Lancet
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Randomized Controlled Trial Clinical Trial
Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial.
The true frequency of deep-vein thrombosis (DVT) during long-haul air travel is unknown. We sought to determine the frequency of DVT in the lower limb during long-haul economy-class air travel and the efficacy of graduated elastic compression stockings in its prevention. ⋯ We conclude that symptomless DVT might occur in up to 10% of long-haul airline travellers. Wearing of elastic compression stockings during long-haul air travel is associated with a reduction in symptomless DVT.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Risk, causes, and prevention of ischaemic stroke in elderly patients with symptomatic internal-carotid-artery stenosis.
Carotid endarterectomy benefits patients with symptomatic stenosis of 70-99% in the internal carotid artery, with smaller benefit for 50-69% stenosis. The benefit of carotid endarterectomy in patients of 75 years and older remains unclear. ⋯ In the prevention of ipsilateral ischaemic stroke, elderly patients with 50-99% symptomatic carotid stenosis benefited more from carotid endarterectomy than younger patients did. To achieve this treatment benefit, surgeons must be skilled and patients with other life-threatening illnesses must be excluded.
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Letter Randomized Controlled Trial Multicenter Study Clinical Trial
UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation: follow-up to age 4 years.
Extracorporeal membrane oxygenation (ECMO) is a supportive intensive-care technique used for babies with acute respiratory failure. We examined morbidity at age 4 years in surviving children recruited to the UK Collaborative ECMO Trial, and provide long-term data on ECMO support compared with contemporary conventional care. The neonatal ECMO policy resulted in improved survival and a favourable outcome. We therefore advocate the safety and efficacy of this intervention.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study.
Atherosclerosis is the most common complication of diabetes. Correction of hyperglycaemia helps to prevent microvascular complications but has little effect on macrovascular disease. Post-hoc analyses of diabetic subpopulations in lipid intervention trials suggest that correction of lipoprotein abnormalities will lead to a decrease in coronary-artery disease. The Diabetes Atherosclerosis Intervention Study (DAIS) was specifically designed to assess the effects of correcting lipoprotein abnormalities on coronary atherosclerosis in type 2 diabetes. ⋯ DAIS suggests that treatment with fenofibrate reduces the angiographic progression of coronary-artery disease in type 2 diabetes. This effect is related, at least partly, to the correction of lipoprotein abnormalities, even those previously judged not to need treatment.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study.
Hydroxyethylstarch used for volume restoration in brain-dead kidney donors has been associated with impaired kidney function in the transplant recipients. We undertook a multicentre randomised study to assess the frequency of acute renal failure (ARF) in patients with severe sepsis or septic shock treated with hydroxyethylstarch or gelatin. ⋯ The use of this preparation of hydroxyethylstarch as a plasma-volume expander is an independent risk factor for ARF in patients with severe sepsis or septic shock.