The New England journal of medicine
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery.
Despite thromboprophylaxis, major knee surgery carries a high risk of venous thromboembolism. Fondaparinux, the first of a new class of synthetic antithrombotic agents, may reduce this risk. ⋯ In patients undergoing elective major knee surgery, postoperative treatment with 2.5 mg of fondaparinux once daily was significantly more effective in preventing deep-vein thrombosis than 30 mg of enoxaparin twice daily.
-
Randomized Controlled Trial Clinical Trial
Reversal of catabolism by beta-blockade after severe burns.
The catecholamine-mediated hypermetabolic response to severe burns causes increased energy expenditure and muscle-protein catabolism. We hypothesized that blockade of beta-adrenergic stimulation with propranolol would decrease resting energy expenditure and muscle catabolism in patients with severe burns. ⋯ In children with burns, treatment with propranolol during hospitalization attenuates hypermetabolism and reverses muscle-protein catabolism.
-
Randomized Controlled Trial Clinical Trial
A clinical trial of estrogen-replacement therapy after ischemic stroke.
Observational studies have suggested that estrogen-replacement therapy may reduce a woman's risk of stroke and death. ⋯ Estradiol does not reduce mortality orthe recurrence of stroke in postmenopausal women with cerebrovascular disease. This therapy should not be prescribed for the secondary prevention of cerebrovascular disease.