The New England journal of medicine
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Randomized Controlled Trial
Endobronchial Valves for Emphysema without Interlobar Collateral Ventilation.
Bronchoscopic lung-volume reduction with the use of one-way endobronchial valves is a potential treatment for patients with severe emphysema. To date, the benefits have been modest but have been hypothesized to be much larger in patients without interlobar collateral ventilation than in those with collateral ventilation. ⋯ Endobronchial-valve treatment significantly improved pulmonary function and exercise capacity in patients with severe emphysema characterized by an absence of interlobar collateral ventilation. (Funded by the Netherlands Organization for Health Research and Development and the University Medical Center Groningen; Netherlands Trial Register number, NTR2876.).
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The prevalence and spectrum of predisposing mutations among children and adolescents with cancer are largely unknown. Knowledge of such mutations may improve the understanding of tumorigenesis, direct patient care, and enable genetic counseling of patients and families. ⋯ Germline mutations in cancer-predisposing genes were identified in 8.5% of the children and adolescents with cancer. Family history did not predict the presence of an underlying predisposition syndrome in most patients. (Funded by the American Lebanese Syrian Associated Charities and the National Cancer Institute.).
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To the Editor: Drazen et al. (Oct. 8 issue)(1) suggest that Judge Bowdre's summary judgment in a recently dismissed SUPPORT (the Surfactant, Positive Pressure, and Oxygenation Randomized Trial) lawsuit highlights a "key concept in the SUPPORT controversy" - the mischaracterization of a risk that is inherent to the patient's condition as being a risk of research. We believe that meaningful informed consent in research comparing standard-of-care treatments, like all consent in intervention research, must rest on a clear explanation to the patient of the differences between treatment that is provided in the context of research and treatment that is not. . . .