Lancet
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of hydroxyethylstarch in brain-dead kidney donors on renal function in kidney-transplant recipients.
Hydroxyethylstarch used as a plasma-volume expander in brain-dead kidney donors has been suggested to induce osmotic-nephrosis-like lesions. We have studied its effect on kidney-transplant function. ⋯ These data suggest that hydroxyethylstarch used as a plasma-volume expander in brain-dead donors impairs immediate renal function in kidney-transplant recipients.
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Case Reports
Thunderclap headache as first symptom of cerebral venous sinus thrombosis. CVST Study Group.
Thunderclap headache raises the suspicion of subarachnoid haemorrhage, and it is not generally recognised as a symptom of cerebral venous sinus thrombosis (CVST). We describe ten patients who presented with thunderclap headache mimicking subarachnoid haemorrhage, who appeared to have CVST. ⋯ The best initial investigation in patients with thunderclap headache is emergency computed tomography. If no abnormality is detected, lumbar puncture should be done after at least 12 h (to detect or exclude subarachnoid haemorrhage). CSF pressure should be measured. If the CSF pressure is high or if a headache of unknown origin persists, the diagnosis of CVST should be considered.
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Randomized Controlled Trial Clinical Trial
Randomised crossover trial of naltrexone in uraemic pruritus.
Most dialysis patients develop pruritus, for which current treatment is unsatisfactory. Endogenous opioids may be involved in this pruritus. We studied the effect of the opioid antagonist naltrexone on the pruritus of haemodialysis patients. ⋯ Our data suggest short-term efficacy with few side-effects for the amelioration of uraemic pruritus with naltrexone.
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Randomized Controlled Trial Clinical Trial
Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group.
Previous studies have shown that alendronate can increase bone mineral density (BMD) and prevent radiographically defined (morphometric) vertebral fractures. The Fracture Intervention Trial aimed to investigate the effect of alendronate on the risk of morphometric as well as clinically evident fractures in postmenopausal women with low bone mass. ⋯ We conclude that among women with low bone mass and existing vertebral fractures, alendronate is well tolerated and substantially reduces the frequency of morphometric and clinical vertebral fractures, as well as other clinical fractures.