JAMA : the journal of the American Medical Association
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Analysis of US Natality Statistics using a bivariate (birth weight-gestational age) approach shows that trends among term-low-birth-weight infants (less than or equal to 2,500 g; greater than or equal to 37 weeks, term low birth weight) and preterm-low-birth-weight infants (less than or equal to 2,500 g; less than 37 weeks, preterm low birth weight) have different patterns over time and by race. Between 1970 and 1980 the incidence of preterm low birth weight for all races declined 7.1%, while the term-low-birth-weight incidence declined almost three times as much (20.9%). ⋯ The reduction in the overall low-birth-weight incidence for both populations is principally caused by reduction in the incidence of term-low-birth-weight infants. Term- and preterm-low-birth-weight infants reflect different etiologic insults and require different intervention strategies for prevention.
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Randomized Controlled Trial Clinical Trial
Imipramine treatment of painful diabetic neuropathy.
Twelve patients with severe, painful diabetic neuropathy in the lower extremities were treated with imipramine and placebo in a fixed-dose, double-blind, crossover study of five plus five weeks. Seven patients experienced notable improvement while receiving imipramine and none while receiving placebo. The rating of specific symptoms at the end of each treatment period showed a beneficial effect of imipramine on pain, paresthesia, dysesthesia, numbness, and nocturnal aggravation. The plasma levels of imipramine and its metabolite desipramine were significantly higher in patients who benefited from imipramine treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Treatment of ventricular fibrillation. Emergency medical technician defibrillation and paramedic services.
We compared the effect of rapid defibrillation by emergency medical technicians (EMTs) combined with paramedic care with that of standard EMT and paramedic care on survival from 540 witnessed episodes of out-of-hospital cardiac arrest caused by ventricular fibrillation. More than 400 EMTs were trained in the recognition of ventricular fibrillation and operation of a defibrillator. ⋯ Similar findings occurred when all cases were considered (38% v 18%). Defibrillation by EMTs combined with paramedic services can enhance survival from ventricular fibrillation, compared with basic EMT and paramedic care.