The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of carvedilol on survival in severe chronic heart failure.
Beta-blocking agents reduce the risk of hospitalization and death in patients with mild-to-moderate heart failure, but little is known about their effects in severe heart failure. ⋯ The previously reported benefits of carvedilol with regard to morbidity and mortality in patients with mild-to-moderate heart failure were also apparent in the patients with severe heart failure who were evaluated in this trial.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation.
The conventional treatment strategy for patients with atrial fibrillation who are to undergo electrical cardioversion is to prescribe warfarin for anticoagulation for three weeks before cardioversion. It has been proposed that if transesophageal echocardiography reveals no atrial thrombus, cardioversion may be performed safely after only a short period of anticoagulant therapy. ⋯ The use of transesophageal echocardiography to guide the management of atrial fibrillation may be considered a clinically effective alternative strategy to conventional therapy for patients in whom elective cardioversion is planned.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known. ⋯ Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects.