Lancet
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Comparative Study
Incidence of recurrent venous thromboembolism in relation to clinical and thrombophilic risk factors: prospective cohort study.
Stratification for risk of recurrence after a first episode of venous thromboembolism (VTE) would affect the duration of anticoagulant therapy. We aimed to determine the incidence of recurrence of VTE in relation to clinical risk factors and standard laboratory testing for heritable thrombophilic defects. ⋯ In unselected patients who have had a first episode of VTE, testing for heritable thrombophilia does not allow prediction of recurrent VTE in the first 2 years after anticoagulant therapy is stopped. However, assessment of clinical risk factors associated with the first episode of VTE does predict risk of recurrence. Patients with postoperative VTE have a very low rate of recurrence.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial.
Neither chemotherapy with a single-alkylating agent nor aggressive combination chemotherapy cures advanced stage low-grade non-Hodgkin lymphomas, even when combined with radiotherapy. Our aim was to compare administration of immediate chlorambucil treatment with a policy of delaying chlorambucil until clinical progression necessitated its use, in asymptomatic patients with advanced-stage, low-grade non-Hodgkin lymphoma. ⋯ An initial policy of watchful waiting in patients with asymptomatic, advanced stage low-grade non-Hodgkin lymphoma is appropriate, especially in patients older than age 70 years.
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A mass outbreak of severe acute respiratory syndrome (SARS) in the Amoy Gardens housing complex in Hong Kong at the end of March, 2003, affected more than 300 residents in less than a month, and has epidemiologists all over the world puzzled about the mode of transmission of this new disease, which until then was thought to be transmitted solely by respiratory droplets. The source of the outbreak was later traced to an individual with SARS who spent two nights at Amoy Gardens. ⋯ A powerful environmental mechanism that efficiently amplified and distributed the causal agent must have been at work to cause this outbreak. One such mechanism could be an animal vector, most probably roof rats, that was infected by the index patient and subsequently spread the disease to more than 150 households.