The New England journal of medicine
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Randomized Controlled Trial Clinical Trial
Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection.
Destruction by oxidation, or oxidative killing, is the most important defense against surgical pathogens and depends on the partial pressure of oxygen in contaminated tissue. An easy method of improving oxygen tension in adequately perfused tissue is to increase the concentration of inspired oxygen. We therefore tested the hypothesis that the supplemental administration of oxygen during the perioperative period decreases the incidence of wound infection. ⋯ The perioperative administration of supplemental oxygen is a practical method of reducing the incidence of surgical-wound infections.
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The ability to identify infants with sickle cell anemia who are likely to have severe complications later in life would permit accurate prognostication and tailoring of therapy to match disease-related risks and facilitate planning of clinical trials. We attempted to define the features of such babies by following the clinical course of 392 children with sickle cell disease from infancy to about the age of 10 years. ⋯ Three easily identifiable manifestations of sickle cell disease that may appear in the first two years of life (dactylitis, severe anemia, and leukocytosis) can help to predict the possibility of severe sickle cell disease later in life.
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Comparative Study
Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer.
Colorectal cancer can arise through two distinct mutational pathways: microsatellite instability or chromosomal instability. We tested the hypothesis that colorectal cancers arising from the microsatellite-instability pathway have distinctive clinical attributes that affect clinical outcome. ⋯ High-frequency microsatellite instability in colorectal cancer is independently predictive of a relatively favorable outcome and, in addition, reduces the likelihood of metastases.