The New England journal of medicine
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ARDS is a complex response of the lung to direct (inhalational) and indirect (hematogenous) insults. It is easy to be pessimistic about the benefit of the approaches we have described, but there is evidence that overall survival has improved in recent years. To maintain this progress, new therapies for ARDS must be rigorously evaluated, and their routine use should be recommended only after careful scrutiny of the evidence. Such a course will eliminate the unnecessary risks and costs often associated with unproved therapies.
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Randomized Controlled Trial Clinical Trial
Complications and failures of subclavian-vein catheterization.
Although catheterization of the subclavian vein is a common procedure, the risk factors for complications and failures, with the exception of the physician's experience, are poorly understood. Ultrasonography has been recommended to help guide the placement of central venous catheters. ⋯ Ultrasound guidance of subclavian-vein catheterization, as used in this study, was not beneficial. In patients at highest risk for complications and failures, catheterization should be attempted by the most experienced physicians available.
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Comment Letter Case Reports
Case 30-1994: antiendomysial antibodies and celiac disease.
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Randomized Controlled Trial Comparative Study Clinical Trial
Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma.
Resection of hepatocellular carcinoma is associated with high rates of morbidity and mortality. Since intensive nutritional support can reduce the catabolic response and improve protein synthesis and liver regeneration, we performed a prospective study to investigate whether perioperative nutritional support could improve outcome in patients undergoing hepatectomy for hepatocellular carcinoma. ⋯ Perioperative nutritional support can reduce complications after major hepatectomy for hepatocellular carcinoma associated with cirrhosis.