The New England journal of medicine
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Randomized Controlled Trial Clinical Trial
Early treatment of acute biliary pancreatitis by endoscopic papillotomy.
Most patients with acute biliary pancreatitis have stones in the biliary tract or ampulla of Vater. Because these stones may be passed spontaneously soon after a patient is admitted to the hospital, the importance of early operative removal is not known. We tested the hypothesis that endoscopic papillotomy within 24 hours of admission decreased the incidence of complications in patients with acute biliary pancreatitis. ⋯ Emergency ERCP with or without endoscopic papillotomy is indicated in the treatment of patients with acute pancreatitis.
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Comment Letter Randomized Controlled Trial Clinical Trial
Valproate versus carbamazepine for seizures.
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Randomized Controlled Trial Clinical Trial
Efficacy of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). The Felbamate Study Group in Lennox-Gastaut Syndrome.
The Lennox-Gastaut syndrome is a childhood disorder characterized by multiple types of seizures, mental retardation, characteristic electroencephalographic abnormalities, and resistance to standard antiepileptic drugs. Felbamate is an investigational antiepileptic drug with a preclinical profile that suggests it would be effective in patients with multiple types of seizures. In controlled clinical trials, felbamate was superior to placebo in reducing the frequency of refractory partial-onset seizures. ⋯ Felbamate is beneficial in patients with the Lennox-Gastaut syndrome.