JAMA : the journal of the American Medical Association
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The steroid RU-486 (mifepristone) is an antiprogesterone that works at the receptor level. It can interrupt pregnancy very early on (contragestion), mostly by interfering with the process of implantation and decidua function. ⋯ Also, RU-486 is the first antiglucocorticosteroid available for clinical use. It deserves further studies to assess its wide range of therapeutic potential.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lithium treatment of depressed and nondepressed alcoholics.
We assessed the efficacy of lithium carbonate in the treatment of 457 male alcoholics in a double-blind, placebo-controlled Department of Veterans Affairs Cooperative Study. Alcoholics either without depression or with a history of major depression, current major depression, or dysthymic disorder were studied. ⋯ Similarly, no significant differences were found when only the 82 alcoholics compliant in taking lithium and the 89 alcoholics compliant in taking placebo were considered. In our study, lithium treatment did not affect the course of alcoholism in either depressed or nondepressed alcoholics.
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Recent regulations require commercial US aircraft to carry an enhanced medical kit. We reviewed kit use on United Airlines during the initial year of the regulations. We also surveyed passengers who became ill during flight and health care providers who used the new kit. ⋯ Health care providers indicated that the kit was useful in more than 80% of emergencies and was occasionally lifesaving. In the emergencies in which the kit was used, 70% fell into one of seven major diagnostic groupings, including syncope/near syncope (29%), cardiac/chest pain (16%), asthma/lung disease/shortness of breath (10%), and allergic reactions (5%). With 450 million domestic air travelers per year, we would expect 3000 in-flight medical emergencies annually, and conclude that the enhanced medical kit is beneficial and propose that its effectiveness would be improved by the addition of a bronchodilator for inhalation.
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Comment Letter Clinical Trial
Ethics of a randomized trial of periconceptual vitamins.