JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study Clinical Trial
Recombinant human interleukin 1 receptor antagonist in the treatment of patients with sepsis syndrome. Results from a randomized, double-blind, placebo-controlled trial. Phase III rhIL-1ra Sepsis Syndrome Study Group.
To further define the safety and efficacy of recombinant human interleukin 1 receptor antagonist (rhIL-1ra) in the treatment of sepsis syndrome. ⋯ There was not a statistically significant increase in survival time for rhIL-1ra treatment compared with placebo among all patients who received the study medication or among patients with shock at study entry. Secondary and retrospective analyses of efficacy suggest that treatment with rhIL-1ra results in a dose-related increase in survival time among patients with sepsis who have organ dysfunction and/or a predicted risk of mortality of 24% or greater.
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To quantify access to recombinant human erythropoietin (EPO) among patients with dialysis-dependent end-stage renal disease (ESRD). ⋯ Three years after Food and Drug Administration approval and Medicare coverage of EPO, there was no evidence of racial disparity in access to EPO among Medicare patients with ESRD who were receiving long-term hemodialysis. However, there was evidence of greater need for EPO among black patients.
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To assess the clinical consequences of duration of adult respiratory distress syndrome (ARDS) on lung structure and function. ⋯ The lung structure and function changes markedly with ARDS duration, and the late stages may be described as restrictive lung disease with superimposed emphysemalike lesions. Presence of pneumothorax affects survival and appears to be related to the lung structural changes occurring with time.
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Multicenter Study Comparative Study
Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study.
To examine the longitudinal associations between a pregnancy and persistent changes in adiposity in young black and white women. ⋯ These data suggest that women experience modest but adverse increases in body weight and fat distribution after a first pregnancy and that these changes are persistent.