The New England journal of medicine
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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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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure.
Actions of angiotensin II may contribute to the progression of heart failure despite treatment with currently recommended drugs. We therefore evaluated the long-term effects of the addition of the angiotensin-receptor blocker valsartan to standard therapy for heart failure. ⋯ Valsartan significantly reduces the combined end point of mortality and morbidity and improves clinical signs and symptoms in patients with heart failure, when added to prescribed therapy. However, the post hoc observation of an adverse effect on mortality and morbidity in the subgroup receiving valsartan, an ACE inhibitor, and a beta-blocker raises concern about the potential safety of this specific combination.