The New England journal of medicine
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Letter Case Reports
Treatment of brain metastases of malignant melanoma with temozolomide.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Effect of prone positioning on the survival of patients with acute respiratory failure.
Although placing patients with acute respiratory failure in a prone (face down) position improves their oxygenation 60 to 70 percent of the time, the effect on survival is not known. ⋯ Although placing patients with acute respiratory failure in a prone position improves their oxygenation, it does not improve survival.
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The independent prognostic value of elevated jugular venous pressure or a third heart sound in patients with heart failure is not well established. ⋯ In patients with heart failure, elevated jugular venous pressure and a third heart sound are each independently associated with adverse outcomes, including progression of heart failure. Clinical assessment for these findings is currently feasible and clinically meaningful.
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Multicenter Study Clinical Trial
One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon.
Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for colorectal cancer, but the sensitivity of such combined testing for detecting neoplasia is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence of neoplasia and the sensitivity of one-time screening with a fecal occult-blood test plus sigmoidoscopy. ⋯ One-time screening with both a fecal occult-blood test with rehydration and sigmoidoscopy fails to detect advanced colonic neoplasia in 24 percent of subjects with the condition.