The New England journal of medicine
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Editorial Comment
Rapid-onset type 1 diabetes with pancreatic exocrine dysfunction.
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Comparative Study
A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group.
Type 1 diabetes mellitus is now classified as autoimmune (type 1A) or idiopathic (type 1B), but little is known about the latter. We classified 56 consecutive Japanese adults with type 1 diabetes according to the presence or absence of glutamic acid decarboxylase antibodies (their presence is a marker of autoimmunity) and compared their clinical, serologic, and pathological characteristics. ⋯ Some patients with idiopathic type 1 diabetes have a nonautoimmune, fulminant disorder characterized by the absence of insulitis and of diabetes-related antibodies, a remarkably abrupt onset, and high serum pancreatic enzyme concentrations.
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Randomized Controlled Trial Clinical Trial
Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection.
Destruction by oxidation, or oxidative killing, is the most important defense against surgical pathogens and depends on the partial pressure of oxygen in contaminated tissue. An easy method of improving oxygen tension in adequately perfused tissue is to increase the concentration of inspired oxygen. We therefore tested the hypothesis that the supplemental administration of oxygen during the perioperative period decreases the incidence of wound infection. ⋯ The perioperative administration of supplemental oxygen is a practical method of reducing the incidence of surgical-wound infections.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators.
Observational and experimental studies suggest that the amount of vitamin E ingested in food and in supplements is associated with a lower risk of coronary heart disease and atherosclerosis. ⋯ In patients at high risk for cardiovascular events, treatment with vitamin E for a mean of 4.5 years had no apparent effect on cardiovascular outcomes.