (95% CI 1.3 79.2) lower in the conventional (vs. intensive) treatment group and was 45.5 mg/24 h (4.8 86.2) lower in the secondary intervention (vs. primary prevention) cohort, comparing extreme thirds of dietary n-3 LC-PUFAs (Table 1).
Metformin In the UK Prospective Diabetes Study UKPDSS), 'intensive' treatment starting with metformin in overweight patients reduced the rate of all micro- and macrovascular complications vs less intensive diet-based treatment alone.
In the consolidation phase, patients were randomised for either recieving the 6-week consolidation block followed by one intensification block vs three intensive courses of chemotherapy.
These studies evaluated megatherapy vs continuing intensive chemotherapy (Matthay et al, 1999), or maintenance chemotherapy (Berthold et al, 1990; Castel et al, 2001), or no treatment (Pritchard et al, 2005).
3, 4 Other trials of more vs less intensive blood pressure lowering were unable to demonstrate benefits, in either aged individuals or high-risk hypertensive patients, by lowering systolic blood pressure <140 mmHg.
The equal N content at 200 V indicates intensive formation of reactive sites.
No differences were found between double and standard dose arms in median days on supplemental oxygen (3 (interquartile range 2-5) v 3.5 (2-7)), in intensive care (4.5 (3-6) v 5 (2-11), and on mechanical ventilation (2.5 (1-16) v 8 (1-16)), respectively.
In the comparison of intensive vs less intense care, only shoulder dystocia was significantly diminished by intervention, with no significant change in LGA/macrosomia or birth trauma.
