Lancet
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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.
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Randomized Controlled Trial Clinical Trial
Readers' evaluation of effect of peer review and editing on quality of articles in the Nederlands Tijdschrift voor Geneeskunde.
Academic biomedical journals use peer review and editing to help to select and improve the quality of articles. We have investigated whether articles accepted by the Nederlands Tijdschrift voor Geneeskunde, the Dutch Journal of Medicine, were improved after peer review and editing (post-acceptance scientific and copy editing). ⋯ Evaluations by readers of the Ned Tijdschr Geneeskd indicated significant improvement of published articles after both peer review and editing. We think that peer review and editing are worthwhile tasks. We also think that possible biases would have had a negligible effect on our results (including the fact that we selected the first 25 evaluators who responded, that some evaluators may have read the published version, and that one questionnaire may have looked more scientific than the other, more editorial one).