JAMA : the journal of the American Medical Association
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Meta Analysis
Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis.
Ephedra and ephedrine sometimes are used for weight loss or enhanced athletic performance, but the efficacy and safety of these compounds are uncertain. ⋯ Ephedrine and ephedra promote modest short-term weight loss (approximately 0.9 kg/mo more than placebo) in clinical trials. There are no data regarding long-term weight loss, and evidence to support use of ephedra for athletic performance is insufficient. Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations.
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Trauma centers benefit thousands of injured individuals every day and play a critical role in responding to disasters. The last full accounting of the number and distribution of trauma centers identified 471 trauma centers in the United States in 1991. ⋯ Although the availability of trauma centers has improved, challenges remain to ensure the optimal number, distribution, and configuration of trauma centers. These challenges must be addressed, especially in light of the recent emphasis on hospital preparedness and homeland security.