The New England journal of medicine
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Editorial Comment
Low glutamine levels during critical illness--adaptive or maladaptive?
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Randomized Controlled Trial Multicenter Study Comparative Study
Nonemergency PCI at hospitals with or without on-site cardiac surgery.
Emergency surgery has become a rare event after percutaneous coronary intervention (PCI). Whether having cardiac-surgery services available on-site is essential for ensuring the best possible outcomes during and after PCI remains uncertain. ⋯ Nonemergency PCI procedures performed at hospitals in Massachusetts without on-site surgical services were noninferior to procedures performed at hospitals with on-site surgical services with respect to the 30-day and 1-year rates of clinical events. (Funded by the participating hospitals without on-site cardiac surgery; MASS COM ClinicalTrials.gov number, NCT01116882.).
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Randomized Controlled Trial Multicenter Study
A randomized trial of glutamine and antioxidants in critically ill patients.
Critically ill patients have considerable oxidative stress. Glutamine and antioxidant supplementation may offer therapeutic benefit, although current data are conflicting. ⋯ Early provision of glutamine or antioxidants did not improve clinical outcomes, and glutamine was associated with an increase in mortality among critically ill patients with multiorgan failure. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00133978.).