JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Clinical Trial
Effect of glycemic control on early diabetic renal lesions. A 5-year randomized controlled clinical trial of insulin-dependent diabetic kidney transplant recipients.
To determine whether optimized glycemic control in type I diabetic recipients of renal allografts will prevent or delay diabetic renal lesions in the allograft. ⋯ This trial indicates a causal relationship between hyperglycemia and an important lesion of diabetic nephropathy, mesangial matrix expansion, in renal allografts transplanted into diabetic recipients. In addition, the results with other lesions central to the development of diabetic nephropathy support the major conclusion.
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To evaluate how well quality of life is being measured in the medical literature and to offer a new approach to the measurement. ⋯ Because quality of life is a uniquely personal perception, denoting the way that individual patients feel about their health status and/or nonmedical aspects of their lives, most measurements of quality of life in the medical literature seem to aim at the wrong target. Quality of life can be suitably measured only by determining the opinions of patients and by supplementing (or replacing) the instruments developed by "experts."
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To determine the incidence of rib fractures visible at autopsy or with postmortem radiographs after cardiopulmonary resuscitation (CPR) in infants younger than 1 year. ⋯ Cardiopulmonary resuscitation is unlikely to cause rib fractures in infants.