The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients.
Some observational studies suggest that the use of pulmonary-artery catheters to guide therapy is associated with increased mortality. ⋯ We found no benefit to therapy directed by pulmonary-artery catheter over standard care in elderly, high-risk surgical patients requiring intensive care.
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Hyperphenylalaninemia is a common inherited metabolic disease that is due to phenylalanine hydroxylase deficiency, and at least half the affected patients have mild clinical phenotypes. Treatment with a low-phenylalanine diet represents a substantial psychosocial burden, but alternative treatments have not been effective. ⋯ Tetrahydrobiopterin responsiveness is common in patients with mild hyperphenylalaninemia phenotypes. Responsiveness cannot consistently be predicted on the basis of genotype, particularly in compound heterozygotes.