The New England journal of medicine
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Comment Letter
Endothelial protein C activation in meningococcal sepsis.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Naltrexone in the treatment of alcohol dependence.
Although naltrexone, an opiate-receptor antagonist, has been approved by the Food and Drug Administration for the treatment of alcohol dependence, its efficacy is uncertain. ⋯ Our findings do not support the use of naltrexone for the treatment of men with chronic, severe alcohol dependence.
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Multicenter Study
Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both.
Patent foramen ovale and atrial septal aneurysm have been identified as potential risk factors for stroke, but information about their effect on the risk of recurrent stroke is limited. We studied the risks of recurrent cerebrovascular events associated with these cardiac abnormalities. ⋯ Patients with both patent foramen ovale and atrial septal aneurysm who have had a stroke constitute a subgroup at substantial risk for recurrent stroke, and preventive strategies other than aspirin should be considered.
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In adults with suspected meningitis clinicians routinely order computed tomography (CT) of the head before performing a lumbar puncture. ⋯ In adults with suspected meningitis, clinical features can be used to identify those who are unlikely to have abnormal findings on CT of the head.