Lancet
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Comparative Study
Relation between heavy and binge drinking and all-cause and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study.
Moderate alcohol consumption is associated with reduced cardiovascular mortality, but binge drinking is thought to be detrimental. We examined effects of heavy and binge drinking in a population with high rates of binge drinking. ⋯ The risk of death from cardiovascular disease seems to be increased in frequent heavy drinkers, but is not necessarily associated with episodic binge drinking.
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The pharmaceutical industry has produced many drugs that have benefited man. Political frameworks designed to govern the industry must maintain these benefits. ⋯ The extent of industry influence over drug regulation, at the expense of other interested parties, suggests that the current system could be more robust. The many ways in which the pharmaceutical industry can influence governments and regulatory agencies are discussed, and methods by which this influence can be curbed are suggested.
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In patients with septic shock, oxygen consumption is increased, but oxygen delivery and extraction is impaired, partly because of microcirculatory shutdown and shunting. Orthogonal polarisation spectral (OPS) imaging allows visualisation of the microcirculation. ⋯ The infusion of 0.5 mg of nitroglycerin intravenously then resulted in a marked increase in microvascular flow on OPS imaging. Improved recruitment of the microcirculation could be a new resuscitation endpoint in septic shock.
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Case Reports
Management of profound hypothermia in children without the use of extracorporeal life support therapy.
Profound hypothermia is managed more and more with extracorporeal life support technology, especially when a patient's circulation is compromised. Many centres do not have rapid access to this service, however, and are still dependent on active internal rewarming techniques--eg, peritoneal and pleural lavage. Such interventions are invasive, and associated with inherent risk. Here, we report our successful experience with an active external rewarming technique in children with profound hypothermia (core temperature <20 degrees C).