Arch Intern Med
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Randomized Controlled Trial Clinical Trial
Ketorolac vs chlorpromazine in the treatment of acute migraine without aura. A prospective, randomized, double-blind trial.
Many treatments for acute migraine exist. Chlorpromazine is effective but has serious side effects. Ketorolac has only rare side effects. ⋯ Using 60 mg of intramuscular ketorolac tromethamine is as effective as 25 mg of intravenous chlorpromazine hydrochloride in the treatment of acute migraine headache. Patients who do not respond to one of these medications may respond to the other.
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Randomized Controlled Trial Clinical Trial
The impact of informed consent on patient interest in prostate-specific antigen screening.
Because of the many uncertainties surrounding screening for prostate cancer, authorities recommend that patients be involved in the screening decision. ⋯ Among primary care patients of predominantly lower socioeconomic status, those who received informed consent were significantly less interested in PSA screening than those who did not. For physicians who offer the PSA as a screening test, this finding highlights the importance of apprising patients of the associated benefits, burdens, and uncertainties and allowing them to participate in the screening decision.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ardeparin (low-molecular-weight heparin) vs graduated compression stockings for the prevention of venous thromboembolism. A randomized trial in patients undergoing knee surgery.
Deep vein thrombosis is common in patients undergoing major knee surgery. Static graduated compression stockings effectively prevent venous thrombosis in general surgery. Because of the demonstrated prophylactic efficacy of pneumatic compression in knee surgery, the similar efficacy of static graduated compression and pneumatic compression in neurosurgery, and the easier use of static graduated compression in knee surgery, graduated static compression stockings were used as the control arm in our clinical trial. Although low-molecular-weight heparin had been shown to be effective in general surgery and hip replacement, its efficacy was unproved in knee surgery. ⋯ Ardeparin administered postoperatively twice daily is effective and safe for the prevention of venous thrombosis in patients undergoing major knee surgery. Whereas graduated compression stockings have been shown to be effective prophylactic agents in general surgery and neurosurgery, they have little effect in knee surgery.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Fecal hemoglobin excretion in elderly patients with atrial fibrillation: combined aspirin and low-dose warfarin vs conventional warfarin therapy.
Antithrombotic prophylaxis using combined aspirin and low-dose warfarin is under evaluation in several clinical trials. However, therapy may result in increased gastrointestinal blood loss and clinical bleeding vs conventional single-agent antithrombotic therapy. ⋯ Abnormal levels of fecal hemoglobin excretion were common in elderly patients with high risk of atrial fibrillation 1 month after randomization to prophylactic antithrombotic therapy. Combined warfarin and aspirin therapy was associated with greater fecal hemoglobin excretion than standard warfarin therapy, suggesting the potential for increased gastrointestinal hemorrhage.
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Randomized Controlled Trial Clinical Trial
Effect of potassium supplementation on blood pressure in African Americans on a low-potassium diet. A randomized, double-blind, placebo-controlled trial.
To determine the effect of potassium supplementation on blood pressure in African Americans consuming a low-potassium diet. ⋯ Potassium supplementation reduces blood pressure substantially in African Americans consuming a diet low in potassium. Increased potassium intake may play an important role in reducing blood pressure in this population at high risk for hypertension.